Policy for the Removal of Doctors from the NI Primary Medical Performers List (NIPMPL) where they have not provided primary medical services in the HSCB area in the Preceding 24 Months Context GPs cannot provide primary medical services in Northern Ireland unless they are included in the NI Primary Medical Performers List (NIPMPL). The Regulations which apply to this list are The Health and Personal Social Services (Primary Medical Services Performers Lists) Regulations (Northern Ireland) 2004 and subsequent 2008 amendment ( the performers list regulations ). These regulations can be found at; http://www.dhsspsni.gov.uk/no149_performers_list_regs.pdf http://www.legislation.gov.uk/nisr/2008/434/contents/made GPs apply for inclusion in the NI PMPL and applications are reviewed against criteria specified in regulation. The NIPMPL is therefore a list of GPs that can appropriately provide those primary medical services which the HSCB is obliged to secure for its population. GPs on the performers list are not employed by the HSCB but are independent contractors and deliver services via a number of contractual methods, primarily the General Medical Services (GMS) contracts in place between the HSCB and the general practices throughout NI. There are approximately 1700 GPs included in the NIPMPL and providing primary medical services at any given time. Inclusion in the NIPMPL results in a GP having a prescribed connection to the HSCB Responsible Officer (RO) under the HPSS The Medical Profession (Responsible Officers) Regulations (Northern Ireland) 2010 ( the RO regulations ). The exception to this is where a doctor provides primary medical services in more of the UK countries as well as in NI. In such cases their RO will be in the location in which they do the majority of their primary care work. The RO regulations place a range of responsibilities on the HSCB RO in relation to the fitness of doctors to practice. These include ensuring appropriate appraisals are carried out, investigation of performance 1
concerns and taking any action necessary as a result of those concerns including referral to the General Medical Council (GMC) as appropriate, and making recommendations to the General Council about medical practitioners fitness to practice. Performers List Review Procedures Regulation 10 of the performers list regulations states; 10. (1) Where a Board has determined, in accordance with the provisions of this regulation, that a performer who is included in the primary medical services performers list has not, for the preceding 12 months, performed primary medical services which that Board is, under Article 56 of the Order(a), under a duty to provide or secure the provision of, the Board may remove the performer from the primary medical services performers list, unless the Department directs to the contrary in accordance with regulation 13(11). The HSCB undertakes a review of the list each year which seeks to identify those doctors who have not participated in appropriate and relevant appraisal in accordance with the undertaking that they make when applying to join the list. Currently this is defined as satisfactory annual appraisal undertaken with the Northern Ireland Medical and Dental Training Agency, or other appropriate body, which meets the requirements set out by the GMC for revalidation. The list review considers records of the appraisal process which can identify individual doctors who have not provided primary medical services in NI in the 12 months or more preceding the review. There is a range of reasons for absence of delivery of primary medical services in NI including; Performer practising elsewhere in the UK. Performer practising outside the UK. Performer absent on career break. Performer absent on maternity leave. Performer practising in another HSC sector. Performer practising in the private sector. Performer not practising due to ill health. 2
Performer not practising to inability to meet conditions on practice. Performer not practising due to suspension by GMC or HSCB. These performers are normally under the management of the HSCB Regional Professional Panel due to performance concerns. Policy Intention The intention of this policy is to set out when the HSCB will remove GPs from its performers list due to non-provision of primary medical services in NI, and to summarise the process that will be followed. The HSCB will not automatically remove a performer from the list for the sole reason of non-provision of primary medical services in NI in a 12 month period preceding review of the list. Where, however, a doctor is absent from delivery of primary medical services for 24 months or more in NI they will normally be removed from the list. If a doctor has been solely practising outside NI but within the UK for 24 months or more, they do not require to be included in the NIPMPL. Continued inclusion can result in lack of clarity in relation to the appropriate RO and the local processes that will support their revalidation. If removed from the NIPMPL they require to reapply for inclusion should they wish to return to work in NI general practice and will be accepted onto the list without the need for a refresher programme appropriate to their needs provided they meet all relevant criteria. Those doctors who are practising outside NI primary care, those who have not have been in clinical practice at all, and those who have been practising in other sectors for 24 months or more, are considered to require a structured refresher or induction program which is designed to assess their individual training needs in relation to primary medical services provision, and to meet those needs. This is intended to ensure that they are up to date and can safely provide primary medical services to patients and so also to provide an assurance to the HSCB RO. This policy seeks to ensure that performers on the NI PMPL who have been absent from clinical practice for a period of 24 months or more, regardless of the reason for their absence, are treated similarly. 3
Application of a process of removal from the NIPMPL due to absence from provision of PMS for 24 months or more is in line with the process that is in place for doctors applying for inclusion in the NIPMPL. Where an applicant to the list has not provided primary medical services in the 24 months preceding application they are required to undertake a structured programme before being unconditionally included in the NIPMPL. This is in line with the process applied to doctors in these circumstances in England and Wales. The period of 24 months is deemed reasonable to ensure continuing safe practice and also to mitigate any impact on specific groups such as doctors absent due to maternity leave, caring responsibilities or illness. It seeks to balance the ability of doctors to work in NI with the need to ensure the safety of patients and secure public confidence in the robustness of the NIPMPL. Process for Consideration of Cases of Absence from Provision of Primary Medical Services (Ill-Health) It is intended that any doctor who has notified HSCB or NIMDTA that they are not practising due to ill-health, or who is identified as being ill via the appraisal or annual list review processes, is contacted by HSCB to discuss the likely way forward, and any implications of their circumstances for inclusion in the NIPMPL and for revalidation. Where a doctor is absent from primary care for longer than 24 months due to ill-health, the procedure to remove them from the NIPMPL would not commence in the absence of a discussion with them having first taken place, or of contact with the GMC in the event that they have not personally advised the HSCB of their health concerns but the GMC either is known to have placed health related conditions on their practice (the GMC does not make health related conditions known to the HSCB) or has notified HSCB directly that there are health concerns. In the latter cases, the GMC will be asked for guidance on any potential implications that removal from the NIPMPL might have for the doctor s health in advance of any action being taken to remove them from the list. 4
Procedure for Removal from the NI PMPL Where a performer has been identified as not having provided primary medical services in NI for a period of 24 months or more they will be notified in writing that the HSCB is considering removing them from the NIPMPL pursuant to Regulation10 (1) of the Health and Personal Social Services (Primary Medical Services Performers Lists) Regulations (Northern Ireland) 2004 for this reason. A copy of the performers list regulations will be provided with the letter. The performer will further be advised that following absence from primary medical services anywhere in the UK for a period of 24 months or more a GP is considered by the HSCB to be a returner and so would require an assessment and a structured programme before returning to general practice in NI. They will be advised of the returner scheme in place in NI at the date of issue of the letter and it will be drawn to their attention that they can be included in it only if they able to meet all criteria for inclusion. Where they are known not to meet the requirements for the scheme at the date of the letter, this will be stated. The name of a medical adviser in the HSCB to whom the doctor can make enquiries regarding the process, and about the related issue of revalidation, will be provided. The doctor will be advised that under regulation performers are entitled to make written or oral representations to the Board within 28 days of the date of the notification that the HSCB is considering removing their name from the NIPMPL. The date of notification will be considered to be the date of issue of the letter to them. If the doctor does not make any representations within the period specified the HSCB will make its determination in accordance with the provisions of the performers list regulations and will notify the doctor of the determination within seven days of the decision being made confirming the reason for removal. The doctor s name will be removed from the NIPMPL 28 days from the date of that notification 5
The doctor will be advised of the process that will apply should they wish to appeal for a re-determination of the decision by the Department and will be provided with the appropriate contact details. They will be advised of the HSCB s obligation to advise specified bodies, and will be provided with a copy of the notification. Where the doctor makes written representations or requests an oral hearing within 28 days this will be considered by the HSCB s Review Panel before the HSCB makes its decision regarding removal from the list. Information on this process and membership of the Review Panel will be made available to the doctor. The doctor will be notified of the Review Panel s determination within seven days of the decision being made. In the event that the decision is that the doctor should be removed from the NPMPL they will be advised of the process for appeal to the Department and of the bodies who will be notified of the HSCB s decision together with a copy of that notification. This process should be read in conjunction with the regulations available at the links above. Re-inclusion in the NIPMPL Where a doctor who has been removed from the NI PMPL for absence from the provision of primary medical services in NI of 24 months or more wished to work again in primary care in NI they would require to apply for inclusion in the NIPMPL by submission of the application form and all necessary supporting information. This application would be considered by the HSCB PMPL Committee as appropriate. Where the doctor has been satisfactorily providing NHS primary medical services elsewhere in the UK in the 24 months preceding application, they would be re-included in the list providing they satisfy all other requirements for inclusion. Doctors who have not been working in primary medical services in the NHS in other areas of the UK in the 24 months preceding application would not be included in the NIPMPL until an appropriate refresher programme has been successfully completed. This could be the NI GP Development Scheme which provides a framework to enable doctors to 6
meet requirements, or another equivalent scheme. The number of places on the NI GP development scheme is subject to limits on capacity and availability of funding at any given time. Successful completion of a similar scheme undertaken elsewhere in the UK which meets requirements would also be acceptable for inclusion in the NIPMPL, subject to the applicant satisfying all other requirements. The process for removal of doctors from the NIPMPL due to absence of clinical practice in NI primary care for 24 months or more is summarised in the flow chart at appendix 1. A completed HSCB equality, good relations and human rights screening template for this policy is attached at appendix 2. 7
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Appendix 2 Equality, Good Relations and Human Rights SCREENING TEMPLATE The Health and Social Care Board is required to consider the likely equality implications of any policies or decisions. In particular it is asked to consider: 1) What is the likely impact on equality of opportunity for those affected by this policy, for each of the section 75 equality categories? (minor, major or none) 2) Are there opportunities to better promote equality of opportunity for people within the Section 75 equality categories? 3) To what extent is the policy likely to impact on good relations between people of a different religious belief, political opinion or racial group? (minor, major or none) 4) Are there opportunities to better promote good relations between people of a different religious belief, political opinion or racial group? See Guidance Notes for further information on the why what when, and who in relation to screening, for background information on the relevant legislation and for help in answering the questions on this template (follow the links). As part of the audit trail documentation needs to be made available for all policies and decisions examined for equality and human rights implications. The screening template is a pro forma to document consideration of each screening question. For information (evidence, data, research etc) on the Section 75 equality groups see the Equality and Human Rights Information Bank on the BSO website: http://www.hscbusiness.hscni.net/services/1798.htm 9
Appendix 2 Equality, Good Relations and Human Rights SCREENING TEMPLATE (1) INFORMATION ABOUT THE POLICY OR DECISION 1.1 Title of policy or decision Policy /Procedure for the Removal of Doctors from the NI Primary Medical Performers List where they have not provided Primary Medical Services in the HSCB area in the Preceding 24 Months 1.2 Description of policy or decision what is it trying to achieve? (aims and objectives) GPs cannot provide primary medical services in NI in the absence of inclusion in the NI Primary Medical Performers List (NIPMPL). Where doctors are absent from delivery of primary medical services for 24 months or more it is considered that they require a structured refresher program to ensure that they are up to date and can practise safely in NHS primary care. The intention of this policy/procedure is to clearly set out when the HSCB will remove GPs from its performers list due to non-provision of primary medical services in NI. The policy operates under The Health and Personal Social Services (Primary Medical Services Performers Lists) Regulations (Northern Ireland) 2004 and specifically regulation 10 ( the PMPL regulations ) ; 10. (1) Where a Board has determined, in accordance with the provisions of this regulation, that a performer who is included in the primary medical services performers list has not, for the preceding 12 months, performed primary medical services which that Board is, under Article 56 of the Order(a), under a duty to provide or secure the provision of, the Board may remove the performer from the primary medical services performers list, unless the Department directs to the 10
contrary in accordance with regulation 13(11). The policy seeks to ensure that; The policy seeks to ensure that; GPs included in the NI Primary Medical Performers List (NIPMPL) can appropriately and safely provide primary medical services to patients. Performers on the NIPMPL who have been absent from clinical practice, regardless of reason, are treated similarly by removal from the list due to the requirement for an educational program. This is in line with the process for a doctor applying for inclusion in the list who has not provided primary medical services in the 24 months preceding application. In such circumstances doctors are asked to undertake training specific to their needs. The HSCB Responsible Officer, who has a prescribed connection with all doctors included in the NIPMPL, can meet the requirements of the Health and Personal Social Services, The Medical Profession (Responsible Officers) Regulations (Northern Ireland) 2010 ( the RO regulations ) and specifically paragraph 9; 9. (1) The responsible officer for a designated body has the following responsibilities relating to the evaluation of the fitness to practise of every medical practitioner who has a prescribed connection with that body by virtue of regulation 8. (2) The responsibilities referred to in paragraph (1) are (a) to ensure that the designated body carries out regular appraisals on medical practitioners in accordance with paragraph (3); (b) to establish and implement procedures to investigate concerns about a medical practitioner s fitness to practise raised by patients or staff of the designated body or arising from any other source; (c) where appropriate, to refer concerns about the medical practitioner to the General Council; (d) where a medical practitioner is subject to conditions imposed by, or undertakings agreed with, the General Council, to monitor compliance with those conditions or undertakings; (e) to make recommendations to the General Council about medical practitioners fitness to practice; (f) to maintain records of medical practitioners fitness to practise evaluations, including appraisals and any other investigations or assessments. (3) The responsible officer must ensure that appraisals carried out under paragraph (2)(a) obtain and take into account all available information relating to the medical practitioner s fitness to practise in the work carried out by the medical practitioner for the designated body and for any other body, during the appraisal period. 11
and paragraph 14; Additional responsibilities of responsible officers: prescribed connection under regulation 8 14. (1) Where a responsible officer has responsibilities under regulation 9 in respect of a medical practitioner who has a prescribed connection with a designated body in accordance with regulation 8, the responsible officer has the following additional responsibilities. (2) In relation to monitoring medical practitioners conduct and performance, the responsible officer must (a) review regularly the general performance information held by the designated body, including clinical indicators relating to patient outcomes; (b) identify any issues arising from this information relating to medical practitioners, such as variations in individual performance; and (c) ensure that the designated body takes steps to address any such issues. (3) In relation to ensuring that appropriate action is taken in response to concerns about medical practitioners conduct or performance, the responsible officer must (a) initiate investigations with appropriately qualified investigators; (b) ensure that procedures are in place to address concerns raised by patients or staff of the designated body or arising from any other source; (c) ensure that any investigation into the conduct or performance of a medical practitioner takes into account any other relevant matters within the designated body, for example wider concerns about operational or systems issues; (d) consider the need for further monitoring of the medical practitioner s conduct and performance and ensure that this takes place where appropriate; (e) ensure that a medical practitioner who is subject to procedures under this paragraph is kept informed about the progress of the investigation; (f) ensure that procedures under this paragraph include provision for the medical practitioner s comments to be sought and taken into account where appropriate; (g) where appropriate (i) take any steps necessary to protect patients, (ii) recommend to the medical practitioner s employer that the 12
medical practitioner should be suspended or have conditions or restrictions placed on their practice, and (h) identify concerns and ensure that appropriate measures are taken to address these, including but not limited to (i) requiring the medical practitioner to undergo training or retraining, (ii) offering rehabilitation services, (iii) providing opportunities to increase the medical practitioner s work experience, (iv) addressing any systemic issues within the designated body which may have contributed to the concerns identified, (i) maintain accurate records of all steps taken in accordance with this paragraph. In the event that a doctor has not practised within the HSCB area for a period of 24 months or more, the HSCB is not in a position to appropriately discharge the duties described above. how will this be achieved? (key elements) Under the PMPL regulations the HSCB may remove a performer from its list where they have not provided primary care in the preceding 12 months. Any doctor removed in these circumstances can re-apply for inclusion in the list and, barring inability to meet the requirements for inclusion, they would be accepted onto the list. It is considered, however, that GPs who are absent from delivery of clinical primary care for a period of 24 months or more require to undertake a refresher programme to ensure that they can appropriately provide primary medical services to patients. This is designed to ensure that GPs on the list are up to date, fit to practise, and also are participating in local governance procedures such as appropriate and relevant appraisal in line with the General Medical Council requirements for revalidation. It is intended that GPs absent from service provision for more than 24 months, regardless of the reason for this, will normally be removed from the list. This will contribute to patient safety. what are the key constraints? (for example financial, legislative or other) Key constraints are; Compliance with the requirements of the legislation above, and with wider human resources legislation, such as the Disability Discrimination Act that might apply to doctors in individual circumstances. Given the requirement for doctors providing primary medical services to be on the performers list, this policy may be subject to challenge. Removal from the performers list can be appealed by a performer and the appeal is considered by the HSCB review panel in the first instance. A 13
performer may appeal to the Department of Health and Social Services and Public Safety (DHSSPS). The policy might be subject to challenge under other legislation. 1.3 Main stakeholders affected (internal and external) For example staff, actual or potential service users, other public sector organisations, voluntary and community groups, trade unions or professional organisations or private sector organisations or others Key stakeholders are as follows; GPs included in the NIPMPL. Patients receiving care in NI general practice. HSCB Responsible Officer and staff working in the management of the performers list to include staff in HSCB and BSO. The Northern Ireland Medical and Dental Training Agency (NIMDTA). The HSCB PMPL Committee. The DHSSP which deals with dispute in relation to the management of the NIPMPL. The Local Medical Committees 1.4 Other policies or decisions with a bearing on this policy or decision what are they? o Procedures for the operation of revalidation for GPs under the Responsible Officer Regulations. o Procedures for the operation of the GMS contract regulations. o The NI GP development scheme which provides a framework doctors wishing to return to clinical practice in primary care after absence of 24 months or more. who owns them? The HSCB Assistant Director of General Medical Services, Head of General Medical Services (GMS) and HSCB Responsible Officer (RO). 14
(2) CONSIDERATION OF EQUALITY AND GOOD RELATIONS ISSUES AND EVIDENCE USED 2.1 Data Gathering What information did you use to inform this equality screening? For example previous consultations, statistics, research, Equality Impact Assessments (EQIAs), complaints. Provide details of how you involved stakeholders, views of colleagues, service users, staff side or other stakeholders. Information on the procedures applied to performers in other UK countries was taken into account, ie that a doctor absent from provision of NHS primary care in England and Wales for a period of 24 months or more requires to undertake a returners course. Advice on the policies which apply to the NI PMPL is provided by the Primary Medical Performers List (PMPL) Committee. The PMPL Committee has representation from the Patient and Client Council, Northern Ireland Medical and Dental Training Agency, NI General Practices Committee, Department of Health and Social Services and Public Safety, the HSCB, and Business Services Organisation (BSO). It provides advice to the HSCB Responsible Officer who has the delegated authority to make decisions within the stipulations of the PMPL regulations. This policy takes account of the views expressed by members of this committee. There are approximately 1700 GPs included in the NIPMPL. The HSCB undertakes an annual review of the PMPL based on information drawn from the GP appraisal system provided by NIMDTA under Service Level Agreement (SLA) to HSCB and from the records held in the HSCB for doctors for whom performance concerns have been raised and who have not provided clinical services for related reasons.. The review for 2012/13 indicates that there are 5 GPs on the performers list who are believed not to have provided primary medical services for a period in excess of 24 months due to various reasons which are listed in the proposed policy. 15
2.2 Quantitative Data Who is affected by the policy or decision? Please provide a statistical profile. Note if policy affects both staff and service users, please provide profile for both. As noted in Section 2.1 this policy relates to 1700 GPs approximately included on the Northern Ireland Primary Medical Performers List (PMPL) at any point in time. This number can vary. The HSCB has developed the NI GP development scheme to facilitate GPs in completing a structured programme which will enable their inclusion or reinclusion in the list. Category Gender Age Religion Political Opinion Marital Status Dependent Status What is the makeup of the affected group? ( %) Are there any issue or problems? For example, a lower uptake that needs to be addressed or greater involvement of a particular group? The policy applies to all doctors who have not provided Primary Medical services in NI for 24 months or more preceding date of the review of the NI PMPL. The gender of doctors in this category may vary year on year The policy applies to all doctors who have not provided Primary Medical services in NI for 24 months or more preceding date of the review of the NI PMPL. The age of doctors in this category may vary year on year. The policy applies to all doctors who have not provided Primary Medical services in NI for 24 months or more preceding date of the review of the NI PMPL. The religion of doctors in this category may vary year on year and would not be known to HSCB. The policy applies to all doctors who have not provided Primary Medical services in NI for 24 months or more preceding date of the review of the NI PMPL. The political opinion of doctors in this category may vary year on year and would not be known to HSCB. The policy applies to all doctors who have not provided Primary Medical services in NI for 24 months or more preceding date of the review of the NI PMPL. The marital status of doctors in this category may vary year on year and would not be known to HSCB. The policy applies to all doctors who have not provided Primary Medical services in NI for 24 months or more preceding date of the review of the NI PMPL. The marital status of doctors in this category may vary year on year and would not be known to HSCB. It is possible that those who have been absent from clinical practice for a period has been due to caring for dependents. 16
Disability Ethnicity Sexual Orientation 2.3 Qualitative Data The policy applies to all doctors who have not provided Primary Medical services in NI for 24 months or more preceding date of the review of the NI PMPL. The number of doctors in this category may vary year on year and may not be known to HSCB. It is possible that absence from clinical practice for a period has been due to illness which would be classified as disability under DDA legislation and a small number of doctors fall under this category. The policy applies to all doctors who have not provided Primary Medical services in NI for 24 months or more preceding date of the review of the NI PMPL. It is possible that those who have been absent from clinical practice for a period are non UK doctors who have been working outside the UK. The policy applies to all doctors who have not provided Primary Medical services in NI for 24 months or more preceding date of the review of the NI PMPL. The sexual orientation of doctors in this category may vary year on year and would not be known to HSCB. What are the different needs, experiences and priorities of each of the categories in relation to this policy or decision and what equality issues emerge from this? Note if policy affects both staff and service users, please discuss issues for both. Category Needs and Experiences Gender It is possible that those absent from primary care for extended period have been so due to caring for dependents and so female doctors might potentially be more affected. Age It is possible that the age group most affected would be in the 25 45 age group should they have been absent due to caring for dependents, particularly children Religion Political Opinion Marital Status Dependent Status Disability None None It is possible that the policy might impact more on those who have been absent from work due to caring responsibilities for dependents and so married doctors might potentially be more affected. It is possible that the policy might impact more on those who have been absent from work due to caring responsibilities for dependents. It is possible that some doctors might be absent from work for a 17
Ethnicity Sexual Orientation protracted period due to a protracted period of illness or disability None None 2.4 Multiple Identities Are there any potential impacts of the policy or decision on people with multiple identities? For example; disabled minority ethnic people; disabled women; young Protestant men; and young lesbians, gay and bisexual people. There is potential impact on female doctors who are disabled for example (protracted ill-health due to stress). Steps will be taken to communicate with any doctor in these circumstances. 2.5 Based on the equality issues you identified in 2.2 and 2.3, what changes did you make or do you intend to make in relation to the policy or decision in order to promote equality of opportunity? In developing the policy or decision what did you do or change to address the equality issues you identified? The impact is restricted to a very small percentage of the total doctors on the primary medical performers list. Given the need to ensure safe care for patients, it is considered appropriate to proceed and assess the impact of the policy after one year. The HSCB has developed the NI GP development scheme to facilitate GPs in completing a structured programme What do you intend to do in future to address the equality issues you identified? The policy uses a 24 month period rather than the 12 month period that might be applied under regulation. Use of this longer time period mitigates on the impact on specific equality groups. The appeals process which is in place allows for further consideration of individual cases. Impact of the policy and any challenge to it will be considered after a period of 18
which will enable their inclusion or reinclusion in the list one year. 2.6 Good Relations What changes to the policy or decision if any or what additional measures would you suggest to ensure that it promotes good relations? (refer to guidance notes for guidance on impact) Group Impact Suggestions Religion N/A Political Opinion N/A Ethnicity N/A (3) SHOULD THE POLICY OR DECISION BE SUBJECT TO A FULL EQUALITY IMPACT ASSESSMENT? A full equality impact assessment (EQIA) is usually confined to those policies or decisions considered to have major implications for equality of opportunity. How would you categorise the impacts of this decision or policy? (refer to guidance notes for guidance on impact) Please tick: Major impact Do you consider that this policy or decision needs to be subjected to a full equality impact assessment? Please tick: Yes Minor impact No further impact X No X 19
Please give reasons for your decisions. The policy will affect a small number of doctors on the NI Primary Medical Performers List, is in line with legislation and policy elsewhere, takes into account individual circumstances of doctors and related legislation such as Disability Discrimination Act and maternity leave rights, and is considered appropriate given the HSCB responsibility to secure good quality and safe care for its population. 20
(4) CONSIDERATION OF DISABILITY DUTIES 4.1 In what ways does the policy or decision encourage disabled people to participate in public life and what else could you do to do so? How does the policy or decision currently encourage disabled people to participate in public life? What else could you do to encourage disabled people to participate in public life? 4.2 In what ways does the policy or decision promote positive attitudes towards disabled people and what else could you do to do so? How does the policy or decision currently promote positive attitudes towards disabled people? It is intended that HSCB identifies any doctor who suffering ill health as early as possible and will seek to support them by provision of information and discussion on the issues that arise in relation to the NIPMPL. It is intended that contact will be made with any, or advice will be taken from GMC in the event that they are known to be managing a case where a doctor has health related conditions on their practice before commencing procedures for removal from the NIPMPL. What else could you do to promote positive attitudes towards disabled people? 21
(5) CONSIDERATION OF HUMAN RIGHTS 5.1 Does the policy or decision affect anyone s Human Rights? Complete for each of the articles ARTICLE Yes/No Article 2 Right to life Article 3 Right to freedom from torture, inhuman or degrading treatment or punishment Article 4 Right to freedom from slavery, servitude & forced or compulsory labour Article 5 Right to liberty & security of person Article 6 Right to a fair & public trial within a reasonable time Article 7 Right to freedom from retrospective criminal law & no punishment without law Article 8 Right to respect for private & family life, home and correspondence. Article 9 Right to freedom of thought, conscience & religion Article 10 Right to freedom of expression X X Article 11 Right to freedom of assembly & association Article 12 Right to marry & found a family Article 14 Prohibition of discrimination in the enjoyment of the convention rights 1 st protocol Article 1 Right to a peaceful enjoyment of possessions & protection of property 1 st protocol Article 2 Right of access to education If you have answered no to all of the above please move onto to move on to Question 6 on monitoring 22
5.2 If you have answered yes to any of the Articles in 5.1, does the policy or decision interfere with any of these rights? If so, what is the interference and who does it impact upon? List the Article Number Article 3 Interfered with? Yes/No Yes What is the interference and who does it impact upon? Patient safety. Does this raise any legal issues? Yes/No Article 6 Yes Doctors ability to work in NI Yes the policy might be challenged by a doctor who is unable to works after a period of absence of 24 months or more. * It is important to speak to your line manager on this and if necessary seek legal opinion to clarify this 5.3 Outline any actions which could be taken to promote or raise awareness of human rights or to ensure compliance with the legislation in relation to the policy or decision. The policies seeks to treat all GPs fairly if they have been absent from practice. Doctors will be removed from the Primary Medical Performers List after a period of 24 months, and any doctor applying for inclusion in the list where they have not provided primary medical services for the same period will not be included. The HSCB has developed the NI GP development scheme to facilitate both 23
groups in completing an educational programme which will enable their inclusion or re-inclusion in the list. 24
(6) MONITORING 6.1 What data will you collect in the future in order to monitor the effect of the policy or decision on any of the categories (for equality of opportunity and good relations, disability duties and human rights? Equality & Good Relations The HSCB will maintain a list of doctors removed from the NI Primary medical performers List with reasons to establish the impact of the policy. It is anticipated that the numbers of doctors removed from the list for non-provision of primary medical services will be very small and individuals might therefore become identifiable if annual monitoring data were to be published. The HSCB will therefore seek to review longer term patterns to establish whether any of the equality groupings are over-represented. Disability Duties The HSCB will maintain a list of doctors removed from the NI Primary medical performers List with reasons to establish the impact of the policy Human Rights The HSCB will maintain a list of doctors removed from the NI Primary medical performers List with reasons to establish the impact of the policy Approved Lead Officer: Position: Dr Margaret O Brien Assistant Director of Integrated Care, head of GMS, HSCB Responsible 25
Officer Policy/Decision Screened by: Dawn Raine Signed: Date: October 2013 Please note that having completed the screening you will need to ensure that a consultation on the outcome of screening is undertaken, in line with Equality Commission guidance. Please forward completed template to: Equality.Unit@hscni.net. 26