The Independent Tribunal Service has a reputation for fairness and 
impartiality, and also for competent management of proceedings.
It runs a quality assurance programme, and trains legal, medical and 
lay members and assessors.

It would be sensbile to consider whether the ITS could take on the 
management and supervision of the independent review process in 
the general practice complaints procedure.

>From the point of view of the welfare of the profession as a whole 
it is desirable that any doctor asked to serve on such a panel does 
so, and that doctors who have identifiable qualities[1] making them 
suitable are asked to so serve.

PCGs might enter reciprocal arrangments to cover an absence from teh 
usual surgery of a doctor detached for such work using an assistant 
employed by the PCG as a salaried GP and mainly intended to cover 
holiday absences and PCG board work.

Secondly, the need for a near miss body has escalated recently.  One 
or more should be established.  
Clinical governance has been described as including risk management. 
 Unfortunately, and it may have been merely a slip of the tongue, 
which I will attempt to correct, one lead GP for clinical governance 
managed to express risk management in terms of avoiding complaints.  
Proper action will indeed minimise complaints, but risk management 
should involve far more than that, including targeting training and 
the provision of decision support aids and references to doctors who 
might otherwise feel disinclined to acquire them.[2]

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[1] including but not limited to:-
 - refusal to be dominated or overawed by anyone, including <awe> 
consultant colleagues</awe> (such as for instance the medical 
management of BRI or in Kent)

 - a certain legalistic turn of mind, capacity for logical thought 
and knowledge of the relevant contractual matters.

 - general clinical competence and the ability to acquire specific 
knowledge rapidly in order to make informed comment on particular 
clinical matters.

- a capacity to communicate, better expressed given the speed of 
proceedings and the need to produce a proper report as the ability 
to write than the ability to speak in public or manipulate people in 
committees.

- what are the others, to what degree are they needed, and how may 
they be tested for and measured or inculcated where they are 
lacking.

[2] for instance because their income is in the lower quartile of 
the range, and the materials or training required are expensive.  
Compare and contrast the costs and benefits of giving a GP (say) 
£1000 worth of assistance to getting things right, and the costs of 
running an enquiry.
--- OffRoad 1.9r registered to Adrian Midgley


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