Key role of health managers in new regulations

In May 2011, the Medical Council launches a new system to support doctors in maintaining their professional competence throughout their professional lives.  President of the Medical Council, Professor Kieran C. Murphy and Dr Paul Kavanagh, Head of Professional Competence at the Medical Council, explain the implications for health managers.

Healthcare is changing.  A generation ago, a doctor could complete training equipped with the knowledge and skills to remain fit-for-purpose throughout their career.  Developments such as the internet now make it easier for doctors to access ever-accumulating bodies of knowledge from all over the globe which they can use to continually improve patient care. Similarly, patients’ expectations have changed as a result of being able to access an abundance of information about healthcare online.  This progression in the doctor-patient relationship has created a need for transparent arrangements to help assure the public that doctors are keeping up-to-date and are committed to lifelong learning and skills development.

Prof. Kieran C Murphy
Prof. Kieran C Murphy

In May, the Medical Council will launch new professional competence schemes, which will be operated by Postgraduate Training Bodies.  Registered medical practitioners will be subject to a statutory obligation to maintain professional competence. Health service managers will need to take cognisance that, for employed doctors, their employer will have a legal duty to facilitate the maintenance of professional competence.  This development will positively impact the quality and safety of healthcare.

The Medical Council consulted with a range of stakeholders including doctors and the public on the new professional competence schemes during development in 2010. We have been pleased to work closely with representatives of employers and health service managers in the public, voluntary and independent sectors throughout the process. We listened carefully to these views, and based on feedback received, the schemes have been designed to be straightforward, practice-based and outcome-focussed. The activities which doctors will engage in will be relevant to and embedded in their day-to-day practice. Doctors will be encouraged to plan activity and to reflect on learning so as to drive good professional practice which is centred on patient safety and the quality of patient care.

Dr. Paul Kavanagh
Dr. Paul Kavanagh

The introduction of formal professional competence schemes offers an opportunity for health service managers to review existing arrangements and supports which assist doctors in continuing their professional development. It is recommended that employers examine how this new system can best integrate with local clinical governance systems and clinical directorate arrangements. Maintenance of professional competence activities, such as clinical audit, should reflect current patient, practice and health system needs as well as anticipated future developments and therefore be integral to the business planning process at the level of the clinical directorate and the whole institution. Many activities will be part of local quality assurance processes such as clinical audit and morbidity and mortality meetings which will benefit the doctor’s practice as well as the quality and safety of care. Once the system is fully operational, it is expected that employers will request that a doctor provide evidence that they are pursuing a professional competence scheme as part of an annual clinical appraisal or similar process within the clinical directorate.

Health service managers will need to take cognisance that, for employed doctors, their employer will have a legal duty to facilitate the maintenance of professional competence

While there is no system in the world which can offer a guarantee of professional excellence in all cases, these new professional competence schemes are a step towards promoting good professional practice and improving patient safety and healthcare quality in Ireland. The experience in other jurisdictions has shown that there is no one simple solution to patient safety and healthcare quality, so these schemes must integrate with other healthcare structures to maximise effectiveness. Multiple interventions at national and local level are required which coordinate and integrate together into a system-wide quality and safety framework. At a local level, developing clinical appraisal, credentialing and privileging arrangements as part of a clinical governance system will need to work in conjunction with medical regulatory systems to continually ensure that doctors are fit for purpose.  It is therefore important for the Medical Council’s professional competence system to work in conjunction with local clinical governance systems to strengthen structures which maximise patient safety.  Health service managers have a key role in driving these changes and the Medical Council looks forward to continuing to work closely with this group to improve safety and quality.

Once the system is fully operational, it is expected that employers will request that a doctor provide evidence that they are pursuing a professional competence scheme as part of an annual clinical appraisal or similar process within the clinical directorate

The launch of professional competence schemes is an important step forward which will help to drive good professional practice.  With support from health service managers, and oversight from the Medical Council, doctors will demonstrate their commitment to maintaining and continually developing their knowledge and skills.  This will in turn help to maintain trust between patients and doctors and support employers in delivering improvements to health care services.

Health service managers – What you need to know

  • From May 2011, doctors working in your healthcare organisation are subject to a statutory obligation to maintain professional competence.
  • Employers of doctors – HSE, voluntary and independent alike – are legally obliged to facilitate doctors’ pursuit of professional competence requirements.
  • Employers already provide a range of supports to employed doctors to support maintenance of professional competence and the establishment of this new system may present an opportunity to review these arrangements to ensure they are aligned for best effect.
  • Health service managers should consider how this new system can best integrate with local clinical governance systems and clinical directorate arrangements.  For example, an employer may request that a doctor provide evidence that they are pursuing a professional competence scheme as part of an annual clinical appraisal or similar process; maintenance of professional competence activities, such as clinical audit, may reflect local service needs as part of a clinical directorate business plan.