Our Practitioner Performance Advice service (Advice) has published its latest Insights paper: Trends from Practitioner Performance Advice’s support of the management of exclusions in England.
Analysis and commentary from Practitioner Performance Advice’s support of the management of exclusions in England. This annual publication represents our commitment to provide guidance to inform decisions around exclusion.
Key findings:
- The highest number of exclusions commenced in FY 2024/25 (131 episodes), but the proportion of exclusions in relation to the number of Advice Service cases was broadly consistent with recent previous years.
- The average duration of exclusion has decreased since FY 2020/21.
Groups of doctors and dentists who are statistically more likely to be excluded are: male, aged 65 and over, from Asian or Asian British, Black or Black British or Mixed ethnic groups, or who qualified outside the UK and European Economic Area (EEA). - Specialty/Associate specialist doctors and doctors working in emergency medicine, obstetrics and gynaecology, and surgery remain statistically more likely to be excluded.
- For exclusion episodes which began and concluded between FYs 2020/21 and 2024/25, 47% of practitioners returned to either restricted or unrestricted clinical practice.
- Since 2020/21 there has been an annual increase in the proportion of exclusions where the reported concern relates to sexual misconduct.
Why are we sharing this?
- We invite healthcare organisations to consider these findings and how you engage with the Advice service with regards to the following:
- Do you contact the Advice service when considering excluding a practitioner? Whether exclusion is being considered or not, there is no threshold for contacting us, including in cases where formal processes have not been invoked. For more information on formal and informal case management, please see our Expert View Insight from Sally Pearson, our Responsible Officer and HPAN Lead at NHS Resolution.
- Has your organisation adopted the exclusion resources made available by the Advice service to support best practice in the consideration and ongoing management of exclusions?
- Could your organisation benefit from the training courses provided by the Advice service to improve the knowledge and skills required to manage exclusions and investigations?
- If you are interested in discussing your organisational activity report to reflect on themes and trends in your cases over time, please contact us at: nhsr.casesupport@nhs.net.
- Could your organisation use our Principles and Framework for Fairness and Proportionality to support with managing and resolving performance concerns, including exclusion cases?
Our resources
You can access other publications in our Insights series which cover a wide range of subjects, from behavioural assessments to Professional Support and Remediation action plans.
If you are interested in hearing more about our research and insights programme, please get in touch with us at nhsr.adviceresearchandevaluation@nhs.net or sign up to receive Insights by email.
