Health professionals back to practice

Jon BillingsDirector of Strategy, Nursing and Midwifery Council, UK

Dubai Health Regulation Conference, 22-23 October 2014

General Medical Council, UKYou must recognise and work within the limits of your competence.

Nursing and Midwifery Council, UK39. You must recognise and work within the limits of your competence40. You must keep your knowledge and skills up to date throughout your working life41. You must take part in appropriate learning and practice activities that maintain and develop your competence and performance

Healthcare Professions Council, UKRegistrant practitioners must:1 be able to practise safely and effectively within theirscope of practice1.1 know the limits of their practice and when to seek advice or refer to another professional

Limits of competence

Career-long variables

Limits of competence

Sco

pe

of

pra

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eSpecialisationSpecialisation

Career changeCareer change

TrainingTraining

HealthHealth

Absence from practice

Absence from practice

Return to practice factors to consider

• Duration of absence

• Age of practitioner

• Nature of practice (technical e.g. surgery, interventional radiology v clinical e.g. psychiatry)

Elizabeth S. Grace MD, Elizabeth J. Korinek MPH, Lindsay B. Weitzel PhD, Dennis K. Wentz MD., Physicians reentering clinical practice: Characteristics and clinical abilities†, 22 SEP 2010

Different approaches

Nursing and Midwifery Council, UK•Mandatory minimum 450 hours in 3 years and CPD•Approved return-to-practice programmes

Academy of Medical Royal Colleges, UK•Guidance•Three month threshold•Checklists

Federation of State Medical Boards of the USA•Over half of boards have policy on physician re-entry

Conclusions• Use scope of practice v limits of competence

principles

• Review evidence where available

• Understand regulatory requirements where they exist

• Plan ahead – agree return arrangements in advance

• Develop organisation policies – incorporate supervision and simulation where indicated

Thank you

Jon Billingswww.nmc-uk.org@nmcnews@billingsjon