The Royal College of Surgeons of England

The RCSEng’s regional infrastructure provides Directors of Professional Affairs for each Strategic health authority, along with Regional Specialty Professional Advisers –

Invited Review Mechanism (IRM) – the BOA and other surgical specialty associations, in conjunction with RCS England, provide the IRM to support employers in resolving concerns about the clinical performance of an individual surgeon or surgical unit. The IRM provides a fair, independent and professional process to determine whether there is a cause for concern and make recommendations for improvement.

The objective here is that action should be taken locally at the earliest possible stage with the aim of remedying problems before they affect fitness to practice or impact on patient safety. Concerns about performance may be highlighted from a number of sources including; local clinical governance process, the appraisal process, by other members of the surgical team or through surgical outcome data. We recommend a staged and proportionate response to investigating concerns, considering both the individual and the environment within which they work.

Employers will already have pathways for dealing with performance concerns.

The IRM is provided to support, but not replace existing procedures for dealing with such issues: