Professional support and remediation (PSR)

We create action plans for doctors, dentists and pharmacists who have been identified by their healthcare organisation as requiring support to deliver sustained, safe and effective practice.

With over 15 years’ experience in preparing such action plans, we use our extensive expertise to provide tailored plans to help NHS organisations support practitioners who need to improve their knowledge and skills or are returning to work after an absence.

We provide two types of action plan.

Remediation action plans

When there is clear evidence of performance or behavioural concerns – for example, identified through an assessment or investigation – we create remediation plans to address the concerns. These may focus on:

Knowledge.
Skills.
Behaviours.
A combination of these areas.

Return to Work Action Plans

We prepare action plans for practitioners returning to clinical practice after a prolonged absence (usually more than three months) for any reason, such as sickness absence, parental leave or a career break. These plans provide a framework in which practitioners can refresh their knowledge and skills and reintegrate into the workplace. We can also address any performance concerns by incorporating remediation elements, where needed.

How to request an action plan

Healthcare organisation

Organisations should speak with their assigned Case Adviser or call the Advice Line on 0207 811 2600 to initiate a request.
Organisations then complete a request form which includes case details, concerns, development needs and expected outcomes. The form must clearly state what is expected of the practitioner on completion of the plan. The healthcare organisation should share the form and
accompanying documents with the practitioner before submission.
A representative of the healthcare organisation will be asked to join a 30-minute call with us to clarify expectations, job plans, service needs and available support/resources.

Practitioner

Practitioners can contact the Advice Line on 0207 811 2600 or email nhsr.psr@nhs.net to arrange a call to discuss a potential request with a Case Adviser.
If the healthcare organisation has completed a request form, the practitioner should review the form and supporting documents. The practitioner may add their own comments on the request form before submission.
The practitioner will be asked to take part in a 45–60 minute call with us to share their perspective, any potential barriers and ideas for activities to inform the action plan and to help tailor it to their needs.

Timelines

We aim to issue the draft action plan within 20 working days of accepting the request.

How are action plans developed?

We carefully review each case, including:

Case background, with direct input from the healthcare organisation and the practitioner.
Identified areas for development, such as clinical knowledge and skills, leadership, patient or colleague interaction and/or behaviours.
Local investigation reports or Clinical Performance Assessment/Behavioural Assessment reports provided by Practitioner Performance Advice.
The practitioner’s role and their working environment.
The practitioner’s situation, including their health and wellbeing, and any required reasonable adjustments.
The needs of the service.
Requirements to protect patients, staff and the public.

What does a plan include?

Overall aim: we set out the aim for the practitioner on completion of the plan, which is usually to practise safely and effectively in their assigned role.

Timescales: the plan has a clear end point, which might be subject to change following regular reviews of progress and with the agreement of the parties.

Objectives: we create clear, measurable and time-specific objectives to track progress effectively, with detailed milestones that identify the steps required to achieve those objectives.

Defined roles: we identify the roles needed to be responsible for supervising and supporting the practitioner, with descriptions of their responsibilities throughout the plan.

Development activities: there will be a range of activities tailored to the practitioner’s needs and might include:

Supervision and structured feedback
Workplace-based assessments
Personal development
Self-directed learning and reflection
Coaching and mentoring

Competency frameworks: our plans make reference to recognised competency frameworks, with capabilities in practice (CiPs) and training curricula, to ensure relevance and adherence to professional standards.

Review points: the plan includes periodic reviews so that progress can be assessed and to determine if the plan or its timeline need to be adjusted.

Agreement template: there is a standard template for the healthcare organisation and practitioner to adapt and use. It outlines mutual agreement to the plan, describes outcomes upon successful completion, and specifies the next steps should the plan not be completed or if there is a lack of engagement.

Note: We issue all our action plans as a draft document, which can be amended to suit local circumstances if required, with the final plan being agreed by the practitioner and the healthcare organisation.

Reviewing action plans produced by NHS organisations

If an NHS organisation has already produced an action plan, we can review it and offer constructive feedback. We assess feasibility, identify improvements and always prioritise patient safety. Information about how we conduct a review of a locally drafted action plan is available here: PSR: Reviewing externally drafted action plans; a guide.