Understanding and remedying the performance of doctors in training

Prof Niro Siriwardena, University of Lincoln, College of Social Science, School of Health and Social Care, Director of Community and Health Research Unit

How can we enable more comprehensive and holistic assessment of medical performance to support underperforming trainees? This commentary provides a useful mnemonic: SKIPE

Identifying and responding appropriately to doctors who are underperforming, whether they are in training or in clinical practice, is vital in a profession where high standards are a pre‐requisite for ensuring high‐quality care that is safe and effective and provides patients with a good experience.


University of Lincoln, College of Social Science Research

Niro Siriwardena, University of Lincoln, School of Health and Social Care


 

Substance misuse and community supervision: A systematic review of the literature

Dr Coral Sirdifield, University of Lincoln, College of Social Science Research, School of Health and Social Care

A narrative systematic review was undertaken of the literature concerning the health of people on probation or parole (community supervision). In this paper, we provide an up-to-date summary of what is known about substance misuse in this context. This includes estimates of the prevalence and complexity of substance misuse in those under community supervision, and studies of the effectiveness of approaches to treating substance misuse and engaging and retaining this population in treatment. A total of 5125 papers were identified in the initial electronic searches, and after careful double-blind review only 31 papers related to this topic met our criteria. In addition, a further 15 background papers were identified which are reported. We conclude that internationally there is a high prevalence and complexity of substance misuse amongst people under community supervision. Despite clear benefits to individuals and the wider society through improved health, and reduced re-offending; it is still difficult to identify the most effective ways of improving health outcomes for this group in relation to substance misuse from the research literature. Further research and investment is needed to support evidence-based commissioning by providing a detailed and up-to-date profile of needs and the most effective ways of addressing them, and sufficient funds to ensure that appropriate treatment is available and its impact can be continually measured. Without this, it will be impossible to truly establish effective referral and treatment pathways providing continuity of care for individuals as they progress through, and exit, the criminal justice pathway.


University of Lincoln, College of Social Science Research

Coral Sirdifield, University of Lincoln, School of Health and Social Care

Charlie Brooker, University of London, Centre for Sociology and Criminology

Rebecca Marples, University of Suffolk, School of Law and Social Sciences