Occupational Medicine 2020;70:503–506 Advance Access publication on 17 August 2020 doi:10.1093/occmed/kqaa145 © The Author(s) 2020. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com Peer review audit of non-specialist occupational physician reports D. Lalloo 1 , J. Gallagher 2 , E. B. Macdonald 1 , C. McDonnell 3 and S. Vargas-Prada Figueroa 1,4 1 Healthy Working Lives Group, Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow G12 8RZ, UK, 2 School of Public Health, University College Cork, Cork, T12 YN60 Ireland, 3 Health Services Executive, Mid-West Region, Limerick, V94 7X9 Ireland, 4 Salus Occupational Health & Safety, NHS Lanarkshire, 14 Beckford Street, Hamilton ML3 0TA, UK. Correspondence to: D. Lalloo, Healthy Working Lives Group, Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow G12 8RZ, UK. Tel: +44 (0)141 330 3559; fax: +44 (0)141 330 5018; e-mail: drushca@hotmail.com Background With declining specialist occupational physician (OP) numbers, there is increasing recognition of the importance of non-specialist physicians in occupational health (OH) service delivery, yet to date, this physician group remains understudied and their competency requirements poorly understood. Aims To evaluate the quality of a sample of non-specialist OH reports and compare these with specialist reports. Methods A retrospective peer review audit of a convenience sample of 200 consecutive non-specialist and specialist OH reports from an Irish OH service using an assessment form based on the modified Sheffield Assessment Instrument for Letters SAIL(OH)1. Results Of the 200 peer reviewed OH reports, 159 (80%) were from non-specialists. For all questions, 87% and above of non-specialist reports were ‘satisfactory’ or ‘above expected’. On the overall assess- ment, out of 10, the mean non-specialist report score was 6.8 (standard deviation (SD) 3–10) and the specialist score was 7.3 (SD 3–10). Comparatively, non-specialist reports highlighted legal/eth- ical issues marginally more and adhered slightly better to contractual/ethical/legal boundaries, while specialist reports fared better in addressing manager’s questions, in their structure and clarity and in covering all significant aspects of the case, particularly if the case was complex. Conclusions Our findings demonstrate a high standard of OH report quality in this sample of non-specialist OPs that is consistent across all key OH report components. Potential development areas are also iden- tified that can inform education/training tailored to this physician group and assist in competency standard-setting. Key words Audit; competence; education; occupational health; quality assessment. Introduction While acknowledging the pivotal role of the specialist occupational physician (OP) in any occupational health (OH) team [1], with declining specialist numbers in Ireland and elsewhere [1,2] and maintained OH pro- vision demands, there is increasing recognition of the importance of the non-specialist physician in OH ser- vice delivery [2]. A specialist OP in Ireland is certified to practise independently, having successfully completed Higher Specialist Training and Membership examination [2]. A non-specialist would typically (but not invari- ably) hold a postgraduate qualification, for example a Licenciateship [2]. Mixed specialist/non-specialist models enable more effective use of specialist expertise, tailored to clinical cases and situations that merit a higher competence level. Non-specialists form a substantive and vital part of the Irish medical OH workforce [2]. It is imperative therefore that the competencies of this physician group are understood, for clinical governance and identifying ongoing training/development. The importance of the Downloaded from https://academic.oup.com/occmed/article/70/7/503/5893352 by guest on 13 July 2022