Clinical expert panel framework

Each year, health services need external reviews of individual clinicians, services or functions. As leaders in safety, we frequently receive requests to nominate independent clinicians for investigative reviews. Identifying and engaging suitable clinicians can be complex and can delay the start of an investigation. This affects those involved in the adverse event, particularly the patient and their family. Access to suitable

The clinical expert panel framework sets out how the panel is established, run and governed.

Framework objectives

This page sets out the framework for establishing, managing and governing the clinical expert panel. The framework works towards the following objectives:

• establish a clinical expert panel of clinicians and health professionals with expert clinical skills and strong proficiency in investigative processes
• enable a timely, quality response when we receive requests for independent clinicians or health professional investigators
• set out a governance model that makes accountability and the scope of roles and responsibilities clear
• guide and support the management and oversight of panel membership
• enable evaluation of current and proposed activities
• support education and training of panel members and share learnings from evaluating this work.

Purpose of the clinical expert panel

The panel brings together clinicians and health professionals with skills and expertise in investigative processes. It supports a timely, quality response when we receive requests for independent clinicians or health professional investigators.

What clinical experts do

A clinical expert is a senior clinician who brings independent expertise as a member of a review team. Review teams may be established by a local health district or specialty health network (LHD/SHN), the Clinical Excellence Commission (CEC), the NSW Ministry of Health or another relevant body.

The clinical expert brings independent expert skills and advice to a range of investigation and review types, including:

• review the quality of care a clinical service has delivered
• investigate an individual clinician's practice, including under the Managing Misconduct, Serious Performance and Child Related Concerns policy (PD2025_021)
• take part in serious adverse event reviews (SAERs) under the Incident Management policy (PD2020_047)
• sit on a Lookback expert advisory panel under the Lookback policy (PDF2023_003)
• investigate serious complaints under the Complaint Management policy (PD2020_013) and guidelines (GL2006_023)
• give specialist clinical opinion to another investigation team, without joining that team
• complete a report using our standardised reporting template after each investigation.

Where a policy directive covers the investigation, the investigation must follow that policy directive. As a review team member, the clinical expert advises on the standard of care compared with current practice. They review medical records, documents and other evidence, interview witnesses, and help the team develop and record findings and recommendations. An experienced clinical expert may be asked to lead the investigation team.

Reporting obligation

During an investigation, a clinical expert may uncover reportable behaviour. This includes matters involving the registration board or professional association, child protection, domestic violence, corruption or criminal conduct. The clinician has a professional obligation to make the relevant reports.

They must report the behaviour to the chief executive of the commissioning body. The commissioning body or CEC will assist the clinician where required.

Serious systemic issues mean a continuing risk of harm to the patient, or a serious or imminent risk of harm to other patients, carers, family or staff. If the review team believes such issues exist, they must immediately escalate the risk in writing to the chief executive.

All reviews must be impartial and objective, bearing in mind the setting in which the service functions. The investigator must not have, and must not be perceived to have, any conflict of interest in the matter, people, conduct or policies and procedures under investigation. The clinical expert must declare any conflict of interest to the commissioning body as soon as it arises.

Panel member selection criteria

Panel members must:

• be a registered health professional with the relevant board through the Australian Health Practitioner Regulation Agency (AHPRA), or be eligible for membership of an appropriate Australian professional association
• be a recognised expert in their specialty
• have experience in, or a demonstrated understanding of, the NSW public health system
• meet the relevant police check, working with children check and immunisation requirements under NSW Health policy
• have no conditions of significance on their registration or practice
• not be subject to ongoing serious complaints or performance review.

Retired clinicians must be able to show that their knowledge of current practice is up to date.

Other requirements

Panel members also need to:

• agree to undertake NSW Clinician Expert Training as required
• be able to be absent from work, and possibly from home, during a review
• recognise that investigative interviews and reviewing medical records can be taxing and require a significant time commitment
• be able to complete the full review process, including drafting and finalising the report
• have capacity to meet timeframes set by the team leader or commissioning body
• be available to brief the commissioning body on the findings and recommendations in the review report.

Reporting arrangements

The clinical expert role is in addition to the clinician's usual role. Being a clinical expert does not constitute employment with us. The role involves multiple reporting relationships:

• Local health district, specialty health network or another employer - Approval from their chief executive or delegate will be sought by the CEC to finalise the application process.
• Clinical Excellence Commission - The Clinical Expert is supported, in their role as a clinical expert, by the Associate Director, Patient Safety, and Director, Patient Safety and Clinical Governance.
• The body commissioning the review - The clinical expert is responsible for giving expert advice that is current, fair and free from bias. They must declare any real or perceived conflict of interest.

Remuneration

Participation in review teams is voluntary. Clinical experts can expect to be compensated for their participation in reviews when indicated. The form of compensation depends on the clinician's employment situation at the time of engagement and is negotiated with the commissioning body. The commissioning body is responsible for setting the terms of engagement and meeting expenses incurred.

Protection from liability

Section 133B of the Health Services Act 1997 protects people acting in good faith under the direction of a statutory organisation's board. They are not personally subject to any action, liability, claim or demand. This protection does not prevent a person being called to give evidence, unless the review was a privileged Serious Adverse Event Review.

Clinical experts must keep information obtained and records created during reviews confidential. They must not disclose this information to other parties, as the NSW Health Code of Conduct specifies. This applies in addition to the privacy protections for patients and clients under Commonwealth and state privacy legislation. Members of privileged root cause analysis or serious adverse event review teams face specific legal penalties for breaching confidentiality.

Training

Reviews must be independent and procedurally fair. This makes the findings and recommendations robust and fair to the subjects of the review, affected patients and families, and the health service. Training supports clinical experts to undertake high-quality investigative reviews and supports consistency across the panel. We deliver training through scheduled masterclasses across the various Serious Adverse Event Review (SAER) methodologies.

More about incident management methodologies

Recruitment process

Appointments are for two years, with reappointment possible. Complete the online application form.

Appointment as clinical expert

Clinical experts are appointed for a term of two years. The appointed clinical expert receives a formal letter of appointment from our chief executive, with details of the appointment.

Onboarding clinical experts

Most clinical experts are NSW Health members and have completed formal onboarding in their own workplaces. It is still important that they are familiar with the role and function of the CEC. New clinical experts attend an orientation program of one to two hours, which includes:

• introduction to the associate director, patient safety and the executive director, patient safety and clinical governance
• introduction to the role and function of the CEC
• the role of the Patient Safety and Clinical Governance Directorate and Serious Incident Review (SIR) sub-committees
• the role of governance and assurance as it may relate to reviews
• the role of the Health Care Complaints Commission and other relevant bodies.

Ongoing management of clinical experts

The Patient Safety team gives administrative support, including maintaining the clinical expert database and overseeing the reviews clinical experts undertake. The team also monitors appointment terms and the reappointment process.

A clinical expert may face a situation they cannot resolve, during appointment or in the role. They can discuss any concerns with either the associate director, patient safety or the executive director, patient safety and clinical governance, who will assist.

Evaluation of the clinical expert panel

We seek feedback from:

• panel members about onboarding and training
• panel members after each investigation
• the organisations using the services of the clinical experts.