The College offers an advisory review that may consist of the following recommendations.

We would suggest that the following be undertaken before considering an invited review.

• Have regular discussions about the quality of performance between individuals and their teams/colleagues.
• Act on concerns at an early stage before they affect patient safety.
• Ensure that all staff have appropriate facilities and resources to support them in delivering safe care in a safe and secure environment.
• Ensure that services have identified clinical leaders and that these leaders want to do the job and have the time and resources to make a success of it.
• Review the performance of the multidisciplinary teams (MDTs) regularly to ensure that they remain focused on supporting patients that allows them access to the best care possible.
• Regularly review the quality of the behaviour of all those involved in delivering the best care within the services and address any poor behaviour at an early stage by considering an occupational health referral for the individual
• Focus on the immediate impact on patient safety when the service goes through a significant stage of organisational or structural change.
• Regularly review the service’s processes for gaining consent from patients, as well as how teams introduce new technologies and techniques.
• Regularly review the standard of team-working between all grades and specialties of doctors to ensure that they can support the delivery of high-quality care. 
• Use the experience of trainees to learn about the quality of a service and the team dynamics that underpin it. 
• Ensure that the service undertakes regular reflective practice. Including ensuring the service has: 
  a. high-quality morbidity and mortality (M&M) review meetings; 
  b. programmes of clinical audit that demonstrate patient safety and promotes improvements in quality; 
  c. comprehensive appraisal of individual practice and the use of this appraisal to improve performance; and 
  d. structured and effective learning from patient experience and patient complaints. 
• Ensure that the service has a well-designed system for collating detailed, accurate, and timely data on all activities and the servies outcomes. This data should be given high priority, and sufficient resources should be provided for it to be used comprehensively to assure standards and improve quality.
• Consider the value of an independent external perspective on the situation.