NHS Direct telephone line service could be terminated.

Health Secretary, Andrew Lansley, has confirmed that the government is planning to scrap the NHS Direct telephone line service.  The change will not affect existing helpline services in Scotland and Wales. 

The new 1-1-1 helpline is already being piloted in the north-east of England. However critics claim the new service would undermine the quality of service already being offered with less qualified nurses answering calls.

Currently, NHS Direct employs more than 3,000 staff, of which 40% are trained nurses. The pilot 1-1-1 service currently has less nurses as a ratio, but no figures are available as yet to what the ratio of nurses working on the helpline will be when it rolls out nationally. 

In answer to the critics, Nick Chapman, Chief Executive of NHS Direct said, “the new helpline would be better and more cost effective than NHS Direct. More value for money doesn’t necessarily mean that something will be worse. It will be a more seamless service. The 1-1-1- helpline’s telephone number would also be easier for callers to remember than the current NHS Direct one”. 

Back in June, GPs urged the government to scrap the NHS Direct service claiming it was not cost effective. 

The government’s plan to scrap the service has led to outcry from the Labour party. Andy Burnham, shadow health secretary cited this as evidence of the government’s intention to “dismantle” the NHS. He said, “The health secretary’s statement will stun people across the NHS. It is yet more evidence that Andrew Lansley is on a vindictive mission to break up the NHS, ruthlessly dismantling services before alternatives are in place. The government had shown arrogance and acted in a cavalier way by choosing to scrap NHS Direct without consulting the public. The service saved the NHS £200m a year and played a key role in taking pressure off the health service. It’s been a proven success for a decade and simply to scrap it is no way to run the NHS”. 

On average 14,000 people daily call NHS Direct for medical advice costing £123m a year to run.

Former Labour health secretary Frank Dobson who helped establish NHS Direct in 1998, said, “The decision to replace the service was crackers and said the professionally staffed advice line would be replaced with a call centre”. 

Dr Peter Carter, chief executive and general secretary of The Royal College of Nursing, said, “reducing the number of specialist nurses who worked on the new helpline was short-sighted. We urge the government to consult fully and look at all the evidence before enacting changes which could leave people without expert advice from trained nurses”. 

Mr Chapman said, “Staff involved with the 1-1-1- helpline ‘pathfinder’ in north-east England were currently working with the local ambulance service to handle calls relating to health information or inquiries about medicines. The service would also be tested in the East Midlands and in the East of England, where helpline staff would also assist with nurse assessment, health information and referrals. When detailed plans are made to roll out the service nationally, we hope NHS Direct staff will be able to contribute their experience to the new service”. 

As the government continues to reform the NHS with its plans to scrap NHS Direct, the proposed

1-1-1helpline will see further scrutiny from its critics. With this and other reform changes being introduced by the government, it is essential that NHS Trusts have on board the doctors and medical staff who are able to meet these changes.  

MPP Locums ensures that all doctors are vigorously checked before being placed in key roles. MPP Locums provides general and specialist locum doctor jobs for NHS Trusts throughout the UK. We provide quality staff to our clients and are regulated by the Care Quality Commission and the NHS Buying Solutions. MPP Locums is an approved supplier of locum jobs to the NHS under the National Locum contract starting 1st July 2008 for the next three years.

If you are seeking NHS doctor jobs, doctor jobs, locum doctor jobs contact our registration team by telephone or register on line and be part of the fastest growing and largest specialist medical recruitment agency in the UK.

NHS Hospital consultants’ bonuses could be trimmed.



As part of the government’s review of the NHS, could lead to hospital consultants seeing their bonuses being trimmed. Currently some doctors receive awards of up to £76,000 a year. 

The awards known as “Clinical Excellence Awards” are paid to consultants who have performed over and above the standard expected in their NHS roles. The awards are given as bonuses on top of their salaries, which can range from £75,000 to £100,000 per year. 

Health Secretary, Andrew Langley, said, “Savings generated will be redirected into patient care. We want to continue to reward and recognise those individuals who give outstanding patient care and go beyond the call of duty, but we must ensure that the system is effective and affordable. The NHS must recognise its responsibilities in the current financial climate as the largest public service in the country and this review will ensure that Clinical Excellence and Distinction Awards are in line with other public sector pay and incentive schemes.”

Since the awards where introduced in 1948, the actual number of awards given has been falling, but in 2009, the NHS still paid in excess of £200m for the awards. 

The review, which will be led by the independent review body on Doctors’ and Dentists’ Remuneration (DDRB), has been commissioned by all four UK health departments. 

The British Medical Association said, “It would engage with the review, which provides an opportunity to highlight the value of award schemes to patient care. These schemes exist to promote quality, efficiency and innovation across the whole NHS, all of which are key aims of the recent White Paper.”

John Stanley, who chairs the Royal College of Surgeons’ higher awards committee, said, “Doctors may feel less inclined to go the extra mile.” 

As the government continues to reform the NHS and look at cost saving measures, but without affecting patient care – the demand on doctors is not set to go away. At MPP Locums, we are well placed to provide professional NHS Trust doctors and GP locums in a changing NHS. 

MPP Locums ensures that all doctors are vigorously checked before being placed in key roles. MPP Locums provides general and specialist locum doctor jobs for NHS Trusts throughout the UK. We provide quality staff to our clients and are regulated by the Care Quality Commission and the NHS Buying Solutions. MPP Locums is an approved supplier of locum jobs to the NHS under the National Locum contract starting 1st July 2008 for the next three years.

If you are seeking NHS doctor jobs, doctor jobs, locum doctor jobs contact our registration team by telephone or register on line and be part of the fastest growing and largest specialist medical recruitment agency in the UK.



 

NHS bill of £65bn to build new hospitals.

As the Government increases pressure on the NHS to save money, the NHS in England faces a total bill of £65bn for new hospitals built under private finance initiatives (PFI).  

Under the PFI schemes – private firms pay for and build the new hospitals and mental health units, with the NHS having to pay these costs off over a 30-year period – effectively an “NHS mortgage.”  

In real terms, the costs of the hospitals under PFI means that some trusts annual payments is more than 10% of their turnover.  

The net affect of this is as fees rise each year doctor's fear that it would be harder to achieve savings, which would mean less money available for patient care.  But the government said the 103 schemes were providing value for money.  

Current figures show that the value of the projects when they were built was £11.3bn. However, over the lifetime of the repayments, the “NHS mortgage” due to be paid back will have actually cost the NHS £65bn once extra costs such as maintenance, cleaning and catering are taken into account.  

The figures also show the levels of repayments are rising. Currently the NHS pays back in total £1.25bn each year – a figure, which rises year-on-year until 2030 when it will top £2.3bn. The final payment will not be made until 2048. 

Under current NHS reform – the emphasis is to move more care out of hospitals and into the community with critics of the PFI arguing for the NHS to renegotiate better deals to help it cope better during the public sector squeeze on spending.  

Although the NHS budget is being ring-fenced, the health service still has to find up to £20bn of savings by 2014 to help it cope with pressures from lifestyle changes such as obesity, an ageing population and the rising costs of drugs. 

Professor John Appleby, chief economist at the King's Fund health think-tank, said: "It is a bit like taking out a pretty big mortgage in the expectation your income is going to rise, but the NHS is facing a period where that is not going to happen. Money is being squeezed and the size of the repayments will make it harder for some to make the savings it needs to. I don't see why the NHS can't go back to its lenders to renegotiate the deals, just as we would with our own mortgages." 

Dr Mark Porter, of the British Medical Association, added: "Locking the NHS into long-term contracts with the private sector has made entire local health economies more vulnerable to changing conditions. Now the financial crisis has changed conditions beyond recognition, so trusts tied into PFI deals have even less freedom to make business decisions that protect services, making cuts and closures more likely." 

Nigel Edwards, director of policy at the NHS Confederation, which represents trusts, accepted there was a problem. "They were planned for a different world. I'm sure that in some cases people feel their hands are tied." 

And former NHS trust chief executive Roy Lilley warned, “The building of large hospitals under PFI was out of kilter with the move in the NHS towards community treatment.” 

But a Department of Health spokeswoman said, “The schemes were providing “value for money” and were “affordable”. She added: "All trusts, not just those with PFI contracts, will need to deliver significant efficiencies over the coming years in order to meet rapidly rising demands while protecting front-line services. One of the benefits of PFI is that the buildings are always contractually required to be kept in good condition - good maintenance will always cost more than not maintaining facilities to a high standard." 

As the NHS continues to reform – the affects of the “NHS mortgage,” as well as a move to more care within the community, NHS Trusts will need to seek more cost effective, value for money patient care. With role of NHS Trusts’ doctors and GP locums changing, MPP Locums is well placed to meet the reforms of the NHS.   

MPP Locums ensures that all doctors are vigorously checked before being placed in key roles. MPP Locums provides general and specialist locum doctor jobs for NHS Trusts throughout the UK. We provide quality staff to our clients and are regulated by the Care Quality Commission and the NHS Buying Solutions. MPP Locums is an approved supplier of locum jobs to the NHS under the National Locum contract starting 1^st July 2008 for the next three years. 

If you are seeking NHS doctor jobs, doctor jobs, locum doctor jobs contact our registration team by telephone or register on line and be part of the fastest growing and largest specialist medical recruitment agency in the UK.  

After years of decline, NHS waiting lists have begun to rise again since the introduction of European rules on junior doctors’ working hours.   

Since the 1990s waiting times in the NHS had been dropping, but in August 2009 new legislation was introduced limiting junior doctors to a maximum of a 48-hour week. This has resulted in reversing the trend and seeing thousands of more patients now waiting longer than 18 weeks for surgery.    

With this introduction, Ministers are seeking to renegotiate Britain’s position on the European Working Directive, including a possible opt-out for NHS staff. Since the introduction of the new legislation, The Royal College of Surgeons have carried out the first comprehensive analysis to see how this directive has affected waiting times.   

The research has highlighted that the proportion of NHS patients having to wait longer than the target of 18 weeks for non-emergency surgery such as a hip replacement had almost doubled from 1.5 per cent 18 months ago to nearly 3 per cent in March of this year. By the end of 2008, patients waiting times reached an all-time low with the average waiting time being just a few weeks.   

However, since the EU directive cut junior doctors’ hours from 56 to 48 per week, these gains had been wiped out, the Royal College said.   

According to figures fro the Department of Health, the number of patients waiting longer than 18 weeks from GP referral to being treated as an impatient fell steadily from April 2007, when almost 34,000 people were waiting, to 8,674 in December 2008. This figure remained stable at around 10,000 until June 2009, just before the new rules came in, when the figures began to rise again. By March of this year, the numbers waiting to be seen had risen to 17,515, a level last seen in September 2007.  

John Black, the President of the Royal College of Surgeons, said,  “The increase was predictable. If you have the same number of patients, no more doctors and ask them to work less then it is inevitable that the time available for elective procedures will reduce and waiting lists grow. Most European countries had bypassed the legislation by either not monitoring compliance or, as in Germany and Holland, finding ways around the directive. We look forward to this happening in the UK.” 

Now almost 66 per cent of consultants frequently operated without assistants because departments were so stretched.   

Sir Richard Thompson, the new President of the Royal College of Physicians said, “The directive had been a complete disaster for both patient care and the quality of training for doctors. We are not providing the service or the training that we require. I cannot over emphasise the damage to service provision and to training.”   

Dr Matt Jameson-Evans, a spokesman for Remedy UK, a junior doctors campaign group said, “The impact of the directive on services was inevitable. Patients are simply not being treated by as many doctors as before. A second consequence of this and equally important is that doctors are not receiving as much training as they were and this has serious implications for the future quality of care.” 

In response to the directive, the Royal College of Surgeons has argued for an opt-out. The opt-out will allow trainees to work up to 65 hours per week because under the current 48-hour week, trainees are just not getting enough practical experience.   

The previous 18-week target has now been abolished by the coalition saying it was not backed by evidence that it benefited patients.   

Dr Mark Porter, the chairman of the British Medical Association’s consultants committee, said, “The drive for cuts within the NHS was also a factor in the rise in waiting times.” 

A spokesman from the Department of Health said, “We want patients to receive treatment, not when an arbitrary target dictates, but when it is most clinically appropriate for them to be seen. On the European Working Times Directive, the Health Secretary will support the Business Secretary in future negotiations on its revisions, including maintenance of the opt-out.”  

With the numbers of hours per week doctors are allowed to work, as well as government cutbacks, more NHS trusts will need to seek alternative solutions to reduce waiting lists. With the changing demands for doctors and GP locums, MPP Locums is well placed to meet these changes.   

MPP Locums ensures that all doctors are vigorously checked before being placed in key roles. MPP Locums provides general and specialist locum doctor jobs for NHS Trusts throughout the UK. We provide quality staff to our clients and are regulated by the Care Quality Commission and the NHS Buying Solutions. MPP Locums is an approved supplier of locum jobs to the NHS under the National Locum contract starting 1^st July 2008 for the next three years.  

If you are seeking NHS doctor jobs, doctor jobs, locum doctor jobs contact our registration team by telephone or register on line and be part of the fastest growing and largest specialist medical recruitment agency in the UK.  

Harley Street clinic cheaper for NHS patients.

Faced with a £20m budget deficit in 2007, the Primary Care Trust for Bexley in Kent decided to hand the bulk of the commissioning power to GPs. They now control 70% of the borough’s budget.  

With greater control over budgets, GPs in Bexley now offer a better service for patients through specialist clinics such as those in Harley Street. When Peter Aylott aged 67 needed a scan for a heart condition, he expected it would be under his local hospital in Kent, not in a private clinic in London. He said, “We were transported to and from our doorstep to Harley Street, taken into this salubrious place and really treated as if we were a paying patient.”  

The Harley Street clinic where Peter Aylott was seen is the first clinic in the country to have a CT scanner that can produce a three-dimensional picture of a patient’s heart with a very low radiation dose. 

Dr Chris Harvey, consultant radiologist at the European Scanning Centre is proud of the £1.5m machine. He said, “I think this is the way forward, more GP referrals to specialist centres.” 

The costs for Peter’s Harley Street scan was picked up by his local primary care trust in Bexley. However, Peter is not alone in being seen by Harley Street specialist. In the last 8 months, Bexley PCT has sent over 80 patients to the European Scanning Centre for their scans.  

The benefits are two-fold, firstly the treatment is less evasive for patients and secondly, each patient sent is saving the NHS money, money that can be used elsewhere. The alternative option for Peter Aylott and patients like him would be to have invasive angiograms at his local NHS hospital in Sidcup, Kent. Having a CT scan is much safer than an angiogram, where one in every 500 patients suffers a heart attack or stroke.  

The scan is also cheaper, says Dr Kostas Manis, a GP in Bexley. “The angiogram is £1,300 in the NHS and the private clinic scanner is £900 and we’re negotiating to bring the figure down to £600.” 

Dr Manis, who has been instrumental in developing this new scheme has already saved the NHS in Bexley £300,000 in the past eight months.  

Talking about his experience at the Harley Street clinic, Peter Aylott said, “You go in for full surgery, they are putting tubes up your leg – there’s always a risk, I’d much sooner have a CT scan, no argument.” 

With GPs being given more control over budgets and how it is spent, Dr Manis was convinced there is a better way forward in providing quality patient care, while cutting costs. “The cardiology bill we were receiving from hospitals was astronomical,” he says. Under the community cardiology scheme, which Dr Manis helped to introduce sees patients from GP’s surgeries in Bexley being seen by David Brennand-Roper, a consultant cardiologist from King’s College Hospital, London.  

Before this, 95% of patients with cardiovascular problems were referred for tests at the local NHS hospitals. “The PCT was seeing a lot of money spent at hospital on patients who turned out to be remarkably normal.” The solution was longer consultations. Instead of the normal five or 10 minutes consultation, Dr Brennand-Roper sees them for half an hour. “It does seem to work remarkably well and the referral rates have come down to around 10%.” 

With schemes like this in operation the GPs get to keep more of the money, but with the big loser being the local Queen Mary’s hospital in Sidcup. Furthermore, with more GPs wanting to refer patients to specialist hospitals and the private sector could pose problems for small district hospitals. “If we see patients in the community there will be problems for hospitals.The difficulty for the hospital in the long term is the shortfall of income,” said David Brennand-Roper.  

Dr Manis said, “His experience from Bexley is that the introduction of GP commissioning will mean hospitals and consultants have to radically change. District hospitals have too many managers and too many consultants. GPs are the driving seat and GPs will decide where patients go.”  

With changes ahead in the NHS under the government’s proposed reform, more GPs like Dr Manis will be in direct control of how their budget is spent. And with these changes it is GPs and GP locums who are best placed to ensure patients get the best treatment available to them on the open market.   

MPP Locums ensures that all doctors are vigorously checked before being placed in key roles. MPP Locums provides general and specialist locum doctor jobs for the NHS Trusts throughout the UK. We provide quality staff to our clients and are regulated by the Care Quality Commission and the NHS Buying Solutions. MPP Locums is an approved supplier of locum jobs to the NHS under the National Locum contract starting 1^st July 2008 for the next three years. 

If you are looking for NHS doctor jobs, doctor jobs, locum doctor jobs contact our registration team by telephone or register on line and be part of the UK’s fastest growing and largest specialist medical recruitment agencies.