Avon Local Medial Committee - Latest News

Redundancies, recruitment freezes and service cutbacks – these are the early signs of the impact the economic crisis is having on the UK’s health service, according to a BMA survey of doctors released today (27/6/10).

Launched on the eve of the BMA’s annual conference, where NHS finances are likely to dominate doctors’ debates, BMA research shows that, despite reassurances that front-line services will be protected, many NHS organisations are already taking actions which could have devastating and long-lasting consequences for the NHS.

The survey of local negotiating committee¹ (LNC) chairs found:

• Around one in four respondents (24%) said redundancies were planned in their organisation.  Redundancies planned are for the most part non-clinical and overwhelmingly non-medical.
• Almost two thirds of respondents (62%) said that there was a freeze on recruitment. Seventy per cent of respondents reporting a freeze indicated that it covered medical posts and 80% that it applied to nursing posts.
• Just over half (55%) of those with no explicit freeze indicated that there were unfilled vacancies.
• Nearly three quarters of respondents (72%) indicated that clinical service or infrastructure developments were being postponed for financial reasons and two in five that access to treatments or therapies was being limited.
• Just under half (45%) of responding LNCs were being consulted on cost and efficiency savings. The amount of savings being sought varied considerably around an average of just under 6%.

Commenting on the research, Dr Hamish Meldrum, Chairman of Council at the BMA, said:

“Whilst we accept that difficult decisions need to be taken in this tight financial climate, there is a real danger that cutting back on health now will have a long-lasting impact on our ability to maintain high-quality, comprehensive and universal care in the future.  

“Despite the government’s best assurances that front-line services will be protected, our data show that cuts are already being planned or becoming reality and that these will have an impact on doctors’ ability to care for their patients.  

“Even changes to back-room functions or administrative processes have consequences for front-line staff who, in many cases, may have to pick up the work themselves; this means less time for patients.”

Although the NHS is guaranteed growth in spending, in real terms, this is likely to be minimal and efficiency savings still have to be made.   NHS trusts are already under pressure to make their funding go even further, eliminate waste and improve on productivity.  The BMA accepts the need to be realistic and involving clinicians and local populations in decision-making is key.

Dr Meldrum added: “There may well be areas where there is a genuine need to examine ways of working and services being offered to ensure they are delivered in the most cost-effective manner. But all too often we see blanket bans, indiscriminate cost-cutting and decisions seemingly taken for political and financial expediency rather than because of good clinical evidence.

“Patients, local populations and health professionals should be actively involved in decision-making processes involving change and there should be genuine devolution of decision-making to the local level. We urge the government and NHS organisations to focus on those areas where they can truly eliminate waste and achieve genuine efficiency savings rather than adopt a “slash-and-burn” approach to health care with arbitrary cuts and poorly thought-through policies.“

21 June  2010

For immediate release

Expert advice needed to help us support people with breast cancer

Breast Cancer Care is looking for GPs to help shape one of its services for people who have come to the end of active treatment for breast cancer.

In collaboration with the University of Southampton, the charity is carrying out qualitative research looking at the type of information resource that might help support this patient group.

From speaking to women coming to the end of active treatment, Breast Cancer Care is aware that they will often have concerns over issues including the fear of recurrence, dealing with the long-term after-effects of treatment and adopting a healthier lifestyle. However, they no longer have intensive access to breast care nurses and other healthcare professionals who could offer this support.

In turn, healthcare professionals report that they currently have few if any resources to offer this group of patients. Breast Cancer Care is looking to address this gap by producing a high-quality information pack addressing common questions and concerns.

The study team has carried out focus groups with patients and a number of telephone interviews with breast care nurses, oncologists and surgeons.

It is now looking to recruit GPs willing to complete two phone interviews: the first, which would take place as soon as possible, is to explore what type of information to include and in what sort of format; the second to give feedback on the actual resource we produce. This would be in spring next year.

Any GPs willing to take part should contact Liz Reed, Research Officer at Breast Cancer Care via email: This e-mail address is being protected from spambots. You need JavaScript enabled to view it or telephone 0207 960 3447.

Ends

Note to editors:

For more information or a copy of our logo call the press office on 0845 092 0807 or email This e-mail address is being protected from spambots. You need JavaScript enabled to view it

Breast Cancer Care is here for anyone affected by breast cancer. We bring people together, provide information and support, and campaign for improved standards of care. We use our understanding of people's experience of breast cancer and our clinical expertise in everything we do. Visit www.breastcancercare.org.uk or call our free helpline on 0808 800 6000.

Responding to today’s (Tuesday 22 June) Emergency Budget, BMA Chairman of Council, Dr Hamish Meldrum, said:

“Doctors understand that these are difficult times and we accept the need to be reasonable and responsible about future pay rises.   However, we are seriously concerned that the Chancellor has overridden the whole negotiation process between the BMA and the independent review body and imposed a two-year pay freeze for the majority of public sector workers.  

“The public sector did not cause the financial crisis and should not be singled out as the main vehicle for dealing with it.

“The BMA will cooperate fully with the forthcoming review on public sector pensions. However, the NHS scheme underwent a major review in 2008 and the BMA will take all possible steps to protect the value of current and future pensions.”

  The NHS will begin to make immediate efficiency savings by tackling      
  escalating management costs in order to meet the increasing demands on  
  NHS services, Health Secretary Andrew Lansley said today.                
                                                                           
                                                                           
  A revision to the 2010/11 NHS Operating Framework, published today, sets
  out changes to key priorities for the NHS including plans to reverse the
  rise in management costs seen in the last year.                          
                                                                           
                                                                           
  Health Secretary Andrew Lansley said:                                    
                                                                           
                                                                           
  “NHS spending will increase, but so too will the demand on NHS          
  services.  In order to meet this demand, the NHS needs to make          
  substantial savings and that is why I want to see immediate action this  
  year to reduce management costs so that the savings made can be          
  reinvested in NHS care for patients.                                    
                                                                           
                                                                           
  “Management costs in Primary Care Trusts and Strategic Health            
  Authorities have increased by over £1bn since 2002/03, with over £220m  
  of the increase taking place during 2009/10.                            
                                                                           
                                                                           
  “Management costs now stand at £1.85bn and it’s our intention that      
  during 2010/11 we will remove all the management costs that have been    
  additionally incurred during 2009/10, to get back to the level of        
  2008/09. Then in subsequent years, we will go beyond that, with a        
  further £350m reduction in 2011/12. “                                    
                                                                           
                                                                           
  The overall reduction in management costs by 2013/14 will be £850m,      
  which is a 46 per cent reduction on the 2009/10 management costs.        
                                                                           
                                                                           
  The revised Operating Framework also sets out for the first time changes
  to the use of targets in the NHS.  These include:                        
                                                                           
                                                                           
  ·        removal of targets around access to primary care;              
                                                                           
                                                                           
  ·        removal of top-down performance management of the 18 weeks      
  referral to treatment target; and                                        
                                                                           
                                                                           
  ·        reduction of the 4 hour A&E target threshold from 98 per cent  
  to 95 per cent.                                                          
                                                                           
                                                                           
  Andrew Lansley added:                                                    
                                                                           
                                                                           
  “I want to free the NHS from bureaucracy and targets that have no        
  clinical justification and move to an NHS which measures its performance
  on patient outcomes.   Doctors will be free to focus on the outcomes    
  that matter – providing quality patient care.                            
                                                                           
                                                                           
  “But I want to be clear – while the NHS will no longer be accountable to
  ministers or the Department for its performance in these areas, it will  
  be very much accountable to the patients and public it serves. Patients  
  will still be entitled to rights under the NHS Constitution and the      
  quality of their experiences and outcomes are what will drive            
  improvements in the future.                                              
                                                                           
                                                                           
  “We expect providers to continue to make improvements, for example on    
  referral to treatment times, and to provide this information to patients
  themselves, driving choice and competition in the NHS.”                  
                                                                           
                                                                           
  Today’s revisions also ask the NHS to give greater priority to two      
  important areas, military veterans’ health and dementia.  The NHS must  
  ensure that injured military personnel experience a smooth transition    
  from military to NHS care as well as receiving priority treatment for    
  conditions related to their service.                                    
                                                                           
                                                                           
  On dementia, the NHS must work closely with partners to implement the    
  National Demential Strategy and publish information on how they are      
  doing this so that people with dementia and their families have access  
  to clear information to help them understand local services.            
                                                                           
                                                                           
  The changes set out today also reinforce recently announced plans to    
  publish more transparent hospital infection data; new rules on          
  reconfigurations that must have the support of local doctors and        
  patients; and plans to withhold payment from hospitals where patients    
  are readmitted within 30 days of discharge.                              

Commenting on the intention to remove the 48 hour access target in primary care Dr Laurence Buckman, Chairman of the BMA’s GPs Committee, said:

“Patients should have good access to GPs.  However, while this target may have been intended to improve access it has in fact had adverse consequences.  At the moment practices need to have enough appointments available on the day or the following day to meet the target, so those who want to book in advance find there are fewer appointments available.   We would therefore welcome the scrapping of this target as it will give GPs greater flexibility to organise their appointment booking system in a way that best suits their local patient population.”    

Commenting on the relaxation of the 18 week referral to treatment target; and the relaxation of the 4 hour A&E target, Dr Keith Brent, Deputy Chairman of the BMA’s Consultants Committee, said:

“Waiting time targets have improved the NHS in many respects, but they have also resulted in pressure on staff to make inappropriate decisions.  Patients must always be treated as individuals and we welcome this commitment to allow doctors the freedom to do what is clinically inappropriate.”

Patient satisfaction with their GP practice is still high, despite the swine flu pandemic, the BMA said today.

Commenting on the results of the 2009-10 GP patient survey, Dr Laurence Buckman, Chairman of the BMA’s GPs Committee, said:

“Between June and November last year practices were overloaded with work related to the swine flu pandemic, either seeing patients who had, or suspected they had, the illness and then vaccinating the at-risk groups. We’re therefore not surprised to see the slight dip in the access figures. GPs would obviously like every patient to be happy with the care they receive, but we are pleased that overall nine in ten people remain satisfied with their care.

“We still question whether spending millions of pounds on this survey is value for money and agree with the Secretary of State for Health when he says surveys like this ‘miss the point’¹. We believe there are better, more cost-effective ways to get genuine patient feedback, for example, though local patient surveys or through GP practice patient participation groups.”