NEWS
T
he Federation of Surgical Specialty Associations
(FSSA) has sent an open letter warning of the cost to patients of the routine denial and delay for many kinds of elective surgery.
There is wide variation in the categorisation of non-essen- tial surgeries at different PCTs across the country, as these are not directly regulated by the Department of Health. But those commonly seen as having lower
clinical value include infected tonsils, hernias, wisdom tooth extraction and hip or knee re- placements.
The FSSA argues that the opera- tions included are valuable and should not be rationed in such an arbitrary way.
The Federation says it is “concerned that lists of surgical procedures and interventions, deemed of low clinical
effectiveness or of ‘lower value’, are being used by PCTs to limit access to certain procedures.”
It adds: “Review of the lists reveals that there is little or no evidence to support the view that many of the procedures are of limited value to individual patients.”
The Department of Health said that following an £11.5bn invest- ment in the NHS, there is “no excuse” for waiting times to rise.
A
high-profile group of 42 doctors who head up
consortia representing around 1,110 practices have written a letter expressing their “wholehearted support” for the Government’s health reforms.
They wrote: “The reforms are not revolutionary but an evolution. Our patients should feel comfortable that decisions about the local provision of healthcare are to be taken in future by their family doctors, many
of whom they know personally. We caution the coalition of the danger of confusing and diluting the responsibility for effecting change in any amendments to the current proposals.”
In their letter, published by the Daily Telegraph newspaper in May, they added: “Now that there are considerable financial constraints nationally, difficult decisions will have to be made on the provision of care. Surely it is better that these
decisions
are
taken
locally
by
professionals in daily contact with the patients who will be affected by them, rather than by remote administrators.”
The message from those doc- tors already part of consortia con- tradicts the stance of the BMA and
Royal College of General
Practitioners, both of which have strong reservations about the Health and Social Care Bill in its current form and have spoken out
strongly against it. The RCGP has warned that the proposals could ef- fectively dismantle the NHS as an organisation, leaving it as a “brand name only”.
The Royal College of GPs has writ- ten to the Prime Minister outlining “serious concerns” regarding as- pects of the proposals and offering nine detailed recommendations, many centred on ensuring the NHS remains a comprehensive and free system.
N
ing cutbacks in
early two-thirds of specialist nurses have reported see- their
speciality,
despite Government pledges to protect NHS spending.
A Royal College of Nursing survey of 777 specialist nurses shows that 62% are seeing cutbacks in their specialty and 38% are having to cover staff shortages outside
their specialist area.
Dr Peter Carter, RCN chief execu- tive and general secretary, said: “Innovative nurse-led schemes, which not only improve patient care but also save money, are the future of the NHS. They pro- vide high quality care and many of them could easily be rolled out across the health service, saving
millions of pounds. In many in- stances, care can be best man- aged by community-based servic- es, with as little hospital involve- ment as possible.
“The demand for their services is growing all the time – a recent survey showed that referrals have gone from 250,000 in 2006 to 1.2 million in 2010. Given that more
and more people are living
for
many years with conditions such as cancer, the NHS should be pri- oritising the care which patients find so valuable, especially as it saves so much money.”
Around 11% of nurses in the sur- vey said they faced redundancy and 80% said financial pressures were affecting patient care.
P
arents are increasingly by- passing GPs and taking
children to hospitals’ A&E de- partments for non-emergency treatment. Researchers from Nottingham Children’s Hospital and the Queen’s Medical Centre, Nottingham University, studied the records of approxi- mately 39,000 children attending A&E in 2007/08, and compared them with records from ten years
earlier. The study, published in the Emergency Medical Journal, revealed that 85% had medical problems such as breathing dif- ficulties, a fever, diarrhoea, a rash or a cough. This was 42% higher compared to ten years ago when 10,369 children attended for similar reasons. Researchers told the EMJ that difficulty access- ing out-of-hours GP care may be to blame. GPs are no longer
8 | national health executive May/Jun 11
obliged to provide out-of-hours care and advice to worried par- ents, with large private companies now generally contracted to pro- vide this instead. President of the College of Emergency Medicine, John Heyworth, believes this has caused some confusion for pa- tients, making it harder for them to access care in some cases.
He said: “Parents have found in
the last few years that access- ing primary care is more difficult than previously.We need to change that. There’s a desperate need for better access in hours but particu- larly at weekends and evenings.”
Heyworth concluded: “Out-of- hours care is extremely variable in terms of promptness of response and the level of reassurance given to patients.”
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