FREE TO HCSA MEMBERS, FROM FOUNDATION TO CONSULTANT AUTUMN-WINTER 2018 THE HOSPITAL CONSULTANT & SPECIALIST WHERE NEXT ON DOCTORS’ PAY? 11 12 BAWA-GARBA: GMC HAS QUESTIONS TO ANSWER DOCTORS WANTED: JOIN OUR BIG PUSH ADVICE: SOCIAL MEDIA SURVIVAL WHY BUSINESS AS USUAL IS NO LONGER AN OPTION: P2-5 JOURNAL OF HCSA: THE PROFESSIONAL ASSOCIATION AND TRADE UNION FOR HOSPITAL DOCTORS HCSA MEMBERS MAKE HISTORY Introducing: your 2019 president PAGE 10 8
Transcript
FREE TO HCSA MEMBERS, FROM FOUNDATION TO CONSULTANT AUTUMN-WINTER 2018The HOSPITALCONSULTANT& SPECIALIST
WHERE NEXT ON
DOCTORS’ PAY?
11 12BAWA-GARBA: GMC HASQUESTIONS TO ANSWER
DOCTORS WANTED:JOIN OUR BIG PUSH
ADVICE: SOCIAL MEDIA SURVIVAL
WHY BUSINESS AS USUAL IS NO LONGER AN OPTION: P2-5
JOURNAL OF HCSA: THE PROFESSIONAL ASSOCIATION AND TRADE UNION FOR HOSPITAL DOCTORS
HCSA MEMBERS MAKE HISTORY
Introducing: your 2019 president PAGe 10
8
The HOSPITAL CONSULTANT& SPECIALISTmagazine of the Hospital Consultants and Specialists Association
Editorial: Richard Bagley
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H ospital doctors were left to stew for several months prior to receiving the government’s pay offering. The outcome is
desperately poor, with even the inde-pendent pay review body’s conserva-tive proposals being sidelined.
The suggestion that somehow this six-month deal, to be implemented in Octo-ber and therefore again below inflation for all grades, is fair reward for medical staff is no less than an insult.
HCSA’s quite reasonable proposal was that any rise should match RPI inflation, as a way to begin to tackle the erosion of over nearly a decade of pay restraint.
While rejecting this figure, reached following wide consultation with HCSA members, the DDRB did acknowledge many of the concerns we raised.
Pay packets have fallen by around 20 per cent in real terms over that period. The DDRB recognised the scale and pace of this decline, and it admitted seeing mounting evidence of issues in retention and recruitment.
Its conservative conclusion was that a 2 per cent rise, roughly equivalent to projected CPI inflation, was required this year in a bid to keep pay levels “stable.”
While it is HCSA’s contention that the DDRB position of a 2 per cent rise, rising to 3.5 per cent for SAS doctors, was insuf-ficient, the government’s response was a quantum leap worse.
The Department’s justification, we un-derstand, was that there was insufficient funding in place for Trusts to bridge the gap between the Treasury position of 1 per cent and the additional cost of the pay review body’s recommendation.
But why force the additional costs onto Trusts in the first place? Any workable government plan for health should clearly consider the workforce required to oper-ate services.
By contrast, in recent years it has seen medical staff as a piggy-bank from which
I t was with no great relish that HCSA rejected NHS Employer overtures
to sign a deal on the future of Clini-cal Excellence Awards which has been hailed by the BMA as a major victory for consultants.
Our very real fear is that in return for a few short-lived incentives, CEAs will now mutate into an annual bonus scheme with criteria, dictated by Trust man-agement, based on a narrow range of targets.
While there are undoubtedly issues with the fairness and application of CEAs in their current form, the prospect now is
The HOSPITALCONSULTANT& SPECIALIST
Contents2-3: President’s View4-5: News: Pay award/HCSA706: News: Bawa-Garba/Juniors8-9: Comment: Bawa-Garba10: Interview: Next president11: In Focus: Recognition push12: In Focus: Mis-sold pensions13: In Focus: HCSA Concierge14: Advice: Social media15: Viewpoint: Choosing CESR16-17: NHS News18: And finally... | Sudoku
Autumn-Winter 2018 The HOSPITAL CONSULTANT & SPECIALIST
to extract savings.Effectively the government, by squeez-
ing down pay rates, has been milking the medical workforce to fund its “efficiency savings” over many years. It appears in-tent on continuing to do so.
This in turn has fuelled a locum and temporary staff economy that makes no sense for an NHS tightening the purse strings, and if overused can be destabilis-ing and demoralising for permanent staff.
The government’s failure to acknowl-edge the role of pay in fuelling the cur-rent vacancies crisis, the rapidly growing tendency towards early retirement among our most experienced doctors, and worry-ing dropout levels among trainees, is truly shocking.
The fact that he attempted to dress up further real-terms pay cuts as a generous pay rise has done the new Secretary of State no favours at all.
He will need to work hard to build the bridges with staff that he claims to wish to. That means taking on the might of the Treasury too.
In the meantime, the current callous disregard for medical workforces, who are facing the squeeze in every area, is likely to come back to bite the policy-makers responsible, not just in fuelling the prob-lems within retention and recruitment
but also in the growing rebelliousness of doctors.
The government has indicated its de-sire to press on with “reform” of the Con-sultant and SAS contracts, dangling the carrot of a multi-year package for pay.
Given the ongoing erosion of salaries and the general approach towards medics, it would be naive to expect hospital doc-tors merely to fall in line with its plans.
N HS funding has once again been in the spotlight, this time in
more welcome terms with the Prime Minister at last signalling the end of uncertainty for our health service.
The proposed £20 billion funding boost for England to 2024, matched elsewhere in the UK, marks a refreshing change to a string of “one-off bungs and bail-outs,” as the Nuffield Trust put it.
But, as with every announcement on health, from whichever political party, it pays dividends to scratch a little deeper.
Key questions remain. At an average of 3.4 per cent, front loaded, this plan falls some way short of the 4 per cent rises identified by leading health think tanks the King’s Fund, Health Foun-dation and Nuffield Trust. The 4 per cent figure is based on the belief the NHS needs to recover from years of extreme belt-tightening.
Which highlights another unan-swered question: how the rest of the health budget will fare – training, public health, and
President’s View
the worst possible outcome of all: their conversion into a pure management control mechanism.
It is to be hoped that this fear is unfounded, of course – there will be little satisfaction to be had in saying: “We told you so.” Yet clauses in the deal are a signpost.
Short-term arrangements will protect current recipients, but other clauses threaten a fait accompli on the replace-ment of CEAs before negotiations on national standards have even begun.
It will be a “performance” scheme, and crucially variations can be intro-duced by employers with local consulta-
tion – not the same as negotiation, and enshrining in black and white the right of Trusts locally to undermine any new national agreement.
HCSA maintained that as CEAs are part of the overall wage bill for Consultants, reform should be agreed under the aegis of any new contract as a whole.
Unfortunately the other negotiating parties seem intent and content respec-tively to approach negotiations in a piecemeal way, which threatens a worse overall outcome for doctors.
The CEAs deal truly is a “dog’s dinner”, and I predict it won’t be long before the profession at large begins to realise this.
The HOSPITALCONSULTANT& SPECIALIST
The HOSPITAL CONSULTANT & SPECIALIST Autumn-Winter 2018 3
Pay decline cannot go onhCSA President Professor Ross Welch says the government should not underestimate doctors’ anger in the wake of another real-terms wage cut
Action at last on NhS funding
CONTINUeD ON PAGe 8 ➦
The HOSPITALCONSULTANT& SPECIALIST News
H CSA has supported calls for radical reform to the mecha-nism deciding hospital doc-tors’ pay after the latest be-
low-inflation package was announced by the government.
Following a decade of real-terms wage decline, pay review body the DDRB rec-ommended the government end its 1 per cent policy. It urged an uplift of 2 per cent for all grades, and an additional 1.5 per cent for SAS doctors, backdated to April.
While a change from the previous tone, this recom-mendation still fell substantially short of HCSA’s call for a 3.9 per cent rise to ac-knowledge the damaging long-term slide in hospital doctors’ salaries.
However, in England, the government rejected even the DDRB’s conservative recommendation – instead imposing a rises of 1.5 per cent for Consultants, 2 per cent for training grades, and 3 per cent for SAS doctors. Crucially, the decision to implement on October 1st instead of
backdating to April means the actual val-ue over the year is halved. CEAs were also excluded from the uplift.
In Scotland, the pay settlement reflect-ed those for other public sector work-ers, with doctors earning below £80,000 receiving a fully backdated rise of 3 per cent, and those above a flat £1,600.
Hospital doctors are not alone in ex-pressing their concerns at the decision
to ignore even the independent pay review body recom-mendations. At the Trades Union Con-gress in Manches-ter, HCSA spoke in support of a motion initially tabled by the Prison Officers
Association which called the current re-view framework into question and urged a new system of direct negotiation with employers.
Addressing hundreds of delegates, HCSA Executive member Dr Paul Don-aldson warned: “In the last few years, we have seen our review body approached to consider changes to the working pat-tern of doctors, by a government intent on pushing through changes by seeking
H CSA Scotland has urged the Scot-tish Government to heed its call
for a hospital doctor staffing task force, branding the 2018-19 pay award for medics “a wasted opportunity.”
In Scotland, the pay settlement reflect-ed those for other public sector work-ers, with doctors earning below £80,000 receiving a fully backdated rise of 3 per
cent, and those above a flat £1,600.While acknowledging a notable im-
provement on the award for doctors in England, HCSA Scotland Executive mem-ber Dr Bernhard Heidemann warned: “This pay award is another real-terms pay cut for all grades that will do little to address the difficulties NHS Scotland already faces in recruiting hospital doc-tors.
Scottish award ‘a wasted opportunity’ to tackle hospital vacancies crisis
Fresh salary blow poses questions on DDRB’s future
4 Autumn-Winter 2018 The HOSPITAL CONSULTANT & SPECIALIST
hCSA seeks members’ views on pay review mechanism after latest real-terms wage cut imposed on doctors
Members are now being asked to give
us their perspective on the future of hospital doctors’ pay
O ctober 12th will see a day of cel-ebration and learning in London
when the Royal College of Physicians plays host to HCSA’s 70th anniversary conference.
Places have been quickly snapped up for the free event, which will see attend-ees informed and engaged, with ses-sions on Contract reform, medico-legal developments, technology, the future workforce and workplace well-being.
A series of breakout discussions will allow attendees to discuss and learn from experts on issues such as Clinical Excellence Awards, bullying, and speak-ing up in the NHS, as well as discuss the challenges facing trainee grades.
There will also be opportunities to network and meet HCSA Executive, Council and National Officers on the day, with a free lunch provided. The event starts at 9.30am and will finish
at around 4.30pm. Please note: this event is free but If you wish to
attend you will need to book your place online via Event-
brite. Find out more details via the HCSA
website at www.hcsa.com/
HCSA70.
hCSA invites members to mark 70th
FREE EVENT
www.hcsa.com/hCSA70
October 12th Royal College of Physicians, London
hospital doctors: What does the future hold?
NewsThe HOSPITALCONSULTANT& SPECIALIST
In Brief
Scottish award ‘a wasted opportunity’ to tackle hospital vacancies crisis
Fresh salary blow poses questions on DDRB’s future
The HOSPITAL CONSULTANT & SPECIALIST Autumn-Winter 2018 5
the endorsement of a putatively inde-pendent body. The DDRB have dutifully endorsed its proposed changes and it has handed them down for implementation by employers.
“Unsurprisingly, confidence has been shaken in the impartiality of the pay re-view body. While claiming to be driven by the recruitment to and retention in the profession, the review body awards have done preciously little to this end.
“It appears that the review body has embraced as unchallengeable the gov-ernment’s pay policies over the years, leaving doctors to question: what is the point of its existence?”
Members are now being asked to give us their perspective on the future of hos-
pital doctors’ pay in order to inform the association’s position. In a written state-ment announcing the 2018-19 pay award in July, Secretary of State Matt Hancock signalled the direction of government thinking.
“I am committing to negotiations on a multi-year agreement incorporating contract reform for consultants to begin from 2019/20,” he wrote.
HCSA’s initial view on this plan was stated in a message to members: “His deci-sion to cut an already inadequate DDRB-recommended award to Consultants and Junior Doctors does not bode well for his aims to conclude such a deal. HCSA will certainly not agree to lock hospital doctors into several years of real-terms pay cuts.”
“This is not just about individuals’ pay. Wages in Scotland do not operate in a vac-uum, and the difficulties, particularly in far-flung parts of the country, in recruit-ing and retaining medical staff should be a major concern shaping pay policy.
“Consultant shortages trebled to 430 between 2010 and 2017, and the decision to again suppress wages is a wasted op-portunity to address this problem.
“We call on the Scottish government and BMA to join with us in a task force, as endorsed by the Scottish TUC, to address the reasons behind the difficulties re-cruiting and retaining hospital doctors.”
HCSA is calling for a dedicated Scottish government task force, involving doctors’ unions, to identify current causes of vacan-cies, predict future challenges, and agree an action plan to tackle the issues raised.
Association members have made his-tory by electing their first ever woman president.
Dr Claudia Paoloni (pictured), a Consultant Anaesthetist based in Bristol, will take up the post next April when Professor Ross Welch ends his term.
She said of her election: “When I joined the HCSA as a newly ap-pointed Consult-ant, I was drawn to the specific knowledge, under-standing and focus that the HCSA had for hospital doctors.
“I am delighted to have been elected future president to the HCSA and look forward to continuing the excellent progress achieved under Ross Welch, including the expansion of our membership to include all post-graduate Trainee grades and the recognition of the HCSA by NHS Employers for contract negotiations and collective bargaining.”
Dr Paoloni was elected by mem-bers at the HCSA AGM, which took place in Cardiff in April.
HCSA MAKES HISTORY WITH FIRST WOMAN PRESIDENT
The HCSA’s finance committee agreed over the summer to freeze subscrip-tion rates for members in an acknowl-edgement of growing pressure on salaries. The 2018-19 rates, for the year October 1st-September 30th, will be unchanged as follows:
ANNUALFoundation: £100Core or Specialty Trainee: £110Full: £290
MONThLYFoundation: £8.50Core or Specialty Trainee: £9.50Full: £24.50
MEMBERSHIP RATES FROZEN FOR 2018-19
PAY BROADSIDE: HCSA’s Dr Paul Donaldson speaks in Manchester
H CSA has robustly defended the rights of hospital doctors in the wake of the General
Medical Council’s handling of the case of Dr Hadiza Bawa-Garba.
In July, the junior doctor successfully appealed against her striking off – the culmination of a campaign funded by grass-roots donations, with the judges ruling that the GMC’s Medical Practi-tioners Tribunal Service was indeed the correct body to decide her profes-sional competency.
We have submitted evidence to both the “rapid review” into the ramifications of her treatment led by Professor Sir Norman Williams, and the GMC’s own probe, now led by Leslie Hamilton.
HCSA has called, among other points, for a system of legal “quaran-tine” for trainees, full legal protection for doctors’ reflections, a mandatory induction process, and an end to both the adversarial approach facing indi-viduals and the overreliance on single “experts”. We also called for protected SPA time to allow proper support and supervision of juniors by Consultants, in contrast to the current squeeze.
Many of Williams’s recommenda-tions in June have not yet been imple-mented, not least the removal of the GMC’s ability to appeal MPTS findings.
Other recommendations include:n A call to prevent the GMC requiring doctors facing fitness-to-practise pro-ceedings to provide reflective materialn That an investigation be held into concerns at the over-representation of black, Asian and minority ethnic healthcare professionals in fitness to practise casesn That systemic issues and human fac-tors should be considered alongside individual errors.
HCSA is now working with other interested parties to ensure that the key findings are enacted.
Ramifications of Bawa-Garba still unfolding
COMMeNT: Dr John West on Page 8 ➦
6 Autumn-Winter 2018 The HOSPITAL CONSULTANT & SPECIALIST
The HOSPITALCONSULTANT& SPECIALIST News
H CSA has issued a powerful warning on the continued pressure faced by doctors trying to balance family
and work.
Council member Dr Charlotte Elliot highlighted the impact of the drive to “seven-day” working forced upon junior doctors via the 2016 contract which “neglects to see doctors as hu-man beings.”
“I know of one doctor who was in tears as she was being forced to work weekends – the only quality time she had with her son,” she told delegates to the TUC Women’s conference in London.
“One of my close friends has left medicine altogether as she could not manage her training and two young children.
“Getting a flexible childminder was a
constant worry. Finishing in time was a constant challenge, and pressures from work would impact on her sleep and wellbeing.”
Dr Elliot added: “There exists a gen-der imbalance and I am confident one reason for this is poor access to flexible working coupled with the role of wom-en as carers for their families.
“I am 30, but I would like to have children. But I fear I will fall behind my peers, be penalised for taking time out, and be used to plug rota gaps.
“My wish is that I am no longer seen as just a number or name on a rota, but respected, valued and viewed as an ac-tual human being.”
Dr Elliot was speaking in support of a motion on “Achieving work-life bal-ance in the NHS,” which was moved by the Royal College of Midwives and the Chartered Society of Physiotherapy.
Seven-day contract robbing family timeDr Charlotte Elliot warns of the negative impact of the new junior doctors’ rotas on work-life balance
Against all of this is the eco-nomic and political uncertainty of Brexit.
More details will emerge over the autumn, when a new 10-year plan for health and Social Care green paper is scheduled for pub-lication.
However, HCSA has already made clear our view that addition-al funds must be channelled into addressing workforce issues and front-line services, not squandered on more layers of bureaucracy and interminable restructuring.
We are also concerned that there may be a sting in the tail in terms of both the strings attached in return and the source of the increase, where tax changes could impact negatively on many doc-tors.
All will be revealed, we are told, at the 2019 Spending Review.
Certainly any “plan” must in-clude concerted measures to boost recruitment and retention – and that means real rises to pay as well as improved working conditions.
Over coming months, it will become clear whether health policy-makers grasp the scale of the problems being built up by the relentless squeeze on medical staff.
Until then, hospital doctors, who have suffered years of pay
decline and are often papering over the cracks of unfilled
vacancies, should be for-given for greeting this
announcement with a healthy dose of
scepticism.
➥ CONTINUeD FROM PAGe 3
8 Autumn-Winter 2018 The HOSPITAL CONSULTANT & SPECIALIST
CommentThe HOSPITALCONSULTANT& SPECIALIST
Y ou could almost sense the relief at the GMC after Pro-fessor Norman Williams’s rapid review on Medical
Gross Negligence Manslaughter re-ported back in June.
But if his findings temporarily low-ered the heat around junior Dr Hadiza Bawa-Garba’s striking off by the High Court, her successful appeal in July placed the regulator in whose name the prosecution had been fought, and its Chief Executive Charlie Massey, firmly back on the hotplate.
Scrutiny now falls on the decisions which led the GMC to drag the young paediatrician through the courts in February, a course of action which placed it on a collision course with its own tribunal, the MPTS, which had earlier found her fit to practise.
At the time, then secretary of state Jeremy Hunt tweeted that he was “to-tally perplexed” by the GMC’s deci-sion to appeal its own independent tribunal’s proposed sanction of Dr Bawa-Garba’s Medical Licence.
He commissioned the Williams re-view, to which HCSA was a contribu-tor. Its report was published on 11th June.
In an earlier interview with Pulse magazine, Massey claimed he him-self was “perplexed” that Hunt was perplexed and commissioned his own separate review, originally chaired by Dame Clare Marx.
Thus, the GMC potentially finds itself in a spiral of misunderstanding and conflict with Williams, its own MPTS, and the profession it purports to regulate.
Although Massey has begrudgingly issued an apology to the profession over the case, conspicuously absent has been any acknowledgment that
the GMC was simply mistaken in the decision to appeal its own
tribunal service.Instead, he has maintained that the
GMC had taken “legal advice” which apparently mandated the appeal to the High Court. To date Massey has not elaborated as to why the GMC was so legally compelled.
Freedom of Information requests show that the “advice” was prepared at a cost of £2,000 by Ivan Hare QC, who then went on to represent the GMC in the High Court hearing.
The same FoI request shows that the decision to proceed was taken at executive level by Massey alone, with-out reference to the GMC Council, of which Professor Terence Stephenson is chair.
It was also taken, despite the poten-
Mastery is a blind alleyAfter Dr hadiza Bawa-Garba’s successful appeal to remain registered, the GMC’s CeO should now reflect on his key role in a disastrous episode, argues Dr John West
“Since, moreover, he cannot renounce mastery and become a slave again, the eternal destiny of masters is to live unsatisfied… ”The Rebel: An Essay on Man in Revolt by Albert Camus
It’s a legal requirement that HCSA maintain up-to-date records on members. You can help us comply by letting us know when your details change via [email protected] or by logging in at www.hcsa.com
Changed workplaceor moved house?
The HOSPITAL CONSULTANT & SPECIALIST Autumn-Winter 2018 9
CommentThe HOSPITALCONSULTANT& SPECIALIST
tial significance for the entire profession, without seeking a second independent legal opinion.
If this unilateralist approach to such an important matter is shocking, the tone of the assault levelled at Dr Bawa-Garba in pressing home the GMC case was more so.
Even at the appeal hearing in July the regulator’s defence of its position, put forward by Hare, amounted to a personal attack on the doctor and her integrity, in stark contrast to the more logical argu-ments put forward by her QC which ulti-mately won the day.
Perhaps Massey’s political ineptitude, and a seemingly “star struck” attitude to a single barrister’s opinion, reflects the fact that he lacks an understanding of his role
as the head of an independent regulator.Instead of seeking to resolve matters
by offering to resign from his lucrative post, allowing a fresh start, Massey has responded by stating that the GMC is a “creature of statute” which finds itself trapped in a framework of outdated leg-islation with no flexibility to act.
This position is contradicted by the commissioning of the Marx review, now led by Professor Leslie Hamilton after its previous lead was appointed the next GMC chair. One must assume that this review has been briefed to find the leg-islative and operational flexibility which Massey and the GMC have as yet failed to identify.
With Dr Bawa-Garba’s appeal success-ful, it is time to reflect on the position in
which Massey has landed himself and the GMC, and our response as a professional association representing all grades of hospital doctors.
Massey has been GMC chief executive and registrar since November 2016. He was a career civil servant, having previ-ously worked in the Treasury, Cabinet Office, Department for Work and Pen-sions, Pensions Regulator and the De-partment of Social Security. He was then director general for strategy and external relations at the Department of Health.
He came to prominence to the medical profession in February 2016 after a par-ticularly unconvincing performance as Hunt’s stand-in at a parliamentary select committee hearing, widely shared on so-cial media, examining workforce propos-als for a 24/7 NHS.
Massey’s GMC salary is between £230,000 and £235,000 per annum. He also receives a defined contributory pen-sion worth 12 per cent of salary. This generosity of salary and benefits may perhaps explain the gilded cage in which Massey finds himself trapped.
It appears from the Bawa-Garba con-troversy, and other recent cases, that Massey’s GMC has become over-depend-ent on the opinion of “experts” from both the legal and medical professions. This legalistic approach has created a culture clash in that the legal process often de-mands a “winner” and “loser,” when in fact the complex, team-based nature of contemporary medical practice is far less black and white.
In his interview with Pulse magazine, Massey may have belatedly recognised this, but his response is to consider re-cruiting even more self-appointed “ex-perts, this time in Human Factors”.
Whether Massey and the GMC can extricate themselves from this self-in-flicted damage remains to be seen. HCSA believes the issue highlights the need for wider reform and consolidation of the regulatory sector.
It appears that few doctors would mourn the loss of the GMC, which has a lot of work to do to rebuild trust.
It remains to be seen if the current leadership can achieve this. What is for sure is that repeated “mea culpas” are not enough.
Dr John West chairs the HCSA Commu-nications Committee.
Mastery is a blind alleyAfter Dr hadiza Bawa-Garba’s successful appeal to remain registered, the GMC’s CeO should now reflect on his key role in a disastrous episode, argues Dr John West
In FocusThe HOSPITALCONSULTANT& SPECIALIST
10 Autumn-Winter 2018 The HOSPITAL CONSULTANT & SPECIALIST
seeing its diseases and being part of the amaz-ing science that enables us to cure and support individuals of their illnesses.
AND WHAT THINgS MAKE IT DIFFICulT?Stress through lack of time and working to meet indiscriminate financially driven targets is the worst part of the job. As a clinician you want to be able to offer the best possible care to patients. You need time to be able to do so and to be able to develop and improve that care.
Science progresses and new techniques and medicines develop. More possibilities of treat-ment arise, but financial constraints prevent you from progressing or even meeting the current demands of the job.
Too much time is spent on the administra-tion and delivery of service restructure with the aim of driving “efficiency” or “productivity,” but which ironically causes more delays or problems.
Decisions are often made with little relevant
hCSA members have endorsed the Association’s first woman President in its 70-year history.Current chair Dr ClaudiaPaoloni, a ConsultantAnaesthetist at University hospital Bristol, will begin her three-year term in 2019.We caught up with her following her election.
WHAT DO YOu DO IN YOuR ‘DAY jOB’?I have been a Consultant Anaesthetist at Uni-versity Hospital Bristol since 1991. I specialise in Thoracic anaesthesia and Perioperative Medi-cine. I have been fortunate enough to have been able to introduce and implement several major transformational changes within our Trust with excellent support from our Trust executive, ben-efiting patient care and hospital efficiency.
The skill set required to be a certified civil and commercial mediator have also been useful along the way!
WHAT INSPIRED YOu TO CHOOSE A CAREER IN MEDICINE IN THE FIRST PlACE?I was the first in my family to follow a medical career and fell into it through a combination of loving science at school and seeking the advice of my mother when choosing a career. Both my par-ents were restauranteurs and built their business up from scratch, having left school at 16. When I asked my mother what I should do as a career she was very clear of my options: “My darling, there are really only three choices: medicine, account-ancy and law – so choose from them.” Being the dutiful daughter I chose one, the one that was most associated with my love for science. I have never regretted that choice.
WHAT DO YOu lOVE ABOuT THE jOB?Seventeen years on from qualification and I still do not tire of watching the human body work,
Introducing... the HCSA’snew President-elect
Too much time is
spent on service restructure with the aim of ‘efficiency’ which then causes more problems
In FocusThe HOSPITALCONSULTANT& SPECIALIST
The HOSPITAL CONSULTANT & SPECIALIST Autumn-Winter 2018 11
Introducing... the HCSA’snew President-elect
input from the clinicians undertaking the work, which is also extremely frustrating as generally, whereas managers change regularly, the clini-cians remain for many years and have a wealth of experience that is not utilised enough.
DO WOMEN DOCTORS HAVE IT EASIER OR TOugHER THAN THEY uSED TO?Historically I think women have found it harder to compete with their male counterparts and often found themselves having to “prove them-selves” over and above male colleagues to other male colleagues.
I think now, with more women being success-fully present in all the previously male-domi-nated fields of medicine such as surgery and ac-cident and emergency, management and indeed hospital medicine as a whole, there has been a much greater acceptance of women in these ar-eas by their male counterparts.
There is still undoubtedly an element of eye rolling and sighing that goes hand in hand with any request for family-friendly working terms that I believe should be increasingly available.
HOW IS YOuR OWN WORK-lIFE BAlANCE?I enjoy being a mother of three boys, so spend much of my time at the side of football pitches and swimming pools cheering the children on.
We are an active sporty family who enjoy being outside and playing sport or being on the water.
I think being an active mother of young chil-dren actually keeps me more balanced and dis-tracted from overly focusing on the stresses caused through working in the NHS, which makes me more able to do my job. This is why I am so keen in the NHS embracing family-friend-ly policies and terms of working.
HOW SIgNIFICANT IS IT THAT HCSA HAS ElECTED A WOMAN lEADER?It reflects a change in culture within the Associa-tion – how it is embracing modernisation and its relevancy to the current workforce in medicine.
The workforce is increasingly female and, with that, new challenges arise for us in providing support and advice to employees and employers alike – both are important in order to achieve a sustainable, motivated and successful workforce for the future.
Doctors needed to join local recognition pushDr Umesh Udeshi explains what fellow hCSA members can do to make their voice heard
A Midlands Consultant who helped HCSA secure local
bargaining rights at Worcester-shire Acute Hospitals NHS Trust has urged fellow members to do the same to ensure their voice is heard in direct negotiations with employers.
HCSA has been a growing force in the Trust, which encompasses hospitals in Worcester, Redditch and Kidderminster.
Much of the growth locally has been down to the tireless work of HCSA ex-president Dr Umesh Udeshi, a former medical director and currently chair of the Trust Lo-cal Negotiating Committee (LNC).
The agreement in the Midlands is the latest dividend from the Association’s ongoing campaign to secure negotiating rights for members locally.
Dr Udeshi, a Consultant Ra-diologist, said: “We have good numbers of doctors in our Trust who are HCSA members and they now have direct representation in negotiations with the Trust.
“Increasing numbers of doctors contact me to talk about issues they may have with terms and conditions or other aspects of their work/employment. Some-times, they are not members of a trade union, feeling that they do not need to be members as they are not involved in ‘politics’ etc.
“This makes it very difficult to get professional help to them and I would urge all doctors to become members of a trade union. After all, it is too late to try and get car insurance after you have been in-volved in a road traffic collision!”
Over the summer HCSA took
its place for the first time at the Trust’s Medical Management Committee. HCSA National Of-ficer Rob Quick was present.
“We are now better placed to speak up on behalf of local doc-tors in the Trust,” said Quick. “On recent visits, I have been involved in advising members on job plan-ning and contract issues, and the implications for service redesign.
“We were very happy to support the LNC’s call for reinstatement of the Associate Specialist grade, and we agreed a joint statement on SAS doctors’ autonomy.”
Dr Udeshi emphasised that HCSA members have a key role to play in securing similar bargain-ing rights at their own Trusts.
“They can help to get recognition locally by contacting their HCSA local representative and finding out whether local recognition has been requested or granted.
“If there is no local rep, mem-bers can volunteer and receive training and help from the HCSA.
“Also, members can help by volunteering for membership of their LNC, and the HCSA can also provide training for this.”
LEADING THE CHARGE: Dr Umesh Udeshi
High policy charges, commissions paid to the advisers and poor investment per-formance have resulted in FSAVC plans only providing a fraction of the returns indicated when sold.
If that wasn’t bad enough, the reduc-tion in lifetime allowance and the intro-duction of the tapered annual allowance, subjects to be discussed separately, have further worsened the situation.
Financial advisers were legally obliged to point out other, often much better, op-tions to boost income in retirement. How-ever because they were paid large com-missions by the FSAVC providers many of them failed to do so.
In the mid-’90s I unfortunately took
M any people will never have heard of FSAVC pension plans. FSAVC stands for Free-Standing Additional Volun-
tary Contributions, and the schemes were meant for employees to boost their pensions.
In the 1990s doctors were a prime target for financial advisers selling these plans.
If you’ve never heard of FSAVCs, you are unlikely to have one or to have the problems associated with them.
The sales pitch was that, if you did not manage to complete 40 years of service to qualify for a full NHS pension, the FSAVC would make up for that shortfall.
1990s pension ‘top-up’ paying less than it cost
In FocusThe HOSPITALCONSULTANT& SPECIALIST
Doctors were key targets for FSAVC scheme salesmen, writes Dr Bernhard Heidemann
The HOSPITAL CONSULTANT & SPECIALIST Autumn-Winter 2018 13
In FocusThe HOSPITALCONSULTANT& SPECIALIST
J oining HCSA automatically gives you access to HCSA Concierge,
which provides extra value to your membership with a range of discounts and savings.
A wide variety of offers are available to you, which change from time to time.
As part of a commitment to exclusive savings, HCSA Concierge now features a special offers section which gets up-dated monthly.
So, whatever you need, it pays to take a look to see how you could save.
To access the savings portal, you first need to log in to the website using your username and password. Some of the offers available include:
UP TO 40% DISCOUNT ON CINeMA TICkeTSCatch the latest releases and save up to 40% at nationwide
cinemas*.
DISCOUNTS AT OVeR 3,200 GYMS NATIONWIDeSave on memberships with MyGym Discounts at local
gyms, leisure centres and health clubs*.
BOOk YOUR NexT hOLIDAY FOR LeSSTake advantage of discounts on mini-getaways, car hire, cur-
rency exchange and package holidays*.
SAVe ON YOUR eVeRYDAY ShOPPINGAs an HCSA member, you can also make use of MyCash-
backCards, which gives you cashback on your everyday purchases. This is a fantastic way to make the most of your money – both online and in-store.
MyCashbackCards provide reload-able shopping cards which earn you cashback of between 3 per cent and 12.5 per cent at major retailers such as Sainsbury’s, Tesco, H Samuel, B&Q and Argos.
Every time you load funds onto your cards, the cashback will be paid into your cashback account. This can be loaded back onto your cards to pay for more shopping, or you can accumulate it to pay for special occasions such as holidays or Christmas*.
Access these and many more benefits on HCSA Concierge via www.hcsa.com
Don’t miss out on
out such a policy. When, about two years ago, I looked at the projected return, it became evident that I would have to draw my pension from that plan for about 40 years just to get back the amount I had originally invested.
At this point I went back to the original advice I was given and started researching the matter.
Very quickly it became clear that I had been very badly advised, and deliberately so. However, the company providing the advice had gone out of business in the in-tervening years and so initially I though all was lost.
There are quite a few companies who will provide assistance to customers wanting to claim compensation for mis-sold pension plans. Some of the names will be familiar as they also offer to claim compensation for PPI.
Anyone handling a claim for a client will take a percentage of the compensa-tion, often in the region of 30 per cent plus VAT.
After speaking to several of these companies I eventually settled for a one-person business, as the advice I received seemed tailored to my personal circum-stances. Furthermore, there were no ex-travagant claims as to how much compen-sation I could expect and the commission asked for was at the more realistic end.
My circumstances were further compli-cated by having moved from NHS super-annuation to university superannuation and back.
Due to this complexity, the whole proc-ess took almost two years. Finally, though, I was awarded a substantial sum in com-pensation and I feel that I have received some redress.
Although a poor decision in the past cannot be reversed, the effects can be ameliorated. It pays not to give up, and to obtain expert advice tailored to your cir-cumstances.
Dr Bernhard Heidemann is HCSA Treas-urer and Chairman of the HCSA Finance Subcommittee
*Terms and conditions apply to all benefits. See website for details. Offers correct at time of print. The Cinema Society - Discounts vary between cinema venues. Please check when purchasing vouchers. Registration to The Cinema Society is required to access discount. HCSA Concierge is managed and run on behalf of HCSA by Parliament Hill Ltd.
HCSAConcierge
T he medical world is rapid-ly transforming because of the use of technology. One of the most appealing ele-
ments of smartphones for medical professionals is the range of func-tions they perform. However, there is a thin line between what is ac-ceptable and what is inappropri-ate, and dangers are often only a thumb-swipe away.
With many doctors now using smart-phones and tablets for professional purposes, it is tempting to make use of file-sharing apps and websites to share clinical photographs with col-leagues. While this may appear to be a valuable way to converse about medical conditions with other doc-tors or to seek another professional opinion, the medicolegal risks could outweigh the benefits.
WhatsAppRecent press reports have acknowledged the wide-spread use of messaging
services such as WhatsApp by the medical profession. Widely perceived as being an encrypted “secure” way of sharing information, it is easy to see why utilising this technology can seem more efficient than an old-fash-ioned pager system. However, there is always a risk that messages contain-ing patient information are inadvert-ently sent to the wrong recipient or a doctor’s phone is left unlocked in a public place.
In addition, photographs sent via WhatsApp may also be automatically uploaded to an individual’s photo stream, perhaps on a desktop device to which other individuals have ac-cess. It is important to note that NHS Digital have made clear that What-sApp should never be used to share patient information. Doctors who do so face the risk of disciplinary ac-
tion and complaints in the event of a breach of data security.
TwitterPlatforms like Twitter are valuable for health-care discussions – cli-
nicians are able to easily interact and follow leaders in any area of medicine who distribute the latest medical news and information. But Twitter must never be used to share confidential information and doctors should be mindful of the GMC’s 2013 social media guidance, which states: “If you identify yourself as a doctor in publicly accessible social media, you should also identify yourself by name.”
FacebookSocial media sites blur the boundary between an in-dividual’s public and pro-
fessional life.It is important to note that both
employers and the GMC can take ac-tion in the event of an inappropriate post on Facebook.
Avoiding social media dangers
14 Autumn-Winter 2018 The HOSPITAL CONSULTANT & SPECIALIST
hospital Doctors are increasingly using social media and smartphone apps to connect. It pays to be informed on the risks, explains MPS legal adviser Dr James Thorpe
AdviceThe HOSPITALCONSULTANT& SPECIALIST
1 Maintain and protect patients’ infor-mation by not publishing any informa-
tion that could identify them on social media.
2 Maintain appropriate boundaries in the relationships you have with colleagues.
3 Comply with any internet and social media policy set out by your employer.
4 As a clinician, you have a responsibility to behave professionally and responsibly
both online and offline.
5 Your online image can impact on your professional life and you should not
post any information, including photo-graphs and videos, that may bring the profession into disrepute. Once you post a comment or photograph online you relin-quish control of that information, so think carefully before hitting send or upload.
6 Anything you post on social media is in the public domain and can be eas-
ily copied and redistributed without your knowledge.
7 You should presume that everything you share will be there permanently.
TEN THINgS TO REMEMBER WHEN uSINg SOCIAl MEDIA
For example, in 2009 a group of doctors and nurses were suspended for playing the “lying down game” while on night shift and posting
photographs on social media.Other doctors have been
disciplined for making inap-propriate comments regard-
ing colleagues or patients.Maintaining profes-
sional boundaries is another area where
difficulties can arise for junior doctors us-
ing social media. The GMC makes clear: “If
a patient contacts you about their care or other
professional matters through your private profile, you should
indicate that you cannot mix social and professional relationships and, where appropriate, direct them to your professional profile.”
Dr James Thorpe is a Medico-legal Adviser at Medical Protection. For more information, visit the MPS
website at www.medicalprotec-tion.org/uk
ViewpointsThe HOSPITALCONSULTANT& SPECIALIST
The alternative path to Consultant grade
The HOSPITAL CONSULTANT & SPECIALIST Autumn-Winter 2018 15
8 You should regularly review your privacy settings to ensure unintended audiences
do not access information. You should be aware that the default settings for Twitter are public – unlike Facebook, where mem-bers need to approve social connections.
9 Even the strictest privacy settings do not guarantee your information will
be kept secure. Both Facebook and Twit-ter allow various types of content to be shared beyond an individual’s network of friends.
10 Any information you post could be viewed by anyone, including your
patients, colleagues or employer.
emergency doctor Paul Robinson explains why he is taking a less usual route to senior grade – via the Certificate of eligibility for Specialist Registration
M y department lead winced, and had the good grace to look em-barrassed as I described
the teaching component of my third year of Core Training at a governance meeting.
I was pretty fed up. As part of the training contract, I was meant to re-ceive a full afternoon of structured teaching every two weeks. I was three-quarters of the way through the year and had received this twice.
Like many doctors, I am in part driven by an excited, bounding desire to learn, and the absence of structured education was hitting me hard. The unforgiving emergency medicine rota was taking its toll and my own learning – outside work – had stalled. I had been reduced to a machine of service provision, desperately stuffing cajoled as-sessments into my portfolio, and running into delayed outcomes at every Annual Review of Competence Progress (ARCP).
In searching for an alternative route to the Certificate of Comple-tion of Training (CCT), I recalled
some teaching delivered by an adventurous physician who had an-nounced to the lecture theatre she was qualifying by the “CESR” route – the Certificate of Eligibility for Specialist Registration.
It was prolonged, but she had a career scattered with fascinat-ing, interesting jobs. Unorthodox methods can be refreshing. So what did I do?
A consultant mentor (and now Trust Guardian) spoke to me about the process. “The only disadvan-tage,” he said, “is that it’s a lot of paperwork and it’s not transferable overseas. It’s unclear if that was intentional. They probably forgot.”
Training runs offer a structured approach to CCT with timetabled features and checklists. Writing one’s own book is more of a challenge. As the Twittersphere said, “Find your-self a mentor, a copy of your most recent syllabus, and start.”
Where there is a curriculum for a speciality, you already have a training framework. E-portfolios are available to many specialties as “associate” or “affiliate” of their college, allowing for an electronic
CONTINUeD ON PAGe 16 ➦
N EW Health and Social Care Secretary Matt Hancock has arrived at a crucial juncture.
The Institute for Government set out his top two “in-tray” challeng-es as thrashing out a 10-year plan for future funding and the integra-tion of health and social care.
Hancock sought to place clear water between himself and his predecessor with his first article, which highlighted low staff morale.
However, that mood music was undermined days later when he signed off on a pay deal for medical staff that will see all grades face an-other real-terms pay cut.
Hancock chose to deliver his first major speech in a decidedly tradi-tional way, addressing staff at his local hospital.
Yet inevitably he turned to “tech-nology” – highlighting the use of apps, devices and artificial intelli-gence to provide and analyse infor-
mation and aid patient outcomes.“From today let this be clear:
tech transformation is coming,” he declared.
In a profile piece written back in May, journalist Andrew Gimson de-scribed the 39-year-old West Suffolk MP as “exceptionally ambitious.”
The scribe concluded, tongue-in-cheek: “Hancock has not been stopped, but what, apart from digital transformation, does he stand for?.”
In coming months, he will have ample opportunity to provide an answer – one which will be scruti-nised closely by NHS medical staff.
Matt ‘the App’ takes the reins in WhitehallThe new Secretary of State for health and Social Care takes over the hotseat at a critical time
Health Service NewsThe HOSPITALCONSULTANT& SPECIALIST
16 Autumn-Winter 2018 The HOSPITAL CONSULTANT & SPECIALIST
resource. The disadvantages are there too, however.
Driving one’s own development is fraught with difficulty, particularly retaining enthusi-asm and making sure teaching days are cov-ered independently to meet key skills. There is a clear need to argue for study leave and a study budget, to which potential employers may be sceptical.
Purpose is a challenge by either pathway, and submission of documents at the end of the process carries a hefty fee from the GMC with no guarantee of passing – candidates frequently need more time for additional work and competencies.
Further, there are some specialties which have specific training requirements that are hard to meet independently – for example the six-month Anaesthetic block in Emer-gency Medicine CT2.
Finding an employer willing to push a non-training SHO through their Initial As-sessment of Competence is no easy feat.
There are equivalent problems in surgery and in medicine, not to mention having the ruthlessness to pursue Consultants and men-tors for portfolio material – a process subject to the same pressures in both training and non-training grades.
So far, however, it seems to be working. My enthusiasm for learning and for work returned once I was master of my own fate. I persuaded my Trust to take me on as a 50 per cent educator, 50 per cent clinical ED doctor, providing them with a Registrar and giving me a fresh outlet for my passions.
The portfolio submissions have been a chal-lenge, and the process will take longer than the standard training equivalent, but it is all down to me – no more fights with the deanery, no more cancelled training days. And no more persistant hoop-jumping for ARCPs.
Trade union considerations and work in-demnity need attention for the non-training doctor. I moved to the HCSA because I felt their more individual approach would fit with CESR route training. I’ve felt well supported.
A nasty shock came three-quarters of the way through the year when my indemnifier heard I wasn’t in a training post and almost doubled their fee. A brief search meant I located an alternative at a better price, but there are few resources aside from hearsay, guile, and the experience of others.
This may be changing, as a second hospital has been subsequently persuaded to employ me in a similar role. Hopefully, there is a growing recognition that embracing the un-orthodox can be hugely empowering.
M edical vacancies in England shot up to 11,576 whole-time
equivalent at the last official count – 9.3 per cent of the total doctor workforce.
Figures from NHS Improvement covering April to June show a near 16 per cent increase in vacancies over the previous quarter, and a year-on-year increase of 6.7 per cent.
Acute Trusts in the Midlands, East and Northern England all saw significant rises in reported medical vacancies.
In the Midlands and East the rate in acute Trusts was higher than one in 10, at 11.6 per cent.
The figures are drawn from re-ports submitted by Trusts detailing their vacancy rates and are “not an official statistic”, NHSI notes.
It adds that the resulting pressure on agency bills and higher than ex-pected payments to purchase health-care from external providers helped Trusts miss their £495m quarterly “efficiencies” target by £64m.
Once again the figures revealed an overspend against target on
➥ CONTINUeD FROM PAGe 15
Medical staff gaps grow to 9.3% of total
Elected in 2010 as MP for West Suf-folk. Previously culture secretary. ConservativeHome noted he “has prospered” against expectations un-der the current government despite being a “protégé” of ex-chancellor
WHO IS MATT HANCOCK?
NHS in Brief
Plans for a new body aimed at creat-ing “safe spaces” for whistleblow-ers have been criticised by MPs for allowing Trusts to carry out internal investigations into concerns raised.
Sir Bernard Jenkin MP, chair of the Joint Committee on the Draft Health Service Safety Investigations Bill, said: “For too long health profession-als have worked in an environment where blame can be part and parcel of investigations and speaking openly could be damaging to career pros-pects.
“We are concerned, however, that the draft Bill proposes accrediting some NHS trusts to undertake ‘safe space’ investigations.
“We believe that this is miscon-ceived as only a fully independent body such as HSSIB should be af-forded the powers and responsibility of ‘safe space’.”
Health Service NewsThe HOSPITALCONSULTANT& SPECIALIST
Matt ‘the App’ takes the reins in Whitehall‘DON’T lET TRuSTS PROBE THEMSElVES’, WARN MPs
The HOSPITAL CONSULTANT & SPECIALIST Autumn-Winter 2018 17
bank staff as Trusts grapple with the goal of reducing agency spend.
While agency costs stood at £599m for the quarter – £32m above target – bank staff spending stood £102m higher than expected at £805m.
The report notes: “This contin-ues the trend identified in 2017-18 of increasing use of temporary (especially bank staff) by trusts to manage workload in the face of in-creased demands, high levels of va-cancies, sickness/absence and staff turnover.
“As a result of these pressures, overall spending on bank and agen-cy staff is up by £134m (11%) on the same period in 2017/18.”
B oard papers published by Worces-tershire Acute Hospitals Trust
highlight the struggle hospitals are facing juggling capacity amid an over-all winter beds shortage in England this year predicted at 3,100.
Memories of the last seasonal crisis were evoked by the interim winter plan which warned that without special steps the Trust would be 208 beds short of an op-erational goal of 92 per cent occupancy.
That is the “tipping point” identified by NHS Improvement at which Emergency Departments have historically descended into chaos during winter crises.
The National Audit Office, however, has said that hospitals with occupancy above 85 per cent will see regular bed shortages, periodic bed crisis and increased infec-tion rates.
Worcestershire, like many others, says it is aiming to reduce that worst case scenario through a number of schemes including reopening or redesignating wards, opening up space in community hospitals, and also through improving patient outflow.
However, as of September it could not yet guarantee its winter measures would bring average bed occupancy rates below 100 per cent – and peaks of 113 per cent
Compared to a £335 million injection last December, an additional £145m has been earmarked to assist England’s hos-pitals in opening 900 additional beds, and this falls far short of the extra 4,000 beds needed last winter.
The challenges facing Worcestershire are echoed to a greater or lesser degree elsewhere, but with Worcestershire’s op-erating deficit expected to mushroom to over £57 million this year, it has little left in the kitty locally to stem the tide.
Trusts grappling with winter plans
Nearly 1.5 million cases were admit-ted to hospitals unnecessarily in 2017 due to community and social care health underfunding, the Public Ac-counts Committee has reported.
Committee chair Meg Hillier MP said: “Around a quarter to emergency admissions to hospital could and should have been avoided.”
NHS Digital’s summer update on “rea-sons for leaving” reveals the biggest cause among doctors is “Voluntary Resignation – Other/Not Known”.
It details 740 doctors left for reasons unknown in the third quarter of 2017-18. Even these vague figures come with a health warning – they are drawn from Electronic Staff Records and “their quality will depend on data completeness and accuracy of com-pletion of each person’s records.”
George Osborne as his chief of staff.Gained the nickname Matt “The
App” as the first MP to launch his own smartphone application.
Former Bank of England economist with a first in Philosophy, Politics and Economics from Oxford and a mas-ters in Economics from Cambridge.
FuNDINg CRuNCH SENDS 1.5M CASES TO HOSPITAl
DESTINATION uNKOWN FOR HuNDREDS OF DOCTORS
NEW BROOM: Matt Hancock
Chris McAndrew
s/Creative Comm
ons CC BY 3.0
Light SideThe HOSPITALCONSULTANT& SPECIALIST
And finally...
We are, we are told, living in the age of “fake” news. With the NHS football zipping about the political playing field at near light speed, though, perhaps we should be charitable when the “responsible” media take their collective eye off the ball in the hunt for a good headline.
The culprit? The Institute of Fiscal Studies’ dodgy claim earlier this year that “every household” will need to find £2,000 annually in order to keep the NHS “afloat.”
This figure was, of course, complete bunkum, a construct derived by taking the additional funding estimated for the NHS in years to come and performing a simple act of division.
This hollow claim echoed emptily at the top of the news agenda over a holiday weekend, but did at least have one positive outcome, allowing Guardian columnist Phil McDuff to coin the term “fake maths”.
It was unclear what the IFS was really trying to say, other than enough to grab headlines.
For, as McDuff pointed out, if you’re sitting in a bar and Bill Gates walks in, you will, on average, be a millionaire. “But if you try to buy the most expensive bottle of champagne in the place, your debit card will still be declined.”
For the more long-in-the-tooth hospital doctor, eyebrows may go northwards at comments by the US cardiologist tasked by ministers with reviewing how the NHS workforce must change “to deliver a digital future.”
Dr Eric Topol, whose final report is expected later in the year, is looking at the impact on staffing of advances such as wearable technology, artificial intelligence and genomics over the next 20 years.
Speaking to the Health Service Journal, Dr Topol suggested these new technologies should not lead to a reduction in staffing,
but serve to liberate them to by creating more patient contact time and using “less on administrative and procedural tasks.”
Now, where have we heard that one be-fore? Given the current tendency of squeez-ing ever more work out of the individual for no greater reward, old hands should be forgiven for reserving judgement, Dr Topol…
If those who don’t know the past are doomed to repeat it, then is it just by chance that this year marks the 70th an-niversary of the HCSA’s founding?
For within the Association’s archives lies a September 1974 edition of The Consult-ant (this publication’s forerunner) with an eerie resonance 24 years on: “The HCSA has called for the resignation of Lord Halsbury, the present Chairman of the Review Body on doctors’ and dentists’ remuneration.
“The HCSA no longer believes that the Review Body is independent, and is con-cerned at the way it accepts evidence from the Health Departments without question.”
Or, as correspondent KP Abel writes in the same edition, “It is about as independ-ent of the Government and Treasury as the tail of the dog.”
History lessons and all that...
WElCOME TO THE AgE OF ‘FAKE MATHS’
WIll DIgITAl SAVE uS All?
18 Autumn-Winter 2018 The HOSPITAL CONSULTANT & SPECIALIST
SudokuDifficulty: Hard
Solution
WHAT gOES AROuND, COMES AROuND
InformationThe HOSPITALCONSULTANT& SPECIALIST
Head Office HCSA Elected Officers
HCSA Officers and Staff
Council
APPLICATION FORM 2018-19
Help build HCSA and save up to 100% on your fees next year. Find out more overleaf
Post 1 Kingsclere Road Overton Basingstoke Hampshire RG25 3JA
PresidentProfessor Ross Welch, FRCOG
Chairman of the ExecutiveDr Claudia Paoloni, FRCA
hCSA executiveImmediate Past PresidentProfessor John Schofield, FRCPath
Honorary Treasurer Dr Bernhard Heidemann, FRCAHonorary SecretariesDr Cindy Horst, FRCADr Paul DonaldsonDr Subramanian Narayanan, FRCOGDr John West, FRCPIndependent Healthcare MattersMr Christopher Khoo, FRCS
A full list of HCSA Council members is available at www.hcsa.com. For more information on our democracy and other ways to become involved in HCSA, contact your National Officer or head office.
HCSA, Number One, Kingsclere Road, Overton, Basingstoke, Hampshire, RG25 3JAT 01256 771777 F 01256 770999 E [email protected] W www.hcsa.com
Instruction to your bank or building society to pay by Direct Debit
9 9 7 5 7 2Service user number: Payment refererence (to be completed by HCSA):
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Please pay The Hospital Consultants and Specialists Association direct debits from the account detailed in this instruction subject to the safeguards assured by the direct debit guarantee. I understand that this instruction may remain with The Hospital Consultants and Specialists Association and, if so, details will be passed electronically to my bank or building society.
Instruction to your bank or building society
The Direct Debit Guarantee
This Guarantee is offered by all banks and building societies that accept instructions to pay Direct DebitsIf there are any changes to the amount, date or frequency of your Direct Debit the organisation will notify you (normally 10 working days) in advance of your account being debited or as otherwise agreed. If you request the organisation to collect a payment, confirmation of the amount and date will be given to you at the time of the requestIf an error is made in the payment of your Direct Debit, by the organisation or your bank or building society, you are entitled to a full and immediate refund of the amount paid from your bank or building society.If you receive a refund you are not entitled to, you must pay it back when the organisation asks you toYou can cancel a Direct Debit at any time by simply contacting your bank or building society. Written confir-mation may be required. Please also notify the organisation.
••
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Breaking news: rates frozen for 2018-19
All members of HCSA will benefit in the coming membership year after the Association voted to freeze fees at 2017-18 levels.
What’s more, HCSA members will again be able to save up to 100% of their annual subscription in 2019-20 through the continuation of our popular Recruitment Chal-lenge scheme.
The principle is simple – for every new member you sign up, we will deduct 10 per cent from your membership fees in October 2019.
If you sign up 10 new paying members, your HCSA member-ship fee will be waived for the whole year.
Our application forms now include a special section to allow applicants to record their referrer’s details. Just look out for the Recruitment Challenge logo and ensure that your information is included in the application.
