Archive for September, 2011

NHS cuts “will boost medical tourism” report claims

PA - 30th September 2011 3:49 pm

Government cuts could push up the number of patients travelling abroad for medical treatment, a report suggests.

If waiting times for NHS treatment rise - or therapies go unfunded - more patients will seek help abroad, according to the Economist Intelligence Unit study.

An EU directive on Cross-Border Healthcare, which comes into force in 2013, could also have an impact.

It gives patients rights to be reimbursed for treatment they receive in other EU countries. The report suggests this could lead to more Western Europeans travelling to Eastern Europe, including Poland and Bulgaria, which are rapidly developing services.

Read more at Press Association.

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Are doctors just another one of the trades?

By Caroline Whymark - 3:02 pm

Doctor, plumber, car mechanic. At first these appear diverse professions. The former a highly trained professional, a master of his craft. The other two a pair of air-sucking- through-teeth-oh-it-will-cost-you-missus rip-off merchants.

My recent experiences have had that rare effect of reversing one’s first opinion. The two workmen I’ve had the fortune (or misfortune, depending on your perspective) to deal with of late have made we wonder that perhaps there is not actually all that much difference between our working processes.

Let’s take the car mechanic first. I drew up wearing jeans and trainers - trying to look non doctor-ish - in the belief that this would prevent me being ripped off.

“The engine warning light is on and the coolant chamber is only half full. I wonder if the radiator is leaking?” I suggested.

Chief mechanic - John - looks at me and shakes his head. I wait to hear the extortionate diagnosis but there is no slow, sad shaking of the head. Instead he says “it’s not quite that simple”.

Well, it never is I surmised.

John continued: “First we need to know what we call the Presenting Complaint. What did you first notice was wrong? How long has it been going on for? Anything else you’ve noticed different about the car?”

I nodded solemnly as he continued: “Then you need to think about past problems. Did it pass its last MOT? Servicing up to date?”

I was still reflecting on my cars past medical history when we got to the differential diagnosis…“It could be any of several faults. There are simple things that commonly go wrong but it may be more than that - rare things happen too you know.”

Oh I know I thought.

“We’ll need to do some tests to find out…the first will be to pressure test the system. I give you a ring to let you know what we find.”

I smiled inwardly and felt that me and my car were being well looked after.

The next week the boiler broke down. The plumber arrived and, following my experience at the garage, I gave a succinct and accurate history of my heating systems problems, past and present, culminating with what I thought might be wrong although clarifying that I sought and deferred to his expert opinion.

“Well it’s not that simple” he said. I rolled my eyes and thought here we go again. This did not go unnoticed.

“What is it you do for a living?” he demanded.

I explained I was an anaesthetic doctor and put people off to sleep for their operations.

“Well,” he said. “It’s much easier for you. Patients are all made the same, same parts, same plumbing, same joints and all get the same faults. I bet they all go off to sleep the same way too. In my job it’s different,” he explained as if I was slightly slow.

“All heating systems are different, they all react in different ways to different stresses, have different weaknesses and any one fault can appear as several different problems. It can be very complicated to work out the cause of the problem,” he concluded.

I nodded. “Well I’ll leave you to do some tests on it shall I? Milk and two sugars I presume?”

My sarcasm was lost on him but still I gave him a Kit Kat with his tea. Like emergency abdominal aortic aneurysms crashing into emergency theatres, bad news tends to come in sets of three. After my car and my heating, I’m just waiting and wondering what will go wrong next.

Who knows what I might learn from a joiner.

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Doubling in GMC referrals by medical directors

By Mike Broad - 9:25 am

There has been a doubling in the number of doctors referred to the GMC by medical directors and other public bodies, new figures reveal.

In 2010, medical directors made 1,395 referrals representing one in five of all complaints to the GMC.

The GMC research sought the views of 100 medical directors asking them to explain why more doctors are being referred to the GMC than ever before.

It suggests the NHS has better systems for monitoring doctors’ performance and that there is greater awareness of and commitment to high professional standards, the regulator claims.

Over 85% of the medical directors surveyed had made a referral to the GMC in the last five years. The medical directors also reported that there was an increased commitment among doctors themselves to reporting concerns, as well as patients feeling more empowered to complain.

Niall Dickson, GMC chief executive, said: “More complaints about doctors does not necessarily mean standards are slipping; it could be a sign that the systems to identify problems are improving. Our research certainly suggests that employers are giving priority to detecting and dealing with concerns and that has to be welcome.

“In addition, rather than keeping quiet about problems, doctors are more likely to speak up when they see anything that could pose a risk to patient safety. And that is exactly as it should be. There is no cause for complacency and we know there is more to do in this area, but the system is becoming more open and we have come a long way from the idea of medicine as an ‘old boys’ club’.”

Of medical directors who said the number of referrals they made in 2010 was higher than previous years, the main reason cited for the increase was colleagues being more likely to raise a fitness to practise issue.

95% of those who made referrals contacted the National Clinical Assessment Service for advice.

The GMC is launching a new liaison service to support medical directors in dealing with concerns they may have about the doctors for whom they are responsible.

Dickson said: “A referral to the GMC can be the start of an anxious time for everyone involved, and we recognise that. The piloting we have already done shows that employer liaison advisers can bring real benefits to medical directors and we will soon have someone in each area of the UK to support them.”

Dean Royles, director of representative body NHS Employers, commented: “It is encouraging that the GMC recognises that employers are giving priority to reporting concerns and that this is having a positive impact on patient safety. Protecting patients is of paramount importance to employers, who have worked hard to improve procedures and policies for reporting concerns, making it easier for staff to raise concerns with confidence.

“Employers will act when concerns are raised and will involve the regulators where appropriate, therefore we welcome the GMC liaison service which will help them navigate the appropriate referral route.”

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So are you allowed to play music in theatre or not?!

By Mike Broad - 29th September 2011 2:34 pm

Hmmm, methinks someone has something to push (like a DVD of House).

‘Research’ suggests that 90% of surgeons listen to music while they operate, and half of those said up-tempo rock was their genre of choice.

Seventeen per cent favour pop music, while 11% said they listened to classical music while they operated. Patients undergoing plastic surgery were most likely to be operated on by a music-loving doctor, with all plastic surgeons surveyed said they listened to music while operating.

Maybe the private practice boys and girls play a bit more fast and loose with ‘the rules’ than the Nash. Last time I checked most trusts had banned music in theatre over new copyright laws.

Please update me somebody, otherwise I’ll be stuck in this Land of Confusion (Genesis). Sorry.

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Family’s death plea case rejected by court judge

BBC Health - 10:01 am

The woman, who is 52 and can be referred to only as M, is in what is known as a “minimally conscious state”.

Her family argued she was in pain and that artificial feeding and hydration should be withdrawn. The Official Solicitor and the health authority responsible for her care opposed the application.

Mr Justice Baker, who heard legal argument during a Court of Protection hearing in London in July, said the case was unique and raised “very important issues of principle”.

M had “some positive experiences”, he said, and there was a “reasonable prospect” that those experiences could be extended.

Read more at BBC Health.

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A full listing of the 2011 national CEA recipients

By Mike Broad - 9:52 am

The ACCEA has finally published the list of those doctors who were successful in applying for new national clinical excellence awards in the 2011 round. Bronze awards are worth £35,484 per annum; Silver awards £46,644; Gold £58,305, and platinum £75,796.

ACCEA, Department of Health

Bronze

MEARA, Jill - Public Health Medicine

O’CONNELL, Susan - Pathology

Silver

FARRINGTON, Mark - Pathology

NGUYEN-VAN-TAM, Jonathan - Public Health Medicine

Gold

WATSON, John - Public Health Medicine

ZAMBON, MARIA - Pathology

Cheshire & Mersey

Bronze

BLAIR, Stephen - Surgery

FEARNLEY, David - Psychiatry

MARSHALL, Ernest - Medicine

SKUES, Mark - Anaesthetics

SOLOMON, Thomas - Medicine

WARBURTON, Christopher - Medicine

YOUNGSON, Callum - Dental

Silver

ALFIREVIC, Zarko - O&G

CLARKE, Ray - Surgery

LOMBARD, Martin - Medicine

Gold

GRAHAM, David - Medicine

MOORE, Julia - Anaesthetics

Platinum

POSTON, Graeme - Surgery

SMYTH, Rosalind - Paediatrics

East Midlands

Bronze

BAXENDALE, Brynley - Anaesthetics

CAMILLERI-FERRANTE, Corinne - Public Health Medicine

CHILTON, Andrew - Medicine

DHAR, Sunil - Surgery

Johnson, Simon - Medicine

PAVORD, Sue - Pathology

PEEK, Giles - Surgery

SIDEBOTTOM, Andrew - Surgery

TOBIN, Martin - Public Health Medicine

Silver

ATHERTON, John - Medicine

HAMPSON, Michele - Psychiatry

NG, Leong Loke - Medicine

SAYERS, R - Surgery

SOWDEN, David - Academic GP

Gold

BAKER, Richard - Academic GP

HALL, Ian - Medicine

MAHAJAN, Ravi - Anaesthetics

Platinum

DUA, Harminder - Ophthalmology

LOWE, James - Pathology

SPILLER, Robin - Medicine

East of England

Bronze

BRENTON, James - Medicine

BURROWS, Nigel - Medicine

CORRIE, Philippa - Medicine

COUSLEY, Richard - Dental

CRAIG, Jenny - Pathology

COCKBURN, John - Radiology

DONELL, Simon - Surgery

DUNNING, John - Surgery

DYKE, Mark - Paediatrics

FITZGERALD, Rebecca - Medicine

MARTIN, Keith - Ophthalmology

PEPKE-ZABA, Joanna - Medicine

YOUNG, P - Anaesthetics

Silver

BULLMORE, Edward - Psychiatry

BENNETT, Martin - Medicine

DENTON, Erika - Radiology

GRACE, Andrew - Medicine

KHAW, Kay Tee - Public Health Medicine

MONTGOMERY, Paul - Surgery

SAMPSON, M - Medicine

Gold

BRADLEY, John - Medicine

Platinum

JONES, Peter - Psychiatry

YUNG, Matthew Man-Wah - Surgery

London North East

Bronze

BOMANJI, Jamshed - Medicine

BROCK, Penelope - Paediatrics

BROHI, Karim - Surgery

CAVENAGH, James - Pathology

CURRAN, Ian - Anaesthetics

GILBERT, Ruth - Paediatrics

GOMPERTZ, Patrick - Medicine

LAND, John - Pathology

PEEBLES, Donald - O&G

SISODIYA, Sanjay - Medicine

SAEED, Shakeel - Surgery

TABRIZI, Sarah - Medicine

YONG, Kwee - Pathology

Silver

BARTON, Keith - Ophthalmology

DATTANI, Mehul - Paediatrics

HANNA, Michael - Medicine

KNIGHT, Charles - Medicine

MCEWAN, Jean - Medicine

PRITCHARD-JONES, Kathryn - Paediatrics

THRASHER, Adrian - Paediatrics

YOUSRY, Tarek - Radiology

Gold

AYLWARD, George - Ophthalmology

JACOBS, IJ - O&G

SANDERSON, Ian - Paediatrics

Platinum

DEZATEUX, Carol - Paediatrics

FORTUNE, Farieda - Dental

HAMILTON, George - Surgery

HAWKINS, Philip - Medicine

THOMPSON, Alan - Medicine

London North West

Bronze

DIMARIO, Carlo - Medicine

LEEN, Edward - Radiology

RIBOLI, Elio - Public Health Medicine

SAUNDERS, Brian - Medicine

SHEPPARD, Mary - Pathology

VAIZEY, Carolynne - Surgery

Silver

BROOK, Michael - Medicine

COOK, Herbert - Pathology

COWIE, Martin - Medicine

SCREATON, Gavin - Medicine

TAYLOR, Peter - Medicine

WILSON, Robert - Medicine

Gold

HABIB, Nagy - Surgery

OPENSHAW, Peter - Medicine

Platinum

BUSH, Andrew - Paediatrics

London South

Bronze

BAKER, Emma - Medicine

CHEMLA, Eric - Surgery

CLEARE, Anthony - Psychiatry

HARGRAVE, Darren - Paediatrics

LOFTUS, Ian - Surgery

Lord, Graham - Medicine

MILLER, H - Psychiatry

O’DONOHUE, John - Medicine

PINDER, Sarah - Pathology

REDWOOD, Simon - Medicine

RENTON, Tara - Dental

SIMPSON, John - Paediatrics

SYKES, Nigel - Medicine

WATKIN, Nicholas - Surgery

Silver

DAVENPORT, Mark - Surgery

DAVIDSON, Craig - Medicine

HEYMAN, I - Psychiatry

HOWARD, Robert - Psychiatry

LOVESTONE, Simon - Psychiatry

MURDOCH, Ian - Paediatrics

NELSON-PIERCY, Catherine - Medicine

SCHEY, Stephen - Pathology

THOMPSON, Matthew - Surgery

Gold

HIGGINSON, Irene - Medicine

MARKUS, H - Medicine

ROBB, Peter - Surgery

Platinum

Bhugra, Dinesh - Psychiatry

North East

Bronze

BIRCHALL, Daniel - Radiology

GERRAND, Craig - Surgery

HASAN, Syed Tahseen - Surgery

JAFFRAY, Bruce - Surgery

MANNIX, Kathryn - Medicine

OPPONG, Kofi - Medicine

RUTTER, Matthew - Medicine

ROBINSON, Louise - Academic GP

SNOWDEN, Christopher - Anaesthetics

VISWANATH, Y - Surgery

Silver

Jackson, Graham - Pathology

LEES, T - Surgery

MCLELLAND, Janet - Medicine

SOOMRO, Naeem - Surgery

STEELE, J - Dental

Gold

DAY, C - Medicine

WALLS, A - Dental

Platinum

CANT, Andrew - Paediatrics

CORRIS, Paul - Medicine

FORD, Gary - Medicine

ROBSON, Stephen - O&G

TAYLOR, Roy - Medicine

North West

Bronze

AUGUSTINE, Titus - Surgery

FENERTY, Cecilia - Ophthalmology

HAMDY, Shaheen - Medicine

HELBERT, Matthew - Pathology

KAPUR, Navneet - Psychiatry

MILES, Jonathan - Medicine

PEARCE, Ian - Surgery

SCHRAM, Catharina - O&G

SHERLOCK, David - Surgery

SNOWDEN, Howard - Medicine

SPENCER, Anne - Ophthalmology

Silver

HANSON, Jacqueline - Emergency Medicine

HILL, James - Surgery

NIRMAL KUMAR, Balasubrahmanyam - Surgery

PATON, Robin - Surgery

RHODES, Lesley - Medicine

SLEVIN, Nicholas - Radiology

SOLOMON, Laurence - Medicine

TYRRELL, Philippa - Medicine

Gold

COWARD, Robert - Medicine

MORIARTY, Kieran - Medicine

SMITH, Anthony - O&G

Platinum

BURNS, Alistair - Psychiatry

South East

Bronze

CONGLETON, Joanne - Medicine

DAVIES, Ursula - Medicine

FORNI, Luigi - Medicine

HARRIES, Meredydd - Surgery

MALHOTRA, Raman - Ophthalmology

NEWPORT, Melanie - Medicine

RABE, Heike - Paediatrics

SCHMID, Peter - Medicine

WALKER-BONE, Karen - Medicine

Silver

ELLIOTT, Andrew - Ophthalmology

HOLMBERG, Stephen - Medicine

RAJKUMAR, Chakravarthi - Medicine

SCOTT, Humphrey - Surgery

Gold

BLACK, David - Medicine

South

Bronze

BLESING, Claire - Radiology

CALVER, Alison - Medicine

CONNETT, Gary - Paediatrics

GIBBONS, C - Surgery

GROCOTT, Michael - Anaesthetics

HARDEN, Paul - Medicine

HITCHCOCK, Rowena - Surgery

LEDINGHAM, Joanna - Medicine

OTTENSMEIER, Christian - Medicine

ROSEN, Paul - Ophthalmology

TALBOT, Kevin - Medicine

VYAS, Paresh - Pathology

Silver

CHANNON, Keith - Medicine

GOODACRE, Timothy - Surgery

HULL, Richard - Medicine

ROTHWELL, Peter - Medicine

STROUD, Michael - Medicine

Gold

BARRETT, Jane - Radiology

GATTER, Kevin - Pathology

GLEESON, Fergus - Radiology

HAMDY, Freddie - Surgery

Platinum

SHEARMAN, C - Surgery

WATKINS, Hugh - Medicine

South West

Bronze

BENGER, Jonathan - Emergency Medicine

BLOM, Ashley - Surgery

Bailey, Clare - Ophthalmology

CHESSER, Timothy - Surgery

CLINCH, Jacqueline - Paediatrics

GILLATT, David - Surgery

HAMMOND, Edward - Anaesthetics

JOHNSTON, Robert - Ophthalmology

KNOWLES, Simon - Pathology

KOSKY, Nicholas - Psychiatry

LAM, Wang Hiu - Anaesthetics

LOCKEY, David - Anaesthetics

MANN, Clifford - Emergency Medicine

MCINDOE, Andrew - Anaesthetics

RAMANAN, Athimalaipet - Paediatrics

STOCKER, Mary - Anaesthetics

THOMPSON, John - Surgery

Silver

CORNISH, Jacqueline - Paediatrics

DALTON, Harry - Medicine

FOZARD, Basil - Surgery

HOUGHTON, Kerri - Anaesthetics

MCHUGH, Neil - Medicine

PEDEN, Carol - Anaesthetics

SANDHU, Davinder - Surgery

THORESEN, Marianne - Paediatrics

Gold

DICK, Andrew - Ophthalmology

POSKITT, Keith - Surgery

Platinum

ARMITAGE, Mary - Medicine

WILSON, Iain - Anaesthetics

West Midlands

Bronze

ALLAN, Sris - Medicine

ARLT, Wiebke - Medicine

CHAKRAPANI, Anupam - Paediatrics

COSTA, Matthew - Surgery

COWLING, Mark - Radiology

DAS GUPTA, Indranil - Medicine

GRIFFITHS, Frances - Academic GP

HARPER, Lorraine - Medicine

ISMAIL, Khaled - O&G

JOHNSON, Peter - Academic GP

MALLEN, Christian - Academic GP

PATEL, Kiranbhai - Medicine

PRACY, John Paul - Surgery

PEAKE, David - Medicine

Silver

BARRON, David - Surgery

CRADDOCK, Charles - Pathology

KONG, Kin Leong - Anaesthetics

LESTER, Helen - Academic GP

MORRIS, Kevin - Paediatrics

MOSS, Paul - Pathology

O’HARE, Joseph Paul - Medicine

RADCLIFFE, Keith - Medicine

VOHRA, Rajiv - Surgery

Gold

GRAHAM, Timothy - Surgery

PORTER, Keith - Surgery

SPITERI, Monica - Medicine

Yorkshire & Humber

Bronze

BROWN, Steven - Surgery

DICKINSON, Catherine - Medicine

DULEY, Lelia - Public Health Medicine

GILSON, Dianne - Radiology

GUPTA, Sanjeeva - Anaesthetics

LAYTON, Alison - Medicine

LOCKEY, Andrew - Emergency Medicine

MASON, Suzanne - Emergency Medicine

MCDONAGH, Andrew - Medicine

MURDOCH-EATON, D - Paediatrics

SEYMOUR, Jeremy - Psychiatry

SUTTON, Laurence - Radiology

SCARSBROOK, Andrew - Radiology

VELIKOVA, Galina - Medicine

VERBEKE, Caroline - Pathology

WOODROW, Graham - Medicine

WRIGHT, Neil - Paediatrics

Silver

CLELAND, John - Medicine

CORRADO, Oliver - Medicine

MAKRIS, Michael - Pathology

MITCHELL, David - Surgery

O’CONNOR, PJ - Radiology

TOOGOOD, Giles - Surgery

WOODRUFF, Peter - Psychiatry

WYLIE, Kevan - Psychiatry

Gold

RAINE, Christopher - Surgery

WILCOX, M - Pathology

Platinum

NICHOLSON, Anthony - Radiology

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Quality of emergency surgery has to improve

By Mike Broad - 9:36 am

The quality and consistency of major emergency abdominal surgery must improve, a report claims.

Poorly designed hospital services, particularly access to emergency operating theatres and radiology treatment, are among the problems highlighted.

It means that many of the 170,000 patients who have major emergency abdominal surgery each year are missing out on early diagnosis and experiencing significant variations in care, a report by the Royal College of Surgeons says.

In addition, there is a general lack of appreciation of the level of risk in emergency surgical patients - where death rates of 15% to 20% are typical, and can be as high as 40% in the most elderly patients. Surgeons say this imminent risk of death is not being reflected in the priority given to these patients whose chances of survival can more than double, depending on which NHS hospital they are treated in.

The report, The Higher Risk General Surgical Patient: Towards Improved Care for a Forgotten Group makes nine detailed recommendations. If implemented within two years, they will reduce complications and deaths, as well as reduce the cost of treating a group of patients who account for almost 90% of post-operative general surgical deaths.

The recommendations include recognition of the need for improved services, including access to operating theatres.

Trust bosses should acknowledge the problems that exist within their organisation and work with clinical colleagues to address them. The report says hospitals must provide fast access to operating theatres within defined time periods and prioritise emergency cases over elective surgery wherever necessary. It may be that separation of planned and unplanned operations is necessary.

The report also recommends routine risk assessment and tailored management of every patient. Hospitals should develop, clear, defined diagnostic and monitoring plans as well as assessing the risk of death and post operative complication for every patient. Those at highest risk should be treated under the direct supervision of consultant surgeons, anaesthetists and intensivists, the report says.

Better use of critical care is also urged. Patients at highest risk should be admitted to critical care after surgery. Due to a limited number of critical care beds, less than a third of high risk NHS patients are currently admitted to critical care following surgery; those who are stay on average only 24 hours.

International comparisons show that NHS critical care bed usage runs at 50% lower than in comparable countries and ranks among the lowest in the developed world. Delayed access to, and premature discharge from, critical care are both identified risk factors for post-operative death in general surgery. Routine admission to critical care after high risk surgery reduces complication rates and subsequent admissions to intensive care.

Mr Iain Anderson, report author and consultant general surgeon at Salford Royal NHS Foundation Trust, said: “Every acute hospital in the UK deals with many emergency patients every single day, among who three or four will typically meet these higher risk criteria. Complications and death rates vary significantly between hospital and even within the same hospital depending on the time of admission. Trusts should acknowledge that these problems exist and work to review their services using this guidance.

“Every single emergency patient who comes through the door of an NHS hospital should have an individual risk assessment, diagnosis, treatment plan and post operative care plan prioritised according to need. Instead we have some of the NHS’ sickest patients languishing on inappropriate wards, treated by juniors and with no plan in place to deal promptly with unexpected complications. These tend to be the patients who end up in intensive care units for lengthy periods of time or, sadly too sick to be helped.”

The report also calls for improved post operative care, including treatment of severe infection, and routine audit of emergency patients.

Norman Williams, president of the RCS, added: “The focus on reducing waiting times for elective procedures has resulted in a large group, of mostly elderly patients, becoming seriously under prioritised to the point of neglect in the some NHS hospitals. These changes won’t happen on their own and we are calling on all surgeons and managers to work together to deliver the high quality care that these patients need and which some hospitals are already proving can be delivered.”

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GP referral cuts a “catastrophe” for hospital finances

Pulse - 28th September 2011 5:27 pm

Hospitals are suffering a “catastrophic” loss of funding because of plunging rates of GP referrals as NHS managers block access to services.

That’s the view of Dr Mark Porter, chair of the BMA consultants committee, who said the fall in referrals coupled with other factors such as tariff restrictions was forcing hospitals to consider mergers or cut access to “whole parcels of services”.

GP referrals dropped by an average of 4% in the last quarter compared with the same period the previous year, with falls of up to 37% in areas with controversial schemes to restrict referrals.

Porter said: “This is proving a catastrophe. I know of hospitals coming off the FT pipeline, hospitals being forced to consider merging, hospitals being forced to restrict whole parcels of services, and many of the reductions in referrals are to do with the low-priority procedure lists.

“Some of the reconfigurations will be appropriate. But it’s impossible to know which are appropriate and which are prompted by inappropriate resource restrictions.”

Read more at Pulse.

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Number of national CEAs restricted once again

By Mike Broad - 10:20 am

The body which administers clinical excellence awards - the ACCEA - has finally published the list of those doctors who were successful in applying for new national awards in the 2011 round.

However, the number of awards has been limited to 300 for the second year running in an attempt to cut costs. In 2009, 601 national awards were made to doctors in England and Wales. This was slashed to 317 in 2010.

The ACCEA received 996 applications for bronze, 789 applications for silver, 206 applications for gold and 100 applications for platinum awards in the 2011 round.

It awarded 154 bronze awards, 87 silver awards, 33 gold awards and 25 platinum awards in England. The results for Wales are yet to be announced.

In a letter to the Chair and Medical Director of ACCEA, health minister Simon Burns said: “My judgement is that the best course is to limit the volume of the new awards to 300 as last year. This number of awards would be a significant recognition of the work which has been done by the most excellent consultants in pursuit of NHS objectives.

“It would also allow us to retain scarce resources and enable us to be on a good footing when we launch a new scheme in due course. In the current climate, we are having to take a number of difficult decisions across the public sector. A limit on new awards for consultants this year is just one of these.”

The announcement of successful applicants was delayed by the uncertainty surrounding the scheme following the Pay Review Body’s (DDRB) inquiry into its future. The government asked the DDRB to review the awards scheme back in mid-2010, but the profession is still awaiting the report findings and the government’s response.

It has disrupted the CEA application process, and there is no confirmation as yet on whether the 2012 round for national awards will go ahead.

The ACCEA said the government is currently considering the recommendations made by the DDRB and the duration of the new awards and renewals will be dependent on the transitional arrangements into any new scheme.

ACCEA will communicate with all new award holders and renewals once the details of any new scheme and the implications for the current award holders have been finalised. It said this is likely to be in 2012.

The 2012 round of national awards has not yet opened. Part of the remit for the DDRB review was to give advice to the Department of Health on whether there should be a new awards round in 2012.

An ACCEA spokesman said: “We are still awaiting a decision on this. We are anticipating that there will be a renewals round and although we are working on the assumption that there will also be a new awards round, until we know this for certain, we cannot open the online submission process.

“Therefore, the 2012 round for national awards will have to open later than usual. We are currently preparing on the basis that we would open the round in October and will issue new guidance at this stage. We will aim to maintain the closing date of 9 December 2011 for national awards.”

Bronze awards are worth £35,484 per annum; Silver awards £46,644; Gold £58,305, and platinum £75,796.

Dr Mark Porter, chairman of the BMA’s consultants committee, commented: “We’re extremely disappointed that this is yet another area of stealth cuts being imposed by the government. Consultants deliver high quality, innovative services that save the NHS money. Failing to reward those who go the extra mile is to fail to support excellence and quality

“Many organisations, not least the government, are realising that clinical leadership is the key to both clinical and financial success. Consultants have a proven track record of being these clinical leaders whether in formal management positions or not, and imaginatively producing innovations - exactly what the clinical excellence award scheme has been designed to encourage. It’s quite astounding that at the very moment the government wants to encourage and reward excellent performance on one’s job, the system that does so is being criticised as a ‘bonus scheme’ - which it is not and never has been.”

Read the full list of national CEA recipients.

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NHS chief challenges foundation hospitals plan

The Guardian - 9:16 am

The government’s health reforms ran into further trouble on Tuesday when the chief executive of the NHS publicly challenged a key proposal.

As peers prepare to table a series of amendments to the health and social care bill, Sir David Nicholson said the government was wrong to block failing foundation hospitals from returning to direct NHS control.

Andrew Lansley, the health secretary, wants to repeal a provision in the 2006 National Health Service Act which allows for the “de-authorisation” of failing foundation trusts, triggering their return to NHS control. The change is designed to strengthen foundation trusts - a central element of the government’s plans to decentralise power in the NHS - which will eventually take over the running of all hospitals in England.

In evidence to the public inquiry into failings at the Mid-Staffordshire NHS Trust, Nicholson called on the government to retain the renationalisation of a failing trust in its “armoury”.

Read more at The Guardian.

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