All the political parties have told us that, despite the approaching financial crisis (the tax that dare not speak its name), frontline NHS services will be protected. So that’s all right then! At least the lads and lassies running the excellent medical services for our gallant troops in Afghanistan can sleep easy in their bunks knowing that they will not need to hold car boot sales in order to buy a few sticky plasters.
Meanwhile, at home, the paranoia runs high. I was stopped in the corridor yesterday by a colleague who hissed: “It’s true! Charlie got it straight from his mates in the SHA last Friday; they are considering cutting doctors pay by 30%.” So, here is my contribution to the NHS funding debate.
At the HCSA Council meeting last week we were considering our response to the latest GMC consultation document on revalidation. I also spent some time reviewing the draft report by the NHS Revalidation Support Team on enhanced appraisal.
It is a worthy document and although “the role of the appraiser is already highly skilled” (phew!) the enhanced appraisers will need to have “integrity, commitment, personal effectiveness, self-awareness”, and the ability to be “fair, unbiased, impartial, objective, supportive, understanding, empathic and honest, acknowledging preconceptions and able to adapt behaviour appropriately”. They will also need an extensive “knowledge and skills framework” (how I detest such jargon) in order to “serve the multiple purposes of detecting unsafe practice etc.” to support revalidation. Wow! I am thinking sainthood here!
Now I am no mathematician. At my school if you could do long division you were directed towards engineering and the physical sciences. If you were dyslexic for numbers (like me) you did biological sciences and became a doctor. (There was little in between, other than the arty farty types who did English and became teachers).
However I have done some crude calculations on the likely costs of enhanced appraisal for 37,000 consultants on the back of a fag packet and this is what I have come up with. It is based on the training requirements and costs of about 5,000 appraisers doing approximately eight appraisals per year, estimated PA time for both the training and the actual appraisal of the consultants (about 2 PAs each per appraisal). I will not bore you with the sums, but the total is not far short of £50m per year. Work it out yourself if you do not believe me.
Of course it could be argued that the funding of the PAs is already in the NHS budget so the only new money would be for training. However the enhanced appraisal will be taking consultants away from other NHS work to a far greater degree than the current rather ad hoc system squeezed in over a lunch break, so this will prove a genuine “cost” to the NHS.
I rather suspect some CEOs, desperate to slash costs in the coming storm, may start to question the evidence base for all this.
Tags: Funding, Revalidation
“dyslexic for numbers”
?dyscalculic
You shouldn’t have let on to your smoking habits! The enhanced appraiser would have deducted some points for that. But then you’re a radiologist so hopefully your role is not preaching what you don’t practise!
No seriously; a very valid point you raise. There is even a greater twist in a way. The GMC is now a de facto regulatory body! How many of us are aware that it retains its original registered charity status. Something does not ring right. But I do not recall the DVLA or the CAA being registered charities or have I missed something? Mind you it will only be us ending up paying more for the dubious privelege!