Hospital Dr News

College sets out pre-election health manifesto

The Royal College of Physicians is calling on the next government to continue expanding consultant numbers as part of its pre-election manifesto.

Leading for Quality urges politicians to support consultant delivered care, despite the downturn, and to sustain the numbers of medical students entering the profession.

It says: “Consultants and fully trained doctors, underpinned by the CCT and the national contract, are the foundation of high-quality healthcare.”

While the RCP acknowledges there have been advances in quality, it offers a list of proposals that it claims will drive sustained improvement. Better commissioning, integration of health systems and clinical engagement are dominant themes.

The manifesto calls on the government to ensure greater clinical involvement and leadership in wider healthcare decision making.

“There is a clear need for an effective institutional framework that will allow doctors to be active participants in shaping the landscape of healthcare, and not simply passive responders to prevailing circumstances,” the report says.

“Within local organisations responsible for managing and delivering services, doctors have an additional and critical part to play.”

The RCP also wants to see a more inclusive commissioning culture and reforms that encourage teams to work across traditional boundaries to facilitate better care closer to home.  

This requires “good local clinical networks, strong clinical leadership in primary and secondary care and supportive management structures, and acceptance that the patient needs to be involved in the organisation of individual care plans”.

The RCP wants to see the Payment by Results funding system replaced with aligned incentives that support integrated pathways more effectively.

It says: “Under the current tariff-based system, hospitals are encouraged to treat more patients; while under practice-based commissioning GPs are encouraged to refer fewer patients into secondary care.

“This tension can work against the development of integrated services that provide the best quality of care for patients, as it becomes financially easier to admit the patient rather than manage their condition outside the hospital or commission separate specialist services in primary care.”

The RCP also calls for stronger preventative measures on public health issues, and renewed support of academic medicine.

It warns that major steps still need to be taken to make the NHS more innovative. “Changing models of innovation mean that the talents of the private sector, academia and the NHS will need to be organised differently to meet the dual challenge of competition from overseas for British research talent and investment, and legitimate patient demand for more effective treatments,” the manifesto says.

It calls on the next government to continue investing in medical research and make a service-wide commitment to training and employing research-active physicians in order to preserve the UK’s pre-eminent position in the field of translational research.

The report also suggests that royal colleges should once more have a statutory role in monitoring training standards, claiming that its inspection could well have highlighted recent hospital failings like those at Mid Staffs.

Read the full report.

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2 Responses to “College sets out pre-election health manifesto”

  1. M.Wilkinson says:

    The GMC should be halved in size and its remit (and fees0 restored to that of 40 years ago. PMETB should be abolished, not merged with the GMC, and the Royal Colleges should resume the role of accreditation. This would of course diminish government control over medical education and specialist training, so will of course never happen.

  2. Malcolm Morrison says:

    Few would argue with the principles of this ‘manifesto’; the problem, as always, is how the profession can exert any influence to convert principles into practice. One of the main problems is that the profession has become fragmented; there has always been a division between GP and hospital practice but, in more recent years the hospital doctors have become more ‘specialised’ and so less united.
    Management has also been fragmented with PCTs, commissioning groups, hospital ‘provider’ units (some private) and Foundation Trusts – all of which are more concerned with their own budgets, balancing their (own particular) books and meeting political ‘targets’ than the real needs of patients.
    Then there is the division between ‘health care’ (NHS budget) and ‘social care’ (Local Authority budget) as though the two were separate!
    Unless and until the profession can be seen to be speaking on behalf of their patients (rather than themselves), and advising Govt. and management on the best way of treating patients, I fear the wasteful battles will continue. Furthermore, all must recognise that the ‘one size fits all’ doctrine is ridiculous – the delivery of care has to be different in large cities from sparsely populated rural areas.

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