Junior NHS staff ‘should carry out more aspects of surgery’ in NHS efficiency drive

NHSreality has already commented on the parlous state of surgical training. Indeed, advice to an F2 wanting cutting experience was to go abroad! Reducing standards and opportunity in Surgical Training. Trials are important..There is a vacuum in honesty, leadership and future planning….. No fault compensation will certainly be needed if juniors do more surgery, as the litigation is high enough with consultants .. It will also increase inequalities by boosting demand for private practice.

Junior NHS staff ‘should carry out more aspects of surgery’ in NHS efficiency drive

Nurses and junior doctors should take on surgical procedures currently done by consultants, and patients should be ‘Skyped’ instead of called in for follow-up appointments, in bid to save £1.4bn, regulators say

NHS hospitals could save up to £1.4bn by using junior staff and nurses to carry out surgery now done by consultants and “Skyping” patients after surgery instead of calling them back in, regulators have said.

A report by Monitor, the watchdog for NHS foundation trusts, says as much as one fifth of the bill for planned surgery could be saved, if the health service reorganised the way services are run.

The regulator said “lower grade staff” including nurses should be increasingly employed to undertake some parts of operations which are usually performed by consultants.

It comes amid warnings that the health service is facing the worst financial crisis “in a generation” with a £1bn deficit racked up in just three months.

Such staff could carry out simple procedures, such as injectable treatments for wet age-macular degeneration or assist with others, like applying topical anaesthesia for cataract surgery, the report says.It says more trusts should follow Royal Devon and Exeter foundation Trust, where routine orthopaedic patients are followed up virtually after one face-to-face appointment post-surgery.

Monitor said such steps, combined with shorter hospital stays, could save the NHS up to 20 per cent of the bill for planned operations.

The research compared practices in eight NHS trusts and five clinics overseas, in countries including Finland, Australia and the United States.

It found lengths of stay were commonly much shorter in other countries, with average length of stay for hip and knee replacement surgery around 30 per cent longer in the NHS sites, compared to those abroad.

The report also said the NHS could save money by learning from other countries – such as India – which run “production line” systems, but which were not part of this study.

Under the system, more than 300,000 cataract operations a year are carried out using a method, in which qualified surgeons only carry out the most complex part of the procedure, with simpler tasks given to cheaper staff.

Regulators also said that “whenever possible” follow-up appointments should be carried out using virtual methods such as Skype, instead of calling patients back in.Dr David Bennett, the watchdog’s chief executive said: “The financial challenge facing the NHS is growing and hospitals up and down the country are being asked to do more to make sure they live within their means. We are seeking to play our part by offering practical support to the clinicians, managers and frontline.

“This research identified some practical steps that could help hospitals improve clinical outcomes and reduce their elective care bills by as much as 20 per cent, money that can be reinvested in improving care for patients.”

Roger Goss, from Patient Concern, said any effort to reduce costs must not come at the expense of safety.

He said: “Sight is the thing people most fear losing. Therefore any suggestion that you let lower-paid help do the work is going to be extremely unpopular.

“Patients would feel more comfortable being treated by fully-qualified doctors, not nurses.”

On Friday regulators published figures which show an overall deficit of £930m across England’s 241 NHS hospital trusts between April and June this year.

The figure is more than the £820 million overspend for the entire previous year, with three in four trusts in the red.

Surgery for dummies cartoon.

This entry was posted in A Personal View, Commissioning, Consultants, Patient representatives, Political Representatives and activists, Professionals, Rationing, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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