Filling gaps in NHS workforce… impossible in the short term…

BMJ 21st May 2016 reports: Filling gaps in NHS workforce – Impossible in the short term without importing from other countries, and reducing standards. The result of prolonged rationing of medical school places..

Extending the skills of England’s NHS support staff, such as healthcare assistants, is the best way to build capacity in the health service workforce, said the Nuffield Trust think tank.1 Evidence has shown that support workers can provide good quality, patient focused care and can reduce the workload of more highly qualified staff. Also, nurses, pharmacists, physiotherapists, and paramedics can be trained to manage the growing burden of chronic disease more effectively, and nurses with advanced training, such as a masters degree, can help to fill gaps in the medical workforce by providing mentoring and training for less experienced staff, the trust said.

Better Cancer Care at risk from lack of radiologists (BMJ 2016;353:i2718)

BMJ 21st May reports a press release 12th May: The Royal College of Radiologists has warned that a shortage of radiologists could hamper NHS England plans to provide fast tracked cancer diagnosis.

The national cancer strategy,1 launched by the National Cancer Transformation Board, unveiled plans for patients with suspected cancer to be diagnosed or have their cancer ruled out within four weeks of initial referral by a GP. From 2017 five areas will test the four week diagnosis standard.

NHS England will invest £15m ($22m; €19m) in a bid to provide “world class” cancer care by speeding up diagnosis, improving the experience of patients, and helping people living with and beyond cancer.

However, Giles Maskell, president of the Royal College of Radiologists, said that while he welcomed the ambition of the plans there were not enough radiologists to carry out the increased number of tests.

“Most countries with better cancer outcomes have two or three times as many radiologists per head of population as the UK. We have not yet seen a commitment to address this deficit. The number of radiologists entering training this year has actually dropped due to a lack of funded training places. Unless this is addressed as part of a wider strategy to increase the diagnostic workforce, the ambition will not be realised,” he said.

The strategy also unveiled a new diagnostics fund to test initiatives to improve diagnostic services and set up a two year trial of six new multidisciplinary diagnostic centres.

Cally Palmer, the national cancer director for England said, “One in two people will be diagnosed with cancer and too many people are being diagnosed when their cancer is advanced. We need to change this.

“Through this cancer strategy we will drive a transformation in cancer care that will touch every corner of the country and improve services for thousands of people.”

The action plan follows the NHS’s Independent Cancer Taskforce report, published last year, which identified how the NHS could achieve world class cancer outcomes and save 30 000 lives a year by 2020.2

The new plan also outlined how, from September, the NHS would set up cancer alliances made up of clinical and other local leaders who would review all data for their area including survival, early diagnosis rates, treatment outcomes, patient experience, and quality of life to pinpoint areas for improvement.

Fran Woodard, executive director of policy and impact at Macmillan Cancer Support said, “We hope that added investment in early diagnosis and the setting up of cancer alliances will play an important part in tackling recurring problem such as missed waiting time targets.

“NHS England must also guarantee that necessary funding will be ringfenced in future budgets to ensure the plan published today can credibly be put into action.”

Emma Greenwood, Cancer Research UK’s head of policy, said, “If acted on, this strategy has the potential to transform people’s experiences of cancer care as well as their chances of beating the disease. We urge the government and NHS to now make the investments required and implement this strategy with commitment and speed.”

This entry was posted in A Personal View, 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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