Avoidable delays

At least 1,000 overseas-qualified doctors who have applied to work in the UK will have to wait until the summer to take their entrance exams, which were cancelled by the General Medical Council just before Christmas.

The professional and linguistic assessment board (PLAB) tests, which determine whether an overseas doctor can perform to the same standard as a Foundation Year two (FY2) doctor, were scheduled for January and February. The reason given for the postponement was that up to 54 GMC validated doctors were needed, each examination day, to act as examiners; the absence of these examiners from clinical work in the NHS would further stress services.

News from Nowhere is puzzled by the GMC’s decision. Are there not enough recently-retired doctors who have volunteered to help, and who with some training could perform the examiner role? The shortage of doctors is more acute with the Omicron variant, but it is hardly a surprise. Something feels wrong about a situation in which the entry to the UK of hundreds of doctors is delayed by 6 months whilst NHS medical staff are struggling to cope. 

Source: Health Service Journal Daily Insight 7/1/22

Subjectivity

A recent European study found that those who believed they were less healthy than was actually the case more often reduced their mobility to comply with rules aimed at shortening the pandemic. If you are scared about your health you are more likely to conform to Public Health Advice. Is it true the other way round? If you are not scared about your health (even when you should be) are you less likely to conform to advice? That sounds plausible, but comments welcome.

Source: Spitzer S., Shaikh M., Weber D. (2022). Older Europeans' health perception and their adaptive behavior during the COVID-19 pandemic. European Journal of Public Health, DOI: 10.1093/eurpub/ckab221 [pure.iiasa.ac.at/17733]

Back to the future

Doctors in Unite, a tiny medical groupuscule, have been discussing how private hospitals should be requisitioned by the NHS until pandemic-induced backlogs are cleared. Imagine the headlines: Red medics seize private hospitals, panic in boardrooms! Readers should not mock leftist fancies, there is precedent. AS NfN reported in the previous issue, the NHS arose from the Emergency Medical Service which requisitioned hospitals in 1939. Of course things were different then, with a continental war starting. Maybe Russia and the Ukraine could help out?

Source: Assorted DiU members

Wash your mouse!

COVID-19 has meant that organisations are becoming more conscious of keeping communal areas safe for workers returning to the office. It is important to understand the danger areas for harbouring germs and bacteria. Research by a leading international brand of professional cleaning materials shows where offices need attention.

Swabs taken in offices were incubated and the amount of viable bacteria and fungal cells were measured in Combined Colony-forming Units (CCfU) per cm2

There may be no great surprises but the bacterial and fungal load on the hand sanitizer is unnerving. Readers returning to work in offices should ask how deep their organisation’s deep clean actually goes.

Source: Chicopee 

Save our hospitals!

There is an unwritten rule in the NHS that hospitals must be saved at all costs. In January NHSE issued guidance for the redeployment of the community health workforce to relieve the increasing pressures on acute providers from Omicron and the booster jab programme. This redeployment comes after NHS trusts fell short of the target for reducing delayed discharges. NHSE wants to see deferral of low priority cases to free up workforce capacity.  These include:

• Children’s therapy interventions, including physiotherapy, speech and language, occupational therapy, dietetics, orthotics

• Children’s community paediatric services, including autism diagnostic services

• Audiology services for older adults

• Wheelchair, orthotics, prosthetics and equipment

•  Smoking cessation

So much for prevention, quality of life and relief of disability.

Covid’s legacy

A paper on the damage done to the quality of NHS care by COVID-19 pandemic induced pressures is worrying. The authors say: “We observe persistently worsened performance and longer waiting times in A&E; drastically limited access to specialist care; notably delayed or inaccessible diagnostic services; acutely undermined access to and quality of cancer care. We find that providers under COVID-19 pressures experience notably more excess deaths among non-COVID related hospital episodes such as, for example, for treatment of heart attacks. 

We estimate there to be at least one such non-COVID-19 related excess death among patients being admitted to hospital for non-COVID-19 reasons for every 30 COVID-19 deaths… In total, this amounts to 4,003 non COVID-19 excess deaths from March 2020 to February 2021. Further, there are at least 32,189 missing cancer patients that should counterfactually have started receiving treatment which suggests there will be increased numbers of excess deaths in the future due to delayed access to care in the past”.

Source: Thiemo Fetzer & Christopher Rauh Pandemic Pressures and Public Health Care: Evidence from England CAGE working paper no. 607 January 2022 

A Recovery Plan for Outpatient Departments 

The current NHS outpatient system offers appointments on a certain date and time, based on simply the order in which the referral from the GP is received. This method of operating is far from patient centred. The NHS needs to normalise a virtual outpatient service in which patients self-refer dependent on symptoms and manage their appointment process online. To see the full story, go to: https://www.healthmatters.org.uk/BLOG/rndblog/blog1-a.php?pid=165&p=&cat_id=0&search=#comments;

Leopards and spots come to mind.

In the spring of 2021 an experienced senior NHS manager, David Laughton, was appointed to the board of Walsall Healthcare Trust as interim CEO, apparently to sort out problems of care quality. Allegations made about Mr Loughton’s behaviour led to a review by NHS England. The review was conducted by Kathy McLean, former NHS Improvement medical director, and concluded that the interim CEO “behaved poorly and inappropriately” and had called Walsall directors “useless”. Defenders of Mr Loughton praised his straight-talking, no-nonsense style. NfN moles who had encountered David Loughton in his Coventry days tell us that the most Frequently Asked Question addressed to him was “which part of the word ‘Unacceptable’ do you not understand?” That was 20 years ago.

Source: Chair who was 'ashamed’ of his trust now ‘really proud’   Emily Townsend Health Service Journal 2 February 2022

Hanging on…

What is happening with NHS 111, the phone and online service that provides 24/7 access to advice about immediate health needs? In December 2021 an average of 67 thousand calls were received by NHS 111 per day.  Of these calls 38% were answered in 60 seconds or less but the average time to call answer was a stonking 9 minutes and 45 seconds. Not surprisingly 23% of calls received by NHS 111 were abandoned.  Of the calls triaged, 10.5% were referred to the Ambulance service and 10.0% were recommended to attend an Emergency Department.

Source: Integrated Urgent Care Aggregate Data Collection December 2021 (provisional) NHS England and NHS Improvement 2022 and Elizabeth Fisher How quickly are NHS 111 answering calls this winter? Nuffield Trust 28/1/22

Read more News from Nowhere and articles on the NHS in ERA 3 at htt