Doctors call for NHS Direct review
Time to bin consultants too
Posted in Management, 11th June 2010 11:24 GMT
Watch Now : Virtual Machine Movement with Hyper-V
The chair of the GP's council Dr Laurence Buckman has called for a proper review of the cost-effectiveness of parts of NHS Direct - we're guessing call centres - and changes to the Summary Care Record scheme.
Earlier this week it emerged that NHS Direct is moving to hire call centre managers with no medical experience. Currently about 41 per cent of staff are not medically trained. Plans would cut nurse managers to one in 39 staff, Pulse reports.
Speaking to the Local Medical Committees Conference, Dr Buckman outlined a list of things that should be "consigned to the dustbin of history". These included "wasteful PFI schemes, management consultants, the bureaucracy of the NHS market, management tiers that seem to exist to do little more than micromanage general practice, and patient surveys that provide no benefit to patients".
NHS Direct costs £123m a year and serves five million people who phone its call centres, and another five million who use its website. It deals with another five million calls in response to other services commissioned locally or nationally.
Nick Chapman, chief executive of NHS Direct, defended the service which he claimed pays for itself in stopping people from using other NHS resources instead. He said that more than half of all calls or visits to the website led to people treating themselves at home.
Chapman said: “There is evidence that NHS Direct more than pays for itself through the reduction in demand on face to face services. We have conducted analysis with our commissioner (East of England SHA), which shows that in 2008 we saved the NHS £162m by reducing demand on face-to-face services.
"This includes £106m through reduced demand on emergency care (A&E and 999), and in the order of £56 million on other primary care providers. This includes 1.7 million GP consultations that were avoided through patients calling NHS Direct."
All these proposed savings seem dwarfed by the £12.7bn being spent on the NHS's delayed IT programme. Or the millions the Department of Health also spends on consultants. In 2008 - 2009 DoH, excluding Connecting for Health which runs the technology programme, gave £12m to Ernst & Young, £9m to McKinsey and £4.9m to PA Consulting. Total spending on external consultants was £102m.
Buckman described the SCR scheme as "wrongly-consented - patients currently have to opt out if they do not wish to have their records uploaded to a central spine".
He also questioned the value for money offered by walk-in centres.
The service might not be liked by doctors but it is well-loved by patients, and those caring for the infamous germ factories that are young children. It also contrasts dramatically with the famously unhelpful phone manner of the traditional GP's receptionist.
Buckman's full speech is available here. ®
Watch Now : Virtual Machine Movement with Hyper-V
COMMENTS
What a cock, a corrupt cock. Look at the real reasons.
Walk in centres were set up for two reasons. I know this, I have to deal with it daily.
Save money. A&E if you walk in, immediatly charge money to the Doctor you are with. Regadless of what you need to do. The charge is a lot of money.
The PCT has to pay the doctor for your treatment, that is then paid to the A&E. You pay more if you go to A&E for non emergency stuff. £65 - £500 each.
So the PCT's then decided to save money, tax payers money by putting in a middle ground. a walk in centre which are PCT employees and therefore avoid the stupid tax that Acute PCT's charge us.
Still with me?
Second is the people using A&E that shouldn't, they go to a walk in centre and THEN get sent to A&E if needed. Or treated if the moron patient goes because of snuffles etc.
The A&E (for my area) then complain because there isn't the footfall through the door to warrant the A&E, or the number of consultants. The walk in centre is removing funds from the PCT despite them complaining all the time.
So now the consultants being sacked or the A&E closing hits the headlines and the walk in centre closes or merges with A&E. And we still pay the acute trust vast sums of money for you turning up with your broken finger, or your bruised knee.
The Doctors are complaining because if you walk into a walk in centre, or use NHS direct you are not walking through the surgery doors. And they are paid for each ten minute visit. It is a tick box exercise. Nothing more. (You ask yourself why your Doctor now does 5 minutes?) They are just complaining because they are not getting as much wage as they used to.
Value for money it isn't, Labours internal market is to blame. Though the tory dems are not making it look much better.
What should be investigated is the hospital to be charged if the person returns within a month. It will mean you are kept in longer than needed, so no beds, more cost to the PCT as a result. If they are paid £500 a day by charging your Dr they want to send you home, if they can keep you in and are now told to keep you in or risk fines, it is 500 more a day per patient. It is now in their interest to keep you in.
And of course the plan to make the Dr's control 98% of their budgets and what they spend come from them. Removing them even further from PCT control. So basically removing the PCT and creating in our area 43 separate PCT's (1 for every Dr.) No central control, no central responsibility. And if they treat the PCT like they do. Expect the NHS to die, very quickly.
Patient care records. One practice (all staff) shut down a window by rebooting the machine. They don't understand the X in the top right hand corner. You trust those people with your critical and sensitive patient information????? Are you mad?
Anon as you know where I work.
A drastic but effective approach potentially.
How about sack every non-medically trained manager in the NHS all at the same time.
Then just see who screams a need for them the next day...week...month.
I'm sure nurses etc. can organise themselves to a large extent.
Like pulling the plug on an old server that gets found at the back of the server room. Unplug and see who shouts.
@DominicT
Yes... BUT...
First of all it depends how you define manager. In my book it's anyone without medical qualifications who's paid more than a nurse.
And even within the narrowest of definitions, how much of the cream do they take off the top of the finances? A hell of a lot in my area where the managers really ARE totally useless (direct experience.)
Sub title is a bit iffy
I don't think most GPs want an end to consultants (being the upper tier of hospital doctors), they might want an end to management consultants (being the way to waste large amounts of public money in exchange for shiny documents).
Creep
There's been something of a slip in NHS Direct's function since it was originally announced. We were originally told that we'd be able to call and speak to a medical professional direct. Great idea, but as usual with anything provided by the government the plan and the execution were poles appart.
I've had occasion to phone them once and the "direct" bit was sadly absent. After struggling with my call for some time the operative finally gave in and told me a doctor would call me back. To be fair the call back was relatively quick, within about half an hour. But the delivery of the service falls a long way short of the delivery. The issue at hand was a child drinking some household cleaning product. By the time the doctor phoned back I had managed to get the required answers elsewhere.
If the plan is to take the load off A&E and out of hours doctors services (as we were originally told) then it really doesn't work, not least because after dealing with NHS Direct once you're not going to bother again. So you'll go back to calling your doctor out of hours or visiting A&E. And no matter what we're told by the meeja about A&E departments and long waiting times I've never experienced any problems in that respect.
The new Office Garage series:
Enabling efficient data center monitoring
Top 10 SIEM implementer’s checklist
