BMA Scotland, headed up by Dr Iain Kennedy, who has now shed the union flag on his twitter account, have a piece on consultant vacancies all over the media from 06:30 this morning on BBC Scotland.
They’ll have had this one oven-ready for some time now. Why today?
From the real BMA in London today:
The BMA England GP committee has warned health service officials that the profession is ‘now in dispute’ with NHS England following the overwhelming vote to reject the 2024/25 contract.
Is the profession in dispute with NHS Scotland? The silence talks.
Talking-up Scotland 'Albatraz' 
“Dr Iain Kennedy, who has now shed the union flag on his twitter account”
The bitter tears he must have shed doing so.
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He should replace it with an England flag, that’s who he works for. I wonder what he’s been promised for his services to the BritNat state…
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MSM Monitor Tweeted on this:
“BMA Scotland is a trade union. It is not “senior doctors”. When it issues press releases it should be described as a trade union representing doctors. Concealing the fact it is a trade union is dishonest. Moreover, promoting attacks based on FOI requests is lazy”
As BBC Reporting Scotland reported that “Senior doctors accused the Scottish government of not being honest about the levels of consultants vacancies currently in the NHS”…..”BMA Scotland said FOI via requests to all Health boards”
FOI to all Health boards ?
A trawling through exercise…… for dirt me thinks….mind you we often hear that the SNP rule with “secrecy” according to opposition MP’s, especially via Tory MSP’s , yet why then is all of their, Tories (and others) attacks based mainly via FREEDOM of INFORMATION sources and too even the BBC themselves source FOI for their news reports (that is surely the opposite of a government condoning a culture of “secrecy”)…..while it was reported in January of this year that the UK government is “set to hit a record low as public bodies are granting just a third of FOI requests”……so which government is being transparent and which government is ensuring a lack of transparency in making exemptions of some information……Hmm
NMRN
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Iain Kennedy and his ”BMA -Scotland ” are in the same boat as the GMB and its Labour-ridden spokespersons who constantly moan about things that they would NOT mention if Labour were in Government in Scotland .
They are not to be trusted and I pity any of their members who put their faith in these mouthpieces for unionism !
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Workforce statistics need very careful analysis based on trusted, objective assessment which gives readers ‘perspective’. No longer confident in the BMAs credentials in this regard and certainly not in the The Herald’s reporting on NHS Scotland.
NHS Scotland’s total workforce in Q4 2023 was 160,567 (whole time equivalents), up 18.9% over the past ten years and up 14.1% in the past five years alone.
The Q4 2023 the workforce included:
In Q4 2019 the workforce included:
Source: https://turasdata.nes.nhs.scot/data-and-reports/official-workforce-statistics/all-official-statistics-publications/?pageid=1302
Looking further back in time, using this source: ‘NHS National Services Scotland (28 June 2011 ) NHS Scotland Workforce – Data as at 31 March 2011 – Table MDQT2: HCHS medical and dental consultant staff in post by year: this shows that between September 2002 and September 2007 the number of consultants varied between 3,194.8 to 3,801.7 (WTEs).
So, arguably, there has been a substantial increase in the NHS Scotland workforce during a period of time characterised by imposed ‘austerity’, a pandemic and Brexit. Has any part of the NHS in the UK been able to match delivery capacity with increasing demand for health services? Not even in England where the responsible government – unique in the UK – has ALL the powers to solve such NHS issues – but hasn’t done so!
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NHS backlog data analysis
Analysis of monthly data releases by NHS England to highlight the growing backlogs across the NHS – including operations data, cancer waiting list GP referrals and A&E waiting times.
With demand for hospital treatment outstripping capacity even before COVID-19, it is no surprise that the demands of delivering care during a pandemic have led to significant backlogs and longer waits for patients.
This page provides analysis on capacity in secondary care services and is updated monthly with new data.
Last updated in 12 April 2024
A growing backlog of care in EnglandWhat is the backlog?
The backlog in secondary care consists of the care that the NHS would normally have delivered but which was disrupted as COVID-19 impacted service delivery. This includes:
It will take years to clear the backlog. The ongoing need for stringent infection prevention control measures and workforce shortages mean it will take even longer to work through as demand continues to rise.
More patients than ever are waiting for treatment
https://flo.uri.sh/story/1066522/embed?auto=1
High waits for treatment are not new. Prior to the pandemic in February 2020 there were already 4.43 million people on a waiting list for consultant-led care.
At the beginning of the pandemic, the combination of suspension of non-urgent services and changes to individuals’ behaviour meant that the number of people joining the waiting list initially dropped. However, this has since been rising – and despite some improvements earlier in the year, waiting times remain far higher than pre-COVID.
https://flo.uri.sh/visualisation/17518621/embed?auto=1
The latest Referral to Treatment (RTT) figures for February 2024 show:
The target in the elective backlog recovery plan (February 2022) to eliminate waits longer than 65 weeks by March 2024 will be missed. The longer-running target that 92% of patients should receive treatment within 18 weeks of referral has not been met since September 2015.
NHS England announced in October 2023 that up to 400,000 patients waiting over 40 weeks will be offered the opportunity to travel to a different hospital to be seen sooner. However, many people may feel unable to travel, particularly without support networks.The hidden backlog is growing
The waiting list is a visible backlog, but what we refer to as the growing ‘hidden backlog’ remains an unknown for the health service.
The hidden backlog includes patients who require care but have not yet presented to healthcare providers. Furthermore, the referral to treatment waiting list does not include waiting for non-consultant-led treatment, or patients waiting for follow up appointments once they have begun treatment. Therefore, the number of patients included in the headline waiting list figures does not show the full extent of the backlog.Cancer targets continue to be missed
https://flo.uri.sh/story/2123137/embed?auto=1
Changes to cancer waiting times standards came into effect from 1 October 2023 with the following three core measures replacing the previous standards:
Despite the changes in the cancer care targets, services continue to operate well below operational standards.
In February 2024, the percentage of patients told they have cancer within four weeks (28-days) of an urgent referral remains increased to 78.1% – an all-time high since the metric was reported in April 2021. The 75% operational standard had not been met since February 2023.
The percentage of people receiving their first cancer treatment within one month from a decision to treat increased from 87.5% in January 2024 to 91.1% in February 2024. This is well below the 96% operational standard.
The percentage of patients receiving their first cancer treatment within two months (62-days) of an urgent referral stood at 63.9% in February, an increase from the January 2024 figure of 62.3%. This is significantly below the operational standard of 85%.
The poor performance against these key operational standards illustrates the level of pressure the system is under, and is a clear sign that significant investment in capacity is needed.Patients are waiting longer for emergency care
https://flo.uri.sh/visualisation/8121923/embed?auto=1
Prior to the pandemic, the situation in A&E was increasingly difficult with demand soaring and the percentage of people being seen within the four-hour target reaching an all-time low over the 2019/20 winter.
At the start of the pandemic, A&E attendance decreased significantly which led to performance improvements. However, since lockdown eased demand has steadily risen, reducing performance against targets.
These pressures on emergency care persist into 2023, despite small improvements in certain areas. Demand for care across all A&E departments remained high in March 2024, with total A&E attendances standing at 2.35 million – an increase from 2.15 million in February.
74.2% of people attending A&E were seen within 4 hours in March – an increase from 70.9% in February 2024, but below the target for 76% of patients to be seen within 4 hours by March 2024. In the past 12 months (from April 2023 to March 2024), approximately 1.58 million people have waited more than 4 hours in A&E.
NHSE introduced three new targets as part the Urgent and Emergency Care capital incentive scheme. The trusts that are on track to meet these targets based on their performance will be eligible to receive additional capital funding in 2024-25.
These include:
The BMA has raised concerns regarding the introduction of the capital incentive scheme, on the basis that it risks creating perverse incentives for Trusts, diverting support away from where it is needed most, and widening existing health inequalities.
https://flo.uri.sh/visualisation/16158753/embed?auto=1Waiting times have rocketed
The combination of ongoing pressure on services, the backlog of care and chronic workforce shortages means waiting times have increased to record highs.
The total number of patients waiting over 12 hours for an emergency admission decreased slightly by around 18%, from about 44,000 in February 2024 to approximately 43,000 in March 2024. The number of patients waiting over 12 hours for an emergency admission in March 2024 was about 130 times higher than in March 2019 – pre-pandemic. Note that this number represents an underestimate of actual waiting times, as patients will have been waiting for additional time before a ‘decision to admit’ was made.
These long waiting times are, in part, due to poor patient flow. General and acute bed occupancy has consistently been at over 90% since September 2021, and patients regularly remain in hospital despite being fit for discharge because there is no capacity for them in social care.GPs are finding it harder to make referrals
https://flo.uri.sh/story/1110524/embed?auto=1
We can track GP referrals into consultant-led outpatient services alongside the waves of COVID-19: as the waves have peaked, referrals into secondary care have dropped. These drops are likely due to a combination of changes to patient behaviour alongside capacity issues in secondary care effectively forcing GPs to take a more cautious approach with timings of referrals to avoid having referrals rejected.
GPs can still refer patients, but the pressures in hospitals means there is little capacity in secondary care, and those referrals are often rejected.
The number of GP referrals to consultant-led outpatient services that have been unsuccessful because there are no slots available has jumped from 238,859 in February 2020 to a staggering 401,115 in November 2021 (an 87% increase).
When GPs are unable to refer into hospital services, the care for these patients does not disappear. Instead, these patients need to be cared for by GPs while they wait for hospital treatment to go ahead, adding to the pressure in primary care.The role of the private sector
Enlisting the help of the private sector is one of the measures the Government has taken to reduce pressures on hospitals and help cut waiting lists.
Purchasing private capacity is not new, but the pandemic has demanded unprecedented block-booking arrangements.
A recent BMA survey found that under these arrangements, 60% of private practice doctors who responded were unable to provide care to their patients at the time.
The extent to which private hospitals will be able to take on NHS waiting list initiatives going forward is unclear given the increased demand in the self-pay market and the backlog of private sector patients.
Given that the NHS and the private sector largely draw on the same pool of doctors, additional capacity may be less than it initially appears. This was made clear in the 2020 block-booking arrangements, which saw the NHS gain facilities rather than the workforce to run them.What the BMA is calling forYou may also be interested in…
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