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Historic plan to boost NHS workforce
Some similarities to the US situation.
Many interesting ideas, including shortening the 5 year medical education to 4 years (equivalent to a US bachelors degree).[link]https://www.bbc.com/news/health-66052274.amp[/link]
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35 Replies
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– they do not appear to be good at math. Shortening medschool by a year will give you exactly one additional class worth of practicioners, it will not change the ongoing supply.
– the only thing that keeps the NHS afloat is the fact that UK docs for the most part are well trained and are able to provide ok-ish care in a resource strained environment. Making them less qualified is not gonna help towards the stated objectives.
– sounds like they are trying to learn from cuba.-
Whatever happened with their strike? Doesnt help much if the young docs have degrees but wont work.
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The Junior Doctors (residents) are planning another strike July 13-18.
The Senior Doctors (attendings) are planning a strike at, I believe; the end of July.
Currently the NHS gets about half their doctors from abroad.
There is a component of the plan to massively increase medical school spots and training spots, as well as a type of apprentice program which seems unusual.
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5 eyes nations are so ridiculous, totally suicidal
import the 3rd world …-
Quote from Dream Run
5 eyes nations are so ridiculous, totally suicidal
import the 3rd world …
“if you build it they will come”…I suppose if there’s no threat of litigation then bring it on-
Let me tell you how they will fix it… AI and importing half of Africa.
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There are also situations in which they are allowing nurses to do surgery.
Simple surgery only, of course.
I suspect the definition of “simple” will change over time.
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Sounds like a bad situation for doctors over there in general. Does anyone have any idea what it is like being a radiologist in the UK? Is it a similar grind or do they operate more like the VA?
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Times are interesting.
There’s far too much work, with 10% year on year increased demand, with not enough kit or staff (eg we have 1 MRI and 2 CT for a 450 bed acute hospital).
Despite insourcing (essentially unlimited overtime) and outsourcing, there are 2-5 week delays in OP reporting of CT & MRI.
We do maintain some control over requests/orders, rejecting the non-indicated or excessive, and changing the exam or modality as we see fit.
Only doctors and a few select NPs can request at all, so we don’t usually see the blunderbuss approach to diagnosis that I see whinged about here.
The politics is appalling – those in control promise everything, but won’t fund it and don’t have a coherent plan for anything much. This latest attempt to increase staffing without addressing the causes for the drain of existing staff is typical-
2-5 weeks wow. we get emails from PACS admin if a study is over 24 hours old and unread.
how do you all measure your productivity? is there some kind of RVU? -
Productivity does not equal studies reported.
There are various methods for RVU equivalents, but none really matter as all are inaccurate, don’t reflect actual value and there isn’t much anyone can do to change an individual’s numbers
Some info here
[link=https://www.rcr.ac.uk/publication/radiology-reporting-figures-service-planning-2022]https://www.rcr.ac.uk/pub…-service-planning-2022[/link] -
[link=https://unherd.com/2023/07/the-nhs-is-powered-by-cakeism/]https://unherd.com/2023/0…is-powered-by-cakeism/[/link]
Interesting read… I was unaware, though not surprised, of the role US loans played in the NHS’ founding. -
Socialized medicine in the USA will look like this…get ready!
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Quote from NYC
[link=https://unherd.com/2023/07/the-nhs-is-powered-by-cakeism/]https://unherd.com/2023/0…is-powered-by-cakeism/[/link]
Interesting read… I was unaware, though not surprised, of the role of US loans played in the NHS’ founding.
“Im agnostic on whether wed be better off keeping nationalized healthcare as opposed to some other funding model.”
Right wing drivel. Sounds like Republicans wanting to repeal ACA with no alternative plan. -
Harrington is right of center…
That said, the more I read about universal healthcare insurance systems in other countries, the more I feel that the NHS and even Canadian systems are the least appropriate for the US. -
Quote from NYC
Harrington is right of center…
That said, the more I read about universal healthcare insurance systems in other countries, the more I feel that the NHS and even Canadian systems are the least appropriate for the US.
No easy answers. NHS not the answer, Canadian better than what we have.
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It is a mixed picture in the UK. I work in a big Suburban Hospital of 700 beds and we have 5 CT and 2 MR scanners(one MR is the oldest in the UK). We are in need of a 3rd MR but cannot get it. Not all Hospitals are treated the same-it helps to have a big noise politician close by
We are losing the battle with the tidal wave of requests-CT up 40% since COVID at about 150 a weekday. I am much busier at the end of my career than I was at the start. We use insourcing (all our younger RADS do this) and outsourcing to teleradiology so most scans are reported inside 2 weeks.
We do not give local GP’s access to CT or MR but our ED and physicians are trying to make up for that with increasing lower thresholds for imaging. (I can still vet requests and have just refused 5 US scans) The main drivers are increasing patient expectation driven by political promises and other medical specialities developing new protocols which involve immediate radiology, usually without discussing it with us.
There are new local diagnostic centres starting up with CT and MR. These are privately run by corporate health care and are so that GPs can request complex imaging without Hospital input. What effect they will have on us is unknown but there is a shortage of all staff so that is of concern to us. I think all their scans will be reported remotely but am not sure by who.
We live in interesting times -
Quote from NLynch
There are new local diagnostic centres starting up with CT and MR. These are privately run by corporate health care and are so that GPs can request complex imaging without Hospital input. What effect they will have on us is unknown but there is a shortage of all staff so that is of concern to us. I think all their scans will be reported remotely but am not sure by who.
I’ll make a guess regarding the impact:
– You’ll get asked to redo the poorly done studies to sort out equivocal findings.
– The push button availability in the community drives up your demand further as patients now expect a CT and MRI for anything from a post-booze headache to a ingrown toenail.As for who is reporting it: A sweatshop of Indian rads officially located in Hungary with a UK registered radiologist rubber-stamping the reports. And if anyone asks: those sweatshop rads only do ‘advanced reformatting’ and ‘clerical services’ such as ‘drafting reports’. They totally don’t do any interpretations.
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Quote from NLynch
We do not give local GP’s access to CT or MR
What are your thoughts on nurse practitioners? LOL
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We keep a close eye on NP’s. A colleague is a stickler for governance generally but especially of Radiographer reporting and NP requesting. He alone keeps all on their toes. When he retires I will worry.
NP,s have to apply to us for requesting rights under the umbrella of the relevant clinical team and can be removed from the list. This mostly works quite well. Any illogical requests are bounced as we vet CT ,MR and US. All requesting NP’s are Hospital based and are part of a clinical team so their remit is constrained. They can only ask for imaging pertinent to their team. The bottom line is that legally you need a medical degree to request ionising imaging so we use that to manage them(not sure how many know the physics of MR and US).
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Quote from NLynch
We keep a close eye on NP’s. A colleague is a stickler for governance generally but especially of Radiographer reporting and NP requesting. He alone keeps all on their toes. When he retires I will worry.
NP,s have to apply to us for requesting rights under the umbrella of the relevant clinical team and can be removed from the list. This mostly works quite well. Any illogical requests are bounced as we vet CT ,MR and US. All requesting NP’s are Hospital based and are part of a clinical team so their remit is constrained. They can only ask for imaging pertinent to their team. The bottom line is that legally you need a medical degree to request ionising imaging so we use that to manage them(not sure how many know the physics of MR and US).
Radiographer reporting? Techs report plain films in UK?
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Quote from NLynch
NP,s have to apply to us for requesting rights under the umbrella of the relevant clinical team and can be removed from the list. This mostly works quite well. Any illogical requests are bounced as we vet CT ,MR and US. All requesting NP’s are Hospital based and are part of a clinical team so their remit is constrained. They can only ask for imaging pertinent to their team. The bottom line is that legally you need a medical degree to request ionising imaging so we use that to manage them(not sure how many know the physics of MR and US).
There are a few things that make me envious of UK radiologists. The ability to say no to a bullsh¡t request for a expensive study and a formal process to suspend ordering privileges of individual practicioners are among them. I would have a long list of candidates for the latter 🙂
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Yep we have radiographer reporting. US,ED. plain film, cxr’s and CT head. It is loved by management as they think it is cheaper and they can bully the techs easily.
It has problems.
1:The best techs do it as it means more money so pure radiography suffers.
2:It is inflexible. The techs only report one thing-one set does head CT only, another does plain film, another does US.
3. Minimal governance. When set up originally time for audit, clinical meetings etc was part of the schemes but over time these have been reduced so the techs struggle to attend cancer boards, do audit or attend discrepancy meetings.
4. It’s not that cheap. The techs are paid at a higher rate and do not tend to do as much as Consultants.
5 They also come off the on call rota-a cause for resentment from other techs and Radiologists -
Quote from NLynch
Yep we have radiographer reporting. US,ED. plain film, cxr’s and CT head. It is loved by management as they think it is cheaper and they can bully the techs easily.
It has problems.
1:The best techs do it as it means more money so pure radiography suffers.
2:It is inflexible. The techs only report one thing-one set does head CT only, another does plain film, another does US.
3. Minimal governance. When set up originally time for audit, clinical meetings etc was part of the schemes but over time these have been reduced so the techs struggle to attend cancer boards, do audit or attend discrepancy meetings.
4. It’s not that cheap. The techs are paid at a higher rate and do not tend to do as much as Consultants.
5 They also come off the on call rota-a cause for resentment from other techs and RadiologistsJust crazy.
As an aside, can junior docs afford homes in the UK now? What about anywhere near London? -
It seems few employed Londoners can afford to buy a home in London now, at least in zones 1-4. I cannot see how Junior Doctors in London can even afford to rent a decent place without roommates.
I have professional friends that have moved far outside London (including to Scotland) in no small part to be able to own a home. It is still very expensive by non-coastal US standards. -
how much do junior doctors earn?
Year 1 (FY1) £29,384 per year
Year 2 (FY2) £34,012
Year 3 and 4 (CT1-2 / ST1-2) £40,257
Years 5 to 7 (ST3-5) £51,017
Years 8-10 (ST6-8) £58,398
[link=https://www.myhsn.co.uk/top-tip/how-much-do-junior-doctors-earn#:~:text=What%20do%20junior%20doctors%20earn,hours%20working%20and%20oncall%20commitments.]https://www.myhsn.co.uk/t…0oncall%20commitments.[/link] -
It is truly remarkable to see the downfall of the once great British empire. UK is literally a disaster and only going to get worse.
However, the morons still worship the royal family.
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Can you elaborate on “UK is literally a disaster”?
Quote from Waduh Dong
It is truly remarkable to see the downfall of the once great British empire. UK is literally a disaster and only going to get worse.However, the morons still worship the royal family.
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Inflation out of control, looming debt crisis, immigration issues. -
Quote from Waduh Dong
Inflation out of control, looming debt crisis, immigration issues.Sounds like what is happening in the USA.
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[h2]Specialty doctors and specialist payscale[/h2] If youre working as a specialty doctor youll earn a basic salary of £50,373 to £78,759. If you are a specialist grade doctor you’ll earn a basic salary of £80,693 to £91,584.
[h2]Consultants[/h2] As a consultant from 1 April 2022, you’ll earn a basic salary of £88,364 to £119,133 per year, depending on the length of your service.
[link=https://www.healthcareers.nhs.uk/explore-roles/doctors/roles-doctors/surgery/neurosurgery]https://www.healthcareers…s/surgery/neurosurgery[/link]
A far cry from us neurosurgery pay.
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Yeah, that is weekly income for one of our local neurosurgeons.
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Quote from drad123
[h2]Specialty doctors and specialist payscale[/h2] If youre working as a specialty doctor youll earn a basic salary of £50,373 to £78,759. If you are a specialist grade doctor you’ll earn a basic salary of £80,693 to £91,584.
[h2]Consultants[/h2] As a consultant from 1 April 2022, you’ll earn a basic salary of £88,364 to £119,133 per year, depending on the length of your service.[link=https://www.healthcareers.nhs.uk/explore-roles/doctors/roles-doctors/surgery/neurosurgery]https://www.healthcareers…s/surgery/neurosurgery[/link]
A far cry from us neurosurgery pay.
Not sure why we would compare that to NS incomes in the US.
From my conversations with UK colleagues, the NHS money is a base with most having sources of additional income from the private sector.
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Quote from drad123
Quote from Waduh Dong
Inflation out of control, looming debt crisis, immigration issues.
Sounds like what is happening in the USA.
If we measured inflation the way the europeans do, ours would already be down to below 3%.
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Quote from Phil Shaffer
There are also situations in which they are allowing nurses to do surgery.
Simple surgery only, of course.
I suspect the definition of “simple” will change over time.
When I was over there last a case was being reported where a surgeon let a janitor do a toe amputation. Maybe that was the start?!
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