The NHS Improvement Plan 2004 - Essay Example

The NHS Improvement Plan 2004 s that: "By 2008, the Independent Sector will provide up to 15% of procedures on behalf of the NHS" Critically evaluate the above statement and indicate what effect you think this will have on NHS Services provided by Imaging Departments. The emphasis on the role of the independent sector in UK health care was made explicit when it was stated in the key health policy document, The NHS Plan, July 2001 that: "The time has now come for the NHS to engage more constructively with the private sector, and at the same time make more of its expertise available to employers throughout the country." -- (NHS Plan, July 2001, para 11.1) However, until 2003 the involvement of the independent sector in the NHS clinical services was confined mostly to surgery outsourced to private hospitals and private providers on NHS premises. In 2003, the government flagged off the first wave of specialist diagnostic and treatment centers run by the independent sector along with the NHS. Apart from the UK-based companies, contracts were also awarded to bidders from North America and South Africa. But due to the lack of competitive prices, the UK-based private providers failed to win any of the first wave of treatment centers. As such most of these providers have remodeled their business to be part of the second wave which is currently under way. The NHS Improvement Plan, 2004, predicts a promising healthcare scenario with the policy makers making it clear that the independent sector will play a key role in delivering NHS care, providing upto 15 percent of procedures on behalf of NHS in order to support capacity and choice. This will certainly provide better opportunities for patients as they will have an increased number of choices. For instance, patients needing to undergo an operation would have the opportunity of choosing any private hospital which meets the Healthcare Commission's standards, which can provide the care within the price that the NHS will pay. This will drastically bring down the waiting time to eighteen weeks (as targeted by NHS). In keeping with this target, the Choice of Scan Phase II (underway since April 30, 2006) has it that patients awaiting diagnostic imaging tests who do not have an appointment within 20 weeks will be offered the choice of having their scan at another provider within a maximum of 20 weeks. This brings new challenges to the NHS, for it covers all diagnostic imaging tests apart from CT and MRI, and other clinical specialities like echocardiography, ultrasound scanning performed in urology/urodynamics and GI physiology, and vascular scanning performed in vascular technology departments. This obviously brings the independent providers into the scene. It is true that whenever choice is introduced, local services tend to improve. Firstly, the threat of competition leads local services to improve their standards. Second, choice leads to the creation of new provision which benefits local people. This will certainly ring true for the imaging services as well. People are to have control over issues like when and where to get a screening done and thereby ensure the quality and convenience that they want. But the local independent sector providers are more or less new to the market. As such, strong management and co-ordination of services by clinicians, radiographers and managers is imperative for ensuring the safety of the patients. Moreover, there are various concerns about the quality of service provided by the independent sector. In June 2004, Alliance Medical Ltd. won a contract to supply the NHS with 130000 MRI Scans per annum for five years. The contract was widely criticised by healthcare unions, including the Society of Radiographers (SoR) which said that the government should have consulted radiographers and those who knew the service best. Patients given MRI scans by Alliance Medical Ltd had to wait months for results and got sub-optimal care, while the NHS lost money because AML's capacity was not fully taken up. Complaints about Alliance Medical are on the rise. The Royal College of Radiologists advised its members to double-check AML reports "partly for quality control purposes". As such, it would take some time for the independent providers to win the confidence of the people. But it must be noted that this single deal increased MRI scanning capacity by 15%. The average waiting time for scans has been dropping drastically in various parts of UK with places like Huddersfield experiencing a cut in waiting times from 38 to 8 weeks. In Ipswich, it has been reduced down from 30 to just 5, and in Scarborough this has been halved from 36 to 18 weeks (Quicker Scans, Endoscopies and Imaging for NHS Patients, 1bn to tackle hidden diagnostic waits, UK, ,accessed on 19/05/06). In addition, there is an acute shortage of radiologists worldwide and when it comes to UK, the radiology workforce per head of population is traditionally one of the lowest in Europe. This obviously led to concerns that the centers will draw qualified radiologists out of the NHS. However, for services like radiography, orthopaedics, and anaesthetics, where there is a national shortage of staff, working staff cannot be drawn from teh NHS. In wake of these developments, an increasing international competition for staff is clearly evident. However, at present the major flow is inbound and it is likely that overseas graduates will be recruited to the UK. But this might lead to issues and problems in communication if English is not the first language of the radiologist. "Radiological reports are always in a written format and nuances of language can be vital in defining patient management with implications for patient safety." (Evidence submitted by the Royal College of Radiologists (WP 70) http://www.parliament.the-stationery-office.co.uk/pa/cm200506/cmselect/cmhealth/1077/1077we63.htm, accessed on 18/05/06). Mercury Health has been awarded a contract to run diagnostic procedures such as MRI, ultrasound and X-ray (in addition to their chain of five treatment centres). Mercury, thus, intends to employ 220 people across five clinics in the south east of England. About half of the staff is expected be recruited from northern Europe, Australia and New Zealand. Thus, an increase in the number of choices will have major implications for imaging services as this has reduced waiting times to a great extent. But problems continue to surface, as the services are not integrated into NHS Departments of Radiology to an extent, which the situation demands. An ideal approach, in this case, would be enabling flexibility of staffing, and making the best use of teleradiology with images acquired being transmitted to an available radiologist and at the same time maintaining skills and quality assurance of machines and staff. Read More