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CBS News Update June 2020

05 June 2020

Staff
In common with many other organisations, the Coronavirus pandemic had a major impact on CBS activity and we needed to furlough our 2 members of staff (James Rose, acting MD and Helen Crookes, Membership & Admin manager). However, we are pleased to report  that they have both resumed normal working with effect from the 1st June.

Bullying
CBS is involved in two separate investigations of bullying of its members by management. Progress is slow in resolving these issues as most Trusts have understandably had their focus elsewhere at present. Nonetheless, it is encouraging that there is an increasing awareness in the surgical community about the existence of CBS and its’ commitment to assist surgeons in trouble for whatever reason.
 

FIPO (Federation Independent Practitioners)
CBS has had preliminary discussions with Richard Packard, Chairman of FIPO about affiliation between our two organisations. Hopefully this will develop when the current pandemic is over.
 

OTSIS (Indemnity for Orthopaedic Surgeons).
CBS has had very interesting and fruitful discussions with Ian McDermott representing OTSIS. We have now reached a mutual understanding whereby members of OTSIS would automatically be given scheme membership of CBS at a reduced rate.
 

Post Covid: impact on terms and conditions of employment
The deluge of media cover regarding the pandemic compounded by a tendency to be alarmist makes accurate judgements about the long-term effects of the pandemic on surgical practice difficult to predict. However, a number of factors are likely to be important:

  • PPE: the Consultant contract stipulates that the employing authority (usually Trust in England and Wales) have a statutory responsibility to provide the resources for surgeons to be able to do their jobs safely and effectively. In the past this has been taken to mean provision of theatre / endoscopy / ward facilities in conjunction with adequate office/audit and research back up. Inevitably the future will see, as an essential addition, the need to provide effective PPE.
  • Indemnity: it is generally agreed that the massive restriction on normal clinical activities will result in significant delays in both diagnosis and treatment. Whilst politicians and the public have nothing but praise for the NHS now, the fact remains there is likely to be a large number of claims against surgeons in the future based on delay in diagnosis and treatment. It is the opinion of CBS that individual surgeons should be exempt from such claims. We have written to NHS Resolution seeking clarity on this issue.
  • TWW referrals. The TWW standard is loved by politicians and health care managers but detested by clinicians in the front line. The main reason for this is simply that it is not effective. There is no evidence that the TWW referral system leads to more rapid diagnosis of malignant disease. Furthermore, the system puts all the risk firmly onto the shoulders of surgeons. Surgeons do not control entry criteria but are held responsible if matters go wrong. Covid-19 gives an opportunity to revisit this flawed preferential referral system
  • Referral guidelines: these days there are guidelines for just about every surgical diagnosis. Breach of guidelines is often used as a justification for medicolegal action. Covid 19 has resulted in massive increase in patients awaiting surgery. We must now take the opportunity to do all we can to minimise future referral practice and workload. Where risk is low surgeons should be encouraged to discharge patients from further follow up and investigation.

AGM
When the current restrictions are relaxed and normal working resumed we need to hold an AGM, we have set a date of 15 September 2020. This is likely to be a hybrid of physical attendance and video conference attendance. More information will be sent out regarding the arrangements for the CBS AGM in the next few days.
Topics for discussion would include: 

  • Election of officers
  • Financial report
  • Raising the profile of CBS: advertising
  • A review of member benefitsReview of partnerships (Indigo, Cavendish, Ballards, OTSIS, FIPO
  • Launch surgical expert and appointment of Board
  • Web site activity
  • Annual return to Certification Office
  • TUC congress
  • Employment issues:
    • The split between SPA (supporting professional activities) and DPAs (direct clinical care). This varies greatly around the country. Most surgeons are of the view that the allocation of 1SPA in a 10 PA contract for research, training, audit, revalidation is unacceptable. Surgeons and their outcomes are in the public domain. It is critically important that facility is given to them to ensure published data is accurate.
    • A recognition of the onerous nature of on call commitments for surgeons. Surgeons work in high intensity environments. This should be recognised.
    • Waiting list initiative payments: for some years, governments have encouraged surgical activity out with normal contracted hours in order to reduce waiting times. These additional activities are paid over and above standard salary but the rates of pay vary widely up and down the country. This is unfair and should be standardised.
    • There is now a moratorium on merit awards and discretionary points. There needs to be urgent discussion on means and methods to incentivise surgeons.

Press Activity
You may have seen that CBS has featured over the past few months in a wide range of media including ITV News, the Times, the Daily Mail, the Sun and The Herald. If you have missed any of these media items have a look at the news section on our website for more information.

As always, we welcome your thoughts and opinions and encourage you to engage with CBS social media platforms @Uksurgeons

With best wishes from the CBS Team

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