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CBS News Update October 2020

Welcome to the latest update of work being undertaken by the CBS Team and issues that are being addressed in the best interests of the surgical community.

Medico-legal (non payment of professional fees) - CBS Executive was recently approached by a member seeking advice over what they should do about a firm of solicitors failing to settle his reasonable medico-legal fees, incurred for writing a part 35 compliant report. Apparently, this is not an uncommon problem with settlement of fees being either delayed or never paid at all. We circulated a brief survey to evaluate the potential scale of this problem and the summary of results so far are available here. If you have experienced problems in this area, please do not hesitate to contact us. Where significant problems are identified, CBS can liaise with the Solicitors Regulatory Authority on behalf of individual members.

Future Surgery Show – Don’t forget that the Future Surgery virtual show takes place on 21 & 22 October. Professor John MacFie states that “The potential for new technology to improve efficiency in theatre, drive down costs and enhance patient outcomes is exciting. CBS believes in supporting UK surgical teams’ ongoing education regarding new technology initiatives, equipment and procedures. Towards this goal, CBS sees the Future Surgery initiative as an important consideration for the whole UK surgical community.”

Trainee survey - CBS are carrying out a Survey into the impact of Covid-19 on specialist surgical training in 2020. We are in the process of distributing the survey via email and would be grateful for your assistance in disseminating this survey to trainees in your teams. The survey should take no more than 2-3 minutes to complete and will provide an invaluable insight into the issues and potential barriers that our surgeons of the future are currently facing.

MBA Opportunity - Exclusive to CBS Members – CBS is delighted to announce that it has partnered with Minerva Elite Performance to provide CBS members with the opportunity to achieve a fully supported distance learning MBA in Strategic Management and Leadership at an exclusive discount rate. This qualification will equip you with fundamental knowledge and skills that can immediately be applied in the real world. More information …

Trust mergers - CBS has been involved in different enquiries around the UK relating to Trust mergers and has issued guidance on this that it will now put into the public domain, to inform CBS members

Orthopaedic issues across the UK It is becoming clear that around the UK COVID19 has created significant pressures for our friends and colleagues in Orthopaedics as Trusts are increasingly breaching contracts by asking surgeons to work beyond their normal scope of practice and treat NHS patients on private premises. This is happening whilst the NHS has still not resolved the pensions crisis adequately meaning surgeons will be penalised financially for performing this work. CBS is now talking to a number of prominent senior UK orthopaedic surgeons about how best to tackle this growing problem. 

Cavendish Medical: Pensions A number of CBS members took advantage of the free seminar hosted by Cavendish Medical – if you were one of these members, we’d be grateful for your feedback (a short survey has been issued).

We’re always interested in finding out what information and resources CBS can provide that can be tailored specifically to the needs of our members.

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 employing authority (usually Trusts 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 that 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. Further, 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.

Annual return to Certification Office - Our annual returns were audited, signed off at the CBS AGM and sent to the Certification Office. The Executive Council reviewed the likely effects of the COVID-19 pandemic on the association’s finance and consider that it has sufficient reserves to be considered an ongoing concern.

Media – CBS continues to appear regularly in press articles, is seeing increased activity on social media platforms and responds to current issues by issuing press statements. This week the following statement has been issued in relation to delays in outpatient clincs:

“Our members confirm that they have been seeing significant delays for outpatient clinic appointments across the country compared to pre- Covid times. They report strenuous efforts being made to create extra clinics and extra clinical capacity in order to cope with both the backlog and an increased demand which has built up.  In some cases these efforts also involve new ways of working including telephone and video clinics but there is inevitably an element of clinical prioritisation which is needed to ensure that patients who need care most urgently receive it. These new ways of conducting clinical care are inevitably throwing up some new challenges and the CBS has been working with its members to optimise the benefits of these developments whilst ensuring safe, effective and timely consultations in a clinically acceptable manner and the impression is that these may be beginning to have a positive effect.”

Please share your views with us, either directly or via social media platforms.

Annual General Meeting - The first Annual General Meeting of CBS took place on 15 September at The Principal Hotel in York and virtually via Zoom. Thank you to all that attended.

The AGM agenda was as follows:

1. President’s Report: looking ahead (can be viewed here)               

2. Election of Officers: following the recent nomination of officers, the elected members were welcomed to the meeting and the new Executive Council is now as follows:

President Mr Mark Henley (from Jan 2021)
Vice President Mr Nigel Mercer
Executive Members

Mr Mansoor Khan

Mr Peter Sedman

Mr Parv Sains

Professor John MacFie (Demitting President)

Current FSSA President (TBC)

Co-opted Members (non voting)

Mr James Rose (CBS Managing Director)

Mrs Helen Crookes (CBS Admin & Membership Manager)

3. Rulebook: the proposed amendments were agreed, the latest Rulebook is available to view on the CBS website

4. Financial report: this report was tabled at the meeting and showed the current financial status of CBS along with recently audited accounts.

5. Raising the profile of CBS: James Rose gave an overview of the work undertaken this year to raise the profile of CBS and to increase membership.

6. Communications / Media update: Tingy Simoes of Wavelength Communications gave an overview of the recent media interest following on from press releases relating to issues pertinent to the surgical community. Very positively, it was recognised that every press release issued had created media interest and resulted in articles published across a variety of newspapers and journals.                 

7. Membership: Helen Crookes, Admin & Membership gave an update on membership numbers which showed an increase from 64 members on 1 January, to 132 members as at September 2020. Proposals were made, and agreed, as to simplifying the membership categories and also ending the Lifetime Membership category at the end of the year. Our members are CBS’s best asset for shaping growth and creating a community that benefits the whole surgical team.

8. Surgical Expert - Nigel Mercer gave an overview of the proposed launch of Surgical Expert in 2021. This topic created considerable interest and discussion. Updates on progress will be issued regularly over the coming months.     

We encourage you to share your views and comments around issues pertinent to the surgical world on social media platforms @UKsurgeons and on LinkedIn.

Kind regards

The CBS Team



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