An Alliance of over 18 organisations, including DAUK, which has campaigned for over 16 months to give health workers the protection from Covid-19 they need in the workplace, welcomes new guidance which stipulates that Covid is spread by airborne transmission and that health workers are entitled to enhanced levels of protective equipment.

The Covid Airborne Protection Alliance (CAPA) and British Occupational Hygiene Society (BOHS) issued the following statement this afternoon:

The NHS and the wider healthcare system are still in the grips of dealing with the usual winter pressures along with the significant impact of COVID-19, not only on staff sickness levels but also with the ongoing delivery of services to meet the needs of the populations we serve. As a result, the challenges of ensuring the safety and resilience of the NHS and wider workforce along with patient safety are greater than ever, not withstanding the planned reduction in Covid restrictions announced 19^th January.

For the last 16 months the Covid Airborne Protection Alliance (CAPA) has been campaigning to influence IPC Guidance to ensure that all healthcare workers can access the right level of respiratory protective equipment to protect them from COVID-19. 

We have worked with the British Medical Association (BMA), Royal College of Nursing (RCN) and British Occupational Hygiene Society (BOHS) to support consistency of messaging to government, other key stakeholders and our healthcare workforce.

This includes alerting system leaders of the need to meet their legal responsibilities as laid out in the Health and Safety at Work Act 1974 etc for ensuring the safety of the healthcare workforce through the provision of appropriate respiratory protective equipment (RPE). 

We have evidence that over 30 NHS Trusts across the UK are now leading the way in how they assess workplace risk and provide staff with appropriate levels of RPE including FFP3. 

We are therefore pleased to see that, this week, the Government made important updates to two pieces of guidance which will help to keep healthcare workers, patients and the public safe. 

Dr Barry Jones, Chair of CAPA said:

“I’m delighted that the new IPC guidance makes it clear that healthcare workers can have access to enhanced levels of respiratory protective equipment without being restricted to the current list of aerosol generating procedures (AGPs) which is no longer relevant. 

“The IPC guidance however does not specify how COVID-19 is transmitted, placing risk assessment at the mercy of individual employers or managers views or assumptions on this key part of the risk assessment process. We are pleased the Cabinet Office guidance explicitly states that COVID-19 is spread by airborne transmission, close contact via droplets, and via surfaces. Airborne transmission is a very significant way that the virus circulates.”

“The Cabinet Office guidance is consistent with other government guidance such as that from the Department for Education (England), Coronavirus (COVID-19) and the use of face coverings in education settings (publishing.service.gov.uk) which  highlights that the Scientific Advisory Group for Emergencies (SAGE) has advised that Omicron might show more airborne transmission.

Professor Kevin Bampton, CEO of BOHS added: 

“System leaders now need to mobilise their health and safety and IPC leads to ensure appropriate risk assessments are carried out and the right level of RPE is provided in a safe and effective manner. This includes ensuring that fit-testing for FFP3 is available, and reusuable FFP3 equivalent masks can also be accessed.”

DAUK Chair, Dr Jenny Vaughan, said: 

“For far too long, far too many of our colleagues have been left exposed unnecessarily to Covid because their PPE was simply inadequate. The public were put at more risk as a result. This new guidance, issued after months of work by the CAPA, draws the clear line: no one should be expected to work to save lives if putting their own at risk avoidably was part of the deal. Now it is agreed. This should never happen and this is how the risks, not lives, are cut.”

Dr Christine Peters, Consultant Microbiologist FreshAirNHS commented: 

“As SARsCOV 2 transmits by travelling in aerosols produced when breathing, speaking and talking it is crucial that healthcare workers are provided with the correct RPE to ensure protection for them and their patients. We are delighted to see a change in guidance that advocates for this in line with WHO and urge all employers to ensure rapid roll out of respiratory level protection for this airborne infection”

Notes to editors 

Doctors’ Association UK (DAUK) is an organisation run by frontline doctors for frontline doctors. 

Their Communications Lead is Alan Taman:

press@dauk.org

07870 757309

The new guidance measures

The updated infection prevention control (IPC) guidance:

The Cabinet Office guidance:

Further details on routes of transmission of COVID-19, risk assessment and different types of RPE can be found on the RCN website

Covid Airborne Protection Alliance (CAPA) includes:

 ·      ARTP – Association for Respiratory Technology & Physiology·      BAPEN – British Association for Parenteral and Enteral Nutrition·      BIASP – British & Irish Association of Stroke Physicians·      BDA – British Dietetic Association·      BSG – British Society of Gastroenterology·      CBS – Confederation of British Surgery ·      College of Paramedics Natasha.Weale@collegeofparamedics.co.uk·      CSP – Chartered Society of Physiotherapy·      FreshAir NHS·      GMB Union·      HCSA – Hospital Consultants and Specialists Association·      Medical Supply Drive UK·      NNNG – National Nurses Nutrition Group·      QNI – Queen’s Nursing Institute·      RCSLT – Royal College of Speech and Language Therapists·      Unite the Union·      DAUK- The Doctors Association·      Trident HS&E 

BOHS British Occupational Hygiene Society

The Doctors’ Association UK are dismayed at the governments less than inflation uplift for NHS workers and call for “fair say on fair pay”.  

At a time when doctors have given their lives and livelihoods to this pandemic, with no 
clear end in sight, it is an insult that the Government sees a 3% uplift as fair remuneration. In support of member opinion, DAUK’s ‘Fair say for fair pay’ campaign demonstrated the extremes staff have been put through during the pandemic, risking their own lives, whilst the challenges to the NHS have never been greater. 

The government’s decision to exclude junior doctors, who make up more than 50% of doctors in the NHS, is callous in view of the large number of doctors in training who have worked tirelessly through the pandemic. Junior doctors, a term than encompasses all doctors from leaving university up until becoming a consultant, are at the forefront of the fight against COVID. Many have been redeployed from their area of expertise or training to work in COVID medical wards or in critical care. Not only has their training been disrupted but they have been expected to pick-up shifts and cover rota gaps due to the on-going understaffing.

The 3% offered does not come close to what staff deserve. Inflation this year is estimated at 3.7%, making the proposed rise a pay cut in real terms. 

We consulted with our members last night and the overwhelming majority of responders supported industrial action. We plan to hold an emergency meeting with members soon to formulate next steps and we request that the Government reconsider its position with immediate effect.

Dr Jenny Vaughan, Chair of DAUK: “Any improvement on the derisory 1% previously offered to NHS workers is welcomed, but 3% barely takes the edge off the erosion of doctors’ pay over two decades. Doctors in the NHS have suffered a 30% pay cut in real terms, and after inflation this “pay rise” will ultimately be a pay freeze. DAUK’s campaign ‘fair say for fair pay’ demonstrated the extremes staff have been put through during the pandemic – the effects of which are only starting to be realised. It is time to pay and we hope the BMA and the HCSA as well as allied health professional unions will join us in voicing our discontent – including taking industrial action.”

Dr Duranka Perera, junior doctor and DAUK Treasurer: “We are in an ongoing pandemic that has killed 128,000 people in the UK, including over a thousand colleagues. With staff shortages at critical mass and thousands more on the verge of burnout, no number of claps for the camera can change these cold, hard facts. The service and sacrifice of NHS workers over the past year is being treated with open contempt.

There is no time but now to pursue the most powerful form of resistance. This Government – one that saw fit to pay private Test and Trace consultants £7000 a day – must be held to account. Amidst the most testing era in NHS history, unions across all healthcare disciplines must come together to demand just compensation for the workers that put their lives on the line for their patients and their country. After over a decade of austerity and real terms pay cuts, a 15% pay increase is the bare minimum we at DAUK see as acceptable. If it requires industrial action to achieve this, then we wholeheartedly back that too.’

Neurosurgeon and DAUK co-vice chair Mr Dolin Bhagawati: “The figures put forward by the government show a breath taking level of wilful ignorance regarding the pressures that NHS staff have faced during the pandemic and will continue to face in the current wave of COVID-19 infections. With the NHS staring into an abyss of millions of patients on waiting lists, we need staff that are compensated appropriately for the skill sacrifice and commitment they have and continue to demonstrate. A Government that does not realise this is catastrophically out of touch. “

Nottingham GP Dr Shan Hussain: “GP Practices have delivered over 75% of Covid vaccinations whilst caring for 2 million patients with long covid, looking after rising numbers of patients on secondary care waiting lists, and continuing day to day GP work. All of us have worked incredibly hard without recognition, and for the pay rise to exclude more than half of practicing GPs shows how little the Government values Primary Care.”

GP Partner Dr Rosie Shire: “Since the start of the pandemic GP’s have been battling covid in the community and changing the way we work in response to the ever changing regulations. For the pay rise not to include all GPs shows how undervalued we are.”

PRESS RELEASE

DAUK were disappointed to learn that following the successful employment tribunal of Mr Omer Karim, a renowned robotic surgeon, the General Medical Council (GMC) is appealing against the verdict of institutional racism for which it was held responsible.   

In 2014, Mr Karim – a consultant urologist of Sudanese and Irish heritage – blew the whistle on unsafe surgical practice at Frimley Health NHS Foundation Trust. Citing apparent ‘intimidation’ and ‘threatening behaviour’, he was then accused of lacking fitness to practice by his Trust, who reported him to the GMC. All these allegations were found to be unproven at his employment tribunal. By contrast, a white colleague Marc Laniado, who was the recipient of similar allegations, had his case dropped much sooner than Mr Karim.  

Dr Duranka Perera, DAUK spokesperson said: “Lessons have not been learned from the infamous case of Dr Hadiza Bawa-Garba. She was initially convicted of gross negligence manslaughter but the sanction of erasure at the MPTS was rightly not accepted. She has now been reinstated without restriction. Subsequent analysis of events – as put in the Hamilton review – spoke of a ‘toxic fear of reprisal’ by the regulator if doctors were to ever make mistakes. By appealing this verdict and pursuing the same punitive measures they took against Dr Bawa-Garba, the GMC is doing nothing to repudiate these assumptions – they are only further entrenching them in truth.” 

 “The verdict in favour of Mr Karim has been seen as vindication for the Black and Minority Ethnic doctors who are more than twice as likely as their white colleagues to face referrals regarding their fitness to practice. For the GMC to appeal is for them to misunderstand just how much accountability and restorative justice for institutional racism matters, not just for the nearly 60,000 strong BAME workforce in the NHS, but for the organisation in general.”DAUK have written to the Health Secretary, the Rt. Hon. Sajid Javid and Dame Clare Marx, the head of the GMC, to address these important concerns.
END

DAUK’s Letter:

Dear Health Secretary and Dame Clare Marx

We write with great concern regarding the General Medical Council’s decision to appeal against the employment tribunal decision earlier this month which ruled in favour of renowned Consultant Urologist Mr Omer Karim.

The results of this tribunal have held that Mr Karim, of Sudanese and Irish heritage, was treated differently from a white colleague Marc Laniado – who had similar complaints surrounding intimidating and threatening behaviour put to him – on the grounds of his race. All allegations were found not proved and Mr Karim was adjudged not to have committed misconduct. As such, there was no question of his fitness to practice.

This is a landmark ruling within the medical profession. It is the first time that the GMC has been found to be legally responsible for structural racism and discrimination within the NHS. This was a decision 7 years in the making after Mr Karim blew the whistle on poor surgical practice at his Trust. He had to restructure his entire life – to the cost of £300,000 – to face up to the GMC, prior to the recent decision that ruled in his favour. However, that the GMC appears willing to spend its members’ money on a retributive appeal, rather than investigating and adjusting the local and systemic issues through which a case such as this could ever have arisen, comes across as deeply disappointing. As a campaigning grass-roots organisation for doctors, we at DAUK are very concerned at this decision and its wider impact on the profession. 

These decisions are not made in a vacuum. We know of at least one other case, currently under investigation, where a Trust did not follow disciplinary due process for a BAME doctor; we have strong reason to believe a white doctor would not have been dealt with in the same manner. We will write to you confidentially concerning this.

 The echo of Dr Hadiza Bawa-Garba resounds in these cases. She was initially convicted of gross negligence manslaughter but the sanction of erasure at the MPTS was rightly not recommended. It is of note that Ivan Hare QC, who was instructed by the GMC to strike Dr Bawa-Garba off the medical register, has been once again instructed in the Karim case. We find this decision extraordinary given his role in an unwise appeal which caused such an extraordinary backlash for the GMC. 

The GMC is largely funded by the mandatory subscriptions of doctors. As paying subscribers, we have concerns that once again, our money is being spent in a way which seeks to absolve the GMC of any fault, rather than to understand the many barriers facing Black and Minority Ethnic healthcare staff. We wish to understand what actual learning has taken place at the GMC since the Bawa-Garba case given that in the Karim case, they have simply chosen to repeat their previous actions. 

NHS Improvement’s Just Culture guide expressly states:

 “Action singling out the individual is unlikely to be appropriate; the patient safety incident investigation should indicate the wider actions needed to improve safety for future patients. These actions may include, but not be limited to, the individual.”

With external support, including that of us at the Doctors’ Association UK, justice was served in the case of Dr Bawa-Garba. The many systemic failures which let her down are testament to these flaws. However, instead of following the Just Culture principles and adopting a Learn not Blame approach to promote reflection and progress surrounding these failures – much like aviation does – it seems instead that Trusts and regulators remain committed to singling out and destroying the individual, no matter the cost. 

That this pattern of decision-making has a racial element attached is no surprise.  

By the GMC’s own documentation, Black and Minority Ethnic group doctors and non-UK graduate doctors are more than twice as likely as their white colleagues to be referred to the GMC over fitness to practice issues. These are stark figures indeed, compounded by the fact that as recently as 2012, if one were under investigation by the GMC, they would be 20 times more likely to die by suicide. These recent events speak to a calcification of principle at the top of the profession that simply isn’t willing to shift its views from its position of comfortable, self-serving inertia. 

The simple fact is, given the evolving perspectives surrounding racism within the zeitgeist, whether it be through footballers taking the knee or Black Lives Matter setting precedents for genuine social change across the world, the GMC’s position on this matter comes across as woefully dated and out of touch. With up to 46% of the medical workforce being non-white per government records – a number in the range of 58,200 people – the GMC’s actions will have ramifications and resonance for many. Worse still, their actions will only serve to entrench the distrust many in the profession have of the regulator, especially since the Bawa-Garba case and the subsequent Hamilton review exposed a ‘toxic fear’ of reprisal should a doctor ever make a mistake. 

Referring to Dame Clare Marx’s email from May 2021, it is clear the GMC is aware that progress on the matter of race and discrimination should be made. We make reference to two key points she mentioned, regarding the GMC’s individual goals on the subjects:
·       To eliminate disproportionate fitness to practise referrals from employers, in relation to ethnicity and primary medical qualifications, by 2026.

·       To eliminate discrimination, disadvantage and unfairness in undergraduate and postgraduate medical education and training by 2031.

Appealing this recent case, to our minds, means that these targets will not be met. 

 We still haven’t reached a point in the medical profession, or indeed society, where the discrepancies between the way people of different races (or genders or religions or sexual orientations) experience life are negligible. With this case being the latest in a long line, this means that education and sincere systemic restructuring surrounding micro and macro expressions of racism and discrimination within the GMC has never been more important.

 As such, we recommend that the GMC choose to land on the right side of history. We recommend it takes lasting and restorative action beyond the short-sighted punitive measures that it is currently pursuing, even though it has previously stated it would adopt recommendations for the better after the Bawa-Garba case. 

 Justice is not limited to grand gestures, complaints procedures and formal inquiries. It can rectify problems through the active choice of understanding and transmuting individual or organisational power and privilege for the betterment of those with less. In this case, to achieve that justice, we recommend the GMC:

1. Start sincere conversations about race within the profession.

2. Offer a microphone for the medical workforce’s lived experiences of racism.

3. Seek to make these experiences public, instead of seeking to penalise and self-justify at the first opportunity.

4. Commit to a diverse, but just as importantly inclusive, GMC hierarchy from the top down and even down to Trust level, so lived experience and understanding of the nuances of race and discrimination can ensure more robust countermeasures against both are in place.

5. Encourage the presence of BAME staff guardians on a Trust level upwards, so BAME staff might feel better supported in general, and safer when speaking out.

6. Normalise the process of reverse mentoring, where younger BAME staff share their experience and understanding of modern nuance surrounding race and discrimination with older members of the workforce, much as firms such as Clifford Chance do in the Private Sector.

7. Improve implementation of the Just Culture recommendations beyond lip service, setting in concrete a commitment to diminishing local blame cultures.

8. Improve and enforce systems of accountability for racism and discrimination at Trust level, such that complaints are robustly assessed in an unbiased manner per the GMC’s published criteria and recommendations. This needs to affect patients, clinical and non-clinical staff equally, such that nobody can ever be preferentially targeted due to protected characteristics. 

We request that the GMC reconsider its position in due course.

Sincerely,

Dr Kaveri Jalundhwala

Mr Dolin BhagawatiDr Matt Kneale

Co-Vice Chairs – Doctors’ Association UK  

Dr Hadiza Bawa-Garba’s application to have her medical licence fully restored was granted today by the Medical Practitioners Tribunal Service (MPTS). The Doctors’ Association UK have supported Dr Bawa-Garba throughout her case and welcome the news that she can now work without supervision

The case of Dr Hadiza Bawa-Garba united the medical profession in fear and anger. A paediatrician in training, with a previously unblemished record, was convicted of gross negligence manslaughter for judgements made whilst doing the jobs of several doctors at once, covering six wards across four floors, responding to numerous paediatric emergencies, without a functioning IT system, and in the absence of a consultant. All when just returning from 14 months of maternity leave.

In 2018, the GMC’s aggressive pursuit of an otherwise highly regarded doctor, against the advice of the Medical Practitioners Tribunal Service (MPTS), prompted widespread outrage amongst doctors. The GMC subsequently launched an independent  review of gross negligence manslaughter led by Mr Leslie Hamilton to promote learning from this case. The Doctors’ Association UK expect them to continue to implement all the recommendations of this review

“We welcome the fact that Dr Hadiza Bawa-Garba has had her licence to practice medicine fully restored today to allow her to work independently. We are pleased that the GMC today opted for a neutral stance.
Healthcare desperately needs an open, transparent, learning culture, where harm is minimised by learning from error and failings. Scandals such as Mid-Staffs, Gosport, and Morecambe Bay repeatedly demonstrate how a culture of defensiveness and denial can escalate into widespread cover-up leaving families fighting for answers.

 
We hope that the GMC works toward full implementation of ALL 29 recommendations of the Independent review into gross negligence manslaughter so that learning can continue. Fear is toxic and blame should not be used as a tool. Jack Adcock should have received better care but this was due to system-wide failure. His death was a tragedy due to this. Our thoughts are also with his family”

Dr Jenny Vaughan, Chair of The Doctors’ Association UK, and Learn Not Blame Campaign Lead

Plans for the largest seizure of GP data in NHS history are unlawful and the government faces an urgent legal challenge unless the scheme is stopped and changed, says a pre-action letter sent today on behalf of five organisations and a Conservative MP. 

Tech-justice nonprofit Foxglove are supporting this group – Just Treatment, Doctors’ Association UK, the Citizens, openDemocracy and the National Pensioners Convention, as well as David Davis MP – to take the scheme to court. 

The coalition’s legal letter, sent today to the Department of Health and Social Care and NHS Digital, warns that unless the government pauses the grab of confidential patient data from GPs and seeks meaningful patient consent, the group will seek an injunction to halt the scheme. 

The urgent move follows a decision by DHSC and NHS Digital to seize the entire GP record of all 55 million patients in England. 

A deadline of just six weeks, by 23 June, has been set for patients to learn about the scheme and opt-out if they want by submitting a form to their GP. If a patient fails to opt out by the deadline their health record goes into the central store on 1 July and will not be deleted. 

The coalition bringing this case say that rushing this major change through with no transparency or debate violates patient trust, and that doing so without patient consent is unlawful. 

The government admits companies will be allowed to access the data – without being clear which companies, for what purposes, or what safeguards apply. The health data being collected is not anonymous; it is pseudonymous, so people’s records can later be re-identified. The government’s documentation admits that re-identification will be permitted in some cases. 

The pre-action letter says that this rushed process gives patients no meaningful chance to opt-out, and excludes older people and others who may not be online. It also says patient rights to opt-out only have meaning if the government is clear and transparent about which third parties will access the data – and for what purpose. Without patient consent, the letter says, the process is unfair and likely to undermine people’s trust in their GPs. For these and other legal reasons, the letter says, the scheme must be paused and a real process for informing and involving patients must be built in. 

On 12 May, the government announced the scheme, called ‘General Practice Data for Planning and Research’ (GPDPR). Using a Direction of the Health Secretary to NHS Digital, and a legal notice to all English GPs, the scheme orders GPs to hand over their full medical record on every man, woman and child in their practice. The data being taken includes sensitive issues like depression, autism, STIs, erectile dysfunction, and addiction – for planning, commissioning, and commercial research. 

The scheme is in many ways a repeat of the disastrous 2014 care.data system, in which the government last tried to collect partial GP records, but did not explain to people the terms on which companies would access the data. The new scheme is broader – it collects more sensitive records on people – and it doesn’t even send people an individual leaflet to give them a chance to opt out.

The groups are today launching a crowdfunder to cover the cost risk of the legal claim: https://www.crowdjustice.com/case/stop-the-nhs-gp-data-grab/

“GPs were barely informed of this major change – how are patients expected to know about it? DAUK supports safe, consensual uses of patient data, including for health research. But we want to see it done in a way that keeps faith with patient trust and won’t erode the relationship between clinician and doctor. Patients need to give informed consent to their data being used. We can’t see why the government won’t do this in a less rushed and more transparent way.” 

Dr Rosie Shire, a GP at Doctors’ Association UK,

“Look, if everyone from senior citizens to GPs to Tory MPs are prepared to sue over this process, something’s terribly wrong. Trust is everything in the NHS, and the way the government has rolled this scheme out has eroded patient trust. We’re having to go to court urgently because of the government’s decision to bounce us all – giving everyone just six weeks to decide what we want done with our health data. We hope the government will see sense but if not, we’re ready to fight for patients’ right to decide – and to defend the relationship of trust between patients and their family GP.” 

Cori Crider, Foxglove Director,

Foxglove is a non-profit that exists to make tech fair. Their prior successful legal challenges include NHS contracts to controversial US data firm Palantir, an algorithm the Home Office used to process millions of visa applications, and the disastrous A-level algorithm. 

Patients who wish to opt out can do so with the help of medConfidential’s guide here: https://medconfidential.org/how-to-opt-out/

The coalition’s lawyers are Rosa Curling, Foxglove Director as consulting solicitor at Scott-Moncrieff & Associates, and Robert Palmer QC and Julianne Morrison of Monckton Chambers.

The Doctors’ Association UK (DAUK) are supporting overseas doctors from COVID-19 red list countries who are unable to travel to the UK to complete an exam required to be eligible for medical training in the UK. 

The forthcoming exam -The Stage 2 Clinical Assessment run by the UK Foundation Programme Office* (UKFPO) overlooks current travel limitations enforced by the COVID-19 pandemic, which have left many overseas applicants unable to progress their applications for the Foundation Programme, to enable them to work in the UK. 

Passing the Clinical Assessment is mandatory for candidates who graduated before August 2019 and now wish to apply for a foundation doctor post. The second stage of this Assessment is a test of a doctor’s clinical skills by way of an Objective Structured Clinical Examination (OSCE)-style, face-to-face exam, due to take place on the 26-27^th May this year. 

Pandemic restrictions currently limit travel from countries in the Red List (including Pakistan, Philippines, Bangladesh, Kenya, Zimbabwe and most recently, India), meaning that candidates cannot travel from these countries to participate in the exam.

A candidate who wished to remain anonymous from one of the listed countries raised concerns with DAUK saying, “this directly goes against the UKFPO duty of fair treatment for all applicants and discriminates against those who are unable to travel due to extenuating circumstances.” “Prior correspondence reassured that no candidates would be disadvantaged for their circumstances. However, the UKFPO have indicated its intention to withdraw myself 

(and other applicants in red list countries) if we fail to attend the assessment in person in May, despite having paid the non-refundable assessment fee (£850) and already being allocated to a UK foundation post for August.”

This doctor and colleagues wrote an open letter to the UKFPO proposing reasonable adjustments to the examination, including rescheduling the date of the assessment and/or adapting the format for delivery via an online platform to enable participants from overseas to complete the assessment. These suggestions have been rejected.

Dr Jenny Vaughan, DAUK Chair:

“DAUK supports the adjustments proposed in the letter, to enable experienced international colleagues to join our NHS workforce. These candidates have already invested significantly in the process of coming the work in our system and many have served resignation notices in their current posts. Passing this exam is their key to taking up roles in the UK, and we urge the UKFPO to find solutions for these candidates, to enable them to contribute to an NHS that is much in need of their skills.”

Freya Rhodes, Medical Student Representative DAUK:

“This is huge concern for these qualified doctors who are ready to work in the UK. 1 in 7 NHS workers are from overseas and their vital contribution to the workforce must be recognised.”

“It is a very challenging time to be entering the NHS. Considering current workforce shortages and high levels of staff burnout, inadequate exam provision is an unnecessary obstacle. The UKFPO must make reasonable adjustments to ensure equal access to training and allow as many new doctors as possible to start work in August.”

CONTACT 

Press@dauk.org

FURTHER INFORMATION

*The UK Foundation Programme

-The UK Foundation Programme Office (UKFPO) manages the Foundation Programme – a two-year structured programme of workplace based training for junior doctors, that forms a bridge between medical school and higher specialty training, and allows trainees to practice as a fully registered doctor in the UK.

-The UKFPO is responsible for allocating places on the programme to all qualifying medical graduates in the UK. They also manage applications for non-UK graduates who are eligible to apply.

-The Clinical Assessment is a mandatory requirement for anyone who qualified from medical school on or before 4^th August 2019. This includes many overseas doctors who may have qualified before this date, and gained valuable experience practising as doctors elsewhere.

In a letter to health and social care secretary Matt Hancock, along with the DHSC and Healthwatch – a statutory body representing patients – GPs from the Doctors Association UK (DAUK) warned that for frontline GPs, demand is ‘going through the roof’.

The group called for an urgent review after a Healthwatch report that highlighted a rise in negative feedback about GP services around the time national COVID-19 lockdowns were imposed.

The Healthwatch report said that while for many people experiences of general practice had continued to be positive through the pandemic, others had reported concerns around booking, remote consultations and access to regular checks and treatment. It highlighted ‘concerns that this would result in extra pressure on emergency services’.

GP workload

However, DAUK’s GP committee warned that if the current colossal workload being delivered in general practice was ‘still not meeting demand’, the government and NHS England must investigate.

NHS England said last month that general practice is currently delivering around 7m consultations a week including work on COVID-19 vaccinations – up around 1m appointments a week from pre-pandemic levels.

This figure is likely to be an underestimate, because data from NHS Digital do not fully reflect the number of telephone consultations in general practice – and GPonline has reported on RCGP surveillance data that show GP practice workload far outstrips pre-pandemic levelseven before COVID-19 vaccination work is taken into account.

The DAUK letter said the Healthwatch report confirmed that ‘the health of the population is suffering as general practice is drowning’.

Remote consultations

The letter said: ‘If primary care is having contact with 10% of the population each week and this is still not meeting demand there must be an urgent review to find out why.

‘The introduction of e-consults has made us more accessible than ever, and has opened the gates to a lot of trivia, which still uses GP time and resources, sometimes inappropriately. GPs are working flat out, and it is incredibly demoralising to find that our best is not enough.’

The letter said it was unacceptable if large numbers of patients were attending emergency departments for care available from their GP practice. But it added: ‘Practices are working at and beyond full capacity which has led to unprecedented levels of burnout, sick leave and tiredness amongst GPs.

‘General practice has been consistently underfunded over the last 10 years. Currently 90% of NHS contacts happen within primary care for less than 10% of the total budget. We desperately need a huge funding increase to aid much needed innovation, improvements in IT and infrastructure, and to increase staffing levels.’

The letter called for reduced bureaucracy, measures to address GP burnout and staff retention, and a review into access ‘so we can work towards finding a solution that involves the whole health service working together’.

Read the GP Online article here

We have sent the attached letter to the heads of NHS England, the Health Secretary and Chair of Healthwatch England requesting a review into why access to primary care is problematic, when as frontline GPs, we are consulting more patients than ever.

DAUK are happy to collaborate to share the views of our members on this issue and work together to find a solution that benefits both patients and the health service as a whole.

Dear Colleagues

CC. Sir Robert Francis QC, Rt Hon Matt Hancock, Sir Simon Stevens, Dr Nikita Kanani, 

We were very concerned to read the recent report in The Times, which states that patients are increasingly having a negative experience in terms of accessing their GP, leading to increased attendances to Emergency Departments. 

This report from HealthWatch confirms the health of the nation is suffering as general practice is drowning. Our experience as Frontline GPs, is that demand is going through the roof.

General practice is currently carrying out 7 million appointments per week, while delivering 75% of all Covid vaccinations and the largest ever flu-vaccination programme to date. Compared to pre-pandemic, primary care is offering a million more appointments per week. 

If primary care is having contact with 10% of the population each week and this is still not meeting demand there must be an urgent review to find out why. 

The introduction of e-consults has made us more accessible than ever, and has opened the gates to a lot of trivia, which still uses GP time and resources, sometimes inappropriately.

GPs are working flat out, and it is incredibly demoralising to find that our best is not enough. It is clearly not acceptable for huge proportions of patients to attend ED, when GP would be more appropriate. However, Practices are working at and beyond full capacity which has led to unprecedented levels of burnout, sick leave and tiredness amongst GPs. 

General Practice has been consistently underfunded over the last 10 years. Currently 90% of NHS contacts happen within primary care for less than 10% of the total budget. We desperately need a huge funding increase to aid much needed innovation, improvements in IT and infrastructure, and to increase staffing levels. 

We urgently call today for a reduction in bureaucracy, a focus on GP burnout and staff retention, and most importantly an analysis into why patients are struggling to access care so we can work towards finding a solution that involves the whole health service working together.

We would welcome a collaboration on this issue and would be happy to meet to discuss the views of our members to find a way forward together.

We look forward to your response

Dr Elizabeth Toberty

Dr Ellen Welch

On behalf of The GP Committee

Doctors’ Association UK

6th March 2021 FOR IMMEDIATE RELEASE

Many NHS staff finished another exhausting hospital shift this week to devastating news regarding the government’s recommendations for NHS staff pay. This represents an unconscionable affront to frontline NHS staff in all roles who have endured a year of torment working without adequate PPE, worrying about risks to their own health and mourning the death of colleagues.

It should be noted that higher pay rises (2.1%) were previously promised by the NHS Long Term Plan prior to COVID. The Chancellor vowed to give the NHS “whatever it needs” to tackle the coronavirus crisis (March 8th 2020). The latest recommendation of a pay rise of 1% therefore represents a conscious policy choice to insult NHS staff rather than that of economic reality and ignores a decade of real terms pay cuts (see figures at end of document from independent research from The Nuffield Trust and The Health Foundation) which has seen pay cut by £600 per employee over the last decade.

Dr Kaveri Jalundhwala, Vice-Chair Doctors’ Association UK said: The Prime Minister has previously told NHS staff that, “We owe you more than words can say” for their work during the COVID-19 pandemic. Now he must back up his rhetoric with action and act to pay NHS staff what they deserve after the last year of hell. If he fails to do so, it will be clear to the public that his priority is not the NHS.

A newly qualified nurse starting in 2020-21 would be earning about 3% less than one who started in 2010-11, once we account for inflation and the impact of pay freezes and caps. This is simply unacceptable. This isn’t a media story for the government to spin. This isn’t an election to score political points. These are livelihoods of exhausted NHS staff who have risked their lives to protect, treat and vaccinate the country in the midst of an unprecedented pandemic.

The Doctors’ Association challenges the government to explain to the country how it is morally or economically justifiable to cut the real-terms pay of staff that saved the life of the Prime Minister in the last year, while paying £7000 a day to management consultants for the outsourced test and trace program. Frontline staff are already shell shocked and considering if they want to keep working in the NHS after the betrayals they have experienced in the last year and previously.

This latest knife in the back may represent an insurmountable barrier to staff retainment and worsening NHS staff vacancies which already stand at over 100,000. The NHS is facing a retention crisis, and this recommendation of 1% maybe the final nail in the coffin.

Doctors’ Association UK 1-2-1 The Barracks Lancashire, LA1 4XQ press@dauk.org www.dauk.org 6th March 2021 FOR IMMEDIATE RELEASE DOCTORS’ ASSOCIATION UK condemns Govt recommendations regarding pay for NHS staff Many NHS staff finished another exhausting hospital shift this week to devastating news regarding the government’s recommendations for NHS staff pay. This represents an unconscionable affront to frontline NHS staff in all roles who have endured a year of torment working without adequate PPE, worrying about risks to their own health and mourning the death of colleagues. It should be noted that higher pay rises (2.1%) were previously promised by the NHS Long Term Plan prior to COVID. The Chancellor vowed to give the NHS “whatever it needs” to tackle the coronavirus crisis (March 8th 2020). The latest recommendation of a pay rise of 1% therefore represents a conscious policy choice to insult NHS staff rather than that of economic reality and ignores a decade of real terms pay cuts (see figures at end of document from independent research from The Nuffield Trust and The Health Foundation) which has seen pay cut by £600 per employee over the last decade. Dr Kaveri Jalundhwala, Vice-Chair Doctors’ Association UK said: The Prime Minister has previously told NHS staff that, “We owe you more than words can say” for their work during the COVID-19 pandemic. Now he must back up his rhetoric with action and act to pay NHS staff what they deserve after the last year of hell. If he fails to do so, it will be clear to the public that his priority is not the NHS. A newly qualified nurse starting in 2020-21 would be earning about 3% less than one who started in 2010-11, once we account for inflation and the impact of pay freezes and caps. This is simply unacceptable. This isn’t a media story for the government to spin. This isn’t an election to score political points. These are livelihoods of exhausted NHS staff who have risked their lives to protect, treat and vaccinate the country in the midst of an unprecedented pandemic. The Doctors’ Association challenges the government to explain to the country how it is morally or economically justifiable to cut the real-terms pay of staff that saved the life of the Prime Registered office: The Doctors’ Association UK, 1-2-1 The Barracks, Lancashire, LA1 4XQ. Company no.: 11562124, Registered in England & Wales Minister in the last year, while paying £7000 a day to management consultants for the outsourced test and trace program. Frontline staff are already shell shocked and considering if they want to keep working in the NHS after the betrayals they have experienced in the last year and previously. This latest knife in the back may represent an insurmountable barrier to staff retainment and worsening NHS staff vacancies which already stand at over 100,000. The NHS is facing a retention crisis, and this recommendation of 1% maybe the final inail in the coffin. Registered office: The Doctors’ Association UK, 1-2-1 The Barracks, Lancashire, LA1 4XQ. Company no.: 11562124, Registered in England & Wales CONTACT Press@dauk.org 1The Doctors’ Association UK (DAUK) is a professional association for UK doctors. Run by frontline NHS doctors, DAUK campaigns for patients and the NHS as well as advocating for the medical profession.

Doctors’ Association UK concerned that Home Office delays are preventing Doctors from helping in pandemic. IHS refunds still not processed

The Doctors’ Association UK has written to the Home Secretary Priti Patel regarding two issues that are adversely affecting the NHS frontline’s efforts to combat the escalating coronavirus pandemic. These are specifically related to delays in issuing Biometric Residency Permits for doctors with valid visas to work in the UK and the ongoing delays in refunding the Immigration Health Surcharge, promised earlier this year.

Delays in issuing BRPs are preventing qualified doctors with valid visas currently in the UK from starting work in the NHS and helping to mitigate the increasing effect of staff sickness from the escalating rates of COVID-19.

This is exemplified by Dr Ahmad Ussaid, a respiratory specialist doctor with a visa approved who is currently in Leicester, a city hit particularly hard by COVID-19. However, he is unable to start work due to an ongoing delay providing him with a BRP, despite multiple contacts by email and telephone in addition to intervention by his MP. He remains ready to jump into the fray but unable to due to this bureaucratic hinderance, depriving him of an income and the NHS of a skilled doctor when the country needs them most.

Meanwhile numerous doctors have also contacted us regarding delays in refunding the Immigration Health Surcharge. A flagship promise made by the Prime Minister and reinforced by the cabinet was to refund the IHS. However, for many charged such as Dr Aqsa Ghanzanfar who has emailed the Home Office thrice, they still await refund of this for no clear reason. Others have been refused as they have paid form bank accounts from their country of origin which have been understandably closed on arrival to the UK.

Dr Dolin Bhagawati, a Neurosurgeon working in London and Editorial Lead for DAUK said:

“These prolonged and ongoing bureaucratic delays are simply unconscionable. We have trained doctors in this country who are ready and willing to help combat the pandemic but unable to work due to the Home Office not doing its job and supplying appropriate documentation.

Meanwhile promises made by the Prime Minister and the cabinet regarding refunding the IHS to NHS staff continue to remain unfulfilled. How can the NHS attract the best and brightest to the UK if the world sees a government unable to fulfil straightforward promises?

Unfortunately, the immigration rhetoric and policies of the recent past has led to many of our valued colleagues feeling crestfallen, unappreciated, and exploited. This country must reward those that come to its aid in its time of greatest need.

We call on the government to do its job to allow the NHS to do its part in leading the country through this national emergency.”

CONTACT

Press@dauk.org