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

The Doctors’ Association UK (DAUK) has been alarmed by the surge in cases and hospital admissions, especially in London and the South East. Doctors called for tighter restrictions well over a week ago expressing concern regarding the relaxation of the rules over the Christmas period.

NHS staff will support the movement of high-risk areas into Tier 4, but with cases surging many will be wondering if this is too little, too late.

Dr Samantha Batt-Rawden, President of DAUK and a senior intensive care registrar in the South East said:

“We realise how disappointing the new restrictions will be for many today, especially those in Tier 4 areas. However, doctors across the UK, but especially those in the South East are telling us that the surge in cases is already putting hospitals and critical care units under enormous strain. NHS staff are grateful to the public who have sacrificed so much to protect each other and our health service. But with the emergence of a new variant, sadly restrictions must be revisited. COVID will not take 5 days off over Christmas, and neither will NHS staff who do all they can to keep patients safe over the festive period.”

CONTACT Press@dauk.org

‘Ministers appear to have been sitting on their hands and not learning the lessons from the first wave.

You tend to have more patients that are not intubated and ventilated than are using other therapies. From a staffing point of view, it would also make sense to have it as a step down facility so you’re not then required to staff it with intensive care doctors and nurses who are already in short supply.”

Ministers have been accused of “sitting on their hands” over warnings that the country’s largest Covid-19 field hospital is ill-prepared to help the capital cope with a second wave of infections.

Last week, Matt Hancock, the Health Secretary, confirmed that the Nightingale hospitals set up earlier this year would be ready to receive patients once again as conventional hospitals in some parts of the country faced becoming overwhelmed.

However, despite warnings in the spring that the London Nightingale needed to undergo a transformation to play a significant role over the winter, NHS England has admitted that no changes have been made to the facilities since the field hospital was put on “standby” in May. 

The hospital, which has the potential to accommodate up to 4,000 patients, was constructed at east London’s ExCeL exhibition centre in April.

It was initially set up to provide up to 500 intensive care beds, but only cared for 51 patients, and senior critical care medics had suggested that it should instead adopt the ‘step down’ model used for the temporary hospitals in Manchester and Birmingham.

Research has shown that far fewer patients require ventilators than was previously thought, but the London Nightingale is designed for patients who have already been put on ventilators and require ongoing critical care.

Dr Rinesh Parmar, a specialist registrar in anaesthetics who chairs the Doctors’ Association, said: “Ministers appear to have been sitting on their hands and not learning the lessons from the first wave.

“You tend to have more patients that are not intubated and ventilated than are using other therapies. From a staffing point of view, it would also make sense to have it as a step down facility so you’re not then required to staff it with intensive care doctors and nurses who are already in short supply.”

Read the full article in The Daily Telegraph here.

Even a fully staffed and rested workforce would find this combination a challenge. Before the pandemic, the NHS was short of 106000 staff. Now, a chronically short staffed and fatigued workforce looks at the upcoming winter with great trepidation.

Waiting lists for extremely serious surgeries look set to double while more than 50,000 patients have not waited more than a year for NHS treatment. Given this, with the additional pressures of rising coronavirus cases, NHS workers need a viable and realistic strategy both to cope with the exhaustion they feel from the initial impact of the pandemic and the increased pressures the winter will bring. This will require genuine additional funding, rather than talking up and repackaging old promises. Further, there must be a strong focus on staff retention.

Without improved working conditions, DAUK fears the UK will witness increasing NHS workforce shortages with burnt-out staff quitting or reducing hours, resulting in even greater waiting lists. This will have knock on effects on an already strained economy with increased numbers of unable to work while awaiting treatment. Given this, this impending challenge must be treated with utmost gravitas.

To achieve such a strategy needs an inclusive team from all parts of the NHS contributing to a workable plan rather than relying on consultancies that have little experience on the ground.

In the immediate term, a functional and efficient testing system will go a long way towards helping to reduce the effect of coronavirus on the NHS and help reduce the burden on our services.

The Doctors’ Association UK has released results of its latest member survey which found:

• 46.9% of respondents had been told not to raise concerns about COVID-19 or PPE via social media

• 47.6% of respondents had been told not to speak to the press about COVID-19 or PPE

• 15.2% of respondents who had offered opinions on social media had been challenged or disciplined

• 32% of respondents had experienced bullying around the issues of raising concerns about PPE

Concerns were raised after the BBC’s Newsnight programme heard from some doctors who’d been told by managers to stop speaking publicly about shortages of personal protective equipment. One was told to “stop causing a fuss”.

Chief Executive of whistleblowing charity Protect, Liz Gardiner, said in a news release: “We have had many calls to Protect’s advice line from NHS workers with concerns over PPE and some NHS staff have told us they do not feel safe speaking up, or are not aware of what support channels exist.”