26 February 2010
NHS operating lists and outpatient clinics for children are still being cancelled across the country due to the chaotic introduction of new Government safeguarding regulations, despite repeated warnings from surgeons. Overzealous interpretation of the requirements by NHS Trusts and long delays in the system mean that NHS surgeons cannot move between Trusts quickly enough to deal with rare cases, of which there are many in children, and to cover absences. The RCS is calling for immediate roll out of passport-style arrangements that allow NHS staff who have already received an enhanced Criminal Records Bureau (CRB) check for one Trust to be recognised across the health service. Is the NHS a national service or not?
Despite flagging up the problem to the Ministers and Senior Officials of the Department of Health in the last three months, and despite numerous promises since by Government to find a quick solution, the RCS has learned that there is no solution on the horizon. As a result, highly specialised surgeons are restricted to working at one site with no flexibility to move at short notice to cover and assist colleagues with rare or emergency operations. Instead the vulnerable child must either wait, or travel an unacceptable distance. It has also resulted in trainee paediatric surgeons, with already limited learning opportunities, missing out on crucial training because they are unable to work across different hospital sites.
The new Vetting & Barring scheme, implemented in October 2009, rightly sets new high standards for checking all those working with children, including surgeons. However, the system to deal with this additional demand does not come into full force for four years. Trusts are being overly cautious and demanding that NHS surgeons who have already received enhanced CRB checks go through the time-consuming process each and every time they work in a different Trust – a process which can take several months.
The College has learned that:
- A family were no longer able to utilise the expertise of the Consultant surgeon in charge of their child’s care due to moving house. Despite the child requiring major specialist bladder surgery the consultant surgeon was unable to assist colleagues during the operation due to a non-transferrable CRB check. The alternative option was for the child to travel around three hours for surgery in London.
- Trusts are unable to fill locum positions or having to wait up to three months for surgeons to begin work, resulting in delays in treating patients and difficulties hitting Government targets.
- Trainee surgeons are unable to work or have training across central London hospitals in order to learn vital specialist techniques - including line insertions into child cancer patients – only carried out in specific hospitals.
- Trainee surgeons on six month placements with a Consultant receiving CRB clearance with only weeks remaining or in some cases after the placement is over.
- Some trainee surgeons have had more than 10 separate CRB checks in just two years.
John Black, President of The Royal College of Surgeons, said: “The College have flagged up this situation with Government on three separate occasions in a three month period, and we were reassured that a solution would be reached within a week. That surgeons are still faced with this situation is simply unbelievable.”
Su-Anna Boddy, Consultant Paediatric Urologist, said: “We are meant to be training expert paediatric surgeons of the future, yet training opportunities are being wasted due to the unnecessary bureaucracy of re-checking doctors who have already passed rigorous CRB checks. It is imperative that we are able to utilise the best training opportunities, in the right hospitals, at the right time, and it is totally inappropriate that children be transferred to another hospital so that trainees can learn.”
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Notes to Editors:
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