22nd January 2016

• BMA suspends upcoming junior doctor strike
• Hunt writes to Health Committee on seven-day services evidence
• Qualification requirements set out for non-surgical cosmetic procedures
• EU cross-border working laws come into force
• EU law facilitates patient data sharing by clinicians
• Duncan Selbie named Chair of North East health devolution commission
• GMC Chief Executive to step down

BMA suspends upcoming junior doctor strike

Following the recommencement of conciliatory talks between the Government, NHS Employers and the BMA Junior Doctors’ Committee (JDC) on 14th January, the BMA has this week called off the 48 hour strike action planned for between 26th and 28th January. The renewed talks conducted through the Advisory, Conciliation and Arbitration Service (Acas) continue and are being led for the Department of Health (DH) by Sir David Dalton, Chief Executive of Salford Royal NHS Foundation Trust. The planned action to withdraw junior doctor emergency care on 10th February has not yet been cancelled.

A DH spokesperson said: “The strike that took place last week was unnecessary while talks are ongoing, so it’s extremely welcome news that the BMA has suspended next week’s action”.

BMA JDC Chair, Dr Johann Malawana, commented: “Following junior doctors’ clear message to the Government during last week’s action, our focus is now on building on early progress made in the current set of talks. … It is important to be clear, however, that differences still exist between the BMA and the Government on key areas, including the protection of patient safety and doctor’s working lives and the recognition of unsocial hours.  Significant, concrete progress will need to be made if future action, currently planned for 10 February, is to be averted”.

Hunt writes to Health Committee on seven-day services evidence

Health Secretary, Jeremy Hunt MP, has written to the Chair of the House of Commons Health Committee, Dr Sarah Wollaston MP, setting out evidence behind the Government’s plans for seven-day hospital services. Mr Hunt addressed the evidence base for the ‘weekend effect’, and acknowledges studies, including research from 2013-14 finding that 11,000 more people die each year within 30 days of admission to hospital on a Friday, Saturday, Sunday or Monday compared with other days of the week. It did however state that “it is not possible to ascertain the extent to which these deaths may be preventable”.

Mr Hunt explained that having reviewed the evidence base in 2013, the NHS England Seven Day Services Forum concluded that the ‘weekend effect’ is likely due to variable staffing levels at the weekend, the absence of consultants, a lack of consistency in services such as diagnostics, and a lack of community and primary care services availability. The RCS supports the move to seven-day services, and believes that the focus should be on urgent and emergency care, early consultant involvement with patients at weekends is crucial, and the evidence base should be improved, including looking at data from current seven-day care pilots.

Qualification requirements set out for non-surgical cosmetic procedures

This week Health Education England (HEE) published new qualification requirements for professionals who carry out hair restoration surgery or non-surgical cosmetic procedures, such as delivering botox or dermal fillers. The aim of the requirements is to improve and standardise the training of such practitioners, in order to ensure patient safety. HEE was mandated to carry out this work by the Department of Health (DH) following the 2013 Keogh review on the Regulation of Cosmetic Interventions. The College fed into this work through the project’s advisory group.

The training for practitioners exists on four levels (above entry level requirements), with ‘step off points’ after successful completion of each level of training, which qualify practitioners to deliver certain procedures. Professionals without previous training or experience have to begin training at the lowest level (level 4) while those already holding certain qualifications will be able to enter at higher levels. Within each level there are modality-specific modules, allowing practitioners to specialise. 

The new requirements are voluntary, but the aim is for them to be adopted as best practice, and in time accepted as standard. HEE also expects professional membership bodies to establish certification or credentialing systems.

Alongside this work, the British Association of Cosmetic Nurses (BACN) and The British College of Aesthetic Medicine (BCAM) plan to establish a Joint Council for the non-surgical aesthetics sector, an idea raised as a possibility by the Keogh review and HEE’s subsequent work. The DH and HEE support this idea in principle but stipulate that to be credible the Council must have widespread support from stakeholders including practitioners.

EU cross-border working laws come into force

On Monday a revised EU law that allows professionals to work across different countries was brought into force in the UK. The Mutual Recognition of Professional Qualifications (MRPQ) Directive was originally introduced in 2007. It provides a framework for recognising professional qualifications, to make it easier for skilled professionals, including healthcare professionals, to work in other EU member states. The Directive has recently been revised to streamline the recognition of professional qualifications across the EU, removing unnecessary barriers to free movement. 

The revised law introduces the European Professional Card (EPC), an optional card or electronic certificate held by professionals to allow more rapid recognition of their qualifications by the regulator in another country, allowing them to become registered and practise. It also allows EU professionals to provide temporary and occasional services in other countries, and allows for partial exemptions from parts of specialist medical training, where individuals have already covered a particular part of training in other country.

In addition the Directive introduces new principles around common training frameworks and tests to help standardise training across the EU, and it allows regulators to carry out checks on professionals where their English language capability is called into question. However, the GMC has serious concerns that the Directive may prevent it from adequately assessing whether doctors have the appropriate knowledge and skills to practise in the UK.

EU law facilitates patient data sharing by clinicians

The recently revised EU data protection law may increase flexibility for clinicians to share patient information, according to the NHS European Office.

The EU Data Protection Regulation aims to protect and regulate the use of personal data, and the revised regulation was informally agreed by the European Parliament, Council and Commission in December 2015.

The NHS European Office believes that current legislation makes it difficult for non-NHS professionals such as social workers to access data. The new legislation, however, may allow such professionals to access personal data where they have a legitimate reason for doing so. This may prove useful for enabling the integration of health and social care.

However, a drawback is that the legislation states that the patient should not be charged for the sharing of information, so the NHS will have to fund requests for such data. 

Duncan Selbie named Chair of North East health devolution commission

In October 2015, the Government announced a devolution deal with the North East region, including provision for the establishment of a Commission for Health and Social Care Integration, which will be jointly run by North East Combined Authority and the NHS.

Duncan Selbie, Chief Executive of Public Health England (PHE), has been appointed to chair the Commission. The Commission will look into integration work across acute, primary and community care, mental health services, social care and public health, and is expected to make recommendations for further devolution in summer 2016.

GMC Chief Executive to step down

Niall Dickson, Chief Executive and Registrar of the General Medical Council (GMC), has announced that he will be stepping down from his role at the end of 2016. Announcing his decision, he said: “We have come a long way and I am incredibly proud of what the organisation has achieved in recent years, but there will be no loss of momentum as I enter my final year in this role. By the end of 2016 I will have served seven years and I think this will be the right moment for me and the GMC to hand over the reins so that there is an orderly transition in senior responsibilities. It will enable Terence Stephenson to appoint a new Chief Executive and Registrar who will be well established when Terence himself finishes his term at the end of 2018”.