Senior policy officer Greg Ellwood-Hughes talked to colleagues and College members about the priorities set out in the government’s 10 Year Health Plan for England. In this blog he discusses how it aligns with our vision for ophthalmology.
On the day the Plan was published last week, College President Ben Burton welcomed progress on two of our top priorities: the expansion of specialty training posts will improve workforce numbers, and a single patient record will improve interoperability. But questions remain about how these ambitious plans will be implemented.
Firstly, how can the new integrated care board (ICB) commissioning framework be reconciled with further outsourcing of NHS services to the independent sector? We agree that ICBs should have more control over spending on activities they commission. They should allocate care based on patient need. But what interventions will stop the draining of limited workforce and resources from the NHS to the independent sector? What new ICB powers will ensure sustainable NHS services are safeguarded?
Will increasing care delivery closer to home cost more? The aim of the neighbourhood health service is to provide long-term financial sustainability to the NHS. The risk is that using private finance initiatives to invest in community care infrastructure means locking the NHS into lengthy and costly repayments. This happened under NHS reforms in the 1990s and noughties when the scheme was judged to have been poor value for money. It’s critical that we avoid a similar scenario this time round.
How will creating more clinical academic roles affect working patterns? We welcome the commitment to reverse the decline. Research is integral to the College’s mission to deliver the highest achievable quality of eye care. We will maintain close working relations with NIHR Research Delivery Network to advance clinical academic ophthalmologists at every stage of their career. It would be good to understand what options will be available to ophthalmologists who apply for research roles.
Can locally employed (LE) and specialty, associate specialist and specialist (SAS) doctors benefit from streamlined career pathways? LE doctors who have been working in the NHS for more than two years should be part of this plan with the option to transition into SAS contracts. We are pleased to see SAS and LE doctors included in career coaching and development plans.
At what stage of the application process are international medical graduates (IMGs) more likely to secure posts than UK graduates? The Plan aims to reduce international recruitment to less than 10% by 2035. But data is needed to better understand the current situation. The NHS depends heavily on IMGs to provide patients with sustainable services so any move that discourages them from applying without solving the existing staffing shortage is concerning. There will be a knock-on effect on the ability of IMGs to fill gaps in non-training roles.
What impact will the plan to “overhaul education and training curricula” have on the College’s curricula for resident doctors? We’d like some clarity on how royal colleges will input into developing a capability framework. And we’re waiting to see what the implications for ophthalmology training will be from both the Leng Report on the role of physician associates (due to be published imminently) and the review of medical training in England.
And finally: How will paediatric ophthalmology help to raise the healthiest generation of children? Good vision, with support for young people who need it, is crucial to realising the Plan’s ambition. We want to see the childhood vision screening programme being prioritised, with a universal model pathway to iron out variations in service provision and availability.
What are your thoughts on the 10 Year Health Plan and the implications for the specialty? Get in touch to continue the discussion [email protected]