10.06.15
Dermatology services ‘nearly collapsed’ after privatisation
The NHS must learn from the mistakes that led to the near-collapse of dermatology services in Nottingham and a more “radical approach to commissioning” is needed in the future, according to the chief executive of Nottingham University Hospitals NHS Trust (NUH).
Peter Homa made the comments following the publication of a review into how dermatology services in Nottingham nearly collapsed following a mass exodus of consultants after their privatisation.
A contract to provide the services was awarded to Circle in 2013, beating out NUH’s bid, following a competitive tender by Rushcliffe CCG.
Prior to 2013, the consultants had all been employed by the trust under NHS contracts but most faced being transferred to Circle under the new contract. However, rather than move to the private provider, most consultants chose to leave and seek jobs elsewhere.
The mass exodus led NUH to cease providing acute adult dermatology services – including emergency services – from February.
Homa said the changes imposed by commissioners “dismantled Nottingham’s previously distinguished dermatology service, including research and teaching to trainees and medical students”.
“This situation was consistently raised and predicted by NUH consultants. Many of our most experienced consultants have left NUH to work at other centres. From July this year we will have one full-time and one part-time consultant,” he added
The independent review, chaired by former National Clinical Advisory Team chair Dr Chris Clough, concluded that “the near-collapse of acute and paediatric dermatology services in Nottingham was triggered by the incomplete transfer of consultant dermatologist[s] from Nottingham University Hospital NHS Trust to Circle Nottingham employment”.
“This led to a cascade of problems, mostly concerning recruitment and retention,” it added.
It criticises the slow response of the providers and commissioners to acknowledge the problem and make moves to solve it, saying that this “aggravated matters”.
Horna said that NUH’s attempt to set up a limited elective service for local adult patients, which he believes would have allowed the trust to retain more of its consultants, was halted by commissioners last year on contractual grounds.
The trust’s priority now is to recruit additional consultants preserve the paediatric service it is contracted to provide.
He added: “Our interpretation of the report’s main finding is that a new model of delivery is required to achieve a sustainable and affordable Dermatology Service in the future. It is clear that without a more radical approach to commissioning and employment contracts that this is unachievable and will not recreate a service that NHS consultants wish to join. We remain determined to work constructively with our partners with the single aim of achieving the best results for patients.”
Vicky Bailey, chief officer for NHS Rushcliffe CCG said: “We accept the lessons learned and recommendations from the report and will work together to take them forward to build a sustainable, high quality dermatology service in Nottingham for our patients.”
(Picture by: Emma Coles / PA Archive)
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