The Herald Live Health Summit takes place on 5 April at the Royal College of Physicians and Surgeons in Edinburgh (RCPE).From left to right: Helen McArdle, health journalist and panellist Dr Conor Maguire; Professor Lindsay Pope; Dr Hugh Pearson; Dr Donald Macaskill
(Photo source: Gordon Terris/Herald&Times)
What’s stopping Scotland’s medical and nursing staff from giving patients the care they want? Why is our activity still lagging behind pre-pandemic levels?
How should we solve the recruitment and retention crisis plaguing the NHS and care sector?
These are just some of the issues discussed by The Herald at the inaugural health summit hosted by the Royal College of Physicians and Surgeons (RCPE) in Edinburgh.
Dr Donald Macaskill, chief executive of Scottish Care, was joined by Professor Lindsey Pope, Deep End GP and Professor of Medical Education at the University of Glasgow, as the expert panel brought together insights from general practice, social care and hospital medicine; Dr Hugh Pearson, junior doctor, BMA Scotland Committee Vice-President; Dr Conor Maguire is a consultant physician specializing in geriatrics and Vice-President (International) of the RCPE.
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There was also a wide range of views from the audience during the Q&A session, covering a range of topics including whether “rural weighting” in wages could be used to attract and retain staff in underserved areas such as the Highlands, and the need to address Sex: There are “unwarranted differences” in services and number of specialists between health board jurisdictions.
Productivity has been highlighted, with figures showing that despite a 13% increase in the number of full-time staff in NHS Scotland and a 10% increase in health spending per head of population, elective activity, emergency admissions and outpatient appointments are now still lower than before the pandemic. By 2019.
Some examples were heard at the event, where access to operating theaters has become so tight that consultants who used to perform surgeries every day are now sometimes only able to do so once a week.
There is a feeling that infrastructure such as equipment and theater space is “not keeping pace with the increase in staffing” and fewer beds are expected to be needed.
Discussion covered a wide range of issues affecting recruitment, retention and patient care (Photo source: Gordon Terris/Herald&Times)
Dr Maguire noted that more than half the beds on his geriatric medical ward were occupied by patients who were well enough to be discharged but who were unable to do so while waiting for care home places, social care packages and guardianship orders.
Dr Macaskill said social care must be more than just a “handmaiden” to ease NHS bed congestion, but admitted the lack of a “whole-of-system approach” was leading to financial inefficiencies.
Dr Macaskill said a week-long stay in an acute hospital costs an average of £2,900 a week on the NHS, compared with £1,500 in a care home, or £1,000 for home care.
However, Dr. Macaskill also stressed that measuring the success of health and care should be based on the quality of patient outcomes and “factory-style” productivity statistics.
Reliance on overseas employees has also been highlighted.
Although NHS Scotland’s reliance on international medical graduates is relatively low compared to the UK average – 19% of NHS Scotland doctors qualified overseas (excluding EU countries), compared with 32% across the UK – Professor Pope stressed that the figure was “much higher than in the UK”. In general practice, the size of the workforce has been shrinking in real terms over the past decade.
The event is the first Pioneer Live Health Summit (Photo source: Gordon Terris/Herald&Times)
Research from Scottish Care found that some providers in Scotland currently employ 95-100% of nursing staff from overseas.
Dr Macaskill said the number had increased “significantly” to compensate for the loss of EU staff post-Brexit and during the pandemic. In some cases, suppliers have lost about 90% of their employees in EU countries, he added.
The role of the private sector was also discussed, with figures showing there are currently 9,000 consultants working in independent hospitals across the UK. Most people are also employed by the NHS.
One option raised during the event was whether the private sector should make some payments to the NHS, recognizing that it has benefited from investment over the years in training doctors.
Dr Macaskill added that perhaps the NHS should be required to pay similar “finding fees” to care providers when recruiting trained care staff into the service.
Dr Pearson said proposals to expand the physician assistant workforce also needed “more clarity” amid concerns there would not be enough senior clinicians to supervise them and the training of junior doctors could be compromised.
There was also consensus among panellists that a “national conversation” was needed on the future of the NHS, making it clear that a choice must be made between more investment or less investment.
The group brings together expertise from social care, general practice and hospital medicine (Photo source: Gordon Terris/Herald&Times)
Nina Holmes, Head of Events at Newsquest Events Scotland, said: “Herald Live events are key to bringing individuals from different industries or issues together to discuss and expand the conversation about change.
“Real change is only possible when we bring people together to discuss a common cause.
“Our Q&A sessions allow for answers from peers or further reflection from our panel of experts.
“In the digital age, it’s increasingly important to carve out space to attend industry events where building connections is at its core.”
For more information about upcoming Herald Live events, visit https://newsquestscotlandevents.com/