Workforce challenges

Simon Hodkinson

Whilst the sun is still shinning on the South Coast it will set all too soon on my year as BOA President. It goes without saying that the last year has been a great privilege and a pleasure.

When I last wrote a piece for the JTO we were entering the summer and although there were the daily problems and seemingly ever-present, ever-growing systemic challenges, I felt that we were entering the holiday period knowing what was around the corner. Of course, 4th July changed that.

As one would hope, many of the meetings and conversations that I have had in this role, have made progress, some more than others: priorities identified and how to achieve them etc. It is now all on hold and there is as yet little idea as to how the new Government intends to move these myriad pieces of work forward.

The new Government has made it clear that the reduction of waiting lists is their priority - for the well-being of patients and of the economy - and has promised 40,000 new appointments per week by paying doctors and nurses overtime rates to take on additional shifts.

More of the same will not achieve this ambition and therefore there must be an element of working differently; more efficiently, more effectively. Post-pandemic productivity is an issue in the NHS as we all know but it is a multifaceted problem and not just down to us as surgeons.

Many of you will be aware that GIRFT requested the BOA to support a minimum number of patients in our outpatient clinics; the BOA declined to support the ‘one size fits all’ proposal. However, I made it clear the BOA would support attempts to improve productivity for the benefit of our patients as long as those attempts are not to the detriment of the quality of care our patients receive; good quality, productive services must be intelligently resourced.

In my last piece, I reported that I had been to several meetings regarding integration of primary and secondary MSK care, and I commented that around the country when these two key elements of the health service worked in collaboration it was clearly a benefit to our patients.

We are yet to hear how this project will progress, but I am pleased that we maintain a good relationship with the National Clinical Director for MSK, Lesley Kay, who will be speaking at the BOA Congress in Birmingham.

Consideration of the role of physician associates in trauma and orthopaedic surgery has been led by my colleagues, Mark Bowditch and Fergal Monsell. This work, alongside submissions by other surgical specialties is now being considered by the Royal College of Surgeons of England and we await the formal publication of a position statement from the combined UK surgical colleges.

Sadly, many of the concerns I have expressed about the T&O workforce have worsened and recent publications from the GMC have confirmed many of my fears. The BOA is looking at a range of these issues in particular those raised by the British Orthopaedic Trainee’s Association and by Training Programme Directors, including maximising training opportunities and the ‘professionalisation’ of trainers.

I raised these matters last month when I met with representatives from the Workforce, Training and Education team at NHS England, some of whom will be joining us at Congress. I came away from that meeting with the impression that they really did understand my concerns regarding recruiting people into our specialty, sustaining our trainees and young Consultants and retaining them in their later years.

Congress has a series of sessions dedicated to these issues not only in the T&O workforce but also amongst the many allied health professionals that support and augment our practise. I hope that these sessions will be stimulating, and that our discussions are robust, constructive and productive.

I sincerely hope those attending Birmingham this year will have an enjoyable and enlightening time and I look forward to meeting as many of you as I can.

Finally, it would be remiss of me in this last piece if I did not express my sincere admiration and thanks to the BOA secretariat.

This small but dedicated group of people produces a huge amount of work, and they have been of immeasurable support to me and to the Officers and Trustees of the Association in this last year. They are and will be working incredibly hard to ensure the smooth running of Congress, the vast majority of their work going completely unnoticed.

So, my grateful thanks to the team for all for the support over the past year and I would like to wish my successor, Mark Bowditch every good wish for his year as your President.