A dispute over the tax bills faced by doctors working additional hours is starting to hit waiting lists in Lancashire.
A board meeting of the trust which runs the Royal Preston and Chorley and South Ribble Hospital heard that there is a “clear link” between nationwide disquiet about how much medics are taxed on their pensions and a growth in the number of patients waiting for treatment locally.
An extra 1,700 people appeared on Lancashire Teaching Hospitals’ patient tracker list between April and June. They are patients who need to be treated by a certain point in order to prevent them exceeding waiting time standards.
A survey of the medical workforce at Lancashire Teaching Hospitals (LTH) found that 56 percent of medics working across the Preston and Chorley sites have indicated that they are considering reducing their hours as a result of the pensions issue.
Rule changes introduced three years ago have resulted in some medics receiving huge tax demands if they have exceeded new limits on their pension contributions by working above their full-time contracted hours. There have been claims that doctors are effectively “paying to work” as a result.
LTH workforce director Karen Swindley said that it was unlikely that the effects of the growing discontent over the issue could be completely mitigated and said suggestions that the NHS could make more short-term use of capacity in the private sector would not necessarily help.
“This isn’t just related to what people earn in the NHS, it’s related to their total earnings – so even if they are stopping doing activity in the NHS, they are not likely to increase their work in the private sector. It’s the same group of people we are relying on,” she explained.
Chief executive Karen Partington also stressed the importance of finding a Lancashire-wide plan to limiting the fallout from the issue.
“The difficulty is that if we all go down an individual path, then we will go into a potentially competitive market, [leading to] people wanting to move – so it’s really important that we try to have some standard approaches to this, Ms. Partington said.
She also called for all parts of the NHS to carry out their own research in order to gain a better understanding of the extent of the potential problem.
The meeting heard that the Lancashire and South Cumbria Integrated Care System is exploring ways of tackling the issue across the region, while LTH has put in place measures to ensure that patients waiting for treatment are properly monitored.
“We will have to make sure that we have really clear safety metrics so we know when a patient is waiting longer than we expect them to – a trigger to know that patients are safe on our waiting list,” Faith Button, the trust’s chief operating officer said.
Just over 80 percent of the growth in waiting patients in Central Lancashire has come from four specialties – general surgery, trauma and orthopaedics, neurology and gynaecology. NInety-two percent of the increase is accounted for by outpatients.
The meeting heard that ophthalmology – which has historically had a long waiting list in Central Lancashire – has recently shown significant improvement.