As surgeons, trainees are at the heart of our profession and we must guarantee that their development and training is not disadvantaged in the long term as a result of the covid-19 pandemic.
With 2.15m people in England currently waiting more than 18 weeks to begin hospital treatment—treble the figure for the same time last year—it’s evident that we must use every means at our disposal to address this growing backlog. The use of private hospital facilities is therefore a pragmatic step in the right direction.
However, private hospitals are not all automatically approved for surgical training in the same way as NHS establishments.
The belief was, therefore, that only consultant surgeons would be used to address the surgical backlog, with trainees losing out on hours of practical experience. This risked the development of our future surgical workforce.
Understandably I was very pleased when NHS England confirmed that surgeons in training will be given access to operating lists in independent hospitals, especially with private hospitals set to play such an important role in the resumption of elective surgery for the foreseeable future.
The past six months have been extremely difficult for trainee surgeons. They have lost out on months of training as elective operations were postponed, and many were redeployed to non-surgical workplaces. The dedication and flexibility they have demonstrated has been exemplary.
Understandably, there has been a great deal of anxiety among the trainee workforce, so I hope this news will provide some reassurance for them.
There are some differences in the way the independent sector and the NHS works, so we will closely monitor the situation to ensure that trainees in independent hospitals receive the same quality of and access to training as their counterparts in non-private settings.
While it’s important that these different ways of working do not cause any disparity in the level of training provided, it is my belief that they also present a good opportunity to look afresh at clinical and non-clinical standards across the two sectors, so that best practice can be identified and encouraged. There are sure to be ways of working that private providers can learn from the NHS, and vice versa.
While the announcement currently only applies to England, I would strongly urge the devolved administrations in Scotland, Wales and Northern Ireland to follow suit. We do not want to find ourselves in a situation where the next generation of surgeons in these parts of the UK is disadvantaged.
Of course, surgery and training aren’t the only things which have been put on hold in recent months. Diagnostic services have also been vastly reduced, which has led to a considerable backlog. In England, the number of patients waiting more than six weeks for a diagnostic test has risen from just over 37,000 in July 2019, to almost half a million in July 2020.
The use of private hospital facilities may be useful here, but work will need to be done between the independent sector and the NHS to ensure tests and results are processed smoothly and efficiently.
Likewise, it’s important that post-operative care isn’t negatively affected, and that the patient journey is as straightforward as possible.
The RCSEd is completely committed to supporting trainee surgeons, and we will continue to work on their behalf to ensure they have access to as many training opportunities as possible during this uncertain time.
Michael Griffin, President of the Royal College of Surgeons of Edinburgh.
Competing interests: None declared.