Daily Insight: Avoidance tactics

Avoiding GP referrals by providing ‘advice and guidance’ will count towards the NHS meeting the government’s elective care targets, according to draft health service guidance seen by HSJ.

Under the elective recovery plan, hospital specialists are being asked to offer more advice when GPs are deciding whether to refer a patient for an outpatient appointment, which would avoid some patients being added to waiting lists.

New documents seen by HSJ, shared in draft by NHSE last week, reveal this avoided activity will be counted in assessing if the service or individual trusts have hit a key government target to carry out 10 per cent more ‘clock-stop’ activity in 2022-23 than pre-covid levels. The document envisages ‘advice and guidance’ to GPs contributing an estimated six percentage points towards the overall completed pathway activity target.

Meanwhile, the draft guidance suggests funding for outpatient follow-ups will be cut by 15 per cent, as part of a wider ambition to reduce this activity by 25 per cent. The goal, it suggests, is for this to free up resources that can be shifted towards hitting the overall 110 per cent activity target.

Bowing out

Considering some of the serious workforce issues the NHS has been grappling with over the last few months – most significantly the panic around and then government back-tracking on vaccination as a condition of deployment – the absence of the chief people officer has been notable.

NHS England has finally confirmed in a message to people directorate staff today that Prerana Issar will not be returning to her CPO role, because she is taking time to recover from a covid related illness.

In a separate message Ms Issar said the decision to step down had been “very hard” but said it was the right one for her, the directorate, and the organisation.

In 2019 her recruitment was welcomed as a senior voice on staff issues and a senior director with a minority ethnic background.

However, during her tenure as CPO, no substantive, financially backed workforce strategy has been published and 2020’s People Plan was criticised for its lack of substance.

As HSJ readers will know, a more detailed plan is being worked up and leadership of the people directorate passed to interim CPO Em Wilkinson-Brice, amid discussions about how it will operate when HEE and NHSE merge.