The Department of Health has published its Operating Framework for 2010-2011. This effectively provides the plan for the last year of funding growth in preparation for the period covered by the From good to great document.
Both reports state there will be growth of more than 5% in NHS funding until 2011, after which there will be no further increase in real terms for three years.
Society CEO Richard Evans explains what the Operating Framework for the NHS in England 2010/11 means for radiography services...
'Make no mistake, even with a 5% increase, it is going to be hard to get your hands on money unless you have got good innovative ideas. We will have to fight for additional resources.
That said, this is not the time to wring our hands in despair.
Remember that imaging and radiotherapy services are essential services. Managers need to act now to plan in detail how services can be improved, identify the costs involved (both expenditure and savings) and the support needed for change.
The framework document is long and written in complex jargon, but if you can see through to the underlying messages – positive and negative – you can turn that to your advantage.
There are several points that I feel are especially pertinent for radiographers:
• The report calls for ‘renewed focus’ on delivering high quality services and looks for these changes to be clinically driven. This means all clinical staff including radiographers – not just doctors. We have a chance to make our voice heard and demonstrate our value as a profession by leading in innovation.
• System changes over a five year period will mean less activity and investment in the Acute Sector and more being spent in primary care. The two sectors will be sharing risk and all parts of the NHS will be expected to work together.
• Although quality has become the watchword rather than focus on targets, they will want to see improvements on the 18 week work for example and the reporting of diagnostic tests happening much more rapidly.
More pressure for radiographers? Yes, but also an opportunity to gain support (financial and otherwise) for new ways of working, such as radiographer reporting and the use of rapid CT for stroke and cancer screening. In radiotherapy, the 31 day target for all patients receiving radiotherapy will still stand, to be reached by December 2010. There are also plans to run a cancer patient experience survey nationally.
• In workforce planning we are told redundancies are to be the last resort, but while next year’s pay deal has been agreed and must be paid, after that there is less certainty.
• The document calls for better conditions and staff engagement, though worryingly these calls are accompanied by targets for Trusts to reduce sickness absence. Perversely this could lead to aggressive policies that penalise employees for genuine sickness.
• In terms of education and CPD, many departments are already struggling with training budgets cut to the bone. Nevertheless, the framework stresses that innovation and more efficient working must be instituted now. Managers should spell out the training needs for their departments and explain how this will translate into service improvement.
• Expect some quite aggressive financial controls intended to reduce demand in the acute sector, including for diagnostic imaging. In emergency work, for example, any activity over the agreed local baseline level will only be reimbursed at one third of the tariff rate. Acute trusts and commissioners should be looking carefully at demand management and imaging departments should be ready to advise on use of guidelines, triage in the department and institution of decision support systems.
Prepare to work smarter
It is all pretty scary but the point is to prepare to work smarter in the future. The delivery of innovative, quality care is something I think radiography managers will be able to advise on very well, particularly if we can work with clinical staff as much as possible.
The framework mentions oversight by Strategic Health Authorities. It would be worth making contact with the Diagnostics Lead and the AHP lead in the region so that they are aware of plans. Local liaison with Primary Care leaders and commissioners will be essential.
We cannot cross our fingers and hope we won’t be affected by the economic crisis. We know that we cannot go backwards in providing great services. The answer is to take up the challenge and show that development of radiography will reap real financial benefits.
Although the Operational Framework is specifically about the NHS in England and despite the fact that the mechanics of the system described are English, the themes and need for a strong response from radiographers is the same across all parts of the UK'.
Visit the Department of Health website to download the Operating Framework for the NHS in England 2010/11.
