BIOS News

The BIOS has just heard that of the UNISON members who turned out, 76% have voted 'Yes' to industrial action to defend pensions in the biggest trade union ballot ever held, by 245,358 votes to 70,253.

This means that with only one in three members voting - there will be fierce debate about how to interpret the result and perhaps uncertainty about whether this gives a clear mandate for striking on November 30th.

Commenting on the result, general secretary Dave Prentis said: "The decisive Yes vote in the ballot, reflects the deep concern that our members have over government ministers’ proposals for their pensions. Yesterday's statement in Parliament was a marked improvement on earlier proposals.
But, it is important to understand that the statement has to be translated into offers in the scheme-specific talks.We still have had no offer in those negotiations, where such an offer can legitimately be made. We support the TUC day of action on 30 November," added Mr Prentis, "but will be negotiating right up to then and beyond to get a fair deal for our members."

The union balloted members including nurses, teaching assistants, social workers, care assistants, paramedics, police staff, school dinner ladies, probation workers and cleaners.

The turn-out was low - with 30% in local government, 25% in health and 48% among members covered by the Civil Service scheme.

In local government, the votes were: Yes 171,428, No 54,500 - 76% in favour. In health, the figures were: Yes 73,930, No 15,753 - 82% in favour. The civil service scheme ballot saw an 87% Yes vote.

Seven separate ballots were held for the Local Government Pension Scheme in England and Wales, Scotland and Northern Ireland, the NHS Pension Scheme in England and Wales, Scotland and Northern Ireland and the Civil Service Pension Scheme.

The official result of each ballot, provided by Electoral Reform Services, can be seen by clicking on the link below: http://www.unison.org.uk/news/news_view.asp?did=7342

Orthoptists Support Day of Action for Pensions – But No Strike Ballot Planned

BOS TU Council made the decision on 11^thOctober that they would not be balloting members about strike action over pensions. However, they made clear their support for the planned day of action over public service pensions on November 30^th and will issue guidelines for members who want to show their support.

The BOS TU Council are in support of the day of action in November, called by public sector unions, but decided it was not appropriate for the Society to ballot its own members on industrial action at the present time. This was due to a number of factors, but particularly because members were surveyed in August about strike action and over 75% of members rejected the idea.

Members were also asked about their propensity to work to rule and seven in ten were in favour of this method of protest.

The BOS TU's position is in-line with the positions from the Royal College of Nursing, Royal College of Midwives and the British Medical Association, for whom strike action is a step too far at this time. All of these bodies are not balloting members but are in support of the day of action.

This was what some members said in the 251 verbatim comments collected from the survey (55 of these were pro strike action and 196 were against):

• "We need to be very careful and ensure duty of care prevails. In principle, I agree with the reasons for striking, but feel my patients must come first. All sectors are having difficulty in the current climate and we can't all strike."
• "I do not agree with strike action. I would work to rule and any goodwill left in the health service will disappear. Staff have put themselves out for far too long."
• "Working to rule would demonstrate how much extra responsibility/work staff currently undertake...Pension changes will already represent a pay cut on top of pay freezes in a climate of high inflation."
• "I do not agree with striking in the current climate and would hope that a satisfactory outcome would be reached through negotiation and low level industrial action in the form of work to rule - to minimise the impact on patients."

BOS TU Council chair Lesley-Anne Baxter said: ‘We are only too aware of the strong feelings of our membership on the topic of pensions and the way in which the government is attempting to bring about fundamental change to our pensions without sincere negotiation or debate. Everyone in the NHS including orthoptists, will be expected to work longer, pay higher monthly contributions, and yet, almost certainly receive a considerably lower pension.

The BOS dessiminates information regularly on pensions on the members' website and in the monthly newsletter, Parallel Vision. We will continue to do this and also offer guidelines for supporting colleagues on the 30^th November. We reserve the right to ballot members later on in the year should there be another day of action in early 2012. "

Guidelines for BOS TU Members who wish to support the day of action on 30^th November will be issued shortly.

Anita McCallum

BIOS Business Manager

Tel 01353 665541

Informatics – Get With ITor Start Losing Orthoptic Services

“Good practice is no longer enough; services need to provide detailed information: to referrers and commissioners.”

Informatics may sound like something deeply unappealing or a topic you would want to avoid at all costs, but it's actually the way that the NHS is talking about technology, data and information these days – particularly in relation to commissioners/referrers and patients.

In a workshop we attended on 14^thSeptember and chaired by Karen Middleton, NHS Chief Allied Health Professions Officer (pictured above), she opened the session by calling Allied Health Professionals “luddites” in their approach to IT, data and all-round lack of understanding of how important it is to get up to speed with the topic.

Laying down the gauntlet, Ms Middleton did admit that she had been a skeptic until quite recently about the area. But she did an analysis of how many allied health professional services were listed on Choose and Book systems and was horrified at how few there were. She was also dismayed about the lack of up to date listings on the NHS Choices website, where many patients will get their knowledge about how well services are delivered by particular departments in NHS Trusts or Independent Providers offering free NHS services.

The day was a real eye opener for us (no pun intended!) and it covered:

• How we provide patients with information about our services? (e.g. NHS Choices)

• How referrers choose AHP services (e.g. Choose and Book system)

• What information commissioners need to purchase our services (e.g. Community Information Data Set or CIDS)

• How the impact of our services is recognised and coded in a standardised way (SNOMED coding of AHP problems, goals, interventions, and outcomes)

• What technological means we are using to assist our efficiency (e.g. use of mobile and remote applications – e.g. texting patients the day before appointments to reduce DNAs)

One action we can all take is to make sure that your Trust and department is listed in NHS Choices; this data is then automatically linked to the Choose and Book system which GPs use as their main tool when selecting patient services. We will provide more guidance and also we will cover at the Managers Forum on 13^thOctober 2011

Lesley-Anne Baxter, Chair, BIOS

Anita McCallum, Business Manager, BIOS

Many organisations are working on this issue on your behalf including the TUC and NHS Employers.

This week saw a statement from the TUC on where it stood on the pensions debate - see full response here: pensions final statementFINALJuly 28_2011.pdf

http://www.hm-treasury.gov.uk/d/letter_cst_to_tuc_180711.pdf

Commenting on the announcement from the Treasury (above) concerning proposed increases in public sector pension contributions, TUC General Secretary Brendan Barber said: "Today's consultation documents reveal exactly what kind of increases could soon be hitting millions of public sector workers, when they are already in the middle of a pay freeze and facing a huge squeeze on their living standards.

The proposed increases, along with other changes the government wants to make to public sector pensions, present the individual schemes talks with a hugely difficult agenda to address over the summer."

NHS Employers said the following: "The Government's announcement confirms that separate scheme-specific consultations will lead to proposals being made by the end of October, on how these savings are to be achieved based on these principles.

They also establish that there should be no increase in member contributions for those earning under £15,000 and no more than a 1.5 per cent increase in total (before tax relief) by 2014-15 for those earning up to £21,000. 

The total increase will also be capped at 6 per cent (before tax relief) by 2014-15 for the highest earners. This amounts to a 2.4 per cent cap (before tax relief) in 2012-13 on a pro-rata basis."  Read the full analysis here http://www.nhsemployers.org/PayAndContracts/NHSPensionSchemeReview/IncreasedEmployeeContributionsForNHSPensionScheme/Pages/IncreasedEmployeeContributionsForNHSPensionScheme.aspx

With the future of public sector pensions threatened by Government reform, over four in ten (44.9%) of all public sector workers said that they would rather their pay were cut than their pension. In advance of last month's strikes, over half (53.8%) said that they firmly believed that their benefits were worth striking over. These findings are in a new study released on 5th August by Badenoch & Clark,and it seems that public sector workers are "desperately" holding onto their pension packages in the face of ever-decreasing morale levels.

Read the full article here:

http://www.hrmagazine.co.uk/hro/news/1019902/cut-pay-pensions-public-sector-employees

The Department of Health has published operational guidance to the NHS setting out plans to deliver the Government’s commitment to extending patient choice of provider. The full guidance can be accessed via this link:

http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_128455

The guidance has taken into account the relevant issues raised in response to the consultation, and the NHS so-called Listening Exercise. The Government's response to comments received on extending patient choice of provider (any qualified provider - AQP) has also been published. A fuller response covering all of the remaining issues and questions in the consultation document will follow later this year.

Patient choice through the ‘any qualified provider’ scheme will be extended in a more phased way and will start in April 2012. To ensure competition is based on quality not price, the choice of qualified provider will be limited to services covered by local or national tariffs. Initially, the scheme will be extended to services where patients say they want more choice, such as community services.

The Department also conceded there was activity where any qualified provider would never be practical or in patients’ interests, including accident and emergency and critical care. New pathway tariffs would also be developed to encourage more integrated care.

It agreed with the Future Forum that it should introduce more safeguards against "cherry picking" of profitable cases as this could undermine services. As well as the development of currencies and limitations on the any qualified provider scheme, it will introduce additional safeguards:

• Introduce a duty on Monitor – when setting the tariff – to ensure providers are paid fairly, taking into account the complexity of their cases (see box)
• Work with the Royal Colleges to identify procedures most at risk of cherry picking and ensure fair prices are set for these procedures from 2013/14
• Require commissioners to adopt best-value principles when tendering for non-tariff services, rather than simply choosing the lowest price
• Oblige commissioners to make public any variations to national tariff prices.

How will it affect orthoptists in clinical practice? Well, providers will have to qualify and register to provide services via an assurance process that tests fitness to offer NHS-funded services. Referring clinicians (GPs?) will offer patients a choice of qualified providers for the service being referred to - eye healthcare and treatments.

BOS response to AQP
AQP-BOSMember Briefing AUG2011.pdf
This will temporarily extend the role of the SHAs who will oversee the development of patient choice of AQP by PCT clusters and clinical commissioning groups. SHAs must also assess the suitability of alternative services to those on the national list.

Anita McCallum
BIOS Business Manager

The UK Vision Strategy meeting was attended by Lesley-Anne Baxter, Chair BIOS and Anita McCallum, Business Manager, BIOS. There were also other BIOS members and past-honorary officers there including Lindsey Hughes, Low Vision Service Lead, from the Royal Hallamshire Hospital, Sheffield, presenting at the poster competition.

Bob Hughes, Chair of the Eye Health Alliance, talked about sight loss set to double by 2030 and although he acknowledged that there were criticisms of the current strategy, at least he said it was " a unifying start".

Lord Howe, Parliamentary Under Secretary of State for Quality (with responsibility for eye care)  started off by saying that sight was probably the sense that people feared losing the most. He reassured the audience that the Government was committed to playing its part in improving quality of life for the visually impaired. He said that local commissioning groups would be able to commisison services with groups such a optometrists working with the QIPP Rightcare programme to make best use of resources. Lord Howe mentioned an initiative in Leicesetrshire and Rutland where the "do once and share" approach was being implemented and it is hoped that this would be rolled out nationally. Pertinent to this was the development of the Eye Health Indicator to enable professionals from different specialisms to work together effectively all with a common focus and reference point.

On a lighter note in the afternoon during a panel chaired by BBC Political Correspondent, Gary O'Donoghue, he shared an anecdote of his own experiences at an eye clinic recently and how patient records were woefully inadequate. Just wanting to get a stye removed, the health professional in the clinic wanted to give Mr O'Donoghue a full eye test. He postulated that he had been blind since birth, but the person wouldn't hear of it. In desperation he picked up a pen and stabbed himself in his artificial eye and said "Now - do you believe me!".

NHS Alliance Chief Executive, Michael Sobanja launched new eye care commissioning guidance to aid clinical commissioning groups to provide quality, cost-effective eye care services for their patients.

Speaking at the Vision UK 2011 conference Michael Sobanja said: "It is important to have patients right at the heart of eye care service commissioning. This new guidance will assist commissioners to improve quality of provision in a sustainable manner."

The BIOS is delighted that Michael Sobanja has agreed to address the BIOS Managers' Forum on October 13th in Birmingham.

Responding to Danny Alexander's comments on public sector pensions today (Friday), TUC General Secretary Brendan Barber said: 'At such a critical time in complex negotiations this is a deeply inflammatory public intervention with a clumsy mix of announcements apparently designed to pre-empt the talks, coupled with crude threats that even worse terms might be imposed if unions refuse to acquiesce to this assault on their pensions.

'Many of the detailed proposals set out by Danny Alexander today have not even been put to the TUC negotiators, and the government has yet to give a response to specific proposals tabled by the trade union side.

'I have found over many years that if you are seriously trying to build trust to settle a difficult dispute you should talk honestly and openly inside the negotiating room and exercise self restraint outside.

'This speech, and the media-spinning operation around it, has dealt a serious blow to union confidence in the government's good faith in these talks.'

 

The statement is available on the TUC website here:

http://www.tuc.org.uk/mediacentre/tuc-19680-f0.cfm

The results from the NHS Future Forum led by Dr Steve Field are out today.
Latest release attached - hot off the press.

BIOS experts are analysing full findings and will post conclusions for the NHS and orthoptists within the next 48 hours.
NHS Future Forum Press Release 130611.PDF

THE PRIME minister visited Ealing Hospital on 16th May in a bid to help dispel concerns about plans to reform the health service. Speaking to a crowd of staff, patients and the press, David Cameron repeatedly declared his love for the NHS while stating the need for change saying: “If we don't modernise today we face a crisis tomorrow.”

Lesley-Anne Baxter, Chair BIOS and BOS TU was part of the invited audience and writes:
"An invitation was received last Friday 14th May  to attend a speech that David Cameron was to give at Ealing Hospital on Monday 16th May.

This occasion was part of the listening meetings across England and the Prime Minister was introduced by Professor Steve Field, leading on this work.

The Prime Minister used this time to reiterate his commitment to the NHS as patient centred and free at the point of delivery but also said that this would be clinician-led with GPs at the centre. He went onto say that the NHS needed to change and what he wanted was a sustainable service for the future. He also said that their was a recognition that "Any Qualified Provider" meant that training had to be undertaken and there would be no cherry picking of service provision.

In the audience were Chief Executives from the Institute of Biomedical Scientists, the British Association of Occupational Therapists and a number of Charities and Royal Colleges as well as the Department of Health and Chief Executives from Strategic Health Authorities.

All through the speech there was mention of doctors and nurses. In the question and answer session we were able to ask for reassurance that Allied Health Professionals would also be in a position of influence This was a good opportunity to raise the profile of Orthoptics with colleagues and officials from the Department of Health communications team. The speech will be e mailed to those in attendance but will also be on the DH website,...."

The speech comes on the day a survey revealed 94 per cent of NHS managers believe the Government's controversial health service shake-up is 'irrelevant' and 'dangerous'. This, alongside a report from nhsManagers.net - which consulted 4,722 NHS managers and clinical leaders - found many feel reform can be achieved without 'disruptive' legislation and claim the proposals should be abandoned.

Many hospital doctors are concerned the reforms give too much power to GPs. One clinician said: 'I just don't think GPs are ready to take this on.'

See the full story http://www.number10.gov.uk/

On the 6^th May the AHPF Board, which included representation from BIOS, was invited to participate in one of the NHS Listening Exercise events with Earl Howe (Parliamentary Under Secretary of State for Quality ) and Dr Kathy McLean (leading onClinical Advice and Leadership).

Lesley-Anne Baxter, Chair of BIOS, commented on the meeting: "BIOS had the opportunity to raise issues such as commissioning for a small profession and the difficulties of managing the existing change agenda alongside the radical health care bill. For example, organisations appear to be using QIPP as a cost cutting exercise instead of an opportunity to raise quality and this kind of existing change agenda is having to be juggled alongside the challenges of GP-led commissioning. We also raised the issue of difficulties with not having an AHP voice at national and local level. Other professional groups (such as the Royal College of Nursing) have been invited to participate - but not AHP. This meeting sought to change that and redress the balance."

All of the AHP twelve organisations were represented and had developed a robust message beforehand. They put the case for AHPs to be present at the decision making tables in their own right wherever they exist in the new structures formed. The discussion focused on the four areas identified by the Future Forum Listening Team, namely: Choice and Competition, Public Accountability and Patient Involvement, Clinical Advice and Leadership and Education and Training.

The NHS Listening Exercise presented a major opportunity for AHPs to be empowered in the future health and social care environment and thus liberated to enhance the quality of patient care in a sustainable way. It gave us a further opportunity to reinforce the message that AHPs need to be positively included in decision making.

The key point made was that given the important role of Allied Health Professionals in so many aspects of care including improving public health and wellbeing, reablement, management of long term conditions, providing integration across health and social care and delivering care within the education and justice contexts, the AHPF believes that the Health and Social Care Bill should be amended to ensure AHPs are represented at all levels in the new NHS structures, on the NHS National Commissioning Board, on the GP Commissioning Consortia and on the Health and Wellbeing Boards.

Earl Howe and Kathy Mclean took on board these points and explored them further especially with regard to what specific models might be helpful in terms of decision making structures.

Examples included the damage being done to services by the ‘salami slice’ approach to saving money, the potential fragmentation caused by Any Qualified Provider (AQP), the need for a national tariff and coding for AHP services to enable appropriate commissioning, the need to enhance and sustain self referral as a way in to the system and the importance of AHPs for patients with communication and other difficulties for whom accessing the system might be challenging.

The NHS Listening Exercise formally finishes on the 31^st May but the passage of the Health and Social Care Bill proceeds into the House of Lords for further debate and potential amendment. The AHPF and the individual professional bodies (including BIOS) will continue to engage with the process with intent to influence the final outcome on your behalf. There is still time to get engaged. Contact BIOS , the AHPF or get involved direct.

The NHS Listening Exercise document is available at http://healthandcare.dh.gov.uk/files/2011/04/NHS-Listening-Exercise.doc