20 consultants sought to practice off-site

More than 1,200 NCHDs enrolled on the Professional Development Support Scheme last year

A total of 20 applications for changeover to consultant contracts allowing off-site practice were considered in 2019 by the “Type C” Contract Committee of the National Doctors Training and Planning (NDTP) unit and 17 were approved.

The 2019 annual report of the NDTP showed this comprised 20 requests from individuals to change their contract.

There were no requests from employers seeking to designate approved replacement consultant post as a Type C.

The number of requests considered was down by nine on 2018 when a total of 29 new applications came before the Type C Committee.

Of the 17 Type C applications approved in 2019, three related to recommendations in 2018, nine from applications first considered in 2018, and the remainder were for applications considered and dealt with in 2019.

As in previous years, the primary reasons for seeking a change to a Type C contract were to: free up capacity within public facilities; and help specialists refine, maintain, and develop their clinical skills.

There were some common themes emerging in the submissions. As in previous years the primary arguments remained: the lack of opportunity to retain hard-earned specialist skills due to resource constraints, including but not limited to, lack of theatre time, lack of diagnostic capacity, shortage of beds, shortage of specialist theatre staff.

Freeing up of the capacity of the public facility with the transfer of private patients to private hospitals; the introduction of professional competence schemes was adding further weight to the individual’s argument to have opportunities to practise and retain competence in their skills.

In a number of cases, the predominant argument put forward related to moving patients who had private insurance into the private sector so as to use the resultant release of capacity for public patients and subsequent reduction in waiting times.

During 2019, some 339 applications for consultant posts were considered and reviewed by the Consultant Applications Advisory Committee (CAAC).

Most of the posts approved last year by the Committee were new posts, 10 per cent for a change of contract; almost a quarter were replacement posts; 9 per cent were restructuring of posts and a further 5 per cent were replacement of restructured posts.

However, of the total applications, three posts were withdrawn by the clinical sites and, in some cases, were re-submitted under different application numbers; 11 posts were presented to the CAAC on more than one occasion, including posts due to recruitment difficulties requiring amendments to geographical locations or seeking revised titles/qualifications.

On December 31, there were 3,354 approved permanent posts, an increase of 3.7 per cent from the total of 3,234 a year earlier, added the report.

A breakdown of medical consultant approved posts in 2019 showed that just less than 2,000 were held under Type B contracts; more than 600 were Type A contracts; another 278 under Type B* contracts; and 171 under Type C while 172 posts are under Category 1 and 143 under Category 2.

The role of the CAAC is to provide independent and objective advice to the Health Service Executive (HSE) on applications and qualifications required for consultant posts.

A review of the HSE-approved qualifications and titles for consultant posts was to commence this year with the medical discipline of Medicine with other disciplines to follow on a rolling basis in consultation with relevant stakeholders i.e. Postgraduate Medical Training Bodies and Clinical Programme Leads, throughout 2020.

Some requests to alter terminology had been received last year including a change from “Anaesthetics” to “Anaesthesiology”.

In 2019, some €2.3 million was spent refunding a total exam and course fees under the auspices of this Clinical Course and Exam Refund Schemes, accessible to all holders of the non-consultant hospital doctor (NCHD) 2010 contract.

The NDTP annual report showed the numbers of doctors in service posts enrolled on a Continuous Professional Development Support Scheme (CPD-SS) last year came to more than 1,200 NCHDs.

The scheme is funded by the NDTP to facilitate NCHDs not in training posts to continue to maintain and enhance their clinical knowledge and skills, and to maintain their professional competence in line with Medical Council requirements.

From July to December 2019, some €1.6m was approved for payment by clinical sites under the Training Supports Scheme and approximately 6,000 applications were submitted.

The report added that the NDTP continued to work with clinical sites to ensure compliance to the scheme, and to troubleshoot any operational challenges.

Over 350 doctors were participating in structured training to date under the International Medical Graduate Training Initiative.

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