Number of consultants employed and details of waiting list for each medical discipline togher with total number of operations carried out January 2005 to December 2009

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WRITTEN QUESTION TO THE MINISTER FOR HEALTH AND SOCIAL SERVICES

BY DEPUTY M.R. HIGGINS OF ST. HELIER

ANSWER TO BE TABLED ON TUESDAY 19th JANUARY 2010

Question

1. For each medical discipline/specialism (for example: cardiology, neurology, orthopaedics etc) would the Minister advise the Assembly of the following information:

1. the number of consultants employed on a full time and part time basis in each area
2. (i) the number of non-private health insurance people on waiting lists to see a consultant in each of these areas; and

(ii) the average time they are waiting to see the consultant

3. (i) the number of private health insurance people on waiting lists to see a consultant in each of these areas; and

(ii) the average time they are waiting to see the consultant.

2. The total number of operations carried out in each discipline at the hospital during the last five years, starting on 1st January 2005 ending on 31st December 2009 stating:

1. the number of private and non-private operations carried out in each discipline for each year;
2. the cost of performing these operations in each area for each year for non- private health insurance patients and private health insurance patients.

3. The number, disciplines and costs of locums and agency nursing staff employed by the hospital for each of the five years starting on 1st January 2005 ending on 31st December 2009.

Answer

For the purpose of clarity this question is answered in accordance with the subsections as identified. The research required to achieve the level of detail given in this response was significant and challenging in relation to the time period available. (See next page)

1 a – Chart 1 shows the number of consultants in each speciality area. Chart 1

Visiting

consultants  Locum  Locum Consultants:-  Consultants :-  part time  Consultants  Consultants

Speciality  number full time  Part time  from UK  Full time  Part time A+E  3

Anaesthetics  6

Community Dental  1

Oral Surgery  1

Orthodontics  1  1

ENT  2

General Surgery and Urology  3

Trauma and Orthopaedics  3  4

General Medicine all

specialities  8  1 Obstetrics and Gynaecology  3  1

Ophthalmology  2

Paediatrics  3  7

Pathology  4

Psychiatry  4  2

Radiology  4  1  1

Rheumatology  1

Oncology  1  1

Plastic Surgery  1

Vascular Surgery  1

Cardiac Surgery  1

TOTAL  46  3  18  4  1

For 1b (i) and (ii) see Chart 2 which shows the total number of patients waiting to be seen for public consultation in out-patient clinics as at the 3rd January 2010 and also the average

waiting times for that speciality in weeks waiting.

The waiting times are calculated from the date of receipt of the referral at the hospital. Clinically urgent patients, as determined by the receiving consultant, are fast tracked through the system. (See next page)

Chart 2

Speciality  Numbers on waiting list  Average waiting

as at 3rd January 2010  time in weeks Anaesthetics  6  6 Breast Surgery  8  2 General Surgery  344  18 Plastic Surgery  9  7 Urology  178  22 Orthopaedics  376  11 Paediatric

Orthopaedics  6  2 Sports Injury  173  28 ENT  164  4 Ophthalmology  397  27 Pain  236  17 Back Pain  60  2 Gynaecology  155  9 Infertility  73  20 Well Woman  12  2 Community

Contraceptive Clinic  6  1 Ante-natal  121  0 Oral Surgery  147  5 Orthodontics  146  12 Community Dental  83  10 Diabetes  168  23 General Medicine  24  4 Bariatric  105  156+ Endocrinology  11  4 Nephrology  26  12 Gastroenterology  205  48 Medical Micro-

Biology  13  6 Neurology  269  31 Cardiology  121  7 Respiratory Medicine  57  21 Dermatology  535  34 Rheumatology  5  1 Clinical Haematology  23  11 Paediatrics  123  14 Clinical Oncology  7  4 Medical Oncology  3  2 Geriatric Medicine  6  2 Adult Mental Illness  2  3 Old Age Psychiatry  10  2

1 c (i) and (ii) Health and Social Services do not manage the lists of private patients waiting to see consultants as out-patients. These patients are seen in consultants' own private rooms from where the lists are managed

For Question 2 a, please refer to Chart 3 below. This shows activity relating to the number of public and private operations by speciality. It should be noted that a proportion of the private work is undertaken in dedicated private lists on Saturdays. Furthermore the number of operations performed is not directly comparable between columns i.e. some are short procedures whilst some are much longer and this chart cannot, therefore, be used for direct analysis purposes as it only represents patient numbers.

2 b The level of detail required to answer this sub section is not currently available, it would take approximately 5 months to develop this information. Our current practise is to use the UK Health Resource Group tariffs with uplift for Jersey, when this is required for individual patient costs. We plan to develop this area further after the implementation of the new IT system which goes live late 2010. (See next page)

Chart 3 :- Analysis of operations taken place in Endoscopy and Main and Day surgery theatres 2005-2009

In response to Question 3: Agency Nursing

In 2009 a total of 64 Registered Nurse Agency staff were used.

The table below provides data on the number of shifts covered by Registered Nurse Agency staff.

Shifts covered lasted between 5hrs (minimum day shift) and 12 hours (maximum night shift).

A total of 34 Registered Nurse Agency staff were paid at a UK Band 6 pay rate (approx Jersey Grade 5)

A total of 30 were paid at a UK Band 5 pay rate (approx Jersey Grade 4)

The HSSD finance department calculation on Registered Nurse Agency cost for 1st Jan – 30th Sept 2009 was £560,788 providing a projected full year cost of £747,717.

The year on year spend for Registered Nurses, Health Care Assistant prior to 2009 was calculated as part of a total annual Agency, Bank and Overtime spend of approx £3.3 million.

Table 1. Agency Nursing Staff shifts covered

The increase number of Registered Nurse Agency used in 2009 reflect year long vacancy factor in areas such as Theatres, Critical Care, Older People Mental Health and mirrors UK trends of market competition due to global shortages.

Increasing number of Specialist Registered Nurse Agency staff were also required to back fill to release HSSD staff to up skill to support clinical areas such as Paediatrics and Critical Care in relation to the contingency planning for Pandemic Flu.

Locum doctors

The information relating to locum doctors is not readily available in the format requested. It is currently being compiled and will follow once it is available.