Consultant rheumatology workforce in the UK: changing patterns of provision 1997–2001

Turner, George F.; Symmons, Deborah; Bamji, Andrew; Palferman, T G

doi:10.1093/rheumatology/41.6.680

Cited by 18 publications

(8 citation statements)

References 6 publications

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“…Concerns regarding the future supply of rheumatologists in Canada 27 , the United States 37 and the UK 43 have been documented. The increasing mean number of years in practice for rheumatologists in Ontario in 2007 implies an aging of this physician population; the mean age was 43 years, with several respondents over age 65 years.…”

Section: Discussionmentioning

confidence: 99%

“…The clinical practice time of rheumatologists in teaching LHINs was 60% (compared with 90% in LHINs without teaching hospitals), a slightly higher proportion than in Hanly's study of academic rheumatologists, which reported that 54% of the physician's time was devoted to clinical care 44 . Other research has documented rheumatologists' participation in various non-clinical activities such as teaching and research 43,44,54 . In the UK, rheumatology consultants divide their time amongst activities related to direct clinical care (i.e., clinics, ward rounds and associated paperwork) and supporting professional activities at a rate of approximately 3:1 for a typical 40-hour work week 24 .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

System Integration and Clinical Utilization of the Advanced Clinician Practitioner in Arthritis Care (ACPAC) Program–Trained Extended Role Practitioners in Ontario: A Two-Year, System-Level Evaluation

Passalent

Kennedy²,

Warmington³

et al. 2013

hcpol

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

System Integration and Clinical Utilization of the Advanced Clinician Practitioner in Arthritis Care (ACPAC) Program–Trained Extended Role Practitioners in Ontario: A Two-Year, System-Level Evaluation

Passalent

Kennedy²,

Warmington³

et al. 2013

hcpol

View full text Add to dashboard Cite

“…A UK national workforce register has been tracking the impact of policies to improve provision of and access to care, and highlighting persisting inequalities in delivery of rheumatology services since the 1970s [36]. In the early 2000s, provision of rheumatology services changed dramatically.…”

Section: Reporting Variation In Levels Of Service Provisionmentioning

confidence: 99%

“…Levels of provision, set against benchmark targets of 1 whole-time equivalent per 85,000 population (1 per 90,000 population since 2003), improved from 53 % (1 per 164,000) in 2001 [36] to 75 % (1 per 115,000) by 2009 [35]. Pattern of inequalities of provision within the UK also changed over time [33][34][35][36]. In 1997, provision in England (47 %) was 13 to 15 percentage points higher than in the other countries of the UK (Wales, Scotland, Northern Ireland) [36].…”

Section: Reporting Variation In Levels Of Service Provisionmentioning

confidence: 99%

Incentives in Rheumatology: the Potential Contribution of Physician Responses to Financial Incentives, Public Reporting, and Treatment Guidelines to Health Care Sustainability

Harrison

Milbers²,

Mihic

et al. 2016

Curr Rheumatol Rep

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Concerns about the sustainability of current health care expenditure are focusing attention on the cost, quality and value of health care provision. Financial incentives, for example pay-for-performance (P4P), seek to reward quality and value in health care provision. There has long been an expectation that P4P schemes are coming to rheumatology. We review the available evidence about the use of incentives in this setting and provide two emerging examples of P4P schemes which may shape the future of service provision in rheumatology. Currently, there is limited and equivocal evidence in rheumatology about the impact of incentive schemes. However, reporting variation in the quality and provision of rheumatology services has highlighted examples of inefficiencies in the delivery of care. If financial incentives can improve the delivery of timely and appropriate care for rheumatology patients, then they may have an important role to play in the sustainability of health care provision.

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“…A series of publications [1][2][3][4] have summarised changes in provision using data from the register, most recently from the 2007 update, 5 and a consistent finding has been inequalities in wholetime equivalent (WTE) consultant rheumatologist provision between regions and countries of the UK. Provision is assessed against benchmark levels set by the Royal College of Physicians (RCP); in 2007 recommended levels of provision were one WTE per 90,000 population.…”

Section: Introductionmentioning

confidence: 99%

UK rheumatology consultant workforce provision 2007–9: results from the BSR/Arthritis Research UK Consultant Workforce Register

et al. 2011

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The continuing objective of the register has been to monitor and report changes in the provision of rheumatology services. A series of publications 1-4 have summarised changes in provision using data from the register, most recently from the 2007 update, 5 and a consistent finding has been inequalities in wholetime equivalent (WTE) consultant rheumatologist provision between regions and countries of the UK. Provision is assessed against benchmark levels set by the Royal College of Physicians (RCP); in 2007 recommended levels of provision were one WTE per 90,000 population. 6 Provision in England and, more recently, Wales, has been higher than in Scotland and Northern Ireland. For example, in 2007 the population per WTE rheumatologist in England and Wales was less than 130,000 (70% of recommended provision) but exceeded 155,000 and 170,000 (57% and 53% of recommended) in Northern Ireland and Scotland respectively. 5,7 The data and publications provided by the BSR/Arthritis Research UK Rheumatology Workforce Register are unique; a review of the literature did not identify comparable estimates of levels of recommended provision for other specialties. Using raw consultant numbers suggests that this inequality in provision has not been evident in a range of other specialties (Table 1), where Scotland has generally had the lowest population to consultant ratio, although these figures are based on numbers of consultants and not WTE. Within England, inequalities in provision have been consistently reported with provision in London and the South East, the West Midlands and North West having the highest levels and the Eastern and South West regions having lowest provision. 5,7 The most recent RCP needs-based estimate recommends an optimal provision of one WTE consultant rheumatologist per 86,000 population. 8 The key assumptions underpinning this estimate are that rheumatologists provide a service for both inflammatory and non-inflammatory musculoskeletal conditions; and that consultant rheumatologists are supported by specialist rheumatology nurses.Over the past decade, a number of changes in policy have shaped the provision of rheumatology services, primarily the new consultant contract which was introduced in 2004 9,10 and, more recently, the Musculoskeletal Services Framework (MSF), which affects England and Wales. The MSF introduced targets for provision of services by December 2008. The data collected in January 2009 provide a timely opportunity to review the impact of this policy on rheumatology workforce provision.The MSF aimed to improve access to services by moving themcloser to the patient, and reducing the time from presentation to the GP to receiving hospital treatment. 11 Innovations in service provision were introduced to provide more efficient patient pathways appropriate for patient needs. By 2007, up to one fifth of consultants reported running musculoskeletal services in conjunction with Clinical Assessment and Treatment Services (CATS) and GPs The aim of this paper is to describe changes in the provisi...

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Consultant rheumatology workforce in the UK: changing patterns of provision 1997–2001

Abstract: There are ongoing inequalities in the provision of rheumatology, especially between London and Scotland, Wales and Northern Ireland.

Cited by 18 publications

References 6 publications

System Integration and Clinical Utilization of the Advanced Clinician Practitioner in Arthritis Care (ACPAC) Program–Trained Extended Role Practitioners in Ontario: A Two-Year, System-Level Evaluation

System Integration and Clinical Utilization of the Advanced Clinician Practitioner in Arthritis Care (ACPAC) Program–Trained Extended Role Practitioners in Ontario: A Two-Year, System-Level Evaluation

Incentives in Rheumatology: the Potential Contribution of Physician Responses to Financial Incentives, Public Reporting, and Treatment Guidelines to Health Care Sustainability

UK rheumatology consultant workforce provision 2007–9: results from the BSR/Arthritis Research UK Consultant Workforce Register

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