Circle fully commits to collaborating with NHS on service transformationBMJ 2015; 351 doi: https://doi.org/10.1136/bmj.h3636 (Published 07 July 2015) Cite this as: BMJ 2015;351:h3636
- Paul Manning, consultant orthopaedic surgeon and clinical chairman1
Iacobucci’s article noted that Circle has provided a good dermatology service in Nottingham, but it missed three crucial facts.1
Firstly, dermatologists employed by Nottingham University Hospitals (NUH) have been working for Circle since 2008 and were required to transfer employment to us only in 2013, thanks to a change in national law.
Secondly, the independent review noted that dermatology staff who transferred thought that Circle is a good, empowering employer and would encourage colleagues to think again about Circle.
Finally, for context, four dermatologists chose not to transfer to us. One subsequently came to work for us anyway. Across the entire hospital, 119 NUH staff chose to transfer.
These facts all point to the same conclusion: this is not simply about working for private partnerships like Circle.
The independent review makes it clear that the solution is for all the main parties to work closely together, and Circle fully commits to collaboration with NUH and commissioners on securing services.
The issue at stake, though, is one being faced across the NHS and across different specialties. Demand is going up, the workforce is not always expanding at the same pace, and funding is tight. Alongside increasing the number of training places, part of the answer has to be service transformation, involving better use of technology, self care, using trained nurse and GP specialists, and better diagnosis. Circle’s approach has been to try to lead that transformation, and our firm belief is that only strong clinical input can create sufficiently imaginative solutions.
The example of Nottingham shows that leadership is needed for the NHS to navigate a challenging time, and that will be most powerful when it is driven by clinicians.
Cite this as: BMJ 2015;351:h3636
Competing interests: PM is clinical chairman, Circle Nottingham.
Full response at: www.bmj.com/content/350/bmj.h3161/rr-0.
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