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Royal colleges produce evidence of reduced activity

BMJ 1994; 308 doi: (Published 05 March 1994) Cite this as: BMJ 1994;308:661
  1. L Beecham

    Medical royal colleges have reported to the secretary of state for health and the chief medical officer examples of pressure to reduce activities. Last year Mrs Bottomley asked for hard data rather than anecdotal evidence on the effects of the NHS contractual arrangements on clinical activity. Several colleges have conducted surveys of the work patterns of their consultants during the past year and the results were presented to the Joint Consultants Committee last week.

    The Royal College of Surgeons had a 75% response from a survey of over 230 surgical tutors. In the eight months from April to November 1993, 44% of surgical divisions were told to reduce or stop some activity. This compares with a reduction to 62% that emerged from the previous year's survey after 10 months. Most of the reduction in activity was related to cold admissions and cold surgery but some units had been told to reduce the number of outpatients and investigations. Fifty seven general surgical units and 45 orthopaedic and trauma units had been told to deal only or selectively with general practice fundholders. Twenty seven general surgical units had been told to deal with non-urgent waiting list cases regardless of clinical priorities. The college found that waiting lists had increased in 98 general surgical and in 68 orthopaedic and trauma units.

    The Royal College of Obstetricians and Gynaecologists had a 79% response rate from questionnaires sent to over 260 district tutors. Seventy five hospitals reported that waiting lists for gynaecological admissions had increased, 68 that the number of beds had been reduced or wards closed, and 50 that the patients of fundholders were given priority.

    The Royal College of Ophthalmologists surveyed 160 units and there was a 71% response. More units reported a reduction in clinical activity in the six months from April …

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