Review of the Cosmetic Surgery Industry

A review of the cosmetic surgery industry by the Department of Health has been announced  in a bid to protect patients from botched procedures.

NHS Medical Director, Sir Bruce Keogh, is aiming to tighten the rules on advertising and strengthen regulations following the review commissioned in light of safety fears surrounding PIP breast implants.  He commented that although there are many very good clinics, there are also some “grubby areas” of the industry which don’t give patients enough protection.

In an interview with The Times, Sir Bruce, said he was likely to suggest tighter rules on various areas:

• Making it routine practice for all surgeons to register all devices
• Requiring clinics to join a scheme similar to that run by the travel industry (to protect patients if the company goes bust)
• Tightening rules on anti-ageing dermal fillers
• Introducing minimum training requirements for surgeons carrying out cosmetic procedures
• Carrying out psychological screening to ensure people are not seeking to solve mental health issues with surgery

The crackdown aims to drive out cowboy surgeons and make it more difficult for inexperienced beauty parlour workers to give Botox jabs, dermal fillers or conduct laser hair removal.  Botox can currently be injected by anyone who has done a half day course.

Sir Bruce went on to say: “I am concerned that too many people do not realise how serious cosmetic surgery is and do not consider the life-long implications – and possible complications – it can have”.

A poll conducted by the government found that many consider the cost of surgery more important than the qualifications of the people doing it.  Of those surveyed, 67 per cent consider cost as a factor when deciding whether or not to have cosmetic surgery.  Only 54 per cent take the qualification of their practitioner into consideration.

The industry is currently regulated by two organisations but, unbelievably, the doctors who carry out operations don’t have to be qualified surgeons.  The first regulator is The General Medical Council who can strike off dangerous surgeons.  The second is the Care Quality Commission who can carry out spot checks to inspect everything from the premises to the standard of treatment.  Businesses that are below standard can receive warnings, be fined, face prosecution or be shut down.

The review is welcomed by many in the industry as it will enhance the protection of patients, Professor Norman Williams of the Royal College of Surgeons, added: “ In an increasingly quick-fix and image-conscious society, it is easy to forget that cosmetic surgery has life-long implications.  Patients must be assured that the practitioners have the right qualification and experience”.

Spending Panel Analysis

From a recent Spending panel analysis, Andrew Lansley, Health Secretary, appears to be failing to deliver on his promise to devolve responsibility to doctors who were “best placed” to control local health spending, and cut back on high-salaried managers who were out of touch with the needs of patients.

According to a recent analysis, family doctors are being outnumbered by non-medical officials in the Government’s reorganisation of local health spending.  Original pledges put GP’s at the forefront of its NHS reforms.

The results show that GP’s make up less than half of the places on new clinical commissioning groups, in some areas accounting for less than 20 per cent of the groups.  The report by medical newspaper, Pulse, suggests that former executives of primary care trusts and strategic health authorities are taking control of the new commissioning bodies that will be responsible for spending £60billion a year on local health services.

Of the 1300 board positions analysed; GP’s held only 645 and nurses just 65 places.

Peter Carter, the chief executive the Royal College of Nursing, said: “Without the experience of senior, experienced nurses, clinical commissioning groups are missing out on a voice which will help them connect with patients and to represent their best interests.”

Clare Gerada, the chair of the Royal College of General Practitioners, said: “GP’s are much more interested in providing care to patients than in the commissioning process.”

When asked about the report, the Department for Health said: “Clinical commissioning groups are at the heart of plans to deliver more power to doctors and nurses and reduce costs of bureaucracy.”

Agency Nurses Pay and IR35 Rules in the Private Sector ( Large & Medium Sized Companies)

Agency Nurses Pay & IR35 in the Private Sector

Last week HMRC announced its plans to push ahead and roll out the IR35 off payroll rules into the private sector from April 2020. These rules came into the public sector in April 2017 and have had a huge impact on agency nurses pay and agency healthcare professionals pay.

IR35 Rules

Pre April 2017 contractors working through their personal service companies could decide if the IR35 rules applied to them and make their own IR35 status decision. Post April 2017 the new rules moved the IR35 decision away from the contractor to the PSB ( Public Sector Body). This for most agency nurses and healthcare workers means the NHS decides if a healthcare worker falls inside IR35 meaning tax and national insurance must be deducted at source when the agency worker is paid. This in turn has had a huge impact on agency nurses pay in the public sector.

To aid the IR35 decision making process HMRC released an online tool called CEST ( check employment status tool). There has been wide spread criticism of this tool as it does not take into account all relevant scenarios, is far to simplistic or align with current tax case law. The tool in many cases is unable to make an IR35 status decision.

As a result of CEST not being fit for purposes many agency workers have been forced onto payroll and deemed inside IR35 when in fact they could be genuinely be self employed and fall outside IR35.

So how do the proposed April 2020 rules effect agency nurses pay and healthcare workers pay in the private sector?

If the IR35 rules are rolled out as planned into the private sector any agency nurse or healthcare worker working for a private company ( medium or large in size ) through their PSC ( personal service company) will have their tax status decided by the end client. The contractor or agency nurse will no longer be able to make their own IR35 status decision. This will mirror what is now happening in the public sector since April 2017.

Will the agency worker working in the private sector be able to challenge the end clients decision?

This is currently one of the major issues with the public sector and with the proposed new rules. Under the proposed plan the contractor will have to receive an IR35 status decision and the reasoning behind the decision. The contractor may challenge the decision and the end client will have 45 days to reply. The issues is there is no appeal process if the contractor is still not satisfied with the end result or they feel the incorrect IR35 tax status has been determined. There is also a worry that end clients in order to avoid any potential tax risk or tax exposure they will blanket contractors inside IR35 forcing them into an employment status without any employment rights. Nursing Personnel has seen this happen in the public sector.

If you are working for a private medium or large company as an agency nurse or agency healthcare worker and being paid through your PSC this proposed new legislation could have a high impact on your business and earnings. You would be advised to take professional advice from your account or tax adviser. If the proposed legislation is passed the new rules will have a big impact on your earnings and the way you are currently being paid.

For more information on the new rules visit the government website by clicking here.

Interesting Facts about Registered Nurses in the UK

Registered nurses are an integral part of the UK healthcare system providing critical support to patients in times of need. They are highly skilled, compassionate, and dedicated professionals coming from diverse backgrounds.

The job of an agency nurse is highly rewarding with each working day bringing its own set of challenges. Overcoming these gives you a deep sense of purpose and fulfilment as you go about positively impacting human lives. Some interesting facts about nurses registered in the UK are listed here:

Demand More Than Supply

Out of the practising nurses registered, some work in the NHS while others work in the private sector. However, many nurses opt for flexible hours to work around personal commitments. The nursing workforce comprises of those from the European Union and other countries as well with the latter outnumbering the former.

With an increase in the number of vacancies for qualified nurses and fewer posts being filled, there exists a huge shortfall. To really address this large shortfall more nurses need to be trained in the UK, and more nurses need to be applying for nursing college places.

Inherent Soft Skills an Asset

In addition to having a caring nature and advanced communication skills, a UK agency nurse also has to be a good listener. They will realise that every interaction with the patient and their loved ones must be delicately handled. These soft skills will invariably leave a lasting impact and are the differentiating factor between recovery and further deterioration in the patient’s health.

Revalidation is Mandatory

Every three years nursing registration comes up for revalidation. To retain it, nurses must have at least 450 practice hours to their credit within a three-year period. It includes practical nursing experience and active learning hours spent in improving one’s skills. In addition, feedback from practice, patients and colleagues is considered.

A nurse must give a personal synopsis of how certain situations they have encountered in their professional journey, and this has to be discussed with their accessor. A declaration stating your fitness to practice and acknowledging of your indemnity insurance cover must be signed off by a senior colleague. Once your dossier is submitted for revalidation, it may subsequently be audited.

Job Opportunities are Plenty

The traditional concept of registered nurses only working for the NHS no longer exists. With additional training there are many other avenues open to nurses. Nurses can explore careers in the military, the prison service, private practice, cosmetic clinics, private healthcare organisations and even working in an office environment as a nurse assessor or even with a drug company. Your nursing skills can be utilised in many sectors.

With the development of technology and globalisation the opportunities for qualified nurses are endless. However keeping your skills constantly updated and keeping in touch with technologies will always improve your chances for advancement.

MPP APP: Download our FREE APP available on Android and iOS

Nursing Personnel have developed an amazing app, it’s FREE to DOWNLOAD and available on both Android and iOS. MPP App allows staff registered with Nursing Personnel to manage both their working diary and track any compliance issues in one easy and convenient place.

New users can effortlessly register and book an interview with Nursing Personnel. Once they have become compliant, they will have full access to all benefits of MPP App.

Full App Benefits:

• Seamlessly book shifts and update your availability directly on the app
• View all live shifts and check shift availability in advance. Become your own boss and book shifts when it suits you
• Keep track of your compliance and renewal dates
• Receive push notifications on available shifts
• Check the status of your Timesheets
• Keep up to date with Nursing Personnel News

Take control and be the master of your own work with the ease of MPP App

Note: MPP APP has been developed for healthcare professionals that are registered with Nursing Personnel. If you would like to register, please visit the following website: https://www.nursing-personnel.com/