UKSSB Quarterly eBulletin
September 2015





Professional Practice Issues

  • UKSSB Private Practice Advisory Group (PPAG) - Harshad Dabke (Chair)

Established in June 2015 with representatives from BASS, SBNS and BSS.

























UKSSB Chair & BOA Liaison


·       The PPAG supports good medical practice by implementation of robust clinical governance measures and aims to review all current PMI schemes using following criteria:

­       Adherence to Good Medical Practice and Good Surgical practice
­       Adherence to whole practice appraisal and revalidation
­       Engagement with national and local audit (but not exclusively BSR)
­       Compliance with CMA recommendations regarding fess and commercial interests
­       Compliance with best practice relating to the management of, in particular, complex spinal surgery

­       Declaration of commercial and professional interests


·       The first meeting - 7th August 2015
Current situation with regards different initiatives put forth by PMI’s was discussed and it was agreed that a unified response via UKSSB is required.


­       Regulations
Work done by FIPO, PHIN and CMA (including the latter’s 11 hospital and consultant specific performance indicators) was discussed.


­       BSR
Agreed BSR to be used as the default option by all spine surgeons in the UK, to record outcomes and performance. It was recognised that some centres which had used non-UK based registries for a long time would be unlikely to suddenly change to BSR. It was also felt that hospitals should register patients on BSR and ensure that the questionnaires were completed. Consultants would be responsible for clinical data describing treatment.


­       Data Collection
The responsibility for collection and collation of data would require defining in conjunction with the provider hospitals and ensuring that appropriate mechanisms are in place for this.


­       MDT
Should be used for both NHS and private patients to drive quality and implementation of evidence based, peer reviewed treatments. MDT, constitution could be decided by individual surgeons/groups, depending on factors like case-mix, skill, etc. It was felt that Medical Directors of PMIs and private hospital groups should be approached to facilitate this process.


­       Surgeon networks in private practice
Some PMIs have suggested this option and it was felt that while there were some advantages to it, the group would not support formation of “cartels” or commercial groups.


­       Fees

­       SBNS expressed opposition to any negotiation about on fees but others felt that fees should be discussed. It was agreed that fees should be discussed but the main focus should be on quality, however advice would be taken from the CMA on this matter.


­       Commercial interests

It was agreed that surgeons should declare commercial and professional interests in NHS and private sectors, which would help in improving quality of clinical care.


­       Recognition of surgeons
It was agreed that PMIs should not be allowed to “recognise” or “derecognise” spinal surgeons. It was felt that PMI’s should grant approval on the basis of quality and not fees and that patient choice should be maintained.


·       Advice has been obtained from FIPO, BOA, PHIN and CMA.

·       The Chair of PPAG (currently Harshad Dabke) has been co-opted to UKSSB to provide a summary to the Board on a regular basis and to BritSpine.

·       Members of PPAG will be meeting a representative from CMA on 25th September and details of future strategy will be decided.

·       A letter addressed to Medical Directors of Private Hospital Groups and PMIs has already been drafted, inviting them to send their response to this initiative. This letter will be sent in early October, after a final strategy has been decided.

·       After analysing responses from Private Hospital Groups and PMIs, a face-to-face meeting with them will be arranged early next year to establish a common platform to drive this initiative forward.



Training and Education

  • Spinal Surgery Training Interface Group (SSTIG)

The JCST has been reconfiguring the framework for official peri-CCT Fellowships and this will be completed later this autumn. Further discussions have occurred with Lisa Hadfield-Law to act as an educational adviser. Representatives have been nominated by all societies and a Doodle poll for dates for a first meeting of SSTIG is being circulated.


  • BASS/BSS Presidents’ Travelling Fellowship

The British Association of Spinal Surgeons (BASS) and the British Scoliosis Society (BSS) offer senior residents, spinal fellows and junior consultants a chance to have extensive exposure to complex spinal procedures at established spinal units over 2 weeks.

The Fellowship programme includes mandatory attendance at the following BASS/BSS meetings.

The programme rotates between established orthopaedic and neurosurgical spinal centres allowing significant contact between fellows and leaders in the field.

The Fellowship will take place in late February/early March 2016 around spinal centres in the north of the United Kingdom between Glasgow, Edinburgh and Newcastle, culminating at the President’s institute in Norwich.

The Fellowship is funded by the United Kingdom Spine Societies Board (UKSSB) which represents BASS, BSS and the Society of Back Pain Research (SBPR).

Further details can be obtained from Mr Iqroop Singh Chopra, BASS Education and Training Chair at: ichopra@doctors.org.uk.


Application Process:

1.    To apply, please submit your CV, along with a personal statement describing your career pathway, interests and future plans.

2.    Please submit a letter of recommendation from your supervising consultant/clinical lead.

3.    Your application should be sent to Julia Bloomfield at j.bloomfield@boa.ac.uk by 15th October 2015. Selected candidates will be informed in early December 2015.


Eligibility Criteria:

1.    Applicants should be members of BASS or BSS or BOA or SBNS or local spine society.

2.    Applicants should be post-FRCS exam senior residents, clinical spinal fellows or junior consultants in the first 2 years of their appointment.

3.    Previously unsuccessful applicants can re-apply.

4.    Fellowships cannot be awarded retrospectively.


The Fellowship:

1.    BASS/BSS will reimburse travelling expenses up to £1,000. Claims must be submitted within 6 months of the Fellowship. Detailed financial arrangements will be provided to successful candidates.

2.    International fellows will be required to pay for their flights to the UK.

3.    By accepting the Fellowship, all awardees agree not to partake in any activities that will bring BASS/BSS and/or sponsors into disrepute. BASS/BSS accept no liability for the actions of the candidates whilst on the Fellowship or for activities related to it.

4.    Each Fellow is required to submit a report of approximately 500 words within 6 weeks of completion of the Fellowship. This may be published on the BASS and/or BSS websites.


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