Medical Family Finance Spring 2022 Newsletter

news Spring 2022

+ Training ‘War Doctors’ The David Nott Foundation delivers specialist training to surgeons in countries affected by conflict and catastrophe.

In response to the Ukrainian crisis, the Foundation has been adapting its resources.

Following this, the Foundation produced a condensed 6-hour recording which is being translated into Ukrainian. The course draws on David’s own experiences of surgery on the frontline as well as that of his colleagues.

Co-Founder David Nott and former consultant surgeon at St George’s Hospital Henry Marsh delivered a 12-hour online war surgery course to hundreds of doctors in Ukraine on Saturday 5th March.

David said: “The emotions that healthcare professionals in Ukraine are feeling and the circumstances within which they are working – I’ve been there. I’ve worked in hospitals that have been hit by bombs. I’ve performed surgeries in the dark. I’ve been terrified for the lives of my patients. I can’t stop this war, but I can arm them with knowledge.

After the Russian invasion of Ukraine, David developed a surgical training course for doctors who are working to save lives as the devastation continues to unfold.

David condensed his five-day surgical training course into a comprehensive online version to ensure Ukraine teams are best prepared for complex war injuries. The course attendees learned a range of skills that can be used when faced with limited resources, from learning how to create make-shift pelvic binders to knowing when to operate without a CT scanner.

Medical Family Finance News Spring 2022

“Condensing my war surgery experience into a recording that can be streamed from any device means any doctor within Ukraine can gain life-saving skills. All of us at the Foundation will continue to do all we can to help.”

The team at Medical Family Finance has made a donation to the David Nott Foundation of £1000. If you would like to find out more about its work or donate to the charity, please visit www.davidnottfoundation.com

+ Spring Statement 2022: Another McCloud legislation consultation Following the chancellor’s Spring Statement in March, the Office for Budget Responsibility (OBR) reported an update to the costs involved in implementing the McCloud remedy.

However, in choosing the larger of the two, they may receive additional benefits which might cause them to breach their annual or lifetime allowance.

This April, all NHS pension members will move to the 2015 scheme. The McCloud remedy sets out how the government will make up for the deemed ‘age discrimination’ caused by moving some legacy scheme members to the 2015 scheme but not those who were within ten years of retiring at the time.

The OBR reiterated that the government has committed ‘to provide tax-free compensation and that members will not bear the cost of additional annual allowance charges’ in the year of retirement – if they choose the benefits of their reformed scheme rather than those of their legacy scheme. This last line is the crucial point. What we need urgent clarification on is whether the annual allowance charges will be scrapped whichever remedy a scheme member takes at retirement.

The NHS, along with most public sector schemes, opted for a ‘deferred choice underpin’ following the McCloud remedy consultation. This means members can choose which benefits they would like to claim for the ‘remedy period’ from 2015 to 2022 – those from their legacy scheme or those from their current scheme but crucially, will not have to make the choice until they draw their benefits.

Comment: Paul Hart, Director

The government has confirmed that a further consultation will be launched in summer to finalise the McCloud legislation which is then due to go before parliament later in the year. pension contribution rates will be going ahead but the new levels will not apply until October this year.

We were extremely surprised that the new rates were due to apply from April given the lack of information issued around the changes and the significant step of introducing enforced 2015 membership.

Now the government has confirmed that the new contribution rates have been put back six months which will give everyone more time to check their new position.

Yet again, it appears that doctors are having to jump through hoops in order to navigate the latest changes to their pension. Not only are we waiting for much-needed clarification on how the McCloud remedy will work in practice, but also, the impact of moving every NHS scheme member to the 2015 policy this month.

For many, this will mean understanding two different sets of scheme rules and contribution rates. In addition, following the government consultation which ended in January, changes to

+ Client loyalty programme Congratulations to Dr Amira Girgis and Professor Paul Gringas who win our latest loyalty programme prize. Amira and Paul have won their own professionally written and published biography.

All clients recommending four colleagues or peers who go on to contact one of our advisers will receive a biography package from Dragons’ Den entrepreneurs Story Terrace. Many thanks to all our clients who introduce us to more doctors needing our help.

Medical Family Finance News Spring 2022

One of the main updates is that contribution rates will be based on pensionable pay rather than notional whole-time equivalent pay. Part-time members will therefore pay reduced pension contribution sums in the future.

The number of contribution tiers will also be decreased from seven to six and be phased in over two years. As a general rule, higher earners will be contributing less into their pension. For example, the highest contribution tier will be lowered to 12.5 per cent from the current 13.5 and 14.5 per cent levels.

We are in no doubt that further pension changes will be raised over the next year and will always keep you updated of the latest position.

+ Interview with Professor Mandeep Sagoo the prosthesis to be hand made by an artisan process, including hand painting of the iris and the veins are made from individual silk threads. The whole process has now been digitised – we take a scan of the normal eye and then the same machine scans the socket after the eye has been removed. Then bespoke software 3D-prints the prosthetic, layer by layer.

The project is a result of a collaboration between several different parties: UCL, Moorfields, a small UK medical technology company called Ocupeye Ltd and our German partners Fraunhofer. The ophthalmic scanner comes from the Japanese company, Tomey.

Professor Mandeep Sagoo (l) with product engineer Steve Bell

Professor Mandeep Sagoo is a consultant ophthalmologist with a clinical practice in the management of adult and paediatric eye tumours at Moorfields Eye Hospital, St. Bartholomew’s Hospital and the Royal London Hospital, and in Harley Street. He also holds an academic appointment at UCL Institute of Ophthalmology.

What made you decide to specialise in ophthalmology?

Even at school I was interested in the eye and remember being intrigued when we dissected an animal eye. I was already interested in biology but that sparked my interest further. At medical school, I did the MB/PhD programme where you do combined medicine and a research project for my PhD. This was on retinal electrophysiology and how light converts into an electrical signal in the eye that goes to the brain. I was doing a basic science project on how that works and how we adapt to different lighting conditions. That was the key thing that got me interested in the academic side of things and how vision works.

You enjoy a very varied workload…

Within ophthalmology, I deal with eye tumours which is a rare subspeciality of the profession and I also look after both adults and children which is quite unique in this country. We treat children at the Royal London with retinoblastoma and at Moorfields, we treat adults with mainly melanomas or other tumours.

Our group has a research programme which includes some of the molecular studies and clinical outcomes in eye tumours. And we do technology projects including artificial intelligence. One of those projects is being able to identify from opticians’ photographs or scans whether a presentation is a simple mole compared to a melanoma in the eye.

Finally on the technology side, we have created a process for 3D printed prosthetic eyes. We produced the first fully digital 3D printed prosthetic eye last year and now we have started clinical trials at Moorfields. A prosthetic eye is needed when the eye is removed due to a tumour or other severe eye disease, trauma or if there is congenital malformation. The current way of making a prosthetic eye is to take an impression mould of the socket and for Medical Family Finance News Spring 2022

How did the project arise?

There has been an unmet need in prosthetics, particularly highlighted by the pandemic with long waits to obtain a prosthesis. Rehabilitation for the patient has been central to this project – to try to improve things. Together with Ocupeye Ltd, we have worked on this project for about five years.

Over 70,000 people wear a prosthetic eye in the UK. The current way of creating prosthetics has remained largely unchanged in 70 years, so the 3D printed technique is allowing us to develop a new tool for supplying prosthetics in a timely manner. The skill of the artisan ocularists is still required in the final fitting of the prosthetic and any adjustments. We can 3D print an eye prosthetic in a fraction of the time. It's quicker, less painful and you get a better match as you can mimic the anatomy of the actual eye.

How are the first patients coping?

Steve Verze was our first patient and he’s enjoying wearing it.

We’ve had permission to treat a few more patients outside of the trial so about five patients are now wearing one.

We have also started a clinical trial so we can prove the technology works under a proper scientific study. We have 40 patients who will wear one prosthetic for four months and then switch to the other prosthetic. Tests of fit, function and cosmesis will be done with each type to see if the new technology is not inferior to the old technology.

If the trial is a success we can develop the prosthesis technology further but the main thing will be easing the backlog caused by the Covid pandemic. We estimate that around 80-85 per cent of patients with a prosthetic eye will be able to have a 3D version.

This will then free up the ocularists to concentrate on the 15 per cent who can’t have it.

How important was the support of charity funding?

It has been amazing to have the support of the Moorfields Eye Charity. Without this, we wouldn’t have managed to get the project off the ground. Our previous funding was through NIHR (National Institute of Health Research) for our preliminary work but with this study, we reached the point where we almost

+ Interview with Professor Mandeep Sagoo continued needed to stop. It was a significant philanthropic donation from the Drayson Foundation which allowed us to continue.

How has the pandemic changed your work?

It changed the way we delivered care to eye cancer patients. It was harder to do the surgeries but, in my department, we treated any child or adult who needed treatment in a timely way. None of our cancer targets were delayed. We were one of the few departments who could carry on operating as many of my colleagues were redeployed out of Moorfields to help in other hospitals.

We developed more innovation in terms of the way we work on the adults’ side. For example, when a patient has a growth or tumour on the surface of the eye, we have developed a one-stop service which involves a video call to look at the eye or they can send us a photo from their phone. We decide whether it’s the type

of growth to be operated on. If it is, the actual operation will be the only time they come physically to Moorfields for day case surgery. All the follow up is done virtually.

We can also conduct a lot of our reviews virtually by phone or video call – even if they visit their local hospital to get photos taken which can be sent to us for examination. In a way, it’s enhanced triage and working out who really needs to come to hospital.

How do you manage your time across many work interests?

I’m not quite sure! I’m also director of the MSc programme in Ophthalmology for UCL. It’s busy, but worthwhile training the next generation. I travel a bit with work too – for conferences and lectures. In my spare time I enjoy leisure travel as well as literature and theatre. And I get to as many Arsenal games as I can!

+ Spring Statement 2022: Summary • • •

Income tax is to be cut for the first time in 16 years – from 20% to 19% – by the end of Parliament in 2024.

Fuel duty has now been cut by 5p a litre until March 2023.

Class 1 employees NI – the Primary Threshold will rise from July 2022 to equal the income tax personal

• •

allowance (currently £12,570 per annum).

Class 2 self-employed NI – from April 2022, the starting threshold will increase to £11,908.

Employers NI - the Employment Allowance (for smaller employers) increases to £5,000 for 2022/23.

+ In brief Staff news We are always very proud of our team at MFF, particularly as we have been able to continue growing over the last two years when many companies have sadly had to scale back. We are delighted to

Medical Family Finance 020 7252 5765 Medical Family Finance News Spring 2022

welcome six more members of the team. Roxana Hatch joins as an operations assistant together with administrators Ricardo Fernandes, Emma Ineo, Tom Sexton, James Crawley and Susana Marques. (l to r)

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