Mr Sam Church – Consultant Knee Surgeon BSc MB BS FRCS (Tr & Orth)

Sam Church is a consultant orthopaedic and trauma surgeon at the Chelsea and Westminster Hospital specialising in all aspects of knee surgery.

Sam Church is a consultant orthopaedic and trauma surgeon at the Chelsea and Westminster Hospital specialising in all aspects of knee surgery. He has a private practice at the Fortius Clinic and his surgical interests include meniscal injuries, complex ligament reconstruction and joint replacement. He also has a specialist interest in anterior knee pain in athletes.

Although the negotiations for the consultant contract continue to drag on, I try not to get bogged down by thoughts of the inevitable changes a revised contract might bring.

I try to accept that the constant tinkering within the NHS, although frustrating, is the price I pay for having such an interesting and varied workload. I’m part of an excellent team and enjoy working with junior doctors in the NHS who keep me up-to-date. As Chelsea & Westminster is a specialist centre, I often work on cases I might not see in private practice.

Many orthopaedic surgeons enjoy NHS work for this very reason but rely on their private practice to provide the majority of their income, particularly here in London.
We noticed a tailing off of private patients during the economic crisis, particularly in those patients who funded their own treatment (self-pay) but experienced a resurgence during the recovery period. From a business point of view, I was concerned that a political change after the Election in May could have an impact on the recovery and negatively affect the amount of work that we receive. From a personal point of view, the proposed tax increase for higher earners and the cap on higher rate tax relief on pension contributions would not have been welcomed.

While the cut to the lifetime allowance rate is an issue for most senior doctors, I think we all understand that this is an age of austerity and at 44 I hope to have plenty of time ahead of me when the LTA may change back again.
I feel very strongly about the NHS pension. For colleagues who have an NHS-biased workload, the pension scheme is their total retirement plan. Doctors who have been making contributions based on an agreed outcome only for that plan to be changed are understandably concerned.

For many, the NHS pension was seen as a nest egg that would not only be protected, but was a just reward for the many sacrifices made in a long and highly-pressured career. It has already been amended two or three times since I have been practising.

Unless you continue to work right up until retirement age, the new 2015 pension is a reduced offer; the older pension contracts are much better.

We have to consider whether surgeons should be working into their 70s. There is no facility within the NHS pension to differentiate between types of jobs and the ability for older members of staff to undertake them, unlike with the army, police and fire service. It is well known that the life expectancy of a surgeon working beyond 65 years of age is significantly less than one who retires at or before the age of 60.

Often the generic information we receive about the NHS pension scheme, which many consultants won’t have time to go through in detail, seems to suggest that we should go on working well into our 60s, making more contributions and retire much later. In fact, in many cases it is better to retire earlier, reap the benefits while you have time to enjoy them and save on contributions. Luckily, I had a financial planner at Cavendish who carried out detailed calculations and set out the various retirement options for me so that I was able to make a fully informed decision.