President’s perceptions: setting priorities for the next four years

14 Nov 2018

14 Nov 2018

This is my first piece of writing for Commentary, but not my first bit of writing for the RCP. In my previous job I wrote a bimonthly blog for fellows called Registrar’s Reflections, the style of which seemed to go down well with many (although I accept not all).  I therefore plan to follow a similar tone in the Commentary opener – I usually follow a theme for the eagleeyed.

Although I have only moved two offices down the corridor in the RCP’s London building, I am conscious that I am very much a newbie in my role. I am also stepping into some pretty big shoes, and I must start by saying a big thank you to Dame Jane. During her tenure the RCP has grown in stature and modernity and she has a created a culture of positivity and openness. If I can achieve half of what she has, then I will be happy.

Later in Commentary there is an interview with me by the magazine’s editor. In the interview, I talk about the three Ws: workforce, wellbeing and worldwide, that I want to focus on in the next four years. I have already been hard at work in these areas.

The last resort

Regarding workforce, I recently had a meeting with the National Audit Office to help them in their review of future funding of the NHS.  I explained the data and rationale behind our call for a doubling of medical student numbers, and this seemed to hit home. I also talked through the importance of retaining staff, especially in the years just before retirement. I’ve watched lots of GP colleagues retire early due to the pressures in their jobs and we must ensure that the same fate doesn’t follow for hospital consultants. We have already done some work to try and make continuing to work in the NHS more attractive than a blanket and slippers, but we need to develop this. Any examples of what has worked in your hospital or career will be gratefully received.

Life in the fast lane

One of the reasons for early retirement is ‘burnout’, defined as ‘an enduring, chronic state of emotional exhaustion, depersonalisation and reduced sense of personal accomplishment’. The causes are well-recognised: the burden of administration, increased patient expectations and increased demand for services.

Addressing this is part of my wellbeing theme. I have been corresponding with colleagues in the American College of Physicians about this, and the US has (again) come up trumps. The Mayo Clinic has an Office of Staff Services or OSS which is specifically geared up to help physicians in their work and home lives. It has been going well for 15 years and is highly regarded by staff. Now, I accept that most UK hospitals are different from the Mayo, but there is some interest in trying to set up some pilots of ‘consultant support units’ in the NHS. Hopefully, the RCP will be part of this.

Wasted time

The final ‘W’ is worldwide, and includes matters related to the EU, and most readers will have noticed that Brexit is hotting up a little. I’ve been plugging away at the politicians, both in blogs and in person at the party political conferences to ensure that a post-Brexit world has been prepared for.  An effective immigration policy is crucial and the costs to the NHS if we get this wrong are frightening. Some simple maths allows us to estimate that if new EU staff pay the same immigration related costs as non-EU doctors currently do, it will cost the NHS almost £0.5 billion over three years. Much of the debate at the moment is about a deal or a no-deal. What is important is what is in the box when it gets opened. Time is short to get this right.

It’s not all doom and gloom

I had the honour of helping host the memorial for Sir Roger Bannister at the RCP in September. This was a celebration of a life well run and although he retired from athletics at the age of 25 his contribution to neurology and medicine thereafter was equally record breaking. Steve Cram was one of the speakers, and he made the observation that we don’t celebrate the heroes of our fields like we used to.

Talking of heroes, I’ve also been trying to find ways to acknowledge the hard work people do for the RCP. College tutors and regional advisors are two groups of unsung heroes and, after catching the treasurer in a weak moment, I have got him to agree to cheaper rates to stay at William Harvey House for those who are actively working in their roles.

I’m always happy to receive feedback:

I saw an Aristotle quote in a slide at a recent RCP finance meeting (oh, the joys of the job). To paraphrase: the only way to avoid criticism is to do and say nothing. I do not intend to do either, so am happy to take some stick.