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President writes - December 2016

Mr Michael Lavelle-Jones provides his final update of 2016

"It is your continued membership and support of the College that puts us in the privileged position of leading and representing the surgical and dental professions"

Over the next few months, I will be leading a series of regional events around the UK that will enable representatives of the College to meet with our Fellows, Members and affiliates, as well as all those engaged in healthcare delivery, to discuss the issues affecting our professions. The opportunity to meet with our Members face to face and listen to their views on the challenges and opportunities across surgery is one of the highlights of being President of the College.

Our first event, held in Newcastle on 2 November, focused on the future of the NHS. Many of the discussion topics were reflective of current pressures and constraints on the NHS, with all voicing concerns on issues such as the junior doctors’ contract, bullying and undermining in the workplace, and patient safety. I look forward to our next event in Belfast in the new year.

The Newcastle forum took place just a few weeks after the GMC published its annual report, which warned that poor morale among doctors could put patients at risk. None of the issues cited in the report will be a surprise to those who work in the NHS: the loss of the traditional ‘surgical firm’, shrinking numbers of specialty trainees, rota gaps and burnout are all familiar to surgical departments across the UK. As such, they are issues that concern us as a surgical college and I am asked frequently what the College can do to support Members faced with these challenges.

One solution is to provide a platform for clinicians to share their experiences and concerns. In October, the College hosted a panel discussion on the issue of burnout, led by Council Member, Chair of our Younger Fellows Network (and our new editor of Surgeons’ News), Clare McNaught. The session brought together surgeons of different career stages, specialties and grades for an open and frank discussion about work-related fatigue and stress. Undoubtedly, this will be the first of many similar discussions.

Another example of our support for Members is our campaign over the course of this year to address the challenges faced by surgeons and trainees in rural and remote communities. This began in March with the publication of our report, Standards Informing Delivery of Care in Rural Surgery, which included recommendations to tackle problems surrounding recruitment and retention. The release of the report, and the coverage it received, provided the foundation for a programme of lobbying and political engagement. So far, we have focused our efforts on the governments of Scotland and Wales, where rural surgical services have been in steady decline over many years. In recent weeks, we brought the issue to the top of the agenda with a cross-party meeting held at the Scottish Parliament engaging NHS managers and parliamentarians in Scotland, as well as a very successful event in Aberystwyth, Wales, held in conjunction with the English College.

It is clear that issues affecting remote and rural practice do not have national boundaries and we have much to learn from each other. No doubt there are areas of England and Northern Ireland with similar problems, and we intend to address the issue across the whole of the UK.

Ultimately, activity such as this can help us influence the rules, regulations and financial structures under which we all work for the benefit of our profession and patients. However, I am keenly aware that our ability to shape the actions of governments and regulators would not be what it is without the weight of 24,000 members behind our reports, consultation responses and meetings. So, it is your continued membership and support of the College that puts us in the privileged position of leading and representing the surgical and dental professions.

With one of the largest and most widespread global memberships of any surgical college, staging such events outside the UK can be more challenging. Nevertheless, these are highly valuable and enjoyable activities and provide me with the opportunity to meet as many of our international Members as possible. It was a great pleasure to host a reception in Washington DC in October – our first such event in the US, timed to coincide with the Annual Congress of the American College of Surgeons. Our event attracted around 60 US Fellows and, with some 400 Members across the US, this was an impressive turnout, particularly given the geographic size of the country. A similar international event is planned for Malta in February next year and, no doubt, there will be further opportunities to meet members around the world as 2017 progresses.

During a period of constraints on the health service, it is timely to remember that some tests and procedures do not always equate to better treatment or outcomes when reviewing options with patients. In October, the Academy of Medical Royal Colleges launched its Choose Wisely campaign, which listed 40 treatments, procedures and tests shown to be of minimal benefit to patients. This initiative, which we shall consider in detail in a future edition of Surgeons’ News, resonates with Realistic Medicine, the theme of the Chief Medical Officer’s 2015 report in Scotland and the earlier launch of Prudent Practice in Wales. Of course, campaigns such as this are about more than simply making efficient use of resources during times of financial pressure. Choosing Wisely encourages cultural change towards transparent and shared decision making, in which both patient and practitioner take decisions together based on full and frank conversations about all aspects of care.

In recent weeks, I have been privileged to attend three undergraduate/early years training events: the Oxford Surgical Skills Symposium, the STARSurg 5th National Meeting in Edinburgh and, most recently, the All Wales Student Research Surgical Symposium. A huge sense of enthusiasm, engagement and optimism shone through each event. It must be our mandate to ensure that this energy does not get lost in the face of the extreme pressures of healthcare delivery during the early years
of training in the NHS.

Finally, as this is my final update of the year, I would like to thank you for your continued support of the College and wish you well for the year ahead. This has been another productive year for us, with the continued introduction of more examinations, courses and faculties that affirm our position as the professional home for surgery and dentistry. I hope you have time for rest, recuperation and relaxation over the festive season. On behalf of everyone at the College, I look forward to working with you and continuing to represent you in the year ahead.

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