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The President Writes - September 2018

"Enthusiastic role models will be pivotal if we are to move forward"

It seems impossible that I am already writing my final piece for Surgeons’ News. One of the many pieces of good advice I received from my immediate predecessor, Ian Ritchie, was that three years as President will pass in a flash, and I echo that sentiment. It is the tradition that this final piece should reflect some of the significant triumphs and challenges of the last three years. I shall endeavour to do that but time does not stand still and I think it is important first to look at some of the key events of the past quarter in no particular order.

In June, I attended the NHS Confederation’s Conference Confed18 at Manchester Central. This was a key event not only for NHS England but also for the Northern Ireland Confederation and the Welsh NHS Confederation. There was much recognition and praise for the landmark achievements of the NHS over the last 70 years, and full recognition of the challenges ahead. Keynote speeches by Niall Dickson, Chief Executive of the NHS Confederation, Simon Stevens, Chief Executive of NHS England, Ian Cumming, Health Education England, and then Health Secretary Jeremy Hunt on the eve of Theresa May’s pledge to accelerate NHS long-term funding spared no punches.

The striking thing about this event was the relative paucity of clinicians in attendance at what is clearly a key event, and the apparent lack of representation from Scotland. I would encourage you to consider attending this event in 2019 and would applaud any move to engage all four nations within the UK – there is much we can learn from one another. Whatever the rhetoric, we have more in common than we may care to think.

In Inverness, Rethinking Remote 2018 brought together expert opinion from across the globe on the delivery of remote healthcare. This second conference (the first was in 2016) showed how much progress has been made in addressing the unique challenges in this area of practice. Despite the apparent progress in technology and communication, recruitment and retention remain key issues and it seems clear that enthusiastic role models in this branch of the profession will be pivotal if we are to move forward.

Focusing on local service needs, in collaboration with the Scottish Government and led by Ian Findlay, our College hosted a workshop looking at the alignment of general surgical training in Scotland with patient/ service needs. Built upon a review led by Bob Diament of the current configuration and medical staffing of general surgical services in Scotland, the workshop highlighted the issues surrounding varying caseloads among 26 hospitals with an acute surgical receiving service in Scotland, especially the high ratio of emergency to elective practice. Tensions between providing

generalist versus specialist training again surfaced, along with the need to balance career aspiration with societal need and expectation. Inevitably, there is a need for both specialists and generalists – and a clear need to retain emergency surgical practice as a key component of most surgeons’ careers.

Further afield, it was my privilege to represent the College at two major international conferences – the Royal Australasian College’s meeting in Sydney and the Annual Scientific Congress of the College of Surgeons, Academy of Medicine Malaysia, in Ipoh. The conference themes, reflecting on what really matters, and first do no harm, respectively, bore much in common and reminded me that we all share a common vision – and have similar problems in facing up to ever-expanding healthcare expectations within a finite budget.

Closer to home I attended several College events in north-west England which gave me great encouragement. Around 80 undergraduate students and early-years trainees gave up the opportunity to watch the royal wedding and instead applied themselves to a technical and non-technical surgical skills training day in Chorley at an event organised by the Preston Surgical Society. A few weeks later the Surgical Educators’ Day – organised by Council member Stuart Clark and held in collaboration with Health Education England North West – brought more than 120 surgical trainers from the region together in a packed room at Haydock Park. This was the third successive annual RCSEd/HEE meeting I have attended and it has gone from strength to strength. It is extremely encouraging to see the interest these events generate, both in trainers and trainees, and it shows that despite all the pressures we are under there is still enthusiasm and willingness to engage in educational and training activities.

What of the last three years? Against a backdrop of professional unrest at home fuelled by unrelenting service pressures, an unwelcome new contract for junior doctors culminating in industrial action and the ramifications of the Hadiza Bawa-Garba case, steering the College on a steady course has been challenging. I hope that the College position has been perceived as balanced and fair to all. We shall continue to make our position felt independently, with our sister Surgical Colleges, and through the UK and Scottish Academies.

On a more positive note, I am hugely proud of the #LetsRemoveIt campaign led by Alice Hartley targeting the culture of bullying and undermining in the workplace. Our next workshop will be in Edinburgh on 24 September and I would encourage you to engage with this important event. Further afield, the launch of RCSEd Malaysia in Kuala Lumpur was a pivotal step for our future engagement in the region. At home in Edinburgh, the extension to our hotel, Ten Hill Place in Surgeons Quarter, will provide an income stream to support our core education and training agendas in the UK and the international community.

I will be handing over the reins of the College to Professor Mike Griffin at the annual general meeting in November and join you all in warmly congratulating Mike on his election to the presidency. I have absolutely no doubt that our College will be in safe hands and wish him a most successful and enjoyable three years.

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