News and views from the RCEM President
Hello,
I have to say it’s good to be back after my operation. I am grateful to Higgi and the other VPs for filling in for me while I have been away. And thank you to everyone who has wished me well with the op and my recovery. It means a lot.
I am not naturally someone who finds doing nothing easy. So, while I am not able to be back on the shop floor just yet, I have been using my time productively and getting stuck into College work – thank goodness for Zoom.
We have already had the first snow of the year in many parts of the country and, as the temperatures fall, my level of concern about just how bad this winter could be, continues to rise.
As part of our advocacy work, on behalf of our members and for the specialty, we aim to keep the pressures facing EDs on the news agenda, and in the minds of politicians and policy makers. And at this time of year, we tend to be even more vocal.
It is always powerful when we speak as a specialty which is why last month, we decided to conduct a short ‘snap poll’ of ED Clinical Leads across the four nations. It’s a quick and dirty method of taking a temperature check (no pun intended) about how prepared and confident departments are ahead of the inevitable winter spike in demand.
The results were stark:
I know many of your clinical leads will be busting a gut looking after their staff. And this data shows just how worried they (and I am sure you) are about the months ahead.
The results of the poll rightly caught the attention of the media and led to me being asked to do a number of interviews – and then being called / summoned to a series of meetings with the powers that be to discuss our concerns.
And while some people may just be starting to think about winter, it is something which is constantly on our minds here at the College.
You may recall in the summer we hand delivered a ‘Christmas’ card to every MP. The aim was to highlight our concerns, suggesting policy solutions, and offering them a chance to meet to discuss what could be done to help.
These led to a series of follow-up requests, and we now have several MPs preparing to ask questions in parliament about the pressures currently facing EDs and asking what the government is doing to alleviate them.
Following the release of NHSE monthly performance data covering October – we also contacted the MPs whose constituencies cover the trusts under the most pressure, providing a personalised briefing and offering to meet to discuss further. These offers have already been accepted by many.
Just this week I was at Portcullis House meeting the Former Health Secretary Jeremy Hunt and MP Andrew Pakes. With both I emphasised that the problems were almost entirely due to exit block and lack of hospital-wide capacity. Both meetings were productive and constructive.
This week we also submitted our response to the consultation on the Government’s 10-Year Plan for the NHS. We focused on a range of issues including eliminating crowding, increasing bed numbers and improving data transparency.
While the deadline for ‘organisational responses’ has now passed, individuals can still submit their thoughts. Do so here – Change NHS
The Telegraph had some interesting data last weekend which revealed the low vaccination rates against Flu among NHS staff and older people. I was happy to provide them with a quote as this is something I think is very important.
I’ll say no more than – please do get vaccinated. It protects you; it protects your colleagues, it protects our patients and our hospitals.
Among all the doom and gloom there is a small gimmer of light in the form of the RSV vaccination. More than one million people have now had it – and hopefully this will translate to fewer attendances and admissions over the coming months.
After the recent drama of the US elections, we are now moving into our own election season at RCEM. Today (Wednesday 4 December 2025) the voting opens to select our new Scotland Vice Chair.
Dr JP Loughrey’s term as Vice President Scotland ends in the spring. (Huge thanks for everything JP.)
As is customary at the College, the current Vice Chair, Dr Fiona Hunter, will succeed him. Which means her role becomes vacant.
We have had two candidates throw their stethoscopes into the ring – Dr Jayne McLaren and Dr Krishna Murthy.
The election runs from today (Wednesday 4 December 2024) until noon on Wednesday 18 December 2025.
Much more detail about the process, the candidates, and how to vote is on the College website.
And, although I can hardly believe it, next week the process to appoint my successor begins with the nomination process opening for potential Presidential candidates. But it’s not a quick process and I won’t be handing over the reins until autumn next year.
I won’t go into the details of the process here, as my College colleagues will email you all you need to know in the coming days. So, keep an eye on your inboxes.
With all this going on it is easy to forget that the festive season is upon us.
I hope those celebrating get some time away from work, and a chance to relax.
For anyone who will be working through the holidays I, and all of us at the College, thank you and share our appreciation.
As ever there may not be much (any?) room at the inn – but we will always do our best.
I wish you all a heathy and happy festive season.
Adrian
Hello,
Higgi here standing in for Adrian while he recovers from his hip operation. I am sure you will all join me in wishing him a speedy recovery.
It’s Remembrance Sunday this week, and this has a particular meaning for many of our colleagues who are or have been in the military, and those with connections to the military and our war dead both now, and in the past. To mark it we have added the Poppy to our logo.
The link between Emergency Medicine and warfare is unfortunately strong. I know all of our thoughts go out to our colleagues in many countries around the world who are caring for those affected by the awful conflicts currently playing out, often under intolerable circumstances. Many have lost their lives doing so.
Elsewhere, a lot has happened since the last newsletter, and I’ll attempt to capture the key points here.
At the start of the month, I was in Gateshead attending our Annual Scientific Conference. We were joined by several hundred colleagues at the venue, and more on-line. The Glasshouse overlooked the Tyne and the iconic bridge, proved an excellent setting to showcase our speciality.
The talent on display was inspiring, and the sessions were diverse and informative. Speakers ranged from medical undergraduates to some of the founding members of the speciality. Topics included some cutting-edge studies reporting for the first time and thought-provoking reflections. The posters were of a high standard and covered a wide range of subjects.
The ASC always focuses on science and research, and it was great to see so much of that going on. Along with clinical care there were also strong themes around education and environmental impact, and plenty of evidence that it is still possible to make improvements in our departments at a local level.
As ever, it was wonderful to have the space and time to meet new colleagues, to reconnect with others, and to chat about both work and life.
Our Royal Patrol HRH The Princess Royal made time to come and visit the conference, meeting some of the attendees, watching Rick Body being brilliant, and giving a well-informed speech of her own. As ever, she was engaged, enthusiastic and entertaining, and shared some of her reflections having been a patient when she suffered a head injury.
It was an honour to host her, and we remain grateful for her time and support. I know it meant a great deal to many of the delegates who were able to meet and chat with her during her visit.
Our thanks must go to the local organising committee for all the effort they put in, and to the College’s fantastic events team for hosting such an excellent conference with their usual good humour and efficiency.
If you are experiencing retrospective FOMO, all of the content from the main track is available on demand. Visit the Events pages of the website to find out how you can access sessions.
We held our AGM during the ASC and it was good to see many members attending in person and online. There were updates from Adrian, RCEM VP (Treasurer) James Gagg, VP (Membership) Salwa Malik, and the College’s CEO Gordon Miles. All their presentation slides are available on our website as is a recording of the meeting itself.
The VP Treasurer’s report included a new formula for calculating the percentage increase to be applied to annually to membership fees which is an average of previous three years inflation, capped at 5%.
The AGM is one of the opportunities for members to have their say in how the College is run. During the meeting, attendees were asked to vote on four questions as follows:
| Vote | Result |
| To accept the President’s report | Agreed (98.5% in favour, 1.5% against) |
| To accept the CEO’s report | Agreed (99.1% in favour, 0.9% against) |
| To accept the Vice President Membership’s report | Agreed (98.2% in favour, 1.8% against) |
| To accept the Vice President Treasurer’s report | Agreed (95.5% in favour, 4.5% against) |
| To accept the recommendation to reappoint Moore Kingston Smith as auditors for the financial year 2024 | Agreed (97.3% in favour, 2.7% against) |
More details about the 2025 Subs can be found here – along with details about how members can apply for tax relief on these payments.
Following the publication of the Darzi Review the government has moved to the next phase of its stated mission to “fix” the “broken” NHS by launching its ‘Change NHS’ campaign which has been described as ‘a national conversation [which ] genuinely wants to create a roadmap for reform’.
RCEM has been asked to contribute as an organisation and we will do so, but the government also wants to hear from you, as people working on the shopfloor, so please do consider sharing your thoughts on how things can be improved via the portal – Change NHS.
However, I can’t keep the sceptic in me entirely at bay. At the moment it seems there is a lot of talk, and not much action.
We appreciate that there is no magic wand, but it frustrating to see the lack of tangible progress around emergency care when our new government has had years to plan, and has been in power since July.
We have been anxious to see if money will follow rhetoric and we expected the Autumn Budget to give us the first indicators about how the government intends to improve things for our patients and staff. I don’t think I have ever known a budget so heavily trailed, and we didn’t hear much about emergency care up front, so our expectations were somewhat low. Sadly, there were no nice surprises on the day itself.
The Chancellor Rachel Reeves MP described the money being allocated to the NHSE – £22.6bn through 2025/6 and 2026/7 – as a ‘downpayment’ on the future.
There’s a lack of clarity regarding what this will buy, and what difference it will make.
How money is allocated to the health and social care sectors in the devolved nations is a matter for their governments, but there will be extra cash available to point at healthcare, if they choose to do so, as a result of how the national finances work. Our national VPs are on the case.
Once again, the focus in England was on driving down waiting lists, providing equipment and increasing productivity. This is obviously needed, and welcome, but won’t have a significant impact on emergency care. In fact there was almost no mention of emergency care in the whole budget. The only glimmer of hope was buried in the statement document which is published alongside the theatrics in Parliament, and where some of the ‘devil in the detail’ is revealed.
On page 82 there is a line which says that the government will make available “£1.5 billion for new surgical hubs and diagnostic scanners; …new beds across the estate to create more treatment space in emergency departments, reduce waiting times, and help shift more care into the community; and £70 million to invest in new radiotherapy machines to improve cancer treatment.”
So there is a pledge to increase beds, but there are no numbers, no detail of where these beds will be, and who is going to care for the people in them. We’ve pointed this out in our reaction statement,
What about social care? We all know that the NHS will continue to be in trouble until social care is reformed and revitalised (thanks Ed Davey for amplifying that!). Sadly, there wasn’t much for social care either, apart from £600m for local governments to use to help people remain in and return to their homes. It won’t be enough in isolation.
So all a bit Meh. What really worries me is that it also feels like this winter has been written off, especially since the Health and Social Secretary acknowledged people will continue to receive care in corridors this winter, and that there would continue to be deaths associated with long stays in EDs.
Whilst acknowledging the reality is a good, the novelty is beginning to wear off, and I find the implication that we and our patients just have to suck it up, difficult to swallow.
Many of us are already overwhelmed by the levels of demand we are facing, along with crowding caused by exit block. We know short-term cash injections are not effective or sustainable, and that strategic approaches will take time, but it is pretty rubbish now. There are things that could be done even at this late stage. For instance:
Even if Mr Streeting has given up on winter, we haven’t.
We will keep lobbying, advocating and championing on behalf of you, our colleagues and our patients.
The ASC reinforced what we can do as a speciality and as individuals. We are a remarkable bunch. We and our patients are worth fighting for.
Higgi
I write this just having returned from Birmingham and the Conservative Party Conference. This was my second event in as many weeks having attended the Labour Party Conference the week before. Both were soggy events, possibly reflecting the political mood.
My thanks to my VP Membership Dr Salwa Malik who kicked off conference season for the College by attended the Liberal Democrats Conference in Brighton.
We think long and hard about attending these conferences, and what we achieve. A great deal of consideration goes into it.
The reason we attend on behalf of the College is that these events really do allow us to get into the room with, and to speak to, some very influential people.
An opportunity we seize and make the very most of.
Over the past month we have advocated, lobbied and cajoled ministers, Private Parliamentary Secretaries, MPs, journalists and policy formers on behalf of our members and the specialty at every opportunity.
We have established relationships, started conversations, set up meetings and opened up lines of communications which would never have been possible if we weren’t – to quote Alexander Hamilton via Lin Manuel Miranda – in the room where it happened. I prefer the sentiment. ‘if you’re not at the table, you’re on the menu’.
My thanks go to the College’s Policy and Communications team who attend with us and who keep us on schedule and in the right place.
The political parties’ conferences may be done for another year, but the most important (IMO) autumn conference is yet to happen – RCEM’s Annual Scientific Conference which this year is taking place in Gateshead.
I know I have said it before, but our conferences are one of my favourite things. To be together with such a passionate group of peers, committed to the specialty and to improving it really is the best thing.
I am lucky to be able to attend in person albeit still on my crutches – but I know even if I couldn’t get there I would be logging on as a virtual delegate to watch some of the fantastic presentations on offer.
Once again, the Local organising committee and Research Committee with the College’s Events team have organised a stellar line up. And although the deadline for in-person registration has passed you can still sign up for a virtual delegate place.
Traditionally the College’s AGM takes place at the end of the first day of conference and this year is no different.
To find out more about the AGM, how you can attend and who is eligible to vote click here.
The timing of the conference this year has fallen (excuse the pun) well for me as I am due to have an operation at the end of the month to repair the damage to my hip that I sustained in January after being let down by my bike handling skills.
The operation is another chance to don my NHS ‘secret shopper’ guise and view the system with a patient rather than a physicians’ eyes. No bad thing I assure you.
As well as me in recovery, the end of the month will also see the first budget from the new government.
Following Lord Darzi’s assessment of the state of the NHS we certainly have a new direction of travel as well as a new mantra.
One which was recited multiple times in Liverpool from: analogue to digital, sickness to prevention, and hospital to community.
Nice soundbites but a little light on substance so far. Perhaps we will get more of a steer in the Autumn Statement.
While long term planning (expect a new 10-year plan for the NHS in the spring) we are keen to remind the powers that be – old and new – that ‘winter is coming’. We can’t allow a long term plan to stop meaningful action for this winter.
All the signs are that we are facing another hugely challenging few months.
The summered stats show this has been an extremely busy time. Overcrowding in our departments is now at winter crisis levels all year round.
And that is before the inevitable seasonal spike.
I make no apologies for repeating this – please get vaccinated against flu and covid. It helps protect you, you family, your colleagues and your patients. Our hospitals are so vulnerable to a flu outbreak.
I do hope that the RSV vaccination campaign helps reduce some attendances – it’s a nasty illness not just for the patient but for worried parents and for ED staff too.
One real high point for me since my last update was attending the Senior Fellows’ Lunch at Octavia House.
It was a great event and quite emotional for me to see people who had trained, employed, examined, mentored me over the last 30 years all in one place – sharing stories and news over lunch.
It was so well received that we are planning another one. But not before I have recovered from my op!
Now, that’s enough from me – I have to unpack my bag and wash my purple socks ready for conference next week.
I hope to see you there.
Adrian
I suppose it is a hangover from back to school, and the start of a new academic year. I watch the children going back to school in the sunshine with a mix of pity and nostalgia. It almost feels like it should get its own set of ‘new year’ resolutions.
This year that sense of renaissance is exacerbated as we have a new Government which also reconvened this week.
The narrative so far seems to have been – “we inherited a mess”. I don’t quite understand how ‘the NHS is broken’ is a policy, rather than an opinion.
The new incumbents will now need to start making their own mark and get down to the business of sorting out that mess and fixing what is ‘broken’.
The first step has been to conduct a ‘diagnostic review of NHS Performance’ led by Lord Darzi.
We have taken part in this and submitted evidence.
This is designed to inform the upcoming 10-year plan. I can’t help thinking that a 10-year plan is far too long.
We’ve offered a mix of short-term solutions for the next year and acknowledged the need for long term planning, especially around estates and capital funding.
The discourse in the Darzi review has been dominated so far by discussions about falling productivity, the effect of the ‘three hits’ austerity policies, the Health and Social Care Act and the pandemic.
Our new Prime Minister and his new Chancellor have already started warming us up for some tough times ahead.
Despite the executives of the four nations being on recess we have been maintaining our advocacy work across the UK. Just this week our VP Scotland, Dr JP Loughrey wrote this piece highlighting our concerns for the Scottish UEC system this winter. Meanwhile, I was quoted in the Daily Mail following a survey conducted by Marie Curie about end of life care.
Autumn is also conference season, and this year is no different. The College will be representing our members at the Party conferences of all three of the main political parties.
These events are a good opportunity for us to meet with MPs and policy makers and to advocate for members and the specialty.
The College also has its own flagship Annual Scientific Conference at the start of October.
We all know the world has changed so much since Covid, but I still really look forward to and enjoy the opportunity to come together and interact face to face.
However, I am also acutely aware that that is not possible for everyone to come in person which is why the virtual delegate option is so important for members in the UK and internationally.
As a tradition, we hold The College’s Annual General Meeting (AGM) at the end of the first day.
All members are welcome to attend – either in person if you are at Conference or online if you are not.
Our VP Treasurer James Gagg will present his report and the accounts. I very much enjoyed James’ blog on his role as RCEM VP Treasurer which gave a great insight into the job.
Details of how to register to attend are in the newsletter itself, and we will be sending out a special AGM newsletter in the coming weeks with lots more detail.
The College’s Policy team has been feeling very festive over the past week – sending out hundreds of Christmas Cards.
No, we aren’t confused – or very early – it is because our minds are already on the winter and the added demand the UEC system will inevitably face – and we think the minds of politicians should be on it too.
So, we sent a festive greeting to each of MP, highlighting our #ResuscitateEmergencyCare recommendations and offering to meet with them to discuss the issues locally and nationally.
I mentioned last month that we were expecting the NHSE winter planning letter any day.
We are still waiting.
Talking of winter, this week saw the launch of NHSE’s RSV vaccination programme which is something we lobbied for with the RCPCH and are very supportive of.
Infection control has been in the news elsewhere this month also with the usual ‘back to school / university’ messaging about Measles as well as warnings about the new Mpox variant.
The College’s Quality team is also analysing all the updates and will issue further guidance if necessary.
As well as all of these, Covid has not gone away and ‘flu season is looming large on the horizon.
Please do get vaccinated. Not doing so presents a risk to you, your families, your colleagues and your patients. And we really should be leading by example.
Adrian
‘Tis the summer of discontent
The beginning of August is the time we welcome our new starters into our department. I can certainly remember my first day in emergency medicine nearly 30 years ago. Our induction programs are much better now, and it might be worth pointing newbies to RCEM Learning for all the resources that can help them.
Last weekend saw the awful protests and violence across many English cities. I want to speak for our members and fellows when I say that racism has no place in our society and as a College we condemn what we have seen. The NHS is probably the most multicultural part of British society and better for it. We published a statement here.
As it’s August though, I’m already thinking about winter. And I am not the only one. We know that the NHSE’s usual summer missive to Trusts detailing what it wants them to do this winter is expected any day now.
The inevitable seasonal spike in demand used to be just that – a spike. But increasingly the goal posts and the baseline have moved. There is now no summer respite. There is just constant pressure which gets even worse in winter. Fifty shades of crisis if you like.
There are two places where winter is permanent – in a land created by C.S. Lewis and accessed through the back of an old wardrobe, and Emergency Departments.
I mentioned this ‘Narnian winter’ in a podcast I recorded earlier this month with Baroness Watkins of Tavistock FRCN.
A cross-bench peer, a non-executive director of NHSE, a Nightingale Scholar, world renowned nursing expert, emeritus professor of healthcare leadership, and Deputy Vice Chancellor, at Plymouth University to name but a few – her accomplishments and experience are stellar.
We had an excellent constructive conversation about what we both think the new government can do – and do quickly – to start to make a difference to Urgent and Emergency Care. You can listen here. (Don’t worry it’s only 23 mins, I know you are busy!)
The new government has certainly got down to business. An independent investigation into the performance of the Health Service chaired by Professor Lord Ara Darzi is already underway.
The College has been asked to be involved, I have been invited to join an Expert Reference Group. Lord Darzi has also invited anyone else who would like to make a submission to do so – the details are here – Independent investigation of NHS performance: submission of evidence (dhsc.gov.uk)
Elsewhere the new Health Secretary has brokered a deal the BMA was prepared to put to its Post Graduate Doctors in Training members. While as a College we don’t comment publicly about industrial action, we want to see the matter resolved as soon as possible.
But just as one dispute might be ending, another one starts.
GPs have embarked on a phase of work to rule. Again, we have no comment to make on the rights or wrongs – but we will be closely monitoring any knock-on effect this action may have to EDs and to our patients.
A great deal of our public facing work is aimed at influencing politicians and policymakers for the good of our members and the specialty. But we are also a very highly regarded academic institution.
To help us continue to offer the highest educational standards we have developed, and this week published, our Academic Strategy covering the next three years.
A core element of our academic work is of course our exam portfolio and we have just published our 2025 Exam Calendar.
In addition, to help our members and candidates as they progress with their learning and careers, we have updated and streamlined our eligibility criteria for exams taking place in 2025 and beyond. All the details and lots of information about the new criteria can be found here. (Exams which are taking place in 2024 are unaffected.)
Despite the continued pressures and demand I know you are all facing – and I know there is never a good time to talk about holidays – I do hope you get the chance to have some time away from ‘the office’ this summer.
Finally – but certainly not least – a huge hello and welcome to all our new EM trainees. You have made an excellent career choice. Emergency Medicine is tough, but it really is the best specialty there is. A very warm welcome to you all.
Best wishes,
Adrian
My goodness! Considering the announcement of the General Election at the end of May came as something of a surprise it now feels like the ‘pre-election period’ has been going on an eternity!
It has been an interesting time. Everywhere you look, people are vying for attention.
The politicians want the attention (and votes) of the public and everyone else wants the politicians to pay attention to their particular policy ask or cause.
And we at the College are no different. I make no apologies for raising the UEC crisis in public and behind closed doors at every opportunity.
Our asks are clear, and we know what needs to be done to #ResusitateEmergencyCare
You and I clearly see the impact of the crisis every time we go to work. But the public – and politicians – only every really get a sense of it when we share shocking statistics or data, or if they need to visit an ED themselves.
Showing the day-to-day reality is difficult.
But that is exactly what the makers of Channel Four’s Dispatches did.
The producers of Undercover A&E wanted to show what it is really like in a busy ED.
And, in reality, the only way they could do it was by covertly filming.
Now I, and we as a College, do not condone secret filming especially in a sensitive health care environment, and we had nothing to do with arranging it. (In fact, we only knew about the filming when they approached us to comment on it.)
And when they asked, I thought long and hard about it.
In the end I felt that it was better for the voice of the College’s members to be included in the programme, and for me to be able to stress that the issues shown were not isolated and could have been observed in any number of EDs across the country.
Before the programme aired, I reached out to the ED staff at the hospital featured and also made sure all our UK members were aware it was coming and my reasons for taking part.
The Dispatches was followed by a debate programme hosted by Krishan Guru-Murthy.
You get a small insight as to the fast-moving nature of the world of current affairs TV when on Friday afternoon the programme is a going to feature a panel of politicians and by Sunday morning it has pivoted to become a panel of experts. All because petty political posturing meant that when one politician refused to take part the whole thing is off.
I was disappointed at first. I felt that the College’s members and the public were being robbed of the chance to probe much deeper behind the headline health policies and soundbites we have seen over the past few weeks.
But what the programme developed into was probably a much easier watch for the viewers and I hope a little more constructive.
I was privileged to have been asked to sit on the panel alongside Matthew Taylor the CEO of the NHS Confederation, former chair of the Commons Health Committee and GP Dr Sarah Wollaston, as well as Sarah Woolnough chief executive of the King’s Fund, and Dr Chaand Nagpaul former chair of the BMA.
To be faced by a live audience and to have no idea what they are going to ask you or what they have experienced is pretty unsettling!
There were some truly harrowing stories and I have so much respect and admiration for the people who were brave enough to share their experiences, many doing so in the hope that lessons can be learned, and no one else has to endure what they and their families have.
It is so important we take the time to listen and to empathise – as well as to learn.
When I read the responses afterwards, what struck me was the overwhelming send of solidarity – so many clinicians sharing their support and own experiences. As well as the out-pouring of support from the public for NHS staff. The consensus that it is very much the system, not the people, at fault. It reaffirmed that this was most definitely not a ‘one bad apple’ scenario as was initially suggested by NHSE (but was quickly followed by a letter to ALL Trusts reminding them of their duty to provide safe and sanitary care.)
Whenever I decide to speak to a journalist or to the media, I always ask myself ‘what am I trying to achieve?’
At a time when everyone is squabbling and posturing, I hope this important programme cut through the noise.
The image of an elderly man stripped of his dignity, having to urinate in an open ED corridor should shock and move the most hard-hearted.
Horrifying and heart-breaking situations like that are why we will never shy away from highlighting the unacceptable, for telling uncomfortable truths, for giving a voice to our patients and for championing the clinicians who go above and beyond every single day.
This week the next government will be elected.
And we go again.
The College is ready to work with them to do what must be done to resuscitate emergency care and get our NHS functioning as it should so shocking TV exposés are never needed again.
Hello,
The old saying goes ‘a week is a long time in politics’.
Well with just over a month ago since my last blog and things have certainly moved on.
We are now very much in the pre-election period with all the posturing and political pantomime that accompanies it. The College is Apolitical – we will work with any elected government to make sure our members and our specialty is heard and seen, and to advocate and lobby for improvements. But that doesn’t mean we won’t applaud positive policy announcements or call out when the crisis in Urgent and Emergency Care is not getting the focus it deserves.
I thought it was positive to hear Keir Starmer mention the ED crowding crisis in his election announcement response speech – even if we came after his mention of sewage!
The College has been working hard to ensure politicians and policy makers are as informed as possible about the situation in UEC and more importantly what we know needs to be done to fix the problems. That is why we published our own election ‘manifesto’ #ResuscitateEmergencyCare last September. We are now in the process of updating so it becomes more of a ‘roadmap’ for the next government.
The election manifesto update was one of the many important items discussed at the College’s Council meeting yesterday (6 June 2024). You may have been wondering why this newsletter – which is always sent on the first Wednesday of the month – was delayed. Well, we held off so we could make sure we were able to include the updates agreed at Council, so you got them as soon as possible.
Council was held in person, which I feel is always the best way, and my thanks go to all who made time in their busy diaries to attend. There were certainly some pretty important topics on the agenda, not least the item around the College’s updated position on PAs in EM.
Both the recommendations of the College’s Short Life Working Group – convened to examine the issue – as well as the findings of the membership survey which many of you completed in March, were carefully considered. (My sincere thanks to all who did take the time – it is so important to have your views and experiences captured in the process).
Council gave this a great deal of time and consideration as is only right and after a lengthy and productive discussion it voted and unanimously agreed RCEM’s updated position on PAs in EM which is:
The Royal College of Emergency Medicine does not currently support the expansion of the PA workforce in Emergency Medicine
The full position statement is here – please do read it. The results of the member survey are also available.
At this point I repeat my call for us all to engage in a reasoned and adult debate about this issue. There will be some people who welcome the position, and there will be others who vehemently disagree.
Healthy and constructive debate is always welcome. But what I have seen from some quarters recently has been disgraceful and unacceptable. The College is always happy to engage but we will not respond to vitriol or downright trolling.
I am also acutely aware of the impact and concerns which may be being experienced by our existing PA membership. And we have reached out to them directly. The College will continue to support them as they progress through their careers and they remain a valued part of the College.
Other important discussion at the meeting also included our England Census. Many of you will have been involved in collating the data for this – no small task – and we are infinitely grateful for your time and work. It is vital that we have an accurate picture of where, how, and why EM clinicians are working, so that we can ensure our asks for additional training places and workplace improvements are correct. We will be releasing more information about the work and the findings shortly.
This week I was pleased to welcome the President of the Irish Association for Emergency Medicine, Professor Conor Deasy (pictured with Adrian) and to be able to have a good chat with him about the shared challenges both our memberships are facing.
During our chat, the issue of crowding and corridor care of course came up. We were pleased to see the issue again getting the attention it warrants in the media with the publication of the RCN survey findings. This is the most visible indicator of a system which is not functioning as it should, and we will continue to noisily and frequently highlight it and call for the additional staffed beds needed to end it.
This month also saw the ACP Conference take place in Glasgow. And I have to say that from reading about the sessions held and from seeing the fantastic pictures my FOMO was immense! It is so good to see such a passionate and dedicated element of the College coming together and sharing learning and just having a really good time doing it. My thanks ACP Chair Ash and her team, and to my VPs Higgi, Salwa and JP who did get to go as well as to all of you who also made the time to attend. And as ever, to the College’s super slick Events team for organising.
As we work to develop as a College and ensure we are giving you as our members a service you want and need, we are undertaking some work to gain personal insights from our members – more info will be coming soon. This important work has the potential to be really beneficial for you, and the College as we go forward so, please do get involved so your voice is heard.
On a final note, I always like to see the College’s branding adapted as we support important events and the Pride colours being incorporated this month is fantastic. We as a College are committed to inclusion and equity and we are proud to support Pride, as I am.
Best wishes,
Adrian
PS don’t forget to vote!
Hello,
Reading this month’s newsletter, I have to say I am more than a little envious of Dr Anthony McLaughlin who is running the Copenhagen Marathon this weekend (04/05) for RCEM.
Although I admit I would definitely rather do a nice 26.2 mile bike ride than a run.
All the best Anthony, the whole College is behind you (and if you feel like donating his fundraising page is here).
No such physical exertion for me, as I have been confined to barracks pretty much since my cycling accident in January.
But there is some good news. As of last month I have started to make – literally – tentative steps towards being mobile again.
Much to my, and my wife’s, joy!
Admittedly it’s no marathon – but sometimes it feels a bit like one.
This rediscovered mobility means I have started to attend a few events and meetings – in person! And I was absolutely thrilled to have been able to attend our Spring CPD Conference in Newport.
The Welsh welcome was stellar, the venue was perfect – and the programme was educational, informative, entertaining and, at some points, deeply emotional.
As ever the event was slick and professionally run by our fantastic events team. Kudos.
What did strike me was not just how wonderful it was to be together in person to share knowledge and best practice with peers, but also to be able to catch up outside of the four walls of a Zoom call and to have the time to chat and enjoy each other’s company in a more relaxed environment.
My thanks to everyone who took the time to attend, and who came over to ask how I was doing as I hobbled around.
One of the sessions which resonated with me was from Dr Natalie Whitton who gave a very candid, honest and entertaining presentation about her career as a SAS doctor.
I, and the College, are hugely appreciative of the work that SAS doctors do in EM – our EDs would simply not function without them.
And it is only right that we should support them in every way we can as they develop in their chosen career – which is why we are advocating for all SAS doctors to have access to an Educational Supervisor if they want one, to provide the support they deserve as they progress within the specialty.
I was able to make exactly this point at a workforce roundtable hosted by the Secretary of State, and this was well supported.
Another strong recurring theme of the Conference was – unsurprisingly – wellbeing and how we can best look after our teams and colleagues.
Dr Non Evans and Dr Amy Owen from Bangor ED gave a really insightful presentation about what they have put in place to ensure their staff feel valued and included – and it was easy to see why they were named the best ED for training in the country in last year’s GMC Trainee Survey.
(That reminds me – PGDiTs – please ensure you complete this year’s GMC Training Survey – the deadline is this week (Friday 2 May 2024) – and while you are in a survey filling mood you can do our own EMTA survey which will help us to better support you. The deadline for that one is Monday 13 May 2024)
Inextricably linked to the pressure we are all facing in our EDs is crowding, and my thanks to Higgi for his great session discussing the issue, its effect, and what we know needs to be done to address it and better care for our patients. Read our updated crowding guidance here.
I am so pleased that so many of the College’s executive team were able to attend – Maya, JP, Rob, Higgi, James Gagg, Jason and Russell – Salwa was gutted to have missed it after contracting the dreaded Covid – you were missed.
I was also able to have great to catch up with members of the EDI Committee, and made sure to visit the GreenED Stand. To do it all while enjoying some Welsh cakes and Welsh tea was lovely. (but is harder than it sounds when you are on crutches!)
Most of all it was so wonderful to look across the auditorium full of passionate and dedicated EM professionals coming together to further their learning and our specialty – with all the challenges we face it was really heartening to see.
If you were able to attend, I hope you enjoyed it as much as I did. And if you weren’t – don’t worry the events team has already prepared a ‘box set’ of the conference which you can access online and can also net you up to 15 CPD points, so you won’t miss out.
And make sure you keep an eye out for the dates for next year’s event and book the time off.
If I have whetted your appetite for conferences, you don’t have to wait too long as we have our other flagship event on the horizon.
Our Annual Scientific Conference is being held in Gateshead in October – and the call for Abstract submissions is open – the deadline is 12pm on Friday 14 June 2024.
My foray back into the world of the mobile did not end there. I have also been able to attend some in-person meetings – with some careful logistical planning!
As I mentioned above, last week I, along with presidents of a number of other Royal Medical Colleges, had a meeting with the Health Secretary Victoria Atkins.
We were able to raise several important issues with her including the need for educator capacity, staff well-being and retention and the need to reduce the amount we spend on locums.
I was also able to go the Tri Service Emergency Medicine Conference and support our military colleagues. There were fascinating sessions on cold weather and poisoning.
It was a real privilege to hear Major General Hodgetts reflect on his long and illustrious career. (That’s us in the picture)
Next week we have an extended College Executive meeting where we will be reviewing and potentially refining our policy asks for the next Government to ensure that Emergency Care remains one of its top priorities.
Related to this we will also be discussing the result of our England Census. My thanks to all of you who took the time to complete the survey. It is so important we are able to evidence our asks and such strong and compelling data is invaluable.
Similar censuses (censi?!) in Scotland and Wales have led to tangible positive change; and we are currently in discussion with the Northern Ireland Executive about the findings of the census there.
We will be releasing the results in the coming weeks and putting it under the noses of politicians and policy makers to help with our on-going influencing work. My thanks to the College Policy team for again doing an excellent job collating and analysing huge amounts of data into clear and coherent asks.
We will also be getting an update about our work around the sensitive issues of PAs in EM from the SLWG. Although we may not be shouting about it, believe me there is a lot of work going on and we will provide further updates on this work in due course.
This meeting will also be held in person – so another test of me navigating public transport.
So, I’d better get back to practising.
Oh and if you’re wondering about the cake picture – I did indeed celebrate my birthday in Newport.
Having had a lovely celebration with my family before conference I got a surprised by a cake and a card while there. I could get used to a double celebration – I might do it again next year.
Now where are my crutches? I’m off to do 26.2 metres down the garden to feed the Guinea pigs – small steps!
Adrian
PS – Good luck to all sitting their upcoming FRCEM OSCE exams in London! Remember – you face these kinds of situations every day IRL – you have got this!
Hello,
Welcome to April’s update. It finally feels like Spring might be here.
I hope all of you who celebrate had a lovely Easter. Perhaps you even defied the warning from one NHS medical director not to eat a whole chocolate egg in one go – I know I did! (everything in moderation Dr!)
Also, Ramadan Mubarak to all observing – those fasting while working have my utmost respect, and an early Eid Mubarak for next week.
Like many of you I spent my Bank Holiday working – unlike you I am still ‘legless’ as I continue my recovery from my cycling accident.
Despite not being fully mobile I am still able to keep up to date with my College work and advocating and influencing on behalf of our members.
Monday was spent doing multiple media interviews regarding the analysis the College has done examining the efficacy (or not) of NHSE and DHSC’s UCE Recovery plan launched in January 2023.
One of the key calculations – and which rightly attracted the media’s attention – was the analysis which showed that there were more than 250 deaths per week in England in 2023 associated ED waits of 12hrs prior to admission. Our explainer document is here.
Shocking stuff, but I doubt surprising to any of us who work in the ED.
The reason we engage with the media like this is to ensure that we keep the issues experienced in EDs across the country at the forefront of the minds of people – especially those of policy makers and politicians.
We saw good engagement from a number of MPs including the Shadow Health Secretary and other members of the shadow cabinet and we are planning meetings to discuss the challenges facing you every day in more detail and highlight our #ResuscitateEmergencyCare Manifesto which offers practical and pragmatic solutions.
Another piece of work which has seen us successfully influence for positive change is our Workforce Census. Last your we unashamedly badgered Clinical Leads across England to complete it – which dozens of you did, thank you.
The data we collected from similar pieces of work in Wales and Scotland has resulted in increased EM training places and we are in the process of meeting with the Health Minister in NI to try to secure the same there.
Our Policy team is currently finalising the results of the England census and I intend to share some of the key findings with you during my presentation at our Spring CPD Conference in Wales on the 16 to 18 April.
I am really looking forward to the conference and I hope as many as you as possible will be able to attend.
But you need to be quick – registration for in-person delegates closes at 11.59pm on Monday 8 April, and virtual registration closing at 7am on Tuesday 16 April.
There is a jam-packed informative and interesting programme, and it is CDP accredited – book here.
One issue which continues to dominate social media – often in a very unpleasant way – is the on-going discussion around Physician Associates.
The College’s Short Life Working Group continues its work and is seeking some additional members (see the update in the newsletter). The SLWG will also be analysing the data we collected via our Members’ Survey.
We had a good response with more than a quarter of the membership feeling they wanted to respond – my thanks to all who did. We will share the results of this survey in due course, but the working group and Council need to consider these results first.
While the weather may be improving the demands on ED clinicians continue. This week the UKHSA has issued a warning about the rising cases of Scarlet Fever.
The UHKSA page is kept updated with the latest advice and guidance and check out our own eLearning content about Scarlet Fever.
The College’s Quality Improvement team is busy at the moment publishing the annual reports for our current QIPs. The latest was the Year One report on our Mental Health Self Harm QIP.
The report itself is here – and its findings were picked up by The Independent.
This in turn led to the office for the Parliamentary and Health Service Ombudsman to contact us and ask for a meeting which is excellent news and shows the impact our work in this area has.
April is ‘Stress Awareness Month’ – and believe me we are aware of the stress you are under.
The recent British Social Attitudes Survey may have made for disheartening reading but when you look a bit more closely at the data you see it is the system which most people consider to be at fault – when it come to the care and compassion they have received, patients are full of praise and gratitude; which is often reflected on our own social media channels.
We will keep advocating for you to relieve the pressures so you can do what you do so well.
As ever, my inbox is open, if you want to ask me anything – president@rcem.ac.uk or come along to my Monthly Members’ Meeting and chat directly.
Now, where are those Easter Eggs….
Adrian
Hello, it certainly is good to be back after my ‘little’ cycling accident. I am on the mend, however the road to full recovery for me is going to be a long one – I am still not able to weight bear for a little while so I’m steering the Good Ship RCEM from my home office. I – and indeed my wife – are very much looking forward to the day when I am fully mobile again.
I must pay thanks here to all of you who have sent me messages and best wishes – it was so lovely to receive them. And I owe a huge debt of gratitude to the medics who looked after me when I was injured (a helpful reminder of our patients’ experience) and to my wonderfully capable team of VPs who stepped up while I was (literally and metaphorically) unable to.
While my hip may be not be fully functioning, I am still able to get stuck into College business, and it has already been a busy couple of weeks since I returned from my ‘break’.
The conversation about the role and scope of PAs in the healthcare workforce continues – as does our work as a College to examine the potential role and scope of PAs in EM. This includes our survey which has been sent to all members (there is also a link at the top of the RCEM website homepage and a QR code in the newsletter).
We really want to hear your opinions and experiences so please do complete it – it only takes a few minutes. The deadline for completion is 5pm on Friday 8 March 2024 so get your response in before then. The results of the survey will be fed into our Short Life Working Group as it continues its work towards establishing the College’s position on this matter.
I was very sad not to have been able to attend EMTA’s conference in Gateshead at the end of February. I was able to follow via social media and the feedback I have received from those who were able to be there has been very positive. It was such a varied and engaging programme – well done to the EMTA Committee, and to the EMTA and College Events teams. Another fantastic event, topped off by a visit and address from our Royal Patron HRH The Princess Royal.
The next major event in the calendar is our Spring CPD conference which is being held between 16 and 18 April at the ICC Wales. It looks great. And even if you can’t get there in person there is the option to join virtually too so make sure you book your study leave and place asap!
Our policy and influencing work continue. We have been closely monitoring and analysing the weekly ‘Winter Sitrep’ data published by NHSE. They really do show the pressures we are all facing at work with long waits, long stays, long delays in discharging people who are well enough to go home, as well as reminding us it has been a very long time since bed occupancy fell below 90%. The need to #ResuscitateEmergencyCare is clear for all to see when you look at the graphs and we will continue to use this and other data to campaign on your behalf as we head towards the General Election (whenever that may be!).
It seems the Government is also keen to focus on ED wating time data with the story breaking that unless EDs meet the 76% target for four-hour waits before April they will be financially penalised – less carrot more stick and very much in line with the ‘the beatings will continue until morale improves’ ethos.
But sarcasm aside – focusing on this one metric could have the serious consequence of focus shifting on to the less sick patients to hit the target, potentially resulting in the sicker or more complex patients being side-lined and facing even longer waits. Four-hour waits cannot and should not be considered in isolation – we must examine the 12-hour data alongside it to get a real sense of the issue.
One part of the Government which has recognised the extremely important role that ED staff can play is the Home Office. They approached us as leading experts and ask us to work with them to establish a new Standard Operating Procedure for the way EDs share information about violent incidents in our communities. Working with experts across the country we are relaunching the Information Sharing to Tackle Violence (ISTV) programme (there are more details in the newsletter and on our website).
I feel passionately about this as we know that around three-quarters of violent incidents are not reported to police. If we can help identify particular hotspots, we can help make our communities safer, and reduce the number of injuries caused by violence presenting in our EDs.
Data is at the heart of much of our work here at the College and another way we are utilising it is to lobby for tangible benefits for Members. As part of our #ResuscitateEmergencyMedicine manifesto one of our key priorities is an increase in the EM workforce. At the start of this month, we revealed the findings of our Northern Ireland Workforce Census at a launch event held at the Northern Ireland Parliament. The Census found that there are currently just half the number of EM consultants working in the country than there should be.
Similar pieces of work in Scotland and Wales resulted in an increase of EM training places and we will work hard to ensure the same in NI. We’ll keep you updated how that progresses.
Spring is also QIP Report publication season. We have already published the final report of our Infection Control and Prevention QIP – which was covered widely in the media – and which concluded that increasing pressures being experienced in EDs since the pandemic have contributed to a fall in the number of infection control measures abled to be implemented. Read more via the link in the newsletter. There will be two more QIP reports – one on Mental Health- Self Harm and one about the Care of Older People in the ED published in the coming months.
These are good examples of the depth and breadth of the work the College does. And if you are interested in getting more involved with our work – be that at a regional level or as a member of one of our committees or professional advisory groups – then please check out the current vacancies which are highlighted in the newsletter.
Lastly, I just wanted to remind you that I and all at the College know and understand how hard you are working and how difficult things are. We appreciate it, and we know from the feedback we get that patients and the public do too. We will keep working tirelessly to secure positive changes for you and your colleagues.
Adrian
This is normally the President’s blog but I am stepping in for Adrian while he is incapacitated.
For those of you who are not aware, Adrian was due to be taking part in a cycling “holiday” which would have seen him undertake the Trans Andean cycle challenge – 1,100 miles over nine days and a daunting climb up to 3,800 metres on gravel.
He was planning to raise money for RCEM Fundraising. Unfortunately, he came off his bike whilst training, and fractured both his hip and collarbone. I am sure you will join me in wishing him best wishes and a speedy recovery.
I am also sure we will hear about his experiences as a patient in future blogs. In the meantime, although we can’t keep him off social media, the VP team are covering his (RCEM) shifts.
It won’t come as a surprise to anybody who works in EM that January has been … well … January. EDs in all four nations are overwhelmingly crowded. RCEM publishes Winter Situation Reports data.
It’s tough, and frustrating that the responses remain inadequate. It still seems that at many levels the need to spin, for political or preservation purposes, outweighs the requirement to acknowledge the reality of what is going on in our EDs.
The latter is a pre-requisite if we are to see the policy, funding and practical changes needed to tackle the problems we face. We work hard to advocate noisily for our members and patients, and to constructively engage with policy makers and health service leaders whenever we can.
In England, it is one year on from the much vaunted Urgent and Emergency Care Recovery plan. NHSE is claiming an increase in 5,000 beds, although there is some uncertainty about how much smoke and how many mirrors have been involved.
Last year we estimated that we needed at least 12,000 additional beds in England alone, so it is little surprise that things don’t feel much better in our departments. In a snap poll of clinical leads the majority felt that in terms of crowding and safety, things have got worse. There is no reason to think that this is anything other than a widespread sentiment.
Currently there seems to be a focus on driving ambulance offloads into our corridors, and on focusing on lower acuity patients. In England, the latter is likely so that NHSE can claim success against the unambitious goal of hitting 76% performance against the four-hour standard.
It is infuriating that we still see targets being chased by putting more pressure on our departments. The focus needs to be on the root causes, and on those patients waiting for beds in every available space. We continue to be vocal on this point.
If you haven’t seen the new crowding guidance it is now published.
We’ve been clear that we shouldn’t have to be publishing it, but we hope it proves useful. There’s a separate blog about it. All feedback gratefully received.
In other news Measles is on the up and is likely to continue to increase. We will be publishing some information but there is already good guidance on the management of measles available. Please see the link in the newsletter.
Importantly, as health care professionals we need to consider our own vaccination status. The advice we have had is that evidence of protection includes documentation of two doses of MMR vaccine or a positive antibody test for both measles and rubella.
This should be available in your occupational health department. Anyone born in the UK before 1970 is likely to have had measles as a child. You can check whether you had your childhood vaccines with your GP, and if not, you can receive MMR vaccination on the NHS.
If you are not sure, you can still be vaccinated. The rate of side effects is lower with second (and subsequent) doses and so it is not harmful to have an extra dose.
It’s soon time for the EMTA conference up in Newcastle (late Feb), and also for the CPD conference which will take place from the 16-18 April at the ICC Wales in Newport. The programme has just been published. Time to book your tickets if you haven’t already. It should be a great event and I hope to see you there.
Our thanks also go to the team from Medics’ Money – Ed Cantelo (Doctor & accountant), Andy Pow (doctor & accountant) and Tommy Perkins (doctor) who last week hosted an extremely informative and practical online session about finances, tailored especially for RCEM members. There is a recording is available – link in the newsletter. And we are already planning the next one.
Finally for this brief blog, we’ve welcomed two new colleagues to the RCEM team. Dr James Gagg has just been appointed to the rebranded role of Vice President Treasurer, and Professor Matt Reed has taken over at the chair of our Research Committee.
There are profiles of both James and Matt on the website (links in the newsletter). They take over from Dr Scott Hepburn and Prof Jason Smith respectively, and we would like to thank both of them for their contribution to our College over the last few years.
If you would like to get more involved in the many different activities that RCEM undertakes for our speciality, there are many opportunities, wherever you are in your career.
They tend to be advertised on the College website, in the newsletter, and on social media. If you are interested but aren’t sure about where you might fit in, please feel free to contact us and we can point you in the right direction.
Please do look after yourselves and each other. There is a range of support options available through the College – details in the newsletter.
There is still joy to be found in EM, whether it’s in our clinical work, service development, training and education, research, or from the other opportunities that our extraordinary skills open up. I remain proud to be an Emergency Physician, and both to be part of, and to represent, our specialty.
Take care.
Higgi,
Ian Higginson,
Vice President
I hope you managed to get some respite from our crazy world over the festive period.
Although there does seem to be a strange ‘medical’ phenomenon that when you take a break from working at 100 mph you get ill. I have heard it referred to as ‘relaxers’ sickness’ (not sure that’s an official ECDS recognised diagnosis!). But it appears I am a case in point.
I was very much looking forward to spending some time with my family over the New Year but found myself banished to another room after getting struck down with a bug – no one wants to hang out with someone with an infectious disease apparently!
And it’s obviously not just me. As you will all be more than aware we are fully into flu season and there has also been a spike in Covid again – so I hope you have managed to avoid the bugs as much as possible.
January is always an extremely busy time in the ED and I know how hard all of you will have been working. On top of the seasonal pressures this year we are navigating some of the added challenges resulting from a prolonged period of industrial action.
The College has previously commented on the strikes – and we recognise the disruption they can cause and the toll their impact can have which is why it is so important that while you are doing all you can to look after your patients, you are doing all you can to look after yourself too.
EM is, by its very nature, fast-paced and stressful. It would be like that if everything was running perfectly – but add in crowding, patients experiencing long waits, multiple competing demands and the moral injury which can be caused by having to practice in these situations, is it not surprising that many EM clinicians are exhausted, disillusioned and burnt-out.
How can you be expected to care for others if you yourself are in need of help and support?
That is one of the reasons I asked Dr Jo Daniels, PIPP Project Lead, Senior Lecturer and Clinical Psychologist, from the University of Bath and North Bristol NHS Trust to look into the issue of burnout and workforce retention in EM on behalf of the College. The findings of her research are published this month in the EMJ and her ‘Impact of staff burnout and how to improve retention’ report is here.
Unsurprisingly it shows across the board, participants reported feeling undervalued due to their basic demands not being met.
Examples cited included things such as ‘sharing toilets with patients’, poorly functioning IT systems, the absence of rest spaces and staff rooms and a lack of private space within hospitals which meant many found it hard to decompress.
The prevailing sense was of ‘just rearranging the deckchairs on the Titanic’ while working in under-resourced and high-pressure EDs. The report’s content is sobering, yet sadly unsurprising.
My thanks go to Jo, her team and all of the clinicians who gave their time and shared their experiences.
This important report makes a series of recommendations and we will be sharing it with parliamentarians and policy makers, and we will use it as part of our advocacy work to help improve things for you.
With the Prime Minister indicating he is planning for an autumn election we will be ramping up that work to influence those formulating the parties’ manifestos, and who will be in power this time next year.
We have already set out a very clear set of priorities that the next government should adopt in order to #ResuscitateEmergencyCare in our own General Election Manifesto and I and my team will be doing all we can to get them implemented.
Part of helping to look after your welfare is making sure you try to get a break from work. As I often tell people, it is important to ‘invest in rest’.
I know given our profession that it is not always possible however and that many of you will be – by nature – ‘active relaxers’. I am.
I am most content on my bike – the combination of exercise and fresh air I find helps to clear the head and clear out the cobwebs. And because I may well be some sort of masochist, I have taken my hobby to the next level and signed up for a rather daunting bike-based challenge.
At the end of the month I – along with a group of similarly minded MAMILs (middle aged men in Lycra) and some (age unspecified) women – are heading off to South America to take part in the Trans Andean cycle challenge. This goes from the Chilean Pacific coast to the Argentinian Atlantic coast, covering 1,100 miles in nine days and a daunting climb up to 3,800 metres on gravel.
And, so that someone benefits from my cramps and creaking bones, I have decided to raise money for RCEM’s charity work at the same time. All money raised will be used by the College to support emergency care in low-income countries and advancing medical research programmes and well-being support for EM staff in the UK.
If anyone you would like to support my efforts, there is a just giving page here.
If I’m up to it I may pop some posts on X (Twitter) along the way so do follow me (@RCEMPresident) if you want to enjoy my suffering!
Right, I’m off to buy some more padded cycling shorts and an industrial sized tub of barrier cream.
Adrian
Adrian Boyle, President, Royal College of Emergency Medicine
@RCEMpresident
Hello,
A busy weekend on call was a reminder of my core job, looking after my patients. I had one of those shifts where every patient had an additional level of complexity. The patient with ureteric colic was also pregnant, the person with the major pelvic fracture also had incidental septic emboli and the child with a benign sounding head injury was a haemophiliac.
We know winter has arrived when the Government starts publishing weekly ED performance ‘sit reps’ – these are statistical bulletins which show in rather stark numerical form the very human crisis we are each experiencing every day in our EDs.
We have made an effort to turn this data into meaningful information. Check it out here – Sitreps 2023/24 | Flourish. This tells me that this winter might still be tough, but maybe not as bad as last winter.
Last Sunday the new Health Secretary Victoria Atkins MP (who replaced Steve Barclay MP in the PM’s reshuffle last month) was doing the media rounds. Speaking on Sky News she promised that the winter crisis was her priority.
But she will have other things on her mind too as on Wednesday, the Junior Doctors Committee of the BMA announced that their talks had broken down and announced two continuous strikes over December and January.
Whatever your view is on the strikes, it is disappointing that the talks have broken down. My condolences go to the rota writers.
And we know the inevitable rise in flu cases is coming. If there is one thing you take away from my musings here – it is PLEASE do get vaccinated against flu.
For some counterintuitive reason healthcare professionals can often be reluctant to get immunised.
And while I respect it is a personal choice, please do give it some serious consideration if you haven’t taken it up so far.
Having the jab protects you, it protects your family, it protects your colleagues, and it protects your patients.
Whatever challenges we are facing here, I am sure you would all agree they are nothing when compared with the horrific situation in Gaza and Israel.
I, and other members of the College, have received numerous communications asking us to make a further statement on the conflict. We have also received many messages asking us not to say anything.
We were a signatory to a statement by the International Federation of Emergency Medicine but we have been urged by members with many different viewpoints to say more.
We had a lengthy discussion at Council last week where it was accepted that a statement from a small medical royal college would have little influence on the conflict itself.
However, it was striking that many members and fellows working in UK departments are carrying significant personal strain about this issue.
We have deliberately avoided any comment on issues which are beyond our remit. You can read it here. This statement will simultaneously be too much and not enough for many people.
November continued to be a busy month with the publication of our report Right Place, Right Care. It is a detailed piece of work published by RCEM but written in collaboration with 16 other leading health care organisations and Royal Medical Colleges. It attempts to capture the learning from last year’s ‘ground zero’ moment in EM and makes a series of practical recommendations aimed at preventing the same thing happening again.
We also saw important changes to CESR come into effect – find out more here and the publication of our latest position statement regarding Pharmacists and Pharmacy Services in the ED.
In last month’s blog I mentioned the College’s new Quality Improvement Programme on Time Critical Medications which had just been launched.
And which is being spearheaded by the amazing and inspirational Dr Jonny Acheson (check out his new video in the main newsletter).
Well, I am delighted that we have already had more than 100 EDs from across the country sign up. If you don’t know if yours is one of them – find out. And if it isn’t, get involved. Patients who need TCM will attend every one of your EDs and it is so important we get their care right.
At the next Monthly Members’ Meeting next week on 14 December, my Vice President Ian ‘Higgi’ Higginson will be hosting a short segment on an important guidance he has put together around ED Crowding. It’s free to join and I would welcome seeing you there if you have half an hour or so.
Now I’m off to see if I can still fit in my best suit after all the Quality Street and Mince Pies which appear in the staff room this time of year, as tomorrow (Thursday 7 December) we are holding one of my favourite events of the year – our winter Diploma Ceremony.
I am delighted to say that for the cohort of graduands who are attending the morning session there will be a very important guest in attendance – our wonderful Royal Patron HRH The Princess Royal which will make the event even more special.
I, and everyone here at RCEM give our wholehearted congratulations to everyone who has worked so hard to get to this special day. Enjoy it – you’ve earned it!
Now, while it is a little away just yet, this is the last newsletter from me for 2023, so it just leaves me to wish everyone a healthy and safe festive period, and a very Happy New Year. It has been an honour to represent you this year.
Adrian
PS – Next month’s newsletter will be sent on Wednesday 10 January 2024.
Adrian Boyle, President, Royal College of Emergency Medicine
@RCEMpresident
