News and views from The Royal College of Emergency Medicine. Please use the "On this page" menu below for contents.
I hope you all manage to get some holiday and downtime over the summer.
I enjoyed a family road trip across Western Canada and recharged myself for the coming turbulent months.
The spectacular scenery reminded me once again why it is so important we continue to do all we can to look after our amazing planet.
Which is why I am pleased to hear that our GreenED initiative, which launched at the start of July has been so well received with sign ups already coming in. If you don’t already – follow them on X (formerly Twitter) at @GreenED_uk
Clinical work continued to be busy, the persistent industrial action in England creates new ebbs and flow.
I must confess to a slight sense of bereavement as many of my post graduate doctors in training move on to other posts.
But this is tempered by being able to meet a whole new cohort who start this week. Welcome to the best specialty in medicine!
Good training depends on good relationships and these take time to cultivate. I was delighted to attend a couple of regional conferences, thanks to Sue Dorrian for inviting me up to the West Midlands, and Sally-Ann Wilson to the Yorkshire Wildlife Park.
Summer is traditionally a time where the College regroups and does some necessary behind the scenes maintenance.
We are gearing up for a busy Political Party Conference season.
The long-awaited Long-Term Workforce plan for England was finally published. We think it better to have a workforce plan than not, but many questions go unanswered, not least around the apparent silence on training numbers.>
Council will be considering the plan in detail and working with NHS England and the Department of Health and Social Care to make sure it helps us look after our patients better. We are increasingly concerned about progress against the Urgent and Emergency Care Recovery plan and little reassurance was provided by NHSE’s winter plan unveiled at the end of July.
We are consistent that the harms from long stays are mainly suffered by the horizontal not vertical patients, and that the solution is adequate capacity and staffing. We continue to keep a beady eye on both the number of beds and the length of hospital stay and express our concerns at Ministerial level.
See our campaign to improve care. Resuscitating Emergency Care
Dr Adrian Boyle
President, Royal College of Emergency Medicine
@RCEMpresident
North West Regional Meeting – all welcome!
Dear North West members,
We’d love to see you at our next regional meeting on 12 September, which we’re planning will be in the early evening. We’ll have a clinical speaker, as well as a session on supporting CESR trainees. We want to make sure as many of you can come along so please email NWchair@rcem.ac.uk to say whether you would come to a virtual meeting on Teams, a face-to-face meeting if it was East of the M6 or a face-to-face West of the M6 (or indeed if you would come to any of these options!). We can then firm this up and send on the full details once planned, with exact timings.
Many thanks, Andy Ashton
Yorkshire & Humber learning event
It was great to see so many of you at the Yorkshire & Humber Regional Board’s learning and networking event in June, at the Yorkshire Wildlife Park. Run in association with the Faculty of Emergency Nursing, 60 delegates enjoyed a variety of presentations on topics ranging from an update on burns management, intensive cave medicine and even how to tame your gorilla! Thank you for supporting this event and we look forward to the next one!
Scotland
Now is the time to plan to avoid another catastrophic winter.
That was the warning from RCEM Scotland Vice President Dr John-Paul Loughrey, after the latest performance data for Scotland was published in June. It showed it was the second worst June on record, with 116,244 attendances at major Emergency Departments. Despite this, A&E performance in Scotland is slowly trending in the right direction.
Dr Loughrey said members continued to work hard to reduce delays, mitigate dangerous overcrowding and improve patient care and the figures were in no small part thanks to them, but warned that now was the time to take action.
“To capitalise on these improvements, we hope to have continued engagement with the Health Secretary and support from Scottish Government,” he said. “Now is the time to plan and prepare for winter and provide adequate resources and beds as well as measures to retain staff. Our #ResuscitateEmergencyCare campaign lays out the necessary steps we need to take to ensure the health service is equipped to deliver effective, high-quality care and prevent another catastrophic winter.”
Headlines were:
The number waiting more than four hours was an increase of 296% compared with June 2021.
Northern Ireland
Northern Ireland performance figures published in June saw some of the worst Quarter 1 performances on record.
RCEM NI Vice President Dr Russell McLaughlin, said the figures provided “a depressing yet accurate” reflection of emergency healthcare in Northern Ireland and urged the Northern Ireland Executive to reconvene to “get a grip of the situation”.
“Our members are working tirelessly to provide the best care possible in these increasingly difficult times, but they lack the beds, resources, and staff they need, and they can only stretch themselves so far. It is a challenging and demoralising situation,” he said.
“Action to improve this unacceptable situation is urgently required but without a functioning Executive, we continue to head towards winter which is an iceberg looming on the horizon. The Northern Ireland Executive must reconvene to get a grip of the situation and #ResuscitateEmergencyCare before we head into the inevitable increased pressure of winter.”
There were 172,931 attendances at Type 1 (Major EDs) A&E services in Northern Ireland for Quarter 1 2023/24. On average 45% of attendances at A&E services were seen and resulted in a subsequent admission, transfer, or discharge within four-hours; the worst Quarter 1 performance on record. 15.8% of attendances at major A&E services spent 12-hours or more in an A&E department, equal to more than one in every six patients. This is the worst Quarter 1 performance on record.
In England the RCEM EM Workforce Census is now live for you to complete! Has your department submitted its response yet?
Talk to your colleagues and Clinical Lead to make sure you have your say in the staffing needs for your department by responding to our Workforce Census. This is our chance to evidence staffing issues across the country; our census projects in Scotland and Wales led to an expansion of training places. If you are a Clinical Lead, you can access the online census link here. If you are not, we urge you to pass this onto your Clinical Lead or another relevant colleague. To view the questions in advance of submitting and to collate the necessary information, you can download a PDF of the questions here.
Thank you in advance for your time. If you have any questions, please email census@rcem.ac.uk
The GreenED programme is based on a framework of evidence-based actions that improve the environmental sustainability of an Emergency Department (ED), divided into bronze, silver and gold levels, along with the tools and guidance to help achieve them.
The GreenED website is now live and you can explore the open-access resources, benefits, how to get involved and sign up to the programme online.
Signing up gives access to the Framework, which is available on an online portal hosted on the GreenED website.
Joining GreenED will also give access to a comprehensive package of support, and on completion the option to apply for formal accreditation from RCEM.
Online Q&A
To support the launch of GreenED we are holding an online Q&A session on 18 July 7-8pm.
This is one of a series of networking events we run via our Emergency Sustainable Care Network, hosted by the Centre for Sustainable Healthcare.
We recommend joining the network to connect with others working to a sustainable NHS.
You can read more about the GreenED launch here: Setting standards for green emergency healthcare/.
Follow GreenED on social media @GreenED_UK and get involved.
Thank you for reading. If you have any further questions or want to contact the GreenED team, please email greened.rcem.ac.uk.
Annual Scientific Conference
Date: 26 – 28 September 2023
Places are filling fast for the Annual Scientific Conference taking place online and in-person in Glasgow. This year the programme brings together cutting-edge emergency medicine research through the evidence in practice sessions, plus sessions on mental health and psychiatric care in the ED, toxicology, AI and technology, and care of older people. Book your onsite or virtual space today.
Caring for patients with learning disability, autism or complex needs in the ED
Date: 6 September
This virtual study day will look at opportunities to enhance care for autistic people and people with a learning disability. Hear from public health experts, learning disability specialists, allied health professionals, patients, families and ED physicians. Plus, explore the patient’s pathway through the ED and the role emergency staff play in improving outcomes. Register now.
ACCS Careers day
This event will provide information, inspiration and advice to doctors considering specialty training via the ACCS route (including Emergency Medicine, Acute Medicine, Anaesthetics and Critical Care). Aimed at foundation year doctors or clinicians with less than 24 months clinical experience who are interested in a career in acute care specialties – please pass it on to anyone you know that may be interested. Book today.
Date: 12 October
Catch-up with on-demand events
All our virtual events are available for booking on-demand for 9-months after their live date. This means if you’ve missed a study day you can register and watch the whole thing whenever it suits you. Current on-demand events include:
The University of Bristol is conducting research to improve diagnostic and referral pathways for patients with suspected papilloedema from primary to secondary care (DIPP study) and we need your help.
We would like to find out how emergency care clinicians manage referrals for suspected papilloedema in your region (we’re surveying other health practitioners as well).
If you would like to take part, please click this: https://redcap.link/dipp-study-surveys. You will find our information sheet, consent form and the survey, which should take ~20 minutes (although you can stop and return to it any time).
If you have any questions, let us know: dipp-study@bristol.ac.uk
We’ve launched our new campaign to tackle the problems facing Emergency Medicine. Five Priorities for UK Governments to #ResuscitateEmergencyCare lays out what UK governments must focus on to tackle the crisis, improve patient care, retain staff, and prevent harm. The five priorities are:
You can read the full recommendations here, and the press release here.
RCEM’s National QI programme has moved from 3 annual audits of 6 months of case recording with a focus on data collection to 3-year QIPs focused on improvement and action. Change takes time, good data and a lot of teamwork. This will be recognised in the building of all new national QIPs.
Each year we will develop one new QIP to enter the rotation of project offerings. Once developed a 3-year programme of change will be commenced with an increased focus on connecting the network to share best practices and the national topic teams themselves to help bring forth innovative ideas that might work in other EDs local contexts.
We are inviting YOU to submit your vision for October 2024 – October 2027 QIP cycle.
The only limit on the ideas is that they must have a Emergency Department patient focus. Old audits may be reimagined with a QI focus. Novel ideas are equally welcome. If you are passionate about an area of emergency care that you believe needs to be prioritised, make your case here.
Submissions with be reviewed by the QI co-chairs and other committee members. Successful submission(s) will form the precursor to further development. Successful candidates will also be welcomed to join the national topic team that will then develop the idea into a fully realised national QIP.
This is an opportunity to have your patient-care concerns tackled more directly at a national level, with tens of thousands of pounds of funding supporting an IT platform, dedicated staff and the committee more generally to build robust QIPs and promote improvement.
Deadline: 23:59 – 31 August 2023
https://docs.google.com/forms/d/e/1FAIpQLSdmafHSnKMOrrUFuzaWpIo6cg1NKiaSS1sOj2VutjMSM47Psw/viewform?usp=sf_link
Quality Improvement is now an integral part of what EM trainees are expected to engage in throughout their training. This is encapsulated in the QIAT, marked by the educational supervisor, and submitted at each ARCP.
Are you an EM educational supervisor? Do you want to know more about SLO 11 in the RCEM Curriculum? Would you like to learn more about QI methodology so that you can support your trainees more effectively? If so, this training day may be just the thing for you.
It covers RCEM Curriculum requirements for QI, interactive workshops on key aspects of QI, guidance on supervising a trainee and a detailed exploration of the QIAT and how to mark one. The day is open to all trainers, including Specialty Tutors and local QI leads.
When? September 14, 2023, 10:00 – 16:00
Where? Royal College of Emergency Medicine 7-9 Bream’s Buildings, London, England EC4A 1DT
RCEM QUALITY IMPROVEMENT TRAIN THE TRAINER COURSE PROGRAMME
14TH September 2023
10:00 QI Assessment in the RCEM Curriculum
10:30 Choosing a topic
11:00 Initial analysis of your problem
11:45 Generating change ideas
12:30 Lunch
13:15 Working with others
14:00 Measuring
14:45 Supervising your trainee through their QI project
15:15 QIAT marking workshops
16:00 Staying in touch with RCEM
OBJECTIVES
• Understand how Quality Improvement sits within the RCEM Curriculum, and how it is assessed
• Gain a basic appreciation of the key elements of Quality Improvement
• Become better-equipped to supervise and support your trainee through their QI project and submission of their QIAT
See More and sign up – Train the trainer course programme
Get involved!
Committee Vacancy – Service Design and Configuration Committee Chair post – APPLICATION DEADLINE 15TH AUGUST
Volunteering Opportunities | RCEM
Committee Vacancy – Service Design and Configuration Committee member post – APPLICATION DEADLINE 20TH AUGUST
Volunteering Opportunities | RCEM
Committee Vacancy – Professional Advisory Group Member – Emergency Preparedness, Resilience, and ResponseProfessional Advisory Group (EPRR PAG)
Volunteering Opportunities | RCEM
College Assessors wanted!
The College routinely sends a College Representative, also known as an Assessor, to attend recruitment panels across the UK (in-person and virtually) for consultant appointments interviews, known as Advisory Appointment Committees (AACs). Having an Assessor on a recruitment panel ensures transparency, fairness and equality is achieved for the candidates and appointing trust.
RCEM would love to extend the list of Assessors to improve availability and diversity while also relieving pressure on the Assessors who already support us. If you’re interested, more information can be found here, or email: AAC@rcem.ac.uk if you’re keen to sign up.
Our latest podcast discusses some of the best papers published in the July 2023 issue of the Emergency Medicine Journal (EMJ). Sarah Edwards (Social Media Editor of EMJ) and Rick Body, (Deputy Editor of EMJ) talk through topics on pre-hospital assessment of chest pain, management of pain in the emergency department and some thoughts on improving the experience for the waiting patient. Read the highlights here
You can also subscribe to the EMJ podcast via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify, to get the latest podcast every month.
If you would like to keep up to date with the latest content from our journal, please sign-up to receive eAlerts.
