College VOICE Edition 14 Sample

C O L L E G E

WORKING DIFFERENTLY IN THE SHADOW OF COVID-19 ON THE RISE:

LTFT WORKING

FOR DOCTORS IN TRAINING

INEQUALITIES IN DENTAL HEALTH

The time for change is now SAMPLE VERSION View the full version on your member dashboard ISSN 2632-0185

FOR MEMBERS OF THE ROYAL COLLEGE OF PHYSICIANS AND SURGEONS OF GLASGOW

EDITION 14

PODCAST

Join Digital Heritage and Engagement Officer, Kirsty Earley, as she interviews a brand new set of guests for season 3 of Body of Work. Tune in to hear from a variety of professionals who have a connection to the College and learn about their careers, passions, and weird history obsessions!

Episode 15 - Professor Miles Fisher

Retired diabetologist and past Vice President (Medical) Monday 6 February 2023

Episode 16 - Elena Trimarchi

Learning and Engagement Manager at the David Livingstone Birthplace Museum Monday 13 March 2023

Episode 17 - Mr Thisara Weerasuriya

Specialty Surgeon in Trauma and Orthopaedics Monday 10 April 2023

Episode 18 - Maggie Reilly

Former Curator of Zoology at the Hunterian Monday 22 May 2023

Episode 19 - Jane Chiodini MBE

Travel Health Specialist and past Dean of the Faculty of Travel Medicine Monday 12 June 2023 Listen to Body of Work at

rcp.sg/heritageevents

or on Spotify, Apple Podcasts, Google Podcasts, Buzzsprout and more

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EDITION 14 4

UPDATE FROM THE PRESIDENT

8

WORKING DIFFERENTLY IN THE SHADOW OF COVID-19

13

ON THE RISE: LTFT WORKING FOR DOCTORS IN TRAINING

20

GLOBAL HEALTH SPOTLIGHT: ST ANDREW'S CLINICS FOR CHILDREN

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THE UNEQUAL BURDEN OF OBESITY?

36

HOW WE BECAME A ROYAL COLLEGE

+ 6

NEWS BITES

18 OPHTHALMOLOGY MEMBERS’ AREA 26 COLLEGE UPDATES

16

30 EDUCATION CALENDAR

THE TIME FOR CHANGE IS NOW

VOICE is the magazine of the Royal College of Physicians and Surgeons of Glasgow. If you are interested in contributing to VOICE please email media@rcpsg.ac.uk Copyright 2023. The text and images in this publication may not be reproduced without permission from the Royal College of Physicians and Surgeons of Glasgow. To request permission, please contact the Creative Manager.

Produced by the office of the Chief Executive Officer and Strategic Marketing and Digital.

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TC WHITE CONFERENCE PRESENTATION AWARD REPORT

32 EXAMINATIONS CALENDAR 34 NEW MEMBERS WELCOME

Editor Fraser Paterson Design Kirsty Smith, Steven Pirrie Print Winter and Simpson Print Photography Nick Callaghan, Ian Marshall, Chris Watt, Lorraine Hannah, Kirsty Earley Royal College of Physicians and Surgeons of Glasgow 232 - 242 St Vincent Street, Glasgow, G2 5RJ +44 (0) 141 221 6072.

Registered Charity SC000847.

EDITION 14

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FROM THE PRESIDENT

W

elcome to Edition 14 of College Voice, which I hope will bring some support and diversion at this time of considerable concern for all involved in the UK National Health Service. Usual winter pressures have combined with high numbers of Covid and influenza infections, and ongoing issues in social care, to produce a capacity crisis in our hospitals, which is the worst many of us have ever experienced.

The current crisis follows almost three years of disrupted service provision caused by the pandemic. This has resulted in unprecedented waiting lists for elective care, disrupted training, education and assessment, low morale among trainees and trainers alike and difficulties in retention of the NHS workforce across all disciplines and at all career stages.

Workforce issues have been a key College workstream for several years and the data from the Physician Census run by the three UK Royal Colleges of Physicians (p8) confirms the ongoing challenges of staff shortages across medical specialties. The related article on less than full time training (p13) reports on the growing numbers opting to pursue a better work life balance, perhaps in response to the impact of the pandemic, not only on the health service as an institution, but on trainees themselves.

It is wonderful to read of the opportunities for new learning and experience afforded by our College Scholarships (p27) and of work in Global Health (P21). I also urge you to consider the impact of climate change on human health, and the impact of healthcare delivery on carbon output, recognizing the challenges for all of us, as outlined by College Scottish Clinical Leadership Fellow, Alice Harpur, as she reflects on the President’s Conference 2022 (p17). The team from Obesity Action Scotland, housed within our College, describe the obesity crisis and the differential impact it has across our society (p23) This is a subject which College will be addressing in the coming year as we consider our response to the widening gap in health inequalities.

One day, I hope we will look back at this challenging time with some pride and satisfaction that we did our best in difficult circumstances as did our predecessors in the early years of the NHS when they sought to develop postgraduate education in what was then the Royal Faculty. The story of our change of name to become a Royal College (p37) records their effort, diligence, and pragmatism.

Our College is actively involved in discussions about the current NHS crisis with all specialties in primary and secondary care, governments and devolved administrations, the BMA, the GMC and others. We are here to speak up for the professions and are doing so. Please let me know if the College can be of more specific assistance in any situation you and your colleagues are facing by emailing me at president@rcpsg.ac.uk

RCPSG.AC.UK

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HYBRID CONFERENCE

Interactive Cardiology Conference Friday 10 March 2023 9am - 5.30pm GMT

We look forward to welcoming you to this hugely popular, always sold out event. This year’s programme will offer comprehensive updates on key contemporary topics and will provide a practical approach to the management of frequently encountered clinical scenarios. We will welcome national and international experts, who will present reviews of the latest evidence shaping the rapidly changing landscape of cardiovascular medicine.

As in previous years, this year’s conference will include keynote lectures, interactive case based discussions, and poster presentations. In addition, for the first time this year, you’ll hear a nursing perspective, and a first-hand account of the patient experience. These unique insights will enhance your knowledge of all aspects of cardiovascular healthcare.

rcp.sg/Cardiology2023 #RCPSGCardio

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NEWSBITES JANE CHIODINI PRIZE LAUNCHED AT ANNUAL TRAVEL MEDICINE CONFERENCE A new prize was launched at the College’s Annual Travel Medicine Conference by Professor Sir Chris Whitty, who paid tribute to Jane’s work in the field of Travel Medicine.

The prize recognises the outstanding contribution to Travel Medicine Education made by Jane Chiodini MBE, and will be awarded annually to the highest-performing student in the RCPSG Postgraduate Diploma in Travel Medicine.

The Diploma commenced in January 2022, and the first intake of students will complete their studies in June 2023.

The recipient of the prize will receive a cash award of £250, and will be invited to attend the Annual Conference of the Faculty of Travel Medicine.

Jane Chiodini MBE MSc, RGN, FFTM RCPS(Glasg) QN began nursing in 1973 at St George’s Hospital in London and undertook subsequent postgraduate training in neurosurgery and neuromedicine, as well as completing midwifery training. Her interest in travel health began when a practice nurse in the 1990s. Jane undertook a distance learning travel health medicine course at the University of Glasgow and graduated with a Master of Science degree in Travel Health Medicine in 1998.

Since that time, Jane’s career has developed in travel medicine and she has held a number of prestigious positions in relation to this, both nationally and internationally.

Her involvement with the Royal College began in the early 2000s when she was a personal advisor and tutor on the Diploma and Travel Medicine courses run initially by the University of Glasgow and subsequently with the College in conjunction with Health Protection Scotland. In 2006 Jane was one of the founding fellows of the Faculty of Travel Medicine in the College, and between then and 2017 held positions on the Executive Board of the Faculty, including as Honorary Secretary and Education Director. In 2017 she became Dean-Elect and subsequently Dean of the Faculty of Travel Medicine, being the first female Dean of this Faculty and the first nurse to hold the position.

Throughout her career Jane has been a leading figure in the world of Travel Medicine education, strongly advocating for high-quality academic and practical training for those involved in the delivery of travel medicine. She has tutored, mentored and examined countless individuals through their careers and education, and created and delivered material to thousands of nurses, doctors and pharmacists involved in travel medicine.

Maintaining and raising standards has also been a priority for Jane and during her Deanship she was instrumental in leading the publication of the Good Practice Guide for Providing a Travel Health Service, which sets the standards of care for practitioners in travel medicine. Jane also drove forward the establishment of the Professional Development Certificate in Travel Medicine and the RCPSG Postgraduate Diploma in Travel Medicine, for which this prize was given.

Jane was awarded an MBE for her services to training and development of travel medicine in 2022. The College recognises Jane’s role as an inspirational contributor and leader in relation to all elements of education for travel medicine.

RCPSG.AC.UK

SURGICAL COLLEGES LAUNCH GREEN THEATRE CHECKLIST Leaders from three of the UK’s surgical Royal Colleges have come together to declare a climate emergency as they launch new guidance for those in the profession aimed at reducing the environmental impact of surgery.

In response to the ongoing environmental crisis, the Royal College of Physicians and Surgeons of Glasgow, The Royal College of Surgeons of Edinburgh and The Royal College of Surgeons of England, which collectively represent over 75,000 healthcare professionals, have co-authored the ‘Green Theatre Checklist’.

The checklist includes a range of suggested actions to reduce the environmental impact of operating theatres, and the experts who have devised this intercollegiate strategy are hopeful it can eventually be rolled out and introduced as a new standard for operating theatres around the world.

While surgery saves millions of lives and betters the lives of many more, there is an environmental cost, with a typical single operation estimated to generate between 150-170 kgCO2e the equivalent of driving 450 miles in an average petrol car.

The greenhouse gases used in anaesthetic, the heavy plastic usage to uphold hygiene standards, and other industry specific reasons mean surgery contributes heavily towards global healthcare’s production of carbon emissions, estimated at around 4 to 5 per cent of total carbon emissions per year.

The Green Theatre Checklist can be found on our website at: rcp.sg/GreenTheatreInitiative

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THE COLLEGE WELCOMES DR CHRISTINE GOODALL AS DEAN OF THE FACULTY OF DENTAL SURGERY Dr Christine Goodall has been elected Dean of the Faculty of Dental Surgery at the Faculty’s Annual General Meeting which took place on 11 November. She succeeds Mr Andrew Edwards.

Christine is a Professor of Oral Surgery and Violence Reduction at The University of Glasgow’s School of Medicine Dentistry and Nursing, Lead Clinician for Oral Surgery at NHS Greater Glasgow and Clyde and one of the Directors of the charity, Medics Against Violence.

She has held several college roles including examiner and convener for the MFDS Part 2, Director of Dental Examinations, and Vice Dean of the Dental Faculty. Most recently she served as a member of the College Wellbeing Committee and as Dean-elect.

Christine’s research interests lie in the fields of alcohol, violence and facial trauma. Her work with facial trauma patients over many years led to her founding Medics Against Violence in 2008. The charity now runs several programmes across Scotland that aim to prevent violence and support vulnerable groups.

She is an Honorary Member of the Faculty of Public Health, a Founding Fellow of the Faculty of Medical Leadership and Management and was awarded an OBE for her work in violence prevention in 2016.

She was a member of Project Lift’s first ‘Leadership Cubed’ cohort.

On taking up the post of Dean, Dr Goodall said: I am honoured and delighted to have been elected and I look forward to the opportunity to play such a leading role in the work of our Faculty, particularly as we continue to meet the challenges faced by our membership which have only been exacerbated by the pandemic.

I’d like to place on record my thanks to Andrew Edwards who has been a great support to me in my time as Dean-Elect and I know all in our Faculty are grateful for his service.

As Dean, I hope to focus on the areas of inequality, wellbeing and sustainability in promoting the interests of our profession and our patients. I can’t wait to get started.

HONORARY FELLOWHIP AND PRESIDENT'S MEDAL AWARDED AT DIPLOMA CEREMONY An Honorary Fellowship and the President’s Medal were awarded at the College’s latest Diploma Ceremony in November.

Professor Brian Kennon received an Honorary Fellowship of the College in recognition of a decades long career at the forefront of diabetic care.

Professor Kennon graduated from Glasgow University with MBChB in 1993 and continued his education by completing his Doctorate in 2003 before becoming a Fellow of the College in 2005.

He was appointed consultant diabetologist at Queen Elizabeth University Hospital in 2004 where his main sub-specialty interests include diabetes foot care, adolescent transitional diabetes services and utilising technologies to improve diabetes care.

He uses his passion and commitment to promote awareness of the issues facing people living with diabetes in Scotland through managed clinical network groups and in recognition of this he was appointed by The Scottish Government in 2017 to the post of National Lead for Diabetes in Scotland and chair of the Scottish Diabetes Group as well as Speciality Adviser for Diabetes & Endocrinology to the Chief Medical Officer Scotland.

Jason Leitch received the President’s Medal for his work during the Covid pandemic, often communicating complex messages at an uncertain time.

Professor Leitch – a Fellow of our Faculty of Dental Surgery - has worked for the Scottish Government since 2007. In January 2015, he was appointed as The National Clinical Director in the Health and Social Care Directorate.

Jason is an Honorary Professor at the University of Dundee. From 2005 to 2006 he was a Quality Improvement Fellow at the Institute for Healthcare Improvement, in Boston, sponsored by the Health Foundation. Jason is also a trustee of the UK wing of the Indian Rural Evangelical Fellowship which runs orphanages in southeast India.

He qualified as a dentist in 1991 and was as a Consultant Oral Surgeon in Glasgow. He has a doctorate from the University of Glasgow and Masters in Public Health from Harvard. He is also a Fellow of the Higher Education Academy.

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WORKING DIFFERENTLY IN THE SHADOW OF COVID-19:

THE 2021 UK CENSUS OF CONSULTANT, HIGHER SPECIALTY TRAINEE AND SAS PHYSICIANS

Graphics - Royal College of Physicians of London

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Two and a half years since the UK’s first national lockdown, Covid-19 continues to have a major impact on the NHS, its staff and patients.

The pandemic has created new challenges for everyone working and training in the health service and has required us to re-think the way we deliver care. The latest annual census – conducted jointly with the Royal College of Physicians of Edinburgh and the Royal College of Physicians in London – provides crucial insight. It helps us better understand the issues that consultant and trainee physicians across the UK are currently dealing with, and how the workforce is set to change in the years ahead.

Key findings Only

10

Full-time consultants worked

%

48

%

Contract

more than their contracted hours While those working less than full time worked

20

%

of advertised posts were filled.

This has decreased year on year, and is the lowest rate recorded to date

20

more than their contracted hours, mainly due to clinical workload

%

74

%

of the current consultant workforce will have reached their intended retirement age by 2025

More than half of physicians did not take all of their annual leave entitlement

of consultant and SAS physicians said they undertook some work remotely

EDITION 14

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GEOGRAPHICAL DISTRIBUTION OF HSTS

The census reveals that over half (52%) of advertised consultant posts were unfilled in 2021. This is the highest proportion of unfilled posts since current records began in 2008, and the first time that more than half of advertised posts went unfilled. In three-quarters of cases, posts went unfilled because there were simply no applicants.

The census also shows that workforce pressures will become even more severe without determined action. Almost half (44%) of the consultant physician workforce is set to reach retirement age in the next decade. At the same time, demand for care will increase as the population ages: the ONS projects that the number of people aged 85 and older will double between 2020 and 2045. In this context the wellbeing and development of trainees, who represent the future of the NHS workforce, is particularly important.

The census shows that Covid-19 Missed training opportunities due to Covid-19 has had a significant impact, with Outpatients 67% three-quarters (74%) of higher specialty trainees (HSTs) missing Local teaching 64% training opportunities. They also Exposure to procedures for training 50% missed out on providing outpatient care (67%), local teaching (64%) Worked in an environment not 30% relevant to my training and gaining exposure to procedures (50%). Nearly a third (30%) Discuss patients with senior colleagues 21% had been required to work in an Clinical supervision meetings 13% environment that was not relevant to their training.

Other 8%

Full time and less-than-full-time working – HSTs

29%

LESS-THAN-FULL-TIME WORKING IS ON THE RISE

18% 71%

LTFT

FT

7%

82%

LTFT

93%

FT

Full time and less-than-full-time working – consultants

LTFT

FT

42%

25%

58%

LTFT

FT

13%

75% LTFT

87%

FT LTFT

RCPSG.AC.UK

FT

Another key trend for both consultants and HSTs is the continuing rise of less-thanfull-time (LTFT) working. A quarter of consultants and 18% of HSTs worked LTFT in 2021. A higher proportion of women worked LTFT: among consultants, 42% of women compared with 13% of men, and among HSTs 29% of women compared with 7% of men. Coupled with the fact that the proportion of women in the workforce is rising – 39% of consultants and 52% of HSTs were women in 2021, compared with 23% and 42% respectively in 2004 – this has important implications for workforce planning. Two-thirds (62%) of HSTs would like to work on a less than full time basis due to wanting an adequate work–life balance (83%), avoiding burnout (73%) and gaining exposure to other aspects of medicine such as quality improvement, research and leadership (65%). This suggests that the demand for LTFT will only increase, so we will need a higher overall number of doctors.

The NHS must plan now, and government must enable it to do that.

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OUR SOLUTIONS

A long-term solution requires proper workforce planning that aims to match supply of clinicians with demand for care, and the sustained investment necessary to deliver it. But even if that was done today, the length of time it takes to train a doctor means we won’t see the impact for many years, so we also need to think about what we can do now. We have used the findings of the census to emphasise the urgent need for action to ease pressure on the NHS workforce. In short, we need to increase the workforce, improve retention and support doctors who are approaching retirement.

Enabling physician associates to play a bigger role in the delivery of care would be an important part of increasing capacity within the workforce, so we need to bring them into regulation at the earliest opportunity.

While overseas recruitment should not be seen as the primary solution to the workforce crisis, without further significant investment in training more people in the UK this will have to be part of the short- and medium-term solution. And formalising the foundation interim year 1 programme and reforming the CESR system to make it easier for SAS doctors to become consultants are other measures that can be taken.

Next steps

Equally, improving retention of the existing workforce is crucial. We need to get the basics right by ensuring access to hot food and drink and rest facilities at all hours of the day, as well as allowing staff time off for significant life events. Helping employees access affordable childcare is also important, along with enabling staff to work flexibly and remotely as working patterns change. It is also vital to support clinicians who are approaching retirement to continue working for as long as they want to, in a way that works for them. Fundamental to this is finding a permanent solution to issues around pension taxation so that senior consultants are not forced to reduce their hours. Employers should work with doctors in their early 50s to minimise burnout by reviewing job plans, as well as facilitating and supporting retire and return arrangements.

Everyone working in the NHS understands the scale of the challenges it currently faces, and that tackling the workforce crisis is fundamental to dealing with them. This is not beyond us, but swift and decisive action is needed to ensure that our health and care service is there for everyone who needs it in the years ahead. We eagerly await the NHS workforce strategy commissioned by the Secretary of State and expect it to address everything we have mentioned here, and more.

We will continue to:

1

use the census data in our discussions with government about the need for accountability and transparency in workforce planning

2

work with governments across the UK and our partners to double the number of medical school places, and increase the number of training posts

3

work with the NHS across the UK to help develop the workforce strategy commissioned by the secretary of state for health and social care

4

£0

highlight the urgent need for transparent job planning and scrutiny of the amount of work that goes unpaid

5

identify and promote ways of encouraging trainees to work in specialties and locations with the largest recruitment gaps

6

make the case for the UK to be accessible and welcoming to trainees and doctors from other countries.

EDITION 14

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