|Professional challenges, common ground|
|Friday, 01 October 2010|
Neil Dewhurst, President of the Royal College of Physicians of Edinburgh, discusses areas of shared concern for surgeons and physicians
Now more than ever, mutual aspirations and challenges mark the relationship between surgeons and physicians, and between the two Edinburgh Colleges. Both institutions are committed to setting the highest standards; both too have a heritage with which to inspire trust in our memberships and the wider community. Indeed our memberships are closer than we sometimes recognise – a recent case in point is the welcome appointment of Iain Macintyre, a former RCSEd Vice-President, to the editorial board of the RCPE’s journal.
Above all, surgeons and physicians face a number of mutual professional challenges. Primus inter pares is that of revalidation. The RCPE’s response to the GMC consultation is largely supportive. However, we have called for a workable system that will earn the confidence of the public and the profession, and for simplifying the specialist standards and frameworks to reassure doctors that the task they face is manageable and will evolve as clinical information systems mature.
‘As there is unlikely to be a return to long working hours, solutions to these difficulties must be found’
Most profoundly of all, we believe that standards should be viewed as a benchmark against which individual doctors measure their own practice. Appraisal – as part of revalidation – should aspire to support all doctors to improve their practice continuously. Revalidation must not become a proxy for minimum standards.
Another mutual challenge is, of course, compliance with the European Working Time Regulations. There is evidence to suggest a significant disparity between the number of rotas which are compliant on paper and in reality, and that the implementation of the EWTR has had a deleterious effect upon training, patient safety and consultants’ work/life balance. As there is unlikely to be a return to long working hours, solutions to these difficulties must be found.
A third, related issue is that of consultants’ supporting professional activities, in the light of moves by some Trusts towards 9:1 contracts. Consultant physicians, like surgeons, require sufficient time in their contracts to perform the non-clinical activities that are key to maintaining high professional standards, a situation that will be exacerbated by the additional requirements of revalidation. While there must be some degree of flexibility, it is essential that sufficient SPAs are maintained.
Finally, it remains to be seen how significant the expected cuts in public sector spending will be following the global economic crisis. In parallel, political and public opinion would appear to be turning against the development of specialised centres of excellence, which the Colleges believe could provide a higher standard of specialised care than can always be provided locally.
With so many pressing professional and political concerns at stake, it is all the more important that the Colleges continue to work in the interests of public health, as well as their members. The RCPE, for example, is heavily involved in smoking and alcohol advocacy and legislation. But without the participation of our memberships – and without seeking to champion their views as widely as possible – the Colleges would simply cease to exist. Surgeons’ and physicians’ requirements for training and support vary significantly, but the challenges facing us both, in individual and collegiate terms, demonstrate how much we have in common.