Bulletin April 2016 Number 174

As the dispute between junior doctors and the Government continues,the President has continued to call for the the government to reconsider imposition of the contract in its current form. The President also reports on the implementation of a national system of independent medical examiners.

Junior doctors

The dispute between junior doctors and the Government continues, with Jeremy Hunt having announced that a new contract will be imposed from August and the British Medical Association (BMA) calling a series of strikes, which seem set to continue and escalate if a solution isn’t found soon. Discussions between individual Colleges, the BMA, Government and junior doctors’ groups have so far failed to find a compromise. I have kept closely in touch with the College’s Trainees Advisory Committee, speaking regularly to the chair, Dr Alice Wort, and attending their latest meeting. Trainee members have been in touch with their concerns and I have taken every opportunity to raise these. I have co-signed an open letter with other medical leaders urging a return to negotiations and will continue to support our trainees in their campaign for a fair contract. As the Bulletin goes to press, NHS Employers have published terms and conditions of service for the new contract, indicating that the government is not considering negotiation. The Department of Health also published the Equality Analysis on the new contract. This accepts that there are features of the new contract that impact disproportionately on women but believes that this can be justified. I am concerned that our trainees, 67% of whom are women, will be disadvantaged by the new contract or will be deterred from entering the profession at all. I will continue to call for the government to reconsider imposition of the contract in its current form.

Medical examiners

At last, the long-awaited announcement that a national system of independent medical examiners will be introduced has been made by the Government. From April 2018 medical examiners will review all deaths not referred directly to the Coroner. The College is the lead college for medical examiners and has campaigned for many years for their introduction. There is currently a consultation in progress and members are encouraged to respond individually, copying their responses to the College to inform the College’s response. We understand that the number of responses is important, so the more members who submit their views the better. There is information about the role of medical examiners on the College website and a booklet is being produced to support the consultation and implementation. While there are still some questions about exactly how the system will work, including whether there’s capacity for the anticipated increase in more complex coronial post-mortem examinations and how all aspects will be funded, I believe that medical examiners will play an important role in improving the accuracy of death certification, answering bereaved families’ questions and identifying trends to improve healthcare for future patients.

The Goodman Building

Another long-awaited announcement received recently is planning permission for redevelopment of the Goodman Building, the College’s new premises on Alie Street. After waiting several months, the application was approved in minutes, with no objections to the architects’ plans. We expect demolition of the current building to start in the next couple of months and construction of the new premises to begin later this year. The new building is expected to take around 18 months to construct and fit out, giving an estimated opening date of spring 2018. Please see the website for our regular Alie Street blog, with updates on progress.

Carter report and quality dashboard

In February, Lord Carter published his latest report, Operational productivity and performance in English NHS acute hospitals: Unwarranted variations, which sets out recommendations to improve efficiency in NHS hospitals. One of the 15 recommendations refers to pathology, and recommends consolidation of services if benchmarks are not reached, the introduction of a Pathology Quality Assurance Dashboard and publication of a definitive list of NHS tests and how they should be counted. While efforts to improve productivity and performance are welcomed, we are concerned that decisions will be based on inaccurate data and that enforced consolidation will lead to deterioration in services rather than improvement. The development of a national catalogue of tests is welcomed as long as it builds on the significant amount of work already done on the National Laboratory Medicine Catalogue. As well as identifying areas of concern, the College response suggested alternative solutions, which we will be discussing with representatives of NHS England and NHS Improvement over the coming weeks. Please visit the College website to read the full response.

Clinical Excellence Awards

The Advisory Committee on Clinical Excellence Awards (ACCEA) has announced the closing date for this year’s national awards of 16 May. The deadline for those seeking College support is noon on 19 April. The College is given a quota so unfortunately we cannot support all members. You do not need College support to apply. Following a survey last year and feedback from members, a new panel has been established to rank all applications. Many thanks to everyone who volunteered to join the panel. More information about the process is available on the College and ACCEA websites.

Lay Governance Group

You may remember that two Lay Trustees were appointed last year and have been contributing to the work of College since then. A Lay Governance Group (LGG) has since also been established, made up of newly appointed members and several people who have previously been involved in the College’s Lay Advisory Committee. The first meeting of the LGG was held on 24 March and was a great success. Terms of reference were agreed and members volunteered to join several College committees, ensuring that patients’ views are at the heart of College business.

It is with sadness that I must report the recent deaths of two former members of the Lay Advisory Committee, Karen Sandler and Roger Goss. Karen chaired the Committee and introduced many positive changes. Roger was a member of the LAC and was made a Friend of the College for his contribution and support, which continued until his death. My condolences to both their families.

A global College

This year has been a busy one for travel so far, giving me the opportunity to meet members and colleagues around the world. I have attended meetings with College members in Dublin and Edinburgh and represented the College at the annual International Liaison Committee of Pathology Presidents in Melbourne. It is always interesting to learn about the challenges facing colleagues around the world; not surprisingly they’re very similar to ours. Topics discussed in Australia included quality assurance, demand optimisation, molecular diagnostics (particularly training), personalised medicine, research and valuing junior colleagues.

I have trips to Swansea, Belfast, Nottingham, Manchester and Newcastle lined up over the next few months and look forward to meeting as many members as possible. I welcome any opportunity to meet and listen to members – please do invite me if there’s an appropriate event taking place near you.

Around 20% of the College’s members work outside the UK so I hope you will enjoy reading about some of the work of the International Department in this issue. I am delighted that so many new international and country advisors have been appointed, giving us contacts around the world and enabling sharing of expertise in both directions.

College manifestos

For the first time, the College has published our policy priorities for the upcoming elections in Northern Ireland, Scotland and Wales. The manifestos set out key pathology-related recommendations that we believe will help improve healthcare in each of the countries. There is inevitably some overlap between the three documents: investment in workforce and informatics being vital in all countries, for example. The Northern Ireland manifesto was launched at Stormont in March and was welcomed by the chair of the Northern Ireland Assembly Health Committee. The Wales’ priorities document was launched on St David’s Day and was welcomed by political and health leaders. The Scotland manifesto will be launched soon. Congratulations to the Regional Council members and Communications team for putting together an excellent set of documents, which I hope will raise the profile of pathology and its vital role in healthcare. All the documents are available on the website.

Medical Innovation Bill – final update

Those of you who have read this column over the last few years will know all about the Medical Innovation Bill, which the College opposed as being unnecessary and unworkable. The original Bill, proposed by Lord Saatchi, failed to be passed but was resurrected as the Access to Medical Treatments (Innovation) Bill last year. Following campaigning by many organisations including the College, the Bill was amended to remove what we regarded as the most harmful aspects. The Bill was eventually approved by both Houses and received Royal Assent at the end of March. It is now the Access to Medical Treatments (Innovation) Act 2016 and gives the Secretary of State for Health the ability to establish a database to record treatments that fall outside those currently accepted.

New Fellows

One of the nice things about visiting different parts of the world and different Colleges is attending other organisations’ new Fellows’ ceremonies. The College is always trying to improve our ceremonies to give new Fellows and their families the opportunity to celebrate their achievements and record the milestone in their professional career in the best way possible. Over the last few years, we have responded to feedback by replacing the formal post-ceremony dinner with an informal buffet, providing a crèche so that new Fellows can bring their children and enabling Fellows to bring more guests. New Fellows’ ceremonies are probably the most enjoyable College events that I and the other officers attend – it is wonderful to meet so many new colleagues and their families. I’m often asked how I manage to smile for over 300 official photographs at the ceremony; it’s not difficult on such a happy occasion.

Pathology Summer School

The College has co-hosted popular summer schools for medical students for the last two years. Applications for this year’s school are now open. It will be held on 19–20 August at the Gordon Museum at Guy’s Hospital in London and is open to all UK medical students. I am delighted that the Association of Clinical Pathologists, the British Infection Association, the British Neuropathological Society and the British Society for Haematology have joined the College, Pathological Society and British Division of the International Academy of Pathology in sponsoring the summer school. This secures the future of the event and ensures that it is truly multi-specialty.

Public engagement

Long-standing readers of The Bulletin will recall that I used to be a regular contributor to the public engagement section. As President, my public engagement activities have inevitably had to be reduced but I remain committed to engaging school students and the public with pathology. I still do regular ‘virtual autopsies’, speak at schools and judge science communication competitions. I am looking forward to the Chelsea Flower Show in May, at which the College will have a stand focusing on plants and allergy. The College exhibits are always very popular with those visiting the show, provide a great opportunity to raise the profile of pathology and have won several prestigious medals in previous years.

National Pathology Week remains the highlight of the College’s public engagement programme and plans are well underway for this year’s events, which will take place on 7–13 November. As Council will meet that week in Newcastle, several events are planned in the North East, including a careers fair and virtual autopsy. Please start thinking about what you might do for National Pathology Week this year.

Patron’s Lunch

On 12 June the world’s largest street party will be held on the Mall to celebrate the Queen’s 90th birthday. Representatives of the 600 charities of which her Majesty is patron were given the opportunity to buy tickets. Congratulations to those who were successful in the draw for seats at the College table; it should be a fantastic day. Representatives of the Lay Governance Group, Trainees’ Advisory Committee and College staff will also be present.

And finally…

Congratulations to the RCPath Steppers, a team of six members of staff who took part in Vertical Rush, racing up the 42-storey (932 steps) Tower 42 in London and raising over £1200 for the housing charity, Shelter. I’m considering putting a Fellows’ team together for next year – any volunteers to join me?