Some important success first. You may well know that we have been trying to attract trainees into the profession – and I am really happy that for the first occasion in recent years we are not having to go out to second round recruitment for ST1 training in histopathology in most regions in the UK. There is a decent prospect of achieving a fill rate much nearer to 100% than the previous 72%. The final fill rate is yet to be confirmed, but a full house in round one is a really good sign. This success in attracting high class candidates to the profession has been one of the key features of the work in highlighting pathology, and a low fill rate has been a factor in preventing us being successful in asking for more training posts.
Our undergraduate leads are doing sterling work with attracting students, and those of you with foundation and taster positions are really making a difference. So we are delighted to welcome in all our new trainees, and thank you to everyone, in all our disciplines, making such great efforts to show undergraduates and foundation doctors what a great profession pathology is.
Workforce... and a thank you
Workforce continues to be a major thrust of our efforts across the board. Our census in histopathology has been very effective in highlighting workforce needs in that area, the census in clinical biochemistry is in analysis and the haematology laboratory and transfusion census is now live. We are continuing to ask members to complete these so we have good data on which to base our communications and policy efforts.
Workforce implications of the NHS Long Term Plan are a major source of activity within NHS England and Health Education England (HEE) at the moment, and we have been part of several work streams on this. The high level work to inform the HEE budget of 2019/2020 is expected to be complete by the end of March. We continue to emphasis our need for IT that is fit for purpose, for more training places in all disciplines, and for continuing professional development opportunities for all staff in pathology.
The Topol review of training was published by HEE, and the College has produced a response.
The implications for us include the need to accelerate the pace of provision of resources for digital training. To this end we have proposed creation of a competence-based morphological training platform that will be multispecialty and multiprofessional, to assist the progressive demonstration of competence in line with the range of RCPath curricula. We have made a significant bid to HEE to work with them on the creation of this, and they are keen to pursue, but we await a formal response.
We also have a focus on well-being as part of our workforce efforts. We have supported the Fight Fatigue campaign, and are keen to ensure that training pathologists work in a supportive environment with no bullying, trainees don’t have to change contracts every three months and all pathologists have some flexibility when personal circumstances need this. We have also been supporting a wider campaign to support trainees and trying to stop insensitive and poor practice when dealing with bereavement, illness and difficult personal circumstances. We have heard some terrible things from trainees across a range of specialties and are keen to make sure that support and kindness is a key feature everywhere.
Our profession has a well-deserved reputation for being caring about each other, and we value this. We are generally very caring about our trainees and about each other, and we treasure this about our specialties. Those who care for children, for partners, for friends, for elderly relatives or those who are personally unwell are fortunate to have supportive colleagues. A huge personal thank you to all of you, all over the world, who have, in a time of stress for a colleague, said ‘no worries, I’ll handle it, I hope everything is OK’.
Out and about, and optimising demand
We have been supporting members across the UK and abroad in a range of regional events, and the UK events are logged on the very natty interactive map, to be found on the College website. My lab tours are also logged here.
My most recent lab tour was to Swansea, where excellent pathologists of all disciplines are doing excellent work in a lovely part of the world. I was particularly taken with a very different approach to demand management of erythrocyte sedimentation rate (ESR) tests, where the lab had taken the test off the electronic ordering system and replaced it with a clinical question-based request form. This had the impact of leading colleagues through the appropriate testing basis for ESR, effectively helping them learn what was appropriate. After a very significant and sustained drop in requesting, they reintroduced the electronic system, but the lower rates remained.
Another approach to reducing ESR requesting rates used in East London was the simple one of dropping the test to the bottom of the list! Not as educational, but apparently quite effective. We will continue to share experience on demand management, and this activity is absolutely ideal for the upcoming continuous quality improvement (CQI) awareness month!
I had the privilege of attending the Trans- fusion 2024 event, where the really effective programmes to manage the giving of blood to optimise patient benefit were highlighted. Do take a moment, no matter what your discipline, to look at the patient blood management programme linked to the better blood transfusion initiatives. These programmes are probably the best examples of demand management though teaching and active management, and are relevant to all our members in every country, and of vital importance to our patients.
You are excellent
We had great pleasure in launching the RCPath Excellence Awards. These provide the opportunity to celebrate the work of individuals and teams across a range of categories, and we have had a wealth of nominations. Find out more here.
We hope that this will help to highlight all those currently unsung epic heroes and look forward to celebrating the winners!
We continue to work with NHS Improvement and NHS England on mitigating the effects of the cytology reconfiguration, and remain concerned about the impact on workforce. It has been suggested that a rapid implementation of a limited scope modular histopathology training programme for cervical biopsy and cervical loop reporting, at a level below that of the conjoint qualification, might be one approach that would be very helpful, and we will be exploring this with the Conjoint Board and taking advice.
The College hosted a very key meeting with Mike Richards to help inform his review of cancer screening. We had a very good range of speakers from the cervical, breast and bowel programmes, as well as the neonatal blood spot programme. Other areas covered included training, public engagement, IT and workforce. This was an important meeting to help inform future policy, and we were glad to be able to lead on it.
RCPath and medical examiners
Medical examiner training is being rolled out, with many thanks to Dr Alan Fletcher, Professor Peter Furness, Dr Suzy Lishman and all the members of the Medical Examiner Committee for their speedy and very effective work on this. Dr Fletcher has been appointed National Medical Examiner. The work has been highly effective in engaging professionals across a range of organisations, patient groups and faith leaders.
Online training (I have completed mine!) needs to be followed by face-to-face training, and this second stage of training has been trialled and is being rolled out in many centres (check out all the very helpful information and dates on our website). Dr Lishman has been leading in the face-to-face training, and the feedback has been superb. The RCPathME will be coming soon to a place near you!
Genomics is an evolving, rapidly expanding area and one where we are really fortunate to have tremendous commitment from the NHS. We are working to try to help ensure that the data we need for interpretation is good quality, equality of access is ensured, diversity is addressed, and the results can be understood and correctly interpreted by all those involved in the patient pathway, including patients.
Training and capacity are clearly major features that need to be addressed as we expand the offer, not just for our genetics practitioners, but also for everyone who is involved in patient care dependent on this key information. We are contributing to the discussion and debate on ethics, as well as the implications of open access purchased genomic screening. As part of this we’re meeting with a range of bodies, including the Nuffield bioethics team.