At the time of writing this I’ve been in post for just a few days but have already represented the College at the General Medical Council, Royal College of Physicians and Academy of Medical Royal Colleges. I have met politicians and journalists to try to drum up support and publicity for some of the major issues facing pathology. The learning curve is steep, I probably haven’t processed so much new information since I started medical school, but it’s been fascinating so far.
I am looking forward to the challenges of being President. During my time in office I hope to raise the profile of pathology so that the users and commissioners of pathology services can see the value of what we do and how much more we could do with the right support. We need to target medical students to educate them in the requesting and interpretation of pathology tests; something that the College’s new undergraduate membership scheme, joint annual summer school and public engagement programme have started to address.
Increasing early exposure to pathology is also likely to improve recruitment, attracting the high-calibre entrants that the profession needs. NHS England has just set out its five-year view of how we can develop even better quality and more efficient care. With over 70% of diagnoses relying on pathology we need to ensure that the specialty is at the forefront of the innovation and leadership that will be required to deliver this vision.
I would like to begin by thanking the immediate past-President, Vice-Presidents, Directors and Council members who demitted office at the AGM in November. Together they delivered a phenomenal amount of work, giving their time and expertise for the benefit of the profession and patients. I would also like to thank their families and colleagues, who supported them in this important work.
There are over 2000 separate roles filled by College Fellows, meaning that at any one time around a third of members working in the UK are involved in College business. As well as our UK members, many international members are also taking time to volunteer to identify opportunities overseas for engagement, project collaborations and membership development.
Apart from a handful of remunerated posts, the majority of this work relies on the goodwill of members, their colleagues and employing organisations. It is getting increasingly difficult for members to fit additional duties into their job plans and many trusts are clamping down on external activities.
This is not a new problem; the 25th anniversary issue of the Bulletin in 1987 included a report of concerns about finding volunteers. While trusts are encouraged to release consultants to do work on behalf of the wider NHS by the Chief Medical Officer, many choose not to, and the recommendation cannot be enforced. Payment for College Officers is a topic that is discussed regularly at Council and the Academy of Medical Royal Colleges.
A calculation was done last year to work out what it would cost to reimburse employing organisations for the time spent on College work by their employees – the total came to over £4 million. Membership and exam fees would have to almost double to cover this cost, obviously that is completely unacceptable. A suggestion has been made that at least the officers’ trusts should be reimbursed (officers cannot be paid directly as they are trustees of the charity). Some other Colleges pay for the time of their officers. The RCGP covers the cost of a locum for its officers and the RCPI covers the cost for the term of its president. Reimbursing trusts for the officers’ time would cost in the region of £250,000 – much less than the £4 million to pay for all working on behalf of the College but still unaffordable without an increase in income.
I will explore possible alternative sources of funding. Council Several new Council members and Honorary Officers took up their roles at the AGM in November. They join a strong group of existing Honorary Officers and Directors, several of whom have held College roles in the past. Interviews have recently been held (or are about to be held) for Directors of Training and Assessments, Examinations, International Affairs and Communications, who will complete the team.
You can find out more about the new Vice-Presidents on page 7. The table on page 4 shows the composition of the new Council. Representing all specialties It is important that the College Officers understand the issues facing all nineteen pathology specialties and the different professional groups who work in them.
Members of all specialties, particularly the smaller ones, are encouraged to take on College roles to ensure that as many specialties as possible have a voice in the decision-making processes. Members from under-represented specialties have been co-opted onto College Council.
For the first time, an Honorary Officer will liaise with every Specialty Advisory Committee, attending meetings, working closely with the Chair and representing the specialty to the Trustee Board and other general committees. Leadership I was delighted to be invited to the final day of the Leading Transformational Culture Change leadership course in November.
Twenty-five pathologists and radiologists had come to the end of a ten-month programme, which aimed to equip them to take on roles as clinical leads and directors. The participants gave short presentations about their experience of the course and the quality improvement project that they undertook as part of it. Posters summarising their projects were also on display.
The final day was an opportunity for the delegates to bring supporters to join them in a celebration of their development. Everyone present voted for their favourite posters and presentations and prizes were given at an awards ceremony. It was very good to meet all the participants and to hear about the work they had already done as a result of what they had learnt on the course.
Their achievements were impressive and I have no doubt that they will go on to even greater things. The obvious question now is whether the course will be repeated. Originally funded by the Academy of Medical Royal Colleges and the Royal Colleges of Pathologists and Radiologists, there is no funding currently available to repeat the course.
One of my first tasks as President is to try to secure funding so that more Fellows can have the opportunity to attend similar courses in future. Making lives easier Many of the challenges I’ll face as President can be predicted, such as implementing the recommendations of the Pathology Quality Assurance Review or responding to the Shape of Training Report. Others are less predictable, and responses are often required quickly, if not immediately.
There are also constant changes in the way the College works on behalf of its members – new staff are appointed and new projects developed. When faced with approving or responding to these challenges my plan is to ask ‘what would make members’ lives easier?’ All doctors employed in the NHS are working very hard, are under pressure to reduce SPA time whilst completing a lot of mandatory training.
The College can’t remove the necessity to comply with regulation but it can try to make participation as easy as possible. The Learning team, for example, led by Vice-President Professor Tim Helliwell, are looking at ways to increase the number of CPD opportunities provided by the College, keeping the cost to a minimum and considering venues outside London to make attendance easy for as many members as possible. Online learning, including through the e-Learning for Healthcare project, will make accessing learning material remotely much easier. As digital pathology becomes a reality, the College is in a good position to lead its implementation, particularly in relation to training, assessments and CPD activities.
The College’s two main income streams are subscription and exam fees. No one likes having to pay these, but they form an essential part of College revenue. I am often asked how the College can justify increasing subscription fees in line with inflation when members’ salaries are not increasing at the same rate.
This is because many of the College’s expenses go up each year, including utility bills, staff wages, insurance and venue hire for example, at a rate that is greater than inflation.
Many savings were made as part of the College’s 50-year review in 2012, significantly reducing the number of meetings and size of committees. This saving has been essential for the College to continue its work. All College fees are kept under constant review and efficiency savings made where possible.
Regional visits Over the last three years the Honorary Officers have visited Belfast, Dublin, Glasgow and Cardiff to meet members and answer questions about the work of the College. Digby Ingle, the Colleges’ Regional Coordination Manager has also travelled the country, meeting College representatives. This programme of regional visits will continue over the next three years. I would like to visit as many parts of the UK and meet as many members as possible during my term of office and will be working closely with Digby to develop a programme of visits.
It makes sense for officers’ visits to coincide with a scientific or regional meeting that members are already attending. Please get in touch if you would like to host a meeting in your department or university or are aware of an event onto which an officers’ visit could be added.
I would also like to consider holding some of our Council meetings outside London.
Do let me know if your organisation has an appropriate venue we could use. An open meeting for all local members would be held to coincide with the Council meeting. Lay representation One of my priorities over the coming months is to strengthen lay representation at the College. The Lay Advisory Committee was disbanded last year but patient representatives have remained involved in many of the College committees.
Dr David Bailey, Vice-President for Communications, is leading work on how best to involve patients in the work of the College. Options being considered include a regional network of lay people, a central committee with regional representatives or a combination of the two. Meetings with patient groups and lay members of other Colleges have already begun and will help inform the Trustee Board’s decision. Summer school January seems very early to be thinking about the summer but plans are already underway for the second annual pathology summer school, to be held in August.
Last year’s school was organised in partnership with the British Division of the IAP and the Pathological Society but other specialist societies will be invited to get involved this year.
As the College is unlikely to have a permanent home by August, this is a good opportunity to hold the summer school outside London. Venues being considered include Oxford, Leeds, Bristol, Newcastle and Glasgow. Lessons will be learnt from the extensive feedback collected after last year’s school, with consideration being given to making the course longer and more interactive.
Volunteers to participate in the summer school will be sought nearer the time. Engaging policy makers You may have seen the College’s response to the Labour Party’s recent announcement that all cancer test results will be available within seven days of the patient first seeing their GP. When pressed, the Labour Party acknowledged that they didn’t mean all test results, just the initial investigation such as a scan or endoscopy.
It seems there was little consideration that pathology might have a role in the diagnosis of cancer. Andy Burnham’s team seem to have accepted their omission and are keen to meet regularly to learn more about the issues facing pathology. Topics discussed at our first meeting included funding for implementation of the National Laboratory Medicine Catalogue, which will otherwise run out in March 2015, and the stalling of the introduction of the Medical Examiner system, which has been postponed until after the General Election.
We also discussed the progress of the Medical Innovation (Saatchi) Bill, which the College has opposed since the outset. Even with recent amendments we remain concerned about the potential detrimental effect on clinical trials and the voluntary nature of reporting treatments and outcomes. I have raised these concerns with several politicians and encouraged them to oppose the bill or slow its passage.
Meeting members of the Labour party is just the start of a process of engagement with policy makers. I am planning to meet members of the other main political parties over the coming months in the run up to the general election. Get in touch Many of you have already been in touch to share your views on the work of the College and the role of the president. I welcome your input and feedback and encourage you to contact me on email@example.com. I look forward to meeting of many of you as possible over the next three years and to welcoming you to the College if you visit our current, temporary or new home.
Dr Suzy Lishman