Bulletin July 2019 Number 187

It is a great honour to work with the College. We are a College of all the talents: scientific, medical and veterinary, supported by our skilled College staff. We diagnose and care for our patients, human and animal. We research and we educate, we develop new diagnostics, new treatments and new professionals. We operate across 17 different specialties.

As you think about the wide range of areas we cover and those we care for, have a thought also to all those who work to set standards and provide guidance, those working in assessment, training, exams and qualifications, those who work with our overseas colleagues, those who work with our undergraduates, foundation trainees, postgraduates, and our public. We have a great and very active membership who participate in all this activity. We thank you all, we would be a poorer healthcare community without you.

Everywhere I go I see amazing work from amazing people. My recent lab tours have taken me to meet pathology teams at St Thomas’ Hospital in London, and to the Personalised Medicine Centre of Excellence at Belfast City Hospital, which included a visit to the superb Northern Ireland seminar and a meeting with the great trainees there. I have also been to Glasgow to visit the amazing reproductive sciences team, who have extraordinary expertise in fertility and pre-implantation genetic diagnosis through embryo biopsy. By the time you read this, I will have been back to Wales for a trainee meeting and the Wales Regional Symposium, which is always brilliant.

We recently had the pleasure and privilege of celebrating some of the superb work of colleagues in our inaugural RCPath Excellence Awards. A joyous process that has highlighted some of the truly brilliant work going on in education, innovation and safety across our specialties. We were able to celebrate with some of the winners at our annual dinner, and I will be meeting with the other winners and highly commended teams over the coming weeks at the College building and in their own organisations. Many of those nominated by their colleagues were unsung heroes, who were very touched to have been recognised. Microbiology, parasitology, virology, haematology, chemical pathology, molecular pathology, autopsy education and more. Their citations from colleagues, on pp160–161 and the College website at www.rcpath.org/rcpath-excellence-awards, are well worth a read.

Some of the work of the Excellence Award winners will be shared across a wider stage. We have suggested some of the work as best practice recommendations for the expanded roll out of rapid diagnostic centres in England. Some such centres already exist in the UK, but there will be many more. These centres are aimed at reducing the time to diagnosis for cancers with non-specific symptoms. Currently, a significant proportion of cancers present in the emergency department, and the hope is that improved early diagnosis will lead to better outcomes. We have successfully advocated in the specification for these that blood cancers are a core part of them, and that chemical pathology and many of our other disciplines need to play a key role.

Many congratulations also to those pathologists recognised nationally in the Queen’s Birthday Honours: Professor Geraldine Thomas for services to science and public health; Professor Lynne Boddy for services to mycology and public engagement in science; Professor Beverley Hunt for services to medicine; Professor James Bonham for services to young people with genetic metabolic diseases. It is a real pleasure to see their sustained, world-leading work recognised.

Early diagnosis has been a theme across our work with Bowel Cancer UK too, and at a visit to 10 Downing Street we presented a petition asking for wider Lynch syndrome screening. It is not equitable or in keeping with the evidence base to continue with the current patchy use. I met George Howarth MP and Norman Lamb MP there, who are both supporters of this. I also talked to several patients with the syndrome, including the amazing Mo Haque, who was diagnosed with stage 4 bowel cancer at the age of 32. His diagnosis has helped earlier diagnosis in his family, and his work with the charity to raise awareness is tremendous.

So, what about the workforce needed to make these diagnoses? The Interim NHS People Plan has been published, and some of the things we have asked for have been included in the document – improving working lives and consideration of pension disincentives. Read our response to the document.

We also welcomed the Migration Advisory Committee’s recommendation to broaden the list of shortage specialties for medics and scientists, as short-term help in the UK while we build up a homegrown workforce. To grow this sustainable workforce, we are also pressing for further increases to the number of medical student places.

Having very pleasingly filled our medical training posts across the UK this year, we are asking for more such posts, and for more clinical scientists and advanced practitioners. Our joint working with the Institute of Biomedical Science and the National School of Healthcare Science (NSHCS) is also one of the key strands in workforce support. The conjoint training programme has been growing in popularity and our Diploma recognition has been well received. Our commitment to healthcare scientists as an integral part of our College remains, and we are pleased that recent discussion with the NSHCS has supported the concept of expanding advanced practice in healthcare scientist training through funded places and a ‘schools’ model. Many departments now have advanced practice dissection as standard in their cellular pathology departments and several have reporting consultant scientists as part of the team. We will continue to push for support for the entire workforce and for investment in IT and digital resources that will help make life easier.

I had a good meeting with the Chair of NHS Improvement (NHSI) Baroness Dido Harding at the College. We discussed all the areas that pathology covers, the work that we do, the expertise we have, as well as the experts behind diagnoses that the patient will never meet. We have had some support from NHSI in leveraging investment in pathology via the networks, seeing investment in digital pathology systems and more modern laboratory systems, to support flexible working and easier linkage and referral – although we are all aware there is a long way to go. We discussed the need for significant capital investment alongside workforce support. Baroness Harding has asked to meet again soon, to spend half a day being shown round a pathology department, and I will be delighted to do this!

We have seen very welcome support from Health Education England for our Digital Now project to create a truly innovative adaptive digital training programme, which will support trainees and flexible learning in many of our specialty areas. This will take a while, and some hard work, but will make a real difference to the way we all train and stay up to date. More of this at another time.

The interim report on cancer screening in England by Professor Sir Mike Richards has been published and, as we hoped, contains key recommendations on most of the items that we have been concerned about: coordinated commissioning, IT and workforce planning. The full report will follow, and we will press for implementation of the changes we have fought for.

Leslie Hamilton’s independent review of gross negligence manslaughter and culpable homicide for the General Medical Council (GMC) has been published. The review tackled issues that arose out of the death of Jack Adcock and the conviction of Dr Bawa-Garba for gross negligence manslaughter. It has sensible and important recommendations. The GMC accepted all recommendations within its remit, which is key for the future. The recommendations on expert witnesses are entirely in keeping with those in the joint work we have carried out with the Academy of Medical Royal Colleges in producing the guidance for health professionals acting as expert witnesses. This is reassuring and helpful.

There is lots more on the agenda for all of us. More detail can be found on the website and real-time updates on Twitter – follow us @RCPath.