Bulletin July 2020 Number 191

It has been a time of enormous change for everyone, all over the world. We have changed what we do and how we do it, including the services in which we work, in an incredibly short period of time and at a rapid pace with considerable personal effort. We have done this at a time when there has been huge change in our own circumstances in the face of personal loss or significant difficulties.

Change all around us

Thank you for all you continue to do for our patients and for our profession. We really value your skills, your effort and your enormous dedication.

We have also made significant and large-scale changes at the College. You will have seen the speed with which we have been responding to the need for information-specific guidance across a whole range of issues during the epidemic. This has been achieved by the efforts of our Specialty Advisory Committees and Chairs and our Communications department, with exceptional responsiveness to professional needs. Some of the other changes were already planned, but have now been accelerated by the advent of COVID-19 – a digital Bulletin being one of these. The era of posted journals is being superseded by the era of digital media. This is good for both the finances and the environment, and especially good during the epidemic. I do know that there will be nostalgia for the paper format for some, but I hope that you will enjoy this version equally.

Virtual meetings and education

We have moved to online meetings for all our committees, Council and Trustee Board and will continue with the virtual format for the vast majority of College activities, even after the lockdown has been lifted. This approach is both financially and environmentally beneficial. We have run an excellent weekly series of short educational COVID-19 webinars, all free to access. The entire series so far is available on the website for review, and I would commend them to you. All are instructive, and many are very thought provoking and entertaining! I have hugely enjoyed all of them, and they continue weekly. Check the COVID-19 resources hub on the website and register. We are also developing our virtual educational programmes to replace, or in some cases to complement, events that have been deferred, with new themes being planned.

COVID-19 testing

Over the last month we have done a huge amount of work on the development and publication of COVID-19 testing: a national strategy. We have brought the focus back to the purpose of testing, the skills for interpretation and quality control, and the key infrastructure and data connectivity that we need, rather than just numbers of tests being performed. We have the support of 22 organisations and the strategy has been very well received by our stakeholders. We have had excellent media coverage and interest and support from politicians. Feedback from the government has been positive and we are determined to ensure it informs policy development in the UK. Do have a look at it if you have not had a chance so far. It’s a strong message in a clear format.

We have brought the focus back to the purpose of testing, the skills for interpretation and quality control, and the key infrastructure and data connectivity that we need, rather than just numbers of tests being performed.

The College has been heavily involved in the development and championing of an innovative crowdsourcing platform ‘Testing Methods 2020’. This has posed specific challenges for the community of pathologists, laboratory professionals and industry related to COVID-19. Examples have included extraction-free rtPCR methods, alternatives to swab methods and multiplexing. A new challenge has also just been launched on ‘greener testing’ that is being championed by Dr Esther Youd, our Assistant Registrar, who is also our RCPath Trustee Board sustainability champion. This has suggestions on plastic-free swabs, and we are looking forward to ways in which we might be able to reduce our plastic usage for the transport of samples. Do get involved to help spread great ideas and new ways of working!

As we move into the next phase of dealing with the epidemic, and as we try to build back up to some form of normality in our health services, I am acutely aware that many of the problems around lack of workforce, especially in transfusion and histopathology, are still there. With the requirement to isolate for 14 days if ‘tracked and traced’ I have highlighted the specific risks around transfusion staffing and have asked for all Chief Executives of Acute Trusts to urgently risk assess their own service. During my pre-pandemic lab tours I saw several labs with only three people providing a 24-hour service. This is not sustainable.

Digital Now

Yet more change is in development and has been proceeding at pace during lockdown. This includes the design and scoping of a digital learning platform to support morphological learning – the Digital Now project. The platform will help provide graded learning materials in digital format, to enhance learning for both trainees and current practitioners. Members will be able to upload digital slides to the resource to help grow the content and share great cases. I led a successful bid to Health Education England for this and I am very passionate about the possibilities of digitally supported morphology-based learning, with excellent quality-assured content mapped to the curriculum. It will be available to all our members across all nations, as well as registered trainees. Initial work will include the migration of existing suites of histopathology materials, but the platform will be developed for our other specialties, too. I will continue to chair the project and work with the clinical lead Dr Hasan Rizvi and a broad team, including trainees and the College’s Learning department. The project will deliver the platform later this year, towards winter time.

We have continued to put a great deal of pressure on the commissioners of medical and scientific training posts to place more people into pathology training across many of our disciplines. We have done all we can (and have done it well) to increase recruitment into our profession. Following two years of full recruitment into histopathology, there can no longer be an excuse for not increasing the numbers of posts. You may have seen some of the press on this, and we have included the issue in our strategy document, too. We will continue to press on this, and for full digital pathology rollout.

Your input is needed

Proposed changes to the charter, ordinances and bylaws are out for consultation and we would like to hear your views on these. Some of these are simple (members are not all ‘he’!), others are to enhance good governance. The issue of those holding College diplomas being able to vote in elections is also raised, which is very strongly supported by our trainees and Trustee Board.

There is a really important question for you to consider in the communication about rotation of Presidents through the specialties. There is a balance here between an entirely democratic process where any Fellow can stand, and the feeling that the presidency should rotate between specialties. Trustee Board was divided on this, so we are asking you. Please do respond to the email consultation. Any change to this would take effect following the term of my successor.

A new President Elect

With regards to my successor, I am delighted to see Dr Michael Osborn take up office as President Elect. He will succeed me in November and I know he will do a great job. He will represent the College across all our 17 specialties and will do this excellently. I have worked with him closely in meetings with the Chief Coroner and on cellular pathology work. Dr Osborn has served as Chair of the Death Investigations Committee and the Cellular Pathology Specialty Advisor Committee, as well as leading work on the post-mortem portal for COVID-19 and writing many very helpful guidance documents under extreme time pressure during this period.

As I come to the close of this piece, I am acutely aware that many of us have been operating flat out for many months. 13-hour days and working weekends have been the norm for me and for so many other colleagues. We are tired. This epidemic will continue for the foreseeable future, and it has already seen some regional resurgences. Do take some time for yourselves and your loved ones as soon as you can. You deserve a break. Please work with colleagues to plan in some downtime. It might not be sitting on a beach in an exotic location, but it should at the very least include some time to catch up with rest and have some moments of calm.

My very best wishes and grateful thanks to you all.