Bulletin Number 195

Hello and welcome to the July edition of the Bulletin. It has been a very busy period for our members and the College on many fronts since the last Bulletin.

Our work across the devolved nations

Following the elections in Scotland and Wales we are developing relationships with their recently re-elected governments. We are looking forward to working with them to ensure that our priorities for pathology services, outlined in our College manifestos, are met. We are writing to the new Minister for Health and Social Services in Wales, Eluned Morgan MS, and the new Cabinet Secretary for Health and Social Care in Scotland, Humza Yousaf MSP, to highlight the key areas on which we would like them to focus. We are showcasing the vital role pathologists play in research, advancing medicine and devising new treatments to fight viruses, infections and diseases.

In Northern Ireland, the Department of Health published Elective Care Framework, Restart, Recovery and Design. The Framework proposes a £700m investment over five years and plans to reduce the backlog of patients currently waiting for assessment and treatment. It commits to supporting the Pathology Network so Health and Social Care Pathology Services are equipped to support delivery across all relevant Rebuild programmes.

This is a good start towards tackling the backlog, and the progress of the regional pathology modernisation, combined with the digital pathology roll-out, will improve throughput. That said, we still have serious concerns over the backlog and the related surge of demand for pathology services, particularly for cancer diagnosis and treatment, both tissue and blood cancers. See more about our advocacy in the article from our Public Affairs Officer, Janine Aldridge, on page 415.

Northern Ireland and Wales symposia

The recent Northern Ireland and Wales symposia gave me the opportunity to discuss issues pertinent to those nations and virtually meet trainees. Such meetings help to inform our plans for how to champion the pathology needs of these nations. I was just disappointed I could not attend these beautiful areas in person, although I have been promised an ‘Ulster Fry’ in Northern Ireland next year and have agreed to walk a section of Offa’s Dyke in Wales as part of the College 60th Jubilee celebrations next year.

Investing in the future of pathology services

I and members of the College have continued to make the case for investment in pathology services with politicians, policymakers and stakeholders. College Registrar, Dr Lance Sandle, and College Fellow, Dr Mohammad Raza, Consultant Virologist, attended a virtual roundtable meeting organised by the King’s Fund on the role of point-of-care testing in preventing the spread of communicable disease and, in particular, respiratory disease.

Other members of the College have also had recent speaking engagements, for example, Professor Darren Treanor spoke at the Westminster Health Forum conference on the use of Artificial Intelligence in Healthcare, and Professor Sarah Coupland, College Vice President for Communications, spoke at a Westminster Health Forum event on the next steps for the use of genomics in healthcare.

I was delighted to present at the British Association of Gynaecological Pathologists on ‘Pandemic tales’, and at the Association for Clinical Biochemistry and Laboratory Medicine’s UKMedLab21 event on Workforce Issues and Solutions for Cellular Pathology. I covered the core work of our pathology specialties during COVID-19, redeployment, lost training and the College’s ongoing work with health education bodies and the NHS in England and the devolved nations to try to address these issues. I was also recently interviewed by The Pathologist discussing what it is like taking up the role of President in a pandemic, where I see pathology in 10 years’ time and more.

The cancer backlog

Following a productive meeting with Elliot Colburn MP (Conservative, Carshalton and Wallington) and Macmillan Cancer earlier this year, we were very pleased to see Elliot Colburn MP write to the former Secretary of State for Health and Social Care Matt Hancock to highlight concerns over backlogs in cancer services.

Continuing with the College’s lobbying activities in this area, I spoke at the #CatchUpWithCancer roundtable discussion and cancer summit events hosted by the All Party Parliamentary Group for Radiotherapy, All Party Parliamentary Group on Cancer and All Party Parliamentary Group on Health. These events brought together experts from across the cancer healthcare community with parliamentarians to discuss and highlight the cancer backlog and the issues relating to reducing it, particularly around pathology and diagnostics. These discussions informed the Catch Up With Cancer – The Way Forward report, which made recommendations to the government. With 40,000 ‘missing’ cancer patients and referrals down 350,000, urgent action is needed. Along with 70 MPs, heads of medical colleges and leading oncologists, I signed a letter addressed to the Prime Minister urging him to accept the recommendations from the summit and asking to meet with him to discuss the urgent response needed to tackle the COVID-19-induced cancer backlog.

Secretary of State for Health and Social Care

I have written to the new Secretary of State for Health and Social Care, Sajid Javid, offering my congratulations on his recent appointment. I outlined the College’s serious concerns over preparations to deal with the backlog of cancer care, and other serious illnesses, and the surge of demand for pathology services as a result of the pandemic. We need increased investment in pathology services, particularly in the recruitment and training of pathologists and scientists. I have also requested a meeting to discuss these areas in more detail and invited the Secretary of State to visit a pathology laboratory to see first-hand the amazing work of our members.

Improving diagnostic pathways

The College was delighted to support a new report, Crohn’s and Colitis Care in the UK: The Hidden Cost and a Vision for Change, published by the IBD UK alliance, of which we are a member. The report looks at issues in diagnosing Crohn’s and colitis, and poor care after diagnosis − their findings show people wait too long for diagnosis and just 8% of inflammatory bowel disease services have enough histopathologists.

I was also very pleased to contribute to the National Institute for Health and Care Excellence (NICE) impact report on diagnostic pathology. Focusing on NICE guidance where uptake data was available, the report covers how NICE identify and support adoption of new diagnostics, uptake of NICE-recommended pathology diagnostics and diagnostic pathology during the COVID-19 pandemic. This guidance was produced using evidence provided by our members and gives us a useful NICE-recognised benchmark against which to highlight pathology issues going forward.

Lobbying for additional training posts

The College continues to highlight the issues facing our profession and our activities and discussions with policy makers and stakeholders are bearing fruit. After years of lobbying, Health Education England (HEE) has put funding towards an additional 35 histopathology training posts in England, with the aim of the posts being recruited to in the current recruitment round. They will increase the current annual intake of histopathology training posts by about a third.

HEE has also allocated an additional four haematology training posts. These new posts will go some small way to alleviate the workload issues in these specialties, although it will take many years before these posts translate into working consultants. There is still a huge amount of work to be done in these and all our specialties in terms of addressing staffing and other service issues, but it’s a start.

The medical examiner and coroner services

We were very pleased to receive a letter from Nadine Dorries MP, Minister of State for Mental Health, Suicide Prevention and Patient Safety, thanking the College for hosting the Medical Examiner (ME) Conference in April. She recognised our support in the implementation and roll out of the ME system, including the delivery of the ME training programme and the ME committee. As the lead medical royal college for MEs, we welcome the roll out of the ME system to cover deaths in non-acute and community settings. It is another important step towards creating a world-leading system of death investigation and patient safety improvement, with every death in England and Wales that is not reported to a coroner being scru-tinised by an independent ME. Crucially, it will also give all bereaved families the opportunity to ask questions or raise concerns about the care of a loved one. The College has trained over 1,500 ME and ME officers, and expects to train many more over the coming months.

The College also welcomed the report from the House of Commons Justice Select Committee on the Coroner Service. The report follows on from evidence that I and others gave to the Justice Committee in September 2020. I spoke alongside the Coroners’ Society and the Chief Coroner highlighting the shortage of pathologists to carry out post mortems. We are pleased that the report contains a number of recommendations to address the shortage of pathology services, including the call for an immediate review of and increase in Coroner Service fees for pathologists.

Supporting the implementation of College guidelines

The College has introduced an exciting new member benefit in response to a survey about how our clinical guidelines are being used and how we can support their implementation. Created by the Clinical Effectiveness team and the Working Group on Cancer Services, with the help of many members, this webinar programme is led by guideline authors to provide support in imple-menting new or revised clinical guidelines. The first webinars in the online learning programme were hugely popular. Please see our website for more information about future webinars.

Volunteering for the College

Many of our activities depend on our members volunteering to become involved in College and without these roles the College could not function. We thank you all for your help and hard work. We celebrate our volunteers each year during Volunteers week and this year we profiled three colleagues who contribute to College work. From a specialty advisor role on a College committee, to being a College examiner, to joining the Pathology Portal editorial board, there are many ways you can become involved in helping to shape and guide our work. Whoever you are, whatever your field of work, wherever you work, there’s a role for you at the College.

We also have lay representative volunteers who form the College’s Lay Advisory Group, helping to support members in delivering excellent patient care. We now have a new Lay Trustee Board Member, Vince Voon, who is already providing active input into College activities. We welcome Vince to the College. I asked Vince for his thoughts a couple of months on from his appointment and he shared the following:

'I joined RCPath as a Lay Trustee in May 2021 and it has been a pretty immersive experience so far. I’ve also had various introductory calls that have been very helpful in understanding the workings of RCPath. Everyone has been incredibly welcoming to such an extent that I feel I will suffer from some level of ‘imposter syndrome’ but hopefully, will be able to genuinely contribute to the great work being done!

On the subject of great initiatives, I have been hearing about the work on diversity and inclusion (D&I) and am really impressed as to how important it matters to the Trustees and the Council. I won’t steal the thunder from the D&I Advisory Group on their forthcoming initiatives but just wanted to share a few initial thoughts.

My personal view is that as D&I features more and more on the strategic agenda, we need to focus on the specific issues we wish to solve − whether it’s challenges in career progression, having a more representative workforce, members’ training or having more positive role models.

There’s also something about becoming more of a ‘listening organisation’, how we embed this in our culture and how we hear (and learn) from staff and members’ experiences. A cultural narrative that visibly demonstrates that we are listening and addressing these issues.

Thank you for the warm welcomes from everyone I’ve connected with and I look forward to meeting more of you in the months to come.'

The College’s Strategy 2021−2024

The College’s three-year strategy has recently been published and our key strategic aims include delivering high-quality member services; developing and maintaining high standards of education, training and research; promoting excellence and advancing knowledge in pathology; increasing the College’s influence through a clear, coherent, professional voice; and resourcing the future development of the College. These are the areas we plan to focus on and, through this focus, we will build on the previous successes of the College and ensure everyone feels we work to help and support them. Further details of the College’s strategy are available on our website.

Congratulations

The spring exams are now over and I would like to congratulate all those who have passed their RCPath exams in this recent session. This is a major achievement, especially in the context of the challenges presented by the pandemic. Our thanks and appreciation must also go to our amazing examiners and the fantastic College Exams team who, together, have successfully delivered another round of examinations, many of them online in very difficult circumstances. We have learnt a huge amount about running online exams during the pandemic and have been working hard with our trainee representatives and other members to plan how best to develop and run our exams in future. We expect most Part 1 exams will be online while most of our other exams and vivas will be in person (circumstances permitting). In this way, we can maximise our resources and make exams as COVID-19 proof and as stress free as possible for all involved.

Finally, on 12 June it was our patron Her Majesty the Queen’s birthday and College members were among those named in the Queen’s Birthday Honours alongside other colleagues working in health, medicine and science. These are awarded to recognise the outstanding achievements of people across the UK and it is fantastic to see the vital work of our members recognised. This includes those whose work made a crucial difference to the impact of the pandemic, but in many other areas as well.

College members were awarded the following honours: Dr Jonathan Paul Sheffield awarded Commander of the Order of the British Empire for services to medical research particularly during the COVID-19 response; Professor Marie Ann Scully awarded Order of the British Empire for services to blood disorders; and Professor Anthony Walter Rowbottom awarded Order of the British Empire for services to pathology during the COVID-19 pandemic. I would like to offer my congratulations and to thank them for all their work during such a challenging and difficult time.

Thank you all for your continued support to the College. I wish you a sunny, happy summer.