Bulletin October 2015 Number 172

Welcome to the October issue of the Bulletin. I hope you managed to take some time off to relax over the summer, which feels like a long time ago after a busy September.

Annual Report

As a registered charity the College is required to publish a printed annual report; the 2014/15 report accompanies this issue and sets out some of the work the College has done in the last year. You will see that the format and content is rather different this year. We wanted to make the document more interesting for members to read, so have highlighted key facts rather than including reports from every committee. As well as being distributed to all members, the Annual Report is shared with politicians and policy makers to try to increase their understanding of the vital role the specialty plays in healthcare. We hope you like the new format and would welcome your feedback.

As well as the official summary of the year’s achievements, we have also published a more detailed account of the College’s activity over the last year. A few highlights from this Annual Summary of Activity are on page 242 and the full document is available on the College website. It sets out the diverse areas of work covered in the last year, from responding to consultations to assessing candidates in exams. I would encourage you to read this excellent overview of the activities funded by your subscriptions and would like to thank the College staff for their hard work.


Pathology Summer School

One of the highlights of the summer was the second annual pathology summer school, organised by the College, the British Division of the International Academy of Pathology and the Pathological Society. This year’s two-day event was held at St Hilda’s College, Oxford, a beautiful setting for the 70 students and 20 pathologists who attended.

The programme included talks on generic topics, specialty-specific talks and ‘find out about’ sessions, which gave students the opportunity to meet pathologists in small groups.

Feedback from the students was very positive, with 98% saying that they were more likely to pursue a career in pathology after attending the summer school. Dinner on the Friday evening was followed by a pathology quiz, with prizes generously provided by the Association of Clinical Pathologists.

Part of the prize for each member of the winning team was to write a short report for the Bulletin. Next year’s summer school will be held in London but other venues outside the capital are being sought for future events. If resources allow we would like to hold more than one meeting each year and introduce additional specialty specific study days for students who would like to learn more about a particular specialty. If you are interested in helping organise one of these events or would like to be involved in next year’s summer school please do get in touch.

Junior doctors’ contract

The Government announced recently that a new contract would be imposed on all new junior doctors from August 2016. The main gist of the changes to the contract include replacing banding by a basic salary that reflects scheduled working hours, extending routine working hours and reducing the number and frequency of pay increments.

Time taken out of training for research, gaining experience in another specialty or for parental leave will not count towards seniority. Although the College is not a trade union and is not permitted to get involved in negotiating terms and conditions of employment, I feel very strongly that we should support junior colleagues when these changes are likely to affect their well-being, training and ability to provide the best care for their patients. I co-signed a letter to the Secretary of State with several other College presidents, outlining our concerns and strongly urging further negotiation, and a letter highlighting my concern was published in The Times.

By the time this is published I hope to have had further opportunities to raise these concerns, which are shared by College Council.

7 day working

There has been talk for some time about introducing seven day working across the NHS and, as I write, the BMA has just restarted negotiations with the government over the consultants’ contract. In July the Secretary of State for Health gave a speech at the King’s Fund, in which he outlined plans

to impose a new contract if the BMA would not agree to proposals. I issued a response on behalf of the College, which is in the ‘News and Press Releases’ section of the website if you haven’t seen it.

The main point I make is that many pathology services are already delivered around the clock but that without significant sustained investment in training, workforce and organisation it will not be possible to develop a routine 7-day service across all specialties. Spreading the current workforce across 7 days will only dilute the service and is likely to introduce delays while fragmented teams try to communicate effectively.

Cancer Taskforce

In July, the Independent Cancer Taskforce, chaired by Dr Harpal Kumar, CEO of Cancer Research UK, published its report, ‘Achieving World-Class Cancer outcomes; a strategy for England 2015-2020’.

The report identified the importance of diagnostics in cancer care and the significant workforce deficits in diagnostic services but focuses on radiology rather than pathology. The College issued a press release, a long response to the report and a joint statement with the ACB and IBMS, in which we call for investment in pathology staff, equipment and estate as well as better education for users of pathology services and the introduction of IT programmes such as the National Laboratory Medicine Catalogue.

All these documents are available on the College website. I have been invited to contribute to some of the follow-up meetings and will continue to highlight the importance of investing in pathology. I was recently co-signatory on a letter to George Osborne drawing his attention to the recommendation of the Taskforce report and asking him to prioritise funding for the recommended actions in the upcoming spending review. In September Jeremy Hunt announced that several of the recommendations of the taskforce report would be implemented, including an investment of £300 million in diagnostics and national commissioning of molecular testing. He also announced a target of 95% of cancer patients receiving a diagnosis or the ‘all clear’ within 28 days of first visiting their GP by 2020. The Sunday Times printed a letter in which I highlight the need to invest in pathology to meet these targets.

Capacity and training

The three issues above have a common theme –decisions made by Government which will have significant implications for pathology. Many services are already at full stretch and there is insufficient capacity in the system now. Increasing the length of the working week and imposing new targets will not be possible unless capacity is increased rapidly and soon. As it takes over five years to train a pathologist there will be no quick fixes. I will take every opportunity to share these views in the national press, at meetings with politicians and through the Academy of Medical Royal Colleges. In the meantime we are working on finding solutions to the challenges.

Medical Examiners

We are not expecting any news about the introduction of Medical Examiners until after the Comprehensive Spending Review, the outcome of which will be announced on 25 November. In the

meantime we have continued to campaign to keep the issue in the headlines. BBC Inside Out, a regional news programme (with this episode broadcast in the North East and North West) featured families who lost children at Morecambe Bay, Bill Kirkup, who chaired the report into what happened and College fellow Dr Alan Fletcher, who was one of the pilot scheme Medical Examiners. There was associated national print media coverage, in which the College position was quoted. The evidence and Participants at the Summer School support for the introduction of Medical Examiners is overwhelming and I remain optimistic that this will be recognised in the spending review. You can read an interview with Professor Peter Furness, National Medical Examiner, on page 234.

Medical Innovation Bill

As I reported in the last issue, the Medical Innovation Bill, which the College helped to block before the last election, has re-emerged in a slightly different form. Chris Heaton-Harris MP is using a private members’ bill to draft an Access to Medical Treatments (Innovation) Bill. The main purpose of the Bill is to promote access to innovative medical treatment by establishing a database of new medical treatments and encouraging responsible innovation. I attended a meeting with Mr Heaton- Harris at the Academy of Medical Royal Colleges to find out more about what was proposed. The first sticking point was the definition of innovation, which was described as any departure from standard practice but not including research.

There was no appreciation that standard practice can differ in different circumstances or in different parts of the country or that there was a huge overlap between innovation and research. The additional burden on clinicians of recording ‘innovative practice’ on a central register would make it unworkable and there was no answer to the question of who would pay for innovative treatment if its use was not evidence-based or approved by any of the advisory bodies. There is no evidence that doctors avoid giving innovative treatments because of fear of litigation so I believe there is no need to change the law in this area. No thought had been given to what would happen if patients refused to allow information about them to be stored on a central database or how confidentiality would be assured, particularly for rare cancers.

In summary, the College continues to oppose this Bill on the grounds that it is unnecessary and unworkable. The second reading is on 16 October, after which there will be further opportunities to try to influence its content. I will report back in January. Political engagement One of the key roles of the College is to represent its members’ views to the parliamentarians and civil servants who are involved in making decisions about health policy, particularly about where scarce resources are invested.

As well as working closely with Ed Davie, the College’s Public Affairs Officer, and the rest of the communications team, I have found the Academy of Medical Royal Colleges very helpful in providing additional opportunities to raise concerns and promote the role of pathology. I was pleased to meet Heidi Alexander, Shadow Secretary of State for Health, shortly after she was appointed to bring her up to speed on some of the issues facing the specialty.

The Goodman Building

Those of you who have been following the blog on the College website will know how things are progressing with the redevelopment of our new premises, the Goodman Building on Alie Street.

The architects, Bennetts Associates, have drawn up plans and refined them with feedback from College staff and members. Initial discussions with Tower Hamlets planning department have been encouraging and an open day for local residents and businesses was a success, with staff and architects answering questions and demonstrating the plans for the building. The planning application has been submitted to Tower Hamlets Council and we will begin demolition of the current building as soon as permission is received.


College officers and staff work hard to minimise expenditure on College business but inevitably many of our costs increase each year. Although many members haven’t received a pay rise for several years, the College’s expenses have risen considerably. Attracting and retaining high quality staff in central London is not cheap and recent changes to pension and National Insurance regulations mean that the College is paying an additional 4.4% on its wage bill, even before any pay rises are taken into account. There have also been additional costs of not having our own premises, on top of the rent that we are paying for Prescot Street. Hiring external venues for meetings and ceremonies has added considerably to the costs. The cost of train tickets and hotel rooms continue to rise, making meetings more expensive to run. We were fortunate to pay only £2000 a year to lease 2 Carlton House Terrace; not surprisingly 21 Prescot Street costs considerably more than that.

Other significant expenditure includes a completely new website and the appointment of additional staff to support the busiest areas of College work. Please see the summary of the Annual Review of Activity to find out more about the breadth of work undertaken by the College.

While we have reduced activity in several areas to keep costs down, there is still a shortfall which can only be made up by an increase in subscriptions. In addition to the usual ‘cost of living’ increase this year there is an additional charge of up to £30 (for fellows, less for other categories of membership).

This is to cover the additional costs of our temporary accommodation and developing the new building. Although this charge will be consolidated into future subscriptions, it is not anticipated that there will be further increases above the cost of living increase. May I remind members that subscriptions can be offset against tax.

New appointments

I am delighted that we have made some excellent appointments to key College positions over the last few months. Avril Wayte, who has chaired the Wales Regional Council for the last three years, was elected Assistant Registrar in June and took on the role immediately. I am delighted that Avril will continue to contribute to the work of the College and that Esther Youd has been appointed the new chair of the Wales Regional Council, to take up office from the AGM in November.

Esther has been involved in College activities for many years, particularly leading public engagement in Wales. In addition to the new Directors featured in this issue, Dr Bridget Wilkins has been appointed Director of Clinical Effectiveness, and will take up the role from this month. Professor Peter Furness has been appointed Director of Professional Standards, with effect from the AGM in November.

They will reflect on the challenges of their new roles in the next issue. I would like to thank all the fellows who put themselves forward for the Director positions that were advertised earlier this year. We had more than one applicant for all the posts and held competitive interviews to help us select some outstanding individuals who, I’m sure, will make a significant contribution to the College’s work over the next three years.

Several committee chairs come to the end of their terms of office in November and their replacements are currently being appointed under a new, more transparent process. All fellows are eligible to apply and elections are held if there is more than one applicant. We expect all the posts to be filled by the time this goes to print and look forward to welcoming the new chairs in November.

It is heartening to find that fellows are still willing to get involved at the College, despite the pressures of the day job. I’d like to take this opportunity to thank everyone who put themselves

forward for a role and thank those demitting office for all their hard work.

College medal

The College medal is awarded for distinguished service to the College and to pathology in general. It has been awarded 13 times since 1991. Past recipients include Patricia Wilkie and Charlotte Williamson for their work setting up and contributing to the Lay Advisory Committee and Tim Wreghitt for his many years of service to the College, particularly his award-winning Chelsea Flower Show exhibits.

I am delighted to announce that the College medal has been awarded this year to Dr Peter Cowling and Dr Kevin West, who have recently come to the end of their College roles after decades of contributing to a wide range of College activities. Each has held several roles at the College and has introduced important improvements to the work of the College. The medals will be awarded at the New Fellows’ Ceremony in March and citations will be published in a future issue of the Bulletin.

Any fellow can nominate anyone for a College medal or honorary fellowship. Please contact me if you know of someone who deserves this recognition.

Coming up

The next few months will be busy ones for all of us. At the College we look forward to National Pathology Week (NPW), the highlight of our year round public engagement programme. This year, we were fortunate to be successful in the ballot to hold a parliamentary exhibition from Monday 26 to Friday 30 October.

We are also hosting the second International Pathology Day on 18 November. The AGM on 12 November, which all fellows are welcome to attend, will see new directors and committee chairs taking up their posts. We will continue to lobby for investment in pathology and related projects and to speak out about proposals that are unworkable or will not benefit patients. I look forward to attending the first meeting of the Lay Governance Group and to welcoming two new lay trustees to the Trustee Board, ensuring that patients’ views are central to the decision-making process. I wish you a rather early happy Christmas and look forward to reporting back on College activity in the January issue of the Bulletin.