Bulletin October 2016 Number 176

The President gives an update on the junior doctors’ contract dispute, the introduction of a national system of medical examiners and the introduction of consolidation targeting ‘back office functions and pathology.’

Junior doctors
At the time of writing, the BMA has just called off the first of a series of five-day strikes following failure to find a resolution in the junior doctors’ contract dispute. I have called on the government and BMA to set aside past grievances and resume talks to bring this dispute to an end. I have talked to many trainees and have kept in close contact with Dr Alice Wort, Chair of the Trainees Advisory Committee, to gauge opinion and to ensure that I understand the issues. I am grateful to the trainees who have taken the time to contact me to share their concerns. The College will continue to support its trainees and to call for a return to negotiations for a fair contract that reflects trainees’ valuable contribution.

Medical examiners
A national system of medical examiners is due to be introduced in 2018. A public consultation, to which the College contributed, closed in June and the responses are currently being considered by the government. Implementation will require input from the Treasury, Department of Health, Ministry of Justice and local government, and so is complex. A Strategy Programme Board has been established, with representation from all stakeholders, including the College. An Implementation Group is also being set up to oversee the practicalities of introducing medical examiners.
The main challenges around their introduction are the cost and the timescale. The College will continue to push for implementation to proceed according to the stated deadlines and for the funding to be adequate for the system to function properly from the outset. The role of medical examiners has been recognised by the Secretary of State as an important part of the work being done to reduce avoidable deaths, and is something that the College has argued for for some time.

Pathology consolidation
You may have seen the letters from NHS Improvement over the summer in which ‘back office functions and pathology’ were targeted as an opportunity to save money. Business plans for consolidation were demanded within two weeks, irrespective of whether that consolidation would be cheaper or provide a better-quality service than the existing arrangement. I wrote strongly worded responses, both individually and as a joint letter with the Association for Clinical Biochemistry and Laboratory Medicine and the Institute of Biomedical Science. I have also been to talk to those leading the productivity and modernisation work at NHSI and NHSE and have further meetings planned, including one with the Pathology Alliance, a group of many of the UK’s pathology organisations.
I have previously asked members with experience of consolidation, both good and bad, to let me know of the issues they faced and how they overcame these. I am grateful to the members who have contacted me to discuss their local services, and I plan to collate the most useful information obtained into a ‘top tips’/‘lessons learnt’ document to help those considering or going through consolidation.

Pathology Alliance
You may not be aware of the existence of the Pathology Alliance (PA), a group of presidents of the following pathology organisations:

  • The Royal College of Pathologists
  • The Association for Clinical Biochemistry and Laboratory Medicine (ACB)
  • The Association of Clinical Pathologists (ACP)
  • The British Division of the International Academy of Pathology (BDIAP)
  • The British Infection Association (BIA)
  • The British In Vitro Diagnostic Association
  • The British Society for Haematology (BSH)
  • The Institute of Biomedical Science
  • The Pathological Society.

We meet regularly to discuss issues of common interest, such as quality assurance, the latest Carter report, how to promote research and international activity. It was following a discussion at the PA that many organisations decided to sponsor the summer school, which has been enormously successful. An additional meeting of the PA has recently been convened to talk to members of the Carter team.

Summer school
The third pathology summer school for medical students took place at Guy’s Hospital in London in August. The original sponsors (the College, Pathological Society and BDIAP were joined by the ACP, BIA, BSH and British Neuropathology Society for a truly pan-pathology event. Seventy-six students from 30 UK medical schools attended a series of lectures and breakout sessions, all held in the historic Gordon Museum, the largest pathology museum in the UK. Twenty pathologists gave lectures and held breakout sessions on topics ranging from regenerative medicine to pathology in far-flung places. The breakout sessions gave students the opportunity to chat to pathologists in small groups on topics such as many of the pathology specialties, leadership and research.
As with previous summer schools, feedback from students has been overwhelmingly positive: 95% of students said that they were more likely to pursue a career in pathology after attending the summer school; and 100% would recommend the event to a friend. Comments included:
‘I don’t think that anything could be improved. What’s already being done is great and the fact that you provide it for free is unbelievable.’
‘Had a wonderful time. I think it is really great that we get to learn so much as undergrads so we can make an informed decision in the future. Wish other Colleges would do the same.’
‘It’s lovely seeing how passionate everyone is about the work they do – I am looking forward to a career in pathology.’
‘I had a great time and gained an excellent insight into a career in pathology. The enthusiasm of all the trainers/consultants was very clear and inspiring.’
‘Thoroughly enjoyed the event and has inspired [me] to start up my own student pathology society at Liverpool.”
You can read about one student’s experience of the summer school on page 276 and see more on the College website.
I am grateful to the speakers and sponsoring organisations for their support of the summer school and look forward to many more such events in years to come.

The Goodman Building
By the time you read this, the current Goodman Building, the property on the site of the College’s future headquarters in east London, will have been almost completely demolished. Hidden behind hoarding for several months, the existing six-storey building has been dismantled from the top down. The Trustee Board signed off the stage-four plans for the new building and appointed Gilbert-Ash as constructors at the end of July. Once the site is completely cleared, it will be handed over to the constructors and building will begin. This is expected to take around 18 months and we hope to be moving into the new building in mid-2018.

End-of-year review and Annual Report
A copy of the 2015/16 Annual Report accompanies this issue of the Bulletin and summarises some of the activity of the College over the last year. It also highlights the role of pathologists in patient care, with several case studies illustrating the vital role of the specialty. This document will be sent to other organisations, parliamentarians, charities and patient groups as part of our campaign to raise the profile and understanding of pathology. I am often asked why the Annual Report (and Bulletin) are not made available to members only electronically, to save money. VAT rules mean that it is actually cheaper to produce printed copies and many members prefer these. It is a legal requirement that a printed Annual Report is produced.
In addition to the Annual Report, there is a separate financial summary, circulated to members only. You will see that the College’s outgoings were greater than its income last year, which is not a position that the Trustees would usually endorse. However, the additional expenditure was planned and relates to the extra costs incurred as a result of being in temporary premises, such as office rent and the cost of venue hire for large meetings. The cost of these was incorporated into the overall financial plan for the move from Carlton House Terrace to Alie Street and so was anticipated and budgeted for.
If you would like additional copies of the Annual Report to give to your Trust Board or to use as part of a public engagement event, for example, please let us know.
In addition to the Annual Report, the College staff have recently published their end-of-year review. This summarises all the work done by College staff on behalf of members and is available on the College website. Despite being so closely involved in all aspects of the College’s activities, I am always amazed at just how much work is done and progress made each year. If you’ve ever wondered what your subscriptions are spent on, have a look and find out!

Next President
The next President of the College will be elected in October and will spend a year as President-Elect before taking up office in November 2017. Five candidates have put their names forward, so an election will be held during October, run by the Electoral Reform Society. The closing date for voting is 24 October. If you haven’t already voted, please do so before the deadline. Each candidate has completed a 500-word statement, a link to which is provided in the voting email. In addition, candidates had the opportunity to answer a set of questions, suggested by members, to give them an opportunity to address some of the most important issues and to minimise the need for canvassing, which is discouraged. These are in the members’ area of the website – please do have a look if you’d like to learn more about the candidates and their vision for the College.
When the Trustees decided to change the electorate from Council to all Fellows in 2012, a long discussion was had about how to avoid ‘tribal voting’, i.e. members voting for candidates from their own specialty irrespective of merit. We also considered how to ensure that the smaller specialties were represented among future Presidents. Solutions such as weighting votes from different specialties and having a rule that consecutive Presidents must be from different specialties were considered. However, in the end it was agreed that a good President could represent all specialties and that it was more important to elect the best person for the job. So the election is one member, one vote, with no restrictions on the specialty of future Presidents.
My most important message is to please use your vote and encourage colleagues to do the same. The election process was changed to give Fellows the opportunity to have a say in who leads their College and the more Fellows who vote, the stronger the mandate the President will have to represent your views.

And finally…
I would like to congratulate the International Team for being shortlisted for an award in the International Collaboration of the Year category of the Times Higher Education Awards 2016 for their work on the LabSkills Africa project. There were a record number of entries in this category and it is a huge achievement to have made it this far. I will report the outcome in the next issue.
Many congratulations also to Consultant Clinical Scientist Dr Tim Lang from Durham who has been shortlisted for the 2016 HSJ Awards in the Rising Star category for his work on minimum retesting intervals and public engagement activities. The results will be announced towards the end of November.