Referring to the GMC news that 25,000 doctors have successfully renewed their licence to practice, the Academy is pleased with the progress made in the first year of Revalidation – it gives us confidence that a robust system of checks is in place.
However, it is important to understand in more depth the reasons for the number of deferrals, and we will be exploring this with the GMC.
Read the GMC statement hereWednesday, 04 December 2013
The Academy of Medical Royal Colleges Flexible Careers Committee has published the results of it's 2012 Flexibility and Equality Survey.The survey was devised to identify, and subsequently quantify, important current issues for less than full time doctors. It asked:
- If consultants, SAS doctors and trainees currently working less than full time are experiencing difficulties in working LTFT
- How frequent are these difficulties?
- What types of difficulties are commonly encountered?
- How (or if) they are resolved?
- Whether or not working LTFT currently restricts the ability to take on additional roles and responsibilities?
Key findings from the survey showed that:
The report recommends an action plan for College and Faculty less than full time officers to take forward with their respective organisation.Please see the Flexible Careers Committee webpage for more details about its work.Monday, 02 December 2013
- 23.5% of women, 35.5% of men and 42.0% of those declaring a disability or long-term health problem had difficulties when negotiating the time commitment of their current contract
- 24.5% of women and 25.0% of men reported that they had been bullied at some point in their career
- 58.6% of 251 respondents felt they had been subjected to persistent undermining behaviour as a consequence of their LTFT working
- Only 39.7% of female respondents reported taking on additional roles compared to 86.7% of male respondents
- Only 36.8% of respondents currently have a mentor.
Speaking on the Government's full response to the Francis report, Professor Terence Stephenson, Academy Chairman said:“The Government’s full response to all the recommendations of the Francis report is welcome and the detailed level of deliberation it contains is appreciated."Like other organisations, the Academy and medical Royal Colleges have spent a considerable time since the publication of Robert Francis’s report earlier in the year considering the recommendations to see how we can help take them forward so that the appalling problems at Mid-Staffordshire do not happen elsewhere. We have also welcomed the opportunity to work with the Department of Health in thinking through and informing its response to the spread of recommendations."Medical Royal Colleges have been at the forefront of championing many of these changes across the UK and most of the specific recommendations in which the Academy or Colleges could play a role are now embedded into the mainstream of our work programmes. We have, for example been working with the GMC over the role Colleges can play in quality assurance of medical education and GMC visits (Recommendation 155) and with CQC on standards and metrics to underpin their ratings and inspection regime (Recommendations 11, 18, 154). The Academy’s recent publication “i-Care: Information, Communication and Technology in the NHS” responds to recommendations on the importance of sharing information."The Academy is happy to take forward those specific recommendations where we are called on to take action by the Government. For example, following a seminar in September with the Secretary of State we are undertaking work on having an “accountable clinician” with their name over the bed for every hospital inpatient (Recommendation 236) and hope to produce guidance by the spring."The emphasis on transparency and publication of information, including staffing levels, locally is welcome and will be supported by Colleges who have advocated having information on standards in the public domain. Having been a national advisor on patient safety I know that transparency is an essential tool for raising quality."We believe it is right that the duty of candour for individual clinicians is a matter of professional regulatory responsibility rather than statutory duty."We agree that it is right for patient, employers and professionals themselves that professional regulatory issues should be resolved or brought to a hearing within no more than twelve months (except where police investigations may still be under way). Having been a member of the GMC I know the complexities but welcome that this is now being achieved by the GMC."Finally, we continue to support all moves for greater medical and clinical involvement in leadership throughout the NHS. We hope that Colleges and particularly the Faculty of Medical Leadership and Management are centrally involved in taking this forward."Doctors and medical Royal Colleges recognise the failings at Mid-Staffordshire must not be allowed to happen again. The Government’s response provides the framework for medical Royal Colleges individually and the Academy of Medical Royal Colleges collectively to continue the work already under way to help ensure this is the case."Tuesday, 19 November 2013
Most patients in hospital over a bank holiday or a weekend would benefit from a daily review of their care led by a consultant, according to a new report published today by the Academy of Medical Royal Colleges.Seven day services, it argues, would create a transformational shift in the way the NHS delivers medical care. If healthcare teams carry out their patient reviews on Saturday and Sunday, patients could, in many cases, be discharged sooner; freeing up beds for new admissions, leading to more effective, safer and speedier care for all. The report makes clear though, that for the proposals to succeed, strong links between hospitals and community care need to be in place, particularly for frail, elderly and vulnerable patients.Today’s report, builds on the Academy’s recent work on standards for better inpatient care. It concludes that to achieve seven-day service is also likely to need additional consultant appointments as well as a reorganisation of the current workforce, and more resources to integrate primary and social care more effectively.The Academy, which represents 20 medical Royal Colleges and Faculties, also acknowledges that there is likely to be a financial impact, at a time when there are serious resourcing pressures on the NHS across secondary and primary care. Moving to the new system will require more funding initially, although re-organising services and reducing morbidity could well reduce overall costs over time.Seven Day Consultant Present Care has been contributed to by 50 medical specialties and includes the results of a survey to determine the implementation implications in terms of staffing and access to a range of facilities and support services, both in hospital and in the community that will be essential to making seven day care a reality.The report also finds that:
- The majority of specialties surveyed in the report indicated the need for diagnostic radiology services including ultrasound, CT, MRI and access to an expert radiology opinion.
- Support services such as physiotherapy, occupational therapy, pharmacy, dietetics, specialist nursing, operation theatres, administrative and clerical support are also key to provide care over seven days.
Professor Norman Williams, Steering Group Chair and President of the Royal College of Surgeons, said:‘What we want to see is a health service that can truly meet the demands of the 21st century. It is not acceptable that over weekends and bank holidays, patients receive a lower standard of care than they would during the week.‘Using the findings of this report, we must work together to re-shape hospital services in a way that strengthens the quality of care given to patients regardless of when they are admitted. Ensuring that key staff and facilities are available to provide this support will come at a cost. However this is crucial for the full benefit of seven day consultant-led care to be realised.’Professor Terence Stephenson, Chair of the Academy of Medical Royal Colleges, said:‘Across the UK, there are already instances where successful seven day working has been introduced and we must learn from these examples.‘The Academy recognises that such recommendations will not be easy to achieve without significant reconfiguration at a time when NHS budgets are already stretched.‘What is important to remember is that in some cases money will be saved, as patients will improve more quickly and not face delays in receiving appropriate care over the weekend.‘The Academy is part of the NHS Seven Day Services Forum and is pleased to see the importance seven day service delivery is being given. We look forward to continuing to work together and hope this report will be supported and acted upon by the government and the NHS so patients can receive the best care and treatment regardless of when they need it.’Read or download the report:Monday, 18 November 2013
- Currently, 11% of people occupying hospital beds do not have an on-going serious medical problem; their discharge is delayed by non-medical factors. The report states that early weekday engagement and advance discharge planning between hospital and community based staff would increase the ability to transfer care from the hospital at the weekend.
The Academy of Medical Royal Colleges welcomes the publication of NHS England's Urgent and Emergency care review.We believe the vision it sets out represents a positive solution to the very serious difficulties currently facing urgent and emergency care provision in the NHS.The Academy was particularly pleased to see how the report recognises that all parts of the healthcare system will play their role in tackling the issue. It will be the input of patients themselves, GPs and other primary care professionals, smaller and larger emergency departments and networks of care coordinating their activity and working together that will provide sustainable urgent and emergency services.The pressures on urgent and emergency services are not restricted to England alone. The NHS in Scotland, Wales and Northern Ireland is facing similar difficulties. They will need to develop solutions that fit their own circumstances but an integrated approach is likely to be required.It is important to recognise that it is very often the medical profession itself which has been leading the debate and advocating these sort of changes. For a number of years medical Royal Colleges have been saying that patients will benefit from some services being provided in larger centres. Colleges consistently seek to set out a vision of how services in hospitals and primary care can best develop and adapt to met changing patient needs.There are immediate and pressing issues about the capacity of staff in emergency departments and primary care to deliver urgent and emergency services at the present time. These are not specifically considered in the report and need to be addressed as this work is taken forward.The Academy and Colleges which represent doctors in hospitals and primary care will be keen to work with NHS England in developing and delivering these proposals.Read the NHS England report here.Wednesday, 13 November 2013
The four UK Chief Medical Officers (CMOs) asked the Academy to provide further information on concerns regarding the prescription and administration of cytotoxic agents by foundation doctors.Concerns regarding the potential risk to patients from prescription of chemotherapy by foundation doctors were raised at the Academy Foundation Programme Committee and reported to the CMOs who acknowledged that this was an important issue and asked the Academy to undertake further work on the issue.The Academy therefore established a cross-specialty working group and, in conjunction with the UK Foundation Programme Office, subsequently carried out a survey to seek further information. The findings and a series of recommendations were then set out in the attached report.The results of the survey suggest that:
We believe that the survey has identified that there is a real patient safety issue and risk to patients in current practice.The report recommends that:
- Prescribing cytotoxic and immunosuppressant agents by foundation doctors and core medical trainees is not uncommon and occurs in the context of oncology and several other specialties
- There is a perceived lack of understanding of the risks of these agents and the requirements for monitoring and supportive therapy which accompany their use
- Adverse incidents related to prescribing these agents are not uncommon and at least one death was reported
- There is a perceived lack of specific training and guidance for doctors involved in the prescription of these agents.
The Academy will now be setting up a small Task and Finish Group to develop appropriate guidelines and educational materials.Read the report hereThursday, 07 November 2013
- Training in the use of agents with a narrow therapeutic index is included in undergraduate curricula and is formally assessed.
- Realistic and proportionate standards of training and assessment should be developed for healthcare professionals prescribing these agents. The relevant medical Royal Colleges should adopt these standards into their core and specialty training curricula.
- Specialty specific educational and assessment resources are developed by medical Royal Colleges and the Royal Pharmaceutical Society relevant to the prescribing and monitoring of these agents.
- All healthcare providers should ensure that systems and safeguards are in place to prevent harm to patients from incorrect prescribing / monitoring of agents with a narrow therapeutic index.
- Induction sessions should specifically state that prescribing of chemotherapy and immunosuppressive agents is prohibited without satisfactory demonstration of appropriate competence e.g. by completion of a designated and approved training programme.
The NHS must radically overhaul the way it collects and shares data if patients are to be treated safely and effectively, according to a new report by the Academy of Medical Royal Colleges.The report, titled i-care: Information, Communication and Technology in the NHS, sets out seven key challenges for achieving the technology revolution within the NHS.The report has been developed in answer to the Secretary of State for Health’s ambition to make the NHS ‘paperless’ by 2018.The seven key recommendations state that:
While noting examples of good practice in hospitals, clinics and doctor’s surgeries, the report also reveals a healthcare system in which information is dispersed across sites in incompatible formats which are too often focussed on the illness rather than the patient.In some cases, even electronic data transfer remains stuck in the 1990s, with some GPs unable to receive an email which is larger than 5mb. The result, all too often is poorer and less effective patient care and greater costs to the NHS as information is sent by post, courier or sometimes even via the patients themselves.The report builds on a statement produced four years ago by the Royal College of Physicians and adopted by the Academy of Medical Royal Colleges which set out the ‘case and vision for patient focused records’. As the culture of openness and choice develops within the NHS the report says patients and their carers must also have greater online access to their own records, enabling them to be kept up to date and involved with decisions about the care they are receiving.Commenting on the report, Professor John Williams, Director of the Royal College of Physicians Health Informatics Unit, said:"Information is absolutely critical to the NHS. When you visit your GP, when you attend hospital, when you undergo surgery; all of it relies on high quality information. Today’s NHS information systems are way off the mark. This document sets out how we can realise the technology revolution."The Francis Report and Berwick Review both identified that the NHS has lost its way, and must be reoriented to deliver patient-focused, compassionate, safe care. Central to achieving this is the availability of real-time accurate information that focuses on the patient."Professor Terence Stephenson, Chairman of the Academy of Medical Royal Colleges said:"If the NHS is to continually improve patient care and safety it is essential that we bring our IT and communication systems into the 21st Century. Computer technology plays a huge part in medicine and is key way in which we can strengthen the patient experience. Poor systems could disempower staff leaving them fighting to deliver care effectively."The Academy is committed to working with Department of Health, General Medical Council and NHS England to produce and maintain informatics standards. But, it’s clear for the findings that doctors, clinicians, nurses need to raise their game too, and we are dedicated to ensuring that the necessary skills are acquired so that the Academy’s vision can be realised."Health Secretary Jeremy Hunt said:"It is deeply frustrating to hear stories of elderly dementia patients turning up at A&E with no-one able to access their medical history, or doctors prescribing the wrong drugs because they don’t know what drugs a patient is already on. We need to put this right."That's why one of my top priorities is helping the NHS meet the challenge of going paperless by 2018. Technology is key to helping our A&E staff meet the massive demand they face as the population increases and ages.“We welcome this report - it will help make a paperless NHS a reality, and as a result it is set to make a real difference to NHS patient care.”Download the Academy report hereWednesday, 06 November 2013
- Patient record must be both the cornerstone of integrated patient care, and the main source of data to inform the service.
- Patient record systems must be focused on the individual, not on the disease, intervention, service or the organisation in which the patient is seen, in order to provide an integrated picture of their problems and the care they receive.
- Clinical data quality and ease of data capture must be of paramount importance
- The structure and content of records must be standardised across the NHS
- Patients should be given appropriate, standardised access to their records
- The NHS must learn from the information it collects in the course of everyday care
- Professionals and patients need access to reliable information, from both the individual record and the knowledge base of healthcare.
Speaking on to the publication of the Shape of Training Report the Academy said:
“The Academy of Medical Royal Colleges congratulates Professor Greenaway on the “Shape of Training” report and expresses strong support for the underlying principles.
Colleges particularly welcome the move towards generalism and the greater flexibility in the context of maintaining a UK wide system of medical education, whilst still appreciating the outstanding improvements that have been made to patient care through specialisation over the previous decades.
There are, of course, many issues still to be resolved and some of these will be thorny. Royal College and Academy involvement in addressing these is essential.
The Academy and Colleges are, however, absolutely committed to working with others to ensure the recommendations are implemented in an effective and practical manner."Read and download the full Academy response here.Read the final Shape of Training Report hereMonday, 28 October 2013
Speaking on the appointment of Simon Stevens as new Chief Executive of NHS England, Professor Terence Stephenson, Chairman of the Academy of Medical Royal Colleges said:"I congratulate Simon Stevens on his appointment to this crucial role. With clinical engagement so crucial to taking the NHS forward successfully the Academy and Medical Royal colleges look forward to working closely with him over the coming years"Thursday, 24 October 2013
The Academy recognises the principle that migrants should contribute to the cost of healthcare when in the UK.However, in its response to the DH consultation, the Academy was clear that proposals must not undermine a doctor’s duty of care or the trust between doctor and patient. It is therefore essential that any arrangement for the charging of individuals or the checking of eligibility is removed from the sphere of the personal interaction between the clinician and the patient.In addition, proposals to tackle the issue must not create a bureaucratic process and burden that outweighs any tangible benefits.The Academy were also absolutely clear that no-one should be denied access to immediate necessary treatment wherever they may be irrespective of their means and status. The exemption of charges in relation to infectious disease is essential for public health purposes. We believe that there is also a strong case for exemption of particular mental health problems.The Academy and medical Royal Colleges and Faculties are keen to discuss possible arrangements with the Government to ensure that a scheme brought in for understandable reasons is practical proportionate and does not create unintended adverse consequences.Read the Academy's response to the DH Sustaining Services and Ensuring fairness consultation here.Tuesday, 22 October 2013
The Academy of Medical Colleges organised a seminar for the Secretary of State on 25 September on how to take forward his proposals for having a clearly accountable clinician for hospital patients as outlined in his speech on patient safety in June. The Secretary of State made clear his wish for there to be specified accountable clinicians (doctors and nurses) with their "name over the bed" so patients and their relatives know who has responsibility for the overall care and experience of a patient during their stay in hospital and also who is the responsible for the patient's care at any given moment.The seminar members who comprised medical, nursing, patient, employer and regulator representatives all supported the concept of the "accountable clinician" whilst recognising that there are complexities in making this work easily and effectively at local level.It was agreed that the Academy, working with all the relevant stakeholders, would develop a set of simple principles and standards that would seek to define issues of accountability, responsibility and coordination to help all trusts implement the "name over the bed" at local level.Monday, 30 September 2013
The Academy is keen to understand the effectiveness of specialty guidance on appraisal and revalidation.Three surveys will be open until 15 November 2013; one for doctors (as appraisees), one for appraisers and one for responsible officers. The surveys will gather views on the effectiveness of the specialty guidance and help Colleges and Faculties to continue support their members through appraisal and revalidation in the future.You are invited to complete all surveys that apply to you. Each should take no longer than 15 minutes to complete and all responses will be treated anonymously.Follow the links below for each of the surveys:Thank you - your feedback is gratefully appreciated.For more information on Specialty Guidance and the work of the Academy and the Colleges and Faculties on specialty advice please see our revalidation specialty advice pages.Monday, 30 September 2013
The Academy welcomes the thorough external review of the Membership of the Royal College of General Practitioners (MRCGP) exam carried out for the GMC by Professor Esmail of Manchester University.His report certainly has concerning findings about differential pass rates in the various components of the exam. It is clear that the reasons for this are highly complex and not simply related to the exam itself or the actions of the RCGP. There is, for example, a differential for machine marked knowledge tests.Medical Royal Colleges are committed to ensuring that examinations are designed and implemented in the fairest possible way for all candidates to eliminate bias whilst maintaining high standards of care and patient safety. We believe that RCGP has been assiduous in seeking to ensure that the construction and performance of its exam is free from bias.However, there is no room for complacency and there are recommendations that all involved in the process of training and selecting doctors – Colleges, the GMC and LETBs/Deaneries – will want to consider. Colleges, for example, should strive to have examiners reflecting a mix of ethnicity and gender.Friday, 27 September 2013
The revalidation portfolio for several medical Royal colleges is now available for use free of charge by their fellows and members. The portfolio has been developed with Equiniti 360° Clinical, and will cover the following colleges:
The College of Emergency Medicine, Royal College of Paediatrics and Child Health, Royal College of Physicians of Edinburgh, Royal College of Physicians and Surgeons of Glasgow, Royal College of Physicians of London, Royal College of Psychiatrists and the Royal College of Ophthalmologists. The Royal College of Physicians of London acts as the lead agent for the cohort and coordinates the project on behalf of the group, with support and financial backing from the Academy of Medical Royal Colleges.
During their five-year revalidation cycle, doctors will be expected to provide appropriate supporting information at annual appraisal to allow their appraiser to assess the quality of professional practice, and ultimately for a responsible officer to recommend revalidation to the GMC. To support this, they need an online system to securely record, manage and facilitate submission of their supporting information, including CPD, and the results of 360 degree appraisal and patient feedback. Using the revalidation portfolio is optional but should be of interest to those doctors who do not have an electronic appraisal and revalidation system available to them at their organisation or who move frequently between organisations.
The revalidation portfolio will:
- Be straightforward and easy to use
- Be accessible online over the internet
- Be customisable by each participating medical royal college or faculty
- Only be accessible to the doctor using it and those to whom he or she gives permission
- Reduce the need for duplication by interfacing and communicating with existing systems and applications
- Provide intuitive assistance in gathering the supporting information for appraisal and revalidation
- Be designed and developed to the highest standards
- Anticipate future revalidation developments
- Be secure, private, and confidential.
Members of the relevant colleges will be receiving emails and other communications explaining how to access the portfolio, and each college will have its own helpline for queries.
Dr Andrew Goddard, chair of the medical Royal colleges revalidation cohort group, said:
"Work on the revalidation portfolio started four years ago when it became clear there would not be a tool developed by the NHS. The Academy of Medical Royal Colleges was given funding by the DH to develop an electronic revalidation portfolio and has brought seven medical Royal colleges together to achieve this. Despite the different colleges having different requirements, it was possible to meld requirements and come up with a system to suit everyone.
The portfolio allows large amounts of information to be stored remotely and can be accessed from any secure PC. Supporting information can be kept for as long as needed and clinicians can chose to show or not show their information to their appraisers as needed."Thursday, 26 September 2013
This project identified and tried to address the issues surrounding clinical coding to support the use of HES data for revalidation. It specifically explored and sought to enhance the relationship between activity and coding, between clinicians and coders. The report outlining the discussions from the round table seminar can be found here.Wednesday, 25 September 2013
REVALIDATION IS HERE!
The Academy welcomes the Department of Health’s response to the Caldicott review. Information is at the heart of partnership working, and Dame Fiona’s report emphasised the need for patients, carers, healthcare professionals and those in governance to work together to create the right balance of protecting and sharing patient data. A clear joined up code of practice for dealing with patient information is vital for coordination and continuation of patient care and increasing safety.The Academy is already working with the medical Royal Colleges and the GMC to incorporate information governance into the essential training of all postgraduate doctors. And we look forward to working with the Professional Standards Authority to further develop consistent guidance on sharing and protecting patient information.Thursday, 12 September 2013
The Academy welcomes the publication of the Future Hospital: Caring for medical patients report. The Royal College of Physicians is to be congratulated on producing such a considered and authoritative piece of work.The report aligns with the recent Academy reports on The Benefits of Consultant Delivered Care, Seven Day Consultant Present Care and Changing Care Improving Quality on service reconfiguration.It provides another example of how Medical Royal Colleges provide a voice for the medical profession and are at the forefront of debate about the development of the healthcare.There has already been considerable cross-specialty involvement in the Future Hospital project and I am sure that all the Colleges and Faculties in the Academy will want to take forward the debate initiated by this report.Thursday, 12 September 2013
Applications are invited for the post of Chair of the UK Donation Ethics Committee (UKDEC).
Organ donation and transplantation is one of medicine’s greatest success stories, transforming tens of thousands of lives every year. There is an ambitious programme across the UK to increase the levels of organ donation significantly.Organ donation often occurs in difficult clinical circumstances and at a time of great emotional distress. To support clinical staff working in these circumstances an independent UK-wide Donation Ethics Committee was established in January 2009 to help explore the ethical, legal and professional issues that arise.
We are looking for an experienced Chair to build on the achievements of the UKDEC and lead it as it continues to develop its reputation as the UK’s definitive source of advice on the ethical issues arising from organ donation.If you think you have the qualities we require and want to apply please see the information pack and application form below.
24/7 care: here's one NHS reform we should all agree onDear SirI welcomed Jackie Ashley’s article on 24/7 Care and believe that Medical Royal Colleges are in the position you call for to “step forward and surprise you”.All doctors are not opposed to the requirement for seven day services. Indeed the Academy of Medical Royal Colleges report on the Benefits of Consultant Delivered Care (January 2012) stated that it is ethically unjustifiable to provide a lesser standard of care to patients at weekends. This was followed by our Seven Day Consultant Present Care report (December 2012) which set out the standards required to ensure that the benefits of consultant-delivered care can be available to all patients regardless of the day of the week.That report also made clear that to deliver this level of care it is likely that service reconfiguration onto fewer sites will be needed. That message was clearly reinforced in the Academy’s joint publication with the NHS Confederation and National Voices in May this year Changing Care, Improving Quality.As Jackie Ashley states there will undoubtedly be arguments about the costs of seven day working and about the implications of service reconfiguration – and some of these may descend into petty point scoring.However, I believe that the medical Royal Colleges, as the professional voice of doctors, have clearly nailed their colours to the mast and set out what is the right thing to do for patient safety and improved quality of care.Yours sincerelyProfessor Terence StephensonChairman, Academy of Medical Royal CollegesTuesday, 13 August 2013
The Academy of Medical Royal Colleges was asked by the Mid-Staffordshire Trust Special Administrators (TSAs) to establish a National Clinical Advisory Group (CAG) of senior medical consultants nominated from medical Royal Colleges to provide them with independent advice.The role of the CAG was to advise on the clinical safety of proposals, their likely impact on the recruitment and retention of medical staff and whether they would move services closer to or further from meeting College clinical standards. The CAG only examined proposals put to it by the TSA. It was not the role of the CAG to design or propose its own service models.The conclusions and recommendations of the CAG are set out in a letter of 22nd July from Professor Terrence Stephenson, Chair of the Clinical Advisory Group and of the Academy of Medical Royal Colleges to the Trust Special Administrator, Professor Hugo Mascie-Taylor.Professor Terence Stephenson said“The Academy and Medical Royal Colleges were very willing to accept the invitation to work with the TSAs because we believe it is essential that any changes to the configuration or provision of health services should be informed by clinical expertise and do not reduce clinical standards and safety.The local population of Mid-Staffordshire rightly expects to have access to high quality, clinically sustainable healthcare services.We examined the proposals presented to us by the TSAs and our view, on the evidence that we have seen, is that if implemented effectively the TSA model recommended should deliver a clinically safe and sustainable solution for services at Stafford and Cannock hospitals for patients and staff”Read the Clinical Advisory Group Letter to the Mid-Staffs Trust Special Administrator and the CAG terms of reference.Wednesday, 31 July 2013
The Academy of Medical Royal Colleges welcomes the publication of Sir Bruce Keogh's review of mortality in 14 Trusts. The Academy was represented by Professor Terence Stephenson on the National Advisory Group for the review process.Speaking on the review's publication Professor Stephenson, Academy Chair said:"It is absolutely right that when data raises questions we look in more detail and understand the reasons and the problems. The report clearly highlights actions and behaviours that should happen."We believe the Review was conducted in a mature and open manner and it is important that the conversation about what should happen in these 14 organisations takes place in the same way."What we want to see is a process whereby at local level clinicians and trusts themselves are regularly questioning their data and taking appropriate action as a matter of course. If this happens all the time and the new CQC surveillance and inspection system works effectively, this will protect quality and safety for patients."Tuesday, 16 July 2013
Responding to the publication of NHS England's report 'The NHS Belongs to the People - A Call to Action', Professor Terrence Stephenson, Academy Chairman said:“The Academy of Medical Royal Colleges has always been clear that there needs to be bold action to change the way our services are organised to ensure that we can maintain high quality sustainable services.Doctors would certainly agree that it is unacceptable that the only solution to the financial pressures is to reduce care to patients or charge for services. However, to achieve this change will be a huge challenge which will depend for its success on the engagement and leadership of clinicians.But we do need politicians, the media and the NHS professionals themselves to have the courage to have an honest debate with the public. Only this week the Academy of Medical Royal Colleges Council expressed its deep concern at the tone of recent debate across the UK about the NHS. Rational discussion appears to have given way to a torrent of febrile accusations and generalisations. Engaging in public debate at such a level on an issue of the importance of healthcare in the UK undermines patient confidence, causes unnecessary anxiety amongst the public and demoralises staff."Thursday, 11 July 2013
The Academy wishes the NHS a happy birthday as it turns 65 year!
To see what some of our member medical Royal Colleges and Faculties are doing to mark the occasion scroll down the page.
The Royal College of Physicians is running a series 'the NHS at 65' examining the past, present and future of the UK healthcare system, from a variety of perspectives.
The Royal College of Anaesthetists has produced a short film, called ‘Anaesthesia: Art and Science, 65 years in the NHS’. Watch it here.Wednesday, 03 July 2013
Crisps, chocolates and fizzy drinks on hospital trolleys could be a thing of the past if a motion put forward at the British Medical Association Conference today gains backing from doctors.Cardiologist, Dr Aseem Malhotra tabled the motion at the BMA Conference in a bid to prevent unhealthy food being offered to patients - which he says is part of getting the medical profession’s own ‘house in order’ in an attempt to stem the growing problem of obesity amongst the UK populationWriting in the British Medical Journal today, Dr Malhotra said:“An oversupply of nutritionally poor and energy dense foods loaded with sugar, salt and trans fats, fuelled by aggressive and irresponsible marketing by the junk food industry has even been allowed to hijack the very institutions that at are supposed to set an example and promote positive health messages; our hospitals.”“It’s time for the British Medical Association to join with the Academy of Medical Royal Colleges and lobby for a ban of junk food and beverages to be sold in all hospitals. To combat obesity we must start in our own back yard.”The motion: 'That this meeting asks the BMA to lobby the DH and NHS Confederation to ensure that all NHS premises should ban the sale of junk food and junk drinks', follows a call from the Academy of Medical Royal College (AoMRC) in its Measuring Up campaign launched earlier this year to make nutritional standards mandatory in hospitals, similar to those schools and prisons.Professor Terence Stephenson, Chair of the Academy of Medical Royal Colleges, backs the motion. He said:“In many hospital receptions patients pass by fast food outlets or vending machines selling confectionery, sugary drinks and crisps. If the NHS is to send out a message that it takes the obesity crisis seriously, it cannot recreate the same unhealthy environment inside hospitals as exists on the high street. We have to make sure that patients and staff alike are offered healthy and nutritious meal choices.”The latest statistics on obesity show that:
- There has been a four-fold increase in the in the number of children and teenagers admitted to hospital for obesity-related conditions in the last decade
- Just over a quarter (26%) of adults in the UK are classed as obese
- The UK has the highest rate of obesity in Europe with one in three children overweight or obese by the age of 9
This guide offers simple, practical recommendations that can be implemented in organisations to help mitigate the problems associated with simultaneous trainee changeover.Doctors in training in the UK have historically started new six-monthly rotations in February and August, with the majority of junior doctors rotating to new training programmes during the first week of August. There is increasing evidence to show that simultaneous changeover is associated with reduced efficiency and increased mortality. The Academy of Medical Royal Colleges (AoMRC) and NHS Employers have worked with partner organisations to recommend four simple measures that can help avoid these potential problems.Tuesday, 25 June 2013
The Academy is pleased to accept the Secretary of State’s request run a seminar on having the name of the responsible consultant and responsible nurse written above every patient’s bed.In his speech today on patient safety the Secretary of State spoke about the concept of an accountable clinician. This is supported by Medical Royal Colleges. Professor Terence Stephenson, President of the Academy of Royal Colleges will lead a seminar with the professions, regulators and employers to discuss how as part of ensuring there is an accountable clinician having the name of the responsible consultant and responsible nurse written above every patient’s bed can best be taken forward in the NHS.Friday, 21 June 2013
Responding to the launch of the consistent nutritional food labelling system launched today by the Public Health Minister, Anna Soubry, MP; Professor Terence Stephenson, Chairman of the Academy said:“We welcome the today’s launch of a consistent front of pack food nutritional label. In our report on obesity – Measuring Up – published in February this year, we called for a unified system of food labelling. Too often people are confused by the different ways the nutritional content of the food they eat is displayed to them. It is therefore very encouraging to see that the UK’s major supermarkets and retailers, along with others, have signed up to this single system.Obesity directly affects over a quarter of the adult population and costs the NHS an estimated £5.1 billion a year. It is all of our responsibility to tackle the problem and make steps to improve the health of the UK. We believe that this step begins to go some way to helping people make the healthy choice the easy choice.”Wednesday, 19 June 2013
The Care Quality Commission today launch a consultation on their plans to help ensure that patients receive high quality care.The plans aim to make sure health and social care services provide people with safe, effective, compassionate, high-quality care and to encourage care services to make improvements.The consultation is open until 12 August 2013. Learn more about the consultation and submit your response by visiting to the CQC website.Professor Terence Stephenson, Chairman of the Academy said:"I welcome the publication of CQC’s consultation on the way it will regulate, inspect and monitor care services.Following the Francis Report it is essential that the way standards of care are set, rated and monitored is made both more transparent and more robust.For these processes really to deliver results for patients, clinicians need to have confidence in and a sense of ownership of the arrangements.It is good to see that CQC wants to engage clinicians with this consultation. I am sure that the Academy, Medical Royal Colleges and other professional clinical organisations will want to participate in this process. We are committed to work with CQC to develop and deliver a system that will help ensure the highest possible standards of care for patients.”Monday, 17 June 2013
Responding to the Secretary of State’s announcement on following the Independent reconfiguration Panel review into the decision to reorganise children’s cardiac services across England into fewer more specialised units Professor Terence Stephenson, Chairman of the AoMRC said
"We welcome the fact that the Independent Reconfiguration Panel and the Secretary of State acknowledge the case for change. The Academy of Medical Royal Colleges recognised that the Safe and Sustainable decision to concentrate surgical expertise into fewer larger surgical centres and the development of local networks of care could improve cardiac services for children, based on the need for a minimum of four surgeons per centre.
Change remains a matter of urgency – it is 12 years since the report of the Bristol Inquiry was published and patients have waited too long for improvements to be made. We would imagine that everyone who wants to see improvements in the care for children would be frustrated at another delay.
We do recognise that national service change on this scale is a complex undertaking and we offer our full support to work with NHS England and other stakeholders going forward to ensure the benefits of whatever long overdue changes to children’s heart services are necessary to provide the best possible service children and their families."Wednesday, 12 June 2013
Unless the NHS faces up to the need to change how it delivers its services, it will descend into a 'vicious spiral' of poorly planned, reactive responses resulting in unsustainable demand, according to three organisations which have joined forces to call for a better approach to NHS service change.
The three organisations together represent royal medical colleges, patient groups and NHS organisations. It is the first time bodies representing all three major parts of the health service - patients, clinicians and its senior leaders - have come together to examine the need for changing how services are organised and how best to do so.
The NHS Confederation, National Voices and the Academy of Medical Royal Colleges are calling for 'more meaningful' engagement in how health services are arranged and changed with all those groups who are impacted by them. It says past experience of NHS changes, which can be driven by financial or clinical crisis, has polarised the debate to the extent that the service risks being paralysed, even though major change is essential for its successful future.
Their report, Changing care, improving quality, says rising demand and limited resources mean the reorganisation of services is essential for the NHS to remain sustainable and to continue providing safe, effective clinical care that meets patients' needs. It says that the term "reconfiguration" has become loaded with negative meaning, associated with making cuts and downgrading services, and that service changes are frequently viewed by the public as a threat rather than positive and necessary reforms.
The report says that making the case for change must happen earlier and that public and patients need to be fully involved from the outset. It emphasises the importance of a whole-system approach so that communities do not perceive change as a loss but understand how reinvestment in community-based services will deliver the quality and access they prioritise.
Published on the first day (Wed 5 June) of the NHS Confederation's annual conference, the report calls for meaningful engagement of the public, patients, politicians and health professionals in proactive, well-planned service changes, and highlights the highly influential role for clinicians in communicating a clear case for change.
It sets out five recommendations each for local health service leaders and their national counterparts in order to ensure essential reconfigurations - underpinned by sound clinical reasons - can proceed with the understanding and support of relevant stakeholders.
Mike Farrar, chief executive of the NHS Confederation, said:
"More than two-thirds of NHS Confederation members have told us 'political resistance' is the biggest barrier they face in relation to successful service reconfiguration. But political courage by itself is not enough to deliver the kind of change that the NHS needs at this point in its life; the service itself must overcome its paralysis in relation to change, and it must bring the right people with it.
"It is not good enough to say that it is 'difficult' to communicate the need for change to the public. Local people who use and rely on NHS services, whether they are regular service users or just count on it being there if they need it, deserve to have safe, sustainable health services. 'Tweaking' bits of the system in isolation from each other or changing only in response to external pressures will not deliver the long-term change we need for the NHS's survival.
"The onus is on us in the NHS to build the case for change amongst the people we need support from, so that 'reconfiguration' stops being a dirty word and starts to represent the kind of planned, well-evidenced change programme which the NHS deserves."
Jeremy Taylor, Chief Executive, National Voices, says:
"Patients are not best served by the current pattern of services. For the safest, highest quality care, hospitals need to be organised differently and more services are needed closer to people’s homes. But the changes needed are often highly controversial. The NHS has often failed to make a good case; to involve patients and communities in ways that would build trust and to follow through to ensure that the new pattern of services is better than the old. And the public are rightly suspicious of closures and downgrades that seem to be more to do with money than quality of care. It is hardly surprising that local politicians often rush to defend the status quo – even if it is not the longer term interests of patients.
"The NHS has always evolved to meet changing needs. We need a more honest debate and a better way of making the decisions. This should not be about the NHS getting smarter at public relations, but about working with patients and citizens to jointly shape the decisions."
Professor Terence Stephenson, Chairman of the Academy of Medical Royal Colleges, said:
"As clinicians, patients are at the centre of everything we do. Changes in how the NHS delivers care will need to happen to continually deliver high quality patient care in the future. These changes cannot be delivered by one group alone. We believe that bringing together clinicians, patients and managers is vital to ensure that everyone is working together for the same standards of care. We want to create a culture of joint working, where it is normal for patients to be involved in every stage of designing their healthcare. Leading positive change together will ensure that we are able to deliver the excellence in care people have a right to expect from the NHS."
View or download the Changing Care, Improving Quality report.Wednesday, 05 June 2013
The Health and Social Care Information Centre (HSCIC) are working with key stakeholders, including the Academy, Royal College of Nursing and Care Quality Commission to define a candidate list of Present on Admission conditions and associated guidance.There are a number of conditions that, whilst preventable, can be acquired in hospitals and have an adverse effect on a patients morbidity and/or involve substantial financial cost to the hospital. Analysis of these conditions is currently difficult as it is not always known whether a condition has been acquired during the patients stay or was present at the time of admission to the hospital.The consultation can be accessed via the HSCIC website. Closing date for submissions is 28 June.Tuesday, 28 May 2013
The Royal College of Surgeons of Edinburgh announced on Tuesday 14 May that following negotiations between the College’s Trainee Member of Council, Issaq Ahmed, and HM Revenue & Customs (HMRC), it has been successful in obtaining agreement that all mandatory training fees payable by all medical trainees will become tax deductible: for surgical trainees this includes the fee payable to the Joint Committee on Surgical Training (JCST).The initiative to approach HMRC with this issue, following previous unsuccessful attempts, was spearheaded and led by Trainee Member of Council, Issaq Ahmed. Speaking about the new agreement, Mr Ahmed said:“As a Committee which represents the interests and concerns of trainee surgeons, and as trainee surgeons ourselves, the cost of training is an issue of great importance to us. We know that it is also of great concern to our colleagues in other areas of healthcare. Although mandatory fees such as the JCST fee were not recognised as tax deductible, we firmly believed that such fees met all the guidelines set by HMRC as to what constitutes eligibility for tax deductible status. We set our case before HMRC and, following some months of communication and submitting evidence, our assertions were accepted. We are absolutely delighted with the outcome which will make a real difference to the amount that medical trainees have to pay throughout their medical training.”RCSEd President, Mr Ian Ritchie added:“It is central to the aims and beliefs of our College that we support each new generation of surgeons. We made the decision to have an elected Trainee Member of Council and, subsequently, constituted the College’s Trainees’ Committee, to ensure that the College could stay abreast of the issues facing trainee surgeons. I am delighted that Issaq has had such success and I commend all his efforts. Through his hard work and dedication he has not only been able to help his fellow surgical trainees but all his medical trainee colleagues.”Further information can be found on the HMRC website.You can download and read the confirmation letter from HMRC via the RCSEd website.Friday, 17 May 2013
From today, NHS consultant doctors can apply for certificates that will help verify them for short-term work elsewhere in the NHS or at universities.This initiative is designed to help improve responsiveness to patient emergencies and to enable more consultants to be present providing extra support, when and where patients need them.The existing system requires checks to be resolved before consultants can transfer between organisations and this can often be a lengthy process, taking up to several weeks. However, consultants who are successfully eligible for the new certificates will immediately be able to carry out short-term, ad hoc or urgent activity in other hospitals and universities.Called The Certificate of Fitness for Honorary Practice, it has been developed by NHS Employers and the Academy of Medical Royal Colleges (AoMRC).Rather than replacing the more detailed and time-consuming honorary contract, this certificate will enable short-term placements by ensuring all consultants' employment checks - such as occupational health and Criminal Record Bureau checks - are up-to-date and agreed. The certificate is then held on the consultant's file, to be produced when they are invited to assist in patient care or training at another organisation on a short term basis.Dean Royles, Chief Executive of the NHS Employers organisation, said:“This certificate retains all of the safeguards that ensure doctors are fit to work. But it will help doctors to work across organisations, being in the right place, at the right time, when patients and colleagues need them most.“We’ve been looking at what’s happened in the NHS and seen occasions where there’s simply no time to carry out the mandatory checks when a consultant is best placed to do short-term work elsewhere. We’re really pleased to have worked with the AoMRC to produce a workable, efficient way of speeding up the process.“Having an ‘honorary contract’ with another organisation is already common among consultants. But the new certificate expedites all the other checks that come with honorary contracts, and creates short-term opportunities when those contracts aren’t in place.“Adaptability is essential in modern healthcare and I hope this is just one of many changes that see doctors working more flexibly right across the NHS.”Professor Terence Stephenson, Chairman of the Academy of Medical Royal Colleges, said:“The certificate will make it quicker and simpler for doctors to work temporarily at another trust, which will benefit patient care and treatment as well as doctors’ skills. Too many times opportunities have been missed by the extended time it takes to obtain an honorary contract. It is essential that we make it easier for doctors to support the NHS as a whole by being able to cover absences and emergencies as well as improving their own training and skills in other trusts.Su-Anna Boddy, Consultant Paediatric Urologist, Royal College of Surgeons England, said:“This certificate provides excellent opportunities for improved patient care by allowing clinicians to move between trusts much more easily than is currently the case. In particular, allowing them to work in other hospitals with significantly reduced paperwork will help doctors to share expertise and facilitate better working across clinical networks.”The certificate can be used for:
The certificate is not intended to be used for:
- Emergency or occasional treatment of a patient (e.g. to cover sick leave)
- Promoting continuity of care of a patient
- Allowing a consultant to provide short-term specialist training to other clinicians in the area of his/her expertise
- Allowing a consultant to receive short-term training/continuing professional development to expand their skills in an area of practice that is new to them or in innovative techniques and technology.
More details and documents are available here:Wednesday, 15 May 2013
- Providing evidence of personal identity
- Ongoing honorary employment or research activity (an appropriate honorary contract should be used)
- Making an offer for long-term paid or unpaid employment
- Any other circumstance where an honorary contract is more appropriate
- Sanctioning activity when the consultant is scheduled to be working for his/her substantive employer (except by agreement with the substantive employer)
- Locum appointments
- Remediation purposes.
The Revalidation Support Team initiated a specialist portfolio project last year to explore what a high quality appraisal portfolio for doctors would look like; and to gain a better understanding of what information is needed and how it could be collected and used in the most effective way. This project was to build on the medical Royal Colleges and Faculties' work exploring how specialist guidance could most effectively lead to improvements in quality of care. The Faculty of Medical Leadership and Management, Royal College of Physicians London and the Royal College of Surgeons of England participated in the project and the portfolios have now been published.
Joint Statement from the Trust Special Administrators of Mid Staffordshire NHS Foundation Trust and the Academy of Medical Royal CollegesThe Trust Special Administrators are required to act in the interest of patients. This means that any recommendations for the future of the services at Mid Staffordshire Trust have to be clinically safe as well as financially sustainable.Professor Hugo Mascie-Taylor, one of the Joint Trust Special Administrators, has set up an independent clinical advisory group and asked the Academy of Medical Royal Colleges to nominate senior representatives from the UK’s Medical Royal Colleges to form the group and consider any proposed arrangements to ensure they are safe for patients.Medical Royal Colleges are independent professional medical organisations whose central concerns are the standards of clinical care for patients as well as the post-graduate training of doctors. This group will provide the Trust Special Administrators with independent advice on the impact of their proposals on the quality of care for patients in the Stafford and Cannock area. This will be particularly in relation to the likely impact on the safety of clinical care and the ability to recruit and retain medical staff.The formal advice of the Clinical Advisory Group will be publicly available. Any final recommendations will, however, remain the responsibility of the Trust Special Administrators and ultimate decisions rest with the Secretary of State for Health.The precise composition of the Clinical Advisory Group and individual membership are still to be decided. Most specialities are relevant but acute medicine and surgery, paediatrics, anaesthetics, emergency medicine, obstetrics and general practice as well as diagnostic support services will definitely be represented. The individual members will be senior experienced doctors from the relevant Medical Colleges who can provide authoritative medical input on clinical issues.The Group will work within the TSA timetable and is likely to meet on a number of occasions and will visit Mid-Staffordshire Trust.Commenting on the establishment of Clinical Advisory Group Professor Terence Stephenson,Chairman of the Academy of Medical Colleges said:“Medical Royal Colleges’ principal concern is the quality of clinical care for patients. Where changes in NHS services are required it must be clinical quality considerations that drive the process and underpin the solutions.Medical Royal Colleges will provide that independent medical opinion and we welcome the opportunity to form the Clinical Advisory Group and advise on any recommendations. Colleges will wish to help so that patients in Stafford continue to receive safe, high quality care”Hugo Mascie-Taylor said:“The quality and safety of services are as important as their financial sustainability. For that I need to have an independent clinical opinion on any proposals we produce. The Royal Medical Colleges as the custodians of clinical quality standards are best placed to provide that independent viewpoint. I am grateful for their input”
For further information please see the Office of the MSFT Trust Special Administrator website.Monday, 29 April 2013
Evidence based medicine is the key to the success of modern healthcare. A booklet, launched on 25 April by Sense About Science and the Academy contains case studies of 15 of the game changers in evidence based medicine.All agree that evidence based medicine must be at the core of medical Royal Colleges’ role in raising the standard of patient care. They also agree that there are frustrations and challenges to this aspiration. It will never be possible to investigate every intervention for every possible circumstance and some treatments escape rigorous scrutiny. Complicated discussions about whether funding, time and expertise should be focused on clinical research, basic research or training are going on. Grappling with these frustrations must continue. Medicine is driven by precisely this kind of critical approach. It is because medical professionals are willing to open things up for discussion again and again that we can move medicine forward.“The 15 case studies illustrate the role evidence based medicine plays in shaping and influencing healthcare across the profession. The Academy and its members are committed to continually improve patient safety through the development and testing of treatments, tests and prevention strategies to take medicines and healthcare into the future. We are pleased that this booklet highlights that work and the dedication of the Colleges and Faculties to patient welfare through evidence based medicine.”Síle Lane, from Sense About Science said:“The Colleges have shown us that the caricature of modern medicine as immobile and blind to new ideas is wrong. The way doctors continually draw questions about treatments back into the frame stands in stark contrast to some traditional medical practitioners who champion long use of a treatment over anything else.”Download the Evidence Based Medicine Matters report. For more information see the Sense about Science website.Thursday, 25 April 2013
The Secretary of State for Health is seeking to appoint 2 Non-Executive Directors to the board of NICE with experience in either social care or hospital medical practice.You must be able to demonstrate that you have current experience of commissioning or delivering social care at a senior level or current experience in hospital medical practice at consultant level.Please see the advertisement for the positions here.Friday, 19 April 2013
The GMC today published independent research (commissioned from the Academic Unit of Primary Medical Care, University of Sheffield, in collaboration with Capita Health) on the impact of CPD on doctors’ performance and patient/service outcomes.The report raises a number of issues around the effectiveness of CPD and concludes that it is most effective where:
- Time is provided for individuals to reflect on their learning after it has completed
- It is integrated with appraisal, linked to personal development plans and aligned with organisational objectives
- Organisational support is provided to facilitate change following completion of learning.
Speaking about the report, the Chair of the Academy's Directors of CPD Committee, Dr Ian Starke said:
"We welcome this study as a preliminary step to review the impact of CPD on a range of doctors. We support many of the recommendations in the report and hope we can use it as a stimulus for further development of an evidence base to support CPD across the whole scope of work of a doctor rather than looking at individual CPD activities.
"Following initial discussions with the GMC regarding the report’s findings, DoCPD is looking forward to future collaboration particularly in the following areas which were highlighted in the report:
Friday, 12 April 2013
- The role of employers in facilitating effective CPD
- The links between effective CPD, appraisal, PDPs and service need
- The role of reflection
- Practical ways of promoting effective learning through CPD."
The Academy of Medical Royal Colleges has been seeking clarity from the Government on the implications of the revised Regulation 75 on competition and procurement. Following discussions, the Secretary of State has agreed to meet Academy representatives to discuss the concerns of Colleges. The Academy welcomes the Secretary of State’s offer and plans to meet with him as soon as is practicable.Thursday, 28 March 2013
In response to the Government’s statement today on the Mid Staffordshire NHS Foundation Trust Inquiry, the Academy of Medical Royal Colleges said:The Academy of Medical Royal Colleges (the Academy) and all its constituent member Colleges and Faculties strongly supported the central messages, principles and recommendations of the Francis report when it was published in February 2013.The Academy and its members recognised that there were shocking failures in care at Mid Staffordshire Trust and systematic breakdowns in how the NHS safeguarded the quality of care for patients. They accepted that all professionals, from the medical and nursing profession to managers had a share in the responsibility for this failing.The Academy and its members therefore welcome positive actions taken to implement the Report’s recommendations and ensure quality of care must be the foremost priority for all involved in the delivery of health services. The Academy, Medical Royal Colleges and Faculties are keen to work with Government and other bodies to implement change.In practical terms the Academy and its member Colleges and Faculties are:
Medical Royal Colleges and Faculties are looking specifically at change through education and training, clinical standards, quality of care and raising concerns. Examples of such work include:
- Drawing up implementation plans for how they and others can effect a major change in patient care and professionalism among medical practitioners
- Identifying which of the report’s recommendations they can actively help implement and where they can lend support
- Holding a seminar in April for Colleges and Faculties to prioritise and develop their activity and proposals
- Developing a programme and tools to support clinicians and managers in deciding priorities and ensuring quality in difficult financial circumstances.
Tuesday, 26 March 2013
- The revision of quality assurance systems to identify and review unsatisfactory performance in pathology departments (Royal College of Pathologists)
- Working with trusts to support clinicians in creating a culture where the clinical voice is strong (Royal College of Psychiatrists)
- Launching a Clinical Accreditation Service to allow Trusts and Boards to benchmark service provision against evidence based standards (Royal College of Anaesthetists).
The Academy would like to congratulate Mr Walter Merrick on being reappointed as Chair of the Academy Board of Trustees for a further three years. We look forward to continuing our work with him over that time.Monday, 25 March 2013
The Academy of Medical Royal Colleges (the Academy) today formally publishes a statement encouraging support for the engagement of health professionals in voluntary work. Healthcare in the UK is widening its focus from local to global health related challenges. This means that doctors need to be more aware of health issues from a broader perspective and also in delivering that care in low resource environments.Professionals who volunteer are able to expand their knowledge of global health as well as develop their own skills, to benefit not only the NHS but also improving health and healthcare in developing countries.The Academy has identified six challenges that face healthcare professionals when it comes to volunteering:
- Granting of time out from training and/or employment for volunteers
- Formal recognition of volunteering for professional development
- A fragmented environment for volunteering activities
- Monitoring, evaluation and research of volunteering activities
- Information, training and support for volunteers
- Additional expenditures and the loss of employment entitlements for volunteers.
The NICE Implementation Collaborative (NIC) NIC harnesses the skills, experience and dedication of organisations and individuals from across the healthcare system to improve patient outcomes for all. The NIC is a unique partnership whose members are committed to working together to support a system where patients have faster and more consistent access to NICE-recommended medicines, treatments and technologies.
This independent partnership between the NHS, the life sciences industry, healthcare professional bodies, key health organisations and the public is transformational and heralds a collaborative approach that will be critical in achieving improved outcomes for the whole population. The signing of the NIC concordat by all its partners is the very first time that the NHS and it's stakeholders have come together to work in this way and completely re-draws the landscape.
The Academy has signed up to the NIC Concordat which can be read here.
The NIC brings together all the key players in one place to find out what's stopping NICE treatments being used and then aims to find ways to overcome these barriers, in the new environment of CCGs locally determining appropriate and affordable prioritisation.The NIC has already started pilot work related to four specific pieces of NICE guidance, more information can be found about each of these below:
These pilots will allow the NIC to better understand the barriers within the system and developknowledge of how it can work most effectively and within the new NHS environment. Thepilots will also develop solutions that promote better and more consistent access to NICE recommended treatments, medicines and technologies.
- Denosumab for post-menopausal women with osteoporosis (NICE TA204)
- Novel Oral Anti-coagulants for prevention of stroke in patients with a trial fibrillation (NICE TA 249 & 256)
- Insulin pumps in type I diabetes mellitus (TA151)
- Natriuretic peptide testing in heart failure (CG108)
Members of the NIC:Academic Health Science NetworksAcademy of Medical Royal CollegesPatients Involved in NICEWednesday, 13 March 2013
"The Academy of Medical Royal Colleges welcomes the decision of the Government to withdraw the proposed regulations on procurement and competition."We are pleased that the Government has clearly listened to the concerns expressed by the Academy both in writing and in person to Earl Howe about the potential effect of the regulations."We now await the revised Regulations which we trust will address the concerns we expressed and more clearly align with the assurances given by the Government during the passage of Health and Social Care Act"Tuesday, 05 March 2013
On Monday 25 February, the Academy formally launched its report Measuring Up: the Medical Profession's Prescription for the Nation's Obesity Crisis at the House of Commons, sponsored by Dr Sarah Wollaston, MP, who gave a speech welcoming the report's recommendations. Also supporting the campaign launch and speaking was the Chair of the newly formed Obesity All Party Parliamentary Group, Rosie Cooper, MP.
The launch was well attended by those individuals and organisations that had given evidence to the Academy's report as well as Lords and MP's; including the Minster for Public Health, Anna Soubry, MP, and the Shadow Public Health Minister Diane Abbott, MP and Shadow Health Minister Andy Burnham, MP.
Professor Terence Stephenson, Chair of the Academy of Medical Royal Colleges, opened the launch summarising the 10 recommendations of the report including actions to be taken concerning healthcare professionals, the obesogenic environment and making the healthy choice the easy choice.
In conclusion he said that:
"Every person we heard from wanted help to lose weight, they wanted help to swim with the tide not against the current.
"Obesity is not any one government or industry's fault, there is no single solution and therefore it is everybody's responsibility to get together and put this situation right. Which is why we are inviting partners to create a coalition of the willing, of organisations across all four nations and governments to come together and begin to tackle this crisis."
Rosie Cooper, MP supported this view stating that:“We need together, to do more, starting right now before the problem becomes worse and the NHS can no longer cope."The work of the Academy of Medical Royal Colleges through the Measuring Up report is showing the way through the “united front” of the medical profession."
Speaking after the launch Dr Wollaston MP said:"One in three children in our primary schools are obese or overweight and one in five are obese by the time they are at secondary school. Those who are obese as children have an eighty-five percent chance of becoming obese adults and this is linked to long term health problems. It cannot be right to ignore such a pressing health crisis for our children and I will be campaigning to make sure that Government recognises and responds. In particular the role of sugary drinks and how we can increase children's fitness through sport both in and out of school and encouraging cycling."
The Academy is looking forward to taking this campaign forward in 2013 and working with all those with in an interest, including Government, organisations and individuals.
Dr Sarah Wollaston, MP & Professor Terence Stephenson Anna Soubry, MP, Professor Terence Stephenson & Rosie Cooper, MPWednesday, 27 February 2013
Medical professionals – from surgeons and psychiatrists to paediatricians and GPs – have set out their recommendations for tackling obesity in a report published today by the Academy of Medical Royal Colleges (AoMRC).Measuring up: the medical profession's prescription for the nation's obesity crisis follows a 6-month inquiry by a steering group comprising representatives from 20 of the Royal Medical Colleges and Faculties.The report presents an action plan for future campaigning activity, setting out 10 recommendations for healthcare professionals, local and national government, industry and schools which it believes will help tackle the nation’s obesity crisis.Recommendations include:
- Food-based standards to be mandatory in all UK hospitals
- A ban on new fast food outlets being located close to schools and colleges
- A duty on all sugary soft drinks, increasing the price by at least 20%, to be piloted
- Traffic light food labelling to include calorie information for children and adolescents – with visible calorie indicators for restaurants, especially fast food outlets
- £100m in each of the next three years to be spent on increasing provision of weight management services across the country
- A ban on advertising of foods high in saturated fats, sugar and salt before 9pm
- Existing mandatory food- and nutrient-based standards in England to be statutory in free schools and academies
The Academy welcomes the Shape of Training review and recognises the need for postgraduate medical training continually to evolve to keep pace with the changing patterns of delivery of healthcare and the needs of patients. Training must deliver doctors fit for the purpose and service in which they will work.The Academy supports a broad general training period at the beginning of all doctors’ careers, where experience must be gained in primary care and in emotional/mental health well-being as well as acute illness. There should be an emphasis on communication, team working and leadership capabilities. This should be followed by a period of specialisation, as appropriate for the different specialties, based on the requirements for the future healthcare needs of the nation.The agreed Academy of Medical Royal Colleges response and Academy Trainee Doctors’ Group response are available to read and download.We look forward to seeing the outcomes of the review and being involved in the future developments of this important piece of work, to ensure that we continue to train world class doctors who deliver excellent patient centred care.Friday, 15 February 2013
The Academy of Medical Royal Colleges which represents the medical royal colleges and faculties in the UK has made the following statement in response to the publication of Robert Francis’s report into the failings at Mid-Staffordshire NHS Foundation Trust:There were shocking failures in care at Mid Staffordshire Trust and system breakdowns in how the NHS safeguarded the quality of care for patients.Quality of care must be the foremost priority for all involved in the delivery of health services. That was not the culture in Mid Staffordshire. All professionals from the medical and nursing profession to managers have a share in the responsibility for this failing. As such we express our profound regret for the breakdowns in professional standards experienced by patients and their families.We believe that poor care is not everywhere in the NHS but has the potential to happen anywhere. Many doctors will have had experience of aspects of what happened at Mid Staffordshire. Within organisations which in overall terms provide a good standard of care there can be departments, wards or teams where standards fall below what is acceptable.The delivery of quality care is a shared responsibility and all parts of the healthcare system – politicians, national leaders, managers and clinicians – must really listen to and hear what is said to them by patients and carers to ensure that quality of care, patient safety and patient experience are truly the central drivers of what happens in the NHS.Medical Royal Colleges exist to raise standards across the health system. All the activities they have been and continue to be involved with in relation to developing clinical standards and responsive high quality medical education are all aimed at improving the quality of care for patients.The Academy and all individual Royal Colleges will be carefully examining the specific recommendations of the Francis Report to see how they, working with others, can take forward the necessary improvements to ensure that the circumstances in Mid Staffordshire cannot be repeated and we continually improve patient care.ENDSNotes to editors1. The Academy’s role is to promote, facilitate and where appropriate co-ordinate the work of the Medical Royal Colleges and their Faculties for the benefit of patients and healthcare. The Academy comprises the Presidents of the Medical Royal Colleges and Faculties who meet regularly to agree direction.2. The Academy is organising seminar in April for member Colleges and partner organisations to consider in detail how Medial Royal Colleges and professional organisations can support implementation of the relevant recommendations in the report.3. The Academy Chairman, Professor Terence Stephenson, is available for comment or interview4. For further information contact Rosie Carlow on 020 7490 6815Wednesday, 06 February 2013
We are looking for your ideas to inspire improvement!
Trainee doctors are being asked to seize the opportunity to come up with ideas that will make training work better for them.
Health Education England's Better Training Better Care programme has £100,000 to fund innovative ideas through its Inspire Improvement! project. The funding is for trainee-led ideas that will improve their training and education, and in turn, improve patient care.
The trainee-led project ideas should demonstrate outstanding potential to meet the challenges set out in Sir John Temple’s recommendations, which are:
1. Training must be planned and focused for the trainees’ needs
2. Training requires a change from traditional perceptions of learning which recognises the modern NHS
3. Trainees must be involved in the decision making and implementation of training innovations that affect their present and future careers
Applications close on 2 April 2013. After this there will be a shortlisting process. An expert panel consisting of senior figures from Health Education England, the Faculty of Medical Leadership and Management, the Academy of Medical Royal Colleges and the Conference of Postgraduate Medical Deans will judge the shortlisted applications and award funding in late April 2013.
Howard Ryland Clinical Fellow at the Academy said:
"As trainees we are ideally positioned to see where things could be improved, but we can lack the senior support, financial backing or voice to be able to effect these changes. The Make a difference! project will change that. The BTBC programme has identified £100,000 to fund a number of trainee-led projects that demonstrate outstanding potential to meet the challenge set out in Professor Temple’s recommendations.
"There are no limits about what the project could look like, as long as it can show how it would positively impact on training and address one or more of the recommendations. Projects can have a local focus, but need to be generalisable in a national context. They also need to be sustainable, even when the original trainees have moved on... Good Luck!"
Download the Inspire Improvement! flyer.Friday, 01 February 2013
The Ethical Standards in Health and Life Sciences Group (ESHLSG), a group of 20 organisations (18 full members and two observing members) working together to improve the relationship between healthcare professionals and the pharmaceutical and life sciences industries, has launched a consultation on establishing a public register of payments made to healthcare professionals by commercial organisations.
Healthcare professionals and commercial organisations collaborate and interact in a range of activities from developing innovative treatments, sharing good clinical practice and delivering patient care. The group believes that the public disclosure of payments to health professionals represents a significant step towards fostering greater transparency and building greater trust between the medical community, industry and patients across the UK and Europe.
In June 2012, the pharmaceutical industry stated its ambition to work with the healthcare professional community to introduce a system of public disclosure of payments across Europe by 2016. Companies operating in the UK, will begin disclosing the total of payments made to healthcare professionals and the number of individuals receiving payments in spring 2013.
All healthcare organisations, commercial companies and individual healthcare professionals are being encouraged to complete the consultation questions online and to read the document Establishing a register of payments received by UK healthcare professionals from commercial organisations before completing it.
Sir Richard Thompson, co-chair of the ESHLSG and President of the Royal College of Physicians, commented:
“This consultation is intended to establish whether there is, in principle, support for a publically available, single, searchable system for disclosure of payments that is inclusive of all commercial life science organisations working in healthcare.”
As part of its work in evolving the relationship between commercial organisations and healthcare professionals in the UK, the ESHLSG has considered and outlined a set of principles on which a model of disclosure could be established, and, in particular, how healthcare professionals and industry might work together in such a system.
Deepak Khanna, co-chair of the ESHLSG and President of the Association of the British Pharmaceutical Industry, commented:
“The consultation outlines ESHLSG’s vision of the principles behind how a system of declaration could work. It does not make recommendations about which payments to declare or cover, or make specific recommendations about the practical implementation of such a system.
“Our view is that the co-creation of a system to declare payments is the right course of action and that it should be developed and agreed jointly by the relevant stakeholder groups. A move to greater transparency would address societal demands, represent an evolution in the relationship between commercial organisations and healthcare professionals and would support new ways of working in the future.”
The consultation is open for a period of three months and the ESHLSG is actively seeking views from all members of the healthcare community which will inform how the system of declaration would work.Tuesday, 29 January 2013
The Academy funded the Royal College of Surgeons of England to produce a report: Hospital Episode Statistics: Creating the evidence to support revalidationThe project's aim was to assess the strengths and weaknesses of using administrative data for revalidation in the areas of ischaemic heart disease, urological malignancies, and peripheral vascular disease. The Project Group distinguished between procedure-specific indicators and disease-specific indicators as well as between hospital-specific and consultant-specific outcomes.
The report has been published this month. Follow the link above or download the report below.Monday, 14 January 2013
The Department of Health's commissioned DDRB report, Review of compensation levels, incentives and the Clinical Excellence and Distinction Award schemes for NHS consultants was published today. The report also includes recommendations on the consultant contract and career. An NHS Employers scoping report on the contract for doctors in training has also been published.It is understood that the reports are also being published by the devolved administrations.Professor Terence Stephenson, Chair of the Academy of Medical Royal Colleges said:“Whilst the detail of terms and conditions are not a matter for Royal Colleges, continuing to encourage excellence and maintaining effective careers for doctors are proper concerns for Colleges.We are therefore pleased to see that the DDRB and Government have recognised the need to continue to with arrangements to reward that who make an outstanding contribution to the NHS nationally and for UK healthcare as a whole. This recognises excellence in achievement for the wider NHS whether in clinical, academic, educational, R&D or service improvement fields. It also supports the retention of national and international expertise within the UK health service.”Monday, 17 December 2012
The NACT UK 11th National Multi-Specialty Conference is being held in London on 22 & 23 January 2013.The conference for Heads of Schools, Programme Directors, Directors of Medical Education & Clinical Tutors and all responsible for local postgraduate training in Acute, Mental Health and Primary Care Trusts, will discuss the approval of trainers, the shape of training review, update delegates on LETBs / COPMeD and the foundation programme amongst other training related areas.The conference will also hold an open session for delegates to share idea. Anyone wishing to offer a topic for the open session please can download the call for papers document on the NACT UK website and return to their office by no later than 31 December 2012.Further details on NACT UK and the 2013 conference can be seen on the NACT website.Wednesday, 05 December 2012
Patients in hospital should be reviewed by a consultant at least once every 24 hours, including weekends and bank holidays, unless there are good reasons for them to not to have a daily review, an authoritative report out today has recommended.The Academy of Medical Royal Colleges, which brings together 20 colleges and faculties, has today launched its report outlining its commitment to delivering high quality care to patients seven days a week.The publication: ‘Seven Day Consultant Present Care’, recommends three key standards to ensure all patients receive high quality care led by a consultant regardless of the day of the week.The report raises a series of areas for improvement and highlights that it is unacceptable to not provide consultant-led care at weekends if evidence suggests that this is best for patients.Currently, the availability of consultants and equivalent senior doctors varies widely across locations and across different areas of medicine in the evenings and at weekends. The report calls for the NHS to ensure that appropriate resources and adequate numbers of consultants are provided to enable consultant-led care to be achieved, seven days a week.In addition to this, mortality and complication rates are significantly higher for patients admitted as emergencies at the weekend. Patients admitted to a UK hospital at a weekend are more likely to die during their hospital stay than those admitted during weekdays.The report demonstrates the high level of commitment among the medical Royal Colleges to see an improvement in the quality of care delivered to patients at weekends and after hours. It aims to ensure patients receive the best consultant-led care regardless of when they are admitted.Three patient-centred standards to guide the delivery of consistent care irrespective of the day of the week are highlighted in the publication:
The report highlights that the Academy of Medical Royal Colleges does not see these standards as a panacea for all patient safety issues, but as a strong contribution to improving consistent quality care for patients.Professor Norman Williams, Steering Group Chair and President of the Royal College of Surgeons of England, said:"The standards we recommend in this report reflect the importance of daily consultant-led care and the support that needs to accompany this to ensure that patients receive the very best treatment. It cannot be right that over weekends and bank holidays, patients may receive a lower standard of care than they would during the week.Clinical staff and managers must work together to re-shape hospital services in a way that strengthens the quality of care given to patients regardless of the time of day they are admitted. Similar arrangements will be necessary to support patients in the community when discharged at weekends. Ensuring that key staff are available to provide this support will come at a cost. However this is crucial for the full benefit of seven day consultant-led care to be realised."Professor Terrence Stephenson, Chair of the Academy of Medical Royal Colleges, said:"The evidence for the benefits of consultant delivered care is clear. We hope these standards will be supported and acted upon by the NHS Commissioning Authority so patients can receive the best care and treatment regardless of when they need it."Tuesday, 04 December 2012
- Hospital inpatients should be reviewed by an on-site consultant at least once every 24 hours, seven days a week, unless it has been determined that this is not necessary for the patient
- Consultant-supervised interventions and investigations along with reports should be provided daily if the results will change the outcome or status of the patient’s overall care before the next ‘normal’ working day. This should include interventions which will enable immediate discharge or a shortened length of stay
- Support services both in hospitals and in the primary care community setting should be available daily to ensure that the next steps in the patient’s treatment, as determined by the daily consultant review, can be taken. It also acknowledges that it is outside its scope to look in detail at community services.
Revalidation of licensed doctors begins today. Senior doctors in medical leadership role will be amongst the first to go through the revalidation process under the GMC’s new way of regulating licensed doctors.
It is expected that the majority of licensed doctors in the UK will have been revalidated by 2016. Revalidation aims to give patients and the public, as well as employers and other healthcare professionals, extra confidence that doctors are up to date and fit to practice. All licensed doctors will need to revalidate on a regular basis (usually every five years) in order to keep their licence to practise.
Speaking on the process, Dr Tony Falconer, Academy Revalidation lead and President of the Royal College of Obstetricians and Gynaecologists said:
“I am pleased that the process of revalidation has finally started and like the majority of doctors, I hope that this process will improve the quality of medical care for patients and look forward to seeing the evidence of such progress.”
Professor Terence Stephenson, Chair of the Academy said:
“The Academy of Medical Royal Colleges supports the principle of revalidation. All the UK's doctors will be demonstrating that they are fit to practise in whichever field they work in”.
More information on revalidation can be read on the GMC’s website
The Academy’s role and involvement in revalidation can be read hereMonday, 03 December 2012
1081 NHS hospital consultants and two general practitioners who volunteered to take part in the survey.The results of the survey showed that:
95% would like to access HES data and there was a strong support for using this data for appraisal, revalidation and improving the quality of patient care. In terms of improvements, 91.9% would be prepared to code diagnosis in outpatients given the right tools. The highest priority for improvement is clinical validation of diagnostic data.The survey findings conclude that clinical engagement with coding and access to HES data is poor. However, there is professional support for improvement. Clinical requirements should be considered in all future developments of national data collection to provide the quality and scope of data that is required to deliver the information revolution.read the full findings of the report at the BMJ Open webpages.Monday, 26 November 2012
- 3.4% of the sample regularly access HES data
- 21% are regularly involved in clinical coding
- 6.2% meet coding staff at least monthly
The Academy of Medical Royal Colleges welcomes publication of the first Mandate to the NHS Commissioning Board and supports the focus on the NHS Outcomes Framework. The Academy is pleased to note the Mandate is now more concise and focussed than it was previously.
Professor Terence Stephenson, Chairman of the Academy of Medical Royal Colleges said:
"A mandate from the Government to hold the NHS to account against high-level outcomes will keep the spotlight on the importance of a patient-centred culture whilst allowing flexibility and innovation in how to achieve it
Seeking across the board improvement is ambitious. However it does avoid previous problems of distorting clinical activity and behaviour in unhelpful ways by setting specific targets in selected areas.
We are pleased to see that issues raised by Colleges during the consultation on education and training, seven day working and rare conditions have been included in the document.
It is good to see the recognition of the role that Royal Colleges play in achieving improvement in outcomes and the Academy, Colleges and clinicians look forward to working with the Government and Commissioning Board to improve patient safety, experience and outcomes"
For more details go to the mandate website: www.dh.gov.uk/mandateWednesday, 14 November 2012
The umbrella bodies representing NHS trusts and commissioners, patients groups and medical colleges have joined forces in a bid to help deliver the right care in the right place for patients.The NHS Confederation, the Academy of Medical Royal Colleges and National Voices have today come together to carry out a joint project on the reconfiguration of healthcare.There is a growing consensus that change is needed to take advantage of modern healthcare techniques, meet the needs of an older population, and enable the NHS to live within its means.The NHS Confederation, Academy and National Voices joint work will assess:
This joint work will provide practical advice on the implementation of service change, looking at where reform has gone well and where it has not.Joint teams will over the next few months carry out interviews and hold a workshop with NHS leaders, clinicians, patient representatives and MPs around the country to inform this work. The project will also draw on the expertise of the NHS Confederation’s Hospitals Forum and Community Health Services Forum.The organisations plan to jointly publish the final report at the NHS Confederation annual conference and exhibition in June 2013.Professor Terence Stephenson, chairman of the Academy of Royal Medical Colleges, said:“Service reconfiguration is at the top of the Academy’s agenda and we have been heavily involved in taking elements forward, such as seven-day acute care. For the NHS to continue to deliver high quality patient care we recognise that the provision of healthcare services has to change. Increased patient expectation and personalisation of healthcare combined with community focus and technological changes mean that we cannot sit still on this. The Academy is pleased to be part of this joint project and we believe that by providing a national view the necessary consistent approach will follow locally.”Mike Farrar, chief executive of the NHS Confederation, said:“This has the potential to be a powerful coalition for change. It is certainly one which would be foolish for politicians and policy makers to ignore. We need to make progress on behalf of the public and we need the leaders of NHS trusts, clinicians and patients to be shoulder to shoulder on the big issues."I hope the project will inform the public and the political debate about what needs to happen, as well as give valuable insight and practical tools to those commissioning and providing services."Jeremy Taylor, chief executive of National Voices, said:“Reconfiguration should be always be about better outcomes for patients. Getting it right means listening to what patients, carers, service users and local communities tell commissioners and providers. We look forward to working with our members, the NHS Confederation and the Academy of Medical Royal Colleges to ensure people get the right care, at the right time and in the right place.”Monday, 05 November 2012
- What change is necessary and why;
- The benefits to the public and how risks might be managed;
- The barriers that have hampered change and how they might be overcome;
- The principles that should govern any proposals, including the role of the public and clinicians.
The Academy of Medical Royal Colleges welcomes publication of the first Mandate to the NHS Commissioning Board and supports the focus on the NHS Outcomes Framework. The Academy is pleased to note the Mandate is now more concise and focussed than it was previously.