The first six months – springing forward

Rattling cages, battling (media) dragons and the ‘rock and roll’ of EM! These seem to have been some of the key themes of my first six months of presidency. Time has indeed flown by but amongst the wider crisis facing the NHS, there has been a clear RCEM message heard loud and clear that if governments value emergency care systems in this country (as the public seem to) then they will need to prioritise to support us and invest wisely. A first world country deserves a first class system and we remain significantly short of that.

The three areas that I said I was committed to in late September 2016 – core Policy, the Pact of the College with its members and a clear focus on Patient centred care – remain at the heart of my endeavours as your President. The vital building blocks are I feel now in place going forward. A six month report in April 2017 seems a good time therefore to reflect and also describe the roadmap for the next 3 years.  So here are 10 things to know about what we have achieved so far :

1. Core policy – The RCEM Vision2020 strategy that we have developed has now been out for consultation and we have developed 10 key themed areas for activity around the three pillars of – Staffing, Systems & Support. We have taken this core strategy to the ‘top table’ in England and been met with significant approval. I have been clear to all that we are not interested in them cherry picking what might be expedient but must find a way to have an engaged, constructive and collaborative approach if we are to succeed in the medium term (three years). This we hope will be described as an Emergency Care Transformation Programme or similar – we will see. The policies developed can, I hope, be appropriately tailored by national Boards to the devolved countries.In the meantime I have also made clear both privately and in the media that the absolute priority in the short term is to address exit block by securing more funding for social care, more acute beds and more staff in ED to cope with the increased workload. News will emerge I have no doubt, by the time you read this.

2. Workforce models – A key component of RCEM Vision2020 is that we must have the right tailored workforce models for our large (MTC equivalent) systems, medium sized and smaller remote/rural systems so that we can build towards safe and sustainable care models for our staff. This is the key first theme and I have asked our two excellent Vice Presidents – Chris Moulton & Lisa Munro-Davies to lead on this. Some great work will emerge I am sure.

3. Defining quality in ED – Deciding how we should define the quality of care we deliver in ED is vital and the 4hr standard has been a major focus of attention as a system metric. We now have engagement with NHS Improvement on this key topic and will provide them with expert advice. I have asked Adrian Boyle to chair a group on this and report back to Council.

4. The Emergency Care Data Set (ECDS) – You will know that our informatics systems have for too long not accurately recorded the work that we actually do in ED. This then translates badly in how that activity is recognized in the tariffs that go to fund our service. I am grateful to Tom Hughes and Aaron Haile at the College for all their ongoing work in this area that has recently been given the green light for implementation. If you work in England, please visit the College website to learn more about ECDS – launch planned in October 2017. If you don’t work in England, it’s still worth knowing as some variant of this will be coming your way soon.

5. Research – Led by Alasdair Gray and colleagues on the R&P, there has been excellent College academic activity on many fronts. The College recently completed a collaborative partnership on research priorities with the James Lind Alliance which was led by Prof Jason Smith from Plymouth. If you haven’t heard about it, well worth visiting the College website.A major focus, led by Alasdair is now to devise the wider research strategy for the next three years as part of RCEM Vision2020. We look forward to hearing more very soon on this.

6. Committee structures – We have also revised the committee structures across many aspects of College work. Included amongst this has been the opportunity to develop new Special Interest Groups in a number of areas including Frailty/ElderlyEM (Chair – Jay Banerjee), Ambulatory Emergency Care (Chair – Tara Sood), Public HealthEM (Chair – Ling Harrison), Remote & Rural EM (Chair – David Snow). Other groups may also well emerge. You will hear much more from these groups in the coming months and am grateful for the enthusiasm and engagement we have had thus far.

7. International strategy – The College has been at the forefront of developing and supporting examinations in India and a number of countries in recent years. We are aware though of the need to bring together a host of initiatives into a more coherent approach and benefit colleagues in other countries too. In discussions with our Deputy CEO, Emily Beet, Jason Long our Dean and also Gordon Miles our CEO we have been developing this new approach and will hope to publish on this in the next few months. This will benefit colleagues in developing countries, our members who are keen to support them and of course patients in some of the poorest systems in the world. Thank you to Emily who is leading this work.

8. Golden Jubilee celebrations – I have spoken before about the fact that 2017 is the 50^th anniversary of the inception of our specialty in 1967. We want to celebrate in a host of different ways and I am delighted that Diana Hulbert from Southampton (patient Editor of EMJ Supp!) has accepted my invitation to Chair the Organising committee. Lots of ideas are emerging and we will be launching at the Spring CPD Conference in London – thanks to Diana for all her work on this.

9. RCEM Foundation – The development and launch of the Foundation has been a seed for potential development for many years and am pleased that we will finally be able to launch it this year, using our 50^th celebrations as an important springboard for it to be a great success. We hope to appoint an excellent Chair for the Foundation very soon. It will be a superb chance to provide funding for research, education and systems development both at home and abroad. Thanks to Gordon Miles for all his help getting it off the ground.

10. RCEM Annual Awards – It is an absolute pleasure to announce that we will be launching the RCEM Annual Awards at the Liverpool autumn Conference in Oct 2017. Robin Roop (VP for Wales) has been leading the work on developing the structure around this and we think it will be a great way for the specialty to ‘look up’ and celebrate excellence in emergency care. Again, more news to follow soon.

This has been a long update but much to tell. Thanks again to all those who I have met on my travels at regional and national meetings. Please keep feedback coming.

And finally ….the Hassan household Black Lab puppy continue to entertain and not follow commands as yet. Feel free to feedback on twitter #puppyrules

Dr Tajek Hassan
President, The Royal College of Emergency Medicine
@RCEMPresident