President’s Blog August 2014

August!  And with it a new cadre of doctors, an increase in barbecue related burns and dare I hope; a Test match win for England?

I have now compiled a dozen of these short epistles and to those of you who have read them my thanks and apologies! The challenge is always to be topical despite a 10 week lag time between submission and publication and this challenge is particularly testing over the summer months; whilst the College remains busy, parliament is in recess and the news media generally happier covering the bizarre and peculiar.

However having been in post for a full year I would like to record my thanks to all fellows and members for their continued support of, and engagement with, the college. The rising number of subscribing members encourages me to believe that the College is seen as relevant and worthy of support. I would particularly like to thank my consultant colleagues in Taunton, whose encouragement and accommodations with the rota have enabled me to carry out my responsibilities as president and EM consultant. Without the support of Gillian, Jon, Jason, Paul, Alistair, James and Rhona it would simply not have been possible.

As I write the DH in England has issued a document ‘Operational resilience and capacity planning for 2014/15 Guidance’ – unlikely though it is to win any prizes for literature or indeed be widely reported at its time of publication the College has been negotiating hard to ensure key components relevant to emergency medicine have been included.

In particular there are specific references to ‘Exit Block’ and ‘co-location’ – the first time that this has occurred in a national guidance document from a statutory body.   The College is also specifically referred to, as is our ‘Crowding Guideline’.

The significance is considerable as it means that two of the five items of the ‘CEM 10’ that require action by others are now endorsed by the DH.

Of the three others, ‘Tariff reform’ we hope will be included and referenced in a Monitor document in July, ‘Contract reform’ is the subject of ongoing negotiations between the BMA and NHS employers in England and locum expenditure over the winter will be closely monitored by us as well as others,  as it has been the subject of much media interest and at least one Freedom of Information request.

By the time you read this we will have launched the output of our March summit. This document entitled ‘Acute and Emergency care – prescribing the remedy’ contains 13 key recommendations. Importantly, and again for the first time, this document has been endorsed by the RCS, RCP and RCPCH who are co-signatories.

We will be making full use of this consensus to press for action on all the recommendations over the coming months and will be co-hosting meetings at the party conferences of the coalition parties and main opposition party.

I have just returned from the Hong Kong conference where there was good representation by CEM members. The work of the African Federation of Emergency Medicine was particularly in evidence. The College has an international committee and I know many college members have a keen interest in humanitarian work and the development of emergency medicine in low income countries. The AFEM website is an excellent resource for any who wish to find out more about emergency medicine across the continent of Africa.

Surprisingly I found there was considerable international interest in our Sentinel Sites data with many colleagues expressing similar frustration in respect of poor national data sets and even more woeful misinterpretation. We have been invited to Amsterdam and Stockholm to present both the methodology and the data. The EuSEM meeting at the end of September offers a useful opportunity to any of us with study leave still to take. However mindful of the pressures of time and money I fully appreciate that many members are unable to attend such meetings. For this reasons it was thought some years ago that it would be useful to video presentations at College conferences, however the practicalities are onerous and in truth few such presentations are ever watched. For the Exeter conference we are trying a new format – many of the presenters will be asked to give a 3 minute summary of their key points, these will be recorded and edited by a professional film producer and uploaded to the ‘soon to be launched’ CEM YouTube channel. We hope this will mean that anyone can access the key messages from a smartphone or tablet whenever they wish. Personally I think the time it takes to microwave my ready meal whilst on a late shift will provide the perfect opportunity!

I hope all of you will be able to take leave during this summer period and have the opportunity to refresh both mind and body in the company of friends and family.

Dr Cliff Mann
President
The College of Emergency Medicine
@RCEMPresident