Consultant physicians working with patients 5th edition - FSEM

Consultant physicians working with patients
developed an infrastructure through which the research
active physician should be able to contribute to this
vision. Despite this, challenges remain. Cultural changes
in the NHS place an increasing emphasis on clinical
service over teaching and research.
The potentially conflicting demands of employers (eg
NHS, universities, industry and grant-awarding bodies),
those who fund research (eg national awarding bodies
and charities), and training and regulatory institutions
(eg royal colleges, and the GMC) need to be reconciled.
The move towards a consultant-delivered clinical
service and the workload relating to clinical governance,
revalidation and CPD may mandate new ways of
working; and achieving a balance between clinical and
academic training, and geographical mobility will be
needed.
Through a series of working parties and associated
publications, the Academic Medicine Committee
(AMC) of the RCP has attempted to address these issues.
First, it has held workshops and published position
papers concerning routes of entry and training systems
in academic medicine. 25 The need for a transparent
career structure up to and including properly structured
and supported consultant posts has also been debated. 26
Second, the AMC has been an integral part of the RCP’s
Medicines Forum, leading the work stream relating to
translational research. Specifically it has identified ways
in which the RCP can act as a link between national
agencies and the research active physician, thereby
facilitating the UK research agenda. Finally, the AMC
has provided evidence to a number of investigations,
consultations and reports, the most significant of which
has been the 2011 report of the Academy of Medical
Sciences into the burden of regulation impacting on UK
research and clinical trials. 27
Summary
The context of clinical practice has changed rapidly
since the millennium and is set to change further.
Revalidation, changes in medical education and
research, and the expansion of the potential portfolio of
the consultant coupled with a move towards a
consultant-delivered service and service
reconfiguration, pose challenges and unrivalled
opportunities. There is a need for clinical leadership in
management, quality improvement and commissioning
and planning of services.
12
Better planning, support, education and training of the
consultant workforce are now needed to ensure that we
can positively influence these changes and ensure that
patient care not only remains at the centre of our
endeavours but continues to improve.
References
1 Royal College of Physicians. Leading for quality: the
foundation for healthcare over the next decade. 2010.
www.rcplondon.ac.uk/policy/responding-nhs-reform/
leading-quality
2 Royal College of Physicians. Doctors in society: medical
professionalism in a changing world.Reportofaworking
party. London: RCP, 2005.
3 Royal College of Physicians. Future physicians: changing
doctors in changing times. London: RCP, 2010.
4 WanlessD. Securing our future health: taking a long term
view. London: HM Treasury, 2002.
5 MarmotReviewTeam.Fair society: healthy lives. The
marmot review. London: Marmot Review, 2010. www.
marmotreview.org.
6 Royal College of Physicians. A strategy for quality: 2011
and beyond. www.rcplondon.ac.uk/policy/improvinghealthcare/rcp-strategy-for-quality.
7 Department of Health. Equity and excellence: liberating
the NHS. London: DH, 2010.
8 Royal College of Physicians. Care closer to home.
www.rcplondon.ac.uk/resources/clinical-resources/carecloser-home.
9 Department of Health. Ourhealth,ourcare,oursay:a
new direction for community services. London: DH, 2006.
10 Tooke J. Aspiring to excellence: final report of the
independent inquiry into modernising medical careers.
London: MMC Inquiry, 2008.
11 Smith J. The Shipman Inquiry: fifth report. Safeguarding
patients: lessons from the past – proposals for the future.
London: Department of Health, 2004.
12 Chief medical officer. Good doctors, safer patients.
London: Department of Health, 2006.
13 Department of Health. Trust, assurance and safety: the
regulation of health professionals. London:DH,
2007.
14 Medical revalidation – principles and next steps: the report
of the Chief Medical Officer for England’s Working Group,
July 2008. www.dh.gov.uk
15 General Medical Council. Revalidation: a statement of
intent. October 2010. www.gmc-uk.org
16 National Confidential Enquiry into Patient Outcome and
Death. Elective and emergency surgery in the elderly: an
age old problem. 2010. www.ncepod.org.uk
17 Lewis G (ed). Centre for Maternal and Child Enquiries
(CMACE). Saving mothers’ lives: reviewing maternal
death to make motherhood safer. The Eighth Report of the
C○ Royal College of Physicians 2011