Computer generated transcript

Warning!
The following transcript was generated automatically from the content and has not been checked or corrected manually.

Evidence showing that. Yes. Yes. That was nearly at the very end. Yeah. There was just one last thing that I'd really like to tell you about because, you know, things have changed a lot in that 34 years that I've been a GP, I think it is easier to be flexible now. Um, I think it's, um, sad that we have more people leaving the profession than we have joining it because of course, it just becomes, um, uh, almost a vicious circle, doesn't it? That it makes things worse and worse and worse. Um, we need, we need good leadership. We need people to stand up and speak and that's not just me, um, as chair of the college, all of all of us. Um, we'll get opportunities to stand up and speak and we need to, um, and I need all of you to support me and, um, to, to work with me to make sure that we survive as a profession. But I did want to just point you to something or which you can find on the internet, which I found a couple of years ago and have used often and it's really inspiring. Because we're standing on the shoulders of giants um today and one of them was Dame Clare Marks um the former chair of the G M C and I found a clip online of her giving an interview in 2015 to somebody from the King's Fund, Vijay Noth. Um And it's um called challenges facing women in medicine. So if you Google Claire marks King's Fund challenges facing women in medicine, you'll find it. And it is a beautiful clip that talks about um many of the things that we're talking about today and she says it ever so much better than I ever could. So please please do watch it. Thank you. Thank you, Camila. I'll definitely be um googling that challenges facing women in medicine. Definitely. Thank you. Um So there were loads of questions in the chat and thank you Kate for sign posting the S A S Charter and the Academy of Medical Royal Colleges, documents about S A S careers as a useful reefs source too, but going back to the initial questions and then try and go in order. So it's by Susan and she had a question for Rob on the panel specifically, she said, have there been problems with the introduction of new S A S doctor rolls on the ground in the trust's um short answers? That would be a resounding. Yes. Yes. There have been some problems getting the new SASS contracts implemented across trusts and sadly, the SAS contract reform for England, Wales and Northern Ireland occurred essentially mid pandemic. Um Scotland may have been marginally more sensible by holding there's back for the better part of a year and launching their contracts a little bit later. Um But basically what happened is that, that the new contracts launched at a point where everyone was slightly distracted by other things. Um And this has led to a variety of, of minor and some more major problems. So for for existing specialty doctors. So for specialty doctors on the contract that was available from 2008 until 2021 they had the opportunity to transfer over to the new specialty doctor contract. And for some confer some doctors, this will have made financial sense or contractual sense for them for others, not so much existing associate specialists have been created before 2008, have the opportunity to transition over to the new senior role, the specialist role and again, some will have done so. But I think the majority chose to keep their existing contract and probably the single biggest implementation problem we've got is that in none of the four nations, has there been any means for existing senior specialty doctors to progress to the new senior role without a job being created and advertised and applied for? Which means that there are a large cohort of doctors who are now very clearly and very obviously working beyond their contract. Um This is a problem for a number of reasons. Not least of which because it's overwhelmingly affecting doctors of BME, ethnicity and international medical graduates. So I personally think this would be a scandal if it were, if it were more widely known. Um So at the moment, yes, the biggest implementation problem is trying to convince employers and organizations that they need to recognize their existing seniority via either internal processes or by agreeing to advertise jobs so that people can progress to the right contract for their work. And I would encourage anyone who is listening to go back to your employing organizations and make this a priority because this is affecting an awful lot of doctors and in a workforce crisis, we could probably do with recognizing the senior ones who already exist in order to retain them within our workforce. Thank you, Rob. And then the next question is by Lucy and it, she said it's a question to all panelists but particular Camillus, we might start off with Camilla. Then she's said, how can we collectively change the culture and the language within the NHS to help enable each doctor to flourish? Well, what a question, um Lucy, I think um the best way really is by speaking up in the way that you do. Um And uh the way I hope I do, uh it's about having good role models. I think it's about making sure that we bring this up and talk about it. Regularly and openly. Um, we are spend a lot of time um, through, uh, sort of G M C guidance, being really good with patient's, but we're not actually very good with each other. And there are times when we're really not at all good with each other. Um, and I think that that is, um, something, it's just such a shame really. Uh, and there's no harm in being kind to each other and helping each other, such as within a practice, for example, uh not getting too wound up if, if somebody needs to come in a little bit later so that they can drop their child off at school. It's that kind of thing. Um And I do remember all those years ago, the really upset I, I gave my partners when I announced I was pregnant and that was very much along the lines of a, but you said that you were going to travel the world, you never said you're going to have a baby. Um And, you know, it does make you feel guilty for, um, starting a family. Um, and I was 30. It wasn't as if I was that young. So, you know, I think it's that sort of thing. Um And even though I really enjoyed those partners, I think, really enjoyed that practice. We don't forget such things. Thank you, Camilla. And I can see Lucy's even set up a website to help people w W dot Welcome back to work dot co dot UK. Is there anyone else from the panel would like to add to what Camilla said? How can we collectively change the culture and the language within the NHS to help enable each doctor to flourish? I can add if you want. Um I think, you know, a lot of us are senior enough in the situation and the position. I, I personally don't think that a lot of us challenge when we see poor behavior. I think there's a lot of us who would want to do the right thing and we see it around you that doesn't happen. So if you want to change that culture, it starts from your own department. If you see something, which is not right, you say it. And I think all of us on the panel will have seen multiple examples because thing, they're thinking somebody needs to speak up, somebody needs to say something uh when it's against you, nobody is and they're supposed to be realized. So uh you'll hear this a lot, we hear this a lot in N H S single. There's a term which is like, oh there's a bigger picture and I've never been able to find out what this bigger picture is and I've been there for eight years. I'm not sure what the bigger picture is and where it ends. So I think my, my philosophy is that, you know, if you see it in your workplace, which challenges your values, you say it. And I think that's how you do the change in small spheres. Thank you. And I can see Rob with his hand up, go ahead. I'd come back on partners point and say that in my opinion, the bigger picture is that we are in a workforce crisis and we are currently hemorrhaging colleagues and anything that is costing as colleagues out of the workforce, be it? Racism, sexism, the inability of doctors to progress their careers. Well, that seems like a very foolish way to, to to run a healthcare service when we don't have enough people to begin with. Um Coming back on the, coming back on the conversation about culture and language, this is something that I speak an awful lot about when it comes to that comes to doctors who are not in formal training programs. And an awful lot of what happens to local employed doctors and SAS doctors comes down to culture, be that organizational culture, be that departmental culture and an awful lot of why what I do in the wider world is trying to change that culture. Um This is why I speak so much about alternative career pathways rather than discrete jobs or rolls because I think doctors who find themselves outside of formal training programs could very easily become stuck. And there have been an awful lot of documents written over the last decade about maximizing the potential of this aspect of the work force. And that relies on the fact that we all as individuals and organizations recognize that the professional development of doctors, be they in formal training programs or outside of formal training programs, be their GPS or consultants that our own individual professional development is vital because today's service is always the priority. But actually what we need to consider is what the service need five and 10 years time is. And today's service absolutely should not pay the price for five years or 10 years down the line. Individuals need the ability to progress and develop and the kind of culture for assassin local employed doctors sadly is often that they are in non training rolls or consider to be perpetual middle grades. And both of those things are very damaging because all of those doctors are future senior colleagues until proven otherwise. Um And if we were to support the professional development of people outside of formal training programs a little bit more, we have an awful lot more future senior colleagues. Thank you, Rob. And this next question I'm gonna hand over to for Charlie. So this question was by Jot E and she said I'm a G P but also S A S doctor in hospital, breast clinic, flexible working is possible but pays a big discrepancy for non training. S A S doctors. Are there any guidelines around this? Are there any thoughts on the role of H E E N S A S career progression and what could be done to improve this? Um I think that's a good question. Thank you, Jody. Um Yes, a lot of GPS are with special interests are doing S S S clinics. Um I have, I do breast imaging and I see a lot of GPS doing um sort of surgical clinics as breast physicians. Um and I think there is a lot of uh S S in primary care that is something that like scoping exercise has been um start just starting. I think that is something when we discuss this, we will need to consider the, the different pay grades that the SS have compared to the GPS. And that is something we do need to take into account and get it right the first time if we're planning this as a, as a as a futuristic workforce, and I think that is something we do need to consider. Um and we are doing a lot of work with college of G P and G M C to actually um exactly uh sort of uh have this problem tackle this problem. Um The second question was about the uh H E I think a lot of work has actually has done a lot of work about supporting the S S doctors. And as Rob mentioned, the maximizing potential came out in 2019 and there were several commitments and in different domains. Um and we have an academy did a lot of work to actually look at these commitments to see what can be done to fulfill these commitments. Um There is a lot of uh discrepancy between Royal Colleges in offering educational and clinical supervisor roles. Some colleges have good practice and some not so good. And I think there is a lot to learn from each other in this. Um We, we also see that um a lot of uh sort of uh if you look at these uh commitments, you see all these national documents. But if you see at the ground level, at, at the trust level, one of the important ones is S S Charter and S S Charter has not been implemented in the, in the local level. So I think we, we do need to know the next thing would be how to implement these recommendations from national documents at local level. And I think that is the crux of the matter. We have a lot of publications with all good recommendations, but the important discussion will be how do we bring this in practice? And there's a lot of work to be done by employers, by stakeholders, but a lot of work to be done by S S workforce themselves as well. I don't know if you want to add anything rob to this. Um Yeah, I would say that the uh implementation of national rhetoric into the day to day, cold, day to day life at the coalface of the typical Sasso local employed doctor should be a massive priority for future workforce planning. You know, the the new contract structure and all of the national documents support the idea of people reaching their individual potential outside of formal training programs if that is their choice. But we're not very good at it and we're very good at telling people that they're just for service and keeping people at a level for their entire careers. Whereas actually, in my opinion, and in the opinion of both the contract structure and all of the national documents of our SAS careers being a SASS doctor should allow us to develop an extraordinarily large number of future senior colleagues and allow people choice. And I think, you know, really that is that, that's the crux of it. If we were to better support SASS careers, we wouldn't have training number shortage because an awful lot of people would choose to develop their career within one organization rather than rotating for eight or nine years. And, and I think that, that, you know, that is an important, an important part of future workforce planning for all of us is recognizing that if we are reliant on H E funded national training numbers to generate the next next generation of senior colleagues, uh we're gonna have far fewer of them. Thank you. And the next question I'm gonna direct to professor and grad. So, are there any particular considerations about less than full time in academic posts? And how can men undertake more childcare. So two questions there. Uh Okay, shall I start with the considerations in academic posts? So I've already mentioned about being beware of the changes when you're changing employers and the changes that might happen to your recruit occupational benefits. Um Another pitfall and a consideration for less than full time in academia specifically is that academia is, it's quite different from the NHS in terms of on, on the good side, it's, there's potentially more flexibility in terms of when you carry out your work. But that works both both ways. And on the other hand, there is just no end to what you can do. And for a lot of that work, there's no cover from other people when you're not there. And by its very nature, it has a nasty habit of sucking you into work extra hours all the time that, that you're not contracted for. Um And that goes for the full time academics as well as less than full time. You may find that you want to achieve more than you confected into your hours. And of course, your medical school will be delighted with that arrangement. So you, you really need a will of iron and a lot of self discipline to avoid being in that situation. Uh something which I perhaps haven't managed as well as I could have that sometimes and maybe I'm not a very good person to take advice on, on that, but I'd say be very, very careful about that and consider the nature of your role. If the role is to go into medical school for certain agreed sessions and deliver a session of teaching, you should be able to keep that under control. But if it's a more wide ranging or general role than that, um then you have to give that very careful consideration. Um And the other question was about father's. Yes. So I did see a comment in the chat about saying, don't the Scandinavian countries give uh overall parental leave for longer. That is true for the case. I think I know that in Sweden, uh the overall parental leave is 480 days, which is more than here and but 90 days of that, which is three months, of course, is specifically for the father only. So only the father can have that if you don't have that you lose those 90 days. Um I think that's very, very progressive. It sets the scene not only foot for the parent, for the new parents and for the child care of, of, of their child going forward, sets a precedent for them. It also sets uh changes the expectations on among employers that parents are not only women, not only women take parental leave, not only women have to go on maternity leave, it applies to fathers as well. So I think it's, it's very important in changing the perceptions of, of the parents themselves, but also society more generally. Uh, so that's why I'm uh, the Medical Women's Federation supports that. I absolutely agree that we need to make sure that fathers are involved in child care as much as possible. That's good for everyone. It's good for both the parents. It's good for the child and it's good for society. Thank you. I'm going to hand it back to Scarlett now and, um, we're gonna end on the take home points. Yes, thank you. I wanted to invite each of the panelists to give a very short take home point about the future NHS workforce. Um So starting with Partha, please, I think, be aware of people around you and I think follow through in what you say, I'm not saying to the panel, but people say things that sound right. And I think follow through that in your real life, whether people are disadvantaged because of their race, their sex, their position, we all do talk about what needs to be better data would suggest that that's not quite working out. So maybe I think that's the only bit due to bit in your own little space. Isn't that would go a message. That's brilliant. Thank you very much. Um Rob, I'm going to keep it very brief. Um I take home message from most of my talks is always that there is more than one way to be a doctor. Um And I think that that pretty much sums up my, my perspective on life. Uh Thank you. That's, that's really helpful, particularly when people are struggling, um which a lot of people are um that choices are still available. Um That's really helpful. Um Very surely. Um Thank you. My take home message is putting my ss uh experience. Um So I feel status school, what has been happening with this with careers is not an option any longer. It is one of it is going to be one of the strongest workforce of the future. And from my personal experience being an international medical graduate from BME background and being a woman, if I could achieve what I could, um then I think anything is possible. So that's my take home message. That's lovely. Thank you. Hang around. Uh So my take home message is for clinical academics working less than full time, um which is basically to be very self disciplined. You need more self disciplined to successfully work less than full time than you do to work full time. So, uh that's, that's my message that's really helpful. Thank you. Um And Camilla. So, um when I look back over my career, I think I have been discriminated against both on grounds of my color and my sex. But it's always been difficult to really pinpoint it just as partha was seen in his talk earlier. You know, it's very nebulous sometimes and difficult to pinpoint. But you know what I would say to everybody out there is be confident, have confidence in yourselves and your abilities because I've spent so much time worrying about what the future would bring that I didn't need to, didn't need to do. Uh, really. Um, and my advice would be, be flexible and be ready to change tack if you need to, you need to duck and weave a bit sometimes to get to places you want to go and sometimes the choices you make a forced upon you, they're not necessarily the choices you want. Um And sometimes the choices are the choices you want. And it's about being flexible and being able to um to, to sort of move um in, in the direction eventually that you want to go in. And I always remember, I think one of the best um bits of advice I ever got was from, it wasn't directed at me particularly, it was in the leadership. Of course, I went on some years ago and it was the vice chancellor I think from whole university. And he said, um and this is the only bit I remember the whole course was, he said, if you can't go upwards, go sideways. Um and that's stuck and it has actually been very helpful. Thank you. That's very wise. Um And it's been an absolute pleasure to listen to all the different ideas and, and positivity and different ways of looking at the future in different ways. One can work oneself. I'm going to hand over to Davina to close this session, but I need to remind you that the raffle um has been reopened. There's a link in the chat. Um if you want to buy raffle tickets, um, the uh the proceeds are going to the earthquake appeal. Um So do you pick up the link in the chat? But I'm gonna hand over Davina. Um And it's been an amazing session for me. Thank you. Thank you, Scarlett. I'd like to thank every panel member here today. Very inspirational. We've learned about more about S A S A S rolls less than full time academic careers, maternity leave, potential. IV. And it's very inspiring and I liked Camilla's last comment. If you can't go upwards, go sideways and when they enter that crate as well, I thought that was very inspiring. Um And a lot of activity in the chat. Thank you for all of those people who've signed posters to resources. Um Like for example, people saying thank you so much, the panel, very thought provoking session. Those people are. Thank you. So thank you all. And um everyone, as Scarlett said, there's a raffle and then we'll see you after the little lunch break. Bye bye. So we're back at two o'clock. Um, lot supposed just to look at um, and networking rooms may well be open.