President’s Blog April 2015

From Christmas to Easter in one short jump – or so it seems! After the celebrations of last month with the granting of our ‘Royal’ title it is important to emphasise that ‘laurel resting’ is not something the RCEM can ever be accused of.

To this end we have just hosted a major conference aimed at middle managers and journalists. Entitled ‘Fact not Fiction What you need to know to make your Emergency Department work Summit , it was as ever born of necessity. Necessity because it has become increasingly clear that whilst national leaders and organisations have begun to accept the arguments and evidence proffered by the College, there are many managers working in Acute Trusts who continue to believe and act in accordance with suppositions and conjecture that have been the bedevilment of our specialty.

[Insert image RCEM Myths]

The list of such myths is extensive and indeed when Chris Moulton and I sat down to construct an outline for the day (during a quiet moment at the Labour Party conference) it was immediately obvious that the search for source material would result in an embarrassment of riches!

Our guide in editing this material was to ensure concordance between the topics selected and the RCEM STEP campaign. As always we wished to be clear, concise and constructive and this latter point meant we needed to be able to cite reliable evidence to refute long held opinions.

I have taken the liberty of including the summary graphic of the event. I am sure that many of you would have further suggestions and examples. Suffice it to say the discussions at the event covered a wide range of issues and participants acknowledged the value of the event in illuminating the debate with accuracy and candour.

We have similarly argued the case with other opinion leaders such as The King’s Fund and were pleased indeed to see they have recently updated their analysis of the challenges facing emergency medicine as a result of our intervention and evidence submission.

All of us will recognise that the first three components of our STEP campaign are closely linked, and whilst it is relatively easy to explain and argue for resolution of staff shortages and exit block the subject of tariff reform is rather more arcane (and indeed only applies to England). Rest assured however that the College can turn its hand to ‘arcane’ when required to do so. It was therefore very good news indeed to receive advanced notification and a personal telephone call from NHSEngland informing us that the 30% marginal tariff would be uplifted to 70%. This single action should increase the revenue to Acute Trusts by £130 million and importantly this will be recurring funding. We have not been alone in calling for this iniquitous funding device to be repealed; but our assertion that, as a way to deter customers, slashing the asking price by 70% impugned the credibility of economic science, certainly encapsulated the arguments more effectively than a balance sheet calculation.

I have previously thanked my work colleagues for their support and it is timely that I should similarly pay tribute to the endeavours of the Executive Committee of the College; Kevin Reynard, Chris Moulton, Katherine Henderson, Suzanne Mason, Adrian Boyle and Jason Long. Their commitment both of time and effort to the work required to deliver the CEM10 and STEP campaign has been quite remarkable; not least as their average distance from the College is over 200 miles! These newsletters cannot adequately testify to the work of the Executive Committee but suffice it to say almost every aspect of College activity has been variously formulated, delivered or overseen by these individuals all of whom are full time EM physicians. Such praise is not intended to diminish the role of many hundreds of Fellows who contribute to various committees, examinations and act as representatives on external bodies. Rather it is to encourage anyone who has a mind to directly influence the policies or strategy of the College to consider standing for these roles, each of which has a three year term. Importantly all of us are accountable to all members and fellows. The AGM which will be held at the Manchester conference is the legally constituted vehicle by which we are held to account but we all welcome any feedback or opinion on our individual and collective actions.

I hope the Easter bunny is generous to you – I for one intend to eat more chocolate than is good for me!

Dr Cliff Mann FRCEM FRCP
The Royal College of Emergency Medicine