Leaders In Healthcare 18: Chief Medical Officers Panel

I’m lucky enough to be spending half of this week at Leaders In Healthcare 2018, a national conference from the Faculty of Medical Leadership and Management and the BMJ. Over the next few posts I’m going to cover some talks and themes emerging from the day.

At the risk of quickly becoming outdated, the first keynote invited the Chief Medical Officers and Deputy Chief Medical Officers from the four nations to discuss medical leadership through Brexit. They were joined by Clare Marx who will be leading the GMC from January.

Brexit

Two main challenges emerged. The CMOs were focussed on disruption to supply lines following a No Deal Brexit. This is a response to the highly political issue of drug shortages, as well as other medical equipment brought from European schools. Interestingly Chris Jones, Welsh CMO, suggested that the mapping of procurement routes across the NHS in Wales had been a productive process which would prove useful whether or not a No Deal Brexit materializes. When pressed by the audience for potential benefits of Brexit, Jones pointed out that disruption can often create positive change by forcing leaders to innovate and rethink their worldview.

As well as getting supplies from Europe into the UK, the CMOs were concerned about getting human resources into the UK. Uncertainty concerning the UK’s relationship with the EU is affecting many healthcare professionals working who have come to work in the UK. Gregor Smith, Scottish CMO, said fewer doctors were now applying to work in Scotland since the referendum. On the other hand, Jonathan Van Tam, England’s Deputy CMO, said that since the referendum there were now more people taking the PLAB exam for doctors coming from other countries. Van Tam also claimed that they had made it easier for healthcare professionals to apply for the EU settlement scheme before Brexit. Meanwhile, Clare Marx suggested that one benefit of Brexit would be that it would allow the UK to introduce language testing for doctors from the EU – although she stressed it was a very minor benefit.

The Future

Nevertheless it was by no means doom, gloom and resignation from the panellists. The second half of their discussion was about technology. Michael McBride, the CMO from Northern Ireland, waved his wearable device in the air; Smith felt that iPhone apps promised a more joined-up health service; Van Tam argued that machine learning could ensure frontline clinicians get faster results from radiology; and Clare Marx highlighted the possibilities of telemedicine.

However, one member of the audience drew attention to the difficulties of simply accessing patient records due to old technology, a lack of interconnectivity, and hopeless wireless systems. Marx made an admirable attempt at empathizing, but her suggestion that it must be frustrating if you have to wait a whole 60 seconds for a computer to log on belied her distance from the frontline where it regularly takes 5 – 10 minutes for a computer to log on. The panel all agreed that getting the basics right was crucial and Marx highlighted a document she wrote about basic clinical requirements by 2020.

It was heartening to get a sense that beyond the panic and politics there were enthusiastic, solution-oriented people working hard to ensure patents will be safe even if no deal is reached. The civil servants threw down a challenge: whatever happens over the coming months, how can you ensure the best care for patients afterwards?

The National Chief Medical Officers Panel took place on November 14^th 2018 and was part of Leaders In Healthcare 2018 held at the ICC, Birmingham.