The second day of Medicine 2022 opened with a talk from Professor Trish Greenhalgh, who discussed approaches to policymaking.
Professor Greenhalgh argued that the traditional model of evidence-based medicine driven science had not been sufficiently flexible to meet the challenges posed by the COVID-19 pandemic, and argued for further consideration of complex systems science when evaluating how to respond to public health crises. In the Q&A session, Professor Greenhalgh cited a comparison with Japan to make a point about relying purely on evidence-based medicine:
‘On 9 March 2020, the Japanese government put out statement that said they didn’t know how COVID spread, but they had a hunch it was airborne and spread in crowded spaces. They recommended people avoid meeting in crowded spaces, and this was well before studies on airborne spread. In contrast, the UK government was conveying a level of certainty that didn’t reflect what the science was saying at that time.’
Preparing for the future
In the following session, the RCP’s associate global director for sub-Saharan Africa (and infectious disease consultant) Dr Phil Gothard led a session on COVID-19 and how we can be better prepared for future crises, especially in the context of widening health inequalities, an increase in misinformation, and fears that lessons have not been learned from the pandemic.
In a wide-ranging session, four speakers – Public Health England epidemiologist Dr Susan Hopkins, professor of public health Linda Bauld, director of the NHS Race and Health Observatory Dr Habib Naqvi and deputy chief medical officer for England Dr Jeanelle de Gruchy – presented on epidemiology and behavioural science, engaging public with data, good population health and disproportionate impact, which was then followed by further discussion in a Q&A session.
Challenging poor behaviour
In the RCP’s latest census findings, both consultants and trainees said that undermining is a serious problem in the workforce, which is often under-reported. On Friday afternoon, Dr Simon Fleming chaired a discussion on challenging poor behaviours in the workplace between RCP trainee representative Dr Rose Penfold, director of equality in the medical workforce for NHS England Professor Partha Kar and RCP chief examiner Dr Emma Vaux.
The speakers shared their own experiences of discrimination and poor behaviour in the NHS, and discussed the barriers staff face in speaking up and challenging such incidents. There was strong agreement that cultural change is required to empower staff to have potentially uncomfortable conversations, and each speaker reflected on how they have become more confident in speaking up when they see unacceptable behaviour at work. Dr Penfold cited her experience in founding the organisation Women Speakers in Healthcare: ‘There were a group of us who noticed that women were under-represented, that colleagues were speaking across women at conferences, and that women were not being invited to speak … and collectively we agreed this is unacceptable and decided what action we could take.’
The RCP also launched two new reports at Medicine 2022
The RCP’s acute care toolkits are a series of resources to help improve the delivery of acute care. The toolkits look at current problems and suggest a range of recommendations for improving quality. The latest toolkit, launched at a session on acute medicine chaired by Dr Alastair Gilmore, focuses on acute medical care for people with a learning disability. People with a learning disability experience worse patient safety outcomes and quality of care in hospital. Clinical challenges include delayed presentation, communication, behaviours of distress and diagnostic overshadowing. All staff working in acute medical units should read this toolkit, as they will care for people with a learning disability who present acutely unwell to hospital.
Personalised prescribing: using pharmacogenomics to improve patient outcomes was launched at a session on pharmacology from the British Pharmacological Society. Pharmacogenetic testing involves testing patients for genetic variations that affect how their body will respond to common medicines. The report calls for this testing to be deployed across the NHS to ensure all patients have an equal chance of being prescribed a medicine at a dose that is likely to be safe and effective for them, with minimal side effects.
To see all these sessions and much more, sign up to Medicine 2022, and enjoy access to all sessions on demand until 30 September 2022. You will have until 29 April 2022 to gain the maximum 16 CPD credits and download your certificates. For the remaining days, you can self-accredit as independent learning.