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Always something new to learn | The people who care

In her first blog as RCP vice president for Wales, Dr Hilary Williams reflects on some of the key challenges facing doctors today – including health inequalities, service improvement and workforce wellbeing – and highlights how she wants the RCP in Wales to listen to fellows and members and celebrate their successes.

The Welsh NHS is ‘warm, collaborative and forward thinking’ – I am stealing the words of one of our trainees to explain why I choose to work in south Wales and why I’m so proud to represent physicians across Wales in my new college role.

Welcome, then, to my first blog as RCP vice president for Wales. Luckily, I am taking over from Olwen (to whom we all owe so much) during the summer months, which means I’ve been able to spend some time thinking about the key challenges facing us all.

Making the difference on health inequalities

Working in south Gwent, every week I meet people living with cancer and their families who have been severely affected by late diagnosis; people struggling with treatments due to chronic mental health issues, and significant multiple long-term health conditions at a very young age. We see the impact of health inequalities every single day in our clinical practice and the pandemic has certainly made this worse.

As adult physicians, we meet people when the effects of deprivation have already taken their toll. Whether it is smoking, obesity, or limited health literacy, it can sometimes feel like we are struggling to really help our patients given such widespread societal inequality. When RCP Cymru Wales published Making the difference in partnership with the Welsh NHS Confederation, I suspect many of us recognised the challenges we face in our day-to-day work.

I’m aware there are teams across Wales working across traditional clinical boundaries in their local communities to develop patient-centred services, and the commitment to improving the bigger picture is a real strength. My experience in cancer is far from unique. From talking to colleagues, I’m aware of the impact of deprivation on liver and kidney disease, and of course many of us work in areas where smoking rates remain high – and I’m pleased to say that we’ve recently signed a letter from Cancer Research UK and Tenovus Cancer Care calling on the Welsh government to commit to rolling out a targeted lung cancer screening programme. However, it can feel difficult to know what to do as individuals, particularly when there are so many other challenges in the NHS in 2023.

I want to set myself and the RCP family in Wales a challenge. I want us to work together to make a real difference on health inequalities. How can we begin to translate policy into action in our patient-facing clinical work? How can we support the roll out of successful pilots across Wales? Changing policy may seem a huge step – and I was delighted to read last month that the Welsh government is going ahead with legislation to tackle obesity – but small changes can add up to something bigger. How we use patient information, how we involve the voice of lived experience, how we play a role in secondary prevention, or improving access to healthcare … Personally I want to understand if there are opportunities to clarify our messages on common risk factors and prevention of ill-health. Do we have a role in health coaching and behaviour change? Can we work more closely with Public Health Wales or the third sector?

I would love to know your views on how we can work together as physicians to reduce health inequalities in Wales. Over the next six months, we will plan informal visits to Hywel Dda, Swansea Bay, and Betsi Cadwaladr. We want to listen to you and celebrate your successes.

Forward thinking

One of the highlights of visiting colleagues across Wales is seeing first-hand your commitment to service development and medical training. Whether it’s hearing about quality improvement during our Cyswllt visits, reading the entries to our annual poster competition, or listening to the talks at our annual Update in medicine, there is always something to learn. In the past year, I have learned about physician associate education, digital hospital induction, patient-centred heart failure services, and national asthma pathways.

On that note, I’m delighted to congratulate Dr Simon Barry and his colleagues on their award-winning work to develop a self-management app for people living with asthma and COPD, a wraparound QI toolkit for healthcare professionals, and data dashboards for commissioners. This innovative approach resulted in two HSJ digital awards last month for generating impact in population health through digital and moving towards net zero through digital.

Improving services locally and across Wales is a big part of being a doctor for me, but above all this, I am most proud of being a clinician. Ultimately, being a good doctor is what counts. It’s a tough job, and earlier this month at the Senedd launch of our latest briefing paper, it was very clear that good clinicians, be they nurses, doctors, therapists or pharmacists, need time to train, time to care and time to rest. We need to be valued by our employer and our colleagues for the important work we all do. After all, investment in the future NHS workforce is vital, but we need to focus on retaining people to deliver care and train others right now.

And finally…

We lost my dad this month. He was in hospital and I’m very grateful that his doctors, the ward staff and the emergency department team cared for him with compassion in his final days. Despite the challenges we face, the NHS is there for us, reminding us that caring matters. He didn’t need tests in the end, but words and time. From me to you, I want to thank #ThePeopleWhoCare.

Dr Hilary Williams
RCP vice president for Wales