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Four seasons of COVID – reflections on my first year as vice president for Wales

Dr Olwen Williams examines how healthcare in Wales has been affected by COVID-19, and reflects on her first year as RCP vice president for Wales.

When I took up this role in January 2020, I had an idea that there would be challenges ahead but I never imagined that our professional and personal lives would be completely disrupted. Nor that we would be receiving such a supportive letter from our CMO, Dr Frank Atherton.

Physicians – you are a credit to your profession.

Following a difficult winter, we were all looking forward to spring, an opportunity to engage with our colleagues at conferences and recharge the batteries. My predecessor, Dr Gareth Llewelyn had set the bar high, the college in Wales was thriving, and we were planning our second membership/fellowship ceremony. But this was not to be. Physicians and their teams responded to the ‘call to arms’, re-organised their services, adapted and delivered in the first wave, some at great personal loss. Our doctors in training didn’t rotate and have reflected on the impact this potentially may have had on their careers in an article published in Future Healthcare Journal.

Summer highlighted the unintended consequences of service changes with patients presenting with complications, and we became aware of delayed interventions and increasing waiting times for care. However, re-setting services was enabled, and a new way of working was established, with teleconsultations becoming the norm, and training and education a priority.

Autumn brought a second lockdown, with many of us experiencing fatigue with little respite from the pandemic – however, with the vaccine breakthrough and the potential for doctors having twice weekly COVID-19 testing, there is a light at the end of a very long tunnel.

We have also faced the stresses and strains of the second wave of COVID-19 at the front door. Some of our colleagues in south Wales contacted me earlier last month about their concerns on capacity and patient flow in their hospital, disrupted by the inability to discharge COVID-19-negative patients back into the community without a long isolation period. They had written to their health board team, but I was also able to raise these issues with the Welsh government and the BBC and we published a supportive statement on our website.

As we enter winter, I call on you to take your annual leave, to access wellbeing resources and to take pleasure from those little things in life that we often take for granted. Let’s hope we can celebrate Christmas with our families.

Personally, the past year has been exhilarating rollercoaster – I retired and returned in November 2019 following a great trip to Japan to watch the Rugby World Cup, never anticipating that long haul holidays would be off the agenda, that homeworking would be my new norm and that I would spend my time in the sexual health clinic in scrubs and PPE. While our service was quiet in the first weeks on the initial lockdown, that didn’t last for long! Interestingly, people do not equate sexual activity with new partners as a COVID-19 risk.

Video conferencing for RCP activities became the norm and has enabled some networking that might not have occurred pre COVID-19. I really miss that face-to-face contact and socialising. I’m indebted to Jacqui and Lowri for their amazing contribution to keeping RCP Cymru Wales afloat. They have gone to great lengths to make things happen. Diolch o galon.

I hope that you have appreciated the educational opportunities that we have been able to offer virtually via RCP Player. I was delighted to chair the respiratory update in November, which featured three of our leading respiratory physicians in Wales. It is still available to watch, and I urge you to watch the Wales Turner-Warwick lecture on 20 November when Dr Alexandra Phillips will present ‘Using simulated medical on-calls to enhance preparation for foundation training’.

I was interested to see the RCP consultant census 2019 which highlighted that north Wales had one of the highest ratio of physicians to head of population. However, there is still a concern across the country about unfilled consultant posts, high numbers of locum and worryingly issues around bullying, harassment and discrimination especially experienced by female consultants. The new UK Inequalities in Health Alliance was launched in late October – and during 2021, I hope that we will be able to influence the way that healthcare is designed and delivered, improve health and care, and lead the prevention of ill health across communities in Wales, in line with the RCP’s strategic objectives.

Finally, we have started looking ahead to the Senedd election next year. We have already met with a wide variety of stakeholders, including the Bevan Commission, GMC Wales, the Wales Cancer Alliance, British Heart Foundation, Cancer Research UK and ABPI. A joint memorandum of understanding was published with Healthcare Inspectorate Wales last month.

We continue to meet with the CMO for Wales, DCMO and Academy Wales officers on a fortnightly basis to discuss emerging COVID-19 priorities, and we are gathering case studies from trainees and COTE physicians on the changing face of community medicine as part of our engagement on unscheduled and urgent care with Welsh government; these will also contribute to an updated set of RCP manifesto asks to be published in early 2021.

I am immensely humbled and impressed by your dedication and commitment.