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Modernising physician-led care | A word from the clinical vice president

In this new senior officer blog feature, clinical vice president Dr John Dean highlights the benefits of a quality improvement focus in healthcare and how the RCP is working to support healthcare professionals with resources, events and thought leadership.

Our world is ever changing, and at a rapidly increasing pace. In line with this, our patients’ needs and expectations change, as do ours as clinicians. How can we keep up with this pace of change in our clinical services and professional lives and continue to make improvements, when the pressure of work often means we just want to ‘get through the day’ without causing harm to our patients?

The RCP’s role in supporting you to ‘keep up’ runs through our three strategic pillars of educating, improving and influencing. In truth, physicians and their teams are already leading modernisation and continuous improvement of services for patients, and the RCP aims to champion and disseminate the great examples for others to learn from. We hear lots of doom and gloom about healthcare, and while we need to highlight and tackle the challenges, we also need to celebrate the great care that is being delivered everyday by clinical teams.

One of our latest workstreams looks at modern outpatient care. We hope you can use this recent guidance to reflect on your practice, and work within your organisation to support improvements. We are also working in partnership with NHS England, the Patients Association and others to develop an outpatient care strategy that can enable the changes that are needed by patients, clinicians and the system. We held the first of four clinical summits on 25 May at RCP at The Spine in Liverpool. Dr Theresa Barnes, the RCP’s clinical lead for outpatients, noted that one of the main outcomes was that framing our care as ‘outpatients’ limits our thinking around what patients need, and the best way to deliver it. What patients need is planned and coordinated pathways of care. If you want to be involved in the next stage of our work on outpatients, please email outpatients@rcp.ac.uk. Better still, please share your examples of modern and innovative practice and keep updated on this exciting work though the RCP’s improvement portal Medical Care – driving change.

Reflecting on how the terminology we use for services can constrain our thinking, I remember that when we developed our modern ward rounds guidance with professional partners, we had long discussions on what to call it, as it’s about so much more than the traditional view of ward rounds. It’s actually about good patient-centred multidisciplinary ward clinical care. In these times of enormous service pressures, I encourage you to revisit the ‘fundamentals of modern ward rounds’ outlined in the document, as our practice can slip when we are under pressure. You can use the self-assessment tool to identify areas where your team can improve.

The modern digital world is integral to modern healthcare, and indeed digital enablers of care, and the associated risks are key themes in our work on outpatient care and modern ward rounds. Dr Anne Kinderlerer, the RCP’s digital health clinical lead, is part of the team working on the outpatient care strategy and is also leading the delivery of our digital strategy. We are all users of digital systems and Anne’s blog highlighting some of the frustrations may well strike a chord. The blog includes an invitation to complete a survey about your experience in using digital systems so that we can understand and represent your views. The Medical Care – driving change website also has some great resources to support you to understand and embrace digital health and transformation.

Physicians at an early stage of their careers are major agents of change. They see the gaps in care, challenges and potential solutions. This month’s video guide on how to plan and deliver improvement projects is particularly aimed at physicians in training. Also, the Academy of Medical Royal Colleges has produced a reminder of how to assess improvement experience of doctors in training. And of course, patients are the greatest agents of change in healthcare. Do take a look at last month’s feature focus on co-production and the patient voice in coaching.

The RCP’s Chief Registrar Programme also drives improvement through developing participant’s leadership skills to support them both now and in their future careers. The programme continues to grow, with over half of hospitals in England, Wales and Northern Ireland now having a chief registrar, and more new organisations likely to recruit for the 2023/24 cohort. If you have been a chief registrar, then make sure you are connected to the alumni network. If your hospital doesn’t have a chief registrar, and you’d like advice on how to enable this, let us know by emailing chiefregistrar@rcp.ac.uk. chiefregistrar@rcp.ac.uk

Modern healthcare is complex, and all the component parts are interdependent. That’s why the RCP works with many partners and professional organisations, including other colleges, patient organisations, think tanks, and the NHS. Increasingly, you will see that we are working with and through other organisations in our educating, improving and influencing work. Some of this is visible and some of it less so. One example is our strong partnership with the GIRFT programme: we are currently jointly delivering a series of webinars for the general physician on the management of people with frailty. The next is on 20 June and focuses on managing frailty in community settings. The previous two look at acute care settings and the interface between services, and are still available to access. Cross-organisational and cross-sector working as well as interprofessional working is an important professional skill for us all that continues to develop throughout our careers. While time and opportunities constrain us (rather than the will), that’s where we are likely to find solutions to the problems of today and tomorrow.

Please do contact me via email at cvp@rcp.ac.uk about the areas of clinical care you feel should be given particular focus, and how the RCP can help you and your team to deliver improvement.