A President's Year - Month 2 to 4

29th June 2015

The difficult second blog covers three months – the pace of work meant I didn’t feel I could do a monthly blog justice. My excuse is that this has been the busiest period for policy and politics that BASHH has Presidents have ever had, so our media advisers tell me. Only when Parliament was dissolved for the election at the end of March did the meetings and discussions ease up. April was filled with holidays and electoral “purdah” – when government agencies and departments cannot interact with stakeholders or publish reports for fear of influencing the political agenda before an election. So that’s another good excuse why I waited until early May to post this. I have also included some personal bits to give a flavour of how my working and personal lives sometimes overlap in odd ways.

My Hospital Trust has been finishing the appraisal year, and I completed the assessments with seven colleagues from our Leeds department at the end of March. This was a great relief for us all- although the electronic systems are easier to use with practice, it is very time consuming to upload all the evidence. It’s a real privilege to plan out the development and review the 360 comments and feedback with such a great team.

For the routine of work, see my earlier blog. Weekly teleconferences, emails, etc continued in same sort of pattern.

Some workstreams in this period included -

  • Following up with Health Education England on commissioning issue and training. A survey of GUM training programme directors co-ordinated by Rak Nandwani had shown a general concern that communication with Local Education Training Boards needed to improve. We were pleased to hear that HEE had taken our concerns to the latest meeting of English deans.
  • Continued communication with DH to stress the need for confidential and separate sexual health records
  • Alerting DH, the CMO and the public about the problems generated by some online treatments for gonorrhoea
  • Meeting with FRSH to discuss common issues around integrated service delivery.

February started with a busy week focused on my role as chair of the RCP Joint Specialty training committee. I represented the specialty at the RCP Medical Specialties Board where many views were expressed about the changes proposed in the Shape of Training consultation. It was clear the pressure of opinion was against any cut in specialist training duration. Blending more acute medicine at the start of a longer registrar programme, some form of modular pathway or post CCT credentialing to allow for flexibility of career paths seem to be possible ways forward. I was left with the sense there was plenty of detailed discussion ahead. Genitourinary medicine is a specialty of physicians with a unique spectrum of skills from public health to acute internal medicine. Future clinical services in sexual health will need expert clinicians with those skills and our training curriculum is being reviewed to address these needs.

Late last year, a BASHH member had highlighted a concern about choice of antibiotics, support and follow-up issues in websites offering sexual health diagnostics and treatments for gonorrhoea. Since that time, I had written to the Chief Medical Officer, PHE and the DH expressing concern about implications for patient safety and antibiotic resistance. BASHH were contacted by Dr Faye Kirkland, a GP in Bristol and BBC journalist, who developed a storyline that featured as a 30 minute programme on BBC radio5live on 1st March. Podcast still available here

Claudia Estcourt delivered a clear and professional interview explaining our concerns. Follow up included highlighting the issue to MPs. We saw seven parliamentary questions placed to the health secretary on the issue - four from the chair of the health select committee herself, and three from the shadow Public Health minister.

The final week included a meeting of senior BASHH and FRSH representatives as part of a series of discussions to help us get a better understanding of each other’s organisations.

March was the busiest month of my whole presidency to date and marked one year in post. I spent about half my working weeks on Presidential business, usually in London.

A series of days in London started with a system leaders meeting at PHE, where representatives of sexual health professionals, public health, local government organisations and government shared their views and visions for the role of PHE. These meetings give me a chance to use our member feedback to describe good practice and highlight problems during tendering and implementation.

The end of that week was filled with BASHH business- a Thursday evening with the Officers then a full day Board meeting on Friday. Daniel Richardson has summarised the main discussion points in the letter from the Board - Click Here

My stay in London was extended since I was chairing the BASHH Public panel on the Saturday. A quiet night in the RSM was planned until I got a very kind invitation to join the FRSH table at the UK Sexual Health awards. Thanks to Chris Wilkinson, Jane Dickson and the whole table for a fabulous night out. I was humbled by the dedication of the community workers who delivered services and advice to a huge range of vulnerable and marginalised people. I was also delighted to see many good friends and BASHH members winning recognition. For details see www.brook.org.uk/uk-sexual-health-awards/ or see Twitter @SHUKAwards. Northern Ireland featured frequently in the nominations and prize winners. Project of the year went to the amazing Rowan Sexual Assault Referral centre in Antrim.

Saturday was public panel day – we had a lively meeting discussing the BASHH website and feeding back comments about guidelines and leaflets to the Clinical Effectiveness Group. Thanks to all the lay panellists who gave up their free time to help us.

The second week included media training sessions for officers and members of the BASHH Media group. Our trainer helped us understand how to refine the key messages and gave us an insight about how news editors choose stories - a pithy subject line in an email is essential!

The last Department of Health contact before the election was at the Sexual Health forum - an advisory panel of charities and stakeholders chaired by Baroness Joyce Gould. We discussed the PHE HIV prevention and sexual health promotion strategy and the implications of the PROUD study results on possible PREP provision. Further work will have to wait until after purdah. This standstill period is being used by BASHH to refine our media messages and develop our engagement strategy with the new administration.

MEDFASH asked me to write an article for their sexual Health bulletin. Not surprisingly, I chose to write about the perils and pitfalls of English NHS Commissioning. www.medfash.org.uk/efeature

Our election statement was also published this month - Click Here

Friday was another BASHH day, with committee meetings in the morning and a scientific meeting over the afternoon and evening. The Bacterial SIG topics were as relevant and stimulating as always. I was delighted to see some young investigators presenting their projects with such confidence. I hosted a speakers’ dinner after the meeting and returned to Leeds on Saturday morning.

The twitter feed after the evening meeting described my short tribute to Sir Terry Pratchett OBE who had died the day before. This odd departure from protocol deserves an explanation. Terry had been a dear friend of my husband Pat for many years, calling him “Lord of the Uber-fans”. Pat runs charity auctions for conventions of Pratchett fans across the world and acted as a medical advisor for the novels. Travel home from work could be interrupted by a phone call from Terry researching his latest book. His questions were, not surprisingly, quirky- “How much force does it actually take to rip someone’s head off? How much earwax does an average human produce in their lifetime?” Terry’s sharp wit and humorous satire enchanted and provoked us. He leaves his wife Lyn, their daughter Rhianna and millions of grieving fans.

The final two weeks of March were our final opportunity to comment to government and statutory groups before the election. I attended a feedback session about the ACCEA process at DH and met with Kevin Fenton at PHE and Paul Ogden from the Local Government Association. The All Party parliamentary group on sexual and reproductive health had a meeting in the House of Lords with a focus on workforce training. General practice, nursing and junior doctor representatives gave the parliamentarians their views about options for training, and Chris Wilkinson and I gave updates on the current pressures on specialist training brought about by the new commissioning environment.

I was asked to speak on an update programme about gonorrhoea online treatment on radio 5live. (see earlier-podcast for 22nd March). This glamorous event was held in a tiny shoebox of a studio in BBC Radio Leeds early one Sunday morning. After three weeks and seven parliamentary questions, we had seen no action from DH or the CMO. You can guess my agenda for after purdah…

The last few days before a period of leave were the usually frantic round of desk-clearing and finishing dictation, etc.

I was really excited to get my first AAA pass at a rock concert (access all areas, for the uninitiated) as daughter Katie whizzed into sight again in Manchester during the Sleater-Kinney European tour.


Carrie Brownstein (front) and Katie (background) during the Sleater-Kinney performance at the BBC 6music festival, Newcastle.
Picture from this feature - http://www.independent.co.uk/arts-entertainment/music/reviews/sleater-kinney-gig-review-their-first-uk-show-in-nine-years--but-a-powerhouse-of-a-performance-10061384.html

We met the group backstage, had a peek round the tour bus (extremely well appointed, with leather seats and integral WiFi) and had a great view of the set from the balcony. I spent some time talking to lead guitarist Carrie Brownstein about SRE. A punk rocker interested in Sex education??? Well, Sleater-Kinney support Planned Parenthood, an American charity providing sex education and contraception and sexual health services. I left her with some web links and sample UK leaflets for young people. Work and family are very hard to separate sometimes!

After this frenetic month, Pat and I flew to Australia via Singapore. The first few days of leave were spent at the Australian Discworld convention in Parramatta, western Sydney. I bumped into a former Leeds trainee and ex-pat Julian Langton Lockton who is now a consultant at the West Sydney Sexual Health centre.


Thanks to all the staff for their hospitality that lunchtime.

The next two weeks were spent touring the splendid wild country round Tasmania, admiring the autumn colours, odd wildlife, amazing food and great pinot noirs. Highly recommended as a stress relief and escape from purdah.

See you in Glasgow!

Jan Clarke

 

Postscript:

While I was on leave I heard the shocking news about Professor Martin Fisher. Martin was a key source of advice and a link between BASHH and BHIVA on many levels. His contributions as a clinician and researcher to developing HIV and sexual health medicine have helped to shape patient care across the UK and beyond. My thoughts and condolences go to his partner and family.

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