Annual Conference 2011
Thanks to all who attended our Annual Conference at Mansion House London and helped to make it a huge success.
Our conference on 19th May was a historic event to mark the beginning of a mass movement to return the patient to the centre of care. For the first time, patient experience and safety are enshrined as key outcomes for the NHS. This constant focus on the patient is central to our philosophy. As the conference emphasised, all of this is underpinned by evidence and good science: with patient stories providing part of the source of that evidence.
Some presentations are available on request (noted in bold brackets below where this is so.) There will also be longer descriptions of a couple of presentations in our next newsletter - sign up here.
The conference highlighted some key themes:
- Innovation, collaboration and integration are key to reducing costs and providing better service.
- Preventative medicine – change of lifestyle can prevent (and treat) heart disease and cancer
- Communities-based initiatives that are enhancing local health and well-being. Showcasing of best practice, innovation and community projects.
- Learning from the development of self-care programmes, helping to improve patient experience and delivery savings.
- Mental health issues - depression, the feeling of isolation and loneliness – are by products of modern life and observed across all age groups. These issues are increasingly recognised as contributory factors to health problems.
Our speakers included:
- The Lady Mayoress Mrs Barbara Bear
- Dr William Bird, GP and past Natural England Strategic Health Advisor
- Dr Harry Brünjes, Vice-President of the College of Medicine, Group Medical Director of Capita
- Sir Graeme Catto, President of the College of Medicine
- Professor David Colin-Thomé, past National Clinical Director for Primary Care, Department of Health
- Helen Cooke, National Coordinator of College of Medicine Innovation Network and Demonstration Sites
- Amy Croft, Winner of the 2011 Michael Pittilo Student Essay prize
- Professor Michael Depledge, Professor of Environment and Human Health, Peninsula College of Medicine & Dentistry
- Dr Michael Dixon, Chairman of the College of Medicine and NHS Alliance
- Professor Mustafa Djamgoz, College of Medicine Science Council Chair; Professor of Cancer Biology, Imperial College London
- Dr Phil Hammond, GP, writer and broadcaster
- Professor Stephen Holgate, MRC Clinical Professor of Immunopharmacology, University of Southampton
- Dr Sarah Gray, GP
- Faith Hallett, College of Medicine Patients’ Council
- Liz Kendall MP, Shadow Health Secretary
- Sir Ian Kennedy, Vice President of the College of Medicine
- Dr Fiona MacKichan, Fellow of Integrated Self Care, Peninsula Medical School
- Kaye McIntosh, College of Medicine Vice Chair; Patients' Council Acting Chair
- Simon Mills, SustainCare and Co-lead of the College of Medicine Self Care Faculty
- Professor Dean Ornish, Clinical Professor of Medicine, University of California, San Francisco
- Professor George Lewith, College of Medicine Vice Chair; Professor of Health Research, Southampton University
- Professor David Peters, co-Lead College of Medicine Self Care Faculty; Clinical Director, School of Life Sciences, University of Westminster
- Dr Susan Rankine, Senior Partner, Victoria Medical Centre
- Dr Damien Ridge, Reader in Health, School of Life Sciences, University of Westminster
- Dr Barbara Vann, Head Teacher, Penair School
Why do we need a new perspective?
Sir Graeme Catto, President of the College of Medicine
Professor Catto explained that modern medicine needs to change, by bringing together all health professionals, backed by sound
scientific foundation, with the patient at the centre of health and care. Scandals and demeaning treatment of patients cannot and should not be tolerated. The College of Medicine provides the avenue for collaboration, and to take forward the motivation
for change and improving health care in the UK.
Opening Address: A changing NHS: what does it mean for clinicians and patients?
Liz Kendall MP, Shadow Health Minister and Professor David Colin Thomé, former National Clinical Director for Primary Care, Department of Health
- The UK is still a long way towards a truly patient-centred care, which addresses not only the physical but also mental aspect of health, treat the whole person rather than a collection of symptoms, promote good health rather than just treating diseases.
- Professionals learning with and from each other and with patients should be as important a part in education and training as medical knowledge and experience.
- The leadership and ownership vacuum within the NHS result in a culture of blame and lacking in responsibility.
- There is no quick fix to good health. It involves lifestyle, diet, exercise, supportive community, personal relationships and much more.
- Advocated the citizenship model of health service, in which the patients have clear rights but also reciprocal responsibilities.
Professor David Colin-Thomé
- Consistent theme of healthcare reforms in the past  years: for clinicians to deliver better and more responsive care to patients.
- It is time for action and not mere political rhetoric.
- The College can make commissioning better, by providing the leadership and vision and by making commissioners think more holistically.
Keynote Address: Using lifestyle and other integrated approaches to prevent and treat heart disease and cancer.
Professor Dean Ornish, Clinical Professor of Medicine, University of California, San Francisco
- Power of lifestyle changes to individual health as well as the health system.
- Daily choices – often simple and low tech but also low cost – can make a tangible difference.
- Demonstrable proof and quantifiable evidence that change in lifestyle can reverse heart diseases, help slow or even stop progression of early stage prostate cancer; and prevent diabetes.
- Importance of recognising and treating the root of health problems rather than just the symptoms.
- Move from a fear-based motivation model to a pleasure-based model. Lifestyle changes – and the associated positive outcomes - as motivator towards long term and sustainable improvements. Try to do as much as you can each day and don’t feel guilty occasional lapses.
- Recognised emotional and psychological factors – depression, loneliness and isolation – are significant components to wellbeing but often not adequately addressed.
- Essence of integrative medicine is to help patients use their experience of suffering (physical as well as deeper levels) as catalyst of transforming and improving lives. Doctors should reclaim roles as healers and enablers, not just as technicians, with service to patients as their prime motivation.
Practical examples of how clinicians, patients and organisations are improving local health. How can we prove that these initiatives work?
Dr William Bird GP, former Natural England Strategic Health Advisor and Professor Michael Depledge, European Centre for Environment and Human Health, Peninsula College of Medicine & Dentistry.
Professor Michael Depledge
- People and the environment are inter-connected. Any health intervention must take that into account.
- Outdoors and the environment can help address the current two greatest epidemics facing modern society: (i) depression and (ii) obesity.
- The environment can be used to promote health and wellbeing in a positive way.
- The aquatic environment is found to be attractive to people.
- The Blue Gym, launched in 2009, as a campaign to encourage people to engage in outdoor activities, also presents research opportunities (conducted in SW England), to demonstrate that outdoor activities (including Blue Gym activities) does promote health and well being and reduce incidences of diabetes, workplace morale, and visits to doctors.
[presentation approved by speaker and available upon request]
Dr William Bird
- People, Place and Purpose interplay to contribute to health and wellbeing.
- Breakdown in the trio contribute to chronic stress which in turn results in mitochondria damage and increased unhealthy behaviours; and other diseases such as cancers, cardiovascular, diabetes, dementia and depression.
- Importance for physicians to have a holistic picture of causal relationship and contributing factors of diseases. The College of Medicine is well-positioned to provide that overview and signpost.
- Practical way to improve health: Health Walks throughout the UK (volunteers-led)
[presentation approved by speaker and available upon request]
Moving self care from rhetoric to reality: Saving the NHS £20 billion.
Simon Mills co-lead, College of Medicine Self Care Faculty; and Dr Fiona MacKichan, Research Fellow in Integrated Self Care, Peninsula Medical School; and Dr Fiona McKichan, Research Fellow in Integrated Self-Care, Peninsula Medical School.
What is Self Care? It is what we do when there isn’t a health professional about. It is the predominant way of how people look after their own health. Given better access to information, plus peer-led and non-doctor support, a significant number of patients with chronic health problems and ‘minor ailments’ would use NHS service more effectively (and cost-effectively) Every 1% reduction in prescription results in estimated £2,130 saving per GP (based on 2009 prices).
The speakers reviewed the Department of Health Integrated Self Care in Family Practice project (2008-2011) at four centres:
- Sustained self care happens when people talk to each other.
- Café Sustain – provides the environment and opportunities for patients to interact and talk and form a supportive community; and for practitioners to interact with patients
- Practitioners learn from patients.
- Link up similar initiatives in the area
Bromley By Bow
- Inspiring practice that will change one’s concept of how health can be delivered.
University of Westminster
- Production of assessable, usable and evidenced based information on 12 chronic conditions which GPs face but with little diagnosis and patients struggle to get reliable advice
- Leaflets and information available at www.gpscl.info
Peninsula College of Medicine and Dentistry
- Understanding patients’ perspectives and acting on them is essential to enhancing and sustaining self care and saving costs.
- Review of patient feedbacks points to the need for a new approach in order to better meet patient needs, and to better appreciate their contexts and the inherent burden of illness.
Allergy and the role of patients and clinicians
Professor Stephen Holgate, MRC clinical professor of Immunopharmacology, University of Southampton
- Steady increase in prevalence of allergic diseases globally. Allergy is now a public health problem.
- In the UK, lack of mainstreaming and training result in significant shortage of resources to identify, detect and treat allergies.
- Studies point to the diversity of microbial exposure is inversely related to allergy and asthma.
- The micro organisms and chemicals that are also changing as we take on the western lifestyle.
- Lifestyle goes beyond about exercise and diet, but relate to what is going on in the world around us. We need to understand it scientifically just as we have to understand the medical model.
[presentation approved by speaker and available upon request]
Keynote Lecture 'So what exactly is good care?'
Sir Ian Kennedy, Vice President, College of Medicine
- Understanding of health is more than just healthcare and requires long term planning, sustainable strategies and delivery.
- Good care needs to be seen in a holistic framework, including community, support, exercise, purpose and company, taking into account the totality of the environment and circumstances of fellow citizens
- In the context of medicine, good care should be determined by (i) patients and (ii) professionals, in the context of which they are experts.
- Criterion of good care should be “satisfaction”, encompassing patients satisfaction on their treatment, clinicians satisfaction on their diagnosis and intervention; and researchers in terms of references to peers.
New visions from our future clinicians 'Fat Chance: how do we solve the obesity epidemic?
Amy Croft, Winner of the 2011 Michael Pittilo Student essay prize.
- A trusting relationship between doctor and patient is a key aspect to patient-centred care and invaluable therapeutic tool in dealing with obesity.
- Patient autonomy in decision making process and control; family, together with primary and careconnect and communicate around the patient, taking into account all biological, social and psychological aspects to health.
[Amy Croft’s essay will be published in the International Therapist www.fht.org.uk]
Can GPs make the NICE 2009 back pain guidelines work for patients in difficult financial times?
Dr Susan Rankine, Senior Partner, Victoria Medical Centre; Professor David Peters, co-lead, College of Medicine Self Care Faculty, Clinicial Director, School of Life Sciences, University of Westminster; and Dr Damien Ridge, Reader in Health, School of Life Sciences, University of Westminster
Review of the osteopathy and acupuncture pilot project at the Victoria Medical Centre 2009-2010
– high patient and GP satisfaction registered.
- Observed that patients like a familiar environment, and the benefit for practitioners to engage with patients and learn from them.
- Quality MSK service, delivered in-house by senior practitioners can make a difference to patients’wellbeing and reduce pain and improve functionality.
- Strong evidence that an effective acupuncture/osteopathy service for MSK pain can be embedded successfully in an NHS GP setting.
- Identified service quality criteria for new projects: Acceptability, Appropriateness, Accessibility, Effectiveness, Efficiency, and Equity.
- Success pathway: recruit the best, induct them effectively, co-design service with closeinvolvement of partners, create confidence and credibility, clarity of project objectives, clearcommunication, reflection, data collection, independent evaluation.
- A GP medical centre can quickly adapt to integrate complementary therapies if key principles are followed and a cooperative approach to action research is adopted by all parties involved in the research and clinical delivery process.
Education and Health working together: Integrated Health Clinics based in Cornwall schools.
Dr Barbara Vann, Head Teacher, Penair School in conversation with Dr Sarah Gray, local GP
- Review the inception, history, development and current status of the integrated health clinic at Penair School in Cornwall.
- Early engagement of young people as decision makers.
- Crucial for children at an early age to experience interaction between health and education and their home environment.
- Confidentiality issue in education vs medical context. The health clinic provides an avenue for school children to discuss and address their fears and issues in confidence.
- Educationlists and medical professionals to break from own silos – share training and collaborate for the health and well-being for the next generation.
Thinking outside the box - creating more patient-centred services - examples from the College of Medicine Demonstration Sites
Faith Hallett, College of Medicine Patients' Council; and Helen Cooke, National Coordinator of College of Medicine Innovation Network and Demonstration Sites
Key principles and development of the College of Medicine Innovations Network: aimed at
showcasing practices, projects and educational initiatives that exemplify the Colleges key
principles of Service, Science and Healing
Overview of 2011 College of Medicine Innovations Award winners:
Foxhill Medical Centre, Sheffield (Clinical category)
Whole Person Care Course, Bristol Medical School (Education category)
Connecting Communities, C2, Falmouth (Clinical category runner up)
Foxhill Medical Centre from the patients’ perspective: a welcoming environment, useful information; warm, dedicated and caring staff and practitioners; attend to both physical and emotional health, true commitment to patient care and wellbeing.
Find out more at: www.collegeofmedicine.org.uk/innovations-network
Chaired by Dr Harry Brünjes, Vice President, College of Medicine
For Science: Professor Mustafa Djamgoz, College of Medicine, Science Council Chair; Professor of Cancer Biology, Imperial College London.
For Clinicians: Professor George Lewith, College of Medicine Vice Chair; Professor of Health Research, Southampton University
For Patients: Kaye McIntosh, College of Medicine Vice Chair & Patients' Council Acting Chair
For the Media: Dr Phil Hammond, GP, writer and broadcaster
Q What has the Science Council done so far?
A series of Science Council seminars bringing together experts in their respective fields to discuss
topical issues. Next seminars: 6 July 2001 at Kew Garden on Herbal Medicine; November 2011 on Tuberculosis.
Q What is the Patients’ Council and plans for the future?
The Patients’ Council consists of users of the health service as patients and carers. It is working on building a wider base and networking with other patient organisations. Recognising that the patient voice in the UK is weak, the Patients’ Council seeks to liaise with partners and build a voice together. It is also create a national network of patients to form a supportive community; and to provide the College with a reference point on key patient issues.
Q What would be the one practical improvement in the Health Bill you would like to see?
For the first time, patient experience and safety are enshrined as key outcomes for the NHS. The relentless focus on the patient is in consonance with the philosophy of the College. The Health Bill nevertheless does not do anything actively to encourage patient accountability, promote patient-centred care and improve the patient experience. We would like to see the Secretary of State's duty to provide a health system reinstated in the Health Bill.
Q How do you measure the outcome of a person who is dying through quality of life?
Where is the science and evidence behind a patient’s experience?
The NHS needs to rediscover empathy and compassion. Much can be learnt from patients’ stories. They provide a source of evidence to learn from, to pass on, and to be evaluated. Patient stories are also key to changing opinions.
Q How can we make patient voice attract income and finance?
Phil Hammond: Patient experience is one of the key outcomes on which the NHS will be judged. Noting how much time has been wasted in hospitals and in waiting rooms – we should consider making use of the time to collect data and capture patient stories.
Q How can one sustain and put the ideas discussed at the conference into the NHS, in the face of the widespread budget cuts?
Contact local GPs and make strong cases for and/or demand the service. The only way to save money is by integrating services, stopping waste and duplication. Use the media to hold the NHS accountable.
Conclusion: How can the College of Medicine help to create services and clinicians that will reflect this new perspective?
Dr Michael Dixon, Chairman, College of Medicine
Dr Dixon said he felt humbled by and grateful to all who have given their time, passion and expertise for the College. We need to work together to make the College of Medicine a mass movement of compassionate and committed professionals, scientists and patients. The Health Bill and current reforms are not extreme enough. People at the coal face are making a difference and changing things. The College will work to be the central depository of case studies and best practices.
We are grateful to our lead sponsor Nelsons, event sponsor the Napp Group of UK pharmaceutical companies and founder Capita; and to the Lord Mayor and Lady Mayoress of the City of London.