From the President Simon Kendall

From the President

Simon Kendall

We emerge into 2022 with our health services struggling to cope with the needs of the population and the reduced establishment of beds and workforce.

All the surgical specialties are facing significant challenges and in our specialty it is cardiac surgery that has the extra challenge with its dependency on level 3 facilities. Our colleagues in intensive care have faced unprecedented demand on their expertise trying to give access to all patients needing their care, including patients following cardiac surgery, much of which is done wearing the uncomfortable and draining personal protection equipment.

Our specialty is challenging on its own merits – major surgical interventions requiring great skill, knowledge, experience, dedication and teamwork.

The first four attributes are almost taken for granted; We are blessed with the most able, intelligent, hard working colleagues which correlates with all the extreme hard work and commitment needed to achieve such responsible roles in a tough specialty. We are admired by other surgical specialties with our approach to patient care and training. The challenging year and the solutions and standards to support units in the pandemic and the toolkit to enhance training and emancipate our allied health care providers have been regarded in a very positive light.

SCTS has also addressed the needs of the society and has worked with the SAC in the ST4 Thoracic surgery pilot to support specialist thoracic training.

However, our specialty appears to struggle with the fifth attribute – Teamwork.

Why is it that so many units have issues with team working when we all have a strong commitment to patient care as well as possessing all those other skills?

There are five main themes identified as sources of conflict in medical teams:

Information – lack of information, lack of communication, choosing to use different information

Values – interpersonal, interdisciplinary, inter specialty, organisational i.e. focus on money rather than quality of care

Interest – roles, status, private practice, research, innovations, personal life

Relationship – a clash of personalities, egos, allegiances

Structural – what we all endure with lack of beds, staff, theatre space, funding etc

It is not surprising that the impact of the pandemic has amplified these themes. We have not been able to meet with each other to share information, to share our values, to share our interests and to maintain relationships. Leadership development and team support agendas have been put on hold. Also, the structural theme of conflict has been exacerbated with less ward beds, less level 3 and level 2 facilities as well as significant issues with retention and recruitment of the workforce.

It is a privilege to belong to a high profile specialty but that also brings great interest from the public and the media. Although the other surgical and medical specialties may have similar issues it is our specialty that makes the news too often. This is disappointing when so much excellence is achieved but at the same time there are too many units with teamwork issues that impact so negatively on so many dedicated colleagues. Moreover, and most importantly, there is evidence that around four of every ten conflict stories have a negative impact on patient care.

This situation prompted my letter to the membership in November last year challenging the specialty to add respect, civility and kindness to our portfolio of clinical excellence. Furthermore, to challenge ourselves, that it is no longer acceptable to observe poor interactions without supportive and constructive intervention – if we turn away and ignore such behaviours we are inadvertently making them acceptable.

These challenges overlap with the Honorary Secretary’s article on page 7 which summarises all the progress we are making with Equality, Diversity and Inclusivity: respect, civility and kindness absolutely underpin this agenda as well.

My plea as President, as we confront the challenge of 2022 and beyond, is that we really focus on our behaviours and reflect on the impact we have on each other. Together we can make the difference to our working environment and, where necessary, transform them and maintain them as safe, supportive and enjoyable places to work for everyone in the team. n

“Together we can make the difference to our working environment and, where necessary, transform them and maintain them as safe, supportive and enjoyable places to work for everyone in the team.”