NHS Reset: Why coronavirus must be a catalyst for change | Charlie Massey

Charlie Massey

NHS Reset is an NHS Confederation campaign to help shape what the health and care system should look like in the aftermath of the pandemic.

In this blog, Charlie Massey, chief executive of the General Medical Council (GMC), emphasises the importance of learning from the lessons COVID-19 has taught us, particularly in relation to retaining our doctors and addressing race inequities within medicine. 

Coronavirus has forced a clarity of direction that has galvanised the health system into action. In the face of an acute and immediate need, healthcare workers have responded with Herculean resolve, enormous professionalism and impressive flexibility. Early results from our annual barometer survey show 99 per cent of doctors have experienced changes to the way they work, with almost half (42 per cent) having been redeployed during the pandemic.

But, as the system manages the release of pent-up demand, a hefty backlog of elective work and the uncertainties of winter, it’s clear the real test is ahead of us.

Recovery and renewal

The task is immense, but in it lies not just an opportunity for recovery, but for renewal. 

To make the most of it, we must build on the innovation that has been on display throughout the pandemic. From our use of technology to the willingness to work together, we now have proof that positive, practical change is within our reach and we must focus on how we can sustain and embed it for the longer term. 

At the GMC, our focus throughout this period has been on doing everything in our power to ensure clinicians can deliver the safest possible care to those who need it. 

Increasing the supply of available doctors was a clear priority early on. We moved swiftly to bring around 30,000 past practitioners back onto the register, and to register about 5,000 final-year students early. While workforce issues have rightly been a focus of the response, we all know these pressures didn’t start with the appearance of COVID-19. 

Although the UK has always been good at attracting new doctors, keeping them has been a different matter. Until now, those gaps have been plugged to some extent by overseas medics. But relying on this supply is no longer tenable. The big increases we’ve seen over the last few years are now much less certain to be maintained.

Retaining our doctors

So the focus now has to be on retaining the doctors we already have. We know where the challenges are – unsustainable workloads, poor working environments and a lack of support, to name a few. These are the issues that harm doctors’ wellbeing and undermine their ability to perform at their best. So, these are the issues we must now turn our attention to.

Good clinical governance is also critical. Lifelong learning is central to a doctor’s ability to deliver excellent care. To support both their professional development and their wellbeing, this ethos must be embedded at every stage of a doctor’s career. 

These factors are even more critical when we think of the experience of ethnic minority groups throughout this pandemic. 

The destructive reality of structural racism

The Black Lives Matter movement has illuminated the destructive reality of structural racism. At the same time, the disproportionate toll of coronavirus on black and minority ethnic (BME) people has brought existing health inequalities into sharp focus. 

These inequities play out in medicine too. No one can fail to notice that the majority of doctors who’ve died of COVID-19 are from an ethnic minority background. But these issues predate the pandemic. BME doctors are significantly more likely than their white colleagues to be referred to the GMC. They are also more likely to be treated as ‘outsiders’ and find themselves working in isolated roles without adequate support. All too often, they find the system works against them. 

What is needed now is not just a transient moment of awakening, but a fundamental shift. We can’t just pay lip-service to these issues, we must drive forward solutions. Actions will always speak louder than words.

There is not only a clear moral imperative to improve BME doctors’ experience of medicine, but a practical one too. For them, like all doctors, to be motivated to stay in the workforce for the long term, they need to be properly supported.

There’s much that the GMC, and the wider system, can and should do. We’re supporting a substantial research project led by University of Leicester, which will calculate the risk of contracting and dying from COVID-19 for ethnic minority healthcare workers. We’ll be supplying evidence and data to policymakers so that decisions can be made in near real time.

But there’s much more to do, and this work will remain a priority as we look towards the publication of our new corporate strategy this year. In short, coronavirus must be a catalyst for change. This pandemic will end. But the lessons it’s taught us must not be forgotten.

Charlie Massey is chief executive of the General Medical Council. You can follow the GMC on Twitter @gmcuk

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