It is 4 years since publication of the SMASAC report on Promoting Professionalism and Excellence in Scottish Medicinein 2009. That report which celebrated success and achievement in the first 60 years of the NHS, highlighted several key themes to further enhance the role and contribution of the medical profession across NHSScotland and urged a call to action in a number of areas:
- Promoting better medical leadership at all levels of the service
- More effective team working
- Increasingly evidence based services underpinned by a strong research base
- Doctors as role models for doctors in training and other health professionals
- Doctors as advocates for health services and the health needs of the population.
These themes in the current policy context of NHSScotland with increasing emphasis on Quality-led, person-centred healthcare are ever more relevant. Following definition of a range of actions and an initial implementation phase led by SMASAC in partnership with the Academy of Medical Royal Colleges and Faculties in Scotland this progress report provides a stock-take of current progress and more importantly defines the next steps to increase momentum of delivery and demonstration of further real advancement through a range of initiatives.
The Professionalism agenda is being driven through a number of routes including Medical leadership development, with introduction of Senior Clinical Leadership Fellows, co-ordination of a number of leadership development opportunities and promotion of widespread use of 'paired learning' to promote mutual understanding and to foster a culture between medical leaders and Health Service Management that is driven by service quality improvement rather than performance. Promoting senior clinical engagement at all levels of management is an internationally recognised key to success and high performance in healthcare organisations across the world. Widespread senior medical engagement is enhancing delivery of the Quality Agenda through implementation of the Quality Strategy and in development of the 20:20 vision.
The profession is actively seeking to improve medical recruitment and retention in NHSScotland. This includes ensuring that working patterns and rotations for all trainee doctors are designed to provide a high quality clinical working environment that enhances professional learning and behaviour.
There continues to be much evidence of good medical professionalism at all levels; there is also recognition that this may sometimes be in spite of rather than because of some of the drivers and pressures in the system. Senior medical participation in vital patient safety, medical training and clinical service improvement requires explicit and consistent recognition and support.
The value of individual professionalism in ensuring and enhancing patient safety and quality of care is explicitly recognised in the Berwick response to the recent Francis report into Mid-Staffs trust, 'A promise to learn, a commitment to act'.1
There are a number of stretching, high level aspirations within this stock-take and call to action. While the challenge of achieving them is not to be underestimated, this Progress Report has the endorsement and support of a wide range of individuals and organisations in and allied to NHSScotland, all of whom have made a commitment to actively pursue and deliver this important agenda. Achieving success in these endeavours exemplifies the widespread, cross-agency professional collaboration that has characterised much of our progress in the Scottish Health Service.
On this 65th anniversary year of the foundation of the NHS it is essential that we continue to promote professionalism and excellence in Scottish Medicine. This Progress Report is a reinforcement and reassurance of the explicit commitment of the Scottish medical community to rise to the occasion.
Sir Harry Burns
Dr John R Colvin
Chief Medical Officer
Chair, Scottish Academy
The Berwick Report:1
Email: Diane Dempster