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Surgical Advisory Service Minutes

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Minutes of Surgical Advisory Service

10 August 2022

Held at CFC Underwriters Offices, London

 

Present:

In person

Mark Henley – CBS President
Helen Crookes – CBS General Manager
Jo Clift – CFC UK & International Healthcare Team Leader
Chris Shakallis – CFC Claims Adjuster
Sophie Wortham – CFC Senior Claims Adjuster
Charlie Soden – CFC UK & International Healthcare Underwriter
Thomas Clathern – CFC UK & International Healthcare Underwriting Assistant
 

Via Videolink

Robert Staruch
John MacFie
Simon Downing
Emily Borhan
David Barrett
Ruth Waters
Chris Caddy
Jon Boyle
Duncan Summerton
Peter Sedman
James Rowley
Alistair Jenkins
Philippa Jackson

 

​​​​​​​1.  Welcome

MH welcomed everyone to the meeting, who by virtue of their attendance was expressing an interest in the wellbeing of surgeons and development of the surgical community in a positive manner to address issues that have become apparent in recent times.

2.  Introductions and areas of interest

MH invited attendees to introduce themselves and to express what they see as problems and how they would like to be involved:

Ruth Waters – President of BAPRAS – important to help surgeons seek assistance in situations where they find themselves struggling. Surgical Advisory Service is also something that BAPRAS wants to be help with in terms of issues relating to bullying, harassment, and sexual harassment. Genuinely supportive to help change the culture of the environments people are working within.

Jon Boyle – Vascular Surgeon, President Vascular society in GB and Ireland – most pressing issue is around trainees and issues around bullying and harassment.

Chris Caddy – RCS (Ed), retired plastic surgeon, has a long history of listening to trainees on issues relating to difficulties around bullying and harassment.

Dave Barrett – Turning Moment, facilitator and mediator supporting individuals dealing with bullying and harassment who supports many people within the NHS. Also a Samaritan Listener and trainer experienced in dealing with suicide issues and severe mental distress.

Emily Borhan – Legal Advisor working with PRASIS and CBS to help people who need assistance particularly where there is a gap with their indemnity cover.

Duncan Summerton – Consultant Urologist, President of FSSA and Board member of CBS – interested in supporting surgeons in all stages of career.

James Rowley – Medical Defence Specialist at Hempsons, with 20 years’ experience of defending individuals in GMC cases. Here to continue to support CBS.

Peter Sedman – Deputy CMO of Hull and Exec Officer of CBS helping to develop Surgical Advisory Service.

Rob Staruch – former president of plastic surgery trainee association (PLASTA), previously carried out survey on behalf of BAPRAS in relation to bullying and harassment and continues to advise both organisations.

Philippa Jackson, consultant plastic surgeon in Bristol – author of letter regarding own experience of sexual harassment in the workplace, interested in improving support for maternity and menopause in surgery. Looking forward to working with CBS to help move these issues forward.

Simon Downing – Managing Director of MIC medical indemnity cover, wishes to listen and understand the issues being faced in surgery and to see if there are any gaps in policies that are being sold presently.

John MacFie, Founder of CBS, retired colorectal surgeon - hopes that all individuals help to make SAS work. The world of surgery is now sadly deficient in looking after our trainees and others, which is not a reflection of colleges and associations who have the constraints of not being able to look after the terms and conditions of service and issues around bullying an harassment in the way that CBS/SAS can.

Alistair Jenkins – current President of SBNS, which has set up a bullying and harassment unit along with an equality and diversity unit.

 

3.  Aims and Objectives of Surgical Advisory Service

MH thanked everyone for their introductions - The aim of this meeting is to:

  • work collaboratively
  • identify what the issues are within the surgical world and where Surgical Advisory Services wishes to have an impact
  • affect introductions between all parties so that there is knowledge and understanding of the resources available and how we can all work together rather than competing with each other – a surgical community working together.
  • MH spoke to the Surgical Advisory Document which was originally produced in 2015 by John MacFie following a meeting of the Surgical Forum of GB and Ireland, and updated by CBS to deal with current issues.

MH guided the group through the document (main points summarised below):

  1. Background self explanatory, surgeons account for very small percentage of medical activity in uk, therefore funding from Gov/BMA/major defemce orgs only a very small part of the pie and get treated accoridingly.
  2. Surgeons are at constant high risk of situations occurring from both a physical and emotional nature that are not the same as experienced by other practitioners in other areas of the medical world. Difficulties are summarised in document along with modus operandi of SAS.
  3. Public relations and media management that CBS/SAS employs is very effective as witnessed in a case last year concerning management of a headline case and the guidance BAPRAS received to manage the press. Reputational damange support is very important.
  4. Surgeon as a witness – support from James Rowley and other colleagues in terms of guidance and advice is available.
  5. There are a lot of resources available from the Colleges which can be utilised and signposted to.

Further Discussion:

  • MH explained that the First response guidelines for dealing with adverse events had been produced by Prof Kevin Turner (circulated) in conjunction with RCSEng but does not currently provide the physical resources. He hopes to be able to utilise this work to provide peer mentors going forward to advise and support colleagues, therefore the links with FSSA and SSA’s are so important so that colleagues can be assisted by others who understand the job and pressures faced which is not normally provided by other support organisations.

 

  • In relation to the Management of Cases EB gave examples of recent illustrative cases of bullying in relation to age discrimination and racial discrimination. She had also dealt with non-payment of legal reporting fees which is an increasing problem. There have also been discussions and advice given in relation to job contracts for part time work in relation to childcare

 

  • MH introduced the CFC Underwriters who are the principal insurers for many surgeons, particularly PRASIS for the past 12 years which is a valuable relationship as the language/terminology/culture of the surgical world is different to that of others. There is a mutual understanding and strong working relationship, to the extent that MIC as principal broker are willing to put investment into supporting this initiative.

 

  • A pilot scheme is being undertaken with BAPRAS as a helpline and advisory service to support the plastics community independent and empathetic outside perspective and space for people to go when they are uncertain of response they would get from other established pathways.  MH introduced Philippa Jackson and the letter she had written (circulated), which clearly highlighted the failings of institutions to effectively address and resolve issues when addressing the needs of preserving dignities, reputations and health and mental wellbeing. SAS and its work with BAPRAS will be available as an independent resource for individuals to be heard and not feel threatened, whilst providing them with options to take along with the benefits and risks of each explained. At no point would anyone be co-erced to take any action but to be there for them.

 

  • Dave Barrett explained that a key point to consider is that when people are trying to resolve a situation within an NHS system it takes a very long time which is very stressful, and a key benefit and advantage of this initiative is being able to help individuals navigate through an issue more quickly.

 

  • MH stated that the intention of SAS is to employ a constructive and collaborative approach, to produce a resolution through individuals being able to resolve situations without blame, emotional trauma or fear of professional repercussions. As NHS systems are set up at the moment, there is a lot of fear and blame culture. MH is hopeful that with the backing of CBS/SAS and with the support of FSSA and specialty associations that issues will be addressed with pragmatism and common sense.

 

  • Philippa Jackson urged caution in the use of language when encompassing so many potential areas to address -  as use of the word “resolution” In some matters such as sexual assault would not be appropriate.

 

  • MH agreed and felt that the starting point is that many situations arise from egos and misunderstanding, whereas situations such as PJ’s experience should be dealt with very differently. Other examples are in instances of “near miss” situations where a surgeon is left traumatised and unsupported during the lengthy procedures that are in place. Support from First Response mentors and Surgical Advisory Service would aim to address these gaps.

 

  • Overall the aim of this meeting and SAS is to get everyone working together to make the surgical environment right for everyone at every level because at some stage every individual is vulnerable.

 

4.  Next Steps

MH closed the meeting by thanking everyone for attending and that a set of minutes and proposals for next steps going forward would be issued in due course.