The Value Chain and Education

I established the Silver Scalpel Award in 1999 as ASiT President as I believed that you could have the most innovative training program you like but it will go nowhere without a good teacher.  I still believe that today and am delighted and privileged to be the Director of the Faculty of Surgical Trainers of the Royal College of Surgeons of Edinburgh.  Our aim as a faculty is to identify, develop and grow the surgical trainer.  We want to ‘professionalise the surgical trainer’.  We are focusing on the development of the individual but that is also going to require a system change.

Twenty years of the Silver Scalpel Award has reinforced that good service and good training go hand in hand – there is no conflict.  The shortlisted candidates exhibit exceptional skills particularly around engagement and communication.  The words ‘pastoral’ and ‘nurturing’ abound in the effusive testimonies submitted by the nominating trainees.  Comprehensive 360 multi-source feedback affirms their esteemed and valued trainer status.  Health Education England referred to the award as ‘a badge of honour’.  Who cares, does train and they do that exceptionally well. 

The skills of the modern trainer are predominantly ‘soft skills.’  I am thrilled that Bob Chapman, CEO of Barry – Wehmiller and global leader, is headlining our FST conference on communication on 16 October 2020. He is the co-author of the bestselling book – Everybody Matters: The Extraordinary Power of Caring for Your People Like Your Family.  His book resonates with the ‘nurturing and pastoral’ theme that predominates in the Silver Scalpel Award testimonies.  Trainers are ‘touching people lives’ and we do need to recognise the extraordinary enriching influence of ‘#TrulyHumanLeadership’.  

Excellent surgical trainers are leaders in education and their departments.  I am sure you will agree that every surgical trainee deserves to be valued and respected.  Just think of the impact – I have sadly seen some amazing and talented people leave cardiac surgery for radiology because they did not feel valued nor did they feel that they were progressing.  We know the figures and we hear the stories – trainees are disengaged, and the profession is not attractive to the new generation.  Have we lost the ‘caring’? 

We need a cultural change.  Everybody throws that out as a simple solution to many complex problems.  This can be construed as flippant because many a time you are left wondering what levers do we pull to effect change.  Well, it starts by recognising what is important.  Education is vital to our all our endeavours.  The primary motivation factor for all professionals is the opportunity to grow.  We also need to be valued and enjoy celebration and recognition at work. 

Mr Edmund Leung, a general surgeon at Hereford County Hospital was the worthy winner of the Silver Scalpel Award in 2019.  I was delighted to see a press release in the Hereford gazette, in April of that year, quoting the CEO of the hospital saying that ‘the hospital was on the map because one of their surgeons had won the Silver Scalpel Award’.  I literally jumped for joy.  This CEO got it!  Just imagine if every CEO and the NHS at large got it too.  Just imagine the benefits to our trainees, and all the staff for that matter, if we embrace #TrulyHumanLeadership.  And, the people who will benefit the most, are the patients because this the return on investment and the obvious value proposition. 

I contacted Glen Burley, Chief Executive of the Wye Valley NHS Foundation Group who made that statement for a comment.  Glen did not hesitate and returned with this statement within the hour giving me permission to use all his words.   Thank you, Glen.  I salute you.  I invite you to read Glen Burley’s reply – invite all those in the privileged position of leading, to help change the culture.  As Gandhi said, ‘be the change’ and ‘change begins with one’.  Glen Burley is one…he sums up the value chain and the need to have good teachers.

It was noteworthy that a surgeon working in a smaller hospital was able to win the award for the first time. It is not always easy to find the time for teaching in job plans as much of the focus of DGH life is on service delivery. I am conscious that Edmund willingly puts much of his own time into making sure that our trainees are able to achieve their ambitions.

But teaching and research are really important functions of the NHS and provide wider benefits beyond simply the transfer of knowledge. I think that there are three main reasons why I am an advocate of having as active a teaching programme as possible.

Firstly, I would want any trainee or student to get a great experience at Wye Valley Trust, or indeed in any part of our Group (which includes South Warwickshire Foundation Trust and George Eliot Trust). Being welcomed, supported, and feeling part of a team are experiences which hopefully lead trainees to return to be our consultants of the future. If they too have a teaching interest, then I would want to support them with this so that we can recruit and retain the very best people.

Secondly, a teaching culture is a learning culture, and this brings with it innovation and service improvement which benefits our patients.

But the final, and by far the most important reason is that teaching improves safety. Any consultant who is this good at teaching must be very much on top of his or her ‘game’. You have to know your stuff, be able to explain it but also be open to question, comments and ideas for improvement. Edmund has all these qualities in abundance, alongside a truly humble outlook on his role. So, we were all delighted that he received the recognition that he deserved, and we were all happy to bask a little in the glory. Herefordshire is a little off the beaten track from an NHS perspective, but in the Trust, we have a great culture and some real pockets of excellence to be proud of.

Glen Burley, Chief Executive, South Warwickshire FT, Wye Valley NHST and George Eliot Hospital NHST

About the author:

David O'Regan is the Director of the Faculty of Surgical Trainers. He has been a Consultant adult Cardiac Surgeon in Leeds since 2001.