Remembering Dame Fiona Caldicott

The College was greatly saddened this week to hear of the death of Dame Fiona Caldicott, the first female Dean and then the first female President of RCPsych.

Dame Fiona died on Monday 15 February 2021, aged 80, having achieved an extraordinary amount in her career, making many friendships and inspiring many people on the way.

This week the College’s current President and Dean praised her exceptional contribution to public service, and for being a trailblazer and ‘beacon of hope’ for women in medicine.

"Pioneer"

RCPsych President Dr Adrian James said: “Dame Fiona was a true pioneer. She achieved so many firsts.....but above all her life was steeped in public service and a desire to improve the lives of all, patient, student and all who work in health and education. 

“She was admired and respected by all she worked with, and will be missed by us all.”

"Beacon of hope"

Dr Kate Lovett, who is the College’s third female Dean, said: “As we mourn the sad passing of Dame Fiona, we have so much to be thankful to her for. 

“She was the epitome of selfless public service throughout her life. Her influence was exceptional. 

“For women of my generation, she paved the way for so many more of us to reach our potential. As our first female Dean and President (and  former less than full time trainee) she was a beacon of hope and encouragement to so very many”

As a young doctor

It was at the age of ten when she first decided she wanted to become a doctor. Sure enough, she qualified for medical school at 18 and went on to train as a GP.

Dame Fiona joined the Warwickshire and Coventry Psychiatry Training Scheme in the early summer of 1971 on a flexible part-time basis. Such arrangements were possible thanks to an imaginative scheme set up by the DHSS in 1969, to help married women doctors working in hospitals achieve a good balance between work and home life.

With the support and encouragement of her husband Robert and other family members, this balance was achieved.

Dame Fiona proved an enthusiastic trainee, taking part wholeheartedly in all facets of the programme from neuropathology brain studies to individual and group psychotherapy.

The patient care she provided in those early days was split across two very different locations: the overcrowded Warwick in the County Mental Hospital, built in 1852, and the Walsgrave Hospital in Coventry, the largest and newest General District Hospital in the country at that time. 

Leader of the profession

Later of course, Dame Fiona went on to oversee the training of other psychiatrists, which she excelled at. “Fiona humanised psychiatry,” one trainee recalled many years later. “Fiona was my trainer and was always there when I doubted what I was doing.”

Ultimately, General Practice’s loss was psychiatry’s gain as Dame Fiona went on to become a leader of the profession. 

In 1990 she became the College’s first female Dean, and then in 1993 was elected as the first female President of the College.

Among her many contributions as President, she supported the setting up of the Women in Mental Health Special Interest Group, which is this year celebrating its 25th anniversary.

In her final year as President she took the role as chair of the Academy of Royal Colleges. 

Protecting patient information

Her performance in this roles led to the Chief Medical Officer for England and Wales inviting Dame Fiona to lead a review on how patient information was protected in a new world where data was starting to be recorded on networked IT systems.

It was a complex challenge – leading a committee of 50 people with wide ranging and conflicting views. But thanks to Fiona’s astute leadership, a report emerged which had a lasting impact on medical confidentiality. And out of this came the first six Caldicott Principles, which say that confidential information should only be used when absolutely necessary, for a justifiable purpose, within the law and strictly on a need to know basis.

A recommendation that NHS organisations should each have a ‘guardian’ to safeguard patient confidentiality was also part of the Caldicott report in 1997, leading to the introduction of what became known as Caldicott Guardians a year later. Today there are over 22,000 Caldicott Guardians, throughout Britain and overseas.

Dame Fiona subsequently became Principal of Somerville College, Oxford, and also served as the Pro Vice Chancellor of Oxford University, with responsibilities for personnel and equal opportunities.

She was also Chair of the Oxford University Hospitals NHS Foundation Trust between 2009-2019.

While she was with the trust, she promoted embedding of a set of values across the whole workforce.

When the RCPsych introduced its own values – of Courage, Innovation, Respect, Collaboration, Learning and Excellence – in 2018, she invited the College Chief Executive and Director of HR for a visit, so they could see how workplace values can have a real and lasting impact, if rolled out in a proactive fashion.

Becoming National Data Guardian

In 2011, aged 70, she became chair of the National Information Governance Board, saying she ‘wanted to leave information governance in a good state’.

She was asked to lead a second inquiry in 2012-23 – the Information Governance Review – with the aim of finding the right balance between protecting patient confidentiality and sharing enough information to improve patient care. She conducted this inquiry rigorously and it led to a seventh Caldicott Principle being introduced, as well as all 26 recommendations being accepted by the Government.

Dame Fiona became the National Data Guardian for Health and Social Care in 2015, and conducted a third review this time focusing on data security, consent and opt outs. She was delighted when in 2018 Parliament passed legislation – supported by all parties – to make the National Data Guardian role permanent in statute.

RCPsych Lifetime Achievement Award winner

The same year, Dame Fiona was awarded the RCPsych Lifetime Achievement Award by the College – there could be no more deserving winner. You can watch the video we made to mark her winning the award below.

Dame Fiona will be greatly missed by many at the College, and many more who have worked with her and known her in different ways.