Taking a hard earned break
31 August, 2023
It has been an incredibly busy start to my Presidency. I have enjoyed meeting colleagues old and new across the health and psychiatry fields, ranging from other Medical Royal Colleges to parliamentary stakeholders.
I've found it very rewarding to strengthen relationships with our partners, who we will need to collaborate with to overcome challenges and achieve the College’s goals.
With that being said, I was glad to be able to take some time off this month to recharge my batteries and spend time with family and friends. The work that we do brings challenges as well as successes, and this can be hard work, so I hope that you have also had the chance to take a break.
News about our CEO
Our Chief Executive Paul Rees MBE is stepping down after seven successful years in the role. Paul joined RCPsych in November 2016, having previously been the Executive Director of Policy and Engagement at the Royal College of GPs.
While my time as President has only just started, Paul has been a great source of support to ensure my tenure has had a smooth start. I know that he was similarly valued by Simon, Wendy and Adrian when they were President.
Paul’s time at the College has been marked by several awards and achievements but especially through the significant developments and improvements for the College as an organisation.
Under his leadership, the College has been modernised, including transformation of College IT, better membership communication, more effective stakeholder engagement and a dynamic employee relations strategy with regular internal comms like our staff blogs and staff briefings.
He worked closely with the Officers to introduce the values-based approach to decision-making and organisational culture in April 2018, to ensure that Courage, Innovation, Respect, Collaboration, Learning and Excellence are at the heart of how the College works.
When the pandemic struck in March 2020, the College faced unprecedented challenges. Paul supported the College Officers, Trustees and staff through one of the most difficult times in modern history, both on a professional but also a personal level.
Together with former President Adrian James, Paul guided the College to support frontline doctors and other members of mental health multi-disciplinary teams to continue to deliver essential services to patients. With the completion of the IT transformation programme, the College was well-positioned to overcome the challenges of the pandemic and ensure that we were able to continue operating effectively while prioritising the wellbeing of our staff, switching to being a virtual organisation overnight at the start of the pandemic.
With this, the College was able to digitise the MRCPsych examination in just five months, which was one of the biggest digitised exam roll-outs of any Medical Royal College.
Paul has also driven the implementation of the College’s flagship Equality Action Plan which was published in January 2021. This set out 29 actions showing how the College could promote equality and equity for College members, affiliates and staff, mental health workers, patients and carers, leading to over 400 actions on equality, diversity and inclusion, as well as the College’s commitment to becoming a proactively anti-discrimination organisation.
During his time at the College, the gender pay gap for employees has significantly diminished. Earlier this year, the Equality and Human Rights Commission published a blog and case study about this work as an example of best practice for other employer bodies across the private, public and charity sectors.
Under Paul’s tenure, the College started regularly celebrating International Women’s Day, Pride, Black History Month and of course, South Asian History month – celebrating the contributions of our diverse membership. It speaks to the amazing work that Paul has championed in this area that the College won Charity of the Year in the European Diversity Awards in November 2019, and the Best Equality, Diversity or Inclusion campaign in the Memcom UK Membership Sector Awards in September 2022.
Another area of focus has been recruitment and improving psychiatry’s profile in the field of medicine. Paul led massive improvements in this area with the development of the Choose Psychiatry campaign which won the Best Marketing Campaign in the Memcom UK Membership sector awards in September 2020. This saw an increase in the fill rate for psychiatric training places increase to 100% for the first time on record, and which the College has consistently achieved to date.
With Paul at the helm, the College has gone from strength to strength, with our membership growth reflecting this. At the end of 2016, the College consisted of 17,919 members and our membership has since increased to 21,000, which is an all-time high.
It is no surprise that all of Paul’s hard work in progressing the College has led to well-deserved recognition. In September 2020, Paul was announced as the winner of the Memcom UK Membership Sector Louis Armstrong CEO Leadership Award and in December 2021, Her Majesty the Queen announced the New Year Honours list and Paul was honoured with an MBE for his services to mental health and equality, diversity and inclusion.
While I am sorry to see Paul leave, on behalf of College members, affiliates and staff, I thank Paul for the heart and soul he has given to his role as CEO and for leaving the RCPsych in a better place, a place where people want to work and to which psychiatrists want to belong.
My start as President of RCPsych
I had the privilege of taking on the role of President of RCPsych at our AGM on Tuesday 11 July, and I think it is fitting that I start off by reiterating how honoured I was to have been elected by you in a truly incredible turnout.
At the same time, I know that we must continue to improve our ways of engaging with all of the members in our College. Keep an eye out for our new monthly Question Time with the Officers (accessible by members only) where we will answer your questions or forward your suggestions about how to improve things in mental healthcare that you can submit in advance so that you can learn more about the College that you are a part of.
While I am proud and excited to lead the College with our fantastic Officers, I know that we will not be able to do this alone. After all, you, the membership, are at the heart of what we do. Only together, as a united College, will we be able to really improve mental healthcare, the working lives of psychiatrists, and above all the lives of people with mental health problems.
There has never been a time like this in mental health. We have to be ambitious with what we want to achieve, because now more than ever, so many people are open to and ready to talk about mental health and mental illness. We must capitalise on this because now is our moment. The overarching priorities that I will be working towards are as follows:
- Addressing the treatment gap: fight for resources to deliver therapeutic care.
As a College, we need to address the treatment gap, because we know that psychiatry is over-stretched and under-resourced amidst the ongoing effects of the pandemic, wars and displacements, industrial action and a cost-of-living crisis. Continuity of evidence-based therapeutic care will be central to mitigating this because it is more clinically effective and cost effective, rather than reductive care that forces psychiatrists into being “prescribing agents”. Our patients deserve more than this – they need high quality care in safe and therapeutic environments.
The way our College Engagement Network interacts with regional models of care will also be essential for the College to strengthen its engagement with and support for integrated care boards, in which we must ensure that mental health leaders are embedded. We must also acknowledge that for too long, mental health services have been the poorer relation to physical health services when it comes to access and waiting time standards, and that we must continue to argue the case for parity of esteem. On a global scale, we need to move to sustainable models of mental healthcare because this is crucial for promoting resilience, reducing stigma and discrimination, improving access to care, and fostering a healthier and more inclusive, safer and more productive world for all.
- Nurturing and supporting psychiatrists to retain and strengthen our workforce.
We need to nurture and support psychiatrists so that we can support patients to thrive and achieve their potential. Industrial action is a reminder of what I am being told by UK psychiatrists up and down the country, that you feel undervalued and that you are not given the basic infrastructure you need to carry out your roles. It is essential that employers attend to the needs of their medical staff, for retention as well as recruitment.
We must also harness technology and champion research to drive improvements in prevention and care. We will encourage psychiatrists to feel confident in using an evidence-based biopsychosocial approach by supporting the development of academic research hubs across the country. Our workforce should be able to access good basic research training to support clinical work and develop your research career if you wish to pursue academic psychiatry.
With the recent release of the NHS Workforce Plan, we need to be working with stakeholders nationally and locally to build up the psychiatric workforce to both deliver on the commitments to develop services and to reduce the burden on existing NHS staff. Moving forwards, I will continue to work with decision-makers to ensure that practical actions are implemented at pace. Regardless of your grade, all psychiatrists should feel supported and valued at their place of work, and if you are not, rest assured that we are thinking about ways to improve your working lives, so that you can focus on what you should be focussing on – helping patients who really need it.
- Fairness for all: tackling inequality for patients and staff.
We know that disparities in mental healthcare need to be challenged, for ethical, moral, legal and financial reasons. We need to scope ways to improve access to mental health services and continue influencing key strategic and policy stakeholders. At the same time, we need to focus on tackling workplace inequity faced by women, doctors with disabilities, LGBTQ+ doctors and minoritised ethnic doctors, so that psychiatrists can thrive in their workplace.
I was delighted to see the launch of the Act Against Racism campaign at Congress, which is a great example of what we need to do. It was developed with medical directors, doctors with lived experience, patients, and other key stakeholders such as the NHS WRES, MWRES and the Race and Health Observatory and colleagues from the Mental Welfare Commission of Scotland, amongst others. The College will be lobbying mental health employers across the four nations to get on board with the Act Against Racism campaign, by signing up to adopt the 15 actions in our guidance. Since its announcement, 3 organisations have signed up and a number of others who have committed in principle are taking it through internal governance processes before signing up.
As doctors it is our duty to ensure that all of our patients are offered a comprehensive assessment in order to ascertain their mental and physical health needs. Care should be person-centred, take into account an individual’s rights and wishes, and use the best available evidence to inform practice. This is good practice in medicine and we would urge all our colleagues to work in this way. For instance, there is lots of activity and work going on in transgender health, and I am aware that there are a range of views on this topic, but I am also conscious that there are some misunderstandings about the College's position on this. I want to assure you that the College intends to update its formal position on this once the Cass review is published and we have more information from NHSE. This update will be focused on our role as doctors. As such:
1. We will be guided by good medical practice.
2. We will take an evidence-based approach.
3. We will consult widely.
4. We will not be influenced or driven by ideologies of individuals or organisations.
I also look forward to supporting the imminent country-wide roll out of the Patient and Carer Race Equality Framework, an idea that came from the Mental Health Act Review and was worked up by the NCCMH and adopted by government and is now being piloted in 4 sites in England. Our work on designing, developing and embedding systems that tackle inequality and improve mental health equity, will continue, building on strong foundations established through the delivery of our three-year Equality Action Plan.
Together with the other Officers and myself, our Devolved Nation Chairs, Faculty and Division Chairs will be supporting the development of the College Strategic Plan for the next three years. Underpinning all of this will be the efforts of our talented and knowledgeable Presidential Leads:
- Equity and Equality, Dr Raj Mohan and Dr Amrit Sachar
- Global Mental Health Strategy, Prof. Mohammed Al-Uzri
- Women and Mental Health, Dr Catherine Durkin and Dr Philippa Greenfield
- Compassionate and Relational Care, Dr Russell Razzaque
- Physical Health, Dr Ed Beveridge
- Wellbeing and Retention, Dr Ananta Dave
I am already enjoying working with them, they’re an impressive bunch.
Wishing you all the best for your work and home life,