25 July 2022

As I sit, clammy and flushed, to write this month’s message, I think it's safe to say July has been hot on many fronts. Usually, at this time of year, Sheffield is enjoying typical high summer conditions; the streets thronged with people in raincoats and fleeces. Strangely with outside temperatures in the upper 30’s the place is virtually deserted. The biggest congregation of people for several miles is probably the queue for the ice cream van outside the hospital. This despite the fact that, in these temperatures, a double 99 has a similar life expectancy to a newly appointed Cabinet Minister. With Boris now out of the picture I await the appointment of a new Prime Minister and Cabinet with interest. The whole process is like watching “The Hunger Games” though with less talent on display….Apologies, I think the heat is getting to me.

Amidst this brouhaha, I want to mention two items that have relevance to our beleaguered health service and particularly haematology. Sadly both episodes resulted in unnecessary deaths. 

The first incident led to the demise of a teenager with AML. The coroner felt a lack of out-of-hours paediatric haematology support was a major factor. As a consequence, he issued Regulation 28, or prevention of death notice, to the Secretary of State for Health. This stressed the impact of a shortage of Consultant Paediatric Hematologists requesting that the Secretary of State act on this to prevent further deaths. A DHSC statement issued earlier this month fell some distance short of disappointing, failing to address the key issue and commenting instead, on the “record numbers of doctors and nurses in the NHS”. Are they on your wards? Because they’re not on mine. BSH has been trying to effect change in paediatric haematology training numbers with minimal success for some time; I’m beginning to understand where the problem really lies.

Secondly the report of a death in Oldham after what sounds like a botched sternal aspirate performed by a haematologist in his 80’s using the wrong needle and piercing the pericardium. I would argue that the continued employment of such an individual does not occur in an environment where departments have the choice about who they recruit, or don’t.

Two tragedies, both probably as a result of a lack of appropriate numbers of suitably trained haematologists. There has been a long-standing absence of national workforce planning and little evidence that this situation will be reversed any time soon. One of the frustrations when discussing workforce with higher bodies is the inevitable “well show us the evidence” statement. I naively assumed they had this information rather than us; apparently not. I am therefore pleased to report that the BSH Board has agreed in principle to invest in an ambitious project focusing on the haematology workforce. This, I envisage, will be a wide-ranging look at the current position, future planning, models of service delivery, and demand management. The devil, as ever, will be in the detail and this will be the focus of the forthcoming Board retreat. I will keep you informed as this potentially exciting project develops.

I’d like to highlight forthcoming vacancies for clinical directors at the RCPath and an Editor in Chief role at the RCP, this latter post might suit a quality improvement enthusiast. Please contact the relevant college if you are interested. More haematological voices within the RCP and RCPath can only benefit our specialty. 

Finally, I was sorry to hear that Professor David Oliver, the next President of the RCP, will not be taking up his post. His Personal Perspective on the pandemic and its long-term effects on his health and that of other staff is a moving explanation of his reasons and will resonate with many.