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Creating the Pre-Hospital Emergency Medicine Service in the West Midlands –The Inaugural lecture of the Birmingham Students Medical Leadership Society

Written by jacob matthews · Saturday 23rd November 2013

Many thanks to everyone who attended the Birmingham Students Medical Leadership Society’s first ever lecture on November 7th 2013. The committee was extraordinarily pleased with the turn out and hope to see you all at our next lectures. We must also say a big thank you to Dr Nicholas Crombie for being our Inaugural speaker, he gave a fantastic lecture and we have received a number of rave reviews and requests for a follow up lecture next year!

Dr Crombie’s talk focussed on three main areas:
1) A short personal history focussing on why and how Dr Crombie became head of one of the UK’s best Pre-Hospital Emergency Medicine (PHEM) services and the first post-graduate dean in charge of PHEM trainees.

2) The majority of the lecture was a case history on the behind the scenes activity that was required to create the West Midlands Pre-Hospital Network and training program. In summary, over a decade ago it was realised that the UK was lagging behind other developed nations in our Emergency Medicine and Trauma service provisions. There were a number of disjointed and only partially trained services in place for major incidents. The British government and a number of leading health think-tanks put forward proposals for creating a modern effective service. Dr Crombie was a senior doctor in the West Midlands air ambulance charity, the BASICS program and had worked with the West Midlands Ambulance service. Dr Crombie was able to collect a team of senior doctors, nurses, paramedics and managers from all of the emergency medicine services and charities within the West Midlands together. This collaboration of ambulance service, charities, BASIC teams, CARE team and NHS Trusts was novel to the UK. The collaboration was able to tender for central government and was the first such scheme in the UK to be approved. Since the scheme’s approval 5 major trauma units have been established within the West Midlands and a new trauma desk was created at the Ambulance service HQ which can call on the help of a number of experienced teams that can be deployed within minutes to a major incident almost anywhere in the West Midlands.

This major reformation of a health service was truly inspirational, especially when it was achieved by a number of clinicians with relatively little accredited management training and without them giving up their clinical time, a true clinical leadership success story.

3) The last component of the evening was Dr Crombie’s thoughts on why this project had been successful and how simple basic principles could be applied to almost any other project. Dr Crombie’s 3 big principles were:

Collaborate – leave your ego’s at the door and try to put together a team that can work together. If you have to, invite everyone involved to a free dinner at your expense – even doctors don’t turn down free food!

Governance – establish a set of rules/guidelines that dictate how your project will be run. Try to get everyone involved singing off the same hymn sheet. A very good example of this from Dr Crombie’s case history was that all of the services involved in the scheme agreed to use the same emergency medicine kit and all follow the same Standard Operating Procedures (SOP), so that when the teams work together they almost work as one single effective team rather than distinct groups that cannot interact.

Resilience – the service you reform/create must withstand the test of time. If a project is solely driven by one person then it will collapse as soon as that person moves on. This is a well-known problem with the NHS as a whole, new managers always have “great new ideas” and as soon as that manager changes job all of their hard work goes to waste. To ensure that a project has resilience, the “project manager” must create a sense of purpose and ownership of the project within their teams. Members of the team must “buy in” to the goals of the project and one of the best ways of doing that is to ask the team members for their advice on how the project should proceed. If people feel a project was their idea then they are far more likely to work for it. This requires the manager to keep their ego on a short leash and to let their team take credit.

The take home message from this talk was that the days of doctors being purely clinical is over! If you want to be a consultant in any speciality in the future, you will need a basic underlying knowledge of management and leadership.

Upcoming events from the Birmingham Students Medical Leadership Society:

Wednesday 27th November LT3 Medical School, 6pm
‘Learning to Lead- Preparing the next generation of junior doctors for management’
By Mr Tim Smart, CEO Kings Hospital NHS Trust

Thursday 5th December LT3 Medical School, 6pm
‘Why should doctors get involved in management’
By Dr Mark Newbold, CEO of BHH NHS Trust

If you would like to get in touch with the society or attend any of our events please do contact us by email or via our Facebook group. We look forward to hearing from you.