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No space for doctors to innovate

The leader of Scotland’s doctors has warned that doctors do not have enough time in the working day to innovate and lead on improving care as much as they would like.

BMA Scottish council chair Peter Bennie said that increased demand and long-term vacancies were putting a strain on the medical workforce, and called for an honest debate on what the NHS could and could not afford.

He was responding to Scottish chief medical officer Catherine Calderwood’s second annual report.

Following on from last year’s well-received report, Realistic Medicine, Dr Calderwood has repeated her call for a change in focus in the way the health service works, putting patients at the heart of decision making and avoiding over-treatment, while managing risks and innovating to improve.

Called Realising Realistic Medicine, it sets out a future vision and strategy to put it into practice.

This will include further engagement with health professionals and the public and patients so that they know what to expect from the realistic medicine approach.

Other practical steps outlined in the report include publishing a Scottish atlas of variation and a collaborative training programme for clinicians to create better understanding, aid identification of unwarranted variation and promote high-quality care; developing a single national formulary, and a review of the consent process.

The principles of realistic medicine will be a core component of lifelong learning in medical education.

Dr Calderwood said: ‘I know the health and care workforce at all levels have been putting into practice Realistic Medicine for many years and I hope the practical examples and shared learning from around Scotland showcase the hard work already under way.’

Dr Bennie welcomed the CMO’s commitment to help the wider public engage with Realistic Medicine and understand what it will mean for them. But he warned: ‘Doctors want and expect to be innovators and leaders in improving outcomes for patients.

‘However, to do this well we need time to learn, teach and reflect. It is good to see that the CMO recognises the need for innovation within the NHS but with the ever-increasing demand and high levels of long-term vacancies, the BMA now regularly hears from doctors that they do not have the necessary time to do this.

‘We need to have an honest and open debate with the public and politicians about what the NHS can realistically provide.'

Dr Calderwood said she had not anticipated that her first report would ignite such a broad and enthusiastic discussion.

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