Overview of the Council meeting which took place on 12 February 2021.
Mr Edward Morris, RCOG President, reported on the following activities:
- The COVID-19 Guidance Cell has established a vaccine sub-group chaired by Professor Lucy Chappell, NIHR Research Professor in Obstetrics at King’s College London. In addition to RCOG members, the group includes representatives from key bodies involved in vaccine research and delivery, including Public Health England and UKOSS. The group is focusing on trying to encourage government to support better recording of pregnant women who have been vaccinated and facilitate vaccine research in pregnant and breastfeeding women, and has also developed resources for healthcare professionals and women.
- The College continues to reiterate our messages to NHS England regarding the redeployment of maternity staff into other areas of medicine as a result of the pandemic. Our activity has included writing a joint letter with the Royal College of Midwives (RCM) to CEOs of Trust and Health Boards, which anecdotal feedback suggests has been useful to our members.
- Maternity safety continues to be of significant media and policy interest. The President and the Vice President for Workforce and Professionalism have both appeared in front of the Health and Social Care Select Committee inquiry into maternity safety. The College has also been working closely, in tandem with the RCM, on a number of initiatives to support Trusts to deliver the recommendations in the first report from the Ockenden review, including a focus on calculating the workforce expansion needed, on leadership training and on improving intrapartum care (see Workforce and Professionalism and Clinical Quality updates below for more detail).
Mr Pat O’Brien, Vice President for Membership, reported on the following activities:
- In January, following a number of cancelled ceremonies as a result of the pandemic, the College held a virtual membership ceremony, giving members the opportunity to be formally welcomed to RCOG Membership or Fellowship. Feedback has been positive and the virtual ceremony template now gives the College an additional option for admissions in the face of uncertainty about the ongoing impact of the pandemic.
- The refreshed subscriptions process has been rolled out successfully, with a greater proportion of members renewing their subscriptions by this stage compared with previous years, and a significant number signing up for direct debit payments. The College is also engaging with members who have let their subscriptions lapse, in order to understand the reasons for this and whether there is anything the College can do to address any issues, and a large proportion of these members are now in the process of renewing their membership.
- The College has recently held two webinars to support and engage our members. The first was for Clinical Directors, senior midwives and other obstetric and midwifery leaders, and focused on discussing the recommendations of the first report of the Ockenden review and how to support implementation. The second webinar was for our retired Fellows and Members and included an update from the College as well as insights from the former Surgeon-General to the Royal Household, and a fascinating talk from Dr Jenny Drife, RCPsych advisor on homelessness and mental health.
Workforce and Professionalism update
Dr Jo Mountfield, Vice President for Workforce and Professionalism, reported on the following activities:
- Following the publication of the first report of the Ockenden review, the College has been engaging with NHS England to understand in more detail the recommendations made and the implications for clinical practice. Some of the recommendations reflect those published in the College’s 2016 Maternity Standards document, including the requirement for twice daily ward rounds; however, there remains a lack of clarity about what is meant by the evening ward round. The submissions being made by each Trust about compliance/non-compliance with the Ockenden recommendations will provide valuable information about the areas where it may be challenging to fully comply and the reasons for these difficulties, which will then assist the Colleges and other stakeholders to develop solutions.
- A key issue is the need to invest in maternity staffing, as highlighted in a recent letter to the maternity safety inquiry from NHS Providers advising that an extra £400m/year would be needed to provide safe staffing levels for maternity services, across obstetrics, midwifery, anaesthetics, nursing and other allied healthcare professions. The College’s workforce task group, supported by two HEE/RCOG Clinical Fellows, has submitted a proposal to the Department of Health and Social Care seeking funding for a rapid research and workforce planning exercise to determine the number of obstetricians needed across England and Wales. This would complement the Birthrate+ tool used for midwifery workforce planning.
- Work has re-started on a review of the College’s advanced training curricula and on credentialing (see Education update for more detail on the latter).
Miss Sue Ward, Vice President for Education, reported on the following activities:
- Approximately 2,000 candidates sat the Part 1 and Part 2 MRCOG exams in January. Despite some issues at a small number of Pearson VUE centres, overall the feedback from candidates has been positive, particularly the ability to sit the exam at a location closer to home. In addition, in January the first fully virtual Part 3 MRCOG took place successfully for a small subset of candidates affected by the November cancellation, with the remainder of the candidates affected by the November cancellation due to sit the exam in March. Finally, we have seen an increase in the number of candidates sitting the DRCOG exam since launching the Pearson VUE partnership.
- Together with the Royal College of Surgeons of England, the British Society of Urogynaecology and the British Association of Urogynaecological Surgeons, the College is developing an advanced training programme and credentialing framework for clinicians performing surgery for mesh complications, including removals. The draft curriculum and purpose statement will be submitted to the General Medical Council in the next few weeks.
- Lack of access to training opportunities as a result of the pandemic, particularly in relation to surgery-based ATSMs, continues to be a key area of focus for the College. This includes working on processes and frameworks for trainees who will need additional time to complete the training programme, working with Health Education England at a national level and with Heads of Schools to develop solutions at a local level.
Clinical Quality update
Professor Tim Draycott, Vice President for Clinical Quality, reported on the following activities:
- The College is working with the RCM, NHS England and NHS Resolution to seek funding for a new national programme aimed at preventing intrapartum brain injuries. The programme will include a focus on fetal monitoring and the impacted fetal head and will support the implementation of some of the recommendations from the first report of the Ockenden review.
- Work on clinical guidance covering both COVID and non-COVID issues continues. The Guidance Cell continues to review emerging data on the impact of COVID-19 on pregnancy, with the latest update to the guidance published on 19 February. The Joint Standing Committee on Patient Safety is currently working to develop standards for elective caesarean lists, and for the responsibilities of consultant on-call.
- Other areas of focus within the Clinical Quality team include the development of a tool to measure the impact of Clinical Quality products; discussions on how best to digitise these products; and collection, analysis and use of data on inequalities.
Global Health update
Miss Ranee Thakar, Senior Vice President for Global Health, reported on the following activities:
- Good progress continues to be made with the Making Abortion Safe programme in sub-Saharan Africa, with recruitment of Champions in the five target countries (Nigeria, Rwanda, Sierra Leone, Sudan and Zimbabwe) now completed and an induction taking place on 25 February. A draft training course has been submitted to the Education Quality Assurance Committee for review and approval, and a survey of our international membership will be launched shortly to support the work of the programme.
- Work continues to secure funding for our Essential Gynaecological Skills (EGS) programme in Bangladesh. As part of this work the College has undertaken research into the global burden of benign gynaecological disease and is currently submitting this for publication.
- On 25 February the College held the first of a series of monthly webinars hosted by the Officers, which are open exclusively to RCOG members. The February webinar focused on domestic violence, providing a global perspective of the issue particularly in light of the coronavirus pandemic, and highlighting resources for clinicians to identify and respond to domestic violence. The webinar can be viewed on the College website.
Kate Lancaster, RCOG CEO, reported on the following activities:
- The College continues to operate in a challenging financial environment, but with some green shoots of recovery beginning to appear thanks to work to digitise exams and events, initial work on other elements of our Recovery Programme and the strict cost control measures put in place by the Executive team.
- Plans and timelines for the reopening of Union Street will depend on any easing of government restrictions, which the College will continue to monitor. The Royal College of Midwives have completed their building work on the space they are renting at Union Street ready to join the RCOG and the Faculty of Sexual and Reproductive Healthcare in our women’s health hub when the building re-opens. We have also secured two additional tenants working in the field of women’s health and look forward to making a formal announcement once the contracts have been finalised.
- We had an excellent response to our advertisement for an RCOG Fellow and Member to join our Board of Trustees, and are delighted to announce the appointment of Steve Thornton and John Heathcote.