CMO Annual Report2014-2015

Realistic Medicine

Dr Catherine Calderwood Chief Medical Officer for Scotland,

obstetrician and gynaecologist

• First Annual Report as CMO• Report divided into 2 sections• Realistic medicine –

challenges that face us as doctors today

• Surveillance data – health of the nation

• Feedback welcomed on both – contact me to agree or disagree with the content, use the data to evidence successes or as levers to drive further improvements.

• Plan to engage in conversation with clinicians and ask questions on infographic

• Encourage you and colleagues to also use this for discussion among yourselves and feedback to me.

Young Academy of Scotland: Influencing Policy

Dr Catherine Calderwood Chief Medical Officer for Scotland,

obstetrician and gynaecologist

Realistic Medicine• Added Value of Doctors in a Complex System• Realism in Healthcare• Sharing Decision-making and Informing

Consent: People and Professionals Combining their Expertise

• Doctors and the Management of Clinical Risk• Changing Practice to Support Improvement• Translation of Medical Research into Routine

Clinical Practice

Added Value of Doctors in a Complex System

• Current models of healthcare are stretched

• This doesn’t always suits patients, the people who care for them or the aspirations of workforce

• Good clinical leadership linked to good patient care

• Strong clinical leadership single most effective force to prevent failings in future

Realism in Healthcare

• Doctors generally choose less treatment for themselves than for patients• Striving to provide relief from disability, illness and death, modern medicine may

have overeached itself – is it now causing hidden harm?• Focus on patient – unwarranted variation in clinical practice and outcomes?• Multiple conditions – management leading to over-complex medical regimes?• Clinicians have duty to acknowledge powerlessness at times – difficulty on our part

should not affect patient’s experience of end of life.

Sharing Decision-making and Informing Consent: People and Professionals Combining their Expertise

• Leave behind “doctor knows best”• Shared power and responsibility of decision-making• Requires system and organisational change to promote required attitude, roles

and skills• House of care is useful representation:

Doctors and the Management of Clinical Risk

• Managing risk in healthcare is universal challenge

• Robust decisions against accusations of being paternalistic

• Risk with every clinical decision• No substitute for clinical experience• Sign of burn out is reduced ability to

tolerate anxiety of making risky decisions• Good risk management dependent of

communication of risk with other services

Changing out Practice to Support Improvement

Translation of Medical Research into Routine Clinical Practice

• Translation of research into clinical practice has transformed healthcare

• The route to translation can be challenging: high costs, shortages in key research infrastructure, capacity or capabilities, slow/ incomplete recruitment to trials

• How do we ensure research can more effectively translate to improved patient care?

Your feedback will help shape policy…..

https://www.surveymonkey.co.uk/r/LMDCMWM

cmo@gov.scot

0131-244 2379

@cathcalderwood1

https://uk.linkedin.com/pub/catherine-calderwood/108/979/691

http://blogs.scotland.gov.uk/cmo/