Deborah Eastwood Presidential Speech BOA Annual Congress 2022
For me - there is a certain poignancy about standing here today in Birmingham, as a mere 40 plus years ago, way back in the last century but on this exact day and probably at this exact time – I arrived in Birmingham to begin my medical career. As my mother waved good bye, I was contemplating the bravery required to go and speak to strangers at the evening’s Fresher’s reception in the Arthur Thompson Hall. Somehow I managed that – the first of many career hurdles. Medicine has been good to me. I grew up to be an orthopaedic surgeon and matured into a paediatric orthopod with the Tree of Andry, the symbol of our profession, at the heart of what I do. Standing here as President of the Association which has guided me and supported me throughout my career, I feel I have come of age and I am truly honoured.
The theme of this meeting has been Technology, Data and Recovery. We now understand that data is king. We know much more about the technology that collects the data, the advances in data interpretation, and the role these may play in terms of delivering the recovery process for us and for our patients. What we may still lack are sustainable systems that will drive these processes forward and designing and delivering these sustainable systems may be a focus for the year to come.
As orthopaedic surgeons, our reason for being is to ‘fix things’ – and there is much to fix. I don’t think we can simply ‘keep calm and carry on’, now is the time to challenge for change.
We need to fight against the fragmentation of patient care, and if they say that ‘Teamwork makes the Dreamwork’ then we need to strengthen connections with those that help us care: the anaesthetists, our colleagues in the allied health professions, and of course our trainees.
We must remember that health care and social care are two sides of the same coin – we need to work together.
We must strengthen our connections with the charity sector, with the colleges and with the wider NHS bodies. We must not sell ourselves short, we must not sell our patients short.
I promised Justine, our COO, that I would not over-promise in this address, but I will be disappointed if we cannot make progress in helping those who are less able than ourselves. The children and young people I work with deserve more support. If during my career we have embraced the seismic change in clubfoot management that is the Ponseti technique, why are we still accepting a late diagnosis of a dislocated infant hip? Why are our screening processes deficient? If every joint replacement is in the NJR, why is this not true too for every open reduction of a dislocated hip, for every reconstruction of a neuromuscular hip?
It has been a delight to watch the Specialist Societies flourish and grow over recent years and to celebrate the differences between the hip, the knee, and the elbow, but essentially we are all connected by the basic similarities that make us one body, one association, the British Orthopaedic Association. We must not forget our similarities in acknowledging our differences.
Diversity, equity and inclusion have been centre stage at the BOA over recent years. Our recently appointed BOTA/BOA culture and diversity champions are at the very heart of our agenda and all of us could and should be day-to-day champions of the cause. But in order to be a truly diverse and inclusive association, we need engagement - engagement with the process of change towards a kinder, more caring workplace. If you are a Scottish Trauma and Orthopaedic Surgeon and you have not yet ‘Stepped Up’ and completed the equality survey please do so, if you know someone who is feeling LOST and perhaps alone during surgical training please signpost them to the LOST study – we need to understand the problems that you are facing.
Change challenges us but change is necessary. Of course, not all change is good and we must not change for change’s sake but we must acknowledge when we must change. We need to work together to tackle the work/life balance to bring about sustainable change and greater flexibility: to allow, in fact encourage, flexibility in the way we deliver our training, flexibility in the way we receive our training, flexibility of how you and I work the working week at trainee, SAS or at consultant level.
We must be sympathetic to the fact that there is no ‘one size fits all’ approach to training or to the delivery of care; we must recognise that what works well for you may not work well for me. We must not be frightened of change despite the challenges it may bring but above all we must not shirk our responsibilities to train and we must ensure that our standards are maintained – our patients and our colleagues deserve no less.
Communication and engagement is a two way process and as we face our ongoing challenges together, I look forward to working with each and every one of you to consolidate our strengths but also to recognise the chance to change. To tweak our processes, refine our goals and streamline our ideas – make our systems sustainable. The personal tweaks I hope to make during this coming year will focus on broadening our engagement with you, encouraging your involvement with the BOA in its widest sense so we can represent you better. So please do apply for our committee posts.
To past and current mentors, colleagues and trainees, friends and foes, I am who I am because of you - some of you know who you are – but most of you may not. You are the many that have engaged with me along the way - with whom I have exchanged ideas, shared fears, asked questions and sought answers; you were there with a helpful comment, a point well made, advice freely given; you provided me with a friendly smile when I needed it most. I thank you all.
I know that the last few years have been full of change, change that has been challenging. I know that promoting change is both demanding and fatiguing, but the ability to bring about sustainable change, to respond to challenges we face is what makes us who we are. It’s exciting and inspiring, but because it is tiring we need friends and colleagues to help us through.
So as the focus of the BOA continues to be to care for patients and support surgeons so that lives can be transformed, I am proud to be your colleague in this challenging, changing world.
Professor Deborah Eastwood
BOA President 2022-2023