In March 2021, the Kennedy Review made a series of 16 recommendations designed to deliver ambitious changes and make a commitment to diversity, equity and inclusion within our College and the wider surgical profession. A key recommendation was to deliver a flagship Parents in Surgery project to help current and prospective surgeons balance parenthood and a surgical career.
“Compared to the experiences of all other parents we knew, our experience seemed to be at the top end of how difficult a child could be, which was alienating and hard to manage. It felt like I would have to quit surgery to save my family.”
Anonymous
We spent an initial period conducting explorative research to better understand the challenges faced by parents and those who are intending to be parents in surgery and published our findings in a report in September 2022. Fundamentally, this report addresses the flexibility and sustainability of the workforce, including recruitment, retention and, ultimately, the training and career progression of those who take time out of their career for parental leave
Independent review by Nuffield Trust
In summer 2022 we commissioned the Nuffield Trust to conduct an independent review of the impact of parental or caring responsibilities on pursuing a career in surgery. The review included qualitative and quantitative research. The purpose of the review was to build upon our own initial findings and report.
The Nuffield Trust has now published their findings and made a number of recommendations. We are now working on consolidating these with those from our own report and reviewing our priority activities.
Miss Fiona Myint, Vice President of the Royal College of Surgeons of England and Council lead for Parents in Surgery, said:
“The report is detailed and makes numerous important recommendations for the RCS England, and other organisations, including NHS trusts and the British Medical Association, to improve the culture and policies within which surgeons, and healthcare staff more widely, have to work.
“It is clear there is a very real gap between policy and what is happening in reality. This is concerning and we will need to consider how we can support bridging that gap. We will take time to digest the Nuffield Trust’s recommendations and consolidate those with the findings of our work, before putting forward an enhanced plan that embraces parenthood within a surgical career.”
Themes from the Nuffield report
- The report highlights a gap between policy and reality which is concerning to us. Our work will now be to understand and help to bridge that gap.
- Culture change and flexible working are dominant themes. Through a series of roadshows this year we aim to highlight examples of where things are working well, and provide tools to support individuals and their managers.
- Mentorship, specifically mentorship to support individuals back to work after a period of leave, is a prominent theme within the report. Our mentorship workstream seeks to support the development of mentoring as a core surgical skill and to foster belonging. We will need to be particularly conscious of the needs of parents and those returning to work as this work develops.
Next steps
- We are reviewing our activity for the next 12-18 months, in light of the Nuffield findings. Our commitments include a roadshow, development of networks, development of a toolkit and signposting of key resources and information.
- We will be considering the future workforce as well as focussing on the current workforce so that we can support both retention and recruitment into the profession.
- We recognise the importance of working collaboratively with the profession and other organisations to achieve real change.
Recommendations
We have identified a series of ways in which RCS England may mitigate the challenges faced by parents in surgery. These actions and recommendations are briefly outlined below and are grouped based on their potential impact on parents in surgery and the influence that the College has in being able to effect this change. Please read the full report for the complete recommendations and actions.
High impact, high influence: Action first and resource directly
1. Develop a network of support and build a community to enable individuals to share experiences and lean on supportive colleagues and peers.
2. Develop and signpost resources that support individuals through the stages of planning a family and taking parental leave.
3. We have commissioned the Nuffield Trust to conduct an independent review of the impact of parental or caring responsibilities on pursuing a career in surgery.
High impact, low influence: Work with those who have influence
1. Co-facilitate a workshop with Heads of Schools of Surgery, Postgraduate Deans and NHSE to raise the issues and barriers that have been brought to light in this report
2. Use our influence to advocate for representation within bodies responsible for the design and the delivery of surgical training
3. Develop supportive networks across the regions, developing clinical managers and providing and drawing together resources both for individuals and for their managers and teams.
Low impact, high influence: Work to increase impact for parents
1. Develop a workforce strategy to understand the challenges faced at different points in the surgical career and by different groups.
2. Work with NHSE, BMA, NHS Employers and other external partners to update and provide meaningful job planning guidance.
Low impact, high influence: Work to increase impact for parents
1. Recommend that trusts review their staff facilities and working conditions including providing private spaces to be used for feeding, expressing, injecting, alongside appropriate space to store milk or medicines.
2. Recommend ensuring childcare options are clearly signposted and fit for the workforce’s service hours
Resources, networks and useful links
