Goodbye’ and ‘thank you’ to FSRH's Clinical Standards Committee

Posted 06 Aug 2018

Date: 06 Aug 2018

Author: Lynne Gilbert

This month has seen two significant developments within the FSRH Clinical Standards Committee (CSC). Not only is CSC Committee member, Dr Lynne Gilbert, standing down from the Committee after a six-year term of office, but the CSC has just launched updated Standards for Medicines Management in Sexual and Reproductive Healthcare. In her own words, Dr Lynne gives us an overview of her time within the Committee and in sexual and reproductive healthcare (SRH). Highlighted is just how Lynne has found clinical standards to have an impact both personally and on a service level.

CSC Lynne GilbertGoodbye’ because I am standing down after a six-year term of office on the CSC and ‘thank you’ to the Faculty and Committee for enriching my career.

My career began nearly three decades ago with four separate posts in Genitourinary Medicine (GUM), drug dependency, abortion care and family planning (as it was then called). I recall at least one patient who I saw in three out of the four services. Despite the obvious connections, there was no integration in those days!

Imagine a time before standardisation, annual appraisals, revalidation and the requirement for doctors and nurses to engage in audit. Sounds attractive perhaps, but this was also an era when the concepts of clinical governance, evidence-based medicine and clinical guidelines that underpin and shape our practice today were just emerging. This was my experience in the late ‘1980s and early 90’s.

Working in a ‘family planning clinic’, you were supported by nurses whose role was to record the date of the last menstrual period and the weight and blood pressure of each patient. Apart from operating the autoclave to sterilise equipment, they had few other responsibilities. That vast repository of information, the world wide web, which is now our daily ‘go-to’, was not widely used. If you had a query, where did you go for the answer? Your principal resources were books or, alternatively, more experienced colleagues whose opinions were often shaped by personal experience rather than being informed by in-depth knowledge of the literature. Peppered with a measure of personal anecdote, such advice was often far from being ‘evidence-based’. If you had the time and proximity to a hospital library, and assuming you could negotiate the confusing cataloguing systems, you could access the journals to seek out the most up-to-date information, but did your medical training include the necessary skills in critical appraisal?

Fast forward to 2018 and the comparative luxury of ready access to the wealth of support that the Faculty provides. One of its key objectives, and which is the remit of the CSC, is to maintain and develop standards that support the delivery of high quality SRH care.

This broad brief is covered by a range of subject-specific standards, for example, Workload, Medicines Management and Supporting Doctor’s in Appraisal and Revalidation. Each standard contains evidence-based or best practice recommendations that are comprehensively referenced and auditable. We write and regularly review these with the needs of the user very firmly in mind, and prior to publication post them on the website for public feedback. Please watch out for them and have your say!

The CSC espouses the values of the Faculty in being outward-looking, collaborative and responsive to change. This is most evident in the membership which has evolved over the years and now includes representatives from nursing, general practice, GUM and as far as possible all the devolved nations. It is a rich mix with individuals bringing their own interests and expertise. I’m told mine was an eye for detail and grammar!

Being a member of the team for the past six years, I have inevitably made good use of the standards both on a personal and service level. The Standard on Workload is a particular favourite and has been instrumental in persuading managers that adequate time is needed when training colleagues and for comprehensive consultations in SRH. In addition to the core work on the standards, I have worked with FSRH’s Clinical Effectiveness Unit (CEU) as a member of the Guideline Development Groups for guidance on Injectable Contraception, Emergency Contraception and Quick Starting Contraception.  

The experience has been stimulating, rewarding and at times challenging. I have learnt new skills and deepened both my clinical knowledge and understanding of the inner workings of our healthcare systems. Working closely with colleagues other than those in your daily workplace is refreshing and provides new perspectives. No doubt I have grown both personally and professionally as a result.

I now work in an integrated service. Our nurses are no longer doctor’s assistants and I can meet all the needs of my patients from three decades ago in one setting. Most importantly, we feel fully supported by our professional body, the FSRH, in our aspiration to deliver high quality care. Thank you.