Enhance fellow Dash Hall’s journey: From ER to HEE

The Enhance programme aims to broaden the expertise of all clinical professionals through enhancing the current training programmes. The programme is delivered at a regional level and in the east of England is supported by three clinical fellows.

We talked to one of them – Dash Hall - about his day job, working on the Enhance programme and what he likes to do when he’s not working.

What’s your day-to-day role and how did you get there?

I am an anaesthetic registrar. I think that the TV show ER had a lot to do with getting me here - I liked the exciting trauma calls on it. It took me a few years to work out what specialty that bit comes under. I did an intercalated degree in myocardial, vascular and respiratory physiology and I quite like practical procedures (I also enjoy listening to beeps and sitting down for indeterminate amounts of time, so anaesthetics was a good way to combine all of these things). The only downside I've found so far is the hat hair.

What’s your involvement/role in the Enhance programme?

I started as an Enhance educational fellow in August, there's a lot going on behind the scenes currently. I'm working on the sustainability domain, helping put together learning materials. I've really enjoyed this as I try to be as environmentally friendly as I can be at work. The Delivering a ‘Net Zero’ National Health Service report, and the embedding of net zero into the Health and Care Act (2022) means that the environment will soon have to be at the forefront of every NHS worker's mind. Earth now has 8 billion humans, and a tangible global warming issue, so it's not really an option to have unsustainable systems.

What is the Enhance/generalist approach and what do you see as the benefits of it for staff and patients?

It's a tricky one to explain, because Generalism sounds a lot like "general" which is the word used in general medicine, general surgery, and general practice, to define those medical specialities. But Generalism is the bits surrounding medicine that we don't get taught but, work within every day. It's the topics that cut through all specialties.

Enhance is split into six domains:

• Population health
• Environmental sustainability
• System working
• Social justice and health equity
• Person centred practice
• Complex multi-morbidity.

If all staff have a good knowledge of these six domains it will help deliver healthcare in a world where the systems, therapies, and patients are becoming more complex all the time.

Enhance isn't about the diseases that people have and how to fix them, it's about the overall strategies that a healthcare system uses to tackle the issues. For staff the benefit is that if you understand the system you can more effectively work within it.

From the patients' point of view, I cant imagine people wanting an NHS that is unfair, doesn't care about the health of the population as a whole, damages the environment, doesn't care about individual patient's concerns, and can't deal with anyone with multiple diseases, can you?

Why were you attracted to the Enhance role?

I wanted to do something different, I like education, but I don't have much experience of it outside of bedside teaching and the odd regional teaching day. The Enhance fellowship has specific projects that needed working on. I've found the team are a really good group of people, and I'm really enjoying the work too.

What are you working on at the moment?

I'm currently working on the environmental sustainability element. The outcome aim is to have a "how-to do a quality improvement project focusing on environmental sustainability" workbook. In fact what we hope to achieve is giving people the tools to embed environmental sustainability into every quality improvement project.

What do like to do with your time outside of work?

We have two sons, so a lot of time is spent looking after them. We go to the cycle pump track and BMX racing track a lot, the two-year-old has no fear, but can’t get up the hills, so I have to push him which is a good work out. We also seem to play a lot of mini-golf, which is chaotic - we do it more like a game of hockey with three balls.

A reasonable amount of my time is doing DIY. I fitted the kitchen a couple of years ago, and we are just finishing a bathroom off, next on the list is the other bathroom. I go indoor rock climbing (bouldering) once a week, and I built a small climbing wall in the garage which I train on. I like building bicycles, at some point I want to learn to weld so I can build my own frame, but weirdly I haven't found the time.