Medical trainees join senior leaders to discuss tackling health inequalities

HEE learners and doctors in training were given the opportunity to put questions to Chief Medical Officer for England, Dr Chris Whitty, and Director of Education and Quality and Medical Director at HEE, Professor Wendy Reid, at the National Trainee Engagement Forum (NTEF) Insight Event on 9 June, 2021.

Dr Raees Lunat and Dr Vidushi Golash, NTEF co-chairs and clinical fellows to the Medical Director at HEE, reflected on the event.

It has been a challenging and transformative year for the NHS and the impact has been felt in every role in health and care across the country, but one vital thing has shone through, the importance of communication.

This was the second NTEF Insight Event, following the launch in March. The NTEF was set up to establish direct interaction between senior leaders at Health Education England (HEE) and the wider NHS, and trainees and healthcare learners on the front line so all can share best practice, provide inter-regional support and feed more local perspectives into national discussions about reform and policy.

Our latest Insight Event began with a keynote from Professor Wendy Reid, and asked the question – “How can HEE and healthcare learners play their part in tackling health inequalities post-Covid?” 

Speaking first, Professor Reid highlighted that tackling health inequalities is a “key underpinning value” and one of seven interdependent strategic priorities for medical training reform at HEE. She stressed that knowledge of health inequalities is essential as trainees progress through their career as, ultimately, they become influencers in the health care system. This, she said, is why it is so important for doctors to be skilled generalists as well as specialists.

Professor Whitty reiterated the importance of generalist training and elaborated further on this by asking clinicians to reflect that anyone who is not interested in health inequality is not interested in health. He talked through the main factors influencing public health such as deprivation and age and highlighted how the impact of social deprivation on healthcare has changed over time and will continue to change throughout the careers of those in attendance.

He highlighted the dichotomy that people, particularly those in deprived areas or with existing health conditions, tend to gather more conditions as they get older, but the systemic response is that medical training has become more specialised. In addition to this, older people are moving out of cities to places where healthcare provision is often more limited so medical leaders need to look at the data to see where services are needed and how that can be addressed through training and recruitment.  

The questions from trainees opened up this important debate even further with questions about the role of junior doctors in levelling up health inequalities and how can trainees influence cultural change. You can hear the full Q&A on the recording of the event; although the message from senior leaders was strong and resonated with many of the trainees – health inequalities are dynamic and vital for all current and future workforce to understand. Together as a healthcare system we can play our part in reducing the gap.

Now is the time in our careers when we are most enthused and interested and have the drive to affect change. This is the time when we need to stand up and work with senior leaders directly so we can collaboratively find solutions within our training to help us understand and tackle health inequalities from prevention to treatment. Collectively, our voice is a powerful tool to affect policy change and Professors Reid and Whitty made it clear that they want to listen.

It is rare that trainees have the opportunity to ask questions of two of the most senior doctors in the country, or for them to be in a forum where they can directly hear the experiences of trainee doctors. These interactions, created by the NTEF leave the trainee cohort feeling empowered, stimulated and motivated. The meetings also allow multi-professional learners to soundboard HEE policy and reform ideas, providing constructive and authentic feedback to central teams and senior leaders.

In parallel to the Insight Events, we have established a network of regional trainee representatives from across all regions who form a community of grassroots doctors and dentists in training. The longer-term vision for the forum is to be truly multi-professional in nature, reflecting the increasingly multi-professional teams who deliver modern-day healthcare. It is really important to establish and maintain a dialogue between the developing and future generations of medical professionals, and those who are at the peak of their careers so we can learn from each other’s experiences and benefit the wider health system. It also means that tomorrow’s leaders in healthcare are actively involved in shaping the system they work in.

This event was attended by over 380 learners, HEE employees and wider system leaders and stakeholders, and provided a unique stage to hear from trainees directly on an ever-increasingly important issue. Dr Navina Evans, Chief Executive of HEE, gave the closing remarks, reflecting on how monumental it is to have a trainee forum hosting these essential discussions.

The next event will be held in October with details to follow in the coming months. A recording of all previous and information about upcoming events can be found on the NTEF webpages.