Insight from Professor Jo Szram

Most people who hear where I work and what I do wouldn’t consider me a generalist. I’m a consultant respiratory physician specialising in occupational lung disease, working at a tertiary heart and lung centre.

It’s a clinical field so niche that I isn’t even a defined subspeciality within respiratory medicine – we deliver care, and training, to England and Wales with the next nearest centre being Birmingham. So why do I think of myself as a generalist?

Well, every week we look at the information on our new patients coming to clinic and discuss their clinical presentations and backgrounds. They present with a diverse array of symptoms, often on a background of complex multimorbidity from a broad spectrum of geographical areas and work environments that have an impact on both diagnosis and care. We then speak with our patients, who bring their personal preferences to their health issues to allow us to flex our approach with our clinical and system literacy. The care of work-related disease brings a need for social literacy and justice and brings health equity to the front and centre of my practice. In addition even before the pandemic, due to long travel distances and times we had moved to a hybrid clinical arrangement, requiring a digital adaptability with an environmentally sustainable approach.

Finally, part of our service functions at a population level, contributing to scientific knowledge and data on workforces, leading our profession and our stakeholders – occupational health practitioners, and employers – to change worker health for the better. So, yes, on reflection, I am a generalist – and proud of it.

Most recently, we have added a summary of the Chief Medical Officer’s DEMEC keynote written by our national fellows, Sophie Smith and Sophie Wienand-Barnett, who attended the conference.

The modules map well to the national handbook and we continue to develop content. For example, we are developing educational content on food insecurity including its definition, impact, examples, awareness and sign-posting and resources to identify and help manage food insecurity. The programmes has been informed by the completion of desktop reviews to ensure our investment was based on local priority areas without duplication of existing work. We hope that this innovative and multi-professional approach and targeted use of resources will also support and coordinate improvement and support system working, enhancing learning of current subject areas for the modern healthcare professional for all groups of staff.