Consultant Diabetologist and Endocrinologist
Andrew was Consultant Diabetologist and Endocrinologist at the Shrewsbury and Telford Hospitals from 1993 until January 2016, and still helps to support acute and general medicine at the Trust on a part time basis. He has been clinical lead for his specialty in both hospital and community, and created the diabetes and endocrine centre in his hospital.
He undertook his medical training at Oxford and then London, and was a clinical lecturer in medicine at St Thomas’ hospital where he developed a research interest in diabetic neuropathy.
Andrew has had a major interest in medical education and the maintenance of clinical standards. He was college and then clinical tutor in his hospital, and then chair of the regional training committee and regional specialty adviser for the Royal College of Physicians London. In 2013 he became regional adviser, and led a pilot project to support the medical registrars on medical ‘take’ with sharing of good practice throughout the region. He is now a censor and council member for the College.
Five minutes with… Dr Andrew MacLeod
In this short interview, West Midlands clinical ambassador and consultant diabetologist and endocrinologist Dr Andrew MacLeod shares his thoughts on the GIRFT programme’s work so far and our next steps for the future.
Q. Tell us a little about your background.
Andrew: I started my career as a lecturer in academic medicine in London, which helped me develop a healthy scepticism around claims of success in healthcare. It also gave me an eagerness to find evidence to support any proposed changes and I developed a good knowledge of elementary statistics. When I joined SaTH [Shropshire and Telford Hospital NHS Trust], I had to develop a diabetes centre from scratch, which was a considerable learning experience. I understand the pressure of a busy department and how little time it allows to stand back and think of logical ways to improve the service. Having two hours dedicated to that process, as in a GIRFT deep dive, would have been really valuable. So many of us in the NHS are independently trying to solve the same problems.
Q. Why did you join the GIRFT programme?
Andrew: I previously acted as a regional advisor for physicians in my area and we carried out a small pilot to try to improve the lot of the medical registrar ‘on take’. We gathered information via a questionnaire, then spending a couple of hours visiting each hospital, talking to the registrars, consultants and wider teams. A report was formed and sent to senior management and the acute medicine departments, and we found that the registrars were considerably encouraged by the sense of being listened to and understood. As soon as I heard of GIRFT, I realised it was a more professional and powerful means of a similar process and I was already on board.
Q. What is your role within GIRFT
Andrew: As clinical ambassadors we provide as much clinical support as possible to the local implementation team. We try to attend any West Midlands GIRFT meetings where clinicians are present or where clinical issues stand out, and we try to sort out any issues where one workstream affects another to ensure the impact is positive. I believe we help to preserve the excellent balance of management and clinical expertise created by the GIRFT programme. I’m sure that managers do not like being taught management by clinicians, and I know that clinicians do not like being taught clinical medicine by managers.
Q. What are you most excited about for the GIRFT programme moving forward?
Andrew: The enthusiasm with which clinicians and managers are welcoming the GIRFT approach is very exciting. We’re already making a measureable difference to areas of clinical medicine and, in my view, sharing essential good practice to areas where measurement is more difficult. We now need to keep up the momentum and continue to demonstrate the programme’s value to the NHS and public. These are exciting times for GIRFT!
Q. And finally, is there anything else you’d like to share?
Andrew: I believe we must now make sure that the next generation of clinicians are on board with the GIRFT process. The space for deep dives is often constrained, as are other meetings, but we need to try to include trainees in all aspects of healthcare, including quality improvement programmes like GIRFT.