6 December 2017 International Strategy Development Workshop An International Strategy Development Workshop was held on Tuesday 14th November 2017 at 10:30am (GMT) at The Royal College of Pathologists, 21 Prescot Street, London E1 8BB Dr Lance Sandle Registrar The workshop was chaired by Dr Maadh Aldouri, Director of International Affairs Present: Dr Maadh Aldouri Dr David Bailey Dr Charles Van Heyningen Professor Adekunle Adesina Professor Ismail Matalka Dr Oliseyenum MacDonald Nwose Dr Gary Tse Dr Mona El-Bahrawy International Regional Advisor for South East Asia Pathology Group, ICILG Committee Member Country Advisor for South Africa Lay Member UK Sudanese Diaspora Pathology Group President, National Society of Pathology of the Republic of Moldova Associate Professor, Pathology Department, Republic of Moldova State University of Medicine and Pharmacy Country Advisor for Egypt Miss Joanne Brinklow Miss Rosemary Emodi Miss Faaria Hussain Miss Zuzana Lescisinova Miss Deborah Ko Head of Educational Standards International Manager International Projects Officer International Education Officer International Coordinator Dr Firiad Hiwazi Professor Tahir Pillay Ms Mary Ann Cameron Dr Hussar El-Mugamar Dr Eugen Melnic Dr Ekaterina Foca In attendance: Director of International Affairs Vice President for Communications International Regional Advisor for Europe International Regional Advisor for Sub-Saharan Africa International Regional Advisor for Middle East & North Africa International Regional Advisor for the Americas ITEM NO - WELCOME & APOLOGIES The Chair welcomed members to the meeting and apologies were duly noted ITEM NO – PATHOLOGY IS GLOBAL: STRATEGY AWAY DAY OBJECTIVES Miss Emodi presented the objectives of the day: To review and evaluate the College’s international activities and achievements under the 2013-2018 international strategy To put in place a new year strategy to commence in 2019 To consider current priorities and revise them accordingly To identify a set of key actions that the College should undertake in the next year strategy which would build on current achievements, address challenges experienced and maximise existing opportunities ITEM NO – PATHOLOGY IS GLOBAL: LOOKING BACK (2013-2018) Miss Emodi presented an outline of the key activities, milestones and achievements of the College under the ‘Pathology is Global’ International Strategy: 2013-2018 Strategy: Key Drivers To engage internationally on global health issues through overseas members and UK members interested in global health issues and activities To build using the strength and expertise of the College to promote the College’s standard, curriculum training and examinations internationally To advocate for pathology by building strategic alliances and raising the profile of pathology These key drivers went on to define the five main priorities in the International Strategy and resulted in a number of achievements: Priority 1: Engage Members Priority 2: Improving Standards of Practice & Professional Development The overseas membership of the College has grown its The College has built on its global health capacity work, presence in more than 60 countries around the world developed partnerships with international institutions, and now has a 22% overseas membership looked at capacity building, strengthened laboratories through training and mentoring and reinforced the The College’s international structure, governance and pathology work force, led by International Project Officer presence over the last years has grown Miss Hussain International engagement has been strong in the last Since October 2016 the College has sent UK examiners few years, for instance the College’s engagement with to Pakistan to help examine and observe the CPSP Pakistan has been strengthened by the appointment of fellowship examinations for Histopathology and new country advisors and resulted in a MOU signed Haematology with the Pakistani Association of Pathologists and the Colleges of Surgeons in Pakistan The College has engaged with Myanmar on a ministerial level during its recent SOCA visit when the signing of a MOU was discussed Priority 3: Building Capacity through Training & Technical Skills Transfer The College has grown its global examination centres during the current strategy and now has 10 overseas Part examination centres and Part examination centres One of the biggest achievements of the current strategy was the LabSkills programme which secured £750,000 of funding through the Department for International Development to work with countries in South East and Central Africa to train and mentor 100 scientists in 20 laboratories through 30 volunteers The College succeeded in strengthening the 20 laboratories in the low, middle income and resource limited countries and succeeded in reducing laboratory turnaround time The International Collaboration of the Year Award was given to the LabSkills project in November 2016 In terms of capacity building, The College of Pathologists in East Central Southern Africa (COPE CSA) was established in 2010 at a conference in Uganda The College supported this process, helped them organise themselves, identified and solved challenges, and contributed to the development of their strategy through a partnership with LabSkills The College co-funded their first administrator for a period of years, assisted them in being recognised as a constituent college of the East Central Souther African Community, a regional intergovernmental cooperation body reporting to the regional Ministers of Health, and assisted the development fund of a harmonised curricula for Anatomic General Pathology and Clinical Pathology which has been finalised and will be published by 2018 75% of the LabSkills project management budget was given to employ more staff and build COPECSA’s capacity The next phase in the COPEXA project is to identify training sites with the aim to run the first Fellowship Examinations in 2019 The College developed a partnership with Iraq and Kurdistan through two visits which established Part examination centres in Erbil and a training course as well as resulted in the appointment of country advisors The College’s International regional advisors have run Histopathology workshops since April 2015 in Myanmar The College has established the International Trainee Support Scheme which improved the familiarisation with the College’s examination process in local training programmes overseas The Distance Mentoring Learning Programme was created, which matched trainees with mentors who assisted them in exam preparation, assessed their knowledge, skills and behaviour and helped them fill skill gaps Trainees have gained access to the College’s online e-portfolios A new membership category was created, the International Trainee Member of the College, which the College hopes to build on by establishing an International Trainee Forum where trainees can collaborate and have representation on the International Committee Priority 4: Advocacy & Policy The Global Health Challenges Scheme raised funds and promoted advocacy during the 2013-18 strategy and has been successful in raising £10k in just one project to establish a regional blood transfusion and donation service in Uganda and £20k in total since launching International Pathology Day was created to raise the profile of pathology and now takes place in more than 60 countries The College has run Pathology is Global symposiums which have been well attended with an aim to produce policy papers and statements from the global discussions at the global symposiums In the UK, the College has been running Pathology Summer Schools for years In July, the College ran in partnership with the Armed Forces College of Medicine and Egyptian Committee for Pathology Training the International Pathology Summer School in Cairo, with a future aim to establish summer schools in other countries During the last 2.5 years, the College has increased its social media presence and the College’s Facebook page has almost 4,000 members Its Twitter following is healthy and responsive, and together with the new website, College bulletin and e-newsletter, the College’s communications platform has strengthened Headed by Miss Lescisinova, the College has been promoting the College’s fellowship and examinations, working and supporting speciality training and curriculum in countries that need support, and supporting overseas doctors and scientists who wish to come to the UK for training During the last 2.5 years, the College has increased its social media presence and the College’s Facebook page has almost 4,000 members Its Twitter following is healthy and responsive, and together with the new website, College bulletin and e-newsletter, the College’s communications platform has strengthened Priority 5: Implementation in governance resources • Strengthening collaboration and partnership should continue into the second strategy • The current strategy has seen the College’s growth to international regional advisors and more than 30 country advisors • The International Department has grown from member of staff to a total of full time members of staff • The opportunity to be on the Committee opened up to the whole College membership and this has increased overseas membership to 40% and has increased female membership to one third • The international regional advisor role has been restructured based on the World Health Organisation’s regional office structure which has led to an increase in regional advisors ITEM NO – PATHOLOGY IS GLOBAL: IN REVIEW In this session attendees discussed and considered key aspects of the current International Strategy Working in groups, attendees considered the following key questions: (a) Are the current priority areas identified in the strategy still relevant and appropriate? (b) Are there any new priority areas which should be included? (c) What has worked well and what has not worked so well? ITEM NO – GROUP FEEDBACK Are the current priority areas identified in the strategy still relevant and appropriate? Current priorities are excellent and appropriate and will always be relevant Are there any new priority areas which should be included? • The execution or content of priorities can be adjusted rather than priorities themselves • Promoting the benefits of unified and harmonised training programmes in several countries • Adding to the RCPath strategy • The retention of engagement within the UK training positions, making this a more streamlined process with less paperwork • Engagement with other bodies and retention of engagement What has worked well and what has not worked so well? • It is difficult to implement standard improvement, training and engage members in Ukraine as there are currently no standards in the country • Improved standards practice and professional development overseas in partnership with UCAS has worked well and the College look to expand on this in the next years to involve more overseas laboratories into the RCPath recognition process • Ongoing personal development of clinical staff needs improvement • Full EQA across all 20 laboratories in the LabSkills pilot, the results were that all but one laboratories were successful ITEM NO – STRENGTHS, WEAKNESSES, OPPORTUNITIES & THREATS (SWOT) ANALYSIS Worked in groups for 25 minutes followed by a group feedback SWOT Analysis Strengths Weaknesses • The number of overseas College members has increased from 20% to 23% It is likely that overseas members will account for approximately 25% of the College’s membership by 2020 • The network of International Regional Advisors and Country Advisors has strengthened the College’s contact and engagement with overseas members • Expansion of the College’s overseas examination centres, particularly the establishment of regional FRCPath Part examination centres in the Middle East & North Africa (MENA) has made the College’s Fellowship examinations and qualifications more accessible • College’s independence in the wake of Brexit • Having established Memoranda of Understanding (MOUs)/ Collaboration Agreements gives strength going forward Opportunities • Lack of resources and funding, although this weakness is less than in 2012 • Funding and developing a marketing department would be ideal as this is a weakness • Lack of technology overseas • Country advisors and engagement • The role of the College in global advocacy • Government projects, priorities and the relations with government organisations • College member volunteers travelling and engaging with regions • Potential opportunity for the College after the US pulling out of involvement from the Global Health • Brexit could allow College to look for funding opportunities • Using technology for teaching, training, capacitybuilding and examinations • Brexit, • Conflict between groups • Policy on global health and the US retraction from this • Internal implication of Brexit for various overseas doctors • UK government policy on GP training could impact long-term effects on training for overseas doctors Threats ITEM NO.7 - POLITICAL, ECONOMIC, SOCIAL, TECHNOLOGICAL, LEGAL & ENVIRONMENTAL (PESTLE) ANALYSIS Worked in groups for 25 minutes, followed by a group feedback PESTLE Analysis Political • Brexit may have an impact • Government policy on GP training, looking to increase training • College’s independence in the wake of Brexit Social Gender issues and human rights issues for example in India Not recognising certain conditions, an example is HIV Integration of pathology from villages to cities for example in Ukraine Social • Gender issues and human rights issues for example in India • Not recognising certain conditions, an example is HIV • Integration of pathology from villages to cities for example in Ukraine Technological Communication, IT systems, internet systems to communicate and improve and share knowledge Technologies will be replaced with new technologies and what that means for pathology in general Equipment and continual medical education ITEM NO – GLOBAL HEALTH PROJECT PROPOSAL: PRESENTATIONS (a) Development of an inexpensive quality assurance network for chemical pathology in developing countries (b) Strengthening Ukraine histopathology services in Professor Tahir Pillay • Professor Pillay explained the process of laboratory quality assessment in different schemes across underdeveloped countries in Africa • WHO has a programme for laboratory creation and accreditation and the process of quality assessment involves external agencies • The challenge laboratories in underdeveloped countries have is that they not have local schemes to improve laboratory performance so must use commercial schemes which is costly • This is a proposal for a joint venture between underdeveloped countries such as India and South Africa with the aim to operate with hubs, sending samples elsewhere Dr Charles Van Heyningen • histopathologists based in England have come forward as country advisors to Ukraine, and with their input have come to some suggestions on the College’s collaboration in the country • There is poor training for histopathologists and laboratory staff in general • The medical school had a good programme but overall the histopathologists did not seem to receive adequate training and as quality assurance is deficient in the country, there is very little within the audit to find out what is happening • Some key priorities are to share information and experience through College data sets, autopsy practice, and ensuring quality through audit activities, and providing teaching materials, all of which they ask for through the College’s support • There is benefit in having an international examination centre and would like to work together with the UK in an exchange programe (c) Rationalising the Moldovan National Cytopathology and Histopathology Laboratory Network and Building Capacities to Deliver High Quality Service Equitably Across the Republic of Moldova Dr Eugen Melnic • Dr Melnic explained this context in relation to Moldova which has affected histopathology in the region and has led to shortages of staff, a lack of money and motivation in the speciality • The knowledge and skills of pathologists and laboratory technicians in the Ukraine has not progressed (a) Development of an inexpensive quality assurance network for chemical pathology in developing countries (b) Strengthening Ukraine histopathology services in Professor Tahir Pillay • Professor Pillay explained the process of laboratory quality assessment in different schemes across underdeveloped countries in Africa • WHO has a programme for laboratory creation and accreditation and the process of quality assessment involves external agencies • The challenge laboratories in underdeveloped countries have is that they not have local schemes to improve laboratory performance so must use commercial schemes which is costly • This is a proposal for a joint venture between underdeveloped countries such as India and South Africa with the aim to operate with hubs, sending samples elsewhere Dr Charles Van Heyningen • histopathologists based in England have come forward as country advisors to Ukraine, and with their input have come to some suggestions on the College’s collaboration in the country • There is poor training for histopathologists and laboratory staff in general • The medical school had a good programme but overall the histopathologists did not seem to receive adequate training and as quality assurance is deficient in the country, there is very little within the audit to find out what is happening • Some key priorities are to share information and experience through College data sets, autopsy practice, and ensuring quality through audit activities, and providing teaching materials, all of which they ask for through the College’s support • There is benefit in having an international examination centre and would like to work together with the UK in an exchange programe (c) Rationalising the Moldovan National Cytopathology and Histopathology Laboratory Network and Building Capacities to Deliver High Quality Service Equitably Across the Republic of Moldova since 1980’s and only now are quality assurance policies and procedures begin to be implemented • Key priorities are updating curricula, continuing medical education, and updating knowledge and skills • The proposal is to match service requirements as closely as possible to existing capacities, quantifying capacity gaps and strategically strengthening each laboratory cell to meet local needs to ensure laboratory networks meet national needs There is a wish to participate in training changes to bring Western knowledge and expertise to Moldova ITEM NO – STRATEGY DEVELOPMENT PROCESS - NEXT STEPS Strategy Away Day • Produce the draft Away Day notes for attendees to review and feedback Wider Consultation • College members, volunteers, partners, stakeholders, country advisors and diaspora forum Communications Strategy • College website, social media, the bulletin, e-newsletter The aim is to work on the drafting between January and May, with a final version put to the College council in June to be approved The strategy is to be launched in November 2018 and will take effect in January 2019 ITEM NO 10 – ANY OTHER BUSINESS Technology • Possibility of installing modern technology within educational promotional activities and establishing e-learning facilities • Webinars are a next step and are in the process of being arranged