A Message from BTS Chair Dr Paul Walker

I send a very Happy New Year to all BTS members, recognising that, in January 2023, “happy” may not be the word chosen by respiratory specialists on the NHS front line. 

Previously, ‘emergency’ referred to an acute health care requirement, rather than either a descriptor of the current NHS care crisis or the state of NHS workforce. Over the last eighteen months, where summer has become ‘the new winter’, many of us have been warning repeatedly about this impending crisis and the impact it will have on patients and carers as well as an already traumatised workforce trying to recover from the brutal early COVID years. The current situation was not inevitable, but, at times, 2022 felt like that period between realising the inevitability of an accident and the impact. To everyone who is currently doing their very best working in intolerable conditions, a huge thank you from your peers and colleagues for the difference you are making. BTS will try to support and assist you as best we are able. 

Winter pressures are not new; they are normal and have existed for much more than the 30 years I have worked in the NHS. We also know that respiratory medicine is seasonal with a much higher workload in winter and this is acknowledged in the 2019 NHS Long-term Plan. BTS continues to advocate for annualised working for respiratory specialists and some respiratory teams have been able to show the merit and benefits. However, this is not the case for many and there remains an impression of a lack of support from senior NHS leaders. In national and regional discussions, the Society will continue to campaign for respiratory specialists to have deliverable and reasonable workloads and responsibilities. 

In 1998, before what was the previous worst winter in my career, the Health Secretary Frank Dobson called on all areas of the NHS “to work closer together to improve community support and prevent unnecessary hospital admissions”. I think we would call this ‘integration’. While there has been some improvement, after a quarter of a century we should not still be having the same conversations. BTS continues to advocate and support best practice, across all four UK nations, through Respiratory Futures, through joint working with the Primary Care Respiratory Society and other partners, through our conferences, courses and webinars and by contributing to initiatives such as virtual wards and breathlessness pathways. BTS members are working within ICS and with NHS leaders in each nation to deliver universal access to respiratory diagnostics, pulmonary rehabilitation and admission prevention/early supported discharge, all of which are essential to reduce pressure on hospital emergency services. 

Much of the emergency in acute care relates to the ongoing workforce emergency. We have seen new funding for respiratory physiologists in England and a promised small increase in medical specialist training numbers. BTS continues to pursue increases in the respiratory workforce outlined in our 2022 report and while recognising that this will not provide an immediate impact, it remains essential to ensuring that the winter of 2022-23 is the nadir not the norm.  

My very best wishes to you all for 2023.
 

Paul Walker
BTS Chair