Supporting Elite Sport Practitioners: External Review
More support for the appraisal process, better education and training, and the need for collaborative leadership are just some of the recommendations presented in an external review commissioned by the Faculty into support for practitioners in elite sport.
Last year, we commissioned an external review to be carried out by specialist agency Canham Hall Associates into how FSEM can best support doctors working in isolation in sport. We commissioned this report as a result of our 2021 members and fellows survey and in response to a number of incidents highlighting the particular difficulties experienced by our members working in elite and team sport.
Following a series of extensive interviews and literature reviews, Canham Hall identified a number of risk factors that might lead to professional isolation and the risks associated with that. These risk factors included conflicts of interest and loyalties associated with the drive for success and the perceived prestige of working in elite sport, a potential lack of preparedness from those who have gone straight into sports roles after CCT, challenges to robust clinical governance within elite sport, and the lack of a single authoritative body for ethical practice. In addition, it looked in detail about how FSEM appraisal and revalidation can best work with doctors to mitigate these risks.
The report also offered some recommendations on initial steps the Faculty could take to address these risks. These included:
- Assess FSEM’s strategic goals to ensure we balance our responsibilities to those working in sport against those working in the NHS.
- Engage with elite sporting bodies that are committed to change, seeking guidance and building consensus for culture change in elite sport and SEM practice.
- Work closely with BASEM to develop educational tools and support measures for practitioners working in sport.
- Reinforce the centrality of FSEM’s Professional Code.
- Better support for those who CCT in SEM and advocating for more post-CCT development.
- Review the appraisal process to strengthen its role in supporting doctors working in these environments.
Armed with the valuable insights presented in this report, we took the opportunity during our recent strategy update day to set out some further actions we believe will help.
Consult and Collaborate
There is a clear need to engage with sporting bodies regarding the risks of isolation for elite sport practitioners and to work alongside a coalition of interested parties willing to push for change. We have shared the findings and recommendations from this report with sporting leaders including the CMOs of all major UK sports as well as with interested organisations like BASEM. Through regular consultation with these groups, we are making the case for cross-sectoral culture change and positioning FSEM as a leader in this area.
Education
We have announced plans for a Diploma in team and athlete care in sport with specific sections of the syllabus on ethics and governance. Development is well underway, building on the success of our Diploma in Musculoskeletal Medicine, and we plan to offer the first diet in 2024.
In close collaboration with BASEM, we are working on educational resources to support those working in sport, including events such as the recent webinar on social media use delivered in partnership with the GMC.
We also plan to establish a committee that will look at ethics and governance in sport. We are currently in the process of determining exactly what such a committee might look like, but we believe it will be a vital tool to support the Faculty’s aims and further our educational materials on this topic.
We have also approved plans to update and refresh our Professional Code. The Faculty’s Professional Code sits alongside GMC Good Practice guides as a central pillar of good ethical practice in sport, and we want to emphasise its importance and ensure that all practitioners are aware of and complying with the standards enshrined within the document.
We are also in the early stages of discussions with the Royal College of General Practitioners around accreditation for GPwERs working in sport and hope to have more news on this front later in the year.
Post-CCT Support
We are delighted to have established our first post-CCT Fellowship, which is due to commence in August 2023. This fellowship, in collaboration with Oxford University Hospitals NHS foundation trust and the Rugby Football Union (RFU), will focus on the challenges of medicine in high performing teams while allowing the successful fellow to build high volume musculoskeletal experience and networks in the NHS.
Appraisal
While the report was generally positive about the FSEM appraisal service, it did highlight further opportunities that might be implemented in order to strengthen its role in supporting doctors working in isolation.
We are currently reviewing our appraisal and revalidation process, in the light of CHA recommendations, to better understand how FSEM appraisal can be used to monitor and raise professional standards across sport. Changes will be gradually implemented in 2023/4.
Conclusion
The external review identified several challenges that we must overcome if we are to improve support for those working in elite sport, and we have set a series of ambitious goals to help us do just that. By supporting our members and fellows, we hope to be able to address our core aim, to raise standards for athletes.
There is a huge amount of work to do if we are to achieve those goals, and as always there are plenty of opportunities for interested Faculty members to help – please contact us if you are interested in getting involved. We believe this work is vital in protecting both the reputation of our specialty and the wellbeing of our patients, and we look forward to your continued support as we seek to meet these challenges.