Conference report: SAPC London & the South East Regional Meeting

Well, I always think of SAPC at Madingley Hall as a cosy sort of conference, and it felt even cosier this year surrounded by ice and snow. It’s friendly, too. By the second day, I noticed a distinct increase in nods of hello and recognition between delegates, potentially the result of a lively night at the pub quiz…

Onto this year’s highlights. The organising committee pulled off an outstanding trio of keynote speakers. Clare Gerada was fired up with the current woes of the NHS, arguing that all we need is love to start to address the deep problems of staff morale and burnout (she did present it in slightly more learned tones, of course). There was much debate afterwards about whether the NHS is actually getting better or worse, how much external cultural shifts in consumerism are reflected in current NHS problems, and many other concerns. All in all, I think anyone who loves the NHS should certainly sit up and take notice of what she is saying. Anne Rogers eloquently summarised current (and past) issues in self-management support for people with long-term conditions. In a whistle stop tour of research, she argued that patients do not necessarily look for support where politicians and perhaps practitioners assume they might. Primary care is often perceived by such patients as there for medication and crises, with the work of day-to-day management of their conditions falling to them and their informal networks (and their pets. Don’t forget their pets). David Speigelhalter mostly made us collapse in giggles at the increasingly ridiculous representations of risk in the media (I’m looking at you, The Express). He also had a serious message; that we should be striving for better ways to present risk in relation to important health care decisions such as breast cancer screening. Do check out his website,it’s a mine of information.

Madingley is famed as a sympathetic launch pad for those of us less familiar with conference presentations, and it’s good to see younger researchers and medical students attending in large numbers. There were some great presentations this year. I’ll single out Tom Cowling from Imperial College, who analysed national hospital administrative data to find that patients registered with general practices with poorer reported access had a higher rate of emergency admission to hospital via A&E than patients in practices with higher reported access. Much debate was had about the significance of this, but it was a really nice analysis: even Gary Abel our statistician said so, which is a rare accolade. I also liked Tara Stewart’s work (also from Imperial: it was a bit of an Imperial takeover this year) on whether a video highlighting a GP’s work and career options might influence medical students choice of career – you can watch the full film here. General conclusions: students felt it was all very positive and warm and fuzzy (bit like the shiny new RCGP recruitment video there) but there were some concerns it didn’t show “the whole picture”.

One other overall impression: I do think we all need to pull our socks up a bit on the quality of our research. It was very interesting to observe the nature of debates which happened after presentations. For studies which had drawn on large survey datasets (of which there were many), concerns or criticisms about the analysis were openly voiced and discussed. It’s not too difficult to go back to your stata files and re-run analyses with a random effect chucked in. For qualitative studies, questions from the floor focussed on the content with little questioning of the approach or method. Yet many of these studies, it must be said, were rather lacking in rigour. Of course, it’s pretty difficult to say to someone in a conference setting – not only am I not convinced about your analysis, I’m also rather concerned about your whole approach, and how you gathered your data, and…What can we do about this? I don’t know – I sat silent through many, not wanting to upset or wade in without knowing more details, so I’m just as guilty. There’s some fantastically innovative research going on in primary care – one of my recent favourites is Deborah Swinglehurst’s work using linguistic ethnographic approaches. Why can’t we do more at this level?

With that plea, many thanks to Barts and Queen Mary’s for great organisation, and I look forward to next year.

Thanks to Jonathan Tomlinson for the the picture of Madingley at the conference – he also gets the conference award for champion tweeting. 

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