At the ABN 2024 conference, ACNR Publisher Rachael Hansford spoke to a number of delegates to get their views on current topics in neurology. In this interview, ABN President Richard Davenport talks about his first year in office.
Rachael Hansford
We spoke at the ABN and INA joint meeting in Belfast last year about your goals for your time as president, and your fears last year (listen here). You’re well bedded in now – how your first year has been?
Richard Davenport
Busy, I think was probably the best summary! I think, the realisation that the people at the head of organisations, a lot of the time, things arise that you weren’t anticipating. And that’s certainly been the case. So shortly after we met last time in Belfast, there were significant changes within the office, which was a difficult period. And we were without an Executive Director for six months, which was challenging for everybody, but in particular, the office team. But we got through that difficult period, we recruited a new Executive Director, Emily, who started at the beginning of this year. And that’s made a huge difference. And so I think we’re finally getting the office in a much better place than it was perhaps a year ago, certainly six months ago. So that wasn’t entirely anticipated, and that’s taken quite a lot of bandwidth.
And then as I was sharing with the members this morning at the AGM, a couple of other perhaps unexpected evolutions, both predominantly financial, including the small issue of value added tax VAT, and our registration. Which, again, unexpected things, things that take up time, and bandwidth, but are important to resolve. Not necessarily my forte, financial matters. But there are all these things that emerge that may be push your slightly aspirational plans into second place. And I know we talked about this last year, but I guess that’s just the nature of organisation.
Rachael Hansford
Yes, absolutely. And a lot of the things that we talked about last year are things that are not going to happen overnight anyway? We talked about the number of doctors in training, bringing more people into neurology. And that’s not changing quickly…
Richard Davenport
No, it’s not. And of course, I think you know, we’ve seen further problems, both with doctors in training and of course at consultant levels, particularly in England. We’ve been very fortunate in Scotland, we’ve escaped from as much of the industrial action that’s gone on, nursing staff as well, I’m not just talking about medical staff, just reflecting the significant levels of unhappiness. And that’s a problem, not neurological specific, of course, it’s a problem across the board. The fundamental problem, as we know, is the UK is both failing to produce enough doctors, and then failing to retain them, and they’re leaving, they’re voting with their feet going elsewhere. That’s a problem that the UK really needs to address. I will very sneakily suggest to any trainees who are out there, Scotland is a great place to come and work and we don’t quite have the same industrial problems that have been going on in England. So come and work in Scotland!
Rachael Hansford
Another one of the things that you mentioned last year was diversity and committees.
Richard Davenport
Yes, and I think that this is something that we have managed to achieve and improve upon. We also talked about increasing the membership, the membership has increased by a factor of about 5%. Now, that’s without us actually making any major efforts, although it was something we wanted to pursue, other matters took second place. So we have improved, and we certainly improved our diversity levels of committees, and within the office. And I think also, within the ABN itself. It’s something we’re now actually measuring – we’ve got some metrics on it. We’ll continue to measure that, and we’ll see how it evolves. But just looking at the audience in the meeting, you can see for yourselves the change.
Rachael Hansford
One of the Pharma reps, who is of Indian origin, that I meet at this meeting every year, commented out of the blue yesterday, and said how different it is.
Richard Davenport
It is noticeable now. If you looked at a meeting 10 years, certainly 20 years ago, if you look at the delegates, 20 years ago, 10 years ago, totally different.
Rachael Hansford
The other thing I thought, when you talked about the new Executive Director; in the 20 odd years that I’ve been involved, there’ve been four Executive Directors that have been female.
Richard Davenport
Certainly, when we recruited this time, we interviewed three, two ladies and one man.
Rachael Hansford
That’s great and it’s nice to see it. We also talked about managing new treatments; we’re still not there yet?
Richard Davenport
We’re still not there yet. And certainly, if we talk about the dementia treatments, which are probably the most prominent, which are very close, as far as we understand – to be agreed upon. We recognise increasingly that there is a major problem with the UK, again, UK wide, is not prepared for identifying and delivering the treatments for that particular group of people. And we’re talking about quite big numbers, and when we can talk about some of the rarer treatments for things like spinal muscular atrophy, and maybe ALS. I mean, they’re different enough, but they’re tiny numbers compared to dementia, they’re huge numbers, so much more of a functioning problem. The Panorama programme featuring our very own Cath Mummery, just a couple of months ago, highlighting exactly this problem. So how that plays out, we shall find out!
We do know from our experience with multiple sclerosis 20 years ago, that actually when drug therapies come along, it does really start to attract funding and a focus on that area. So ultimately, it is for the good, particularly because it does have a necessity to attract funding, because governments and doctors realise that we’ve got to do something. So ultimately, this will be something good. But there’s always a rather stressful period as it comes in.
Rachael Hansford
So the work to create pathways will happen after the drug is approved?
Richard Davenport
I mean we already have some pathways, but I think the difficulty when we specifically talk about the dementia drugs, is there’s very strict criteria, licensing criteria for the diagnosis, which involves things like PET imaging, and CSF biomarkers, which at the moment, are not routinely part of the diagnosis. So we need to develop the availability of PET scans, availability of testing for biomarkers, those are things that are very, very, limited at the moment. It’s going to have to be built from the ground up. The pathways themselves are relatively straightforward. It’s actually the infrastructure to make the pathways work, that I think we’ve been struggling with, at least initially.
Rachael Hansford
I can mention the dreaded AI word that everyone’s talking about. You talked about imaging scans, is there a role for AI now?
Richard Davenport
Undoubtedly, I mean, I think you know the point about AI, it’s in collaboration with doctors, as opposed to replacing them, which I think everyone recognises is not going to work. And there are some areas where it’s clearly more obvious than others, radiology being one of those areas. But yes, again, I think neurologists generally appear fairly forward looking. Just the way our brains work. We’re quite interested in that kind of thing. And I think most of us don’t feel threatened by AI, so the notion that it’s going to replace us is mistaken. Will it help us? You bet! You know, any help we can get, we’re keen to take it.
Rachael Hansford
Do you have plans for next year?
Richard Davenport
Well, barring any more unexpected problems emerging, which has been our experience in the first year, but barring that, yes. I think there’s several things, but a couple of things I’ll mention. One, expanding the membership. We’ve expanded by 5% in the last year without even trying, that means there’s plenty of scope to expand. And the bigger we are, the more powerful we are, and more representative, and diverse we are – so expanding the membership.
And also, I think we recognise that hand in hand with that, our communication strategies need to be improved. The one area where we’ve been a little bit backwards, and maybe we’ve not kept up with modern trends, is with communicating with our members, and with the outside world. And I think actually adjusting our position and becoming that. We want the ABN to be the go to place that people come for all matters neurological, whether you’re a government, whether you’re a patient organisation – we want people to come to the ABN. So we’ve got to shout a bit louder and make sure people know about us.
We’re currently the Association of British Neurologists, which at face value, rather excludes a lot of the people who we’ve just been talking about. We need to be the Association of British Neurology, which makes far more sense.
Richard Davenport
Rachael Hansford
Well, certainly I see it with ACNR. We have lots of Parkinson’s, MS Nurses, other allied health care professionals who read the journal, and want the information and the content. It’s very clear that there’s a demand for that among the multidisciplinary team.
Richard Davenport
So that comes back to what we were saying earlier on, about a name change. We’re currently the Association of British Neurologists, which at face value, rather excludes a lot of the people who we’ve just been talking about. We need to be the Association of British Neurology, which makes far more sense. And actually, having thought about it, I’m completely signed up to that. And that may not necessarily be a widespread view, but that’s one of the things that we have to tackle this year, and debate within the organisation, and see whether people are up for a change, which I think it’d be much more representative.
Rachael Hansford
I was looking earlier at the fact that the Association started in 1932. So you’re not far out from 100 years?
Richard Davenport
Yes, and the main changes, no disrespect to history, it’s just everybody knows, life evolves, and life changes, and you have to change along with it. We were hearing in the lecture about a skin problem, which when we were students, we all learnt as cigarette paper skin. Now, of course, that’s a rather disgraced term, and so they’ve changed the term. So yes, it just reflects that you have to move with the times. It’s not disrespecting the past. It’s just recognising that everything has to go.
Rachael Hansford
And the fact that the multidisciplinary team is what makes the treatment happen.
Mr Richard Davenport
Exactly. Right. They didn’t really exist, you know, 50 years ago, certainly. So they’ve evolved so we need to evolve with them.
