As Emergency Medicine (EM) finds itself in the midst of a pandemic, we are reminded that the practice of medicine is a global endeavour. Alongside the traumatic consequences of COVID-19 will also come opportunities to fundamentally rethink our approach to healthcare, including how to engage with global health. In this article, we report on the formation of the Global Emergency Care Collaborative (GECCo), an initiative that aims to enhance global health interest and capacity within the field of emergency care.
RCEM Global Emergency Medicine strategy
The Royal College of Emergency Medicine’s (RCEM) global emergency medicine (GEM) strategy exemplifies how the principles of EM align with those of global health; namely by providing clinically sound and unprejudiced care that is person-centred and adaptable to evolving clinical environments.
Alongside its aim to promote GEM expertise within the college, its very formation acknowledges the rapidly increasing interest of UK-based EM physicians in global emergency care. Through the promotion of global emergency care as a future subspeciality, and by providing networking, academic and clinical opportunities, the GEM strategy provides a firm structure for UK trainees to foster this interest. It is these aims and ethos that GECCo strive to complement for emergency healthcare workers of all experience levels.
Founded in the North West of the UK, GECCo also operates on the other side of the Pennines, in Yorkshire and Humber. The existence of this collaborative stems from the recognition that over the past 5-10 years there has been a growing interest and experience in global health in the North of England, especially among trainees in EM. In Manchester, the University’s Humanitarian Conflict Response Institute (HCRI) has become a burgeoning academic hub for global EM-centred research. The city also hosts UK-Med, a non-governmental organisation hosting a register of NHS health workers trained to deploy in response to overseas emergencies. Meanwhile, Liverpool is home to the world’s oldest school of tropical medicine, counting many EM workers amongst its alumni who work in varying health settings globally. Yorkshire has played host to many global health initiatives such as the long-established intercalated BSc in International Health at the University of Leeds, Students for Global Health (formerly known as Medsin) network founded in Sheffield in 1995, and now one of the country’s first clinical fellowship posts in global emergency care, at Leeds Teaching Hospitals NHS Trust.
Over weeks and months, conversations and ideas were exchanged between colleagues, leading to the formation of a collaborative of emergency care practitioners with a shared interest in global health. Despite differing levels and types of experience, a common vision was shared: namely to provide a platform and a space to meet with colleagues, exchange ideas and build global health capacity in emergency care in the UK. This broad aim encompasses the sharing of training opportunities, educational resources and careers advice as well as the exchange of expertise and knowledge.
The next step was to find a way for others to join in and help create something that was both needed and wanted, which could transcend any perceived boundaries of profession and/or experience. Therefore the title, focus and design of the first event for GECCo was “Breaking silos; building links”.
An inaugural event took place in Manchester on 27th January 2020, sponsored by the HCRI. The 60 attendees were mostly clinicians working in EM and a full range of grades were represented from medical student to consultant. Attendees were mostly from the North West, Mersey and Yorkshire & Humber regions. Though most present were from a medical background, it is hoped that future events will appeal to a wider spectrum of healthcare disciplines.
The primary goal of the evening was to create a platform for those with any level of interest in emergency care and global health to come together, learn from each other and share experience and opportunities. Secondly, there was a focus on discovering what GECCo might be able to offer attendees and other interested parties going forwards.
With this in mind, the format of the event included an introduction to the concept of GECCo. There were two brief key-note presentations: Professor Fiona Lecky discussed global research priorities in emergency care and Ms. Rachel Fletcher presented on international emergency response. However, the majority of time was given over to facilitated group discussion and networking. Feedback was obtained concerning the future direction that GECCo might take. Pop-up stalls were also provided by representatives from the Liverpool School of Tropical Medicine (LSTM), Freedom from Torture, Medact, HCRI, REACHE and Doctors Worldwide.
Feedback from the event
Questions were posed within a workshop setting to groups of 6 – 8 participants. When asked what people might want from an organisation such as GECCo (Box 1), the common themes that emerged centred around the need for a working collaboration that acted as a bridge for individuals interested in both emergency care and global health. There was some desire for content and expertise, but what came through more strongly was the need for a space that links people to existing resources.
Just as importantly, participants were invited to express what they did not want from an organisation such as GECCo (Box 2). Responses were telling, in how they revealed some of the frustrations people experience when it comes to engaging with global health. A strong conclusion was that global health should be inclusive, that it should not be confined to a model based only on overseas working and that it should not feel like a restricted members-only club. The need to avoid the pitfalls of colonialist or ‘voluntourist’ attitudes to global health was also communicated.
Workshops also explored the practical aspects of how the collaborative should coordinate its activity (Box 3) and attendees were asked about how they felt online resources should be prioritised (Box 4). Responses to these questions provide a frame of reference for GECCo’s future, so that the organisation can be tailored to the need and demand of its target audience.
The timing of the first event, followed so closely by the COVID-19 pandemic, has seen the core GECCo team temporarily diverted by clinical care and, along with everyone else, adjusting to a new reality. However, a further event is planned for 23rd July 2020. In addition, an online presence is being developed.
For further details or to get involved in this or future developments of GECCo, please follow us on twitter @GECCoUK or get in touch: email@example.com.
For further details on the RCEM GEM Committee activity follow @RCEMGlobal on twitter.
Dr Anisa J.N. Jafar
University of Manchester
Manchester Royal Infirmary
Dr Philip Delbridge
Royal Liverpool Hospital
Dr Claire Bromley
Tameside and Glossop Integrated Foundation Trust
Dr James Chan
Leeds Teaching Hospitals NHS Trust
Dr Zosia Bredow
Manchester Royal Infirmary
Dr Marie Broydé
Stoke Mandeville Hospital