Mr Stephen Bush (pictured centre), consultant in Emergency Medicine at Leeds Teaching Hospitals NHS Trust, spoke to JLife’s Laura Sefton about the significance of teamwork and why Leeds is best city in the country.
Can you tell us about your role within medicine?
I’ve been a consultant in emergency medicine in Leeds since 2002, the clinical director for urgent care (made up of the emergency departments and sexual health) since 2011, and since 2013, chair of the Advanced Trauma Life Support programme (ATLS) in the UK.
Most recently, I became clinical director for acute medicine in April. I’m really enjoying learning about a whole different group of medical specialties and beginning to meet the teams providing acute care on the wards and assessment areas. There is also an element of planned care within acute medicine and managing this is very different to my previous urgent care role.
What was your journey to where you are today?
I was born and bred in Leeds, attending Leeds Grammar School until completion of my A levels. I then studied medicine at Keble College, Oxford, which has become a bit of a tradition in my family as my dad studied law there and my son is there in the first year of his engineering course. After completing the first pre-clinical three years of the course there I moved to the Royal London Hospital Medical School for my clinical training, qualifying as a doctor in 1992.
I decided not to stay in London for my house jobs and applied to work these back in Leeds. Since then, apart from a year in Pontefract and 18 months in Bradford, I’ve only worked at either St James’s or Leeds General Infirmary.
When I was a junior doctor we did not have the formal training programme in Emergency Medicine from the junior grades that there is now so I did a basic surgical training scheme then worked as an anaesthetist for a year before joining the higher specialist training scheme in emergency medicine in 1998. I was appointed as a consultant in 2002.
Did you always want to be a doctor?
Once I reached the age of 15 medicine was all I was interested in. I did well in the sciences at school and I was also keen on meeting and working with people – I was a leader for Habonim Dror and really outgoing. I found that being a doctor was a perfect fit as it combined for my love of science and meeting new people.
To be an effective doctor you have to be bright and have the capacity to learn as there is a lot to take in. You also have to be able to learn to read people and interpret what they are trying to tell you about how they are feeling.
How did you decide emergency medicine was the specialism for you?
Medicine is a broad church. A vascular surgeon will work differently to an oncologist, and you have to know what’s right for you. For me, I was drawn to emergency medicine because it involves teamwork. In fact, it relies heavily upon teamwork. There is no hierarchy, and there are certainly no airs and graces. I’d struggle on my own as I’d not have others to bounce ideas off, plus we have good camaraderie in the emergency department – you have to, really.
I also liked emergency medicine because you get to do a lot of good in a short space of time. You are always making decisions without having all of the information to hand and have to pick up on what has happened quickly, using your skills and knowledge to treat each individual patient.
Congratulations on your recent award win. What was this for and how did Leeds become a winner?
One of the most exciting things to happen has been the recent award win. Leeds Teaching Hospitals has just been recognised by CHKS, a national health informatics company as the winner of the ‘Excellence in Delivering 24/7 Emergency Care’ accolade.
All acute trusts in the UK were eligible for this award and it was based on a comprehensive assessment of what we do in the emergency departments (EDs). It wasn’t just about data though; the visiting team spent a long time in both EDs, as well as talking to our clinical teams about what they thought about the care we give our patients.
They left with a real feel that there is a great sense of collaboration throughout the entire clinical teams in the EDs. They said that it was clear that patient care was the focus of all we do, we all muck in together and we certainly have no self-important ED consultants!
This accolade is the result of a group effort and to hear the president of the Royal College of Emergency Medicine say that we have the best emergency department in the country was a true honour.
As well as your award win, have there been any other stand-out moments from across your career to date?
Being the first ED in the country to deliver consultant job plans that have allowed us to provide a 24/7 presence of consultants in the ED is a major stand-out moment for me.
We introduced this in October last year and we are already seeing the results. We are very proud of being able to provide the same level of care at 4am on a Sunday morning as we can at 4pm on a Wednesday afternoon.
Another highlight was related to the ATLS course. This is a global programme that has trained over 60,000 doctors in the UK and over one million worldwide. It is an essential part of how we train doctors to look after severely injured people who arrive in hospital. The course is updated every four years and the ninth edition of the ATLS programme was introduced a couple of years ago. This ninth edition caused a real problem however.
The participants had to pass a test paper that accompanies the course to be successful, but the updated paper turned out to be much harder than the previous version. Loads of participants were failing even though their knowledge was really good. The UK team proposed a solution to the problem and took this to the American College of Surgeons’ Committee on Trauma. Once they heard about the solution, they immediately approved it and arranged for the solution to be rolled out to all 100 countries around the world that run an ATLS programme.
What are the top three pieces of advice you would give to someone who is considering becoming a doctor?
Firstly, I would say that it’s important to realise it’s about other people. Then I would say that you have to recognise that you can only work effectively as part of a team. Finally, you have to be able to set aside time for yourself.
If you were to advise a doctor who is planning on specialising in emergency medicine today, what would be your main tip?
As well as the three pieces of advice above, I’d also say that it’s important to make sure they are comfortable with demands on time and with making decisions.
On a personal note, what makes Leeds special to you?
Quite simply, it is the best city in the country. You have everything you could possibly need here and there are few things that London has that Leeds doesn’t offer. I live with my family in North Leeds and can be in the busy centre or in the heart of the countryside in under half an hour.
If someone offered me the chance to progress my career but it involved a move to, say, Bristol, I’d say thanks very much but I’m happy where I am.
What do you do in your spare time?
Not much really. I go to the gym, play tennis – and playing on the Xbox is a guilty pleasure! I make sure I spend time with my lovely family and friends, too.
