A message from the President of RCSI

8 May 2025

Dear Fellows and Members,

In recent weeks, the publication of a HIQA review brought the importance of clinical governance structures and supports into focus and surgery has once again been the subject of considerable discussion in the media. Considering this, I thought it timely to update you on the ongoing work of the RCSI Expert Group on Best Practice in Clinical Governance for Surgery, established in June 2024. I will also share some details of recently published NCCP clinical guidelines in urology as well as information about the recent launch of the revised RCSI Logbook app. Lastly, I am delighted to announce the recipient of the Emily Winifred Dickson Award 2025, which will be presented at a ceremony in RCSI later today.

RCSI Expert Group

The recent HIQA review on the governance of implantable medical devices in Children’s Health Ireland (CHI) has once again prompted discussion about the importance of governance structures and supports within surgery.

The recommendations contained in HIQA’s report – for implementation by the HSE – will be of interest to all within our community. The HIQA report focuses largely on implantable devices, a necessity in many types of surgery, but also on the larger subject of clinical governance systems in hospitals and hospital groups.

Many aspects raised in the report reflect many of the topics and themes that have been discussed at various meetings including our recent Charter Meeting, at which matters such as new and evolving technologies, evaluation of governance structures and change management expertise were all discussed. The report points to the necessity of standardised structures, formalised assurance mechanisms and adequate safeguards.

Well-functioning clinical governance systems and associated supports are essential to enable surgeons to safely deliver the innovations that modern healthcare requires. The work of our own National Robotic Surgery Leads Group, culminating in the recently published Robotic Surgery Governance in Ireland: A Guide to Good Practice provides a blueprint for how good clinical governance can support innovation.

At the start of my Presidency, I established an Expert Group on Best Practice in Clinical Governance for Surgery, which has been chaired by Mr David Moore FRCSI, RCSI Council Member. One of the key objectives of the group has been to create space for a conversation about this subject among our profession, which led to the recent symposium on Best Practice in Clinical Governance in Surgery at the 2025 Charter Meeting.

The Expert Group has also completed a nationwide survey of our community with a view to gaining further insight and understanding of the existing challenges but also best practice in clinical governance. This survey highlights a number of areas that will be more closely examined in the coming months as the Expert Group engages closely with colleagues across the country. We are especially keen to hear about examples of best practice that we can all learn from.

The degree of public interest is a timely reminder of our obligation as surgeons to deliver the safest possible standards of care to patients and of our professional responsibility to engage with and support our colleagues. I encourage all surgeons to inform themselves about safeguards such as the 'Safe Surgery Checklist' and to implement these in your daily practice. For surgeons employed by the HSE, the relevant policy can be found here.

New HSE National Clinical Guidelines

Last month, the National Cancer Control Programme published two HSE National Clinical Guidelines of particular interest to surgeons:

The guidelines provide a series of evidence-based recommendations, and I encourage you to have a look. I want to acknowledge the work of the multi-disciplinary group that led the development of the guidelines, which included patient representatives, and was co-chaired by RCSI Fellow, Mr David Galvin FRCSI and Dr Eve O’Toole.

RCSI Logbook app launched

The Department of Surgical Affairs has launched a new RCSI Logbook mobile app designed specifically for NCHDs and surgical trainees. In response to feedback from our trainees, the new app works fully offline which means that trainees can log procedures immediately, even when there is no wi-fi available. The app can be downloaded for free via Google Play or the App Store.

I would appreciate if you could share details of this with your trainees and across your network as this new app provides a far more efficient and convenient way for our members to log their operative experience ‘on the go’. My thanks to those in the Department of Surgical Affairs who led this innovation, particularly Donncha Ryan, Lead Technology Officer.

New subscription year

The month of May also marks the start of a new membership year for our RCSI community, and I urge you to make payment of your subscription to ensure that you maintain your In Good Standing status and are included in the published Register of Fellows and Members In Good Standing. It is useful to know that it is possible for most of us to claim back the expense of the subscription payment through your annual tax return or against schemes such as the Continuing Medical Education allowance for HSE consultants.

Your annual subscription has a direct impact upon the RCSI surgical community as it goes toward the development and enhancement of training, courses and programmes delivered by RCSI's Department of Surgical Affairs as well as towards a range of benefits housed in the online Fellows and Members Portal. With your ongoing support, we can continue to invest in the wide offering that is available. You can make your payment online by navigating to the 'Fees and applications' section of your profile. My sincere thanks to so many of you who have already taken the time to make your contribution by paying your annual subscription.

Emily Winifred Dickson Award 2025

As I write to you, RCSI prepares to host the annual Emily Winifred Dickson Award ceremony later this evening. This award was established by RCSI to recognise women who have made an outstanding contribution to their field. It is of course named in honour of Dr Emily Winifred Dickson FRCSI, who became the first female Fellow of any of the four surgical royal colleges in Britain and Ireland in 1893.

Previous recipients of the award include Dr Karen DeSalvo, Google Chief Health Officer and Her Excellency Ellen Johnson Sirleaf, former President of Liberia, Africa’s first female head of state and a Nobel laureate. This year’s awardee is Frances Fitzgerald, Member of the Gender Equality Advisory Council to the G7, former Tánaiste and Minister. A globally recognised leader and advocate for equality, Frances is a very worthy recipient of this accolade.

For those who might be interested to learn more about Emily Winifred Dickson, RCSI were honoured to be presented with 'The Dickson Papers' by her grandson Dr Niall Martin in 2012. The papers include correspondence, newspaper cuttings and photographs and they are available online here.

One of my favourite excepts is from a letter written to her son in 1942, shortly before her death, when she said “... I don’t regret anything, even the foolish things, but I see in countless ways that I missed many priceless chances and opportunities, not from wilfulness but from the sheer blind stupidity of not appreciating how much they might mean ...”. If there is a better summary of the wisdom of the aging surgeon – and the value of mentorship to us all – I have yet to read it.

Millin Meeting 2025

Finally, while we can at last look forward to brighter evenings and the summer ahead, a reminder to note that Friday, 14 November is the 2025 Millin Meeting. Block the date in your diary today.

Professor Deborah McNamara
President, RCSI

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