Consultant Urologist - Nitin Shrotri

1. JOURNEY
THROUGH EAST KENT
AND BEYOND
NITIN SHROTRI
CONSULTANT UROLOGIST
BMA UK COUNCIL MEMBER,
CHAIR, BAUS PROJECT SAS

2. MY TIME AT EKHUFT: 2000-2020
Great working colleagues
Wonderful patients
Ruptured kidneys and bleeding bladders
Surgical Innovations
Education and Research

3. IMG
DOCTORS
CURRENTLY
MAKE UP
27.5% OF
DOCTOR
WORKFORCE
18 December, 2020 3

4. 18 December, 2020 4
BMA ACTION TO PROTECT BAME
DOCTORS

5. 18 December, 2020 5
ADVOCATING FOR IMGS

6. BMA LOBBYING FOR CHANGE DURING
COVID• FOLLOWING PRESSURE FROM THE BMA, 2020 HAS SEEN A NUMBER OF CHANGES BY THE
UK GOVERNMENT INCLUDING:
• FLEXIBILITY TO ALLOW DOCTORS TO WORK ADDITIONAL HOURS WITHOUT COMPROMISING
IMMIGRATION STATUS (MARCH 2020)
• FLEXIBILITY FOR A DOCTOR (OR OTHER HEALTHCARE PROFESSIONAL) TO WORK AT A
DIFFERENT NHS SITE (MAY 2020).
• AUTOMATIC INDEFINITE LEAVE TO REMAIN FOR THE DEPENDENTS OF DOCTORS WHO SADLY
DIE ON THE FRONTLINE (MAY 2020).
• AN EXEMPTION FROM THE HEALTH SURCHARGE FOR HEALTH AND CARE WORKERS (MAY
2020).
• WORKING WITH THE GMC AND UKVI TO EXTEND THE VISITOR VISAS OF DOCTORS IMPACTED
BY PLAB CANCELLATIONS (SEPTEMBER 2020).
• BESPOKE ARRANGEMENTS TO SUPPORT GP TRAINEES WHO, HAVING HAD THEIR FINAL EXAMS
DELAYED, ONLY HAD A NUMBER OF WEEKS TO FIND FULL TIME EMPLOYMENT (AUGUST 2020)
• CONTINUATION OF AUTOMATIC VISA EXTENSIONS FOR DOCTORS WHOSE VISAS EXPIRED
BETWEEN 1 OCTOBER 2020 AND 31 MARCH 2021 (OCTOBER 2020).18 December, 2020 6

7. BMA GUIDANCE TOOLKIT FOR DOCTORS NEW TO
THE UK
A RESOURCE TO HELP SUPPORT DOCTORS AND
INTERNATIONAL MEDICAL GRADUATES JUST
STARTING
OUT IN THE NHS IN THE UK.
Email:
img@bma.org.uk

8. PHRASES HEARD BY MANY IMG IN THE NHS
• WE NEED A FACE THAT FITS,
• THERE ARE NO GLASS CEILINGS,
• YOU ARE IMAGINING THINGS,
• THERE IS NO ONE AMONGST YOU WHO IS TRAINED,
• YOU LOT ARE JUST NOT GOOD ENOUGH,
• I DON’T SEE A BROWN FACE AS EVIDENCE OF DIVERSITY
• YOU NEED TO SPEAK POLITELY,
• YOU HAVEN’T FILLED OUT YOUR FORM PROPERLY,

9. BIAS
• THE ACTION OF SUPPORTING OR OPPOSING A PARTICULAR PERSON
OR THING IN AN UNFAIR WAY BECAUSE OF ALLOWING PERSONAL
OPINIONS TO INFLUENCE YOUR JUDGEMENT

10. UNCONSCIOUS BIAS
• THIS HAPPENS OUTSIDE OUR CONSCIOUS AWARENESS.
• THIS BIAS IS TYPICALLY A LEARNED STEREOTYPE THAT IS AUTOMATIC AND
MOSTLY UNINTENTIONAL.
• IT CAN BE SO SYSTEMICALLY INGRAINED THAT IT CAN ALTER ONE’S BEHAVIOUR
AND HOW WE INTERACT WITH THE PEOPLE AROUND US.
• IT OFTEN RESULTS IN NEGATIVE CONSEQUENCES
• AFFINITY, ATTRIBUTION, AGEISM, CONFIRMATION, CONFORMITY, THE HALO
EFFECT, THE HORNS EFFECT, CONTRAST BIAS, GENDER BIAS, NAME BIAS,
BEAUTY BIAS

11. HARVARD IAT
• THE IMPLICIT ASSOCIATION TEST
• RACE COMPONENT
• EYE OPENER

12. FREEDOM TO SPEAK UP GUARDIAN TRAINING
-Communication
-Partnership building and relationship management
-Knowledge of the speaking up agenda and local systems
-Driving continuous improvement
-Measuring effectiveness and impact
-Time management and prioritisation
-Training and capability building
-Working with senior leaders

13. WRES REPORTS
• BAME STAFF FAIR WELL IN JUST TWO OF THE WRTES INDICATORS.
• 3. THE RELATIVE LIKELIHOOD OF STAFF ENTERING THE FORMAL DISCIPLINARY
PROCESS AND
• 4. THE RELATIVE LIKELIHOOD OF STAFF ACCESSING NON-MANDATORY
TRAINING AND CPD.
• BAME STAFF APPEAR TO BE DISADVANTAGED IN ALL OTHER AREAS.
• THERE IS NOW AN URGENT NEED TO BRING ABOUT CHANGE AT EKHUFT
PARTICULARLY AS THESE FIGURES HAVE NOT CHANGED FOR THE BETTER SINCE
2015, THE BOARD OF DIRECTORS MUST LEAD A CHANGE IN APPROACH AND
SUPPORT A WORKING GROUP TO DEVELOP AN ACTION PLAN. THIS WORKING
MUST WORK VERY CLOSELY WITH AND INCLUDE MEMBERS OF THE EKHUFT BAME

14. ROGER KLINE: HSJ OCT 6TH 2020
12 SUGGESTIONS
• 6. IMPROVED BME SENIOR REPRESENTATION IS ABSOLUTELY ESSENTIAL AND
WITHOUT INCLUSION IT CANNOT BE SUSTAINED
• 8. SPEAKING TRUTH TO POWER AND BEING OPEN ABOUT SETBACKS IS CRUCIAL.
• 10. REVIEWING NATIONAL ACCOUNTABILITY IS SELF-EVIDENTLY CRUCIAL SINCE THE
EXTENT TO WHICH REGULATORS ARE CURRENTLY HOLDING NHS ORGANISATIONS TO
ACCOUNT IS SIMPLY NOT GOOD ENOUGH. THIS MAY BE COMPLEX BUT THAT IS NO
REASON NOT TO SORT IT.

15. ROGER KLINE
• KEY PERFORMANCE INDICATORS
• SANCTIONS
• BUT ALSO
• SHARE GOOD PRACTICE
• SHOW WHAT EVIDENCE BASED STRATEGY LOOKS LIKE
• WRES FOCUS RETHINK

16. WHAT WILL HELP BAME DOCTORS
• ROLE MODELS IN VERY SENIOR POSITIONS
• CAREER PROGRESSION FOR STAFF
• STAFF LISTENING SESSIONS WILL NOT WORK UNLESS TRUST
• TARGETS FOR IMPROVING WRES DATA NEED TO MAKE UP FOR YEARS OF
NEGLECT
• UPHILL STRUGGLE, BUT SERIOUS ACTION REQUIRED
• REVERSE MENTORING

17. REVERSE MENTORING BY SENIOR BAME
COLLEAGUES
• IT’S A TWO-WAY PROCESS
• IT NEEDS AN OPEN MINDSET
• THE PURPOSE MUST BE CLEARLY DEFINED
• A FRAMEWORK IS REQUIRED
• COMMUNICATION CHANNELS MUST REMAIN OPEN
• APPROPRIATE MATCHING OF MENTORS

18. TIME TO ACT & WHY
• TRUST COULD BE AN EXEMPLAR
• GOOD TRUST CHIEF EXECS MUST BE COMMENDED
• BREXIT CAUSES CONCERN
• IT’S CHRISTMAS!! DO IT NOW