The Trust is now in its tenth year. This is cause for celebration. Over the past decade we have been privileged to help many of our colleagues deal successfully with problems relating to alcohol and drug misuse and dependence. It is very pleasing when our efforts help a doctor to become well and, thereby, be restored to safe professional practice. While such outcomes are of prime importance to the safety and care of patients, they also bring tremendous mental, physical and social benefits to the recovering doctor and his or her family.

Raising the profile of the Trust and its confidential helpline so that doctors know about us, and how to reach us, is a considerable challenge. We continue to advertise in the medical press, to give lectures to organisations and to maintain a presence at major medical annualconferences. In May the Trust hosted a special conference in Edinburgh. It was the first of its kind in that it was attended by delegates from the GMC, BMA, & MCA in addition to a number of clinical and academic psychiatrists and, most importantly, a large number of doctors in recovery. This conference was entitled “The GMC, The Profession and Addicted
Doctors – How Can We Do Better?” It was particularly gratifying to hear senior members of the GMC acknowledge the work done by the SDT. Because of its success, we plan to hold a follow up south of the border in the near future.

We extend our thanks to our existing funders. Without the help of individual LMCs and the BMA, we would not be able to do this valuable work and it is a tribute to their faith in us that we remain a vibrant organisation. We ask for their continuing support. Fundraising has to be a major priority for the coming year if we are to put in place more innovative ways of publicising our helpline number.

Finally, mention must be made of the dedication and unstinting support of our members and other interested doctors. Their altruism and sheer hard work is crucial to our continuing success.

back to top

The Trust continues to provide support for doctors and medical students who experience problems in relation to their use of alcohol and/or other drugs whether prescribed or not.

This year we provided a number of educational seminars for the medical profession and for students in training.

The Sick Doctors Trust has been an exhibitor at the Conference of LMCs and the annual Conference of Occupational Health Physicians and a conference of the Faculty of Occupational Medicine to launch the publication of ‘Guidance on Alcohol and Drug Misuse in the Workplace.'

A unique and innovative conference entitled “The GMC. The Profession and Addicted Doctors - How Can We Do Better?” was hosted by the Trust at the BMA offices in Edinburgh. It was the first time the GMC had got together with the SDT and we feel there is now a great need to continue with this dialogue.

The SDT was invited to attend a national meeting convened by the National Patient Safety Agency (NPSA). Its purpose was to draft new, thorough and detailed procedures for dealing with poorly performing doctors. Poor performance can be due to a variety of reasons. Many affected members of the profession described their story in front of a large audience of senior NHS staff and leaders of the profession. The draft guidance included proposals for reimbursement of affected doctors undergoing prescribed retraining as a result of their
assessment and very careful arrangements for their supervision, independent monitoring and reassessment.

back to top

Our national helpline is manned on a 24 hour basis by one of six responders. All the responders are doctors and members of the Trust. We receive on average 20 calls per month. There is a seasonal variation in the number of calls with an increase around December and January and a decrease in peak holiday periods.
Most of these calls are from troubled doctors themselves. Some are from relatives or ‘friends', (it is likely that these are sick doctors acting anonymously.) We have also noticed that doctors are increasingly frightened of being ‘shopped' by us to their employing authorities. The telephone responders have to build trust with the callers while engaging them in the helping process. We have become aware that, when answering calls on the helpline, our role is different from that of a doctor in a formal consultation. Thus the interrogation that would
form part of a formal examination is not usually appropriate – indeed demanding identifiable personal information can be counterproductive unless such information is volunteered. This means that the collection of potentially useful statistics is very limited.

Doctors are also referred to us by colleagues who are acting as concerned fellow professionals. Sometimes these colleagues are acting in a more formal mentoring, supervising or training role. LMC members often seek advice from us about constituent members. We are also happy to receive calls from doctors who have not got personal alcohol or drug related problems themselves but whose lives are affected by such problems in their families. We are aware that such situations can be a source of major stress to members of our profession and we are often able to make some helpful suggestions about how they can be helped.

It is becoming clear that callers are getting younger with shorter histories. This seems likely to be to do with starting earlier and having more disposable income but it also includes some factor of greater awareness not only of the problem but also the availability of help. In perhaps too many cases, prosecution or disciplinary action spurs the sick doctor to seek help. Doctors seem to follow the general public in their drug use and choice, a fact consistent with published research. Thus we see a trend of increasing use of cannabis and cocaine (street sources rather than pharmacy), though alcohol remains the single commonest substance
reported.

We remain convinced that, with greater awareness of the nature and extent of the problem and the availability and excellent results of treatment, many more doctors can be helped before prosecution or disciplinary procedures are invoked. Moreover, early intervention can reduce damage to the doctor's health and well-being, thereby minimising risk to patients.

The majority of contacts still come through the national telephone helpline as a result of our advertisements in the medical press. Some callers tend to confuse the nature of the service we offer with that offered by other counselling services set up to offer advice on a range of physical, mental and occupational health problems in doctors. In view of the expertise developed by the Sick Doctors Trust in the specialist field of addiction or dependence over the past decade, it is now time to review the way we advertise in order to clarify this for doctors plucking up the courage to make the call. We greatly value our growing relationship with the Doctors Support Network (www.dsn.org.uk), which helps doctors with mental health problems. Much of the strength of both our organisations lies in the peer support we can offer to doctors and the fact that we have successfully come through the difficulties they are now experiencing. We also wish to strengthen links with the BMA counselling helpline for doctors, which has been established relatively recently, and which offers professionally delivered support for a wide range of problems.

An initial call to our helpline often results in the formation of a long standing helping relationship. In fact we offer as much help as the caller will accept. Having formed a relationship of trust with the caller, we try to assess the severity of the situation and the degree of risk to the doctor and to his or her patients. In some cases, we may suggest a referral to a residential treatment centre. Other callers may be advised to contact the network of Doctors and Dentists Groups or Healthcare Professional Groups, which provide regular meetings
and long term support. In addition to that, some non-residential counselling by counsellors trained to recognise and treat addiction may be appropriate. We like to continue our involvement with doctors in recovery and this becomes possible as many of us come in contact with them through our own involvement with these long term support networks.

Helping doctors to access funding for residential treatment remains a big problem. During the coming year we hope to use the media as much as possible to promote information about the size of the problem. Prevalence studies suggest that around 15,000 doctors in the UK will become dependent on drugs and or alcohol at some point in their lives. It is estimated that about 500 doctors should present annually for help. However we have been informed that the GMC has about 300 doctors with drug and alcohol problems under surveillance at present and the remainder are being managed ‘at local level'. Somehow there is a disparity here and it needs urgent consideration. Heavy social drinking and drug use in the general population may be on the increase but it is not appropriate for doctors, because of concerns about patient safety, about professionalism and about probity. In societies where heavy drinking becomes the norm, increased rates of addiction follow in time. Treatment needs to be abstinence based for doctors just as it should be for pilots, train drivers and others on whose clear thinking and mental health the lives of the public depend. We believe access to help and treatment for addicted doctors needs to be given the highest possible priority.

back to top

All our trustees are involved in raising the awareness of doctors as to how addicted colleagues may present and be best managed. This may be done on an ad hoc basis when individual doctors concerned about the behaviour of a colleague seek advice. It is also done through articles in the medical press, at professional conferences and through any formal opportunities for training which present to individual members of the Trust.

Dr Brown provided training at Leicester University to Medical Students in their first year. More opportunities to repeat this with medical students in their early years would be greatly appreciated.

Dr Chang gave a lecture on Addiction in the Medical Profession to the Association of Anaesthetists in October 2005 and subsequently provided an article on the same subject for the April 2006 edition of the journal Anaesthesia News.

Professor Forsythe attended the Conference of the National Patient Safety Agency on behalf of the Trust and did valuable work in raising awareness about the work done by the Sick Doctors Trust. In addition he was able to apprise SDT members of the remit of this organisation in terms of drawing up detailed procedures for the assessment, retraining, monitoring and independent supervision of doctors whose performance is deemed to be poor for a variety of reasons.

Dr Mayall provided the following training :
• The Association of Anaesthetists in October 2005 at a seminar entitled “The Sick
Doctor”.
• A half day seminar on ‘Addiction and Anaesthetists – Could We Do Better?' in
Nottingham in May 2006.
• A series of talks to medical students on addiction.
• Regular sessions on the subject of addiction with junior doctors in their Foundation
Years.

Dr. Williams and Dr Young were involved in a half-day's study with medical students from the new Brighton and Sussex Medical School.

Dr Young provided the following training / education on addiction in the medical profession:
• Lectures to medical schools at both Edinburgh and Glasgow Universities.
• The annual BMA Junior Members Forum in Bournemouth.

back to top

We continue to hold meetings and training sessions for helpline responders. No extra costs for training have been incurred as such sessions are held immediately prior to and at the same venue as our regular Trustee meetings. In addition all the helpline responders are in regular contact with one another.

back to top

We advertise in both the Clinical and General Practitioner issues of the BMJ, in Pulse and in Hospital Doctor. These advertisements form a major part of our advertising expenditure. We are beginning to explore the possibility of extra free advertising. Many LMCs have expressed a willingness to place an advert or an article about us in their regular newsletters. We are extremely grateful to the Medical Council on Alcohol for including our details in their recently republished newsletter ‘Alcoholis.' During the year we have written to a number of professional journals requesting space. So far we had an acceptance from the Journal of the Royal College of Radiologists and some helpful correspondence is starting between us and the Medical Defence Union and the Medical Protection Society. We plan to continue to develop ways of seeking the help of other professional bodies in raising our profile through their journals and newsletters.

At the Edinburgh Conference Dr Joan Trowell of the GMC undertook to include our details in a list of helping resources to be sent electronically to each PCT . This information would then cascade down to Occupational Health Physicians, GPs and others likely to come in contact with sick doctors

back to top

1. BDDG.
The members of the BDDG are doctors and dentists in recovery. Eleven groups of the BDDG meet monthly throughout the country offering regular long-term support to sick doctors. Family support groups are linked to each group and usually meet in a nearby venue at the same time. The SDT works closely with the BDDG and always refers callers to the groups. The SDT also assists the annual conference of the BDDG with a grant towards the cost of the academic day, thus supporting education in the field of addiction.

2. MCA.
The SDT maintains a good working relationship with the Medical Council on Alcohol. They make referrals to us where appropriate and two of our trustees are members of the MCA Executive Committee.

3. NPSA.
The National Patient Safety Agency has invited delegates from the SDT to attend meetings with advisory input.

4. CHITS
Clinician's Health Intervention, Treatment and Support has, so far, not been successful in persuading the Government to provide funding for the treatment of health professionals. It seems likely that bidding will be revised and renewed during the coming year. In Scotland discussions are already taking place with Dr Douglas Fowlie, Dr Harry Burns (CMO for Scotland) and Dr Young about the possibility of developing services for doctors and other clinicians.

back to top

The Trust's website (www.sick-doctors-trust.co.uk) remains under the management of Dr Chris Wilson. It is registered with major search engines and receives between 500 and 1000 visits monthly. It gives information about the trust; its personnel, work and development plans. One recovering doctor's story is published and an archive section contains articles, reports and synopses of talks on topics of interest. Contact with our helpline responders, either by phone or email, is encouraged.

back to top

We are extremely grateful to the BMA for their generous annual grant of £10,000.

We also extend our gratitude to the following LMCs:
Cleveland LMC, Doncaster LMC, Gateshead and South Tyneside LMC, Kent LMC,
Londonwide LMCS, Manchester LMC, Norfolk LMC, Shropshire LMC and Walsall
LMC who donated to us in the 2005 – 2006 financial year.

There are still fifteen trusty Gift Aid donors who have supported us over the 10 years
since our inception. We wish to thank them for their generosity. More regular givers
of this sort are welcome and an e-mail to treasurer@sick-doctors-trust.co.uk will
enable him to send information and forms.

We rely entirely on the generosity of our donors to enable us to continue our activities.

back to top