by Dr Rupert Payne, Consultant Senior Lecturer in Primary Health Care, Centre for Academic Primary Care, University of Bristol
Dr Rupert Payne reflects on the highlights of the two-day Society for Academic Primary Care (SAPC) Annual Scientific Meeting, which was held virtually this year from 30 June to 1 July. This blog was first published on the SAPC website.
Another year, another conference! The last time I attended a SAPC conference was the regional South-West one that we hosted in Bristol – about a week before the first lockdown kicked in, and normality abruptly ended. Indeed, I suspect it was actually the last big face-to-face meeting many of us attended. This time, Leeds beckoned. But rather than jumping on the train to the “grim north”, I descended the stairs to my rather grimmer basement (yes, my wife has kicked me out the dining room), for two days of online conference. What to expect?
The conference theme: living and dying well. And given the massive impact that the Covid pandemic has had on society, a topic that is perhaps more important than ever – definitely some interesting talks to look forward to.
Usually, when I arrive at a conference, I am scrabbling around trying to find various bits of paper – figure out where I am supposed to be heading, what is first on the programme, which things I might be most interested in seeing and hearing, where the auditorium and refreshments are. The latter two are relatively easy when it’s your own house. But the first aspects were much the same – this time with the added challenge of finding the various emails telling me how to log in to the online platform, and working out how to navigate around a new web-based environment. But it was surprisingly straightforward. The usual chatter of voices in the conference reception area was simply replaced with bubbling noises from the children’s aquarium sitting behind me.
No Guinness – but shuffling!
I started by taking a look around the virtual poster session, where the theme of living and dying well was of course prominent. My own interests are in all things medicines related, and especially polypharmacy and the related issue of multimorbidity. These subjects were well covered, with the usual strong showing from our Irish colleagues: the cost of potentially inappropriate prescribing in middle-age, feasibility of the MyComrade intervention for medication review, medication non-adherence in people with multimorbidity (sadly no opportunity to catch up over a Guinness this year). And, unsurprisingly, a lot of work addressed the impact of the pandemic: everything from patient-reported safety concerns, through vaccine hesitancy and attitudes to contact tracing, to student education and development of long-Covid services. I skimmed as many as I could – and downloaded quite a few to read in more detail at a later date (virtual conference bonus feature, No. 1).
Next on the agenda was the “Networking Shuffle” – it sounded a bit like one of the dodgy dance moves we would normally expect Simon Griffin to be involved in during the evening social event. Unsure what to expect, I clicked with a degree of trepidation on the link to “join a conversation”. And, hey presto – speed dating for academics! The fish in my basement were certainly not offering any exciting conversation, so I spent an enjoyable half hour meeting some fresh-faced, enthusiastic medical students and junior researchers, just setting out on their careers. And had an equally enjoyable time reminiscing with cynical old gits like myself. It was really nice to be able to get to speak to people who I probably wouldn’t have met at a face-to-face conference (virtual conference bonus feature, No. 2).
An inspiring kick-off
After introductions from the organisers, including Robbie Foy reminding us all of Scotland’s recent nil-nil victory over England in Euro 2020, the traditional conference kicked off properly with the Helen Lester Memorial Lecture. Wendy Webb delivered a wonderful lecture based on her PhD, a moving reflection of end-of-life practices within the homeless population. She eloquently described the perspectives of homeless people – their rejection of hypocrisy, their fears of being forgotten or physically dependent, their wish for autonomy, the theme of spirituality, the “Pauper’s funeral”. It was lovely to see someone speaking with such genuine feeling, and for the research to be driven by powerful personal experiences from clinical practice. Helen would have approved.
I always feel a bit sorry for speakers who have to follow on from such a great talk. But Paul Aveyard did not disappoint. He discussed the practicalities and desirability of primary prevention in general practice, highlighting the potential value of brief interventions, and talked about the unwarranted resistance to use of these techniques by GPs. Sadly, he was unable to offer an answer to Judith Ibison’s question as to what brief intervention could be used to deal with such nihilistic clinical colleagues. And Tom Williams, from Parkrun continued the lifestyle topic, discussing the growth of what has been described as one of the UK’s greatest public health initiatives, and emphasising that it is not just about running – it’s about the role of community, connectedness and friendships. As a clinician, I’ll certainly be adding it to my little “toolkit of useful stuff to tell patients about” (and perhaps looking out my running shoes).
The future’s bright (but my tennis isn’t)
The afternoon saw two parallel sessions, interspersed with three great prize presentations from early career researchers (well done Samuel Seidu, Shoba Dawson and Emily McBride – the future of academic primary care is bright). I found myself slightly out of my comfort zone, presenting a colleague’s work in the infectious disease session. But everyone else was great, highlighting the brilliant research done in this important field by so many SAPC members.
By the second parallel session, the incessant whirring of the aquarium filter was irritating me, so I decamped to the sunshine of the garden (virtual conference bonus feature, No. 3). I was really torn as there were several things I wanted to attend, but ended up listening in to Pete Bower and David Blane chair a great session on workforce and careers. I was particularly interested in Sharon Spooner’s discussion of GPs’ changing roles with the growing involvement of non-medical health professionals in primary care. I have already pencilled time into my diary to watch the recordings of some of the other parallel sessions (virtual conference bonus feature, No. 4).
Traditionally, the evening would have usually seen a nice drinks reception or meal with friends and colleagues. Sadly, despite their otherwise fantastic organising, Leeds seemed unable to solve this problem virtually. Instead, I was forced to spend the evening in the company of my in-laws. I drowned my sorrows with a small beer, lost impressively to my teenage daughters at a game of Andy Murray-inspired Swingball, but otherwise reflected on what was a most enjoyable first day.
Distinguished papers and diazepam
The bar was set high for a second day, which did not fail to disappoint. The fish were still swimming around in the basement in an antisocial manner, so I indulged in some more network shuffling. Distinguished papers followed from the AAAPC 2020 winning presentation (Grant Russell from Monash, on optimising primary care for refugees in Australia) and the NAPCRG 2020 winning presentation (Oxford’s Tim Holt, on bone health in people with intellectual disability).
I attended a parallel session on education, which led nicely into a fantastic education keynote plenary, with Alex Harding and Jane Kirby talking about the amazing undergraduate educational innovations SAPC has supported recently (the Virtual Primary Care resource – a library of authentic GP consultations which came from filming of the “GPs: Behind Closed Doors” documentary – is amazing).
The AGM followed, and was better attended than most face-to-face ones I remember (the fish were still unimpressed). A quick bite for lunch in the garden, and I had to be back to chair (and present at) an extremely well-attended and interesting parallel session on Medication, with gratefully received support from my co-chair Ian Maidment. Trying to stick to the extremely tight schedule was no mean feat, but barring a few minor technical hiccups and only a small dose of covert diazepam, we managed it.
The last keynote session of the day opened with Kaveh Shojania from Toronto, who provided a wonderfully insightful talk highlighting how most quality improvement efforts deliver only marginal gains. And KCL’s Katherine Sleeman followed by discussing how we need to better understand policy priorities, and design and communicate our research more effectively to address this. Both were fantastic – I shall definitely be heading to the recording and watching again.
“Leave meeting”
The conference closed with prize giving (well done to my colleagues Debbie McCahon and Matt Ridd in Bristol for winning the NAPCRG and AAAPC awards respectively!) and the usual handing on of the baton to UCLan for 2022. Then I clicked “leave meeting”, and that was it. No bags to pack. No train to catch. No people to say goodbye to. I switched off my computer, and went back upstairs to speak to my mother-in-law.
Did I enjoy SAPC 2021? Well I missed the social aspects, the ability to network face-to-face, the spontaneity of meeting someone in a corridor, or the in-depth challenging discussion you can have with a like-minded researcher. Nevertheless, my answer is an emphatic “yes”. Was it just the chance to be exposed to any sort of academic discourse outside of my own institution? Was it the particularly inspired choice of keynote speakers? Was it the slick organisation or those “bonus features” that real life conferences can’t deliver? I suppose it was a bit of “all of the above”. The fish certainly seem no wiser, but I actually feel rather reinvigorated from an academic perspective, and my basement definitely feels a lot less grim.
Dr Rupert Payne, from a basement near Bristol