A numbers game…

Thursday 24 September 2020

My name is William Ramsden and I began my three-year term as Vice-President of The Faculty of Clinical Radiology at the start of September. For those who don’t already know me, I am a consultant paediatric radiologist in Leeds, initially at St James’s University Hospital (from 1994–2010), and subsequently at The Leeds Children’s Hospital.

Aside from my clinical role, I co-led the development of The Leeds and West Yorkshire Radiology Academy, was Training Programme Director and then Head of School prior to coming to the College as Medical Director, Education and Training in 2016. The three years I served in that role were the most fulfilling of my career, largely due to being a member of a very supportive team at the RCR and sharing with them the prime aim of helping trainees, trainers and training. The experience clearly demonstrated how the College could support and guide our members and Fellows, and building upon this was one of the main reasons I stood to serve as Vice-President.

Outside work I have had a near lifelong interest in walking Scottish Hills and over the years I have worked my way through the Munros (hills over 3,000 feet), Corbetts (2,500 to 3,000 feet) and now Grahams (2,000 to 2,500 feet), following many others trying to complete various hill lists. Days spent on the hills vary between near-perfect journeys in wild country to rain-soaked days with minimal visibility, yet once completed, none ever feel like wasted time. This feeling is sometimes aided by adding another tick to the list, but this can reduce the lived experience of memorable days on the hills to merely another number added to your score.

Numeric data is all around us and plays a huge part in healthcare. I am sure that I shared the experience of many others during the pandemic by watching the evening news each night, charting the spread of COVID-19 and quoting shocking numbers of deaths, despite the magnificent efforts of our colleagues in the NHS and social care. Behind this were stories of tragedy and sometimes heroism, building a fuller picture of our colleagues’ and patients’ experiences, and deepening our understanding of the pandemic. Despite the clinical impact and visual presence of imaging, and the skilful interventions it may guide, we are often surrounded by numbers too, as we quote (and have quoted to us) figures for backlogs and workforce shortages, and try our hardest to achieve targets for throughput and turnaround times.

Numbers can be very powerful to directly convey important messages such as workforce shortages and the need for greater investment.  However just as important are the stories behind the figures, less visible, yet vitally important to understanding the data and guiding appropriate action. Behind the numbers may be stories of difficult circumstances, regional variation and of individual endeavour and commitment to making things better. Just as we would not image or treat our patients based upon their numeric data alone, but would want full clinical details, we should not seek to build our services solely based upon improving our numbers.

All data based upon human interaction is nuanced and subtle by its very nature, and as we seek to improve imaging, it is vital to remember the human context as we and our colleagues restore and build our imaging services. Quality and quantity of work are not synonymous, and it is vital that we remember the former and are not only driven by the latter as we seek to help our patients.

It is often said that one should measure what is important rather than what is easy. Though numbers have their place both in collecting Scottish hills and healthcare, it is vital not to forget the back stories, be they the memories of great days in wild country or the human endeavour which drives our imaging services, allowing us to see the figures in context, rather than isolation.

Dr William Ramsden
Vice-President, Clinical Radiology


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