A trip to the seaside: Reflections on Brighton ASM 2023

One of my take-away thoughts from the SAPC annual scientific meeting in Preston last year was how great it was to see people again in real life. Although I think that most of us are spending a bit more time in the office, sitting in front of Microsoft Teams continues to account for a substantial proportion of our days. I for one certainly don’t need any excuse to get away from a screen. The opportunity to head off to the beach at Brighton to discuss academic matters with like-minded individuals at the SAPC Annual Scientific Meeting was therefore something I’ve been looking forward to for some time.

The Hilton Metropole was a rather grand affair, looking out over the sunny seafront. Most of Tuesday was spent in meetings, with several well-attended SIG meetings in the later afternoon, and some of our more senior members heading to Brighton’s Shelter Hall food market for dinner in the evening. Day one proper opened on the Wednesday on the topic of informed and inclusive primary care. The Health Foundation’s Becks Fisher gave the opening keynote of the conference, highlighting the extent of socioeconomic inequality in general practice, and the failure of Government policy to reverse the inverse care law, despite evidence that change can be achieved. This was followed by excellent presentations from two charitable organisations who work to address inequalities facing marginalised groups, specifically the travelling community and the gender-variant community. The extent of prejudice and ignorance that these groups face was laid truly bare, and some of the statistics presented in support of this were simply awful. A strong case was made of the need for improved access to and delivery of healthcare services, supported by better policy. However, I felt that the session didn’t really answer the big question of how exactly the academic primary care community might help address inequalities: a missed opportunity perhaps?

The opening keynote on day two was the Helen Lester memorial lecture delivered by Glasgow’s Andrea Williamson. She discussed the importance of “missingness” in healthcare, highlighting who is affected (for example, the most deprived or the oldest old), the adverse associations (strikingly higher and earlier mortality in people who miss appointments compared to those of similar health that do not), and the fact that the easy solutions we might first jump at (such as sending reminders) are less effective than more difficult solutions (particularly improving access). Of course, most clinicians are used to a few people not turning up to appointments. But I suspect as doctors we fail too often to consider the negative consequences of this, and I certainly confess to a sigh of relief at such an unexpected chance to catch up with my over-running surgery. I think I will be considering my “DNAs” a little differently in future, and indeed was left contemplating how we could leverage such findings to improve care for people in my own practice.

Aside from the plenary events, there was a great range of parallel sessions over the two days, and I had a sense that the conference theme was perhaps better embedded than I have seen in previous years, when it is often limited to keynotes. The standard of research was generally strong, and as always I was often torn as to which session I might attend. Several presentations did stand out: in particular, the as-yet unpublished findings of the ATLANTIS trial were really interesting for their relevance to practice (watch this space), and various novel methodologies were reported including a story-telling co-design approach to developing solutions for the complex and “wicked” problem that is polypharmacy, and the brilliant collaborative research initiative that is PACT.

In my role as SAPC co-chair, I spent more time than usual this year reflecting on what might we do differently next time. It was a little disappointing that some of the key talks were recorded, including the opening keynote and a few of the award winners (although one could hardly blame the fantastic medical student elective prize winner, Ioan Wardhaugh, for not wanting to miss his graduation as a new doctor). Despite the pressure to increase accessibility, I think it is important we do not lose sight of the invaluable role that post-presentation questions play in challenging speakers, providing greater scientific insights, and generating new ideas. A number of presentations also seemed to forget that this is an academic audience, and not a clinical one; it’s something that unfortunately happens most years, but risks marginalising our PHoCuS members. Additionally, I remain unconvinced by 6-minute presentations – too long for an elevator, too short to be comprehensive – and electronic posters just don’t feel as accessible to be as traditional paper. I recognise others disagree with these perspectives though; perhaps I’m just getting old. One thing I suspect most would not dispute was that the break from a traditional meal didn’t work very well, with some people even resorting to a kebab shop for sustenance. The hilarious sight of flurries of hungry academics charging after a waiter carrying a tray of nibbles, and stripping it bare in seconds like a swarm of locusts, is one that will stay with me for some time!

In spite of my whinges, there was an unquestionable positive buzz and energy about Brighton. The networking space seemed to work particularly well (and had great food too – an added bonus), and I saw a lot of new faces – an optimistic sign for the future. So hopefully we can continue to build on what has overall been a very successful event, and look forward to an exciting summer in Bristol in 2024.

Rupert Payne

SAPC Co-chair, July 2023