Abi Rimmer

There are strategies you can use to help advance your career despite feeling like you don’t fit in, Abi Rimmer hears ### Kath Higgins #### Consultant in diabetes medicine and founder of Leicester Women in Medicine “I answer this question from the perspective of a woman in medicine. Often the problem is framed around fixing the individual. But the ability to progress is less often about individual capability and more about culture and structures. Think about what is impacting you and your progress. Name the factors. “Many women recognise a gap between knowing what is right and feeling able to speak or act on it. Power, hierarchy, and culture can create that gap. Notice when you hold back—what’s behind that? “Power and hierarchy can lead to people staying silent, being over-accommodating, or hesitating to challenge. Consider the dynamics, systems, or biases that are contributing to the feeling that you need permission to act. “Being ready to progress is often judged through a cultural lens—shaped by biases, visibility, and expectation. Women may question their own readiness to advance in their career despite their capability. Practise naming your own readiness. Have confidence …

There are strategies you can employ if you think a senior colleague might have narcissist tendencies, Abi Rimmer hears ### Michael El Boghdady #### Surgeon and medical educator “Most of us have worked with someone who seems highly self-confident, craves recognition, and struggles to accept criticism. It is tempting to label such a person a ‘narcissist,’ but personality traits exist on a spectrum, and narcissistic personality disorder is a clinical diagnosis that should only be made by appropriately qualified professionals. “Rather than focusing on labels, pay attention to persistent patterns of behaviour over time. Does your boss consistently take credit for others’ work, react defensively to constructive feedback, or seem more focused on personal recognition than team success? Whatever the underlying personality, repeated behaviours such as these can undermine trust, reduce psychological safety, and contribute to a toxic working environment. In our study of surgeons, higher narcissism scores were associated with greater hostility and perceived stress, particularly when facing challenging situations.1 “If these patterns are present, the goal is usually not to change their personality but to adapt how you work with them. “Keep communication factual and concise. Document important decisions where appropriate. Present ideas in ways that emphasise shared goals and organisational priorities rather than seeming to challenge their authority personally. “Maintaining professional boundaries is equally important. Avoid …

It is possible to display emotions while remaining professional, Abi Rimmer hears ### Charlotte Smith #### Senior clinical fellow in emergency medicine “I’m not afraid or embarrassed to admit that I have cried at work on many occasions; through sadness, relief, despair, anxiety, exhaustion, and the many more different emotions that come with being a resident doctor in the NHS. Ultimately, to cry is to be human, and being human is central to being a doctor. “Having said that, context is clearly important. As an emergency medic, I am quite often faced with emotive or tragic cases, and while most of these pass by with professional detachment, there will always be some that for one reason or another leave a particular mark “While debriefing as a team in the immediate aftermath can be really helpful and should be encouraged, I often find that the real processing doesn’t happen until sometime later, when the dust has settled and private tears are shed in a quiet corner. This is totally normal. These tears remind us that we care, and caring is at the heart of our profession. “There have also been times that I’ve cried at work from overwhelm, frustration, and tiredness. While crying is a very legitimate response to all these situations, if you’re regularly crying because of overwhelming workload, lack of support, or bullying, it might be time to look at ways of tackling these problems, especially if the emotion is coming out during the working day. “In the shorter term, however, a quick five minute reset with a snack, a drink, and a walk down the corridor can often be hugely beneficial when it all feels like too much. And please, do let someone know if you’re struggling; medicine is hard, and no one need suffer alone.” ### Aaliya Goyal #### GP and occupational health doctor “Tears at work can be a response to genuine distress, and doctors …

An online memorial wall for health and care workers who have died by suicide has been launched by NHS Practitioner Health. Since 2011 more than 2500 healthcare workers in the UK have died by suicide, an average of four a week.1 According to some estimates one doctor dies by suicide every three weeks in the UK.2 The online memorial wall aims to serve as a permanent space for colleagues, friends, and families to share photographs and memories of health and care workers who have taken their own lives. 3 NHS Practitioner Health is a specialist mental health and addiction service for doctors. In addition to the memorial wall it has launched a new webpage dedicated to providing messages of hope. Helen Garr, medical director at NHS Practitioner Health, said she believed the online memorial wall—launched on the third annual National Suicide Memorial Day for Health and Care Workers—is the first of its kind. …

Short term planning and funding and excessive regulation are holding back NHS productivity, a report by the Health Foundation thinktank has warned. The 88 page document argues that better use of technology and staff could save the NHS in England £33bn a year by 2040.1 This is equivalent to roughly £33bn a year in today’s prices, the commission said—around £460 for every person in the country. By 2050-51, this figure would be £83bn a year or £1130 per person, it said. It also suggested that improving NHS productivity could save over 20 000 patient lives each year, and people could spend up to 4.5 additional years in good health. The report’s authors did not specify particular disease areas where deaths could be reduced but suggested that improved diagnostic times for conditions such as cancer could make a difference. In the report, the authors also bemoaned how “short termism” was holding the NHS back. “Planning in the health service is too short term and unstable,” they wrote. Later they added: “Funding is often fragmented, short term and tightly controlled, with multiple pots, late allocations and rules that …

There are a variety of ways you can gain skills as a resident doctor, Abi Rimmer hears ### Sandip Patel #### Consultant in emergency medicine “Looking back to the early 1990s, when I was a freshly minted doctor, I have been reflecting on how I developed my leadership skills. I realise that watching the way consultants treated us doctors in training showed me what leadership should and shouldn’t look like. “Being reprimanded by a consultant for being late to the ward round, for example, or, as on one occasion, for not wearing a tie after a 24 hour duty shift, left me mortified—and clear about what sort of leader I didn’t want to be. “But I also noted when a consultant took care to speak to patients, sat next to them, held their hand, gave them a chance to ask questions, and took the time to explain what was going on. “Later, as an emergency medicine senior house officer, I learnt leadership skills from the boss who took the time to teach us key topics …

NHS England has commissioned an external review of the controversial Advice and Guidance (A&G) scheme. In August, a report from the national patient safety watchdog identified multiple failings with the system, including one case in which a patient died after a delayed response.1 The A&G scheme, established in 2015, is designed to reduce unnecessary referrals by allowing GPs to seek advice from a hospital consultant before making the decision to refer a patient. But it became a source of dispute earlier this year when NHS England announced that, as part of changes to GP contracts, seeking advice would become mandatory for every GP referral to selected specialties. The BMA warned the move could put …

NHS trusts in England made nearly £87m from charging staff to park last year, in what doctors’ leaders described as a “stealth tax” on the profession. Official data show that the income trusts in England received from staff parking increased by 9% during 2025-26, with trusts receiving £86.6m in 2025-26, compared with £79.1m the previous year.1 University Hospitals Coventry and Warwickshire made the most income, £3.8m, from staff car parking during 2025-26. The trust also had the highest income from patient and visitor car parking, at £6.4m. A spokesperson for University Hospitals Coventry and Warwickshire NHS Trust said, “A large proportion of our car parks form part of a private finance initiative contract and, as a result, we generate minimal car park revenue directly from staff, patients, or visitors. “Money generated goes towards essential running costs of the car parks and the surrounding areas, including maintenance, security, lighting, improvements, and increased capacity.” Manchester University NHS Foundation Trust made the second most income, £3.6m, from staff car parking during 2025-26. The trust also …

Temperatures inside NHS buildings reached more than 41°C this summer, so how can the health service cope with hotter heatwaves? Research suggests that British summers could reach 45°C by 2056.1 The effects on health of this kind of heat is stark. In May the government’s UK Climate Change Committee (CCC) warned that heatwaves in 2050 will see 92% of UK homes overheat, creating “dangerous conditions for vulnerable people.”2 The committee also warned that the 2°C global average temperature increase expected by 2050 could triple heat related hospital attendances and admissions. In summary, no. A 2025 report from the UK Health Alliance on Climate Change warned that the NHS was dangerously ill equipped to combat rising temperatures.3 It pointed out that more than 90% of NHS buildings in England are vulnerable to overheating, with some hospital wards recording indoor temperatures above 30°C even when outdoor temperatures were just 22°C. Data from NHS trusts in England showed that one hospital recorded an indoor temperature of 41°C this June, with several others reaching the high 30s.4 NHS England recommends that wards should not exceed a temperature of 28°C—or 25°C in sensitive areas such as recovery or birthing rooms. An obvious solution is air conditioning. But this should be a last resort, says Bob Ward, policy and communications director at the Grantham …

Receiving an unpleasant email can be unsettling, so give yourself time before responding, Abi Rimmer hears ### Deborah Fradkin #### Consultant paediatric anaesthetist and civility educator “Ask yourself three questions: did they intend to be rude? What impact will I allow this to have on me? And what resolution do I want? “Kruger and colleagues found that we overestimate our ability to interpret email communications, especially discerning the sender’s intended emotions and tone.1 Our own emotions at the time of reading are the strongest determinant of how we receive written information. Recognising that your immediate response may be an inaccurate reflection of the email’s intention is a difficult, but powerful, step to avoid miscommunication. Firstly, assume positive intent. “If your initial interpretation of rudeness stands, the next step is to choose how you let it affect you. In their book Unstressable , Mo Gawdat and Alice Law explore emotional intelligence, understanding, and managing our emotions to limit the detrimental effect of rudeness.2 Communication expert Jefferson Fisher’s ‘make breath your first word’ is a powerful response.3 Breathe. A deep breath triggers our vagus nerve, slowing our heart rate and allowing the logical brain to engage. By remaining calm, we have a level head to respond, avoiding the double insult—the inner turmoil compounding the insulting email. “So, we’ve decided there isn’t an alternative interpretation, and we’ve put ourselves in the calmest mindset to manage it, now to choose the resolution we want. Yes, we have a choice. “A ‘reply all’ call out of the outlandish behaviour may feel satisfying in the moment but risks you being interpreted as rude, escalating the hostility. Rising …