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Relative to so much of the rest of the world, Australia and Aotearoa New Zealand are in strong positions in the ongoing global pandemic. As our thoughts remain with those who have been impacted by the disease locally and perhaps lost loved ones – as well as our international colleagues contending with surging case numbers – it is timely to reflect on what has gone well in our two countries and appreciate the position in which we are fortunate to find ourselves.

We all acknowledge the significant effects of the second wave in Melbourne that started in June, with austere community restrictions (lockdowns) in response to large case numbers and deaths from July to the end of October, putting all Victorians under the pump. 

However, with the recent consecutive days of zero new cases and a week of no fatalities in Victoria – then brought to an end by new, but low numbers of cases detected, and sadly two more deaths – I am sure you will share my gratitude and some relief at how far we have come from peaks of more than 700 cases per day.

Thanks must go to the Victorian community and our truly excellent Emergency Medicine workforce for their hard work under pressure, and the immense sacrifices that have been made to help us get to where we are. As we expect more freedoms to be gradually introduced, and more steps taken towards the reopening and re-connecting of our states and even our two countries, we are thankful for the heavy lifting which has been carried out by so many.

While threats and challenges remain, we hope to now enter a more manageable phase. In this context we must also maintain focus on systemic improvements to our healthcare systems, seizing on the opportunities that a renewed focus on the cooperation and importance of public health, that this pandemic has brought.

As a College, while we have faced and addressed many immediate pandemic-related issues, our work seeking long-term change and improvements has also continued.

Following the release in September of the Nowhere Else to Go report, and the coinciding national webinar which examined solutions to the crisis in Australia’s mental healthcare systems, a series of jurisdiction-specific webinars are now underway.

These events, bringing together key stakeholders in our mental healthcare systems – Emergency Physicians, consumers, paramedics, nurses, psychiatrists and government representatives – commenced in Tasmania in mid-October, with further events planned for Western Australia and South Australia on 6 and 19 November respectively.

We welcome the strong engagement and responses we have received to date. As we continue to seek genuine and lasting systemic improvements to our mental healthcare systems, it is crucial that all who use, interact with, work in and administer our systems, have genuine buy in. This consultative approach continues to inform our important mental health advocacy.

Another important issue on which the College is currently seeking the views of members and trainees is the Emergency Medicine workforce of the future, and the College has recently released The Future of the Emergency Medicine Workforce: Issues Paper.

With feedback open until 16 December 2020 this is an important opportunity for you to tell us what you think the future Emergency Medicine workforce should look like.

Geographic maldistribution, an ever-increasing number of doctors wishing to train in Emergency Medicine, the need to maintain high-quality training environments, and the ability to provide safe, sustainable career options are just some of the issues currently facing our specialty; so we are eager to hear your views and ideas.

The College’s Workforce Planning Committee will review the feedback provided before preparing a series of proposals, which will  be released for a second round of consultation, including to external stakeholders.
Based on this feedback, the Committee will then make a final set of recommendations to the ACEM Board. Please do take this opportunity to have your say on this important piece of work.

Another big-ticket advocacy item fast looming, is the launch of College work on recommended revisions and improvements to ED metrics including time-based targets. The introduction of such targets over 10 years ago, represented a major shift in our work, bringing many benefits, as well as some unintended consequences. As with any system-related work, we should always be looking to review and improve. The upcoming work is the result of extensive consultation, and will form the basis of much future advocacy work into 2021 and beyond.

The approaching year’s end by no means represents a slowing down in College activity. In what has been a tumultuous 2020, with all College staff working from home since 30 March, extensive ongoing work is underway for our reignited College examinations, and we continue to keep our trainees – who have shouldered so much additional uncertainty this year – updated with the latest in relation to arrangements.

November also marks the first time the College’s Annual Scientific Meeting (ASM) will proceed on an entirely ‘virtual’ basis. This year’s theme is No Going Back - An Opportunity to Redefine the Role of Emergency Medicine. My thanks go to the College Fellows and staff involved in preparations, as well as the exceptional range of speakers who will feature.

While we will not be able to catch up in person, the 2020 ASM will be a great opportunity to hear about the latest perspectives and issues confronting Emergency Medicine, as well as reconnecting socially with colleagues online.

The virtual conference will also provide opportunities in terms of additional flexibility to attend, and I encourage all members and trainees to make the most of this by familiarising themselves with the program and registering.
Amid all the official and formal College business currently underway, it has also been heartening to note the many achievements and activities which our members and trainees have been involved in and recognised for, this year.

From prestigious international accolades or prizes, to individual localised improvement or reform projects, to contributing to College and broader community COVID-19 guidelines and to wellbeing initiatives, there are too many to list individually.

But as emergency clinicians who have faced down one of the most intense and stressful years of our professional and personal lives, we should all take inspiration, be proud and celebrate the incredible work that is achieved every day in our field of Emergency Medicine.

My gratitude to all of you, for all that you have contributed and continue to give.

Dr John Bonning
ACEM President