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Support services for pharmacists and doctors in the United Kingdom – Part 3 Royal Medical Benevolent Fund

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Kay Dunkley - BPharm, Grad Dip Hosp Pharm, Grad Dip Health Admin, MPS, MSHPA articles by this author...

Kay Dunkley is a pharmacist who has worked in hospital and organisational pharmacy for over 20 years.  She has a broad experience working in public hospitals and in providing support to health professionals through government funded bodies and professional organisations.  Kay also has a strong interest in the health and well being of health professionals and especially the role of peer support.  Kay first became involved as a volunteer with the Pharmacists’ Support Service, a group which has been providing telephone support for pharmacists in Victoria since 1995.  In 2005 Kay became the Program Coordinator for the Pharmacists’ Support Service and has assisted the service to become an independent organisation which is currently seeking to expand to provide support to pharmacists throughout Australia.  In 2007, when AMA Victoria approached the Pharmaceutical Society of Australia (Victorian Branch) with a view to establishing their own Peer Support Service; Kay accepted an invitation to assist.  The AMA Victoria Peer Support Service commenced operation in February 2008.  Kay currently coordinates both of these services and also works part-time as a consultant pharmacist in Residential Care Facilities.

In Australia the Pharmacists’ Support Service (PSS) provides a listening ear and support over the telephone to pharmacists in Victoria, Tasmania, South Australia and the Northern Territory and has plans for expansion to all states of Australia.  The medical profession in Australia has a range of state based Doctors’ Health Advisory Services including the AMA Victoria Peer Support Service which provides peer support over the telephone.  Victorian is the only state to have a state based health program for doctors; the Victorian Doctors Health Program (VDHP). Funding from the Cyril Tonkin Fellowship enabled me to undertake a study tour of services which support pharmacists and doctors in the United Kingdom (UK) in March 2011.
The aim of the visit was to find out how these services support the health and well being of pharmacists and doctors, including the services provided and how they are funded.

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The support services visited were Pharmacist Support, including participation in a Listening Friends training weekend; the Royal Pharmaceutical Society; the Practitioner Health Programme; the Royal Medical Benevolent Fund; the British Medical Association Doctors for Doctors program and the National Clinical Assessment Service.  In addition to obtain background material on the environment for health professionals in the United Kingdom visits were also made to the General Pharmaceutical Council; Manchester University School of Pharmacy and Pharmaceutical Sciences and the Pharmacy Department of the Central Manchester University Hospitals NHS Foundation Trust.

This article is the third in a series reporting on my visit and will detail the services available to doctors through the Royal Medical Benevolent Fund. 

Royal Medical Benevolent Fund

http://www.rmbf.org/

The Royal Medical Benevolent Fund (RMBF) was established in 1836.  The RMBF was set up by doctors to help colleagues and their dependents in need.  Support ranges from specialist information and advice to financial assistance. 

Funding for RMBF comes from legacies, donations, subscriptions (membership), fundraising and investments providing good returns.

The support offered by RMBF to doctors in the UK includes:

* Financial Support
* Area visitors
* Information and advice
* Telephone befriending

RMBF had 11 employed staff members in March 2011 at the time of my visit with a mixture of part time and full time positions and a large team of volunteers including local areas visitors who work closely with the case workers.

Volunteers

The RMBF has an extensive network of volunteers who participate in the following roles:

1. Area visitors

* They are the eyes and ears of the fund who visit beneficiaries at home.
* More doctors than non-doctors, the non-doctors are usually partners of doctors.
* At the time of the visit (March 2011) there were 130 area visitors.  They work in isolation.  They are given OH&S guidelines regarding their role but at present there is no check in/check out systems in place when they are making visits.

2. Guild Officers

* Organise events and undertake fundraising activities.
* Often partners and family members of doctors.

3.Medical Liaison Officers

* These are practising doctors or recently retired doctors who act as charity ambassadors.

4. Telephone befrienders.

The RMBF has public liability insurance for volunteers (covers until 78 years of age).

Financial Support for doctors or their dependents

An application for assistance is initially assigned to a case worker.  The basic criteria for eligibility includes General Medical Council registration (at some time) and participation in the NHS for at least one year.  Refugee doctors are given a one off lump sum of £3000.  Traditionally applications have come more from the widows and families of doctors but now more applications are coming from younger doctors in difficult circumstances e.g. critical illness, substance abuse or mental health issues.

A local area visitor is matched to a potential beneficiary and provided with a full briefing.  The local area visitor makes an appointment with the potential beneficiary and visits.  The local area visitors are equipped with a visiting template which acts as an aid de memoire so that when visiting they can obtain and report on the whole picture of the situation e.g. state of the house, access to transport, additional support required etc.  Each package of help is thus individualised with the aim of promoting the independence of the beneficiary.  However in some cases bills may be paid directly for the beneficiary, especially of there is a concern that the money may be diverted.

The RMBF aims to support the beneficiary to return to work whenever possible.  The case worker also looks at other sources of assistance for which a beneficiary may be eligible and other possible sources of support such as family.  The case workers consider issues such as available transport options and other practical difficulties.  The area visitor provides a report which is vital in decision making with respect to the support that RMBF offers.  The case workers ensure that beneficiaries are getting all state benefits and a freelance money and debt management expert assists with consolidating debts and working out repayment terms.  The Case Committee meets alternate months to make a decision on applications and in between the Chairman can approve £1000 immediately.  If ongoing support is required the case workers can request another visit by the local area visitor every six to twelve months.  The RMBF also provides birthday and Christmas cards and cheques to beneficiaries to enable them to celebrate these events.

Some of the financial support is given as a loan. There is no interest on the loan and there is discretion about the time frame etc of repayments. 

Information and advice for doctors and medical students

The case workers can be contacted for information and advice.  There is also excellent and extensive information and advice available through the following websites:

Support4Doctors website http://www.support4doctors.org/

* Aim for prevention of crisis through provision of information and resources. * Information on career issues, education and training, work-life balance, mental and physical health and practical and financial issues.

Money4MedStudents http://www.money4medstudents.org/index.asp?id=1

* Information and advice about managing finances including a link to lodge an enquiry with an independent money advisor.

Telephone befriending

The RMBF had nine active volunteer befrienders with eleven relationships in March 2011 when I visited.  The befrienders provide a professional friend who is non-judgemental and impartial.  The befriending service is available to doctors and their partners and is primarily for beneficiaries.  The befriender makes the initial call and it is at their discretion whether they give out their phone number or not to the beneficiary.  The frequency of contact is up to the volunteer and the beneficiary.

Medical Liaison Officers (MLOs):

* Role as charity ambassadors, aim to raise awareness of the charity.
* Usually consultants in particular specialty or GP principals.
* In March 2011 had 71 MLOs but aiming for 80 by March 2012.
* Have a representative in every single region and most specialties.
* Network and promote charity in both formal and informal ways.
* MLOs are also used to provide feedback to the charity.
* There is an annual MLO networking and feedback day.
* New MLOs are inducted two or three times a year.

Promotion of the RMBF

The MLOs have a significant role in promoting the RMBF.  They are equipped with promotional material and asked to speak about the RMBF at a range of forums for doctors.

Other organisations support the promotion of the RMBF.

In the UK the three main Medical Defence Organisations (MDOs) are:

* Medical Defence Union.
* Medical Protection Society.
* Medical & Dentists Defence Union of Scotland (MDDUS).

All three circulate flyers about the RMBF to their members.

Australia

In Australia the availability of benevolent funds and services for doctors and for pharmacists is usually on a state basis and is not universal.  The services that are available are also not nearly as well developed or as prominent as the RMBF.  This is particularly the case for the Australian pharmacy profession. 

My vision for the Pharmacists’ Support Service in Australia includes:

* National telephone and online support for pharmacists.
* Face-to-face support for pharmacists in all states of Australia.
* National Benevolent Fund for all Australian pharmacists.
* Referral service for pharmacists to mental health, drug and alcohol services in all states of Australia.

For the Pharmacists’ Support Service to further expand in Australia we need to secure adequate ongoing funding.  The pharmacy profession can assist the Pharmacists’ Support Service to meet the needs of pharmacists throughout Australia through tax deductible donations.  Anyone wishing to support the work of the Pharmacists’ Support Service by making a donation should direct their donation to Pharmacists’ Support Service c/o 381 Royal Pde, Parkville 3052.  Donations can also be made over the phone using a credit card through the PSA (Victorian Branch) office on (03) 9389 4000 or by direct deposit into the Pharmacists’ Support Service bank account BSB 083155 and account number 481820199 (please include a name and contact details so that a receipt can be issued).

Pharmacists requiring assistance can contact the Pharmacists’ Support Service for anonymous and discreet support on 1300 244 910 between 8.00 am and 11.00 pm every day of the year.

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