I am a Consultant Orthopaedic Surgeon, working at Eastbourne DGH, UK. I qualified as a doctor in 1989 and have additional degrees in Clinical Education (MA) and Health Service Management (MBA). I have been a Council member of the Royal College of Surgeons of England since 2011 and Deputy Director of the Centre for Perioperative Care since January 2020.

• DIVERSITY: I have been involved in Women in Surgery and other initiatives to increase diversity, reduce bullying and reduce unconscious bias.
• DOCTORS’ ASSISTANTS: Developing NHS staff at Band 3 (not Registered, with HealthCare Assistant experience) to improve the efficiency of doctors’ time and improve patient care. This needs clear tasks and support. We won prizes for this.
• EXERCISE: The human machine needs to be active. Most NHS spending is on diseases with a large preventable component. Exercise works as both primary prevention (reducing the risk of ever getting common conditions) and as treatment – reducing the risks of complications of existing conditions. Our BMJ article ‘Focus on physical activity can help avoid unnecessary social care’ shows how much the UK economy and citizens would benefit if people understood that getting old and getting unfit are two different processes and that getting unfit is reversible. I was a co-founder and first Chair of bespokecyclegroup.org.uk aiming to support more people cycling in Eastbourne.

Changing behaviour needs a way of building up small changes into a new normal habit. For each person to be active needs: small goals, a plan for failure, the people around them to help and an environment that allows activity. There are parallels with supporting individuals to be their best future self in any sphere. This needs:

• Clarity of role or direction
• Support and respect from those around them
• And some infrastructure