Tribute: Professor Sir Neil Douglas, eminent Scottish surgeon

Neil James Douglas MB ChB, MD, DSc, FRCP, respiratory physician. Born: 28 May 1949 in Edinburgh. Died: 23 August 2020 in Edinburgh, aged 71

Prof Sir Neil James Douglas was an expert on sleep and breathing

Neil Douglas was born in Edinburgh, the second of four children. His father, Professor Sir Donald Douglas, became President of the Royal College of Surgeons of Edinburgh and his mother Di was a superb full-time homemaker. He was brought up in Dundee and educated at Dundee High School and Glenalmond College. This was followed by preclinical medicine at St Andrews University and clinical studies in Edinburgh. He graduated with distinctions in medicine, surgery and therapeutics. An academic career beckoned: David Flenley had succeeded Sir John Crofton as Professor of Respiratory Medicine in Edinburgh and this laid the foundations for Douglas to train in an internationally respected unit.

He became a specialist in respiratory and sleep medicine who built an international reputation both personally and for the Department of Sleep Medicine in Edinburgh. He was also heavily involved in teaching and training as President of the Royal College of Physicians of Edinburgh and founding Chairman of the UK Faculty of Medical Leadership and Management.

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Neil Douglas trained as a respiratory physician and became interested in sleep apnoea, a previously under-recognised condition in which patients have interruption of their breathing patterns during sleep. This causes excessive daytime sleepiness and affects quality of life, cardiovascular health and safety – in particular when driving. Many in the UK were sceptical about sleep apnoea and he remembered being told that he was joining the lunatic fringe by trying to establish this in the UK. Through research in Edinburgh and Denver, Colorado, he investigated the causes and consequences of the syndrome, its diagnosis and its management using Continuous Positive Airways Pressure (CPAP). This relatively simple treatment keeps the airways open using air pressure applied by a pump through a face mask worn overnight. It has proven highly cost-effective and is now used all over the world. Modified versions of CPAP machines have been used in the treatment of respiratory failure as a result of Covid-19. In 1994 he published a randomised controlled trial of the effectiveness of CPAP which led to acceptance of the concepts and benefits of treatment, and funding from the NHS became available to develop it. Lamenting that sleep was barely taught in the undergraduate curriculum he published “The Clinicians Guide to Sleep Medicine”. He established the Edinburgh Sleep Centre which brings together the University and NHS and continues to do outstanding, world-leading research and handle the clinical care of patients with disordered sleep. Douglas was Director from its inception until his retirement in 2012.

In addition to his very busy academic and clinical career he was active in the medical political sphere. As a student he was President of the British Medical Students Association and went on to chair many important bodies. He held various posts in the Royal College of Physicians of Edinburgh, culminating in him being the longest serving President (from 2004-2010). As College President he was a member of the UK-wide Academy of Medical Royal Colleges, becoming Chairman from 2009-2012. It was during this time that a major national problem arose in the placement of junior doctors into training posts across the UK. The Medical Training and Assessment System was widely acknowledged to be a disaster, leaving many young doctors without jobs and many posts unfilled. He was asked by the Government to sort this out and did so with his forensic scientific and analytic skills, coupled with superb diplomacy.

As Chairman of the Academy of Medical Royal Colleges, he persuaded the Academy to establish, in 2011, a Faculty of Medical Leadership and Management hosted by the Royal College of Physicians of London. Douglas was the inaugural Chairman, and with Peter Lees grew the organisation. It now has 2500 members and 190 Fellows, publishes and accredits training programmes and supports young doctors to gain the skills and knowledge to lead clinical services effectively. In this, as in all his roles, he was driven by his staunch support for the NHS and his determination to enhance patient care.

His clinical mentors included Andrew Douglas and Norman Horne. Both were patient-focussed clinicians who also encouraged research of real clinical relevance, an ethos adopted by Douglas throughout his career.

He was an excellent doctor who gave patients the time and care they demanded. He was modest, approachable and gave praise where it was due, and in the many tributes to him, “integrity” was the most frequently used word. A man of enormous energy, he was in great demand to lecture all over the world. On one occasion he was invited to a prestigious meeting in Australia to give the keynote lecture. Unfortunately at the last minute he discovered that the authorities in Edinburgh wanted to close his sleep unit. Being a man of honour he flew to Australia for the day and returned to successfully defend his unit.

He received a knighthood in 2009 for services to medicine. He married his wife Sue (Galloway) in 1977 and she is a retired GP. They have a son and a daughter. Sandy is a pharmaceutical physician and one of the leaders of the University of Oxford Covid 19 vaccine development team. Kirsty is a trainee in palliative care medicine, sharing her father’s emphasis upon high standards of clinical care and training.

When his busy schedule allowed he loved to retreat to the retirement house which he and Sue built on the banks of Loch Tay, gardening, hill-walking and fishing. He regarded his family and his home as his greatest achievements.

Neil Douglas was born in Edinburgh, the second of four children. His father, Professor Sir Donald Douglas, became President of the Royal College of Surgeons of Edinburgh and his mother Di was a superb full-time homemaker. He was brought up in Dundee and educated at Dundee High School and Glenalmond College. This was followed by preclinical medicine at St Andrews University and clinical studies in Edinburgh. He graduated with distinctions in medicine, surgery and therapeutics. An academic career beckoned: David Flenley had succeeded Sir John Crofton as Professor of Respiratory Medicine in Edinburgh and this laid the foundations for Douglas to train in an internationally respected unit.

He became a specialist in respiratory and sleep medicine who built an international reputation both personally and for the Department of Sleep Medicine in Edinburgh. He was also heavily involved in teaching and training as President of the Royal College of Physicians of Edinburgh and founding Chairman of the UK Faculty of Medical Leadership and Management.

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Neil Douglas trained as a respiratory physician and became interested in sleep apnoea, a previously under-recognised condition in which patients have interruption of their breathing patterns during sleep. This causes excessive daytime sleepiness and affects quality of life, cardiovascular health and safety – in particular when driving. Many in the UK were sceptical about sleep apnoea and he remembered being told that he was joining the lunatic fringe by trying to establish this in the UK. Through research in Edinburgh and Denver, Colorado, he investigated the causes and consequences of the syndrome, its diagnosis and its management using Continuous Positive Airways Pressure (CPAP). This relatively simple treatment keeps the airways open using air pressure applied by a pump through a face mask worn overnight. It has proven highly cost-effective and is now used all over the world. Modified versions of CPAP machines have been used in the treatment of respiratory failure as a result of Covid-19. In 1994 he published a randomised controlled trial of the effectiveness of CPAP which led to acceptance of the concepts and benefits of treatment, and funding from the NHS became available to develop it. Lamenting that sleep was barely taught in the undergraduate curriculum he published “The Clinicians Guide to Sleep Medicine”. He established the Edinburgh Sleep Centre which brings together the University and NHS and continues to do outstanding, world-leading research and handle the clinical care of patients with disordered sleep. Douglas was Director from its inception until his retirement in 2012.

In addition to his very busy academic and clinical career he was active in the medical political sphere. As a student he was President of the British Medical Students Association and went on to chair many important bodies. He held various posts in the Royal College of Physicians of Edinburgh, culminating in him being the longest serving President (from 2004-2010). As College President he was a member of the UK-wide Academy of Medical Royal Colleges, becoming Chairman from 2009-2012. It was during this time that a major national problem arose in the placement of junior doctors into training posts across the UK. The Medical Training and Assessment System was widely acknowledged to be a disaster, leaving many young doctors without jobs and many posts unfilled. He was asked by the Government to sort this out and did so with his forensic scientific and analytic skills, coupled with superb diplomacy.

As Chairman of the Academy of Medical Royal Colleges, he persuaded the Academy to establish, in 2011, a Faculty of Medical Leadership and Management hosted by the Royal College of Physicians of London. Douglas was the inaugural Chairman, and with Peter Lees grew the organisation. It now has 2500 members and 190 Fellows, publishes and accredits training programmes and supports young doctors to gain the skills and knowledge to lead clinical services effectively. In this, as in all his roles, he was driven by his staunch support for the NHS and his determination to enhance patient care.

His clinical mentors included Andrew Douglas and Norman Horne. Both were patient-focussed clinicians who also encouraged research of real clinical relevance, an ethos adopted by Douglas throughout his career.

He was an excellent doctor who gave patients the time and care they demanded. He was modest, approachable and gave praise where it was due, and in the many tributes to him, “integrity” was the most frequently used word. A man of enormous energy, he was in great demand to lecture all over the world. On one occasion he was invited to a prestigious meeting in Australia to give the keynote lecture. Unfortunately at the last minute he discovered that the authorities in Edinburgh wanted to close his sleep unit. Being a man of honour he flew to Australia for the day and returned to successfully defend his unit.

He received a knighthood in 2009 for services to medicine. He married his wife Sue (Galloway) in 1977 and she is a retired GP. They have a son and a daughter. Sandy is a pharmaceutical physician and one of the leaders of the University of Oxford Covid 19 vaccine development team. Kirsty is a trainee in palliative care medicine, sharing her father’s emphasis upon high standards of clinical care and training.

When his busy schedule allowed he loved to retreat to the retirement house which he and Sue built on the banks of Loch Tay, gardening, hill-walking and fishing. He regarded his family and his home as his greatest achievements.

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