Professor Sir Neil Douglas was 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 the founding Chairman of the Faculty of Medical Leadership and Management.
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 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. 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.
Figure 1 Professor Sir Neil Douglas
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. 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 facemask worn overnight. It has proven highly cost-effective and is used all over the world. Modified versions of CPAP machines were used in the treatment of respiratory failure as a result of the COVID-19 pandemic. He established the internationally famous Edinburgh Sleep Centre which brought together the University and NHS and which did outstanding world leading research as well as clinical care of patients with disordered sleep. Douglas was the Director from its inception until his retirement in 2012. He felt that one of his greatest achievements was to obtain secure funding from the NHS for the sleep service and CPAP therapy for patients in Scotland. There is no doubt that many people across the globe benefitted from the inspirational work of Neil Douglas as a clinical scientist. He was responsible for getting sleep apnoea into mainstream academic and clinical thinking where there had previously been much scepticism as to its importance. He worked closely with others including John Stradling in Oxford who had great respect for Douglas’s intellect and drive and they were both involved in ensuring that sound randomised trials were undertaken in an area which had previously been driven by anecdote. He was a giant in his field and contributed more than most to its advancement. He trained and inspired many young doctors who successfully carried forward his legacy.
In addition to his very busy academic and clinical career he was active in the medical political arena. 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 (MTAS) was widely acknowledged to be a disaster, leaving many young doctors without jobs and many posts unfilled. He was asked by the UK Government to sort this out which he did 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. By 2020 it had 2300 members and 160 Fellows, published and accredited training programmes and supported 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.
He was an excellent caring doctor who gave patients the time and attention which they deserved. He was modest, approachable and gave praise freely where it was due, and amongst the many tributes after his death 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 world famous sleep unit. Being a man of honour he flew to Australia for the day and returned to successfully defend his unit.
He married his wife Sue (Galloway) in 1977 and she was a GP. They have a son and a daughter. In 2009 he was appointed Knight Bachelor in the Queen’s New Year honours list.
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.
Alan Craft
Emeritus Professor of Child Health
Further Reading
Gibson GJ, Douglas NJ, Stradling JR, London DR, Semple SJ. Physicians Sleep Apnoea report. J R Coll Physicians Lond. 1998; 32:540–4.
Dodds S, Williams LJ, Roguski A, Vennelle M, Douglas NJ, Kotoulas SC, Riha RL. Mortality and morbidity in obstructive sleep apnoea-hypopnoea syndrome: results from a 30-year prospective cohort study. ERJ Open Res. 2020; 14;6:00057–2020.
Engleman HM, Martin SE, Deary IJ, Douglas NJ. Effect of continuous positive airway pressure treatment on daytime function in sleep apnoea/hypopnoea syndrome. Lancet 1994; 343:572–5.
