It doesn’t seem a moment since I was wishing you all a Happy New Year, and already we are at the halfway point of 2023. The professional highlights of my year so far have been the conversations I’ve had with many members across the country. I value these conversations, which help me, and colleagues at the College, to understand what you want from your membership, as well as to gauge views on key issues affecting the specialty.
Anaesthesia 2023 in Birmingham
Our flagship annual conference, Anaesthesia 2023, was one such opportunity. We were joined by over 1,400 delegates, both in Birmingham and online, and it was an invigorating experience.
Having specialised in obstetric anaesthesia throughout my career, I was grateful that both Donna Ockenden and Bill Kirkup were able to join us to share their considerable insights on work to address failings in maternity and neonatal care. While the trauma and loss documented in both their presentations was truly harrowing, they prompted useful discussion about the need for obstetric anaesthetists to be an integral and active part of the multidisciplinary team.
This is something we have sought to support through our guidelines and standards. For example, we have ensured that our guidelines for the provision of obstetric anaesthesia services, which we revised earlier this year, are fully aligned with the immediate and essential actions arising from the Ockenden and Kirkup reviews.
Driving quality improvement
The research session included a presentation from Professor Ramani Moonesinghe on the latest findings from our Perioperative Quality Improvement Programme (PQIP). This ongoing study is designed to help improve patient outcomes from major non-cardiac surgery by supporting clinicians to use local data to enhance perioperative care.
There have been some significant improvements in quality of care since the first PQIP report in 2018, which is a remarkable achievement given the impact of the pandemic. The latest report identifies five priorities, which include ensuring all patients receive an individualised risk assessment, effective postoperative pain management and support with eating, drinking and mobilising within 24 hours of surgery.
The value of PQIP lies not only in its robustness as an evidence base, but also in the practical tools and guidance it provides. This includes new online dashboards to provide clinical teams with the most up-to-date postoperative data for PQIP-recruited patients.
You can find out more about the latest findings at our webinar on 11 July. A registration form, along with information about how to get involved with the research, is available on the PQIP website.
Make every contact count with the A-Team Challenge
Anaesthesia 2023 also provided an opportunity to launch new resources to accompany Dennis has an anaesthetic, our Beano comic strip designed to help manage children’s preoperative anxiety. The new A-Team Challenge includes a reward chart and stickers to encourage children to prepare for surgery by taking simple steps to eat well, sleep well and stay active.
The resources are designed to help you ‘Make Every Contact Count’ and our Patient Involvement Lead, Dr Samantha Black, together with Dr Lucy Connolly and Elena Fabbrani, write more about it on page 28.
Many people contributed to the success of Anaesthesia 2023, and I thank our clinical content leads, Dr Toni Brunning, Dr Gunjeet Dua and Dr Claire Mallinson for their excellent curation. I am already looking forward to next year’s conference in Glasgow.
Speaking of Scotland, I was grateful for the recent opportunity to attend the Scottish Society of Anaesthetists Spring Meeting in Peebles. It was good to be able to update delegates on the work of the College and answer their questions face to face.
Conversations with College Tutors
Last month, I was in Sheffield for our College Tutors meeting, expertly organised by Dr Sumitra Lahiri and Dr Ruwanmali De Silva. These meetings – attended by over 300 of our representatives – enable us to work collaboratively on all aspects relating to postgraduate training.
Our session on recruitment included discussion of the number of anaesthetists currently unable to secure ST4 posts despite being eligible, which has understandably caused a great deal of upset and concern. We have recently conducted two surveys to support our work in lobbying for an increase in ST4 numbers.
The first survey asks current CT3 anaesthetists in training about their plans once they have completed Stage 1 training, for example whether they are looking to progress to ST4, apply for further experience abroad, apply for an LED post, look to undertake a CESR route or something else. The second asks similar questions of anaesthetists who are now post Core Training/CT3 top up and are currently working in an LED, Trust Grade, Specialty Doctor SAS role or similar.
I’m grateful to College Tutors for their help in collecting this data, which will increase the evidence base about the need for increased training places. While we have been successful in securing some extra places throughout the UK, with more coming next year, these are still not sufficient for the number of doctors requiring them. This issue remains a priority for the College, and we will continue to keep the pressure up and to support those who are not yet in a substantive post.
We have recently conducted two surveys to support our work in lobbying for an increase in ST4 numbers.
Addressing differential attainment
Council members Dr Sarah Thornton and Dr Sri Gummaraju led a session on differential attainment. Data from the GMC show significant inequalities in postgraduate medical training for doctors from some ethnic minority backgrounds, Muslim doctors, disabled doctors and those from a lower socioeconomic background. These inequalities are evident in the likelihood of receiving an offer when applying for specialty training and in pass rates for exams.
It is clear that all of us working in medical education need to take action to change this, and to address other persistent inequalities that are having a detrimental impact on individual doctors and the profession as a whole. This is fundamental to the College’s core value of justice and fairness, and our work to understand and counter these inequalities includes:
Undertaking new research to investigate the impact of gender, ethnicity and education background on exam performance. We are also further increasing diversity among our examiners to ensure our examiner pool is representative and inclusive.
Developing our online training hub to make training guidance easily accessible to all and providing training and exam preparation materials for candidates.
Reviewing and improving our process for responding to requests for reasonable adjustments from candidates.
Investigating issues relating to equality, diversity, inclusion and representation within the specialty and the College through our Equality Research Project. As a member, you can help us by updating your information in My RCoA so that we can assess diversity trends within our membership.
We are also working in partnership with the Widening Participation Medics Network to establish a mentoring scheme – GasReach – to help doctors from underrepresented groups access a career in anaesthesia. We will launch the pilot scheme later this year and will be recruiting members who would like to be mentors. You can read more about GasReach in Dr Colette McCambridge’s article on page 38.
Supporting your wellbeing
Our Council Wellbeing Lead, Dr Ramai Santhirapala, led a session on supporting morale and welfare. We have recently published a standardised Departmental Wellbeing Lead job description and person specification, in partnership with the Association of Anaesthetists. Our aim is to make it easier for anaesthetic departments and trusts/health boards to support the wellbeing of staff through the appointment of a dedicated lead.
Alongside this, we have created a new wellbeing hub on our website, which features resources to support your individual wellbeing, as well as those to help you embed wellbeing good practice within your department.
In talking about wellbeing, it would be remiss not to mention industrial action and the reasons for it, which are of course intrinsically linked to conditions of work and their effect on morale. As I write this, action by junior doctors in England is ongoing and by the time the Bulletin is published, we will know the outcome of the BMA’s ballot of consultants. Our focus remains on supporting our members during what is a difficult time, and we have updated our industrial action information and FAQs.
NHS 75 and looking ahead to Autumn
The next big event in the College calendar is the Presentation of Diplomates Ceremony on 8 September. I am looking forward to meeting everyone attending this special day of celebration.
Finally, the publication of this issue of the Bulletin coincides with the 75th birthday of the NHS. There is much I could say about that within the context of current challenges, but to end on a positive note, I will simply reflect that the NHS continues to be a source of national pride. And that is because of you. It is your dedication and expertise, alongside that of our colleagues across the health service, that is so highly valued by millions of patients, year after year. In that respect, the NHS is no less extraordinary today than it was in 1948.