Author: Dr Elisa Bertoja, Chair, RCoA Clinical Quality and Research Board

It is a great pleasure to introduce the summer issue of the Bulletin.

First, I would like to thank Dr Jon Chambers, Bulletin Editor, for the opportunity to write this editorial, typically a privilege of his role. Jon kindly invited me to introduce this research-themed issue in my capacity as Chair of the Clinical Quality and Research (CQ&R) Board at the College.

This role has been rewarding and challenging at the same time, and my ongoing commitment to CQ&R has deepened my appreciation of the vital role we all play in enabling research, both directly and indirectly.

One of the many things that gives me great pride in our profession, is meeting individuals who have vision and the ability to bring that vision to life. In a time when the NHS faces ongoing economic and structural challenges, these colleagues are literally ‘beacons of hope’ into the future, and I’m pleased to say several are featured in this issue.

The range of topics offers an authentic snapshot of the breadth of work developed, supported, or sustained by the College. I hope this Bulletin gives you a real sense of the energy and commitment driving these projects.

Professor Joyce Yeung, Director of the RCoA Centre for Research & Improvement (CR&I), opens this issue with a compelling call to reclaim research as central to clinical excellence. She argues that research is not an optional extra, but is essential to the survival and evolution of our specialty. Her message is compelling and echoed throughout the issue.

Dr Claire Swarbrick’s article is a great example of how research is vital to improve clinical care, and how the participation of clinicians is vital to the success of research itself. We are interdependent. Claire shares the outcomes from the third Sprint National Anaesthesia Project (SNAP3) on the impact on frailty and delirium. I want to highlight some buzzwords from her piece that will resonate with any clinician: holistic assessment, shared decision-making, pre-optimisation, and tailored postoperative care. These are pillars of high-quality, modern perioperative care.

Alongside frailty, socioeconomic disparity continues to shape outcomes. In the article written by RCoA CR&I Fellow, Dr James Durrand et al, they explore the ongoing challenges posed by health inequality in perioperative care. They outline current projects and future plans addressing the impact of socioeconomic deprivation, an issue that has existed since the foundation of the NHS, but which we have only recently begun to quantify.

When problems persist despite repeated efforts to solve them, it is time to try something new. That is exactly what Dr Carolyn Johnston has been exploring over the past year. Already well known as the QI National Lead for the National Emergency Laparotomy Network, and now a Learning System CORES Fellow at the THIS Institute, Carolyn has been examining the complex pathway patients follow from the Emergency Department to the operating theatre. Her aim is to redesign this flow to enable a more timely and effective progression of care.

I will end on a positive note. If you have met Professor Alan Macfarlane, you know the infectious energy and optimism he brings with him. I cannot think of anyone better to lead NAP8, our next National Audit Project, due to start in 2026. It focuses on complications of regional anaesthesia (peripheral blocks and central neuraxial blockade) and other neurological complications of anaesthesia. This issue offers plenty of detail on how to get involved. I encourage you to take part.

I hope you enjoy reading this issue as much as we have enjoyed putting it together. We are indeed part of a remarkable and forward-thinking community.