Co‑opted Council Member, representing Anaesthetists in Training

As my abbreviated term on Council as a trainee representative draws to an end, I’ve spent time thinking about what I’d like to see for my fellow anaesthetists in training in 2024. I remain a cynic about many aspects of life in the NHS but, knowing that many of the items on my wish list have been openly spoken about over at Red Lion Square, I’ll temper my scepticism with hope – for what is the point of the work we do if we can’t aspire to better?

Thus, in no particular order, some aspirations I have for anaesthetists in training in 2024:

Pay restoration.

Lead employers for every region and devolved nation, with the relative security they provide. Correct tax codes, among other things, for those who are still waiting for their lead employers to materialise.

A serious rethink on how we recruit and retain our anaesthetists in training and how frequently they are mandated to rotate.

Parity of esteem.

More training places, because someone centrally has the power to find the money and simply needs the will. For LTFT slots to be shared as a standard and for post numbers to be based on full-time equivalents, not physical bodies. For those who are LTFT to have an easier time organising their rotas and not feel like they must defend why they’ve chosen the percentage of full-time that works best for them.

For our College to continue its work on wider systemic issues within the medical profession, and to double down on its lobbying for anaesthetists at all stages of their career, whether they be trainees, consultants or SAS doctors.

And finally, for us to stop identifying ourselves as ‘one of the anaesthetists’. You are a doctor, entire, and you are this patient’s anaesthetist. Through medical school and on your own training path, you put in the work. The sweat. The money. Own it.

Council Member, Chair SAS committee

As we welcome the new year, it is imperative that we reflect on the year just ended to understand and plan for the year ahead. Undoubtedly, 2023 has been a challenging year on many fronts for healthcare in the UK, and it makes me wonder what 2024 holds for all of us that will inspire us to keep going.

I am writing this as we celebrate Diwali, the festival of lights, and it makes me reminisce about moving from darkness towards light, giving me strength, motivation and hope that things will change for the better. The problems of workforce crises, retention and recruitment, low staff morale, tackling the waiting-list backlog, impact on training and educational support, and inadequate resources for the NHS are like the 10 heads of Ravana, the demon king, and I wish there was a simple solution to it.

What gives me hope is that, among the challenges faced, we have had a significant change in the form of the introduction of a specialist contract for SAS doctors, which is a step towards retaining, recruiting and recognising the knowledge, skills and contributions of this cohort of doctors that will encourage employers to recruit. The amended Postgraduate Medical Education and Training Order, with the new portfolio pathway to gain entry onto the specialist register, will encourage more SAS members to pursue this pathway. The ongoing work at the College, Association of Anaesthetists, and Academy of Medical Royal Colleges to encourage and support SAS doctors in educational, leadership and managerial roles will inspire more colleagues to take up roles as examiners, College tutors, and educational supervisors. The analysis of the Barometer survey 2022, with a spotlight on SAS and LE doctors, done by the GMC with commitment to doing more to analyse the data for LE doctors and SAS doctors as separate and distinct groups, is something to look forward to in the new year. All this definitely inspires me to work towards the collective aspirations of my colleagues and provide better patient care at large.

RCoA Vice-President

My great-grandmother was a seer, holding regular and very well attended seances while living with my grandparents, which apparently drove my grandmother to distraction. Writing a reflective New Year piece in early November, I really feel I’m channeling Amma Sveinbjörg, hoping that the sentiments expressed are a true reflection on where we will be then rather than something that immediately becomes dated.

I think 2024 will be a year of change in many ways. We’re almost certain to have a general election, I am hoping beyond all hope that we will have seen the end of doctor strikes for the foreseeable future, there’s an ambitious NHS workforce plan, and there seems to be a focus on improving the working conditions of doctors.

As vice-president of the College I think the EGM and the sheer level of engagement from our members on the controversial issues involved has been a pivotal moment for us. At the time of writing we are coming up to the discussions at Council and working out the next steps involved. I feel the huge level of responsibility to get this right for our patients and the health service as a whole, both with regard to anaesthesia associates and how we train our doctors.

Anaesthesia is and will always be a doctor-led specialty. Our patients deserve to have easy access to doctors on the frontline across the health service who are trained to make difficult decisions in the patients’ best interests, rather than simply following an algorithm. We undergo rigorous training and assessment, but we do need to make our training more doctor-friendly. The proposals by the EGM to reduce rotational training and improve recruitment are very welcome and give us a renewed mandate to, with other bodies, streamline training and make it flexible and responsive.

No matter who wins the next election, I hope that by this time next year the climate in the NHS will be different. COVID-19 and then protracted industrial action have had an enormous effect on our morale, and we must remember that being a doctor is inherently an amazing job which I still love 27 years later. We must ensure it remains amazing for our successors.