Update on implementation of resolutions carried at the 2023 EGM

Published: 30/05/2024

Following last year’s Extraordinary General Meeting, we committed to implementing the resolutions carried and keeping members updated. This update includes a summary of our progress since our last update in December 2023.  

All the work we have undertaken to date has involved input from members, including anaesthetists in training and our training networks, as well as external stakeholders. We are very grateful for everyone’s time and expertise in supporting our work.  

Resolution 1: Proposed expansion of anaesthesia associate numbers

In response to members’ concerns about patient safety in relation to NHS England’s proposed expansion of the number of anaesthesia associates (AAs), we have:  

  • Reaffirmed our guidance that training for anaesthetists in training should be prioritised. The guidance includes an escalation process to follow if an anaesthetist in training, their educational supervisor or the College Tutor has any concerns about their ability to access training opportunities.
  • Requested that clinical leaders pause recruitment of new, student AAs while the College undertakes further work to look at the impact of the AA role. Our evidence gathering includes our member survey, the findings of which reinforce the case for a pause. We are continuing to gather evidence and have commissioned Cochrane Response to undertake a literature review related to AAs and their international comparators. Our aim is to ensure we have captured a robust synthesis of all relevant published research. We will share our assessment of the evidence and what it means for the College’s position in relation to AAs later this year. 
  • Requested that clinical leaders continue to show their support for all members of their departments, including AAs, and to facilitate positive professional relationships between all members of the team. The College is fully supportive of AAs who are currently training or working in the NHS. They are our colleagues who are working hard to care for patients in a profession they have entered in good faith. Many are members of the College.

Resolution 2: Supervision of anaesthesia associates

We have responded to members’ concerns about patient safety in the following ways:  

  • Requested that clinical leaders pause the development of enhanced roles for AAs until regulation is in place and a scope of practice beyond qualification has been developed. Regulation is due to begin in December 2024 and in line with our commitment prior to the EGM we are currently developing a comprehensive scope of practice for enhanced roles to take effect when statutory regulation of AAs is in place. We recommend that any trusts that currently employ AAs or student AAs also read our information for employers for a fuller explanation of the current situation.
  • Updated the Guidelines for the Provision of Anaesthetic Services (GPAS), the Anaesthesia Clinical Services Accreditation (ACSA) and other relevant College documents to make clear that local opt-outs from the College’s position on supervision of anaesthesia associates (AAs) are not approved by the College:

Resolution 3: Information for patients

College policy has always been that all healthcare workers should be open and honest about their experience, qualifications and role when talking to patients, as set out in the GMC’s Good Medical Practice and our 2016 guidance for Planning the introduction and training for anaesthesia associates.

The College’s Ethics Committee has developed some supplementary guidance on how all members of the anaesthetic team should introduce themselves and the titles they should and should not use. The draft guidance was discussed by Council in April and is now being amended in light of the feedback received.   

Resolution 4: Rotational training

Our work to reduce the negative impacts of frequent rotations on anaesthetists in training is being led by a working group set up for this purpose. Ongoing activity includes:

  • Lobbying NHSE to roll out lead employer status across all regions of the UK. This has had some impact, with NHSE making a commitment to explore the roll out of lead employer models in the longer term. While encouraging, we have made the case to NHSE for why the roll out needs to happen now. We have also ensured this issue will be discussed by the Conference of Postgraduate Medical Deans.
  • Developing principles and processes for enabling greater flexibility in the delivery of the Stage 2 and Stage 3 domains of learning. Following feedback from stakeholders including our training networks, we have submitted the guidance to the GMC for approval and will publish it in due course.
  • Developing guidance on how schools/regions can minimise the frequency of rotations, which we will publish later this summer.

We are looking forward to discussing this work at the College Tutors meeting in June 2024.

Alongside work arising from the EGM we continue to develop and implement other improvements to education and training for our members. This includes:

Resolution 5: National recruitment for doctors-in-training

Following delays to the promised recruitment of additional staff for the Anaesthetics National Recruitment Office (ANRO), we wrote to Amanda Pritchard, CEO of NHS England in February to request immediate action to address the inadequate resourcing of ANRO or to work with the College to identify a viable alternative to the current provision of anaesthetic recruitment services. 

In the response from NHSE, Dr Navina Evans confirmed that three additional posts are being recruited to ANRO, as well as additional posts within the wider Midlands recruitment team. She also made assurances that there will be support from senior recruitment managers from the wider national recruitment team during key points in the process.

While this is positive news, we will continue to closely monitor performance. Representatives of the College meet weekly with the ANRO management team so that we can work together to monitor and deliver recruitment.

Resolution 6: Regional recruitment

We have established a working group to explore options for recruitment at a regional, rather than a national level. To date, the group has:

  • Considered the evidence base and the advantages and disadvantages of regional recruitment.
  • Consulted stakeholders on this subject. Initial discussions have revealed a mix of views with no clear consensus. We are continuing to consult, including with other medical royal colleges and the Medical and Dental Recruitment and Selection Committee.

I hope this update demonstrates our commitment to honouring assurances made throughout the EGM process that we will listen and respond to the voices of our membership.

In addition, I would like to reassure members that the College leadership, Council, volunteers, and staff remain focused on supporting and advocating for them at all stages of their career, for example in our manifesto. We are working hard to deliver our core purposes across training, education, assessment and research in the best interests of our membership, the specialty and patients.

Dr Fiona Donald
President and Chair of the Board of Trustees