President's News, December 2019

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At the time of writing, it is the morning of the day after the general election. We at the College are now looking forward to working with the new Government and are calling on them to deliver on the issues the College raised in its Manifesto.

The College plays an important role in shaping healthcare policy and practice by campaigning for change, working collaboratively with key partners and with local and national governments and ensuring that the opinions of our fellows and members opinions are at the heart of our policy work. What we say is evidence-led, authoritative and independent.

The NHS is at a critical junction with low workforce retention and poor morale amongst clinicians of all grades. If the new Government is to address these issues it must focus on realising the ambitions of the NHS Long Term Plan for England – and those across the devolved nations. This includes committing to collaborative long-term planning to deliver an appropriately resourced, effectively integrated and sustainably delivered healthcare service – a health service that delivers the safest and best care for all patients.

Clinicians across the country are working often under extreme pressures. The Government must commit to listen to those with the experience and understanding of how to start resolving the on-going healthcare crisis. As we move toward a new year, it is a time to be both reflective and I am hopeful that we can work together to build a truly sustainable 21st century NHS.

With the festive season almost here, I am all too aware that, while some of us will be sharing the upcoming festivities with family and friends, many will be working over the Christmas and New Year break, caring for our patients. I hope you all have a chance to spend some time with family and friends. Wherever you are for the holidays, on behalf of Council and myself, we hope you have a happy Christmas and offer our best wishes for 2020. 

Fifth Patient Report for NELA

Research led by the College into the emergency laparotomy surgery of over 24,000 patients in 179 NHS hospitals has shown enhanced patient care to have reduced the average hospital stay from 19.2 days in 2013 to 16 days in 2018, saving the NHS £34 million annually.

The Fifth Annual National Emergency Laparotomy Audit (NELA) commissioned by the Healthcare Quality Improvement Partnership as part of the National Clinical Audit, looked at data from NHS hospitals in England and Wales between December 2017 and November 2018.

The audit also identifies other improvements including the 30 day mortality falling from 11.8% in 2013 to 9.6% in 2018, saving approximately 700 lives a year. 90% of patients are now also seeing a consultant anaesthetist before their surgery.

While there have been improvements in key areas of patient care, these are masking significant concerns with only a fifth of patients (19.4%) who had signs of sepsis on admission receiving antibiotics within the recommended 60 minutes. This has not improved over five years, and has worsened since the last audit. It also shows over a quarter of patients (27.4%) needing the most urgent surgery did not get to the operating theatre in the recommended time, this has stagnated since 2017.

A number of other interesting audits and reports were published on Friday 13 December. Take a look at MBRRACE ‘Saving Lives, Improving Mothers’ Care’ and the National Hip Fracture Database (NHFD) annual report 2019, for some informative data and recommendations which might be useful for your work in anaesthesia.

Results for Election to RCoA Council 2020

Voting for the election to Council closed on Monday 2 December at 12pm. We can confirm the following candidates have been elected for the consultant vacancies:

  • Ros Bacon
  • Sridhar (Sri) Gummaraju
  • Jonathan Thompson

As in previous years the ballot process was independent and managed by Electoral Reform Services (ERS). The full results can be viewed here. Terms of office commence in March 2020.

I would like to thank all four candidates for standing and presenting an excellent choice for the College’s fellows and members. Congratulations to the successful candidates who were elected to Council. I look forward to working closely with them in the future. Thank you also to everyone who took the time to nominate candidates and cast their vote. The Council and its elections are pivotal to the College’s work.

Results for Election to the RCoA Board for Northern Ireland and Scotland 2020 

Nominations for the vacancies to the RCoA Board for Northern Ireland and Scotland closed on 4 December 2019. 

Consultant members of the Board are elected for a term of three years and are eligible for re-election for one further term of three years. Those eligible to stand are fellows of the College (either by examination or ad eundem) working in Northern Ireland who are on the specialist register of the GMC.

There were three consultant vacancies for the Northern Irish Board. The successful candidate for a consultant board position was:

  • Dr Will Donaldson

There were two consultant vacancies and one SAS vacancy for the Scottish Board. On this occasion, there were no nominations for the RCoA Board for Scotland.

Going greener – how to opt out of your printed BJA and BJA Education journals

Whilst the content of our academic journals, British Journal of Anaesthesia (BJA) and BJA Education is second to none, the College has had a growing number of requests from fellows and members who would like to opt out of receiving the printed copies. Whether it’s for ease of reading, personal preference, or for environmental reasons, opting out of print copies is easy to set up. Simply email membership@rcoa.ac.uk with your name, CRN number and your request.  You will still retain full access to the journals online, and Bulletin will continue to be posted to you.  

The College is committed to embedding sustainability in everything we do. Through the work of our President’s Environmental Advisor, Dr Tom Pierce, the College aligns itself with relevant national and international initiatives related to anaesthesia and the wider NHS, aimed at mitigating further global temperature rise and climate change. This includes being a founder member of the UK Health Alliance on Climate Change, working jointly with the Association of Anaesthetists, and there is also a College Council lead for sustainability, Dr Lucy Williams.

More information on environment and sustainability, including our Sustainability Strategy 2019–2022, can be found on the College website.

Annual College award nominations

The College is now inviting nominations for the College annual awards. Fellows and members are invited to suggest nominations for consideration on behalf of Council by the Nominations Committee.

The process for nomination allows for any fellow or member to put forward nominations to be considered by the College Nominations Committee. This Committee is chaired by Dr Kirstin May and includes the President, Professor Ravi Mahajan, and Vice Presidents, Dr Fiona Donald and Professor Mike Grocott.

Past recipients are listed on the College website and can be used as a good starting point when considering for what award a nomination should be submitted - to find out more information and to understand the criteria for the awards, please look at the Criteria for Honours, Awards and Prizes.

Nominations should be proposed using the nominations proposal form and completed forms should be submitted via email to awards@rcoa.ac.uk by Tuesday 31 March 2020.

Medical Workforce Census 2020

The College launches its Medical Workforce Census 2020 in early January. This is your opportunity to get involved and engage in supporting your anaesthetic department by helping to provide the data requested.

We are all aware that demand for anaesthetists is currently outstripping supply. The consultant workforce gap in the UK has risen from 4.4% in 2015, to 5.2% in 2017 and 6.9% in 2018 and we know departments frequently have difficulty appointing to consultant and SAS posts.

The College therefore needs accurate and up-to-date workforce data to monitor the evolving gap and to continue to make the NHS planners aware of the workforce crisis in anaesthesia.

The College Medical Workforce Census 2015 achieved 100% response rate, which is a significant testament to the willingness and professionalism of the Clinical Directors who took the time to complete the survey. We are asking for the same level of engagement again.

The Census 2020 is a little different to the one in 2015. However, it’s even more important that we get complete data as the competing pressures in the system are even greater.  Please encourage your department to complete the census and raise awareness of this important task.

ACSA re-accreditation for University Hospitals Plymouth NHS Trust

This month we saw the anaesthetic team at University Hospitals Plymouth NHS trust re-accredited under the prestigious Anaesthesia Clinical Services Accreditation (ACSA). The hospital was one of the first to receive the accreditation for the high quality care the anaesthetic team provided to patients.

The review team were particularly impressed with how the anaesthetic department worked with trainees to provide excellent teaching, welfare provisions and unified care delivering excellent flexibility to match the needs of patients.

ACSA is the College’s peer-reviewed scheme that promotes quality improvement and the highest standards of anaesthetic service. To receive accreditation, departments are expected to demonstrate high standards in areas such as patient experience, patient safety and clinical leadership. The College’s website has all the information  you need to understand how ACSA could benefit your anaesthetic department.

SALG-BIDMC Safety Scholars – 2nd round closing soon

The second round of the Safe Anaesthesia Liaison Group’s (SALG’s) programme of fellowships for anaesthetists interested in patient safety will be open until 10 January 2020. In collaboration with the College and the Association of Anaesthetists, SALG is offering a unique programme of formal training through Harvard Medical School that aims to develop international expertise in perioperative quality and safety.

The two successful candidates will be known as the SALG-BIDMC Safety Scholars, and will be provided with:

  • a fully funded place in a Master of Healthcare Quality and Safety (MHQS) course from Harvard University while also engaged in clinical practice at a suitable level at the Beth Israel Deaconess Medical Center (BIDMC)
  • co-mentorship from the Vice Chair of Quality and Safety at BIDMC (Professor SK Ramachandran), and the SALG co-chairs: Professor JJ Pandit and Dr CR Bailey
  • scholars will identify project(s) in the UK that they will develop and lead on, after their return to the UK.

Please note that this programme is open to anaesthetists in training, consultant or SAS grade anaesthetists currently working within the UK NHS (or Irish health service). Steps one and two of USMLE are essential. The closing date for applications will be Friday 10 January 2020, with interviews at the end of January 2020. Further details of the programme are available here.

CPD in the Lifelong Learning platform

CPD functionality went live on 13 November and we are delighted to report that over 2,500 CPD activities have already been added and reflected upon.

The old CPD Online Diary can still be accessed and will remain available until the end of April 2020. Please note that historic user records will not get migrated into the Lifelong Learning platform nor will the details of previously CPD-accredited events (prior to September 2019). By the end of April 2020, users of the CPD Online Diary will need to download any documents which they wish to keep (which in many cases should be the CPD activity report used as the appraisal evidence for revalidation) and there is a “document store” in the Lifelong Learning platform (similar to the “personal filing cabinet” in the old system) which can be used for this purpose.

For further information please contact cpd@rcoa.ac.uk.

Research and Quality Improvement

British Oxygen Company Chair of Anaesthesia

The College is inviting applications through the NIAA for the BOC Chair of Anaesthesia Research Grant from clinicians and non-clinicians who are working towards a senior fellowship or developing a credible application for a Chair in Anaesthesia (or related specialities) within the next five years.

A grant of £80,000 per annum (£320,000 in total) is available. This can support the costs of research sessions, projects or infrastructure. The grant is available across a four year period (reviewed after two years) and annual progress reports must be submitted.

Deadline for applications is 5pm on Friday 31 January 2020. More details here.

John Snow Intercalated Awards 2020

The NIAA is also accepting applications for the 2020 John Snow Intercalated Awards. The awards and are designed to encourage medical student interest in anaesthesia and its related disciplines. An institution can submit up to four applications per year, so coordination between supervisors is encouraged.

Awards are £2,000 directly to each successful student, not the supervisor/institution, and are meant to contribute to living costs.

Deadline for applications is 5pm on Thursday 30 April 2020. Click here for more details.

POMCTN Chief Investigator Scheme open

The UK Perioperative Medicine Clinical Trials Network (POMCTN) is running a fresh round of recruitment to its Chief Investigator Scheme. The Scheme provided training and mentorship for talented individuals who wish to lead their own perioperative clinical trials.

Deadline for applications is Monday 27 January 2020. Visit the POMCTN website for more information.

SNAP3 Commissioning Brief

The Commissioning Brief for the 3rd National Sprint Anaesthesia Project (SNAP3) is now live. The HSRC is looking for a Chief Investigator to lead a SNAP based on the topics of frailty and delirium.

Deadline for applications is 5pm on Friday 7 February 2020. Submit your proposal here.

Events update

Anaesthesia 2020, Manchester, 18-20 May 2020 – programme announcement

We are pleased to be able to share with you the programme for Anaesthesia 2020. Visit our website to see the full line up of topics and speakers.

Don’t forget to use code ‘Early10’ to receive 10% discount when registering. Book your place today.

Regional events:

We have been working hard to run some of our popular events outside of London. See a snapshot of some of our regional events for 2020 below:

  • Anaesthetic updates, 31 January 2020, Nottingham
    Stay ahead of the curve and join us for a day of new ideas in anaesthesia, critical care and pain management.
  • L&M: the essentials, 3-4 March 2020, Sheffield

    Gain insight into your own and others’ behavioural preferences and how this can impact on your working relationship; and different approaches to day-to-day activity.

  • AaE: Teaching and Training in the Workplace Edinburgh, 2-3 April 2020, Edinburgh

    This highly interactive workshop relies on you bringing your real-life experiences of teaching in the workplace in order to gain the most benefit.

  • Airway workshop, 13 May 2020, Brighton

    Supportive and expert faculty provide a hands-on and interactive approach to learning, enabling you to learn and practice core technical and non-technical skills.

Further dates will be announced in the New Year! We would like to take this opportunity to thank all of our event volunteers and delegates for helping to make our 2019 events a success.

Doctors’ Download survey

Hundreds of doctors gave their feedback to the Doctors’ Download workshop last summer. The online debate looked at the digital experiences of doctors.

The Academy of Medical Royal Colleges in partnership with the  Professional Record Standards Body are now carrying out the second and final phase of the research through an online survey to turn that feedback into priorities for action. By taking just five minutes to complete the survey and leave your feedback you can make a difference. Please complete the survey and post your ideas or comments on what needs to happen now.

The survey can be accessed here.

National Medical Directors Clinical Fellows scheme

Applications are out for the 2020 National Medical Directors Clinical Fellows scheme – both for Fellows themselves and host organisations. The scheme provides doctors in training with the opportunity to spend one year out of clinical training, working with senior leaders and teams in national healthcare organisations including Colleges, NHS England and NHS Improvement, Health Education England (HEE), the General Medical Council (GMC), the Care Quality Commission (CQC), the National Institute for Health and Care Excellence (NICE) and BUPA to develop skills in leadership, management, strategy, project management and health policy.

The scheme is open to doctors in training from all specialties who have completed foundation training and do not expect to gain CCT before 1 September 2020. Candidates must have full GMC registration.

For further information visit the FMLM website, deadline for applications is 13 January 2020.

If you have any comments on the issues highlighted in this e-newsletter or would like to express your views on any other matter, I would like to hear from you. Please contact me via presidentnews@rcoa.ac.uk

Professor Ravi Mahajan
President