President's News, July 2019

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This month I have been encouraged by the findings of the GMC’s 2019 national training survey. To see a year-on-year improvement where fewer anaesthetists in training are stating that their roles are being affected by fatigue is truly heartening. In response to the findings of our 2017 Welfare and Morale report and our involvement in the Fight Fatigue campaign, I am determined that the work our College has undertaken to support anaesthetists of all grades across the United Kingdom will continue to deliver the impact it is now so clearly having.

Compared to 2018 figures, 10 per cent more trainees who responded to the survey reported that they had been given the opportunity to be trained about fatigue or sleep. Almost seven per cent more trainees stated that they felt supported to take rest breaks while approximately four per cent more trainees said they did not feel too tired to get home safely.

The issue of high workloads amongst NHS staff has been of great concern over the past few years, so I am glad to see a halving of the number of trainees working beyond their rostered hours. I am also pleased to see that trainees continue to rate highly the quality of teaching and training supervision they receive.

Survey results have, however, shown that there are still many areas of concern, such as burnout and the lack of adequate rest facilities, which the College needs to continue addressing in partnership with our stakeholders. It is incredibly important to value our doctors and other front-line healthcare workers. A recent survey highlighting the experiences of almost 1,400 anaesthetists who had lost a colleague through suicide whilst working in the same department found that 92 per cent of respondents reported having experienced suicide through work. This sobering statistic only adds to the imperative nature of the work that the College, along with others are doing to help address the deficits in support for our fellows and members. Keeping medical staff fit and healthy so they can provide the highest level of care for their patients is something the whole healthcare sector should be championing.

Ensuring the provision of a well-supported and sustainable medical workforce is a vital component in the long-term planning process for health and social care services. To address the issue of burnout and fatigue, I will continue to work with NHS leaders and call for the introduction of a national welfare and morale strategy for NHS staff and I look forward to supporting the development and delivery of the forthcoming NHS People Plan.

The College will continue to work on your behalf as we understand the importance of supporting the wellbeing of our fellows and members. Our career and personal difficulties page lists useful websites and resources which some of you may find of benefit.

Election to RCoA Council: nominations open soon

I am pleased to announce that nominations for election to RCoA Council will open on Monday 22 July 2019.

Council vacancies are as follows:

  • three consultant vacancies: Those eligible for nomination are those who are on the specialist register and are Fellows by Examination or Fellows ad eundem
  • 0 anaesthetist in training vacancies: There are no trainee vacancies this year
  • 0 SAS vacancies: There are no SAS vacancies this year.

Nominations close at 12 noon on 30 September 2019. Further information, including a detailed timetable, will be available on the College website from Monday, 22 July 2019.

Anaesthetic CCT Curriculum update

As you will hopefully be aware the existing Anaesthetic CCT Curriculum, which was launched in 2010, is undergoing a major rewrite in order to meet the standards set out in the General Medical Council (GMC) document Excellence by design: standards for postgraduate curricula’. The curricula for all medical specialties must be revised by 2020, and must align to certain requirements including:

  • curricula must introduce Generic Professional Capabilities
  • curricula must be structured around a limited number of ‘learning outcomes’ – activities that describe the work of an independent clinician in each particular discipline.

The Anaesthetic Curriculum Review Group has been working hard to finalise the detailed content of the high level learning outcomes, which describe and define the activities, both generic and specialist, that an anaesthetist at the end of training will be able to perform independently.

We have undertaken a variety of stakeholder engagement activities, most recently during the annual College Tutors meeting, this year held in Chester. We would now very much like your feedback on the high level learning outcomes. This is to ensure that the new anaesthetic curriculum produces anaesthetists capable of managing the acute general workload of a hospital. To that end, we are in the process of developing an online survey, which will be circulated in the coming weeks.

The timelines we are working to are tight, with a planned submission date to the GMC of October this year. Discussions around plans for implementation of, and transition to, the new curriculum are ongoing, but the 2020 Anaesthetic Curriculum must be fit for purpose and your input and support will help ensure this is the case. So please keep an eye out for details of the survey.

Examinations update

The Final FRCA SOEs took place across five full days from Monday 17 June to Friday 21 June 2019. This was the second exam to be run in the new format. A cohort of 413 candidates sat the exam and achieved a pass rate for the week of 67.3 per cent which is within the normal range.

The successful completion of the Final SOEs brings the FRCA exams for academic year 2018-2019 to a close. Over the past 12 months 4,039 attempts were recorded across all FRCA exams with an overall pass rate of 61.2 per cent.

The examinations team are now planning the September 2019 Final Written and Primary MCQ examinations, with application windows for these exams closing at the end of July.

As from September 2019 Constructed Response questions (CRQs) will take over from Short Answer Questions (SAQs). The September paper will consist of six x SAQs and six x CRQs. An SAQ will be followed by a CRQ. Question one – SAQ, Question two – CRQ and so on. With effect from March 2020, the paper will consist of 12 x CRQs. Example CRQs can be found on the College website.

Applying to be an FRCA examiner

The examiner recruitment round is now open until Monday 21 October 2019, recruiting examiners for the academic year 2020–2021. Applicants are recruited to the Primary and Final examiner boards.

The application form and a full list of essential criteria, which must be met on application, are available on the College website.

Call for SAS input into the development of two new GPAS chapters 

The College is currently working on the development of two new GPAS guidance documents using the rigorous, evidence-based process as accredited by NICE.

The two new guidance documents are:

  • Guidelines for the provision of anaesthesia services for the perioperative care of elective and urgent care patients
  • Guidelines for the provision of anaesthesia services for a ‘good/supportive department’ (working title).

As part of this process, the College is looking to recruit SAS representatives to the Chapter Development Groups (CDG) of these guidelines to support the authors and comment on draft recommendations. Each CDG will also include representation from subject-matter experts, clinical directors, lay perspective, anaesthetists of all grades and College staff.

If you are interested in being involved with either guideline, please send a copy of your CV along with a cover letter to the GPAS Co-ordinator at: gpas@rcoa.ac.uk by Friday 30 August.

2019 SALG Patient Safety Conference

The annual SALG Patient Safety Conference will be held on 31 October this year at the College. As in previous years, we are running an abstract competition for anaesthetists in training to submit their projects for consideration. Further information about the conference and the competition can be found here.

Events roundup

Winter Symposium 10–11 December 2019

The theme of the 2019 Winter Symposium is Health and Wellbeing. In an increasingly pressurised NHS, how can anaesthetists take care of their own health as well as the safety of their patients? The Symposium will be a lively mixture of updates, debates and panel discussions. Hot topics will include the new junior doctors’ contract. Experts will bring you up to speed with changes in anaesthetic practice and explore what the next five years may bring.

Enjoy the opportunity to ask questions, participate in discussions and network with your peers.

The Symposium was fully booked last year so book early to avoid disappointment.

Feedback from the 2018 Winter Symposium

‘Fantastic value for money given the quality of speakers’
‘Excellent overview of evolving ideas in many fields of anaesthesia’
‘A must for any responsible anaesthetist’

Simulation Fellows Day – Supporting the delivery of the College’s Simulation Strategy

The College's Simulation Working Group is setting up a national network for anaesthetic simulation fellows and will be hosting a Simulation Fellows Day on 25 November 2019 at the College. The purpose of the network is to strengthen the current provision of simulation training, to share resources and support development of simulation fellows. This will also offer opportunities to get involved with projects that will contribute to the implementation of the College Simulation Strategy.

If you currently hold an anaesthesia simulation fellow post and would like to join the network, please email Fiona Anderson with your name, Trust and school of anaesthesia (if applicable). Please also indicate if you would like to attend the Fellows’ day where the team will be discussing how the network will function, and designing work streams for implementing the College strategy. We may have to restrict attendance to one or two Fellows per school depending on the number of applications.

Stop Press – new location added for Updates in Anaesthesia, Critical Care and Pain Management event

Updates in Anaesthesia will be landing in the Midlands in November. The three-day event will be held in Birmingham on 4–6 November.

As usual, our Updates events will allow you to stay ahead of the curve, and hear about new ideas in anaesthesia, critical care and pain management. Discover new developments on the horizon from today’s thought leaders and learn how best to combat the growing issues you will face in your anaesthetic practice.

Book now to connect with and question specialty experts, discuss your experiences with peers and bring back new ideas that will improve your own practice.

Feedback from our recent sell-out Updates events

‘Fantastic event, simple useful updates on a good range of topics for the general anaesthetist’    
Updates London, February 2019

‘There’s something to add to your clinical practice from almost every talk’
Updates London, February 2019

‘I wish more refresher courses would provide the same value’    
Updates London, February 2019

New location for Leadership and Management: the essentials course

This autumn we will be holding one of our newly revamped Leadership and Management: the essentials course in Bristol on 23 – 24 September 2019. The course is designed specifically for senior trainees and consultants and will help you develop your leadership skills, uncover your behavioural preferences and explore how it impacts your working relationships.

At the end of the course, you will have:

  • learnt about and had the opportunity to discuss NHS policy development and its impact on service delivery
  • gained insight into your own and other behavioural preferences and how this can impact on your working relationship; and approaches to day-to-day activity
  • increased your understanding of how to influence your Trust and others in developing their service
  • begun to construct a personal development plan based on the Academy’s Medical Leadership Competency Framework (AoME)

Places are limited to ensure the best experience for all delegates. Book Now to secure your place.

College, Macmillan and NIHR launch prehabilitation guidance

I was delighted to see the launch of the new principles and guidance document on Prehabilitation for People with Cancer, a collaboration between the College, Macmillan Cancer, and the National Institute for Health Research (NIHR). This is the result of many months of hard work involving hundreds of experts and stakeholders from around the globe. The guidance was launched at the World Prehabilitation Congress on 2 July, where it was inspiring to hear from the patient representatives involved. All spoke movingly about their experiences with cancer and of the benefits they experienced through prehabilitation. Thank you to the three patients who contributed to this important work (Della Ogunleye, Jenny Doe and Clive Moore). 

The document aims to provide guidance to people living with cancer, care providers, commissioners and policy makers. I hope that you will join with the College and our partners in working to deliver its vision.

Research news

RCoA and NIHR Research Award winners announced

Congratulations to the winners of the 2019 RCoA and NIHR CRN Research Awards, which were announced earlier this month. The winners were:

  • Consultant Anaesthetist: Dr Louise Savic
  • Anaesthetist in Training: Dr Jennifer Noyes
  • Anaesthetists in Training Network: Severn Trainee Anaesthetic Research (STAR) Group.

As a former chair of the National Institute of Academic Anaesthesia (NIAA), I am delighted to see the enthusiasm of anaesthetic participation in research. Start planning your application now for 2020!

Book now for Anaesthesia Research 2019

The College is pleased to announce the launch of Anaesthesia Research 2019, a new two-day event, which will take place at The Principal Hotel in York on 2–3 December 2019.

Led by the National Institute of Academic Anaesthesia (NIAA), the event will incorporate the Anaesthetic Research Society and BJA Research Forum, and all NIAA-affiliated activities including the UK Perioperative Medicine Clinical Trials Network (POMCTN), the Health Services Research Centre (HSRC), and experimental/discovery medicine.

The single day rate is £87.50 or £175 for both days of the meeting. There is a reduced rate of 25 per cent for anaesthetists in training and Allied Health Professionals (£65 or £130 across the two days) and a 50 per cent discount (£90 across the two days) for Quality Audit & Research Coordinators.

This event promises top speakers and dedicated work streams to provide you with maximum value, so don’t miss out on your chance to be part of it – book your place now

Latest news regarding hospitals to be ACSA accredited

Anaesthetic departments at Buckinghamshire Healthcare NHS Trust and Norfolk and Norwich University Hospitals NHS Foundation Trust have been awarded ACSA accreditation. Both departments have been recognised for providing the highest quality care to patients. Plaque presentation ceremonies for both hospitals will take place in the coming weeks.

Why become ACSA accredited?

Organisations that engage with ACSA will benefit from:

  • a structured and supportive process for improving services
  • an expert advisory on-site review, followed by a report that provides targeted advice
  • benchmarking against standards and anonymised local, regional and national performance
  • the engagement of staff in service improvement.

Accredited departments will:

  • be entitled to use a quality mark to denote their commitment to quality and patient care
  • be awarded a plaque to display in their department
  • be more attractive to potential employees and trainees.

The accreditations at Buckinghamshire Healthcare NHS Trust and Norfolk and Norwich University Hospitals NHS Foundation Trust takes the number of NHS trusts and boards in the UK that have achieved accreditation status to 30. Encouragingly, over 60 per cent of NHS trusts and boards with anaesthetic departments across the UK are now actively engaged with the ACSA programme which is a great foundation on which to continue to build on quality improvement.

The reflective practitioner

The GMC, along with eight other healthcare regulators, have published a joint statement on the importance and benefits of being a reflective practitioner.

The statement sets out each of the organisation’s requirements for reflection. It also offers advice for practitioners on how to approach reflection effectively, both as individuals and as part of teams.

The work is part of a shared commitment to drive an open and honest culture where professionals feel able to reflect on their experiences to support development and learning.

There are also additional resources, cases studies and learning materials on the GMC website, which provide further support and advice for doctors, including:

  • material to deliver case study-led workshops which explore how and why to use, reflection and for self-learning
  • good practice examples of how to be a reflective practitioner
  • thought pieces from doctors and students on how reflecting benefits their practice.

College patient information resources showcased during Health Information Week

Health Information Week (1-7 July) was a national, multi-sector campaign promoting high quality information for patients and the public. High quality health information can have a huge impact on people’s ability to stay healthy and manage illnesses effectively, giving them a better quality of life. During Health Information Week the College highlighted the Patients and Carers section of our website which hosts a range of materials designed to provide more information about anaesthesia and its effects, as well as answering some frequently asked questions about the specialty.

The Fitter Better Sooner resources endorsed by the Royal College of Surgeons and the Royal College of General Practitioners were showcased throughout the week to demonstrate how they help provide patients with the information they need to become fitter and better prepared for operations.

Throughout the week healthcare professionals were also signposted to the Common events and risks in anaesthesia infographic which illustrates risks in an effective way for patients of all reading abilities. This infographic is a useful tool to help open up discussions with patients in order to help better inform them of their anaesthetic requirements and their individual risks.

A blog post written by Dr Hilary Swales, Chair of the College’s Patient Information Group was also shared on the College’s website to help explain the importance of materials created specifically for patients and carers.

New to the NHS meeting

The College will be running its second New to the NHS day in Manchester on Monday 16 September.  The event is aimed primarily at Medical Training Initiative and Staff Associate Specialist doctors but is open to anyone new to UK anaesthetic practice.  For more information and to secure a free place please book here. Please do pass this on to colleagues who might be interested.

Don’t forget to download your e-Portfolio

The final anaesthetists in training will be moved over to the Lifelong Learning platform this August. So the Lifelong Learning team advises all anaesthetists in training to download their e-Portfolio onto a few different devices, as the Training e-Portfolio will be decommissioned at the end of August 2019.

If you have previously used the e-Portfolio as an anaesthetist in training, please also ensure you download an offline version of your e-Portfolio record from the ‘View Portfolio’ section. The College will not hold a copy of the e-Portfolio after the August 2019 date and will be unable to retrieve entries after this, so please do ensure that you download the necessary materials.

You can find a step by step guide on how to download your portfolio via this link.

Your chance to join the BJA Education editorial board

The British Journal of Anaesthesia is looking to recruit two anaesthetists in training members to the editorial board of BJA Education. The role will include overseeing the production of podcasts and contributing to the social media activities of the journal. Applicants should be in possession of the FRCA or equivalent and the appointment will be for a three year term to commence in January 2020. Please note that these are non-commissioning editorial roles.

Applications, in the form of a covering letter and a brief CV (maximum two sides of A4) should be sent to bjaeducation@rcoa.ac.uk by 31 August 2019.

The selection process for shortlisted candidates will involve a short presentation and interview to be held at the College on Tuesday 17 September 2019.

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