President's News, June 2019

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Following the publication of the General Medical Council (GMC) document Excellence by design: standards for postgraduate curricula, the College has been engaging with key stakeholders to revise the Anaesthetic curriculum. The existing anaesthetic curriculum was launched in 2010 following approximately a two-year development process. In 2014 the College conducted a survey with fellows and members to look at making improvements to areas of the curriculum. Various changes and additions have been made to it since then, but a full review of its clinical content has not been undertaken since it was first written.

Revising the curriculum is a complex project but essential in order to ensure that it equips anaesthetists in training with the skills needed to participate in, and provide continuity of care. We are committed to ensuring that all relevant stakeholders have an opportunity to contribute to a programme of learning that meets the needs of our specialty, supports the pursuit of excellence and allows our members to flourish.

I was pleased to attend this year’s College Tutors meeting in Chester last week and heard from the Chair of the Anaesthetic Curriculum Review Group, Dr Nigel Penfold, as he gave an update on the curriculum review process. The College’s Training Committee, Regional Advisers and College Tutors, as well as anaesthetists in training have, and continue to be consulted as to the content and scope of the reworked curriculum. The steps that have been taken to engage with internal and external stakeholders to ensure robust input from all relevant sectors is commendable.

The 2017 GMC document outlines key standards that curricula of all medical specialties must adopt by 2020. Implementation of the Shape of Training Report recommendations should take into account how changes can better support the needs of patients and service providers. This means that doctors should be equipped with the generic skills to participate in the acute unselected take and able to provide continuity of care thereafter, as well as have the ability to support care given in the community.1

The timing is tight for us to complete this complex project, as the College must rewrite the anaesthetic curriculum and submit our proposal to the GMC by December 2020 at the latest. We are working to ensure that updates on the curriculum review process are included in College event programmes in the coming months.

I encourage you to share your feedback on this. Please do email your views to: 2020cct@rcoa.ac.uk – the 2020 Anaesthetic Curriculum must be fit for purpose and it is your input and support that will ensure that this is the case.

Medical device alert (MDA/2019/022)

The Medicines and Healthcare products Regulatory Agency (MHRA) have issued a medical device alert for Aisys and Aisys CS2 anaesthesia devices with Et Control option and software versions 11, 11SP01 and 11SP02, manufactured by GE Healthcare.

The alert warns that the device may fail to deliver the set agent concentration in end tidal mode, causing a risk of patient awareness due to inadequate anaesthesia when operated in this mode. Further details can be found on the alert available here.

RCoA responds to NHS Improvement’s Interim Workforce Plan

NHS Improvement published its Interim NHS People Plan earlier this month and it was encouraging to see a focus on cultural changes within the NHS. As a College we have championed the need for a flexible and supportive NHS and have specifically called for a national welfare and morale strategy for NHS staff and action on doctor’s fatigue. We are pleased to see the plan’s pledge to develop a ‘new offer’ for supporting staff.

Alongside this, our senior members tell us the current pension scheme has made it harder for them to take on additional work commitments to help alleviate workforce pressures. Therefore, we welcome the government’s commitment to bring forward a consultation on a new pension flexibility for senior clinicians.

Building on the 21st century care model outlined in the NHS Long Term Plan we hope this plan will provide a more co-ordinated, proactive and personalised system of care which has the potential to be transformative for patients and the NHS. This will require adequate resources and it is encouraging to see an acknowledgement of staff shortages. It is important that staffing levels are looked at across the whole of the NHS and in particular the social care sector.

We look forward to seeing the final People Plan and working with NHS Improvement and other stakeholders on what patients should expect from the future NHS workforce.

Anaesthesia 2020 – register now and save 10 per cent

Having now received feedback from Anaesthesia 2019, the College’s Events Team is working with Council members Dr Russell Perkins and Dr Claire Mallinson to build the programme for Anaesthesia 2020. The conference will be held outside London for the first time at Old Trafford – the iconic home of Manchester United football club on 18- 20 May 2020. Significant time has been allocated to clinical talks and updates from new speakers from across the world. We will also devote more time to discussions. This will help make Anaesthesia 2020 a truly interactive event that will spark new ideas and give further insight to your practice.

Register now and use the code EARLY10 to save 10 per cent on the cost of your ticket. We will keep you updated with speakers as they are added to the programme, but don’t delay in booking your place.

Leadership and Management courses introduce new Faculty

As part of our review of the College’s Leadership and Management courses we are pleased to introduce our new Faculty of highly experienced clinical leaders from the NHS. The Faculty will be supported by Val Glenny our long standing course leader, experienced facilitator and expert in leadership, organisation development and behaviour.

Our new Clinical Lead will be Dr Ronan Fenton who will be joined by Dr Yvette Oade, Dr Gill Derrick, Dr Monica Baird and Dr David Throssell. Ronan and Yvette both hold high profile medical leadership roles within the NHS. Yvette has been a medical director in three Trusts spanning over ten years. She is currently Chief Medical Officer at The Leeds Teaching Hospitals NHS Trust. Ronan has been an Acute Trust Medical Director and is now Medical Director for the Acute Hospital reconfiguration for Mid and South Essex STP. Gill and Monica are both currently Deputy Medical Directors; Gill in Cornwall and Monica in Bristol. David Throssell has recently retired from being a Medical Director in Sheffield.

Over the coming year we will continue to refresh our suite of courses to make them even more practical to everyday anaesthetics. We will draw on the most up-to-date experiences of the team within the NHS as well as previous participant feedback to ensure our courses are highly relevant to the world in which anaesthetists do and will inhabit over the coming years. There was never a time when anaesthetists needs leadership and management skills more than today. We look forward to welcoming you onto our courses.

Updates in Anaesthesia, Critical Care and Pain Management 24–26 September 2019

Join us for Updates in Anaesthesia, Critical Care and Pain Management for three days of 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 challenges you face in your anaesthetic practice.

Connect with and question specialty experts, discuss your experiences with peers and bring back new ideas to help improve your work.

Topics will include:

  • acute pain management for the paediatric patient
  • muscle wasting in the critically ill patient
  • advances in TIVA
  • perioperative blood pressure management
  • prepare for surgery
  • long term outcomes following ICU
  • awake tracheal intubation guidelines
  • theatre efficiency
  • what’s new in obstetric anaesthesia
  • anaesthesia, perioperative care and cognition
  • best practice in transfusion
  • functional brain imaging in studying pain
  • perioperative renal dysfunction
  • monitoring neuromuscular blockade.

Feedback from our recent sell-out 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 hold one of our newly revamped Leadership and Management courses 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 your working relationship and different approaches to day-to-day activity
  • increased your understanding of how to influence the Trust and others to develop their service
  • begun to construct a personal development plan based on the Academy’s Medical Leadership Competency Framework.

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

New Anaesthesia Research meeting

We are very proud to announce Anaesthesia Research 2019, a brand 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 meeting will incorporate the Anaesthetic Research Society & 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 are reduced rates for anaesthetists in training and Allied Health Professionals (AHPs), and a 50 per cent discount for Quality Audit & Research Coordinators (QuARCs). 10 CPD credits are anticipated.

PQIP holding largest ever Collaborative event

The Perioperative Quality Improvement Programme (PQIP) will be holding its next Collaborative event on Monday 16 September 2019 at King’s Place, London. The day is free to attend to PQIP participating sites, and will feature the launch of PQIP’s second annual report. Up to three places per site are available – as long as one of the people you bring is a surgeon!

NELA launches updated dashboards

The National Emergency Laparotomy Audit (NELA) has updated its web tool dashboards to provide even better reporting to hospitals. These include modifiable run charts and control charts to help measure your hospital’s performance. If you do not have a secure login to the NELA web tool, please contact your hospital’s NELA lead to request one.

Perioperative medicine MOOC reopens

The next run of the UCL/RCoA Massive Open Online Course (MOOC) on Perioperative Medicine in Action goes live on Monday 1 July 2019. A fantastic overview for clinicians of all grades on the principles and future of perioperative medicine, the course is free and open for six weeks, with an option to upgrade for ongoing access.

Examinations update

The Primary FRCA OSCE/SOE took place during week commencing 14 May 2019. A total of 409 candidates sat the exam with an overall pass rate of 54.3 per cent which is within the normal range. A high number of candidates sat the OSCE component at this sitting of the exam which resulted in further rounds of OSCE being scheduled on Saturday 18 May 2019. The College thanks the examiners and candidates who attended on this day for giving up their time.

Applying to be an FRCA examiner – changes to requirements

Each year the College invites applications for vacancies to the Board of Examiners in the Fellowship of the Royal College of Anaesthetists. The next examiner recruitment round will run from July 2019 to October 2019, recruiting examiners for 2020–2021.

There have been some changes made to the examiner regulations:

  • examiners will be recruited to the Primary and Final examinations at the selection stage, to meet the number of retirements in each examiner board
  • applicants must have the expectation of completing no less than six years and no more than 12 years as an examiner
  • after the first (probationary) year examiners can choose flexible working routines, see paragraph eight of the examiner regulations on related downloads
  • applicants must have at least three years experience as a substantive consult/SAS grade doctor in the NHS
  • applicants will have visited the Primary or Final FRCA examinations within the last five years at the time of being short-listed. Shortlisting is conducted in the February following the recruitment round (February 2020 for this recruitment).

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

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.

Junior doctors contract referendum

Following the negotiations over changes to the 2016 junior doctor contract in England, the referendum on the proposed contract has now opened, and closes on 25 June. BMA members who are junior doctors or final/penultimate year students in England are entitled to vote.

The College has always been clear in our support for junior doctors, that each individual member must make their own decision in the BMA contract referendum, and we want our members to be have as much information as possible in order to inform their vote. 

Junior doctors or final year students currently studying or working in the devolved nations, who can evidence that they will be moving to England to work under the 2016 TCS from August, are also entitled to vote and should contact the BMA on 0300 123 1233 for more information.

More information about the contract referendum can be found here

New AoMRC guidance on acting as an expert witness

Acting as an expert or professional witness - Guidance for healthcare professionals has been produced by the Academy of Medical Royal Colleges following a recommendation from the Sir Norman Williams review of Gross negligence manslaughter in healthcare for the Department of Health and Social Care in England.

This guidance is aimed specifically at healthcare clinical professionals who provide an expert opinion or act as professional or expert witnesses in courts or tribunals. It is produced by clinical professional organisations and sets out the standards and conduct expected of a clinician acting in the role of a witness.

The guidance includes the types of witness healthcare professionals can expect to be, the value of acting as an expert witness as well as the duties and responsibilities of an expert witness to the courts.

While the guidance arose from a report commissioned by the Department of Health and Social Care in England it is intended to apply on a UK wide basis. Although there are differences in the legal systems across the four nations, the principles which should guide healthcare professionals who act as expert witnesses or professional witnesses are the same.

PipeliNE 2019

PipeliNE 2019 will take place on 11 October in Newcastle Upon Tyne – it is a free anaesthetic taster day for foundation doctors and medical students. The day showcases anaesthesia and exemplifies how supportive the Northern Deanery is.

The day is divided into a series of short talks, followed by small group sessions. This allows candidates to not only experience some anaesthetic procedures but also learn new skills which will be of use to them on the wards. Coffee breaks provide further opportunity to talk to faculty, those in training and consultants - including the region’s Training Programme Director.

Last year’s PipeliNE was a fantastic success and the team were extremely pleased with the turnout and feedback from attendees.

If you know of anyone that might benefit from attending this event, please do forward this to them.

Spring Senior Fellows and Members Club meeting

On Tuesday 28 May, the College held its spring Senior Fellows and Members Club (SFMC) meeting, which was a well-attended and successful event. Dr Douglas Justins, Chair of the SFMC, provided the introductions and together CEO Tom Grinyer and I provided updates from the College.

Lord Gus O’Donnell was our guest speaker providing a talk on ‘Building a better state’. Throughout his talk, he drew on his extensive experience, including time working as Cabinet Secretary with four Prime Ministers. It was a hugely enjoyable and enlightening masterclass, mixing personal reminisces with rational analysis of the current state of the nation. Lord O’Donnell emphasised the significant long-term savings that can be gained by early intervention in social and economic affairs and compared this to the benefits of pre-operative interventions in anaesthesia.

A full summary of the meeting, written Dr Justins, will appear in the September issue of the Bulletin.

The next SFMC meeting will be held in Liverpool on Thursday 7 November 2019 at the Liverpool Medical Institute. The topic is ‘Burma Railway Medicine’ and the lecture will be given by Professor Geoff Gill from the Liverpool School of Tropical Medicine.

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