President's News, March 2019
This month the government issued an interim report into NHS access standards, with the aim of determining whether patients would be well served by updating and supplementing some of the older targets currently in use. Steve Powis, NHS National Medical Director, clearly set out what he sees as the four main benefits of this work. These are shorter waits for a far wider range of important clinical services, standards that improve clinical quality and outcomes, shorter waits for A&E and planned surgery and help to hospitals that work to modernise their care.
I believe that the NHS Long Term Plan sets an ambitious series of commitments to improve patient care, so it is right for the current set of access standards to be reviewed. We support NHS England’s plans to pilot new NHS targets and measures across services for mental health, cancer care, elective care and urgent and emergency care. While we were encouraged by NHS England seeking clinical input into the development of these proposed new standards, we urge that engagement with Medical Royal Colleges and patient groups continues throughout the pilot and review phases, to ensure the needs of patients are protected. It is important that new standards support new ways of delivering healthcare, such as perioperative care pathways.
We look forward to the opportunity to work with NHS England on this during the transition year and contributing to proposals so that they can be adjusted if necessary.
In addition, this month the College responded to NHS Improvement’s request for feedback on five emerging themes they are looking at, as they develop the interim workforce implementation plan which is part of the overall Implementation Plan for the NHS Long Term Plan. One of the themes explores how to improve recruitment and retention in the NHS by making it a better place to work. We believe that a national morale and welfare strategy and dedicated capital funding for improving NHS staff facilities are urgently needed and should be among the considerations for meeting the government’s aims.
Within our response we said we would also like to see more done to encourage the further development of clinicians in leadership roles – this is vital if government wants to see real changes to improving the leadership culture in the NHS.
Workforce shortages are also highlighted within the plan, with particular shortages called out within the nursing and midwifery profession. We agree that this is an issue but it should not be dealt with to the exclusion of other workforce areas. The College has made the case that there is a shortage in pipeline supply of new anaesthetists over the next five years. We recommend that extending the Medical Training Initiative scheme can provide a temporary solution to the current workforce issues but efforts must continue to grow the domestic workforce.
Our recommendations to help inform the interim report cover the College’s desire to see anaesthetists developed as ‘perioperative physicians’ as a way to improve patient care. We are calling for more flexible working and development as a way of ensuring that patient care is future-proofed for the twenty-first century. We support the proposals for the development of a single real-time workforce dataset and we believe that all roles should have national standards so that workforce needs can be responded to at the right time and in the right way.
The interim plan will be published in early April and will include a 2019/20 action plan together with a more detailed vision of how the NHS workforce will transform in the coming years. We look forward to seeing the full implementation plan which will follow within two months of the conclusion of the Comprehensive Spending Review.
The College issues awards to those furthering the interests of the College
This month I have had the pleasure of awarding those who have worked towards the betterment of our specialty as well as those who have been elected to become fellows by College Council.
I’m pleased to announce that the following members have been awarded the Fellow ad eundem:
- Dr Jan Schumacher
- Dr Eschtike Schulenburg
- Dr Anand Gore
- Dr Sudhakar Marri
In addition, the #FightFatigue team was also honoured with the Humphry Davy award. Issued to individuals or teams, the award is given for sustained contributions to the College.
Following the tragic death of an anaesthetic trainee who fell asleep while driving home after a hospital night shift, the College, the Association of Anaesthetists and the Faculty of Intensive Care Medicine (FICM) launched #FightFatigue to address the impact of fatigue and shift working on doctors and the consequences for wellbeing and patient safety. The campaign has gone from strength to strength with political support as well as very active members from within the healthcare community coming forward to act as ambassadors and help spread the message. The following team members were awarded:
- Professor Jaideep Pandit
- Ms Nicola Heard
- Dr Roopa McCrossan
- Dr Nancy Redfern
- Dr Felicity Corcoran
- Dr Kathleen Ferguson
- Dr Emma Plunkett
- Dr J-P Lomas
- Russell Ampofo
- Gavin Dallas
- Daniel Waeland
Advisory Appointments Committee news
We are delighted to announce the appointment of Dr Ewen Forrest and Dr Sian Jaggar as joint leads for the College’s Advisory Appointments Committee (AAC) work stream. Dr Forrest has recently demitted as lead regional advisor for the College (2015-18), after many years of acting as regional advisor for Mersey. He is a consultant anaesthetist at the Countess of Chester Hospital in Liverpool. Dr Jaggar is a Training Programme Director for ST3-4 at the Imperial School of Anaesthesia, and is also deputy chair of the Primary FRCA for the College. She is a consultant anaesthetist at Royal Brompton Hospital.
Current AAC assessors have been invited to attend a training day on 2 May, so if you are an AAC assessor and interested in attending please contact Zviko Nuamah or Olive Osei on: firstname.lastname@example.org.
The College marks NHS Sustainability Day with the launch of its first Sustainability Strategy
The College celebrated NHS Sustainability Day with the launch of its first Sustainability Strategy. We are committed to embedding sustainability in everything we do and Council member Dr Lucy Williams has created a comprehensive strategy that encompasses this. It details the strategic priorities, implementation plan and measurement criteria of how the College’s Sustainability Strategy will ensure that achievements clearly align to its commitment.
NHS Sustainability Day is about celebrating the importance sustainable development plays within the UK’s national health services. Through its social media channels the College supported member’s celebration of the day as well as promoted a blog written by Dr Williams which takes a closer look at the aims of the Sustainability Strategy.
The College is a founding partner of the UK Health Alliance on Climate Change (UKHACC) and worked with UKHACC to share messages about the College’s Sustainability Strategy and the blog within its network.
Anaesthesia 2019 – new speaker and poster competition
With only two months to go until Anaesthesia 2019 we are really excited about the Conference and the fantastic line up of speakers we have across the three days. Newly added to the Programme is Dr Aidan Fowler, National Director of Patient Safety who will speak on the first day – 20 May 2019.
We launched this year’s poster competition and the presentation will take place during Anaesthesia 2019. There is still time to enter, so if you have worked on a quality improvement or research project using PQIP data and/or that addresses one of PQIP’s top five priorities, as outlined in PQIP’s 2017-18 Annual Report, submit a poster for a chance to showcase your work to an international audience of over 400 fellows and members.
Anaesthesia 2019 delegate places are selling fast with less than 50 places remaining. This event is a wonderful opportunity to meet anaesthetists from across the world with 15 different countries represented – so book your place now to ensure you will be with us on the 20–22 May 2019 in London.
Register now for our Updates in Anaesthesia, Critical Care and Pain Management Event
17 –19 June 2019, Bristol
Stay ahead of the curve and join us 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 growing issues you will face in your anaesthetic practice. Connect with and question the specialty experts, discuss your experiences with peers, and bring back new ideas that will improve your own practice.
- gastric ultrasound
- pharmacokinetics of anaesthetic drugs at extremes of body weight
- quality improvement
- HIP QIP
- regional anaesthesia
- ATI guidelines
- on being cancelled: a patient’s perspective.
College Update events sell out fast so book your place now.
New Regional Anaesthesia Masterclass – 4 June 2019 in London
Join us in June to explore the use of regional anaesthesia at our first College masterclass. Study the pros and cons of safely using regional anaesthesia, by looking at the past, the present and future, including an in depth look at the latest research. Watch live interactive demonstrations where attendees can learn top tips from the experts on blocks for shoulder and chest surgery.
Network with other anaesthetists and discuss some of the hot topics around regional anaesthesia, including optimising patient access, attitudes to blocks and the pros of giving a general anaesthetic. You will come away from the day more informed on the latest thinking behind regional anaesthesia and renewed confidence on achieving positive patient outcomes whilst using it.
This event will fill up fast so book your place on the 4 June Regional Anaesthesia Masterclass now.
FRCA Examinations update
As the days get longer and we leave the winter behind us, we are now nearing the halfway mark for academic year 2018-2019. Reflecting on the exams held this winter, the Primary MCQ November 2018 saw 328 candidates attend with a pass rate of 55.8%. The November Primary OSCE/SOE saw 406 candidates with a pass rate of 55.7%. Both pass rates are in the normal range.
December 2018 saw the first Final SOE run in the new format, this worked extremely well, with both examiners and candidates saying they liked the new process. Examiners carried out a benchmarking exercise at the beginning of the week applying question scores and global scores to example videos to ensure concordance of marks throughout the week. 315 candidates attended, the overall pass rate was 76%, which is five percentage points higher than the June 2018 pass rate of 71%.
In January 2019, we saw the second of the three Primary OSCE/SOE exams for 2018-2019 take place. 367 candidates were examined with a pass rate of 54%, which is in the normal range.
As we move into spring, we see the Primary and Final written exams taking place. The Primary MCQ was held on 5 March 2019 with a strong attendance figure of 409 candidates the pass rate was 60.6%, which is above the normal range. The Final Written exam, held on 12 March 2019 saw a record 546 candidate attend this exam, which is reflective of the low pass rate at the September 2018 sitting. Results will be released on Friday 5 April 2019 following the marking and standard setting process.
Emergency Laparotomy Best Practice Tariff
NHS England will launch a Best Practice Tariff (BPT) for emergency laparotomy on 1 April 2019. This will be based on the proportion of high-risk patients who receive both consultant delivered care in theatre and admission to critical care – both elements are required. ‘High-risk’ patients are those that have a NELA risk score predicted mortality of 5 per cent or greater, are clinically judged to be high-risk, or who have not had a documented assessment of risk.
The BPT pays on average an extra £700 per case. More information is available on the NELA website.
Propose a topic for SNAP3
The Health Services Research Centre is calling for topics for the next Sprint National Anaesthesia Project (SNAP). Previous SNAPs have examined patient-reported outcomes after anaesthesia and the epidemiology of critical care referral and admission.
SNAPs are short observational clinical research studies that aim to recruit a large number of patients from as many NHS hospitals as possible in a short timeframe. An important feature of SNAPs is their engagement of ‘grass-roots’ anaesthetists, particularly trainees.
Perioperative Clinical Trials Day
The UK Perioperative Medicine Clinical Trials Network’s spring Education Day will take place on Wednesday 1 May at The Studio in Birmingham. The day delegate rate is £55 and there is a 25 per cent discount for trainees, medical students and Allied Health Professionals.
Apply for the RCoA/NIHR Research Awards
Are you an NHS clinician (not a clinical academic) making an outstanding contribution to clinical research? Then you should apply for the RCoA/NIHR-CRN Research Awards. Each award carries a £1,000 prize. Submit an application form by midnight on Tuesday 30 April 2019.
The College invites applications for the role of Bernard Johnson Advisor - Academic Anaesthesia.
The main purpose of this role is to be the lead for developing and maintaining advice and guidance for the smooth running of academic training and the maintenance of College standards in training.
The role requires a commitment of a minimum of three hours per week.
- to provide advice, guidance and expertise for the development and delivery of academic training in the UK, to anaesthetists in training, trainers, members and external organisations
- to represent the College on all matters relating to academic training, including attendance at external meetings as required
- to integrate and work alongside the training department
- to work, and liaise, with internal and external stakeholders such as the National Institute of Academic Anaesthesia (NIAA), Academy of Medical Royal Colleges and others
- to collaborate and work closely with the College Research Lead(s), NIAA Training Leads and the Clinical Quality and Research teams.
Closing date for applications is 1 May 2019.
The College invites applications for the role of Bernard Johnson Advisor for Less than Full Time.
The purpose of this role is to provide high-level representation of matters relating to less than full time training across the UK as well as facilitate two-way communication to enable dissemination of information and coordination of feedback. The successful candidate will also share best practice in less than full time working policy in postgraduate medical education and training.
The role requires a commitment of a minimum of three hours per week and is unpaid, however all reasonable expenses will be covered by the College.
- to integrate and work alongside the College’s Training and Education departments
- to represent the College on all matters relating to less than full time, including attendance at external meetings as required
- to provide support and advice to College staff, Committees and Council in matters relating to less than full time training and working in anaesthesia, critical care, perioperative and pain medicine
- to provide information, advice and guidance regarding less than full time training and working, to both anaesthetists and those responsible for this group within anaesthetic departments or schools of anaesthesia
- to contribute to the development, organisation and delivery of less than full time related meetings and events.
Closing date for applications is 1 April 2019.
Curriculum review – Anaesthetic CCT Curriculum 2020
Following publication of the General Medical Council document Excellence by design: standards for postgraduate curricula in 2017, the curricula for all medical specialties are required to be revised by 2020. The existing Anaesthetic Certificate of Completion of Training Curriculum was launched in 2010 following approximately a two-year development process. Various changes and additions have been made to it since then, but a full, wholesale review of its clinical content has not been undertaken since it was first written.
The curricula for all medical specialties to be revised by 2020 must align to certain requirements including:
- introducing generic professional capabilities
- be structured round a limited number of 'learning outcomes' – activities that describe the work of an independent clinician in each particular discipline.
Further information and regular updates about the curriculum review on specially created webpages which can be found here.
New to the NHS Meeting
The College delivered the New to the NHS meeting on Monday 11 March 2019. Forty-five anaesthesia and intensive care medicine Medical Training Initiative (MTI) doctors attended from a range of nations including India, Sri Lanka, Nigeria and Papua New Guinea. For the first time, we held the event in partnership with the Royal College of Surgeons who had a number of their own MTI doctors in attendance. As such, the day offered a fantastic opportunity for networking.
The programme addressed a wide range of topics relevant to newly appointed MTI doctors. Sessions included the GMC Welcome to UK Practice and tips on how to adjust to the NHS and how to address its challenges and opportunities. In the afternoon, the group was split by specialty, and doctors were provided with information on specific topics relevant to them such as sitting the FRCA and the FICM exams. There were plenty of opportunities for doctors to ask questions and get involved in discussions. An MTI doctor, who has been in post for nearly 10 months, gave an informative talk about her experience. The day wrapped up with a session on how to create an action plan and tips on options for doctors to use their experience and the skills gained in the UK to benefit their home healthcare system once they return. We had an excellent array of speakers that gave MTI doctors lots of food for thought.
Professor Bryn Baxendale discusses the merits of the College’s new Simulation Strategy
This month, the College released a digital recording of an interview with Professor Bryn Baxendale (Chair of the simulation working group) discussing the launch of the new five year Simulation Strategy.
Simulation is a recognised method used to enhance education and training opportunities for the anaesthetic profession. It is also used to examine standards of practice, and ‘stress test’ the safety of existing or new systems and processes.
The simulation strategy aligns with key principles of the College’s overall strategic plan to support anaesthetists, improve standards in clinical practice, research and development.
GMC asks doctors about workplace facilities and their impact on training
I am pleased to see that access to break rooms and study spaces will have a spotlight for the first time in this year’s National Training Survey (NTS) - open until 1 May and run by the General Medical Council (GMC). I strongly encourage all anaesthetists in training and trainers to fill out this survey.
The GMC has included questions about workplace and rest facilities. These are welcome additions, as the College, alongside the British Medical Association continue to champion the need for all healthcare staff to have access to high quality rest facilities.
We know that some hospitals don’t provide doctors and other front-line healthcare workers with adequate facilities to relax in, let alone even a sofa to nap on before travelling home. This after completing a high-pressure shift working in what can be a very stressful clinical environment.
We all understand there are pressures on space, but we believe that a small injection of capital funding could allow hospitals to address the lack of adequate rest facilities - something our data clearly shows is leading to high levels of fatigue and low morale among staff.
We hope that by the inclusion of questions on this topic in the NTS, the government will show its valuing of NHS staff by providing funding for adequate rest facilities.
The survey will seek the views of around 54,000 doctors in training and 46,000 doctors who act as trainers.
Please do take the time to fill out this survey as your thoughts and comments are invaluable in helping ensure this cause remains a priority for local and national NHS leadership.
World Sleep Day: Growing support for the Fight Fatigue campaign
World Sleep Day, (15 March 2019), marked one year since the launch of the national Fight Fatigue campaign, a joint initiative between the College, the Association of Anaesthetists and the Faculty of Intensive Care Medicine. The campaign aims to raise awareness of the impact of fatigue and shift work on our NHS workforce. Despite growing support for the campaign there is still much to be done and fatigue continues to impact the health and wellbeing of those working in the NHS.
To celebrate the day, the team released a short animation across social media about the importance of getting enough sleep and impact that sleep deprivation has on a person’s physical wellbeing.
As momentum for the campaign grows, it now has support from organisations representing a wide range of specialties across the NHS, including the Royal College of Pathologists; the Royal College of Physicians; the British Medical Association; Emergency Medicine Trainees’ Association; the Royal College of Emergency Medicine; the Royal College of Physicians of Edinburgh and the College of Anaesthetists of Ireland.
A series of resources to help increase fatigue awareness have been developed and can be found here.
Norfolk and Norwich University Hospital – help Fight Fatigue
As the #FightFatigue campaign continues to gather pace, the Norfolk and Norwich University Hospital have a special reason to want to be involved. One of their trainees in the intensive care unit, Ronak Patel, sadly died driving home following a night shift. He fell asleep at the wheel.
Ever since, the ICU and anaesthetic teams have been determined to help raise awareness of the fatigue problem, starting with a survey among both consultants and anaesthetists in training to understand the scale of the problem. Despite ensuring that fatigue and its issues were covered at inductions and having on call rooms, survey results showed that whilst both consultants and anaesthetists in training recognised fatigue as a significant issue it was not discussed or addressed often enough.
The team set about a cultural shift, comprising of encouraging those in training to take 20 minute power naps during night shifts, to hold each other bleeps while on breaks and to work more closely as a team during the night, support each other and reduce interruptions to rests and breaks.
Fatigue was also included on the agenda at morning handover meetings and exception reporting encouraged if breaks were not taken. Trainee focus groups have also been held which has led to the improvement to call rooms, rotas have been changed to become more fatigue friendly and minuted discussions about fatigue at all clinical supervision meetings have been implemented.
A poster, supported by senior figures in the trust has also been produced and it includes pledges everyone agrees to adhere to in order to help tackle fatigue.
What the team is doing is to be commended and we wish them continued success with their efforts. If your hospital would like to find out more about the #FightFatigue campaign and the resources available to assist with highlighting this important issue please click here.
e-Learning is evolving
Our award winning e-Learning resource is evolving. Find all the latest BJA Education articles and MCQs to help with your study and gain CPD points.
The improved e-Learning resource offers an even easier navigation experience for members by combining the article link with MCQs within the session. There is also improved user functionality with the e-Learning Physiology module reorganised into a new structure with nine easy to find sub-topics. There are also a number of other e-learning sessions that members can explore on the hub, in order to offer a bespoke learning experience.
e-Learning is free to those within an NHS email address – but if you do not have an NHS email address, you can purchase a licence through e-integrity.
Faculty of Pain Medicine News
The Faculty of Pain Medicine (FPM) has created an Affiliate Fellowship route to open up membership for Acute Pain / Inpatient Medicine doctors to join the FPM family. The Board has been undertaking work on Acute Pain Medicine (from training to membership) over the last two years and there was a strong view from within the Faculty that there was a need for it to be an all embracing home for doctors active in all types of pain medicine. This route is also open to pain medicine consultants without the examination who are not eligible for fellowship by any other route.
The FPM has jointly developed a practical guidance document of outcome scales which are appropriate to pain management and have been specifically selected to assist pain services in selecting outcome measures.
Importantly the measures will improve patient care and allow benchmarking against other services and against targets, helping to bring uniformity locally and nationally.
This important document has been supported by the NHS Specialised Pain Clinical Reference Group and has been developed at a time when the NHS is moving towards outcome-based commissioning.
The document can be accessed here.
Cancer Pain Services
The FPM along with the Association for Palliative Medicine, Association of Cancer Physicians and the Royal College of Radiologists (Faculty of Clinical Oncology), have written a framework for pain service provisions for adults in the UK who have cancer or life-limiting diseases.
The guidance aims to improve pain services for adults across the UK with closer integration of pain management, oncology and palliative care services.
The Anaesthesia and Perioperative Medicine Team of the Year award finalists profiled in the BMJ
The finalists have been announced for the 2019 BMJ Anaesthesia and Perioperative Medicine Team of the Year award and I am pleased to report that all the exceptional efforts by teams have been showcased in the latest issue of the BMJ. The awards ceremony is to take place on the 24 April.
The team at the Queen Elizabeth Hospital in King’s Lynn was nominated for its arterial line safety. By developing a non-injectable arterial connecter which ensured that clinical staff could take a blood sample but never inject into an artery, the team was shown to improve patient safety.
The National Hip Fracture Database showed that the Queen Alexandra Hospital NHS Foundation Trust was in the bottom half of its overall ranking for performing fascia iliaca blocks (FIBs). The team, comprising clinicians from emergency, trauma and orthopaedic departments, was nominated for its results in the development of a specially designed FIB trolley used in the emergency department and a FIB bag used on the wards. As a result this project has seen an 82 per cent increase in patients receiving FIBs.
The Wirral University Teaching NHS Hospitals set up a dedicated pharmacy prescribing team to work alongside nursing staff, surgeons and anaesthetists in the surgical elective admissions lounge to prescribe drugs to patients undergoing elective surgery. The team has been shortlisted for its work to reduce the average time of 36 hours for prescriptions generated to just 43 minutes.
As the elderly population increases, so too do the number of patients presenting with hip fractures and multiple comorbidities. Disappointing results in the National Hip Fracture audit led the team at Sandwell and West Birmingham NHS Trust to start a seven day, consultant-led perioperative trauma care bundle to improve the outcome of these patients. As a result of the bundle initiatives, the uptake of patients receiving FIBs increased from 28 per cent in 2014 to 96 per cent in 2018.
The Freeman Hospital in Newcastle took a fresh approach to pain management after lower limb amputation. Following the procedure, patients were given a low dose local anaesthetic infusion for seven days through a perineural catheter. As a result, over a 72 hour period, mean pain movement dropped and length of stay in hospital decreased. The team has been nominated for its efforts.
Lastly, the team at Sherwood Forest Hospitals knew that they could improve on the day cancellation rates for operations and have been recognised for their efforts. The team managed to backfill operations by contacting patients five days prior to their scheduled operation to check whether they still needed the operation and reminded them of starvation and drug instructions. As a result of the project, the on-day cancellation rate went down and session use in theatres rose.
I’d like to encourage you all to follow the @RCoANews twitter handle on the evening of the 24 April to find out who has won.
NHS England Clinical Entrepreneur Training Programme
Applications are open (until 29 March 2019), for the fourth year of the Clinical Entrepreneur Training Programme – aimed at those wanting to develop their entrepreneurial aspirations during their clinical training period.
The programme offers mentoring and coaching, entrepreneurial placements, the exploration of options to free up time for entrepreneurial activity, facilitation of relationships with commercial organisations, and education, including expert webinars. Video content, e-learning and flexible university modules, regular ‘pit stop’ educational events focused on creating successful start-up businesses are also planned.
An anaesthetist in training reaches out and finds immeasurable support from her peers
Recently the College was approached by an anaesthetist in training keen to share her experiences after imparting her thoughts about juggling a job she loves with a personal life that she felt was increasingly being neglected. Joanna Poole shared a blog across social media in which she wrote candidly about what she felt was missing from her work and life in general – she was overwhelmed by the response she received from others who identified.
Keen to harness this momentum, Joanna contacted the College and we quickly suggested that she work with our colleagues at the Association of Anaesthetists to be an ambassador for the #FightFatigue campaign, offering her support to help address the impact of fatigue on doctors.
I urge you all to take some time to read Joanna’s blog and if it resonates and you would like further support the College has a range of resources to help. Anaesthesia and medicine are stressful careers. The College recognises the importance of supporting the wellbeing of all our members. We understand that from time to time things can get tough, so please be sure to look out for each other and seek help when it is needed.
Huge thanks to Joanna for sharing her story.
Nominate someone special for the HEAT Awards
There is still time to nominate an outstanding individual or team for the Healthcare Education and Training (HEAT) Awards. The awards seek to recognise and celebrate the very best in education, training, leadership and workforce planning within the NHS - the nomination deadline has been extended until 12 April.
Health Education England is looking for the very best examples of inspiring trainees (at all levels), students and apprentices, as well as shining examples of leaders within the NHS.
They are also looking to showcase exemplary examples of workforce planning, diversity, inclusion and widening participation, the NHS Constitution in action, training and digital/technology enhanced learning (TEL) innovation. There are also awards for the best organisation to work and train with and an award celebrating system transformation.
National Institute for Health and Care Excellence: Impact report on sexual health
The National Institute for Health and Care Excellence (NICE) has published a new impact report on sexual health. This focuses on how NICE’s evidence-based guidance contributes to improvements in sexual health.
It is the seventh in a series of impact reports which looks at how NICE’s evidence-based guidance is being used in priority areas of the health and care system. Its impact reports are based on data from national audits, reports, surveys and indicator frameworks that show the uptake of our guidance and quality statement measures.
Professor Gillian Leng, NICE’s Deputy Chief Executive and Director of Health and Social Care recently published a blog with her thoughts about the new sexual health impact report, in the National Health Executive.
You can access all impact reports on the NICE website.
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 email@example.com
Professor Ravi Mahajan