President's News, March 2020

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COVID-19: a message to our fellows and members...

Needless to say, these are very pressing times for all of us. On Monday 16 March the Prime Minister announced that the UK was approaching the ‘fast growth’ phase of the COVID-19 infection curve. This has an added dimension of sudden pressure of workload for all of us and our colleagues. Many of us will be working outside our comfort zone and in a highly unusual and charged environment.

Considering the PM’s announcement and in order to protect the health of the College’s staff and visitors, Churchill House closed at 5pm on Tuesday 17 March. The building will remain closed until the Government’s advice changes. All the College’s staff will therefore be working from home until the situation changes. While the building may be closed, the Royal College of Anaesthetists emphatically remains open for business and the core focus of our work remains supporting our fellows and members through this incredibly challenging period. Please see more information about this here.

The College, Association of Anaesthetists, Faculty of Intensive Care Medicine and Intensive Care Society have been working tirelessly on essential guidance for anaesthetists and intensivists - please visit icmanaesthesiacovid-19.org. This new joint website provides the UK intensive care and anaesthetic community with the information, guidance and resources required to support their understanding and management of COVID-19. New clinical guidance is being developed and uploaded here regularly – visit the website soon and often to ensure you stay up-to-date with changing clinical and national guidance.

Going forward, one big challenge for all of us, in particular for those making decisions locally, will be to make a proportionate response to the crisis in terms of elective surgery, emergency surgery, time-critical surgery (eg. Cancer), utilisation of some theatre facilities for critical care, and workforce deployment. Inevitably, these decisions are going to depend largely upon local circumstances. However, for all of us it becomes important to be flexible and be prepared to work across our traditional boundaries.

If the predictions of the case load requiring critical care are to play out, we will inevitably run out of our current capacity, and this will require our colleagues from other specialties stepping in to help out. This has its own challenges of cross-skilling, being flexible and being supported by the system. We will need to make sure that our colleagues in those circumstances are neither exposed nor made to feel vulnerable.

I am currently in conversations with the Academy of Medical Royal Colleges, and the Presidents of other Colleges to make sure that we are all aligned in our aims and that we have guidance in place soon for cross-skilling and supporting colleagues from other specialties.

Please visit your College website regularly to keep up to date with latest news and developments.

Finally, on a personal note, THANK YOU. You are all working through a very challenging time. In times like these, it is vital that we stay together, support each other and look after ourselves. I trust you and your families are able to stay safe.

 

The perioperative solution to integrated care

Integrating care

By April 2021, every part of England will be covered by an Integrated Care System. In Scotland, 31 Integration Authorities are responsible for £8.5bn of local funding, while Northern Ireland’s 17 Integrated Care Partnerships and Wales’ Integrated Care Fund are transforming health and care.

Perioperative care offers a solution to the integration challenge. That’s why the Centre for Perioperative Care has launched three UK-wide projects to support the ambitions of integrated care:

  1. We’ll make the case for and set out a vision of perioperative care, through CPOC’s ‘State of Perioperative Care’ project
  2. We’ll develop a blueprint on how perioperative care can support Integrated Care Systems and devolved equivalents
  3. We’ll develop a blueprint for the multidisciplinary perioperative care team.

Get involved!

We want to hear your thoughts, learn from your experiences, share our emerging evidence, and create, together, a strong case for perioperative care. We’ll reach out to you through a series of workshops, surveys, focus groups and discussion papers. If you’d like to get involved, please join our informal ‘sounding board’, to:

  • Give us your views by taking part in surveys, feeding back on draft reports, testing our messaging, and helping plug evidence gaps
  • Champion our work on social media using #perioperativecare
  • Blog for us, sharing your experiences, reflecting on our findings, and promoting our work
  • Share your case studies

Please email mweiss@rcoa.ac.uk if you’re interested. Thank you for any help you can give.

Update from the Patient Information Group

Updated RCoA/Association of Anaesthetists patient information leaflets

The Patient Information Group has just completed the review of our main series of Patient Information leaflets. In addition to a fresh look, these leaflets have been updated with the latest evidence and clinical practice.

You and Your Anaesthetic features a new risk section using infographics and clearer signposting to additional sources of information. If your Trust limits printing of materials, this can help signpost patients to the key information they need.

We have optimised pagination to make printing more cost effective for hospitals.  If you regularly print leaflets, professional printing in bulk will produce better quality prints for patients (especially those with limited vision) and is usually significantly cheaper  – you can contact comms@rcoa.ac.uk to request the print ready files.

We have also worked with the Association of Paediatric Anaesthetists to update our most popular leaflet for children Rees Bear has an anaesthetic. New characters in Rees’s family make the resource more representative of modern families. We have also included new fun activities in the leaflet to help children engage with the story and pass the time in hospital. 

Measuring the impact of our Patient Information resources

The feedback received from our survey of preoperative assessment leads in 2017 has allowed us to improve existing resources and develop new ones.

As we start 2020, we would like to ask again for your help in finding out how our patient information resources are currently being used by your preoperative assessment teams and patients, so that we can improve them even further. 

If you are a preoperative assessment lead, we would be grateful if you could complete a short survey by 3 April 2020, or forward the survey to your colleagues who lead and work in preoperative assessment.

    For a Greener NHS – call for evidence

    The environmental target for the NHS is Net Zero Carbon by the middle of this century. But what does net zero carbon look like? And if we know, what do we need to do to get there? At the end of January this year NHS England launched a call for evidence to address these issues.

    In anaesthesia we have already identified the low-hanging fruit of inhaled anaesthetic agents, and many are working to reduce vapour use. However, there are many other aspects of perioperative care that are inherently contributing to additional resource use and by implication additional CO2 release.

    In your own hospital, just think, how many hoops does a patient (and their family) need to jump through to get to theatre? How many of those steps are replicated and wasteful? In surgery how often are you irritated by the sheer mass of stuff required for a simple procedure and once discharged from the theatre suite what are the causes for delayed discharge? In the field of perioperative care, for example, is the fitter, and hopefully leaner, patient also greener by using less resources?

    The NHS is looking for case studies, examples of best practice, ideas, research or anything else that might contribute towards the Net Zero Carbon target. The submissions require less than 500 words and do not necessarily need to be referenced.

    Go to NHS Net Zero and upload your submission before the closing date 22 March 2020.

    Heritage and Archives Committee: recruitment of new members

    The College is restructuring its Heritage Committee to become the Heritage and Archives Committee. The committee will concentrate on maintaining formal and professional archives of all College activity and history including its predecessors, the College of Anaesthetists and the Faculty of Anaesthetists of the RCS(Eng).

    If any fellow or member has an interest in the history of anaesthesia and the College, we would be pleased to hear from you. The committee usually meets twice per year, around April/May and October/November. Current activities include an ongoing review of the College archives and the Lives of the Fellows project.

    If you consider joining, please contact archives@rcoa.ac.uk.

    Reminder about the CPD Online Diary

    With CPD functionality fully live in the Lifelong Learning Platform since November 2019, we have already made some enhancements to the system to further improve the user experience. For example, based on user requests, only one reflection box is now required to be completed for CPD Learners. Further enhancements including offline functionality are now being scoped.

    We would like to remind you that the old CPD Online Diary is going to be decommissioned at the end of next month. Please note that historic user records from this 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 (in many cases this should be just the CPD activity report which will have been used as the appraisal evidence for revalidation).

    Research and Quality Improvement

    NAP7 and COVID-19

    Like everyone else, the College is keeping a close eye on developments with COVID-19. We hope that preparations in your hospital are well underway. In view of the disturbance that COVID-19 will likely cause to usual hospital activities, we have decided that NAP7, examining perioperative cardiac arrest, will not launch until the autumn. The National Audit Projects (NAPs) need to be undertaken at a time when healthcare is normal and stable. We are also very aware of the additional workload undertaking a NAP entails and do not believe this would be reasonable at a time when hospitals may be dealing with a major epidemic.

    We will continue to provide updates on the situation. Visit our webpage and follow @NAPs_RCoA for the latest news.

    NIAA Grants available

    I would also like to remind you that the National Institute of Academic Anaesthesia (NIAA) has opened its Round 1 grants for 2020, including the John Snow Intercalated Awards.

    Upcoming events

    We have taken the decision to cancel all events and courses making up our education programme in March, April and May due to the on-going global COVID-19 situation.

    As a Medical Royal College we have a responsibility to play our part in containing the spread of the virus whilst ensuring the safety of our delegates. Anaesthetists and intensive care practitioners are being called upon to care for patients with COVID-19 and therefore it is in the best interest of the NHS, our members and the wider public to cancel our programme. More details and FAQs can be found on our website.

    We will continue to monitor the situation for events and courses from June onwards and will make a further announcement on these in the coming weeks.

    Anaesthesia 2020, Manchester, 18-20 May 2020

    Event cancellations include our flagship conference Anaesthesia 2020. The conference has been postponed until 18-20 May 2021.

    All delegates, speakers and partners have been informed of the decision and have been transferred to the event in 2021. If delegates are unable to attend the re-scheduled date then full refunds will be available by contacting events@rco.ac.uk.

    Applications now open for 2020 Clinical Excellence Awards

    The 2020 Clinical Excellence Award round opened on Friday 13 March and will close on Thursday 7 May at 5pm.

    Consultants in England and Wales applying for a new award and/or applying for a renewal are advised to refer to our guidance here.

    Those seeking support for their application should note that the deadline for submitting forms to the College is by 9am on Friday 27 March.

    Women in Anaesthesia

    In celebration of International Women’s Day on 8 March, the British Journal of Anaesthesia (BJA) prepared a special issue on Women in Anaesthesia. Covering underrepresentation of women in medical research, leadership positions in anaesthesia and the specialty of anaesthesia itself compared to the general female representation in medicine, the issue aims to recognise, describe and measure the problem.

    Three editors of the BJA issue shared blogs on the topic providing their personal experiences as women in anaesthesia.

    2020 Annual General Meeting

    With our 2020 Annual General Meeting (AGM) having been due to take place during Anaesthesia 2020, the College has postponed this meeting.

    We recognise the importance of this meeting as an integral part of College’s year and are currently working on a solution to reschedule in line with our Charter guidelines. A new date and venue will be announced shortly.

    Professor Ravi Mahajan
    President