President's News, October 2019

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This month the College, jointly with the Association of Anaesthetists, re-issued guidance to provide clarity on safe practice for individual clinicians, managers and organisations in the event of a no-deal Brexit.

The primary focus for every member of the anaesthetic team should always be the safety of patients under their care. Any members of the anaesthetic team that might be concerned about safety not being delivered whether this be related to drugs, equipment, facilities or staffing are duty bound to address these issues before initiating care. Other than in cases of life-threatening emergency care, members’ concerns including the possibility to postpone surgery need to be addressed.

As anaesthetists, it is essential that we always work in the best interests of the patient and this includes offering patients alternative techniques because of drug, equipment or staffing constraints. Patients should always be fully informed so that they have opportunity to give or withhold consent to any alternative plans. Both anaesthetists and patients should have the opportunity to decide whether to either proceed or delay surgery if felt appropriate.

In the event of a no-deal Brexit, redefining service priorities and rationing of care may be needed, but we need to remember that clinicians, managers and commissioners must justify their decisions and be accountable. Any decisions should be communicated to patients in a transparent way.

The Department of Health and Social Care (DHSC) is leading the response to Brexit. DHSC is also the key contact for the sector, liaising with the Department for Exiting the EU and the Cabinet Office. NHS England and NHS Improvement are working closely with DHSC to optimise NHS preparation.

If seeking more guidance, members can review DHSC’s ‘Planning for a no-deal Brexit’. NHS England has also created a new set of FAQs for healthcare staff on the continuity of supply of medicines and medical products. The Welsh and Scottish governments have also developed guidance for their respective health and social care services.

You can also point your patients to NHS information on ‘Getting your medicines if there’s a ‘no-deal’ Brexit’.

The College will continue to liaise with government departments, NHS bodies and other medical Colleges and associations to make sure you are prepared if a no deal should occur.

Election to Council – announcement of candidates

Nominations for election to the Council of the Royal College of Anaesthetists were recently invited. This year there are three consultant vacancies. Terms of office commence in March 2020.

Those who will be standing for election are listed below (in the order their applications were received). 

Consultant vacancies (three to elect to serve a term of six years)

  • Dr Sridhar (Sri) Gummaraju
  • Dr Ros Bacon
  • Professor Jonathan Thompson
  • Dr Abrie Theron

Their election statements will be posted on the election website when ballots are distributed on 30 October 2019.

Important dates
Electronic ballots will be sent by email on 30 October 2019 to your email address that is registered with the College. Look out for a message from RCoAvote@electoralreform.co.uk.

To ensure the process is independent and fair, we are again using leading ballot services provider Electoral Reform Services (ERS) to conduct the election.

You need to vote by no later than midday on 2 December 2019. The election results will be declared via the College website as soon as possible following the ballot count. The results will also be published in the Bulletin.

Who can vote?
Council comprises 20 consultant seats, two SAS seats and two trainee seats.

In response to feedback, we have opened the voting in the consultant category to all members, associate members and trainees. This means that in years when there is no vacancy for anaesthetists in training and/or SAS doctors, those who would have only voted in these categories still get to participate in an annual election. Council believes that this will ensure greater democratic accountability.

CPOC Green Paper response

The Centre for Perioperative Care (CPOC) released its first policy document this month in response to the Government Green Paper Advancing our Health: Prevention in the 2020s. In recent years, the government has moved from a prevention-based system to focus its efforts on immediate, acute demand. CPOC sees the Green Paper as a chance for the government to rebalance its practice and work towards delivering proactive, predictive, and personalised prevention.

The commitments outlined in the Green Paper, combined with those in NHS England’s Long-Term Plan, recognise the key role the NHS has to play in reducing health inequalities and tackling obesity, smoking and alcohol intake. CPOC’s response encourages the government to actively support and facilitate the adoption of a pathway based perioperative care approach, which embeds prevention into routine practice.

Perioperative care can offer practical solutions in delivering prevention and improving the health of populations. By empowering the millions of patients undertaking a surgical procedure each year to adopt healthier lifestyles and change behaviour ahead of their operation, the NHS can improve patient care and population health, while reducing costs.

World Anaesthesia Day

Today we celebrate World Anaesthesia Day. On this day in 1846 the first successful demonstration of anaesthesia took place, it was a milestone that led to the development of modern day anaesthesia. The methods and technology may have moved on, but the goal of anaesthesia to alleviate pain and care for patients at their time of need has remained.

Despite being the largest hospital speciality, anaesthesia can be a specialty that is not always recognised for its central role in the delivery of healthcare. As anaesthetists, you work far beyond the operating theatre, providing a leading role in patient care in what can be challenging situations. At the College we work every day to champion the diverse and critical work of anaesthetists, and the science that underpins our work. Training anaesthetists to the highest level, supporting professional development throughout your career, funding vital research, and working to push anaesthesia up the agenda with national stakeholders. See the array of membership benefits we provide as we work to support and continuously enhance your personal and professional development.

We also want to make sure your voice is being heard, if you have an anaesthesia story to tell, a topic you would like to write about or case study you want to share please do email comms@rcoa.ac.uk . You can also take a look at our blog with articles on Brexit, sustainability, workforce challenges and much more…

Curriculum Review – Anaesthetics CCT Curriculum 2020 update

Arrangements for implementation and transition to the new 2020 curriculum are subject to on-going discussions, in particular with Health Education England and anaesthetist-in-training groups. A fundamental principle is to ensure, as much as possible, that anaesthetists-in-training and their trainers are not disadvantaged when entering the new curriculum or transferring between the existing and the new.

The College’s implementation plan that has been shared with, and has had support from stakeholders, is to introduce the new anaesthetics curriculum in August 2021. In line with GMC guidance, transfer to a new curriculum should be achieved over a two-year window, as per the GMC position statement in November 2012 – Moving to the Current Curriculum.

Until these discussions are complete, we are unable to provide specific details of the transitional arrangements, however once we are in a more informed position this will be shared widely.

The proposed new curriculum will include three years core training (four years for ACCS) then four years for higher specialty training. The total indicative duration of the anaesthetic training programme will remain at seven years. We are aware that this may have implications for those anaesthetists in training who enter and/or complete core training on the existing 2010 curriculum before August 2021.

We would like to reassure all anaesthetists in training that the new curriculum has been produced with their best interests central to the changes that have been proposed, and we are continuing to work hard to ensure no one will be disadvantaged.

Research submission and quality improvement

Anaesthesia Research 2019 bookings open

I would urge all members with an interest in research to book their places at Anaesthesia Research 2019, a brand new two-day event, taking place at The Principal Hotel in York on 2-3 December 2019. The meeting covers all NIAA-affiliated activities ‘from bench to bedside’, including experimental medicine, the Health Services Research Centre (HSRC), UK Perioperative Medicine Clinical Trials Network (POMCTN), and the BJA Anaesthesia Research Forum (ARS).

The single day rate is £87.50, or £175 for both days, with reduced rates for trainees and AHPs. Local Quality Audit & Research Coordinators (QuARCs) can attend one full day for free! A total of 10 CPD credits are anticipated.

CASAP launches data collection

The Children’s Acute Surgical Abdomen Programme (CASAP), the first paediatric project from the HSRC, has now begun data collection. CASAP aims to characterise the type and quality of care being delivered to children undergoing urgent/emergency abdominal surgery (including appendicectomy).

If you think your hospital could usefully contribute to the study, have a look at our list of current sites and contact us if you would like to participate.

RCoA recommends appointment of local anaphylaxis leads

The NAP6 Report, published in 2018, made numerous recommendations and produced standardised resources to improve the care of patients who experience perioperative anaphylaxis.

The College has released a statement in support of the NAP6 recommendation that there should be a departmental lead for perioperative anaphylaxis in each department of anaesthesia. While the NAP6 report describes this as an individual’s role, the College emphasises that responsibilities should be met by the department, whether by an individual or subsumed into another, broader role.

Click here for more information on the departmental lead role and its responsibilities, and click here for further resources and local tools relating to NAP6.

Perioperative Medicine in Action: Free online course

The Perioperative Medicine in Action free online course will be live again on 4 November 2019. This well-received course enables participants to:

  • justify the need for better, more holistic care for the high risk surgical patient, to improve outcomes and reduce healthcare costs
  • demonstrate the need for protocolised care pathways and evaluate the success of the enhanced recovery programmes in reducing variance in practice
  • discuss the current economic pressure on healthcare systems and how perioperative medicine can be used to reduce these pressures
  • engage with risk assessment tools to characterise and quantify the risk of an individual undergoing a particular procedure
  • describe the major challenges in delivering perioperative medicine for the elderly.

This course is designed for all members of the multidisciplinary team who care for high-risk surgical patients. Find out more and register here.

Events update

Major trauma study day, London, 13 November 2019

This is a joint event with the Royal College of Emergency Medicine at which you will receive an update on the latest developments on the management of major trauma patients in the Emergency Department. You will learn the latest techniques in emergency medicine including trauma laparotomy and intravenous access in trauma as well as ‘quick fire cases’.

College members are eligible for a discounted registration fee; please enter the code RCOAMTSD2019 when booking.

Leadership and Management: Working well in teams and making an impact, London, 20 November 2019

Leadership and management skills are both important to deal with the demands of a job and to keep yourself and team happy and fulfilled.

Join this event and learn new practices to improve working in a team, including what makes an effective team, assumptions about teams and understanding the challenges of working across disciplines. At the end of this event, you will be equipped with basic tools and frameworks to grow in confidence as a leader and inspire those around you.

Winter Symposium, London, 10-11 December 2019

We are excited to share with you the programme for the 2019 Winter Symposium. Attend this event to hear from expert speakers on hot topics including patient safety, wellbeing and innovation.

Feedback from the 2018 Winter Symposium

“Fantastic value for money given the quality of the speakers.”

“Excellent overview of evolving ideas in many fields of anaesthesia.”

“A must for any responsible anaesthetist.”

Call for abstracts
Would you like to share your own research? We welcome submissions on anaesthesia research including basic science, translational research, clinical studies, clinical trials and trial proposals, and health services research to be presented as a poster at the event. This opportunity is open to all who are interested or active in research in anaesthesia and perioperative medicine.

For more information, please see the Guidelines for poster competition document.

Closing date for submissions is midnight on Sunday 13 October; submit a copy of your abstract to events@rcoa.ac.uk.

Anaesthesia 2020, Manchester, 18-20 May 2020 - speaker announcement

We are excited to announce another speaker for Anaesthesia 2020: Professor Andrew Klein, Macintosh Professor of Anaesthesia, Royal Papworth Hospital, Cambridge.

Andrew’s main research area is pre-operative anaemia and the effects of iron replacement therapy. He is one of the Principal Investigators of the ITACS trial (Intravenous Iron for the Treatment of Anaemia before Cardiac Surgery). He is also currently researching new point-of-care testing technology for managing haemorrhage during surgery and high-flow nasal oxygen to improve recovery after major surgery.

We have a limited number of early bird tickets left; book your place today to enjoy a 10% discount.

The FRCA examinations update

The FRCA written exams for the first quarter of 2019-2020 have now taken place. A total of 472 candidates sat the Primary FRCA MCQ on 3 September 2019 achieving a pass rate of 72.2%. This is 11.6 percentage points higher than March 2019 diet, which achieved a 60.6% pass rate.

375 candidates sat the Final written exam on 10 September 2019. This was the first time that Constructed Response Questions (CRQs) appeared in the exam and for this sitting the exam contained a hybrid CRQ/SAQ component, comprising, six CRQs and six SAQs. From March 2020 onwards this component will consist entirely of CRQs.

Example CRQs can be found on the Final Written page of the website.

Despite the change to the exam format, candidates achieved a strong pass rate in the Final Written exam of 71.5%, this was 5.2 percentage points higher than the 66.3% pass rate recorded for the March 2019 sitting.

The examinations department are now preparing for the November 2019 sitting of the Primary OSCE/SOE examinations. A very high number of candidates have applied for this sitting of the Primary, which again has resulted in further rounds of OSCE having to be scheduled on Saturday 9 November 2019. The College is indebted to the examiners and candidates who have agreed to attend on this day for giving up their time.

National recognition for Buckinghamshire and Manchester anaesthetic departments

This month we saw the College present two hospital anaesthetic departments with the prestigious Anaesthesia Clinical Services Accreditation (ACSA). The accreditations for Buckinghamshire Healthcare NHS Trust and Royal Manchester Children’s Hospital anaesthetic departments were richly deserved and they both demonstrated their commitment to providing the best possible care for their patients.

It was impressive to see such a high level of integrated working, with both hospitals delivering excellent flexibility to match the needs of patients.

As well as meeting the ACSA standards, the departments demonstrated many areas of excellent innovative practice that have now been highlighted for sharing through the ACSA network.

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.

Global Partnerships

The Global Partnerships team have had a busy couple of months, receiving delegations from Egypt, Myanmar and Uganda to discuss potential collaborations.  We are excited to see how these develop.

We also held our popular New to the NHS meeting for MTI and SAS doctors in Manchester – the first time that this has taken place outside of the College building.  As ever, attendees found the speakers engaging and the sessions informative.  We plan to run our next New to the NHS meeting on 25 March 2020 here at the College.

We are currently reviewing and renewing our Global Partnerships Strategy, which we will be launching in 2020 at our Global Anaesthesia event, running jointly with the World Anaesthesia Society (WAS) which will take place on 24 March 2020. Please put the date in your diary – bookings will be opening shortly.

SALG Patient Safety Conference

The Safe Anaesthesia Liaison Group Patient Safety Conference 2019 will be held on 31 October at the Royal College of Anaesthetists in London. The programme this year will be themed around paediatrics.

Further information, and the opportunity for you to book your place can be found here.

Become a Clinical Lead for e-Learning Anaesthesia – Two year fixed term – 1PA

We are looking for a clinical lead to join the award-winning team behind e-Learning Anaesthesia (e-LA) the College’s online learning programme. e-LA is a multidisciplinary e-learning programme providing free, high-quality learning content to anaesthetists and health and care staff working in the NHS as well as across the world.

The main aspect of the role will be to oversee and plan the infrastructure and process for the sustainable maintenance of e-LA content on the e-learning for healthcare (e-LfH) platform. You will be developing plans, strategies and proposals for e-Learning innovation linked to the College’s education strategy.

To ensure e-LA is kept up-to-date you will be responsible for sourcing, appointing and overseeing editors and content authors to review and create content for e-LA. You will evaluate and sign off content as well as answering clinical questions that arise from authors, instructional designers and users.

As part of the e-LA team, you will liaise and work with the current clinical leads to become acquainted with all aspects of the College’s e-learning provision to take the programme into its next 10 years.

Find out more about the role and how to apply here

GMC Council recruitment

The GMC is recruiting a medical member for its Council. Applications close on 31 October and are open to any medical candidate with a licence to practice from the four countries of the UK.  The Council comprises of 12 members (six lay and six medical). It sets GMC strategy, defines high-level policies and is responsible for making sure that the GMC fulfils its statutory and charitable purposes. You can find out more information about the role on the GMC 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 presidentnews@rcoa.ac.uk

New College website

As some members may know, we’ve been running a project to develop a brand new website for the College and I’m pleased to report that we’re due to launch this site in November.

In addition to a new College website, this project is also developing new online presences for the Faculty of Pain Medicine (FPM) and the newly-formed Centre for Perioperative Medicine (CPOC), as well as a few other projects to be launched in a few months’ time.

With the current College and FPM websites having been in place for well over five years, and the College undergoing significant change under our Technology Strategy Programme, now was an opportune time to develop new and improved shop windows to the College and some of our most critical work.

Providing our membership with tangible benefits and service improvements have been key to this work. Some improvements include:

  • reducing the amount of content on the website and improving the design and presentation to making it easier for members to search for, find and digest this information
  • providing members with a smoother process for booking courses, events and conferences
  • making our websites more accessible for those who require reading support and;
  • the anticipated integration with our up-coming new Customer Relationship Management system.

There are a number of other important elements of work which the College website team is working on and plan to roll out over the next few months: an interactive Member Portal; single sign-on across all College publications and event bookings; and the ACSA Portal.

Look out for more communications from the College about the launches, explore the new websites and tell us what you think. We have tested our new College website with our members and the general public, so we’re confident the changes we’re implementing will be of benefit to all.

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

Professor Ravi Mahajan
President