President's News, September 2019

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This month I had the pleasure of attending my first Diplomates Day as President of the College. The Presentation of Diplomates is the most important ceremonial occasion in our calendar. It is a celebration of those members who have received the Fellowship of the Royal College of Anaesthetists (FRCA), and members of the medical profession and beyond who have served anaesthesia and its related disciplines at the highest level. Congratulations to everyone who was honoured on their well-deserved success.

A total of 390 diplomates from the RCoA, the Faculty of Pain Medicine, and the Faculty of Intensive Care Medicine, alongside 700 family members and friends attended this year’s event hosted in the iconic Central Hall in Westminster. To successfully pass the most rigorously conducted test of anaesthetic knowledge is a tremendous achievement. However, this success would not be possible without the support and good wishes of partners, parents, relatives and friends. I sincerely thank all those who supported diplomates during their testing times.

I would like to thank our guest speaker Professor Rob Sneyd, (College Vice President 2011-2012), and gold medal award winner who spoke so eloquently about his experiences working within the specialty and sharing such inspiring words with our newest diplomates.

In addition, I would also like to take this opportunity to thank former College CEO Tom Grinyer who was awarded the College Medal for his work leading the College for the past four years and for making such a clear and significant contribution to our work. Lastly, I would like to express my sincere thanks to all the College tutors, regional advisers and programme directors who ensure that the interests of trainees are protected, and that the standards of our anaesthetic training is maintained. Without you, there would be no programme of training delivered. Thank you for all for your efforts.

The ceremony was streamed live online for family and friends unable to attend, and I would like to thank the College staff who worked tirelessly behind the scenes to ensure that the event ran smoothly and that it was a fitting and memorable celebration for all in attendance.

The College is an active place - a space for all our fellows and members. Those obtaining the Diploma of Fellowship shouldn’t see this as the end of their active association with the College. Many aspects of the continuing success of anaesthesia, critical care and pain medicine depend upon the energy and commitment of our fellows and members throughout their careers. We encourage them all to remain active and engaged with the College and pass their knowledge and experience to others. They are after all the College tutors, examiners and Council members of the future. Who knows, one among them may become president and have the honour of leading our specialty in the future.

Election to RCoA Council: Nominations closing soon

The deadline for nominations to RCoA Council is fast approaching. Why not consider standing to be a Council member?

The available Council vacancies this year 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
  • there are no trainee vacancies this year
  • there are no SAS vacancies this year.

Everybody has their own idea of what the College does, and usually it’s education, training and exams that first spring to mind - but there is so much more that makes a 21st century College run smoothly and effectively. The College is keen to hear from members that can help a forward-looking, 21st century College thrive.

For example, the Clinical Quality & Research directorate set standards through our Guidelines for the Provision of Anaesthetic Services, which shape the service and patient care you provide. Can you use your specialty expertise to write standards, or work with Anaesthesia Clinical Services Accreditation to accredit anaesthetic departments? The College responds to many, varied consultations, needing knowledge from all specialties - medicolegal experience for example, is greatly valued.

Representation of the profession’s interests to government and employers, and keeping fellows informed relies on excellent communication and external affairs channels. Do you enjoy connecting with audiences and presenting? Do you have a social media presence which can help get the College’s message across?

The College looks for diversity amongst its Council members, and skills acquired from outside medicine are often the most valuable. As anaesthetists, we provide an important service to patients and you deserve an active, caring and responsive College.

Nominations close on 30 September at 12 noon. Please consider playing your part.

Further information, including a detailed timetable, can be found online.

Contact Information:
Rose Murphy
CEO Office Manager
Royal College of Anaesthetists
35 Red Lion Square
London WC1R 4SG

020 7092 1612

Survey reveals extent and impact of fatigue on hospital consultants

This month saw a survey on the scale and impact of out-of- hours working on consultant anaesthetists and intensivists published in the journal Anaesthesia. The campaign to Fight Fatigue amongst anaesthetists is something the College has long been committed to and the survey demonstrated that fatigue is having a large impact with 91 per cent of consultant doctors who responded experiencing work-related fatigue and 50 per cent of them reporting this had a moderate or severe impact on health, wellbeing, work and home life. It is also having an impact on safety with 45 per cent of respondents admitting to either having a car accident or near miss when commuting whilst fatigued, with 1 in 10 of these as a consultant. Senior doctors do not feel they are being listened to in the workplace over their wellbeing and health concerns. We need to see changes in organisations including better rest facilities and a change to working patterns. Improving working conditions benefits both the workforce and patients and by working cross speciality and gaining support from politicians we hope the Fight Fatigue campaign will encourage changes across the NHS.

Events update

CPD Study Day, Newcastle 17–18 October 2019

Join us this October in Newcastle for an update on world-class anaesthetic practice. This event will cover a broad range of engaging topics, bringing you up to speed on the latest thinking and new techniques.

We are pleased to share the programme for the event with expert speakers including:

  • Dr Chris Snowden, Clinical Lead (Joint) for perioperative medicine
  • Dr Rachel Hawes, Consultant in anaesthesia & prehospital emergency medicine
  • Dr James Prentis, Consultant anaesthetist at Freeman Hospital
  • Dr Catherine Penrose, Consultant in paediatric intensive care medicine

Book your place today.

Delegate feedback from previous CPD Study days

“If the same high standard were maintained at future events I think you would have something to continue to be proud of”

“Well thought out, mix of general and sub-speciality oriented aspects of anaesthesia were covered”

“A good way to keep updated on interesting topics run by people who care about the specialty”

“Excellent broad based update in Anaesthesia”

Volunteer as a Clinical Content Lead

Would you like to get involved in planning an upcoming event?

Do you have ideas for topical, relevant and diverse topics and speakers for a programme?

We are currently looking for volunteers to get involved as Clinical Content Leads for educational events throughout 2020. As a Clinical Content Lead you will work with the College to develop event content and themes to meet the needs of our members. This will involve suggesting topical, relevant and diverse speakers and chairs for the programme as well as supporting the event during the build-up, attending on the day and de-briefing to ensure event evolution.

Please Email the events team for more information.

Updates in anaesthesia, critical care and pain management, Birmingham 4–6 November 2019

With the September updates event now sold out, the next updates will be this November in Birmingham. Register for this event to discover new developments on the horizon from today’s thought leaders and discuss your experiences with peers, to bring back new ideas that will improve your own practice.

Topics will include:

  • impact of fatigue and wellbeing on the learning environment
  • perioperative management of patients with dementia
  • post-surgical prescription and opioid dependence
  • the multidisciplinary team approach for high-risk and major cancer surgery
  • nerve injury during anaesthesia.

This event is filling fast so book now.

Delegate feedback from previous updates events

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

‘There’s something to add to your clinical practice from almost every talk’

‘Not only relevant to current practice but really forward looking to how future practice may change’

UK Training in Emergency Airway Management (TEAM), Edinburgh, 7–8 November 2019

Are you a qualified doctor looking to pursue a career in anaesthesia, critical care, emergency medicine or acute medicine? This two-day simulator-based course is designed for you.

You will be taught the foundations of the knowledge, skills and attitudes required to safely manage the airway in an emergency situation outside the operating theatre.

Areas covered during the course:

  • basic airway
  • difficult and failed intubation
  • paediatric workshops
  • post intubation
  • small group work and case scenarios using high fidelity patient simulators

Anaesthesia 2020 – first speakers announced

The third edition of the College’s flagship conference Anaesthesia 2020 will take place in Manchester on the 18–20 May 2020. We are excited to announce the first two speakers for this three-day event:

  • Professor Bruce Biccard, Second Professor and Second Chair in Anaesthesia, Deputy Head of Department, University of Cape Town

    Bruce will be speaking about his research interests, which include perioperative medicine, perioperative outcomes and global surgery

  • Professor Michael Irwin, Daniel CK Yu Professor and Head, Department of Anaesthesiology, University of Hong Kong

    Professor Irwin has published over 260 articles in peer-reviewed scientific journals and is a regular invited journal reviewer. He is an editor of numerous publications including Anaesthesia and the Hong Kong Medical Journal. His research interests include intravenous anaesthesia, pharmacology, enhanced recovery and organ preconditioning.

A limited number of early bird tickets are available now, so book your place today to enjoy these two speakers as well as many others.

PQIP Annual Report launches at Collaborative Event

The Perioperative Quality Improvement Programme (PQIP) is today launching its Annual Report 2018-19 at its Collaborative Event at King’s Place in London. Major outcomes are improving, as well as some key process measures; however, other processes, in particular those that might require multidisciplinary engagement or structural changes are proving somewhat more difficult to gather pace.

Approximately 124 hospitals are now involved in PQIP – sign up at and click here to read the PQIP Annual Report 2018-19.

2019 research award now open

Applications are now open for the NIAA Research Award 2019, which aims to promote and encourage current and active researchers within the field of anaesthesia, perioperative medicine or pain research in the UK. Deadline for applications is Monday 7 October 2019.

The Award will be presented at Anaesthesia Research 2019 at The Principal Hotel in York from 2-3 December 2019. The meeting incorporates all NIAA-affiliated activities 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 discounts for trainees, AHPs and QuARCs. 10 CPD credits anticipated.

NIAA grant and survey deadlines

I would also like to remind you that applications are still open for 2019 Round 2 of the NIAA Grants.

If you have previously applied for funding through the NIAA, we invite you to share your views on the grant application process, which the NIAA is reviewing to ensure it remains robust and responsive going forward. We hope you can assist by answering a short survey that should take less than 10 minutes to complete.

Click here for the survey, which will remain open until Monday 30 September 2019.

The Safe Anaesthesia Liaison Group’s latest Patient Safety Update

The Safe Anaesthesia Liaison Group has published its latest Patient Safety Update, which contains important learning regarding reported anaesthesia-related untoward incidents.

This update contains anonymous case studies from January to March 2019, and includes items relating to:

  • accessory common gas outlets
  • insertion of dialysis and central lines
  • drug errors
  • equipment errors/knowledge
  • sudden absence of monitored vital signs
  • prone position
  • hip fracture frailty

I would like to bring these updates to the attention of as many anaesthetists as possible, so please read and circulate the document as widely as you can.

National recognition for Dudley Group anaesthetic department

This month the College was pleased to present the anaesthetic department at Dudley Group NHS Foundation Trust with the prestigious Anaesthesia Clinical Services Accreditation (ACSA). The accreditation is richly deserved and demonstrates their commitment to providing the best possible care for their patients.

Dudley is the first NHS Trust in the West Midlands to become accredited, and only the 33rd in the UK. I would like to offer my personal congratulations to the entire anaesthetic department on their achievement.

Patient engagement is a key focus of what we do as a medical royal college and the review team was particularly impressed by the integration of services from doctors to support staff, which developed and enhanced the quality of care they provided across the hospital. The anaesthetic team also demonstrated an imaginative use of IT systems in improving processes and the patient journey.

As well as meeting the ACSA standards, the department 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.

e-Learning Anaesthesia – now even more useful to your anaesthetic practice

e-Learning Anaesthesia (e-LA) is our multi-award-winning online e-learning resource created to support education and training in anaesthesia. e-LA is the largest and most accessed e-learning project in the NHS, with over 3.3 million sessions launched and 1.63 million hours of learning delivered since its inception eleven years ago.

e-LA contains over 800 interactive e-learning sessions, which are organised into modules and supported by more than 1,000 other learning resources. RCoA videos as well as articles and MCQs from CEACCP/BJA Education are presented by date and subject, supporting both training and specialist revalidation.

All modules and resources are subject to ongoing review in order to ensure that e-LA remains up to date with current anaesthetic practice and the curriculum.

Over the past 12 months the structure and content of Module 3 – An Introduction to Critical Care has been extensively revised, updated and realigned to the current training programme.

The aim of the new module is to introduce the principles and practice of ICU to core anaesthetic trainees with minimal experience in ICU, as well as ACCS or Foundation trainees rotating through ICU. It is also an excellent resource for anyone taking the Primary FRCA exam.

Led by Ali Hall, Charly Gibson and Nim Pathmanathan, the process involved the peer review of all existing sessions as well as the restructuring of the module to make it more accessible and relevant to the new starter in ICU.

The final result is a new module with 120 new or updated sessions covering recognition of the critically-ill patient, general ICU care, organ support trauma and end-of-life care.

The revisions are now live so log on and explore the new module and see how it can support your learning experience and professional development in critical care.

Recruitment for the 2020 intake of NICE fellows and scholars is now open

The National Institute for Health and Care Excellence (NICE) is again offering an opportunity to those working in health and social care to gain a unique insight into the work of NICE, influence its work and gain access to a range of career enhancing opportunities. Fellows and scholars are supported through a series of workshops, along with access to an allocated adviser.

Previous fellows and scholars have found that the programmes really helped to open doors for them to progress their careers and raise their profiles.

Recruitment for the 2020 intake of NICE fellows and scholars is now open. The programmes recognise the achievements and promise of individuals from health, public health and social care who are working to improve the quality of care.

NICE appoints up to 10 fellows and 10 scholars per year. Fellows and scholars benefit from development opportunities and get to work with like-minded colleagues from different disciplines across the UK.

NICE fellows are senior health and social care leaders who are ambassadors for the Institute at regional and national levels and among their professional groups and peers. Over the course of their three-year fellowship they are expected to dedicate around 1 day per month to using their networks and influence to support NICE in the implementation of its guidance.

NICE scholarships are one-year opportunities for individuals working in health and social care to find out about the inner workings of NICE and undertake an improvement project, related to NICE products, within their local area. Scholars are expected to dedicate approximately one day per week to their scholarship activities.

Both roles are unpaid and undertaken alongside successful candidates’ existing jobs.

Applications close on 28 October. More information can be found at:

National guidelines for Freedom to Speak Up

The national guidelines on the content of speaking up training for all health organisations in England has been published by the National Guardian’s Office for the NHS [NGO].  In a recent case review, it was observed that training on Freedom to Speak Up had not kept pace with developments in the field and did not fully reflect the NHS’s approach to speaking up. NGO have developed national guidelines that are designed to improve the quality, clarity and consistency of training on speaking up across the health sector. The guidelines are for any individual or organisation commissioning or delivering Freedom to Speak Up training for their workers and are applicable to providers of healthcare, regulators, and other bodies with a role in healthcare. They are set out in three parts covering:

  • core training for all workers
  • line and middle management training
  • senior Leaders training.

The National Guidelines can be found on their webpages, and include details of the methodology that organisations could employ when providing training.

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

Professor Ravi Mahajan