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Our working lives as anaesthetists revolve around effective teamwork, communication, and empathy with the many different professions we interact with. Interprofessional education (IPE) is an increasingly familiar teaching methodology which aims to enhance and improve these collaborative abilities. 

Considering recent critical reports on the lack of teamwork and interprofessional co-operation within clinical systems, we present a review of IPE and how its increased adoption may help address these failings.

Authors:

• Dr Chima Oti, Consultant Anaesthetist, London North West University Healthcare NHS Trust; Anaesthetic Lead for Undergraduate Medicine
• Dr Kimberley Hodge, Squadron Leader, RAF ST6 Anaesthesia and Intensive Care Medicine, Kimberley.hodge@nhs.net
• Dr Cara Lewis, ST5 Anaesthetics, London North West School of Anaesthesia
• Dr Aynkaran Dharmarajah, Consultant Anaesthetist, London North West University Healthcare NHS Trust

With such a minimal amount of time in the undergraduate curriculum allocated to anaesthesia, it is crucial that we maximise learning opportunities to inspire and develop future clinicians. Here is how we revolutionised the undergraduate anaesthetic placement at Northwick Park Hospital.

Why do medical students spend so little time on clinical placement with anaesthetics? As a foundation doctor one must be knowledgeable about a broad collection of topics; these include practical skills such as phlebotomy and cannulation, acute- pain management, and recognition and treatment of an acutely deteriorating patient. All of these are skills found within an anaesthetist’s armamentarium, placing us in the privileged position of being able to impart our knowledge to the next generation of doctors. As anaesthetics is a postgraduate specialty, our primary opportunity to help develop these skills for our colleagues is during their undergraduate attachment.

Author: Dr Stuart Connal, ST5, North Central London Deanery

Perioperative Journal Watch is written by TRIPOM (trainees with an interest in perioperative medicine – tripom.org) and is a brief distillation of recent important papers and articles on perioperative medicine from across the spectrum of medical publications.

Welcome to this special issue of the Bulletin, where we will showcase the work of some of the projects from the College’s Health Services Research Centre (HSRC).

We will also hear from our patient and carer group, PCPIE, who have been crucial in ensuring projects have meaningful involvement from development and delivery through to reporting. We are grateful to them for their wise counsel and insightful challenges. HSRC projects could not run without the dedication and vision of their leads and of the project teams supporting them. This includes strong involvement from our HSRC fellows (who, while often in post for only a year, never really leave the team), and we are delighted to have just welcomed our next six fellows to NELA, PQIP, SNAP, and quality improvement projects.

Author: Dr Dave Murray, Consultant Anaesthetist South Tees NHS Trust; Chair NELA

The National Emergency Laparotomy Audit (NELA) is 10 years old this year, so this is a timely point to review progress, highlight achievements, and look at the persisting challenges ahead.

In the beginning

NELA was commissioned in 2012. One of the key pieces of evidence to support its funding was the paper published by the Emergency Laparotomy Network.¹ This observational study of more than 1,800 patients highlighted a 15% mortality rate, but with a nine-fold variation in mortality across the 35 trusts. Consultant presence was 74% for surgeons and anaesthetist presence was 64%. Half the patients were admitted to critical care, and patients returning to the ward had a 6.7% mortality rate.

Author: Dr Carolyn Johnston, Consultant Anaesthetist and Deputy Medical Director, St George’s Hospital; Chair of QI working group

During the early days of the COVID-19 pandemic, the UK government talked about their goal of delivering ‘shots in arms’ as the ultimate goal of the vaccine efforts. This wasn’t an exercise in expanding scientific knowledge or customising production, but the aim was clearly stated as being to deliver those advances to citizens in order to prevent them from becoming patients.

A large number of lives were saved by rapid development and national deployment of the new vaccines: the success of the vaccine programme is a reminder to us all how knowledge without application will not improve care.

The HSRC portfolio of projects creates a huge amount of knowledge that has the potential to improve care for our patients, but this knowledge remains potential unless we implement the recommendations of the various reports and use the rich datasets created to inform us of the most pressing areas for improvement in our clinical pathways.

Authors:

• Dr Andrew Kane, NAP7 Fellow, ST7 in anaesthesia, South Tees NHS Trust
• Professor Tim Cook, RCoA Director of the National Audit Projects, Consultant in Anaesthetics and Intensive Care Medicine, Royal United Hospitals, Bath
• Dr Jas Soar, NAP7 Clinical Lead, Consultant in Anaesthetics and Intensive Care Medicine, Southmead Hospital, Bristol

After a delay due to Covid, we are pleased to say we are in the final stages of NAP7. The baseline and activity surveys are complete and being prepared for publication. The NAP7 panel is working hard to digest all possible learning from the case registry. Here we provide a brief update, with the full report coming in late 2023. We are hugely appreciative of the contribution of all anaesthetists.

The largest NAP yet

Perioperative cardiac arrest has seen the most cases reported of any NAP. The large number of cases reported is an indication of the ability of UK anaesthesia to successfully come together and focus on an important patient-focused issue, and also shows the incidence of perioperative cardiac arrest is greater than events forming the focus of previous NAPs.

Authors:

• Dr Olly Boney and Dr Cliff Shelton, PCPIE Group co-chairs
• Jenny Dorey and John Hitchman, PCPIE Group lay members

We go behind the scenes of the NIAA’s Patient, Carer and Public Involvement and Engagement Group (aka the ‘PCPIE' Group) to speak to some of its members about their work and how they believe it benefits research.

Dr Olly Boney and Dr Cliff Shelton, what does PCPIE do?

OB: In a nutshell, we review research proposals and provide feedback from a patient and/or carer perspective.

Our membership is very diverse, and most members have a completely non-clinical background so they are well placed to appraise studies through a patient-focused lens and suggest improvements to a study’s design to make it more patient-friendly.

Authors: Dr Martha Belete and Dr Eleanor Warwick, PQIP Fellows

The Perioperative Quality Improvement Programme has been running since 2016 and wouldn’t be anything without our collaborators. We would like to thank them all for their hard work.

Despite the COVID-19 pandemic having a massive impact on research studies, we are now well into our recovery and are thrilled that recruitment is gathering momentum and that we have more sites joining us. So far, more than 150 hospitals have been involved, with more than 39,000 patients recruited! It is an exciting time for PQIP. Below we have detailed three of the areas we have been focused on, but if you would like to read about our other activities or get involved please visit our website. We are also part of the Associate Principal Investigator scheme for those who want to develop skills in leading research projects locally.