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I’d like to wish you all a very happy New Year. I realise that January is a very challenging time in the NHS, with winter pressures compounded by ongoing staff shortages and sickness. And in looking ahead to some of the College’s priorities for 2024, I’d like to highlight some of the work we're doing to try to address these issues.  

The urgent need for more doctors to be able to train as anaesthetists is always the first thing I raise in conversations I have with the government, NHS England and other decision makers around the country. Last month I wrote to the new Secretary of State for Health and Social Care to set out the need to address the current shortage of anaesthestists and to outline the impact this is having on the elective care backlog, among other things. 

In the last year we have secured some incremental improvements on this front, but there is a long way to go, and we will do all we can to maintain momentum in the year ahead.

New Year is always a time of reflection, particularly as for me it is also the anniversary of my joining as CEO at the College. That is now four years ago, and I find myself looking back on the challenges the College has faced over that time, the changes that have been made and the achievements of our volunteers, elected leaders and staff team.

It has been a remarkable four years. Within a couple of months of my appointment COVID-19 hit. The challenges for our membership were enormous. The specialty was at the frontline, and anaesthetists and intensivists had to learn and adapt at pace to provide the best possible care for the patients who were most seriously ill under very challenging circumstances. The College too had to urgently adapt.

Exams, which had always been held in person, were rapidly moved to virtual platforms. It was a steep learning curve for so many of us and it didn’t all go as smoothly as we wanted, due in large part to the pressures put on so many by the pandemic. Nevertheless, I was proud of the College, its examiners and the exams team, who, along with candidates, contributed fully to the subsequent independent review of our assessment process. The review was published earlier this year. Lessons were learnt and changes have been made that have seen us continue to welcome almost 5,000 candidates per year to the College for their exams.

Airway management is a crucial aspect of patient care, where effective and prompt actions can be life saving. The RCoA recognises the importance of continuous education and training to ensure healthcare professionals are well equipped to handle complex airway scenarios.

Multidisciplinary simulation has arisen as a valuable tool in this regard, offering an immersive and dynamic learning experience that fosters collaboration among different professionals involved in patient care.

Traditionally, training in airway management has often been siloed, with the focus on individual disciplines. However, real-life situations demand a coordinated effort from various healthcare professionals, including anaesthetists, operating department practitioners, nurses, physiotherapists, surgeons and theatre nurses. Therefore, conventional training styles may not adequately prepare individuals for the intricacies of interdisciplinary communication and cooperation.

Maintaining and improving the LLP

Since its launch in August 2018, the College has committed to improving the reliability, performance and general user experience of the Lifelong Learning Platform (LLP) for our members. With the inclusion of three new curricula and of ICM users in late 2021, it became apparent that the added level of complexity and the need to support more users required additional funding, so a sizeable new budget was approved by the College’s Finance and Resources Board in August 2022.

This additional funding has allowed us to resolve many historic issues, keep the infrastructure and related systems up to date, as well as making significant improvements where needed. We still have a great deal of work to do, but as you will see below, we have already achieved a lot over the last year and have a clear plan of where we are heading in the coming months.

At Nottingham University Hospitals (NUH), it was felt that for our patients with cardiovascular disease, obtaining a preoperative cardiology assessment and perioperative management strategy was prolonging non-cardiac surgery waiting times. 

This was especially compounded by the surgical backlog and increased demand on preoperative services following the COVID-19 pandemic. In order to streamline the assessment process and facilitate safer surgery, a joint cardiology-anaesthesia multidisciplinary team (MDT) meeting was established.

The global problem

It is no surprise that underlying cardiovascular disease can contribute significantly to perioperative morbidity and mortality, with cardiac events being the leading cause of such.¹ Almost half of adults aged over 45 years undergoing major non-cardiac surgery have at least two cardiovascular risk factors, and conditions such as coronary heart disease, heart failure and arrhythmias put patients at increased risk of cardio- and cerebrovascular events in the immediate postoperative period.²

They're the fresh faces of anaesthesia and the future of our specialty.

We introduce you to some of our newest anaesthetists in training. We hope all of them and the rest of our trainees have very long, rewarding, and fulfilling careers as anaesthetists.

The event featured a number of key College stakeholders, including Council members Giovanna Kossakowska and Matt Tuck representing anaesthetists in training, plus other trainees with their own advice to share, alongside our President Fiona Donald and a host of others. 

The College hosts regular online ‘Let’s Talk’ events for our members. These meetings are an opportunity for you to talk with College representatives about whatever’s on your mind. 

You might have questions or feedback for us, or you might want to share your views or experiences on any number of issues affecting the specialty.