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I’ve been wondering recently how far I should be embracing or resisting my own background when speaking as a patient voice.

I took on the role of Chair of PatientsVoices@RCoA in September, and I’ve found it fascinating to learn about a whole range of issues that are new to me and to contribute to discussions about them. But I’ve also been struck by how often I’ve found myself thinking that the need for good communications lies at the heart of whichever issue is under discussion. And I’ve been wondering whether that reflects the reality, or my own particular interests.

Questions around financial viability, impact on relationships with the ‘parent’ College, and loss of corporate strength are all concerns I’ve heard following FICM’s statement. 

You might be interested to know that they were also the exact ones expressed at the time the Faculty of Anaesthetists went through their own journey.¹ The journey leading to the formation of the RCoA was not without setbacks and differences of opinion. Faculty board are cognisant of that history, and so are mindful that for our part discussions leading up to our separation are based in a friendly and constructive spirit.

This credentialing journey has been one long road, but 2024 will finally see us making further inroads.

When the General Medical Council recently approved the ‘Curriculum for the Credential for the Specialist in Pain Medicine’, we were delighted that six years of hard work has come to fruition.

To date, specialist training in pain medicine has largely only been open as part of the CCT training in anaesthesia or post-CCT for a small number of consultants who opted to pursue training.

Author: Dr Stuart Connal, Specialty Registrar in Anaesthesia, 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.

In 2020, the RCoA partnered with the National Institute for Health and Care Research’s Cancer and Nutrition Collaboration and with Macmillan Cancer Support to produce guidelines on prehabilitation: ‘Principles and guidance for prehabilitation within the management and support of people with cancer’. 

One of the actions set out in the guidance was to ‘Develop a “Community of Practice” resource to provide contacts of local/regional sites and share expertise and learning from established prehabilitation programmes’.

The Centre for Perioperative Care (CPOC), founded by the RCoA is dedicated to the promotion, advancement and development of perioperative care. Naturally, CPOC has a vested interest in prehabilitation and therefore set about considering how this action might be best delivered in conjunction with Macmillan Cancer Support.

• Dr Dermot McGuckin, ST7 Anaesthesia & Pain Medicine, University College London Hospitals
  Email Dr McGuckin
• Dr Fausto Morell-Ducos, Consultant in Anaesthesia & Pain Medicine, University College London Hospitals
• Dr Jamie Smart, Consultant in Anaesthesia & Pain Management, University College London Hospitals
• Dr Brigitta Brandner, Consultant in Anaesthesia & Pain Management, University College London Hospitals

Opioids play an important role in facilitating recovery and return to function after surgery. 

However, it is now well-established that surgery is a risk factor for persistent postoperative opioid use,¹ and preoperative opioid use is associated with an increased risk of perioperative complications.²

Perioperative opioid stewardship is a practical approach providing a systemic, multi-layered framework aimed at minimising the risks associated with opioid use around the time of surgery, while allowing their safe administration to those patients most likely to benefit from them. It is increasingly regarded as a solution to the problem of prescription opioid-related harm but there is a lack of structured curricula to develop healthcare professionals’ skills in competent opioid management.