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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.

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.

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.

Author: Dr Alistair McNarry, RCoA Airway Leads Advisor

It may seem that we have been reporting on the HSRC-DAS-University of Nottingham collaboration on the UK eFONA Registry for a very long time. However, I am delighted to say that, a bit like a jigsaw puzzle, all the pieces are finally starting to slot together.

Data-sharing agreements have now been signed between the HSRC, the University of Nottingham and the Difficult Airway Society. This complements the memorandum of understanding signed between the HSRC and DAS last year.