2021 Annual Review: President’s statement

Welcome to our 2021 Annual Review. It is a great honour to write this, my first annual review statement as President of the Royal College of Anaesthetists. Since I took office, the College has continued to flex and evolve to better support you, our Fellows and Members, and despite the many challenges of the ongoing pandemic we have continued to work to deliver for our membership across the UK and internationally.

2021 was a year in which vaccinations allowed us to also start looking beyond the immediate threat of the pandemic. It has become clear that issues already identified have been exacerbated by COVID-19 – waiting lists and the wellbeing and morale of staff have never been in sharper focus.

We know that a rested workforce is an effective and safe workforce which is essential to tackle the elective surgery backlog. However, we have seen from previous surveys that exhaustion and stress have increased due to workloads and an ever-decreasing workforce, and this has left a mark on the mental health of many, with some questioning their very place in medicine. Championing our membership is one of my priorities as President and we will continue to work both within the College and with external stakeholders to support you.

Advocating for the future of the specialty in 2021 could not have been better demonstrated than by the launch of our Anaesthesia – fit for the future campaign which explores the barriers to workforce growth to help visualise ‘team anaesthesia,’ and define the support needed to deliver the best possible patient care in the aftermath of COVID-19 and beyond.

In 2021 our work with the Department of Health and Social Care, Health Education England and other devolved nation stakeholders to negotiate support following ST3 recruitment  was one such example of how we worked to try and remove barriers for our workforce. The ST3 recruitment round in the spring of 2021 saw a record number of applications. Various factors contributed to this, but we know that since the start of this pandemic, our highly valued Anaesthetists in Training have seen immense disruption to their working lives, whether it be the pivot to virtual exams, or difficulties with training because of the pandemic. They have shown real resilience and fortitude during what have been extremely challenging times. In 2021 along with the production of equivalent training guidance and calls to increase training numbers, we continued to advocate on behalf of our future workforce.

Anaesthetists and intensive care doctors, alongside other healthcare workers, have been crucial to keeping the NHS running during the pandemic and the College has worked hard to be innovative to support all our members under the constraints of the last year. A good example of this is the Anaesthesia Clinical Services Accreditation (ACSA) scheme which offers quality improvement through peer review and has continued to see growth, with 74 per cent of NHS organisations now registered with the scheme and 41 NHS anaesthetic departments gaining accreditation. As a result of the pandemic, we adapted the ACSA process to a hybrid model to better support progression through the scheme and following the launch of the web portal for our ACSA community in 2020, anaesthetic departments were able to track their progress across the standards. We also made the Good Practice Library freely available to all registered departments. 

The Guidelines for the Provision of Anaesthetic Services (GPAS) also expanded during 2021 with the publication of Perioperative Care of Elective and Urgent Care Patients and the Good Department chapters. The Good Department in particular focusses on the professional and pastoral needs of members. The policy work undertaken on behalf of the Centre for Perioperative Care (CPOC) also addressed new commitments to improve care across the patient pathway and to embed perioperative care within the healthcare system. CPOC worked closely with the Elective Recovery Programme in 2021 and we look forward to this important stream of work continuing to help us achieve our vision for the future.

I was pleased to see the government’s People Plan pledge to put staff mental health at the heart of the NHS. We will continue to ask for a sustained, coordinated, and funded approach to mental health and wellbeing, a lifeline for some staff who may feel they have given everything they can and cannot give anymore.  Nobody knows what the next five years will bring: we could not have predicted the scale and immediacy of change that the pandemic was to unleash. However, what we do know is that we need to be adept in supporting and training clinicians in the fields of anaesthesia, pain medicine and intensive care medicine to continue to deliver the best possible care for patients, whatever the circumstances.

This is why 2021 was also the year in which we started to formulate our new strategy and vision. Our Five-Year Commitment aims to provide you, professionals in our specialities, with the tools and support needed to be able to look after your own and each other’s welfare and to care for patients.

As a College we must remain connected to our membership, staff, patients and public as we forge these new paths together. We will listen and respond to what is important so that collectively we can be the best we can be. Our strategy is both patient- and member-centric, and we will use our values of being caring and supportive, just and fair, innovative and progressive, and open and responsive as a guide to providing kind and compassionate leadership in everything we do.

I hope that as you read our 2021 Annual Review, you are reminded of the vision we have set out for the College over the next five years. To achieve that vision, we need to continue to work with and for you so that we can ensure that your voice is at the heart of healthcare conversations at the highest levels. We want to provide you, the professionals in our specialities, with the tools and support you need at every stage of your career.

I thank you all for your continued hard work, dedication and commitment and I look forward to working with you in the years ahead.

Dr Fiona Donald

RCoA President