RCoA responds to launch of GIRFT Vascular Surgery Report

Responding to the launch of the GIRFT Vascular Surgery Report, Dr Chris Snowden, joint clinical lead for the Anaesthetic and Perioperative Medicine GIRFT programme, said:

The Royal College of Anaesthetists is pleased that the recommendations of the GIRFT Vascular Surgery Report put particular emphasis on the importance of the perioperative model of care and involvement of an integrated, multidisciplinary team approach to the effective management of predominantly urgent patient caseloads.

“The care of patients undergoing aortic surgery is in many ways an exemplar for the role of perioperative care in improving patient outcomes. The UK AAA Quality Improvement Process delivered a three-fold reduction in mortality for abdominal aortic aneurysm repair.1 Key aspects included the centralisation of services, improved preoperative assessment and engagement of anaesthetists with the Vascular Multidisciplinary Team meetings.

“The Report makes it clear that further improvements in the delivery of enhanced vascular care require a continuation of these aspects. While adopting this approach will be challenging for all specialties and will require substantial changes in practice for some, it holds out the promise of better outcomes for patients.”

“Of specific importance to the College is the report’s mention of prehabilitation (preoperative optimisation of patients’ medical issues including exercise therapy – recommendation 8) and the relevance of good perioperative care after surgery to prevent early patient readmission (recommendation 9).

“The importance of an increase in ward-based recovery is only possible with an appropriate level of perioperative care and emphasises the importance of a dedicated perioperative team that could be led by anaesthetic personnel.

“As mentioned in the Report, the Anaesthetic and Perioperative Medicine GIRFT programme will address all these issues in a cross-cutting theme approach for all aspects of surgical care, of which vascular surgery is just one component.”


  1. Howell SJ. Abdominal aortic aneurysm repair in the United Kingdom: an exemplar for the role of anaesthetists in perioperative medicine. Br J Anaesth. 2017 Dec 1; 119(Suppl1): i15-i22.

07 March 2018