May 2018 Perioperative Medicine Newsletter

Welcome to the May edition of the Perioperative Medicine newsletter. It has been a busy few months with plenty to share and as ever we ask you to get in touch with us to let us know about your projects and news.

Click on the title of this section to view the newsletter online.


31 May 2018

Podcast released: BMJ talk medicine

What Choosing Wisely looks like in the UK


Choosing Wisely was launched in the US, to much fanfare. Since then the movement has spread around the world, with successful chapters set up in Canada, Australia Brazil, Italy, Japan, new Zealand - and most recently the UK.

The campaigns have not been without criticism – from how individual recommendations were chosen, to the way in which patients have been involved.

In this podcast, BMJ talk medicine are joined by 3 of Choosing Wisely UK’s steering group, Professor Sue Bailey, head of the steering committee, Ramai Santhirapala, honorary consultant in anaesthesia and perioperative medicine, and, Richard Lehman, GP.

Listen to the podcast here:


28 September 2017

GIRFT project leads announced

RCoA Perioperative Medicine Leads Dr Chris Snowden and Dr Mike Swart have been announced as the Getting It Right First Time (GIRFT) Clinical Leads for Anaesthesia and Perioperative Medicine.

GIRFT is a clinician-led programme aimed at improving patient care by reducing unwarranted variation in service provision and clinical practice.

Dr Snowden and Dr Swart will work with anaesthetists across England to consider ways to improve the delivery of perioperative medicine and anaesthesia. Unlike in other specialties, where the clinical leads are responsible only for their own areas, Dr Snowden and Dr Swart will be responsible for assessing unwanted variation across the patient pathway.  They will be sharing best practice with clinicians to empower them to replace areas of poor value with higher quality care.

GIRFT methodology includes using data from national registries to produce individualised reports for each hospital with a follow up from the clinical leads. Discussions are held with clinical and managerial teams about variations in practice which result in suboptimal quality of care or wasted resources. The GIRFT leads work with these teams to improve the quality of care and reduce costs for the hospital.

The GIRFT project will work in conjunction with the College’s Perioperative Medicine Programme to improve the quality of perioperative care.  The College’s Perioperative Medicine Programme was established in 2014 and focuses on delivering the best possible care for patients from the contemplation of surgery through to recovery, as well improved quality of life in the long-term.  The evidence of best practice being produced by the Perioperative Medicine Programme will be used to help reduce variations in practice.

The RCoA is co-sponsoring this new role with NHS Improvement.  Dr Snowden and Dr Swart will take up their role from 1 September.

RCoA Council Member Dr Anna Batchelor has also been named as the GIRFT Clinical Lead for Intensive Care/Critical Care. 


24 July 2017

A Survey of UK Perioperative Medicine: Pre-operative Care 

An article on the results of the POM Leads' survey, carried out in Autumn 2016. 
The increasing quality of perioperative medicine delivery in the UK has been highlighted in an article in the latest edition of Anaesthesia.
The article, written by the College’s National Leads in Perioperative Medicine Dr Chris Snowden and Dr Mike Swart, along with the College’s Fellow in Perioperative Medicine, Dr Anne-Marie Bougeard, discusses the variance between preoperative assessment practice in UK hospitals following a survey of Local Perioperative Medicine Leads.
Dr Snowden, Dr Swart and Dr Bougeard discuss the many examples of excellent practice in perioperative medicine, but also the wide variance in processes between hospitals.
As expressed in the article:
“…this survey demonstrates that preoperative Perioperative Medicine services across the United Kingdom vary widely, however it is encouraging that there are pockets of excellent practice which should be shared and we believe this is the best approach to developing consistent services across the country. There are many opportunities for Local Perioperative Medicine Leads to share best practice.”
Improving perioperative medicine is a major aim of the RCoA’s Strategic Plan 2016-2021. The College’s Perioperative Medicine Programme began in 2014 and has expanded to two national leads, a Fellowship in Perioperative Medicine, a National Leadership Group and more than 170 Local Perioperative Medicine Leads.
We encourage all RCoA members to discuss the results of this survey with their Local Perioperative Medicine Leads and their colleagues to consider ways to implement Perioperative Medicine best practice in their local hospitals.


20 June 2017


National Paediatric Pre-operative Network Conference

Members of pre-assessment teams from around the United Kingdom attended the first National Paediatric Pre-operative Network conference sponsored by the Association of Paediatric Anaesthetists (APA) in Birmingham on 9 September 2016. The meeting was well attended by 90 delegates, including anaesthetists, nurses and managers. The conference was a fantastic opportunity to meet, network and share ideas of best practice in setting up and developing paediatric pre-operative assessment. Trade stands included electronic pre-assessment screening systems delegates could trial.
Feedback from the day:
97% of delegates rated the meeting as good, very good or excellent.
"Great sharing of experience in building up services and networking"
"Generous time included for audience participation."
"The day was about improving service in hospitals and was different to other courses."
The meeting explored different ways of working and set the wheels in motion for future collaborative working. To join the network please contact the conference organisers Dr Nadia Ladak ( or Dr Barry Lambert (
The next paediatric pre-op conference will be held in Sheffield on Friday 15 September 2017.


AoMRC Choosing Wisely Campaign Launches - Supported by RCoA 


The Academy of Medical Royal Colleges, supported by the Royal College of Anaesthetists (RCoA), has today launched the Choosing Wisely campaign across the UK.

For Choosing Wisely, the RCoA has developed five evidence-based recommendations for elective surgery, all of which have been endorsed by the Royal College of Surgeons. The recommendations were developed to not only improve patient care and safety, but deter the use of unnecessary treatments which cost the NHS millions of pounds every year.

Read more here. 


BMJ Awards 2017 - Anaesthesia Team of the Year 

Entries now open. 


Once again, the Royal College of Anaesthetists (RCoA) is sponsoring the Anaesthesia Team of the Year category in the 2017 BMJ Awards

Started in 2008, The BMJ Awards are the UK's leading medical awards programme, recognising and celebrating the inspirational work undertaken by clinicians and the teams they work with. The award recognises an innovative project in the field of anaesthesia which has significantly improved the quality of patient care.

Last year the SW Anaesthesia Research Matrix (SWARM) team were recognised as the 2016 Anaesthesia Team of the Year for their work in providing a route into research in anaesthesia, pain and perioperative medicine for NHS clinicians.

Dr Liam Brennan, RCoA President, said: “I strongly encourage as many teams as possible to take part and submit their entries for Anaesthesia Team of the Year. Across the UK, there are many impressive examples of innovative patient-focused research and quality improvement activity which would be very worthy candidates for receipt of this prestigious award.”

Entries are invited until January 2017, with the Awards being announced on 4 May 2017. More information can be found on the BMJ Awards website.


Anaesthesia & Perioperative Care Priority Setting Animation


The National Institute of Academic Anaesthesia (NIAA) has released a short animation describing the process and outcomes of the Anaesthesia and Perioperative Care Priority Setting Partnership (PSP), a collaboration with the James Lind Alliance and numerous patient and specialty association organisations.


The PSP asked patients, the public and clinical professionals to identify the most important directions for new research in anaesthesia and perioperative care.



The full list of top ten priorities for new research and further information on the PSP process can be found at:


The 'professional' stakeholder organisations included the two main anaesthetic professional organisations (RCoA and AAGBI), anaesthetic specialist societies, as well as the Royal College of Surgeons (Eng) and various organisations representing other healthcare professionals involved in perioperative care delivery. Between them these professional organisations represent over 40,000 members.  The 'patient, carer and public' stakeholder organisations represented a diverse range of patients with experience of anaesthesia and perioperative care. The total active membership of the affiliated organisations was estimated at well over 50,000; the overall 'patient reach' of the partner organisations is likely to number several million.


More information on the NIAA can be found at:


New FAQs for Perioperative Medicine Training Modules 


The RCoA has released some Frequently Asked Questions relating to the newly GMC-approved Perioperative Medicine modules of The CCT in Anaesthetics.

The units came into effect at the start of the 2016 academic year (August 2016) and are mandatory for all trainees who started a new level of the training programme in August 2016.  This include CT1s, ST3s and ST5s who started in August 2016. All other trainees will commence their mandatory units when they progress to their next training level (i.e. ST3/5 in 2017).

The Perioperative Medicine units of training are intended to run in parallel with other units of training. They are not designed to be undertaken as standalone dedicated modules. The learning outcomes are applicable to all patients and will be achievable during clinical practice whilst undertaking the other units of training.

Russell Ampofo, Director of Education, Training and Examinations, says: “These FAQs are designed to help trainers and trainees understand the new Perioperative Medicine modules and how they work as part of established anaesthetic training. The FAQs will be updated over time based on feedback from our trainers and trainees”.

Please click here for the Perioperative Training Module FAQs.


'Outstanding' perioperative medicine service in Freeman Hospital, Newcastle...>

12 July 2016

Smoking and surgery...>
5 May 2016

New Clinical Trials Network...>
14 April 2016

NICE update to preoperative guidelines...>
6 April 2016

Dr Simon Fletcher, RCoA Council member, has written this article for the Future Hospital Journal which discusses the multidisciplinary nature of Perioperative Medicine
15 February 2016

8 February 2016

Carter review supports RCoA perioperative programme ...>

Today’s publication of Lord Carter’s 18-month study into how the NHS can become safer and more efficient includes a number of recommendations aimed at saving the NHS £5bn a year by 2020.  The themes within the report chime with the RCoA’s perioperative medicine programme including strategies to ensure patient care is focused on patients’ recovery and how they can leave acute hospitals beds, or transfer to a suitable step-down facility as soon as their clinical needs allow.
5 February 2016

RCP launches four new Future Hospital development sites to provide person-centred care...>

The Royal College of Physicians today announces four new Future Hospital development sites delivering clinically-led projects, focused on providing person-centred care across integrated healthcare services.
28 January 2016

Sixth Annual POPs Education Event, March 2016...>

8 December 2015

Integrating care throughout the patient’s surgical journey – held on Tuesday, 9 February 2016...>

23 September 2015

Perioperative Medicine Themed Issue of RCoA Bulletin

The September 2015 issue of the RCoA Bulletin contained several articles on the theme of Perioperative Medicine.  These include an editorial on the work undertaken to date and other articles discussing both the opportunities and the challenges that may lie ahead.

The RCoA is keen to receive as much feedback as possible from its Fellows and Members on the topic of Perioperative Medicine and the College’s continuing work in this area – your comments are very welcome.

Please click the links below to read the Bulletin articles and leave your feedback in our Comments section at the bottom of this page, or contact us directly.

Working together to deliver better healthcare - Future Hospital 2015 applications open in September...>

4 August 2015

24 June 2015

JLA & NIAA Priority Setting Partnership: Final Results...>

20 May 2015

Choosing Wisely is closely aligned to RCoA’s Perioperative Medicine Programme...>

13 May 2015

Developing the perioperative medicine workforce will deliver a win-win service, says Dr Chris Carey...>

11 May 2015

The RCoA’s key priorities focus on the need to make better perioperative care for the high risk surgical patient a reality; removing the barriers to integrated care and embedding QI across all areas of hospital surgery, including anaesthesia.
24 April 2015

HSJ article: Changing surgical pathways could save money and lives...>

17 April 2015

RCoA response to CfWI Report...>

2 March 2015

The evolution of perioperative medicine can radically revolutionise care, writes Ramani Moonesinghe...>

26 January 2015

RCoA calls for joined up care for high risk surgical patients...>

23 January 2015