News

RCoA 'Fitter Better Sooner' Patient Information Toolkit Released

The Royal College of Anaesthetists has developed a toolkit that offers patients the information they need to prepare for surgery, including the important steps that can be taken to improve health and speed up recovery after an operation. The toolkit consists of:

  • one main leaflet on preparing for surgery
  • six specific leaflets on preparing for some of the most common surgical procedures
  • an animation which can be shown on laptops, tablets, smartphones and TVs.

You can view the toolkit here: www.rcoa.ac.uk/fitterbettersooner

The College has also developed printable posters, flyers and stickers to help signpost patients to the toolkit. You can find all these additional resources and information on how to download the animation in MP4 format here.

 

26 November 2018

The Daily Mail promotes the RCoA's message on prehabilitation

In an article released today, the Daily Mail has highlighted the importance of preparing for surgery to reduce complication rates, length of stay in hospital and re-admission rates. Citing RCoA President, Prof Ravi Mahajan, and the College's recently released Fitter Better Sooner toolkit, the article promotes the RCoA's call for prehabilitation (a combination of exercise, education and psychological support in the months before an operation) to become routine in NHS hospitals. You can read the full article by clicking on the hyperlink in the title above.

 

6 November 2018


Draft Programme for the next POM Local Leads Day released

The next POM Local Leads Day will be taking place on Monday 14 January at the Royal College of Anaesthetists in London. The event will look at the future of POM and highlight key areas of development in terms of pathways and processes. It will also provide an excellent opportunity for networking between those involved in developing perioperative medicine. We have released the draft programme for the day which can be accessed by visiting the Events page on this site. Sessions will focus on regional networks for perioperative medicine, comprehensive geriatric assessment, paediatric perioperative medicine, and much more. 

Bookings are only open to POM Local Leads who will be registered on a first come, first served basis, so please do book on as soon as you can to avoid disappointment.

 

26 October 2018


New Courses Added to Shared Decision Making e-Learning Programme

Health Education England e-Learning for Healthcare (HEE e-LfH) has worked with the Academy of Medical Royal Colleges (AoMRC) and the Winton Centre for Risk and Evidence Communication at the University of Cambridge to add new content to the Shared Decision Making e-learning programme.

The Shared Decision Making e-learning programme is aimed at healthcare professionals, health improvement personnel and patient engagement representatives to inform and educate them on Shared Decision Making in order to embed it in day to day clinical practice.

Two new courses Communicating Risk - Primary Care and Perioperative Medicine – have been added to the programme alongside the existing courses – Guidance on Shared Decision Making, Dialogues in Shared Decision Making and Talking about What Matters.

The Communicating Risk course has two versions; one for primary care professionals and one for perioperative medicine professionals. Each course is designed to help clinicians develop skills for communicating effectively with patients about the risks and benefits of treatment options. Each course consists of four sessions and will take approximately two hours to complete, with each session taking approximately 30 minutes to complete.

Each version of the course includes examples taken either from primary care or perioperative medicine. It includes self-test questions and video consultation case-studies.

By the end of each course, participants will be able to:

  • describe why it is important for clinicians to effectively communicate benefits, harms, trade-offs and uncertainties with patients
  • explain the inter-relationship between shared decision making, evidence-based medicine and patient-centred care in the context of communicating benefits and
  • list key communication skills needed when talking with patients about evidence
  • explain how to effectively communicate statistical information to patients
  • outline the role of decision support tools, potential uses and where to locate them.

The Communicating Risk course was originally commissioned by the Australian Commission on Safety and Quality in Health Care and has been licensed to the AoMRC as part of Choosing Wisely UK. It has been adapted for the UK by the Winton Centre for Risk and Evidence Communication at the University of Cambridge.

To access the Primary Care course select: https://portal.e-lfh.org.uk/Component/Details/543267

To access the Perioperative Medicine course select: https://portal.e-lfh.org.uk/Component/Details/529401

For more information about all courses that are part of the Shared Decision Making programme visit https://www.e-lfh.org.uk/programmes/shared-decision-making/

International learners can access the resources here: https://moodle.wintoncentre.uk

 

9 October 2018


September 2018 Perioperative Medicine Newsletter

Welcome to the September edition of the Perioperative Medicine newsletter. In this quarterly edition, we bring you information on the next POM Local Leads event, the new PQIP app, the fourth run of the RCoA/UCL Perioperative Medicine MOOC, and much more.

Click on the title hyperlink to view the newsletter online.

 

1 October 2018


Welsh Perioperative Medicine (WPOM) Day 2018

The inaugural Welsh Perioperative Medicine Conference was held at the Life Science Hub in Cardiff Bay on the 15 June 2018. It was a multi-professional event awarded 5 CPD from the RCoA.  The conference was organised by Dr Isra Hassan, ST6 in Anaesthesia and Dr Huw Evans, Consultant Anaesthetist at the University Hospital of Wales, Cardiff.   Faculty members included Kelly Ronan, Emily Buckwell, Luke Edwards, Tanya Smith, Gareth Roberts and Ellie Powell. The event was attended by 76 delegates comprising of 41 consultant anaesthetists, two consultant surgeons, 28 trainees ranging from FP1-ST7 level, one medical student and four nurse specialists.

The event included lectures on the following topics:

  • Rehabilitation post-CPET, more than the anaerobic threshold - Dr Richard Davies, Consultant Anaesthetist, UHW
  • Frailty in the perioperative period - Dr Jonathan Hewitt, Consultant Physician, UHL                                                                                          
  • Developing training in POM and introduction into POM fellowship and MSc - Dr David Walker, Consultant Anaesthetist and Intensivist, UCL
  • Anaesthesia delivered perioperative care, 'Living the ‘DREAM’ - Dr Sohail Bampoe, Consultant Anaesthetist, UCL
  • Research introduction - Dr Tamas Szakmany Consultant Intensivist, RGH
  • PQIP: Quality improvement in perioperative care - Dr Rachel Baumber, Consultant Anaesthetist and Intensivist RNOH Stanmore
  • Five trainee presentations were shortlisted and the first prize was awarded to Dr M Cooper who presented a case entitled 'Quantifying risk, it’s not just numbers'.

Delegates also attended a workshop (90 minutes) out of a choice of four workshops:

  • Introduction to CPET - a live demonstration of CPET followed by an interpretation of CPET results
  • Intermediate/Advanced CPET - aimed at those with previous experience in CPET, including a Q&A session on common problems with interpreting and actioning results
  • Shared Decision Making - delivered by the team from Making Choices Together, the session looked at exploring the barriers to unlocking ‘what matters to me’ and translating patient preferences and priorities into true patient-centred perioperative care
  • Perioperative Risk Stratifications - focused on indications for requesting perioperative tests and interpretation of lung function tests, echo and CPET results.

There are now plans to set up the Welsh Perioperative Medicine Society (WPOMS) later in the year and the organisers are already looking at dates for the next WPOM conference in 2019. For any information or enquiries please email welsh.poms@gmail.com or keep informed about upcoming events by following the team on Twitter @PomsWelsh.

Review provided by Dr Isra Hassan, ST7 Anaesthetics, Cardiff and Vale UHB

 

25 September 2018


East of England Perioperative Medicine Group, April 2018

On the 23 April, the West Suffolk Hospital hosted the inaugural meeting of the East of England Perioperative Medicine Group. The group was established with four primary goals:

  •     to promote perioperative medicine (POM) in the East of England
  •     to emphasise the importance of POM in improving the outcomes of surgical patients
  •     to facilitate implementation of the strands of POM by encouraging the sharing of ideas and pathways between healthcare providers in the East of England region
  •     to enthuse trainees and consultants to embrace the POM programme as part of their 'lifelong learning'.

Dr Liam Brennan, President of the RCoA, opened the meeting by giving an overview of the wider need for a perioperative medicine focus in the UK health system to produce safer and more cost-effective care. The meeting then included presentations on:

Education and Training in Perioperative Medicine - Dr Nigel Penfold
What makes me invest in a transformation project? - Dr Stephen Dunn
Shared Decision Making - Dr Jane Sturgess
Managing Perioperative Anaemia - The Papworth Way - Dr Andy Klein
Managing Perioperative Anaemia - Challenges in the DGH - Dr Julia Neely
Frailty Pathways - Dr Fay Gilder
Deprescribing - Dr Patricia Mills
Exercise Prehabilitation - Dr James Hernon
Multimodal Prehabilitation - Dr Mark Stoker

The event was attended by over 100 delegates who provided very positive feedback on their experience of the day. The group believes that the event, alongside participation by local hospitals in the Perioperative Quality Improvement Programme (PQIP), will help to forge a regional network that can draw on the data produced through PQIP to compare outcomes between hospitals. You can read a full summary of the event on page 38 of the September edition of the RCoA Bulletin.

The regionial event was supported by the RCoA's Perioperative Medicine Programme through the award of a small grant. If you are interested in applying for a grant to hold your own regional event focused on perioperative medicine, please contact perioperativemedicine@rcoa.ac.uk

 

20 September 2018


BMJ Editorial on Shared Decision Making by Choosing Wisely UK

Drs Jack Ross and Ramai Santhirapala of Choosing Wisely UK have co-authored an editiorial published in the BMJ focusing on new UK recommendations that emphasise shared decision making. Choosing Wisely is a medically led campaign focusing on engaging doctors and patients in decisions about potentially unnecessary medical tests, treatments, and procedures. It started in the US in 2012 and has now been taken up in 22 countries worldwide, including the UK.

 

25 June 2018


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 (Nadia.ladak@sch.nhs.uk) or Dr Barry Lambert (Barry.lambert@bch.nhs.uk)
 
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: http://www.niaa.org.uk/PSP

 

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: http://www.niaa.org.uk

 


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

NOW RECRUITING: POM Fellow...>
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