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The need for a diverse workforce

It is understood that in healthcare having a diverse workforce that reflects the population they care for can have better outcomes for patients, improve staff retention, and can positively improve staff morale.

Traditionally, medicine has been a career dominated by those from socioeconomically advantaged backgrounds.¹ Despite this, there have been progressive changes in this stereotype in recent times – for the last 25 years more than 50% of medical students have been female, and in 2017 59% of those accepted into medical school were women.² In contrast to this, there is currently a disproportionately low number of doctors who come from lower socioeconomic backgrounds. Data from 2015 shows that only 14% of new medical students were from lower socioeconomic groups, yet these groups represent 56% of the population.^3,4 The RCoA has pledged to develop equality, diversity, and inclusion within the specialty of anaesthesia.

In 2020, the RCoA partnered with the National Institute for Health and Care Research’s Cancer and Nutrition Collaboration and with Macmillan Cancer Support to produce guidelines on prehabilitation: ‘Principles and guidance for prehabilitation within the management and support of people with cancer’. 

One of the actions set out in the guidance was to ‘Develop a “Community of Practice” resource to provide contacts of local/regional sites and share expertise and learning from established prehabilitation programmes’.

The Centre for Perioperative Care (CPOC), founded by the RCoA is dedicated to the promotion, advancement and development of perioperative care. Naturally, CPOC has a vested interest in prehabilitation and therefore set about considering how this action might be best delivered in conjunction with Macmillan Cancer Support.

The first six months have been extremely busy in the world of CPD at the College. At the end of May, the Lifelong Learning Platform featured more than 156,000 individual CPD activities which had been added and reflected upon.

Good Medical Practice talks about the importance of regular reflection on the standards of practice and care which are provided, and this will help a doctor assess whether their learning is adding value to the care of their patients and improving the services in which they work.

The NHS is facing a significant change due to changing demographics and needs of the population and workforce gaps, leading to a rise in international recruitment.

This has led to Health Education England setting out the national vision for the use of simulation to deliver high-quality patient care. Simulation enhances patient safety through a rehearsal of performance, multidisciplinary teamwork, decision-making, and communication skills. Simulation can be a powerful tool for change management, both as an educational tool and as a lens to the system design and processes.

On 27 August 2011, The Times alerted readers to a craze originating in Spain: a drink high in alcohol was vaporised in a hand-held inhaler that contained a heater and a supply of oxygen. 

The alcohol rapidly reached the bloodstream via the lungs, quickly producing intoxication. A local newspaper reported:‘Oxy shots – the latest madness of the British in Majorca’. One of us (AD) recounted the story to an anaesthetist friend, Keith Pooley, who announced that once in his career he had actually anaesthetised a patient with ethyl alcohol vapour. He told me the full story which I later wrote up in The Times as an addendum to the oxy shots’ article. He was visiting a local cottage hospital on a weekly basis to prepare patients for minor surgery, mainly using halothane. On this occasion the induction was slow, with the patient resisting, spluttering and coughing. ‘But’ said Keith ‘I eventually got him down and he had his operation’. Recovery was atypical of that from halothane, and some detective work was called for. Keith unscrewed the vaporiser bottle and sniffed the contents – surgical spirits (typically 70–99% ethyl alcohol). It seems that the previous week he had discarded an empty 250 ml bottle of halothane. Someone else, keen on recycling, later retrieved the bottle from the bin and used it to store the surgical spirits. Unlabelled, it had wandered around the hospital until eventually finding its way back into the anaesthetics’ cupboard….

This year, Santa turns 2,403 years old. Although Greek by birth, the modern-day figure of Santa is based on images drawn by American cartoonist Nast in 1863 from the description given in the poem “ 'Twas the Night Before Christmas”, first published by Moore in 1823. 

During a typical 85-year lifespan, the average American requires 9.17 surgeries. It’s not inconceivable, therefore, that with his rather risky lifestyle, Santa, too, may one day need to go under the knife.

Santa may be reluctant to take time away from work, but thinking of the not-impossible event that he ever requires surgery (perhaps due to Tim Allen-esque trauma), I have started to risk-stratify the jolly old man. Should Santa experience an untimely demise perioperatively, not only will millions of children no longer wake to gifts under the tree, but in true Santa Claus™ style, someone in the hospital might be required to eternally take up his mantle, and the rota in our hospital is difficult enough to staff as it is.

The NHS is responsible for emissions equivalent to 25 megatonnes of CO₂, approximately 5% of the UK’s carbon footprint.^1,2 Healthcare is key to the UK’s COP26 target to reduce the national environmental footprint, with ambitions for a net-zero NHS by 2040.² Anaesthetic gases are a key contributor of NHS emissions, being responsible for 2% of the total NHS footprint.¹ Pressure to reduce the environmental impact of anaesthesia is therefore growing.

Airway management is a crucial aspect of patient care, where effective and prompt actions can be life saving. The RCoA recognises the importance of continuous education and training to ensure healthcare professionals are well equipped to handle complex airway scenarios.

Multidisciplinary simulation has arisen as a valuable tool in this regard, offering an immersive and dynamic learning experience that fosters collaboration among different professionals involved in patient care.

Traditionally, training in airway management has often been siloed, with the focus on individual disciplines. However, real-life situations demand a coordinated effort from various healthcare professionals, including anaesthetists, operating department practitioners, nurses, physiotherapists, surgeons and theatre nurses. Therefore, conventional training styles may not adequately prepare individuals for the intricacies of interdisciplinary communication and cooperation.