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The College’s Quality Network (QN) was formed to share learning, develop quality improvement (QI) knowledge, and encourage local improvement work. It is comprised of regional leads, who are aligned with the schools of anaesthesia, and local leads who are based within the hospitals of each region.

The College’s Quality Improvement Working Group wanted to make a fresh assessment of the QN to take stock of our progress and plan future work. A short national survey, to understand implementation of an important safety initiative, was felt to be an effective way to re-invigorate members and generate learning for future projects.

Prep Stop Block¹ (PSB) was created in 2021 to enhance the message of ‘Stop Before You Block’ (SBYB) and standardise national regional anaesthetic practice, aiming to reduce the incidence of inadvertent wrong-side block. It was launched with a training package and supporting resources. This new standardised operating procedure applies to all departments undertaking regional anaesthesia.

COVID-19 has dominated and it is easy to focus on the negatives, but, as an eternal optimist, I see many positives. I had three objectives when I became dean, the first of which was to promote our specialty.

I think everyone now knows what we do and, as a result, we have increased training numbers, expanded capacity, and embedded enhanced care. My second objective was to develop international partnerships. Despite travel being restricted, embracing digital platforms afforded us the opportunity to work with the College of Intensive Care Medicine of Australia and New Zealand and the Apollo group in India.

Training in anaesthesia is one of the cornerstones of the profession. It is often cited as one of the specific attractions of choosing anaesthesia as a career. However, anaesthetists in training are unfortunately not immune from the challenges faced by all resident doctors working within the UK.

In recent years, there have been growing concerns about low morale and burnout. Anaesthetists in training provide a pivotal role in the provision of services in many areas of secondary care. Furthermore, there is a well recognised shortage of consultant anaesthetists in the UK. It’s essential that the NHS is able to train and retain this uniquely skilled workforce to provide care for patients both now and in the future.

It’s apparent from both the College’s own work, such as the 2017 survey on morale and welfare in anaesthetists in training (‘A need to listen’) and also evidence from the GMC’s National Trainee Survey (NTS), that there is a high proportion of anaesthetists in training at risk of burnout. There have also been significant external factors impacting on the training programme, such as the transition to the 2021 curriculum and the COVID-19 pandemic. Competition ratios to enter anaesthetic training are at record levels, and concerns remain about training-post numbers and progression between Core and Higher training programmes.

The Lifelong Learning Platform (LLP) continues to experience very high levels of use, with each month typically seeing more than 500,000 unique actions taking place among its user-base – which is approaching 24,500 – and the LLP team usually receives around 800 emails per month. This article introduces the team and also some of the wider support and governance around the LLP.

The LLP team is headed by Esma Doganguzel, Product Manager, and she is supported by Avia Spiers and Tunde Arowojolu, Product Owners, and Chris Kennedy, Revalidation and CPD Co-ordinator. The team blends strategic oversight, development, training, and regulatory expertise, and is committed to supporting and addressing the evolving needs of our users and to improving the LLP in innovative and progressive ways.

Read the latest letters submitted by members in Winter's Bulletin. If you'd like to submit a letter to the editor, please email us.

Anaesthetists in training, whatever route they are taking, are the future of our specialty. This is a guiding principle of the College and it cuts across all aspects of our work.

I have always been incredibly impressed by the professionalism, compassion, skill and knowledge of the anaesthetists in training I work with and, as a prospective service user, I can see that the future is bright but that we need to play our part by supporting you to realise that promise.

I hear many positive things from anaesthetists in training, ranging from what you love about the job, to your well-deserved pride in your achievements and your commitment to supporting your patients and colleagues. But I also hear the negative aspects. I hear you when you tell me about training interrupted by the pandemic and the unaddressed trauma from that time. Or how your life and career have been impacted by frequent rotations, exam pressures or difficulty securing a higher training place.

This article looks at why the NHS needs international medical graduates (IMGs) and why we need to do better at integrating them into the workforce to maximise their contribution.

The General Medical Council’s Workforce report 2023 emphasises that the current reliance of the NHS on IMGs will continue in the future, despite an expansion of medical school places. The GMC predicts that almost a third of all doctors will be IMGs by 2036. It declares that the ‘integration and retention….must be improved’ and describes as essential that these colleagues are ‘welcomed into supportive teams’.

The way we welcome our international colleagues not only determines the extent to which they can contribute safely to the service, but also how easy it is to recruit and retain them. Our attitude should include a willingness to learn from their previous expertise and their ability to look at our services with fresh eyes.

In anaesthesia they have been present for the last 10 years but have become more prevalent in the last four years. Many factors have led to this increase, but one of the biggest is the rise in the number of IMGs as new registrants on the GMC register. These totalled 40% of all new registrants in the last year.¹ Other factors include training bottlenecks that have appeared as an unintended consequence of the changes from the 2010 curriculum.

This has led to increased competition for available posts, with significant numbers of doctors sitting in Locally Employed Doctor or Medical Training Initiative posts accumulating competencies that can count towards CESR. Understandably, trusts that can offer all the components of the curriculum in-house have recognised the potential to have a consistently high-quality, in-house workforce, with an ability to fill their own rotas when gaps appear. This is aided by the Lifelong Learning Platform being freely available to all members of the College, enabling training gaps to be easily identified and targeted with in-house training programmes.

As the 2021 curriculum enters its second year, the new curriculum continues to evolve. At each step, this process has been informed by feedback from anaesthetists in training and trainers to guide changes, aid additional clarification, and influence future improvements.

In this article, we explore some of the recent key updates and improvements in the curriculum and look forward to future developments.