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Authors:

• Dr Andrew Kane, ST7 in Anaesthesia, South Tees Hospitals NHS Foundation Trust
• Dr Simon Davies, Reader in Anaesthesia and Perioperative Medicine, Hull York Medical School; Honorary Consultant in Anaesthesia, York and Scarborough Teaching Hospitals NHS Foundation Trust
• Dr David Yates, Consultant in Anaesthesia and Intensive Care Medicine, York and Scarborough Teaching Hospitals NHS Foundation Trust; Honorary Senior Lecturer, HYMS
• Professor Gerard Danjoux, Honorary Professor, HYMS; Consultant in Anaesthesia, South Tees Hospitals NHS Foundation Trust

Chatting in a pub in York in 2019, Simon Davies, David Yates and Gerard Danjoux were reflecting on their academic careers to date. The three colleagues from York and South Tees Hospitals had worked together successfully since 2012, securing prestigious grant funding and delivering high-quality academic studies. Yet something was missing – strategy and infrastructure to create a sustainable programme of work and develop the researchers of the future.

As the evening progressed, more and more ideas were generated in direct correlation to the consumption of the excellent York ales!! Before the end of the evening, an idea was hatched, and the colleagues would form a new collaboration with an academic partner: the North Yorkshire Academic Alliance of Perioperative Medicine.

Authors:

• Dr Linda Nel, Consultant Anaesthetist, Perioperative Allergy Service, Southampton University Hospitals NHS Foundation Trust
  Email Dr Nel
• Dr Tomaz Garcez, Consultant Immunologist, Manchester University NHS Foundation Trust
• Dr Louise Savic, Consultant Anaesthetist, Leeds Teaching Hospitals NHS Trust
• Dr Lucy Gurr, Anaesthetic Registrar, Leeds Teaching Hospitals NHS Trust

The Perioperative Allergy Network (PAN) was set up under the joint auspices of the British Society of Allergy and Clinical Immunology (BSACI), the British Society for Immunology Clinical Immunology Professional Network (CIPN), and the Association of Anaesthetists. It represents a formal collaboration between UK anaesthetists, allergists and immunologists with an interest in perioperative hypersensitivity and is supported by the Royal Colleges of Anaesthetists, Pathologists and Physicians. It is affiliated with the International Suspected Perioperative Allergic Reactions Group (ISPAR).

Why now, and what need is being met?

• Dr Dermot McGuckin, ST7 Anaesthesia & Pain Medicine, University College London Hospitals
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• Dr Fausto Morell-Ducos, Consultant in Anaesthesia & Pain Medicine, University College London Hospitals
• Dr Jamie Smart, Consultant in Anaesthesia & Pain Management, University College London Hospitals
• Dr Brigitta Brandner, Consultant in Anaesthesia & Pain Management, University College London Hospitals

Opioids play an important role in facilitating recovery and return to function after surgery. 

However, it is now well-established that surgery is a risk factor for persistent postoperative opioid use,¹ and preoperative opioid use is associated with an increased risk of perioperative complications.²

Perioperative opioid stewardship is a practical approach providing a systemic, multi-layered framework aimed at minimising the risks associated with opioid use around the time of surgery, while allowing their safe administration to those patients most likely to benefit from them. It is increasingly regarded as a solution to the problem of prescription opioid-related harm but there is a lack of structured curricula to develop healthcare professionals’ skills in competent opioid management.

‘May you live in interesting times’ has a heavy degree of irony at present. However, It is my honour to write my first piece as fifth dean of the Faculty and following our historic public statement, made in conjunction with the RCoA, of plans to start work to develop a UK College of Intensive Care Medicine.

I work as an intensive care medicine consultant in Sheffield, and a recent Diplomates Day photo of four happy ICM specialty registrars from my region brought home to me why it is right to start this work now. All four of them identify as ‘intensivists’, but two are single ICM CCT specialty registrars, one is dual with respiratory medicine, and one is dual with anaesthesia. Intensive care medicine as a stand-alone medical specialty is maturing, and it is inevitable that we should look to a future as an independent college which directly represents the interests of an increasingly diverse group of fellows and members and of the patients we treat.

‘You always own the option of having no opinion. Things you can't control are not asking to be judged by you. Leave them alone.’

Marcus Aurelius (121–180 CE)

For the record: I am a full-time NHS consultant in pain medicine and anaesthesia, and the sole provider of ‘interventional pain procedures’ to my local hospice, where I have a weekly session to see inpatients, outpatients and discuss complex pain problems in the end, and not-so-end, of life scenarios. I am also a former dean of the Faculty of Pain Medicine.

Discussions have started within the RCoA on whether the College, and its faculties, should take a stand on the issue of ‘assisted dying’.

They should not. Not pro, anti, or neutral (this last stance is multifaceted and arguably not ‘neutral’ at all).

Author: Dr Richard Knight, Retired Anaesthetist, archives@rcoa.ac.uk

In April 1982, I was grinding through a locum session in a Swedish regional hospital when my wife telephoned me to tell me that the duty officer in my UK medical unit has asked her to say a single word to me – the super-secret word designating the necessity to report immediately to the unit. 

This was my initiation into Mrs Thatcher's plan to recapture the Falkland Islands.

Most men in the unit knew where Argentina could be found in an atlas, mainly because of the forthcoming football tournament starring Maradona. This had not been the situation when Dr David Owen as Foreign Secretary, had put the unit on stand-by to repel invading Guatemalans from entering British Honduras. Then, the staff sergeant was compelled to send his wife to the NAAFI to buy an atlas.

After days of packing and repacking equipment, the unit was trucked to Southampton to join 2 Para on board a North Sea car ferry. Cabins were allocated, in the best military tradition, by rank, but in reality were all the same tiered bunks. The major in the overhead bunk was to read and reread his copy of Herodotus, in Greek.

I recently listened to two anaesthetists talking in a coffee-shop queue. One was of a certain age and clearly exasperated at having to contemplate the supposed burnout levels in my generation of anaesthetists in training. He simply couldn’t understand it. After all, in his day they worked hundred hour weeks! ‘Bloody snowflakes’, he reflected. The other nodded gravely.

‘Snowflake’ is a term commonly wielded by our elders to bludgeon what they deem to be a fragile, over-sensitive and under-resilient youth of today. A people unable to cope with life. It does however require a certain amount of historical amnesia to use this slight without some irony catching in the throat. Did they not enjoy rock bottom housing prices, free higher education and high levels of job security, only to then preside over their decimation?

Authors: 

• Dr Duncan Kemp, Anaesthetic Registrar and co-creator of the NovPod
• Dr Eoin Dore, Anaesthetic Registrar and co-creator of the NovPod

This month marks a year of hard work coming to fruition since we launched the podcast ‘NovPod: A beginner’s guide to anaesthetics’. With more than 25,000 ‘listens’ in the first three months, it feels like we’ve created a practical, useful podcast that has been well-received.  So to celebrate, we’d like to take you behind the scenes to talk through how we developed the NovPod and discuss some lessons learnt along the way.

From the beginning: why did we do it?

After creating a one-off podcast for a Difficult Airway Society multimedia competition, we wanted to build on this. Our plans coincided with the renovation of the RCoA novice curriculum and so our target audience became obvious – novice anaesthetists. We reflected on our own experiences and set out to share some of the best advice we received as novices. This wasn’t from textbooks or courses, but rather the voices of the friendly registrars and SHOs who would take us aside and tell us how anaesthetics worked in practice – giving us advice and survival tips to help us grow and develop.

Jono Brüün, Chief Executive Officer of the Royal College of Anaesthetists looks at the benefits of research and why it will always be at the centre of our activities, creating significant impact for patients and the public.