Search

In a recent correspondence, I wrote: ‘So many ideas flying around in my head (ADHD). I need to pin them down, put them in order (ASD), and get started (ADHD inertia). I’m over the “I’m broken” phase and now feel that my mission before I finally retire is to help others realise they’re not broken either’.

Why? A Bulletin article entitled ‘Equality, diversity and inclusion (EDI): what it means to the College’¹ with no mention of neurodiversity! The College wants to ‘develop a dataset of the profile and diversity of their membership and workforce’, but without neurodiversity questions I feel excluded!

One in a hundred young people have an autism spectrum disorder (ASD); 10 per cent of these may become high-functioning adults.² Between three and six per cent of children have attention deficit hyperactive disorder (ADHD), and for one in seven of these ADHD will continue into adulthood.³ Also, adults with ASD are more likely to have ADHD!² Everyone has individual attributes and characteristics. Experience of autism is also unique; this is the power of neurodiversity. Some professions, for example aerospace, screen positively for autistic traits⁴ – methodical, attention to detail, ability to hyperfocus, pattern recognition, visual memory, and novel approaches to problem solving. 

Welcome to a new feature in this Bulletin issue in which we share and showcase education and training content to keep you up-to-date on good practice and ways of working.

In this recurring series, we’ll post event video clips, podcasts, and links to downloadable resources, some of them available exclusively to members, via the Bulletin. We’d love to know how you find this. Tell us what content you want to see here and what professional-development areas you’d benefit from.

In this issue we’re focusing on patient safety, looking at communication and simulation and featuring videos, audio, and downloadable resources drawn from across our website and beyond.

Dear Editor

Drs Passi and Oliver state in their article that ‘in-vivo studies to quantify the reduction in serum progesterone concentration following sugammadex have not been performed…’. They are incorrect in this statement.

Devoy et al performed a prospective observational study comparing changes in serum oestrogen and progesterone in women undergoing surgery. 60 patients on hormonal contraception received sugammadex; 30 patients were not on hormonal contraception and did not receive sugammadex; 32 patients were not on hormonal contraception and did receive sugammadex. Blood samples pre, 15-minutes post, 240 min post sugammadex administration were taken to measure oestrogen and progesterone levels. 

In this short interview, Dr Sam Black, our Patient Information Lead, explores the key things to consider when communicating risk to patients with Leila Finikarides, Researcher at the Winton Centre, and Jenny Westaway, Chair of PatientsVoices@RCoA.

Since early 2024, the Patient Information Group has been working with the Winton Centre for Risk and Evidence Communication to ensure that our information for patients on risk reflects the latest best practice and learning from the work of the Centre.

We hope you find the interview an interesting insight into our work in this area.

I’d like to wish you all a very happy New Year. I realise that January is a very challenging time in the NHS, with winter pressures compounded by ongoing staff shortages and sickness. And in looking ahead to some of the College’s priorities for 2024, I’d like to highlight some of the work we're doing to try to address these issues.  

The urgent need for more doctors to be able to train as anaesthetists is always the first thing I raise in conversations I have with the government, NHS England and other decision makers around the country. Last month I wrote to the new Secretary of State for Health and Social Care to set out the need to address the current shortage of anaesthestists and to outline the impact this is having on the elective care backlog, among other things. 

In the last year we have secured some incremental improvements on this front, but there is a long way to go, and we will do all we can to maintain momentum in the year ahead.

Authors:

• Dr Xiaoxi Zhang, ST6 Trainee, University College London Hospitals NHS Foundation Trust
• Dr Helgi Johannsson, Consultant Anaesthetist, Imperial College Healthcare NHS Trust
• Dr Amardeep Riyat, Consultant Anaesthetist, London North West University Healthcare NHS Trust
• Dr Roger Sharpe, Consultant Anaesthetist, London North West University Healthcare NHS Trust

Email Dr Zhang

Becoming a consultant is a stressful and vulnerable time during a doctor’s career. Negotiating a new identity, taking on ultimate responsibility for patient care, becoming the team leader rather than a team member are all difficult even in the best circumstances, especially when integrating into a new team.

When the COVID-19 pandemic struck, changing the role from doctor in training to consultant became even more challenging, especially as many hospitals were at that time utterly overwhelmed. We conducted a qualitative analysis of the experiences of anaesthetists and intensivists transitioning to consultant positions during the pandemic,¹ and in this article we want to share the experiences of those doctors who transitioned into their consultant roles during the absolute peak of this global crisis. Their stories offer unique insights on ways of supporting new consultants and highlight the urgent need to improve staff retention and wellbeing in today’s NHS.

Had your head buried very deeply in the sand for most of the last decade? Then it may have escaped your attention that the UK has cleaved itself away from the European Union. But fear not! The College and the Association of Anaesthetists are both still represented on the European Board of Anaesthesiology (EBA), the Anaesthesia section of the European Union of Medical Specialists.

Known by its French acronym, UEMS is a non-governmental organisation created in 1958 in the same year as the European parliament. The aims of UEMS are to improve patient care throughout Europe by developing and supporting excellence in specialist medical training and practice and, as a by-product, to promote free movement of medical specialists around the EU.

The UEMS represents more than 1.6 million specialist doctors from 41 countries:

• full UEMS members – EU countries plus Iceland, Norway, Switzerland, UK
• associate members – Armenia, Israel, Serbia, Turkey, Ukraine
• observer countries – Georgia, Iraq, Lebanon, Morocco, Tunisia.

Authors:

• Dr Rachael Brooks and Dr Eleanor Warwick, PQIP Fellows and Anaesthetic Registrars, University College London Hospital
• Dr James Bedford, former PQIP fellow and Consultant Anaesthetist, University College Hospital NHS Foundation Trust
• Professor Ramani Moonesinghe, PQIP Chief Investigator

In 2023, the Perioperative Quality Improvement Programme (PQIP) is launching new postoperative morbidity variable life adjusted display charts (pomVLAD) for all sites recruiting patients undergoing colorectal surgery. Having previously been run as a pilot study in 10 hospitals, the quality-improvement dashboard has been refined and will now provide all sites with near-real time, risk-adjusted morbidity monitoring accompanied by the display of a number of key enhanced-recovery quality-improvement (QI) targets. 

For sites recruiting patients of other surgical specialties, there is also a newly developed QI dashboard which does not incorporate risk-adjustment. Dr James Bedford explains how they can be used to stimulate QI initiatives in your local hospital.