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The Royal College of Anaesthetists has undertaken a two-year national project in collaboration with The Healthcare Improvement Studies (THIS) Institute to use new approaches to improve the time it takes for patients to have emergency bowel surgery.

The time taken for patients to get to the emergency operating theatre remains a stubborn problem, despite many years of research and national guidance emphasising the importance of prompt surgery to reduce morbidity and mortality.

The diagnostic and treatment pathways are complex – involving clinicians from emergency medicine, anaesthesia, surgery, critical care, radiology, and often other specialties. Patients also require resources like CT scanners and operating theatres that are often in short supply. Thinking about the multiple steps each patient must traverse, it is no surprise that they often don’t get speedy access to the operating theatre.

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.

October is Black History Month, and we welcome it as an opportunity to celebrate the contribution of black anaesthetists to the specialty and the NHS. This year’s theme is ‘Saluting Our Sisters’, in recognition of the fact that the many achievements of black women are too often overlooked. Over the course of the month, we aim to share profiles of some of our members whose achievements and perspectives we want to champion.

One such colleague is Dr Sethina Watson, who gave the address at this year’s Ceremony of Presentation of Diplomates, or ‘Dips Day’ as it is more commonly known. It was an inspiring speech, not only because it demonstrated the extraordinary determination evident in Sethina’s own path to becoming an anaesthetist, but also because of her ability to articulate the differences in our individual experiences while also identifying the motivations we have in common. We have shared Sethina’s speech on our website and it is well worth a read.

As always, Dips Day was a thoroughly enjoyable day all round, and it was a privilege to be part of people’s celebrations and to witness the pride and happiness of their families and friends.

It’s only the start of meteorological winter, but the recent rhetoric of the newish government does seem to chime for the multidisciplinary team working in critical care services. It is becoming more difficult each day to keep safe services afloat, with bed occupancy well above recommended levels throughout the four nations.

While there’s a definite wish in critical care to accommodate the long list of elective surgical patients and for emergency patients to be located in the best place, be that enhanced or critical care, it will be most welcome to see details forthcoming from government. We hope they lead to the better flow of patients through our ICUs in 2025 and beyond.

Two years ago, the clinical leads census revealed that 50% of responding ICUs have at least one gap on their consultant rota. We continue to seek triangulating information on recruitment challenges, which appear to be in less urban areas and specialist ICUs. FICM continues to engage with relevant stakeholders, including NHS England and the Academy, to make the case for more intensivists in the future.

At the end of January 2024, the GMC published an updated version of Good Medical Practice, the core guidance for all registered doctors. This has been accompanied by guidance on a number of other areas, including confidentiality, consent and research, and legal and regulatory proceedings, all of which can be seen on the GMC website.

The opportunity has been taken to conduct a major review of the College’s supporting information for appraisal and revalidation.

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.

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.

FICM’s Professional Affairs and Safety Committee (FICMPAS) is one of the three large committees of the FICM board. The major focuses of work are, as our name suggests, professional affairs and safety. We have seen important developments in both areas.

In safety there is a new look Safety Bulletin, developed by Dr Peter Hersey. Short; one paragraph, case-reports of safety incidents are shared with commentary and hyperlinks to additional information. The safety incidents come from the National Reporting and Learning System (NRLS), though Dr Hersey is working to be able to draw from a wider source of incidents.

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.