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We hope that this work will not simply add another metric to NELA reports, but will also provide useful information to clinicians, patients and organisations involved in the planning and delivery of emergency surgical care.

The NELA risk-prediction tool was designed to be used to adjust for differences in case mix between Centres but has additionally become an increasingly important tool to support shared decision-making. Population-level risk (as estimated by the NELA risk calculator) can provide a starting point for collaborative discussions, which combine data on risk with patient-specific clinical information and personal wishes.

You may well ask why you should think of becoming an AAC (advisory appointments committee) assessor. Perhaps it will be too arduous/boring/difficult. We hope to persuade you that this is not the case, and further explain what it can do for you and your department.

When your department appoints a new consultant or specialist doctor, there are specific requirements that must be fulfilled. One of the most important of these is to hold an AAC. This is a legally constituted interview panel established by an employing body. Its function is to decide which, if any, of the applicants is suitable for appointment and to make a recommendation to the employing body.

Author: Dr Alistair McNarry, RCoA Airway Leads Advisor

It may seem that we have been reporting on the HSRC-DAS-University of Nottingham collaboration on the UK eFONA Registry for a very long time. However, I am delighted to say that, a bit like a jigsaw puzzle, all the pieces are finally starting to slot together.

Data-sharing agreements have now been signed between the HSRC, the University of Nottingham and the Difficult Airway Society. This complements the memorandum of understanding signed between the HSRC and DAS last year.

Dr Jon Chambers picks up the reins as Editor of the Bulletin and welcomes you to the year's first issue.

As I pick up the reins as Editor of the Bulletin, I do so with an appropriate degree of trepidation. The Bulletin has been a constant throughout my anaesthetic career, and it remains a window into our specialty that combines a mix of news, developments within the specialty, personal stories and guidance. In my short time in the role, I’ve already been humbled by the quality of contributions from the anaesthetic community willing to share their stories and their work with colleagues.

The start of a new year is often a time to look to the future and the new challenges ahead. In the midst of this newness I have always believed that we should also take the time to look back, and to learn from and reflect on the lessons of our past. In the run up to LGBT+ History Month (February) Professor Andrew Hartle does just that, and he writes openly and honestly on the challenges he has faced as an out gay anaesthetist throughout his career in the NHS and the military. His reflections take us through his journey of exclusion and stigmatisation, and then ultimately of acceptance, recognition and celebration. It is an incredible journey and ends with him rightly encouraging us all to feel prouder in 2025.

The concept of ‘complexity’ is synonymous with healthcare systems and is becoming increasingly prevalent in perioperative care. Advancing surgical technologies and approaches are driving the complexity of operations. 

On record waiting lists, there is a growing mix of co-morbidity, polypharmacy, and multisystem issues such as frailty. We must however, avoid a reciprocal increase in the complexity of perioperative pathways as an attempt to manage these challenges. Introducing individual clinics for each long-term condition, with each one arranging a raft of blood tests and investigations, can be overwhelming for patients and healthcare professionals. Messages can get lost in the milieu of appointments, and important work can be duplicated or missed entirely leading to disengagement with the pathway. In order to manage complexity, perioperative care pathways must simplify the message of optimisation, empower patients, and support its workforce to deliver holistic, evidence-based multidisciplinary care.

Welcome to the summer issue of the Bulletin! As I write this, sunlight is streaming in through my window as an indication that British Summertime has finally arrived in more ways than just the clocks going forward. This issue of the Bulletin will arrive on your preferred digital platform as we come to the close of the term of a distinctly inspirational RCoA president, Dr Fiona Donald. While Dr Donald’s nature is one of immense humility, it is worth reflecting on the unique equanimity one needs as a leader at this time within the NHS (including our specialty) when facing immense challenges, turbulence and uncertainty.

Welcome to October's issue of the Bulletin. As I write this piece, we may be struggling to see the light at the end of the tunnel for UK healthcare; an unprecedented state of industrial action by doctors at all stages of their careers, the recent release of an open report on sexual misconduct in healthcare and, as clinicians, the challenges of ensuring high quality care for patients can be a daily struggle. The height of the pandemic may be behind us, but the disparities it has revealed will have to be addressed for years to come.

Authors

• ​Dr Jason Williams-James, RCoA Patients Voices Member, laycomm@rcoa.ac.uk
• Dr Eleanor Warwick, ST6 Anaesthetist and Perioperative Quality Improvement Programme (PQIP) Fellow

Jason Williams-James, RCoA Patients Voices member with personal experience of surgery and anaesthesia, discusses the importance of DrEaMing with Eleanor Warwick, ST6 Anaesthetist and Perioperative Quality Improvement Programme (PQIP) Fellow. They discuss why patients, the surgical multidisciplinary team (MDT), and organisations should be interested in this quality improvement metric.