Delivering training is a complex process. One of the disconnects that crops up between the FICM and intensivists in training is fuelled by the constraints of how the curriculum is delivered. While there are aspects of training that we can adjust, we are very much constrained by the GMC, which is our statutory body for training.
That is what makes the Bulletin so unique, there is an article (or I would hope more!) to suit the interest of each reader. This issue, as is traditional with the autumn issue, focuses on research and innovation within our specialties.
As the first female editor of the Bulletin of ethnic minority descent, it is heartening and relevant to close my tenure with a guest editorial centred on the NIHR’s Race Equality Framework. Ensuring equitable recruitment into research through a framework such as this, underpinned in co-development with those with lived experience, is a significant move forward towards equity and inclusion. Note: I emphasise equity, rather than equality. As a series of specialties, my heartfelt vision would be that, from patient recruitment through to opportunities in research and innovation, we achieve equity – access for all.
A new year signals a new Editor for the Bulletin, and it gives me immense pleasure to welcome you to the January 2023 edition. As I write this, the UK’s NHS is experiencing winter pressures, nurse strike action seems imminent, purple seems the new black in terms of hospital bed status, and elective surgical recovery targets seem an insurmountable challenge. It would be easy to feel discouraged, but a new year always heralds new hope.
Scrolling through the articles in this Bulletin, I am filled with delight at the examples and opportunities for change during these uncertain times. Innovation has long been the forte of our specialties – doing things differently, more efficiently, and more safely for the betterment of patient care. Whether it is the small tweaks made to TIVA settings, the slight adjustment of the ultrasound image during a nerve block, or refining the ergonomics of running an operating theatre list or ICU ward round, continuous improvement is innate to our specialties and specialists.
Shared decision-making, whereby patients and clinicians collaborate to make the best evidence-based decision within the context of the patients’ values, is recognised as a vital component of perioperative care. The benefits of shared decision-making are accepted by NICE and the Centre for Perioperative Care (CPOC), yet evidence suggests we may not be doing it as well as we should. A recent CPOC survey showed that 39% of patients desired more support or information regarding treatment choices. In another study, 14% of patients expressed regret, and said that they would not have had surgery had they understood the risks and alternatives. View the ‘three-talk’ model of shared decision-making suggested by CPOC.
