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‘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.

• Dr Dermot McGuckin, ST7 Anaesthesia & Pain Medicine, University College London Hospitals
  Email Dr McGuckin
• 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.