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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. 

Mrs Shivalkar was a 78-year-old patient with debilitating co-morbidities, scheduled for elective revision hip-surgery at a stand-alone surgical unit without level-2 or level-3 care facilities. Intraoperatively, significant hypotension was poorly recognised and treated. By the time care was escalated, she had developed severe metabolic acidosis and multi-organ failure leading to her death.

The coroner issued a ‘Report to Prevent Future Deaths’ to the RCoA and the Royal College of Surgeons for action. From our review of the available information, the lessons to be learnt by our specialty  were related broadly to risk assessment, remote-site working and team working. My previous article (Part 1) addressed the first two areas, while this follow-up article focuses on team working and the role of multidisciplinary team (MDT) training.

Authors:

• Alessandra Anzante, Employment Lead, RefuAid
• Dr Siân Jaggar, Cardiothoracic Anaesthestist, Royal Brompton Hospital
• Maria Burke, RCoA Global Partnerships Manager

World events have seen record numbers forcibly displaced from their homes – currently estimated at 103 million people.¹ According to the Refugee Council, in the 3^rd Quarter of 2022, 24,511 applications for asylum were made,² an increase of 58.1% on the previous quarter. Government statistics tell us that in 2022 74,751 asylum applications were made (relating to 89,398 people).³

A study by Deloitte in 2017 surveying Syrian refugees in Europe⁴ found that 38% of respondents were university educated, but that despite this 82% were unemployed. It highlighted language as being one of the biggest barriers to re-entering employment, despite 63% of those surveyed wanting to continue their careers in the professions for which they had trained in their home countries. In the case of anaesthetics (and medicine as a whole), there are significant challenges for them in entering UK practice.