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It has both a favourable side-effect profile compared with traditional anticholinesterases and allows for emergency reversal.

With the expiry of its original patent last year, high cost is no longer a factor prohibiting its use, which will invariably further increase. In this article, we seek to highlight the resulting increased potential for contraceptive failure and propose methods to better inform and protect patients.

The risk of contraceptive failure

Due to its ability to encapsulate progesterone – present in contraceptive pills, vaginal rings, implants and intra-uterine devices – the administration of sugammadex may reduce their biological effect and cause contraceptive failure. This was identified in in-vitro studies, using isothermal microcalorimetry, performed as part of the drug’s development. While in-vivo studies to quantify the reduction in serum progesterone concentration following sugammadex administration have not been performed, these results have shaped current manufacturer guidance.

Author: Dr Carolyn Johnston, Consultant Anaesthetist and Deputy Medical Director, St George’s Hospital; Chair of QI working group

During the early days of the COVID-19 pandemic, the UK government talked about their goal of delivering ‘shots in arms’ as the ultimate goal of the vaccine efforts. This wasn’t an exercise in expanding scientific knowledge or customising production, but the aim was clearly stated as being to deliver those advances to citizens in order to prevent them from becoming patients.

A large number of lives were saved by rapid development and national deployment of the new vaccines: the success of the vaccine programme is a reminder to us all how knowledge without application will not improve care.

The HSRC portfolio of projects creates a huge amount of knowledge that has the potential to improve care for our patients, but this knowledge remains potential unless we implement the recommendations of the various reports and use the rich datasets created to inform us of the most pressing areas for improvement in our clinical pathways.

Round one

Our path towards accreditation started back in 2014. We felt we were a good and forward-thinking department, but the challenge was (a) is it true? and if so (b) could we prove it? 

The ACSA process gave us the platform and the tools to provide assurance that we had the policies, and personnel in place, but also highlighted the gaps that had developed over the years. Our original involvement with ACSA and subsequent accreditation in 2018 was a positive experience. ACSA gave the department a common purpose and an opportunity to involve the whole theatre community in reviewing how we work and why we do what we do. We took pride in benchmarking ourselves against nationally agreed standards and opening the department up to external scrutiny. That said, our accreditation in 2018 was not the end of the story.