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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.
Chapter 1: Guidelines for the Provision of Anaesthesia Services: The Good Department 2025
Poor teamwork can impact on the wellbeing of all staff and can lead to lower job satisfaction. Departments should consider providing team-based training to promote cohesiveness and collaboration.
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.
In this episode Council Member Sarah Ramsay talks to retired Consultant Anaesthetist Simon Chadwick about how our perception of observation has changed over several generations of anaesthetists and how a trip to an art gallery can enhance our skills.
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.