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At Nottingham University Hospitals (NUH), it was felt that for our patients with cardiovascular disease, obtaining a preoperative cardiology assessment and perioperative management strategy was prolonging non-cardiac surgery waiting times.
This was especially compounded by the surgical backlog and increased demand on preoperative services following the COVID-19 pandemic. In order to streamline the assessment process and facilitate safer surgery, a joint cardiology-anaesthesia multidisciplinary team (MDT) meeting was established.
The global problem
It is no surprise that underlying cardiovascular disease can contribute significantly to perioperative morbidity and mortality, with cardiac events being the leading cause of such.1 Almost half of adults aged over 45 years undergoing major non-cardiac surgery have at least two cardiovascular risk factors, and conditions such as coronary heart disease, heart failure and arrhythmias put patients at increased risk of cardio- and cerebrovascular events in the immediate postoperative period.2
Maintaining and improving the LLP
Since its launch in August 2018, the College has committed to improving the reliability, performance and general user experience of the Lifelong Learning Platform (LLP) for our members. With the inclusion of three new curricula and of ICM users in late 2021, it became apparent that the added level of complexity and the need to support more users required additional funding, so a sizeable new budget was approved by the College’s Finance and Resources Board in August 2022.
This additional funding has allowed us to resolve many historic issues, keep the infrastructure and related systems up to date, as well as making significant improvements where needed. We still have a great deal of work to do, but as you will see below, we have already achieved a lot over the last year and have a clear plan of where we are heading in the coming months.