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As a maturing specialty, it’s inevitable that ICM looks to its own future as an independent college which directly represents the interests of its fellows and members and the patients we treat.

While we continue to share some services with the RCoA (most obviously exams administration and communications services) we need to expand the clinical and secretariat teams to continue to deliver and grow the functions expected of the future UK College of ICM.

All outputs from the FICM Board and its committees are delivered by volunteer clinicians, many with busy clinical roles or still in ICM training. Likewise, our secretariat team although small is high calibre and punches above its weight. If we are to realise the future UK College of ICM, we’ll need to push further and deeper, doing more with more resources. In preparation for that we’ve made changes to the exams team and also embarked on a series of member engagements.

Most pain medicine consultants in the UK have anaesthetics as their base specialty. Pain medicine specialists are specially trained, qualified and revalidated, and offer integrated expert assessment and management-of-pain knowledge and skills within the context of a multidisciplinary team.

Unfortunately, the COVID-19 pandemic severely impacted the provision of pain services. After the pandemic, the Faculty of Pain Medicine (FPM) commissioned a Gap Working Group to evaluate the state of pain services across the UK. Here’s a snapshot of what we discovered.

The gap analysis reveals that only 65% of the pain services across the country fully met the gold standard for medical involvement in pain services. Tier 1 services (community-based pain services) fared the worst, with only 33% of these services having any medical involvement. This reflects a shift towards non-medical management of chronic pain in the community. Unfortunately, this means patients will wait longer for expert diagnosis and management by pain medicine specialists. While acknowledging that not all chronic-pain patients can be seen by pain medicine specialists, there’s a need for developing pragmatic pain pathways nationally so that needy patients are escalated to pain specialist care expeditiously in a timely manner. We have recently commissioned a ‘Pragmatic Pain Pathways’ working group to address this issue found in the gap analysis.

October’s Black History Month celebrates the contributions of individuals of Black heritage, including those within the NHS. It is also an opportunity to highlight the academic challenges faced by healthcare professionals from under-represented groups, emphasising the need for diversity in our healthcare system.

Disparities in clinical academia stem from the intersection of ethnicity and gender, in addition to other contributing factors, including lack of mentorship, systemic biases, and the ‘minority tax’. For ethnic minorities, the negative correlation between clinical time and scholarly productivity diverts time away from career advancement, hindering their professional growth compared to peers.

Embracing research diversity improves care equity, reduces differential attainment for anaesthetists, and bridges gaps in academic leadership. It promotes equity-minded environments and builds a workforce that reflects the population it serves. This article examines these disparities and efforts to improve diversity in anaesthesia research.

Dear Editor,

I read the wellbeing and burnout articles in the Bulletin (Summer 2024) with interest. Though highlighted for some, it is an ‘eyeroll subject’, but the importance of wellbeing is undeniable. In particular, it is important to ensure that anaesthetists and the wider multidisciplinary team receive appropriate wellbeing and psychological support after traumatic incidents. Exposure to traumatic events is inevitable in anaesthesia. Having systems to support staff afterwards is crucial to recovery and to reduce long-term burnout and emotional toll.

Our full selection of back digital issues will keep you up-to-date and informed on what’s happening in our specialty. We hope you continue enjoying your membership magazine.

I’m hoping that no one reading this has missed the launch of NAP7: perioperative cardiac arrest. The NAP7 data touched every part of anaesthesia practice – from maternity and neonates right through to the frail and older patient – so there’s something there for everyone.

But NAPs don’t stand still; NAP8 is on its way and will be looking at regional anaesthesia and neurological complications of anaesthesia. We are delighted that Professor Alan MacFarlane has been appointed to lead NAP8 – more news will be coming soon.

The work of CR&I is supported by a diverse group of clinical fellows (and this issue of the Bulletin even has a piece from a future research leader – aged 11). We couldn’t do our work without them, and they in turn are supported by their clinical workplaces – both in the NHS and the independent sector – who pay their salaries and give them the space to work with CR&I. I’m delighted that some of our fellows have given an insight into what the role is like – and the challenges of going and coming back from maternity leave.

CESR (Certificate of Eligibility for Specialist Registration) programmes now called the ‘portfolio pathway’ have become popular among many trusts. With more than 2,000 LED & SAS doctors in the UK, there is a growing need for structured CESR programmes to ensure a successful application via the portfolio pathway. 

In 2019, we initiated the CESR programme at Addenbrookes Hospital. This is a three-year structured programme based upon the RCoA curriculum for already experienced anaesthetic CESR aspirants, with dedicated educational supervision and an ARCP-like process. Now, with six years of running, the programme has proved to be an excellent platform for achieving successful registration on the GMC specialist register, as it mirrors the GMC and RCoA requirements for CESR. So far, five out of six CESR fellows have been successfully appointed to substantive consultant posts within the UK.