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Dear Editor

Drs Passi and Oliver state in their article that ‘in-vivo studies to quantify the reduction in serum progesterone concentration following sugammadex have not been performed…’. They are incorrect in this statement.

Devoy et al performed a prospective observational study comparing changes in serum oestrogen and progesterone in women undergoing surgery. 60 patients on hormonal contraception received sugammadex; 30 patients were not on hormonal contraception and did not receive sugammadex; 32 patients were not on hormonal contraception and did receive sugammadex. Blood samples pre, 15-minutes post, 240 min post sugammadex administration were taken to measure oestrogen and progesterone levels. 

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.

As a medical student, someone once told me that helping patients stop smoking was the single best intervention available to us as doctors. I’ve never found a reference for that, but it stuck with me.

While I might not have the evidence for my claim, we do know that each year, smoking-related disease costs the NHS £2.6 billion and causes up to 76,000 deaths. The good news is that rates of smoking are decreasing each year, with the latest figure at 12.9%.

Aside from the general health benefits of quitting, several specific perioperative outcomes exist.

In the operating theatre environment, the perpetual demands, emotional toll, and the need for precision contribute to the potential vulnerability of anaesthetic staff to burnout.

What is burnout?

Burnout, as recognised by the World Health Organization in the International Classification of Diseases, is a syndrome characterised by ‘symptoms’ in three domains:

• feelings of energy depletion or exhaustion
• increased mental distance from the job or feelings of negativity and cynicism related to the job
• reduced professional efficacy.

Burnout is not classified as a ‘health condition’. Instead, it is an occupational phenomenon and due to chronic, unmanaged, workplace stress. People who are burned out are also at high risk of developing mental health conditions, for example depression and generalised anxiety disorder.

This first report, an assessment of the scientific basis of climate change and its impacts and future risks, highlighted the importance of climate change as a global challenge with universal consequences which required international collaboration, cooperation and action.

Unfortunately, all these years later we haven’t made as much progress as we should have done across the world. The latest (2023) Lancet Countdown Report 'underscores the imperative for a health-centred response in a world facing irreversible harms. Climate inaction is costing lives and livelihoods today, with new global projections revealing the grave and mounting threat to health of further delayed action on climate change’. How can we take action? What can we do? You can all achieve so much more than you believe, and we would like to guide, support and empower you to do so.

It's time for us to take action together.

The NHS is facing a significant change due to changing demographics and needs of the population and workforce gaps, leading to a rise in international recruitment.

This has led to Health Education England setting out the national vision for the use of simulation to deliver high-quality patient care. Simulation enhances patient safety through a rehearsal of performance, multidisciplinary teamwork, decision-making, and communication skills. Simulation can be a powerful tool for change management, both as an educational tool and as a lens to the system design and processes.

Welcome to the summer issue of the Bulletin! As I write this, sunlight is streaming in through my window as an indication that British Summertime has finally arrived in more ways than just the clocks going forward. This issue of the Bulletin will arrive on your preferred digital platform as we come to the close of the term of a distinctly inspirational RCoA president, Dr Fiona Donald. While Dr Donald’s nature is one of immense humility, it is worth reflecting on the unique equanimity one needs as a leader at this time within the NHS (including our specialty) when facing immense challenges, turbulence and uncertainty.