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The President's Blog

The President's Blog - November 2020

We are now, clearly, in another significant surge of the pandemic. The Association has heard of real pressures in various parts of the country: many patients with COVID-19 on wards and in critical care; episodes of likely nosocomial spread; large numbers of healthcare workers self-isolating; and, disruption of surgical activity, despite efforts locally and nationally to maintain an elective service.

Our trainees took a big hit in the first surge, and since then they have been affected by changes to the FRCA examination and to recruitment. The recruitment processes at CT1 and ST3 are changing again; some refinements were needed after the problems with the ST3 round a few months ago. We campaigned hard based on our belief that the self-assessment process could discriminate against certain groups. We received some reassurances from the statutory education bodies that the changes to the current round would reduce this risk. The Trainee Committee are now undertaking a survey of trainee experiences. If any of this has affected you, please do complete the survey so we can represent your views.

The Association Board is looking to balance our desire to maintain activities such as educational meetings, guidelines, grant awards, international work and our joint work with other organisations, and the need to prioritise clinical work as we are placed on emergency rotas. This affects our Board, speakers, faculty, volunteers and others we work with. At the beginning of the first surge we shut down many workstreams but maintained the main governance processes to ensure the Association (as an entity) got through the emergency. This time we have a little more time and certainly more experience to allow us finesse how we manage this surge. Most importantly, we recognise that our actions and experiences reflect what every member, their departments and their households up and the down the country are doing this week. We all know the wide impact of the surge and this current national lockdown on society, the economy, our patients and on our colleagues. We have updated the wellbeing guidance on our website, with new links and resources. As I have asked you before, please do check on your colleagues. A small act of kindness or support, or an expression of concern can make a huge difference.

As I mentioned above, there is much effort being expended on trying to maintain elective, cancer and other non-urgent services including surgery and diagnostics. Within London a plan has been developed to create a hub-and-spoke model, prioritising some services such as cataract surgery and joint replacement surgery. Similar projects in other parts of NHS England are underway. Of course, we broadly support such moves, but there is a need to ensure high-quality care and that patient safety is not compromised. Further, many clinical teams have not had time to fully recharge their batteries since the first surge. We have joined the groups created in the last few weeks to deliver this service, and will offer advice, encouragement and warnings as appropriate.

The first pandemic surge came with many surprises. The editors of our journals – Anaesthesia and Anaesthesia Reports – were worried that submissions would fall as colleagues concentrated on clinical work. In fact, they saw the reverse, with a large increase in submissions. We have increased the number of editors to ensure the workload is manageable. We are always hugely grateful to the Editor-in-Chief, Andy Klein, and his team of editors and production staff for publishing month in, month out, such successful journals. Next year marks the 75th anniversary of the first publication of Anaesthesia. There is an ambitious range of activities to mark this achievement – look out for the first of these in the New Year.

Last month I described how we were planning to deliver the Winter Scientific Meeting in a new format. The Chair of the Education Committee – Chris Mowatt, and our Events team led by Zack Puttock are working incredibly hard with our online conference provider – The Live Group, to produce a high-quality ‘product’ in January. Like many, I will miss the physical meeting and its opportunities to meet, socialise and learn with colleagues. In my opinion we cannot easily replace that, but we can offer something new and different and take advantage of the technology to do things differently. Providing we all get through the next two months and are not subsumed by work before then, I do hope we can come together online for a great event.

Finally, I’d like to finish this month’s blog by expressing my thanks to the Boards and Committees of the Association for all the work they do for you – the members. They could not do this without the support of our fantastic staff. We were very disappointed not to be able to reopen our headquarters at 21 Portland Place last month. For our staff, this was a heavy blow and I’d like to thank them publicly for their perseverance and continuing efforts for us. We remain open for business!

Mike Nathanson



Twitter: @mikenathanson61

The President's Blog - October 2020

The Association of Anaesthetists’ year starts at the Annual Members Meeting (AMM) each September. This year, of course, we were unable to conduct the AMM during an Annual Congress meeting; however, we held a very successful online Links/SAS Links/TNLs meeting combined with the AMM and a keynote lecture from Tim Cook. At that event we said goodbye to several Board members and thank you to several officers whose roles have changed. It was my duty and pleasure to pay thanks on behalf of the Association to Kathleen Ferguson as she completed her two-year term as President and handed over the reins to me. I thanked her, on your behalf, for her leadership, for her humility, for her attention to detail, for her commitment to equality and diversity, for her advice and for her friendship. 

I hope to use these President’s Blogs as a way of informing the membership about what the Board and staff have been doing on your behalf. 

One of my personal commitments as incoming President is to improve our communications with members. It's always difficult to get the balance right between timely messages and information overload. I hope to use these President’s Blogs as a way of informing the membership about what the Board and staff have been doing on your behalf. 

As I write this, we are entering the second surge of the Covid-19 pandemic. It is difficult to predict the impact on each of us, on healthcare systems and our patients, and on society in general. Tim Cook’s keynote lecture during the virtual event for our Links and AMM meeting on Sept 25th was a timely if somewhat scary reminder of risks associated with Covid-19. The Association has been working on your behalf throughout the pandemic and will continue to do so. We have another of our very successful free Covid-19 webinars on Saturday October 10th – this one is focused on getting back to normal. The impact of the current surge on elective activity is currently unknown. Not surprisingly, governments and healthcare systems want to try and preserve elective activity as much as they can. We met with Steve Powis Medical Director of NHS England last month focusing on new ways of working. Prof Powis emphasised the importance of maintaining non-urgent surgery, and we committed ourselves to several actions to assist with that.

There is no doubt that the new ways of working will include a much more multi-professional workforce. The issue of Anaesthesia Associates (AAs; previously known as PA(A)s) is one of the true Marmite issues in anaesthesia. It is my opinion, and I think that shared by many others, that the numbers of AAs in training will be increased and their role promoted by our governments.  We could put our collective heads in the sand, but these changes will still go ahead. Now that their regulation by the GMC has been announced we have opted to work with the GMC and will be represented on working groups looking at education, standards and fitness to practice processes. We think engaging and influencing from the inside will be much more effective, but I appreciate this will not suit everyone. Like it or not, the pandemic has highlighted the value of an expanded, multi-skilled and adaptable workforce; a rubicon has been crossed.

To ensure the best experience for our membership we’ve bought a new learning management system to deliver WSM as an online event. 

Our Events team and Education Committee are planning the Winter Scientific Meeting. I imagine the majority of members and delegates would prefer a real, physical meeting – with the extra richness of experience that comes from meeting face-to-face, the opportunity for chats over coffee or lunch, of visiting the industry exhibition, and of bumping into old friends. There are, of course, others who find the whole thing rather tiring, expensive and not particularly environmentally friendly. We’ve thought long and hard about what to do, and it does seem that our only option at present is a virtual meeting. While the Board asked the Events team to retain the possibility of adding in a physical element, that seems increasingly unlikely. To ensure the best experience for our membership we’ve bought a new learning management system to deliver WSM as an online event. As you might expect there are numerous companies competing to deliver these events. I think the one we have chosen will help us provide a new type of experience, with some possibilities that a physical event does not allow. We are not transforming the Association into an ‘online only’ organisation, but ‘needs must’ and being nimble and embracing new technology is part and parcel of the profession of anaesthesia. Bill Fawcett and Chris Mowatt, the outgoing and incoming Chairs of the Education Committee, have developed a great program. See you there!

I can’t write a blog without mentioning wellbeing. It is so integral to the Association and so vital during the extraordinary circumstances we currently live in. Do access the wellbeing pages on our website. We will continue to develop our own resources and signpost those from other organisations. And, just one request from me, please check those around you at work, as a quiet word of support or encouragement may make a huge difference to them.

Mike Nathanson



Twitter: @mikenathanson61