The President’s Blog - February 2022
WSM 2022 and Learn@
There are a few matters I’d like to describe to you in this blog. But, first of all, I’d like to thank all of those who contributed to the WSM last month. I think it goes pretty much without saying that many of us would have preferred a physical meeting. Despite that, the delegates, speakers, chairs and hosts all worked together, along with our great staff team, to deliver a fantastic event. The academic presentations will be available on Learn@ in two months’ time for all members to access. If you have not used Learn@, or not used it recently, do try it out – via the website or via the App. With our new provider the functionality has increased significantly. You can search for lectures, browse the various categories, and add reflective notes. In addition, Learn@ can be used to store reflective notes on any other CPD activity and you can add certificates or other material to the record and then download all of it for your appraisal each year. The first video on the Learn@ homepage is a ‘how to’ in case you need help or advice.
Clinical Excellence Awards
The DHSC and Welsh Government recently published the outcome of the consultation into reform of the national Clinical Excellence Awards scheme. There are very significant changes, and one that particularly concerns us is the suggestion that the number of National Nominating Bodies (NNBs) and Specialist Societies (SSs) will be reduced, with only one for each specialty. We have asked for clarification on how this will work, and have stated our concern that this could reduce the number of applications made by anaesthetists. We know that when anaesthetists apply for a national award (under the scheme in use until now), their chances of success are broadly in line with the overall chances of success of all applicants. The reason why anaesthetists are under-represented in the number of successful awards is that we don’t apply. Reducing the number of organisations that could be approached to support an application could discourage those who may feel that the organisation which is awarded NNB (or SS) status doesn’t acknowledge, or is not aware of, their contribution. We have, and will continue to make, representations on this point.
Tackling the elective care backlog
Amid much fanfare NHSE’s document on tackling the COVID-19 elective care backlog was published this month. The general thrust of the document is laudable. (Damning with faint praise?) But, the specifics are very much lacking. Without producing a precis of the whole document, there are plans to separate (or at least ring-fence) elective care from emergency surgical and medical patients. I went to medical school in the late 70s and finished my training in the mid-90s. Throughout that time small, mostly orthopaedic, hospitals disappeared and their ‘beds’ moved into larger general hospitals. One rationale was that staff could be used flexibly; another was that if patients deteriorated, they could be cared for by a larger hospital’s staff and facilities. That we are moving full circle may induce a wry smile on some. However, high volume, low complexity surgery hubs are working well in parts of the country and the use of independent sector (IS) hospitals for cancer patients during the pandemic has shown what can be achieved.
Independent sector
A recent Coroner’s Regulation 28 Report (Prevention of Future Deaths) from a Coroner in the SE of England, that we have been made aware of, has highlighted the importance of patient selection when considering surgery in a ‘remote’ location (e.g. an elective surgical hub), and also the need for referral pathways and processed for transfers (e.g. for critical care). The NHSE document promotes the greater use of the independent sector to help defuse the crisis in our elective backlog. The same concerns apply here. We have two other concerns about the use of the independent sector. Firstly, the risk of robbing Peter to pay Paul. We don’t just need more anaesthetists, or more surgeons. We need more nurses, ODPs, physiotherapists, radiographers, HCAs, porters, pharmacists, cleaners, and many other groups. We continue to lobby for more anaesthetists, and while so doing highlight these other shortages too. Secondly, if more NHS work is to be undertaken in independent sector hospitals, it is essential that all medical staff providing that care are paid equitably. This is NHS work, on NHS patients, being undertaken for the NHS.
Workforce crisis
NHSE’s plan is notably short on detail about the workforce crisis. While mentioning the use of anaesthesia associates and attempts to debunk pension myths, what will the real action (or result) be? We continue to meet with parliamentarians and discuss the workforce crisis. On pension taxation, it is very hard to make a case for paying less tax. Don’t worry, I get it – we would all like to pay less tax, but making a special case for doctors is unlikely to get much support. We can, we think, make a good case for the negative impact of not being able to predict the likely quantum, and the resulting effect on whether to undertake additional work, have a contract above 10 PAs, or the need for early retirement.
Association work
Now that the effect of this latest, omicron, surge is working its way through the system, the Association’s attention is turning to other matters. Our working parties and guidelines programs are now more or less back to normal. We are planning a range of educational events – both ‘in person’ and online. The Trainee Committee members are incredibly busy working for their colleagues. We are looking to appoint a new Editor-in-Chief of the journal. All the other programs – international, research and grants, environment, heritage, international, safety, ED&I, are getting back to normal. And, as has become usual over the last few years, the Board are spending time working on the budget. All supported and delivered by our fantastic staff. Please do think about joining the Board or Trainee Committee – the adverts are in our various communications channels. As I have said before, this is your Association. We need a diverse range of voices and opinions to represent our members throughout the UK and Ireland, and your help to deliver our ambitious programs.
Community
Finally, if you have an opinion, a comment, a thought, a question, or just want to get something off your chest, have a look and use the new ‘Community’ function on our website. It’s not only for us (Board or staff) to use, it’s to give you a voice amongst your colleagues. Please try it out.
Mike Nathanson
Email: [email protected]
Twitter: @mikenathanson61