The President's Blog - December 2020
I am sure it seems strange to everyone that we are coming up to the holiday season in such circumstances. While the information about current numbers of admissions to hospitals, and specifically the number of patients in critical care beds, shows a rather heterogenous spread of the second wave of Covid-19, we are all feeling the pressure one way or another. We heard recently of the death from Covid-19 of our colleague Krishnan Subramanian in Derby. Every death is a huge loss to family, friend and colleagues. Losing someone from the ‘family’ that is anaesthesia and intensive care has been felt in every department. It seems Dr Subramanian’s death is the first in the UK and Ireland of an anaesthetist. A publication in Anaesthesia will be examining this, and suggesting possible reasons why, so far, we have been mostly spared. However, as we all recognise, this is not a time to be complacent, even with a vaccine now being delivered.
At times, it seems so obvious that we need to train more anaesthetists , and it is disappointing that the number of training posts has not been increased.
The recently published College census shows, again, the number of unfilled vacancies for consultant and SAS posts. This number will inevitably grow. We all want to see that change. At times, it seems so obvious that we need to train more anaesthetists, and it is disappointing that the number of training posts has not been increased. It was good, however, to see the announcement of more training posts in critical care. Of course, many other specialties also need their training posts to increase, so we are – to some extent – competing with them. We will continue to lobby, work with others and highlight this issue.
Our ability to work on behalf of our members has increased hugely.
This links to my next item – our new Policy and Advocacy Committee. Following the appointment of our Advocacy and Campaigns Manager in April 2018, our ability to work on behalf of our members has increased hugely. In the last three year we have responded to 45 consultations on behalf of members. Another major success has been the Fight Fatigue campaign, with interest from many parts of the profession and beyond (for example, Highways England), and the project group won the 2020 BMJ Workforce and Wellbeing Team of the Year Award. Many congratulations to all of the team. Other advocacy work that the committee is overseeing includes workforce, future service design, environment, wellbeing and Anaesthesia Associates.
As I have said previously, our work around the changes to Anaesthesia Associates (the archetypal ‘Marmite’ topic) is very important to members. Their regulation, planned for the end of 2021, offers some opportunities, as well as concerns – particularly on how post-qualification changes to the practice will be managed. To those who believe their introduction should be resisted at all costs, I say ‘that boat has sailed’. As the details of how regulation will work evolve, we will continue to represent anaesthetists and their patients. We plan to consult widely next year on the line we should adopt, but in the meantime, I’d be very happy to hear from members about their experiences and views. There is much to consider, including education, standards, and Fitness to Practice proceedings.
Our Trainee Committee’s survey on recruitment and examinations is about to close and we will be analysing the data in the next few weeks. There is no doubt that recent changes continue to cause anxiety. Thinking of my comments above about workforce shortages, it is even more perplexing to know that we have great candidates who can’t get into specialty training.
We have been made aware of a trend for some private providers to directly employ senior anaesthetists. The use of private providers to deliver some NHS care was a political decision taken some years ago. But one recent change is the use of these employed colleagues to provide care to ‘private patients’, i.e. those with health insurance or self-funding their care. We are not a trade union (consequently we are unable to offer advice on individual contracts) and this development is quite ‘above board’ and legal, but members may wish to read carefully any contract they are offered to ensure it allows them to work, like their NHS colleagues, with professional independence and with access to SPA time, study leave, wellbeing resources, appraisal, etc.
Finally, I was privileged to speak last week to the Tri-Service Anaesthetic Society (on my favourite topic - sustainable anaesthesia). One the other speakers was Dr Richard ‘Harry’ Harris who spoke on his experiences as an anaesthetist and cave diver. Harry was instrumental in the safe recovery of the Thai boys football team stuck underground in 2018. It was a truly inspirational lecture highlighting his huge skill, ingenuity and astonishing personal bravery. I was reminded again of the bravery of anaesthetists when I watched Dr Ian Roberts rescue Romain Grosjean from the burning remains of his F1 car at the Bahrain GP. As we all know, our work is not always recognised by the public but is crucial in so many areas.
I hope that every member has the opportunity for some rest and relaxation during the coming holiday season. I suspect we will need to recharge our batteries for more waves of the pandemic (despite the start of the vaccine program), the inevitable ‘other’ winter pressures, and the demand to catch up on all the elective work already lost this year. And, as the end of the year approaches, my thanks on behalf of all the Association’s members to all of our fantastic staff for their work and efforts in 2020.