The President's Blog | Association of Anaesthetists

The President's Blog

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

mike_blog


Email: [email protected]

Twitter: @mikenathanson61



The President's Blog - October 2021

Another Association ‘year’ has started. We have a number of ‘years’: financial (April to March), calendar, Trainee Committee (July to June), membership year (July to June) and the Board’s year which runs from 12 months starting at the Annual Members Meeting. Why should you be interested in this detail? Well, let me explain! The Annual Members Meeting (AMM) was during Annual Congress last month. As you probably are aware, we converted AC from hybrid to fully virtual earlier in the summer. It was a difficult decision for the Board as we were aware that many of us long for the opportunity to meet in person, but many others remain concerned about the risks of travel and meeting a large number of people. The bookings reflected that, and a physical face-to-face element was not viable. However, we still had just shy of 800 delegates for the virtual meeting, who enjoyed a great programme. The AMM is also the time when we welcome the new Board members that you, the membership, have elected. This year we were joined by Victoria McCormack, Krish Radhakrishna, and Emma Wain. So, the start of a new Association year is a time of saying goodbye to old friends, welcoming new faces (although all three are well known colleagues), and refreshing our ideas, projects, initiatives, and plans.

A happy, healthy and sustainable workforce, means producing the right number of well-trained entrants to the permanent workforce, maintaining their health and wellbeing, and keeping them in the workplace. 

As I’ve said before, our main focus during the pandemic was, and remains, wellbeing and workforce. I’d like to update you on workforce. For most of us the need for more anaesthetists is simply so obvious and clear. The devolved governments have plans on how to tackle the backlog (on top of the underlying workforce shortage), yet don’t appear to see the need for more of us, if they want to deliver more high-quality surgical services. We have made good contacts in Scotland, Wales and England on this (and will continue to work on Northern Ireland, and sharing our thoughts in Ireland), including a number of parliamentarians. Our Policy and Advocacy team attended the recent Labour Party and Conservative Party conferences to push home the same point, and used the opportunities to get support for our work on wellbeing too. The recent trainee surveys (their views on how their training has been impacted last year, and on the destination of those not successful at obtaining ST3 post this year) informed our own thinking and have been useful primers to conversations with politicians. In part these surveys made uncomfortable reading. While not necessarily cathartic, it was important to air emotions and anxieties. The plight of our trainee members (including Locally Employed Doctors) remains a huge concern. We simply cannot afford to lose these colleagues from the workforce.

For myself, entering the second of my two years as President, it has been great to see some of our staff back in our headquarters building, to see and greet Board members in person, and to feel reinvigorated by the desire we all have to help our members. 

A happy, healthy and sustainable workforce, means producing the right number of well-trained entrants to the permanent workforce, maintaining their health and wellbeing, and keeping them in the workplace. The Association is active in all these areas. Our wellbeing resources and events will continue over the winter. Look out for the November issue of Anaesthesia News that focuses on wellbeing, the recording of the wellbeing session at Annual Congress, our website if you would like to find a mentor, and the upcoming Links and TNL meeting which looks at wellbeing and workforce issues.

Our other activities in the next few months include new guidelines, more online events (including WSM 2022), supporting the SAS committee and increasing its representation, updating our Long Term Strategy, work on the environment linked to COP26, delivering our international program safely, and education and innovation ideas to help prevent unrecognised oesophageal intubation.

For myself, entering the second of my two years as President, it has been great to see some of our staff back in our headquarters building, to see and greet Board members in person, and to feel reinvigorated by the desire we all have to help our members. I apologise if that all sounds a little too self-congratulatory; it’s not meant to be. I did, however, want to share with you in this blog what we try to do for you, through our excellent and very professional staff and through our volunteers: Board, Trainee Committee, co-opts, independent trustees and specialists, Links, TNLs, speakers and faculty, editors and many, many others.

Let’s hope the autumn and winter do not see a further increase in Covid cases, or a double whammy from a virulent ‘flu’ pandemic. Stay safe and look after each other.


Mike Nathanson

mike_blog


Email: [email protected]

Twitter: @mikenathanson61


The President’s Blog – March 2021

It’s an unusual time, to say the least. With the ‘R’ number coming down indicating fewer new infections, and the vaccine roll-out hitting milestone after milestone, attention has turned to restarting surgical and diagnostic services. Yet, critical care facilities are still massively over-stretched. Critical care colleagues (nurses, doctors, AHPs) are working above and beyond their normal workloads, mutual aid is being used to provide some ‘relief’ to the busiest units, and anaesthetists, theatre workers and many others are supporting critical care, while the prediction is that the number of patients requiring intensive care will not fall for another four weeks or so.

We have three concerns. Firstly, everyone caught up in this surge (which will be most staff in primary and secondary care) must be allowed some time to recover from their fatigue, stress and burn-out. This period has been given a number of names – decompression, recovery, time-out - but the essence is that it would be unreasonable to expect an immediate return to a normal workload. (And, of course, we will need to work significantly above that to enable us to catch-up with the backlog.) There are many agencies, parts of the NHS, Colleges, membership organisations and others all making this point. We are yet to see a clear instruction to Trusts and Boards mandating such a period of recovery.

The Covid information Hub recently published guidance from ourselves, the College and FICM on the conditions needed to allow surgery to restart. In addition, we are continuing to push for central guidance from the governments.

We would like to see greater coordination to ensure a comprehensive plan, without the risk of a ‘postcode’ effect.

The second concern is about the physical and mental wellbeing of health service workers after 12 months of the pandemic. It is good to read that so many organisations recognise this and are proposing action. However, we would like to see greater coordination to ensure a comprehensive plan, without the risk of a ‘postcode’ effect. Recent publications have highlighted the risk of stress, anxiety, and PTSD on mental wellbeing. The health services in our countries are very resilient, often because of the sheer number of staff who somehow manage to keep the service running. But beneath that, the impact on individuals can be lost or hidden. Our Fight Fatigue campaign has never felt more important, but the issues are now wider than fatigue. Many of us will need to transition from carer to patient.

I offer no apology for emphasising and re-emphasising the messages on wellbeing.

Finally, we and others are working to ensure there is an enduring legacy from the pandemic. This is not opportunism, but a sincere belief that our employers must do more to care for their staff. The NHS People Plan and other initiatives are a good start, but we now need to see the fine ideas turned into action. The philosophy of a well (physical and mental health) workforce, nurtured and cared for, and supported through good and times and bad, must become a reality. These ideas are starting to crystallise, and I will return to them in future blogs.

I offer no apology for emphasising and re-emphasising the messages on wellbeing. Very soon we will advertise the vacancies on our Council/Board, and on the Trainee Committee. Given that two of the Association’s main services for members are education and wellbeing, which have both been affected by the pandemic, there has never been a more important time to come forward and offer your help to our members. Of course, other activities such as guidelines, safety, publications, international, and environment also need support. Please do consider standing for election. This year we are looking to increase representation on the Board from SAS members. We also would like our Board’s membership to more closely reflect the diversity of our membership. There is no ‘right’ time to stand, and there is no ‘right’ person. All we ask is that you bring your enthusiasm and energy for our profession and our patients. You could be at any stage of your career, from any background, and working anywhere in the UK or Ireland.

It is still too early to tell when the Association’s activities will return to normal, and what ‘normal’ will look like for the second half of 2021 and thereafter. 

As I described at the beginning of this blog, there is some light at the end of the pandemic tunnel. The publication by the UK government of a roadmap to the easing of Covid restrictions (and equivalent notices from other governments) gives us hope. It is still too early to tell when the Association’s activities will return to normal, and what ‘normal’ will look like for the second half of 2021 and thereafter. We hope that the Trainee Conference in July and the Annual Congress in September (in Newcastle and Liverpool, respectively) will be run as hybrid events (some physical element, as well as streamed live). The Board are committed to opening up as much as we can, as quickly as we can, while ensuring the safety of our staff and of our members and delegates.


Mike Nathanson

mike_blog


Email: [email protected]

Twitter: @mikenathanson61


The President’s Blog – January 2021

Maintaining staff wellbeing in the face of adversity

One advantage of a blog (over an article in a news magazine, for example) is the ability to publish almost simultaneously as writing the content. In one way that makes this blog easier, as I can reflect on the current pandemic surge, but in another it is no help at all – as we all know either by direct experience, or through contacts, colleagues, friends, about the tremendous pressure the health services in the United Kingdom and in Ireland are under this week. It is not necessary to expand further, except to say that although we are an association of anaesthetists, many members also have a commitment to critical care, and for those who don’t – many are offering help and support to their critical care colleagues.

At this year’s virtual Winter Scientific Meeting the wellbeing session was the most highly rated part of the event. 

It has never been more important for us to focus on our own wellbeing and that of the wider team. We know that many NHS staff (including anaesthetists and intensivists) have been traumatised by the first wave of the virus and are now going through even more difficult times. The Association has prioritised supporting the wellbeing of members for many years and has multiple resources available on our website including the ‘Vital Signs in Anaesthesia (a guide for anaesthetists seeking help and advice during the COVID crisis)’ document. At this year’s virtual Winter Scientific Meeting the wellbeing session was the most highly rated part of the event. The speakers were Professor Neil Greenberg, Dr Anna Baverstock and Dr Fiona Kelly. They spoke about the threats to our wellbeing, how to prepare effectively, how to sustain ourselves and support each other, and what will aid our recovery afterwards. To aid all our members, and also other healthcare workers, we have made this session freely available to all; there is no pay wall. Please do use this resource and share with others in your teams, departments and hospitals.

There is much understandable anxiety about the decision to split the two parts of the vaccination. We published, with others, a statement on this on January 11. We have seen since the continuing disquiet in the general and medical media and also heard from our members. There is no answer that will satisfy everyone. I have heard the disappointment, frustration, anger and – yes – fear resulting from this decision. I have also heard from colleagues who accept the need to vaccinate as many of the population as possible, as quickly as possible. There is a lack of scientific evidence to support the delay to the second part of the Pfizer/BioNTech product; there is also credible actuarial analysis to support the delay. I am in no doubt that the strength of feeling on this matter has been heard across Whitehall, by the CMOs, and by the JCVI.

We are disappointed that the reality of working during this crisis and the professional risks (in addition to the personal risks we take every day) are not being acknowledged.

The Association made a number of representations last year about protecting healthcare workers from coronial, regulatory, civil or criminal action or criticism as a result of the actions and decisions they are taking. Others have continued to campaign on this issue, with a letter to the Secretary of State in England highlighted last week. We support that campaign and are disappointed that the reality of working during this crisis and the professional risks (in addition to the personal risks we take every day) are not being acknowledged.

It may seem a distraction to write on other matters this week. But, the success of our recent Winter Scientific Meeting does suggest to me that members do still want educational material, and perhaps also the sense of belonging or camaraderie that comes from attending a meeting (even if online). I wrote a few weeks ago to members about our decision to continue with the meeting, despite the surge. The recordings of all the sessions (in addition to the one I mentioned above on wellbeing, which is free) are now available to all registered delegates via the meeting platform, and will remain there for the next six months. I confess that we just don’t know when face-to-face conferences will restart. We very much hope that both the Trainee Conference in July and the Annual Congress in September will have a significant physical element. But who can say?

The Association’s work for its members is continuing. The Board will be undertaking strategy work over the next 3-6 months on workforce, Anaesthesia Associates, and new educational activities. We are celebrating the 75th anniversary of the first issue of Anaesthesia, important work on the environment continues in preparation for the IPCC COP26 meeting hosted by the UK government at the end of this year, the ‘Fight Fatigue’ campaign is gaining more and more supporters, and our trainee members are preparing for a change in the curriculum. I would say this, wouldn’t I, but it has never been more important than now to be a member of an organisation that can represent and advocate on your behalf.

Finally, let me just say: “please look after yourself and your colleagues” and “stay safe”.


Mike Nathanson

mike_blog


Email: [email protected]

Twitter: @mikenathanson61


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.

Season’s Greetings!


Mike Nathanson

mike_blog


Email: [email protected]

Twitter: @mikenathanson61


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

mike_blog


Email: [email protected]

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

mike_blog


Email: [email protected]

Twitter: @mikenathanson61