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September 2019
The Centre for Perioperative
Care (CPOC)
Cannabinoids: where are we?
‘Plan-D’ kits: an innovative
emergency solution
A collaboration of specialties
to advance patient care
Page 29
www.rcoa.ac.uk
@RCoANews
Bulletin | Issue 117 | September 2019
RCoA Events
NOVEMBER
Further information about all of our A CAREER IN
events can be found on our website. Updates in Anaesthesia, Critical
Care and Pain Management ANAESTHESIA
%
www.rcoa.ac.uk/events 4–6 November 2019
events@rcoa.ac.uk The Studio, Birmingham 9 October 2019
@RCoANews UK Training in Emergency
RCoA, London
Airway Management (TEAM)
7–8 November 2019 www.rcoa.ac.uk/
Royal Infirmary of Edinburgh career-anaesthesia-2019
SEPTEMBER WICM 2019 Meeting: Striking a
Balance
Anaesthetists as Educators:
Simulation Unplugged
%
RCEM/RCoA Major Trauma
New to the NHS 27 September 2019 2 October 2019 Study Day
Updates in Anaesthesia, Critical
16 September 2019 RCoA, London RCoA, London 13 November 2019 DECEMBER Care and Pain Management
%
General Medical Council, etc venues Prospero House
Developing World Anaesthesia Leadership and Management: 25–27 February 2020
Manchester Anaesthesia Research 2019
30 September 2019 Leading and Managing Change Anaesthetists as Educators: RCoA, London
2–3 December 2019
%
Introduction to Leadership and RCoA, London 7 October 2019 Teaching and Training in the
%
The Principle Hotel, York
Management: The Essentials RCoA, London Workplace MARCH
23–24 September 2019 OCTOBER Ultrasound Workshop
14–15 November 2019 Winter Symposium
Ethics and Law
RCoA, London 10–11 December 2019
%
Bristol % 8 October 2019 11 March 2020
%
Anaesthetists as Educators: RCoA, London
Advanced Airway Workshop RCoA, London FULLY BOOKED RCoA, London
An Introduction
%
24 September 2019 1 October 2019
RCoA, London RCoA, London
A Career in Anaesthesia:
Foundation Year Doctors
Clinical Directors Meeting
18 November 2019
JANUARY 2020 Ultrasound Workshop
13 March 2020
%
Updates in Anaesthesia, Critical 9 October 2019 RCoA,London RCoA, London
Return to Training Network Tracheostomy Masterclass
Care and Pain Management RCoA, London
%
10 January 2020
%
Meeting Leadership and Management: Leadership and Management:
24–26 September 2019 2 October 2019 CPD Study Day RCoA, London
Working well in Teams and Personal Effectiveness
%
RCoA, London RCoA, London 17–18 October 2019 Making an Impact Primary FRCA Revision Course 19 March 2020
Crowne Plaza, Newcastle 20 November 2019 RCoA, London
14–17 January 2020
RCoA, London RCoA, London
Less Than Full Time Matters 2019
MARCH
WINTER SYMPOSIUM 2019 17 October 2019
Association of Anaesthetists, London
Anaesthetists as Educators:
Anaesthetists’ Non-Technical
GASagain (Giving Anaesthesia
%
Safely Again)
Skills (ANTS)
Patient safety, health and wellbeing GASagain (Giving Anaesthesia
22 November 2019
15 January 2020 Cardiac Symposium
Safely Again) Bradford Royal Infirmary
RCoA, London
23–24 April 2020
10–11 December 2019 18 October 2019
Final FRCA Revision Course RCoA, London
RCoA, London FPM LPMES Day 2019
RCoA, London FULLY BOOKED 28 November 2019
20–24 January 2020
RCoA, London
UK Training in Emergency
RCoA, London
MAY
The 2019 Winter Symposium will feature a varied
programme combining lectures and short updates.
Airway Management (TEAM) FPM 12th Annual Meeting FEBRUARY Anaesthesia 2020
28–29 October 2019 29 November 2019 18–20 May 2020
RCoA, London RCoA, London Patient Safety in Perioperative Old Trafford, Manchester
www.rcoa.ac.uk/winter-symposium-2019 Practice
%
13 February 2020
RCoA, London
Discounts available for RCoA-registered Senior Fellows and Members, Anaesthetists in Training, Foundation Year Doctors Discounts available for RCoA-registered Senior Fellows and Members, Anaesthetists in Training, Foundation Year Doctors
and Medical Students. See our website for details. and Medical Students. See our website for details.
%
%
| 1
Bulletin | Issue 117 | September 2019 Bulletin | Issue 117 | September 2019
Contents
The President’s View 4
News in brief 8
Faculty of Pain Medicine (FPM) 14
From the editor
Faculty of Intensive Care
Medicine (FICM) 15
SAS and Specialty Doctors 16 Dr David Bogod
Senior Fellows and Members Club 18
Revalidation for anaesthetists 19 Welcome to the September Bulletin.
Appointing a new colleague 20
The Perioperative Medicine Much of this month’s edition is given over to the evolution of the Centre for Perioperative Care, hereinafter
Clinical Trials Network 26 known as CPOC. This has been a project which has moved smoothly through from conception to
completion, with much hard work being done on-stage by Council members and even harder work
Perioperative Journal Watch 28
behind the scenes by College staff. My friend and colleague, Dave Selwyn, has been appointed as
What is CPOC and why now? 30 CPOC’s inaugural director, and within these pages he describes the task that he and his board face as
New CPOC Director 31 this collaborative programme gets underway. CPOC could have a major impact on patient safety and the
quality of the patient experience, and is a great example of proper multidisciplinary care involving a host of
The future of perioperative care
32
different specialties, including surgery, nursing, physiotherapy and, of course, patients themselves. In years
– launching CPOC
to come, we may well look back at this as the moment that anaesthesia came out of its slightly nerdy and
Who are the CPOC Board? 34 self-regarding shell and explained to the medical world what we do, how we do it, and how important it is.
Guest editorial Improving quality of care 36
Elsewhere, we feature an article by Drs Bhandari and Menon, looking at the rather tortuous process
Cannabinoids: where are we? Shared decision-making 38
39
which has led to the licensing of cannabinoids in the UK for treatment of specific conditions, and why this
does not seem to have produced the flood of prescribing that might reasonably have been expected. As
e-Learning for Perioperative Care
Following the recent publicity regarding cannabinoids – understand all the latest anaesthetists, we are likely to encounter cannabis and its derivatives in two particular areas – chronic pain,
developments Perioperative care is everybody’s
and the interaction of these substances with our anaesthetic drugs. The authors draw some caution, quite
business 40
Page 12 rightly, from the current opioid dependency crisis affecting many countries, warning us that, once again,
Perioperative care: the there is a risk of a drug embraced as a public benefit leading to unintended consequences.
international perspective 41
42
Those readers with a bit of extra time on their hands, wanting to travel the UK and meet interesting people,
Perioperative care: a patient’s view
should read the interview with Sian Jagger, the College’s Joint Lead Assessor for Advisory Appointment
An insider’s view: being an Centre for Perioperative Addenbrooke’s CESR Committees. More AAC assessors are needed to cover the burgeoning number of consultant posts, and
programme: supporting SAS
Advisory Appointments Care anaesthetists 44
this is a great, and relatively painless way, to get involved in the work of your College. The only slight fly in
the ointment, as I recall, is trying to find a parking space when you turn up mid-morning in most UK trusts,
Committee assessor The Centre for Perioperative Care has Mobile medical education: but you quickly learn to make friends in the Human Resources department with whoever has access to the
What does it take to become an now officially launched – read our utilising the social media
reserved slots.
Advisory Appointments Committee extensive 15-page coverage of its aims, phenomenon 46
assessor? scope and multidisciplinary ethos Finally, those of a nervous disposition or who have recently eaten may want to avoid Peter Featherstone’s
Regional anaesthesia: an
Page 22 Page 29 alternative international ‘As We Were…’ article, which features one Henry Robert Silvester. Dr Featherstone highlights Silvester’s
perspective – Switzerland 50 ingenious 1883 experiment with an inflated dog as a buoyancy aid for the rescue of shipwreck victims, this
How urgent is urgent? ‘Plan-D’ kits: an innovative College Tutors’ Meeting 2019 52 unlikely device being created with the simple use of (a) one compliant dog, (b) a small sharp knife to effect
A new four category system helps emergency solution Letters to the editor 55
a subcutaneous puncture and (c) a straw or blowpipe to produce surgical emphysema. Wisely realising that
classify urgency of surgery A simple tear open pack costing just a dog may not always be easy to get hold of in such a situation, Silvester went on to demonstrate that he
30p each can be placed in every
As we were... 56 could turn himself into a human lifeboat by the same method.
Page 24
anaesthetic room New to the College 58
The Editor-in-Chief is happy to offer a bottle of finest burgundy to any reader prepared to try this one out
Page 48 Notices and adverts 60 and produce photographic evidence to confirm buoyancy.
RCoA Events 68
2 | | 3
Bulletin | Issue 117 | September 2019 Bulletin | Issue 117 | September 2019
Professor Ravi Mahajan
President
The global focus on disease prevention over two decades
has led to important reductions in death and disability.
However, these gains have not been mirrored by global
improvements to health systems, service integration,
or hospital-based care. In fact, globally, more people
die annually within 30 days of surgery than from HIV,
tuberculosis, and malaria combined (bit.ly/2KWEjAT).
Around 10 million patients undergo surgery The national picture
annually in the UK, and for most of them it is Recent UK-wide polling of senior NHS leaders
a success in terms of the procedure itself and (including those within anaesthesia, intensive
the care before and afterwards. But while a care, surgery and general practice) has sought
patient receiving surgery in the UK will have a to examine how NHS organisations are
much higher chance of survival and positive responding to the prevention agenda. More
postoperative outcomes, the UK’s population than half of those surveyed consider prevention
is changing and so therefore must our services. a core or large part of their work, and there
There are 250,000 patients at higher risk from is growing consensus that the NHS should
surgery, and this number is set to rise. prioritise a systems approach to prevention,
embedding it into routine practice and clinical
The long-term sustainability of the NHS requires
and/or patient pathways (bit.ly/2XqTGIl).
a shift from treatment of ill health to prevention.
Yet in recent years the NHS has moved away The NHS Long Term Plan for England has
from pathway development for services built based its model of care on population health
around prevention and focused its efforts management – gathering data and insights
on immediate, acute demand. But there is a about population health across care and service
change in the wind. settings, identifying the healthcare needs of
The President’s View
communities, and adapting services. Data
In this President’s View, I will show that while
analytics and digital technologies offer the
direct healthcare provision accounts for a
tools to make this a reality, helping to identify
The vital role of anaesthesia in
relatively small proportion of what makes us
risks, stratify patient populations and design
healthy, the NHS, and surgical and anaesthesia
personalised treatment. This can improve the
The President’s View care, have a vital role to play in improving the
improving the health of individuals
health and wellbeing of populations and the
health of individuals and populations. And never
experience of care, and reduce the costs of care.
TEXT
have the opportunities to place prevention at
and populations
the core of service design and delivery been The Plan also lays out a renewed NHS
better, with the introduction of ‘A Healthier prevention programme focused on maximising
Wales’, NHS England’s Long Term Plan, ‘Quality the role of the NHS in tackling the key risk
2020’ in Northern Ireland’, and the launch next factors identified by the Global Burden of
year of Public Health Scotland. Disease Study – smoking, poor diet, high blood
4 | | 5
Bulletin | Issue 117 | September 2019 Bulletin | Issue 117 | September 2019
pressure, obesity, alcohol and drug use,
and lack of exercise (bit.ly/2OcMqr0).
the full impact or effectiveness of their work. And we
can communicate that impact to others across their
Bulletin
While direct healthcare
In England, local NHS organisations will organisations to further encourage or improve delivery.
of the Royal College of Anaesthetists
increasingly focus on population health As the survey of NHS leaders has highlighted, this matters Churchill House, 35 Red Lion Square, London WC1R 4SG
and partnerships with local authority
funded services through new integrated provision accounts for a because when staff are not directly involved in prevention
activity they are more likely to consider prevention
020 7092 1500
www.rcoa.ac.uk/bulletin | bulletin@rcoa.ac.uk
relatively small proportion of
care systems. interventions to be ineffective or to be unaware of their
@RCoANews
impact.
A population health model will be /RoyalCollegeofAnaesthetists
important in supporting the development
of new integrated care systems which,
what makes us healthy, the Enter the Centre for Perioperative Care
The Centre for Perioperative Care (CPOC), launched in
Registered Charity No 1013887
Registered Charity in Scotland No SC037737
as the Long Term Plan outlines, offer ‘a
pragmatic, practical way of delivering NHS has a vital role to play. May 2019, is a new cross-organisational, multidisciplinary
initiative led by the Royal College of Anaesthetists to
VAT Registration No GB 927 2364 18
the ‘triple integration’ of primary and President Emma Stiby
facilitate cross-organisational working on perioperative
specialist care, physical and mental Ravi Mahajan SAS Member
care for the benefit of patients (bit.ly/2X6tAtf).
health services, and health and social
Vice-Presidents Katie Samuel
care’ (bit.ly/2RnWmAi). It is encouraging CPOC will work closely with key stakeholders such as the
Fiona Donald and Anaesthetists in Training
to see the alignment of this system-level Royal College of Physicians, the Royal College of Surgeons,
The role of anaesthesia in through to full recovery. Good Mike Grocott Committee
approach to prevention and population the Royal College of Nursing, the Royal College of General
population health perioperative care should improve Editorial Board Carol Pellowe
health with the views of NHS leaders. Practitioners, the Association of Anaesthetists and other
patient experience of care, including David Bogod, Editor Lay Committee
Developing multidisciplinary care and a partners to coordinate perioperative care initiatives across
And, there is much to learn from quality of and satisfaction with care.
shared culture will be essential. Clinical the health and social care landscape. CPOC will also work Jaideep Pandit Gavin Dallas
colleagues across the devolved nations. It should also improve the health of
and care teams can work together to with other partners such as NHS England and the devolved Council Member Head of Communications
In Wales, prevention is at the heart of populations, including return to home/
design patient-centred services. As nations’ health initiatives such as Realistic Medicine in
collaboration between the NHS and work and better quality of life, and Krish Ramachandran Mandie Kelly
clinicians, if we are truly to support the Scotland and Prudent Healthcare in Wales.
local government to deliver seamless reduce the per capita cost of healthcare Council Member Website & Publications Officer
NHS to become a wellness, not an illness,
services for patients, in Scotland through improving value. CPOC will support professionals and influence policy, Joanna Budd Anamika Trivedi
service, we all have a role to play in
more than half of the NHS and adult and it will support technology and digital advancements Lead Regional Advisor Website & Publications Officer
addressing acute and chronic conditions
social care budget is delegated to an Perioperative care is prevention in and research and innovation. It will work to inspire Anaesthesia
and looking beyond the treatment of
integration joint board for each area action. It offers a common thread from professionals and hospitals to better prepare patients for
patients with recognised problems. Sudhansu Pattnaik
(apart from Highland), and across national to system/organisational level their surgery, increase coordination between specialties
Lead College Tutor
Northern Ireland 17 integrated care Perioperative care is the integrated prevention strategies. It can support NHS and provide cohesive aftercare programmes to enhance
partnerships are playing a key role in multidisciplinary care of patients from organisations by offering a clear role or recovery and improve quality of life following surgery. Articles for submission, together with any declaration of interest,
service transformation. the moment surgery is contemplated remit when it comes to prevention that should be sent to the Editor via email to bulletin@rcoa.ac.uk
can measure progress. We now have a CPOC will aim to combine the best-practice examples
already being delivered in hospitals across the UK into All contributions will receive an acknowledgement and
chance to embed a perioperative care
shared solutions to improve patients’ lives as well as the Editor reserves the right to edit articles for reasons of
and a population health approach into
taking the pressure off an already severely pressurised space or clarity.
clinical and patient pathways. We have
a chance to think about the current health system. Some of those best-practice examples are The views and opinions expressed in the Bulletin are solely
highlighted in the RCoA’s report, ‘A teachable moment:
We now have a chance to
surgical pathway, and how we might those of the individual authors. Adverts imply no form of
delivering perioperative medicine in integrated care endorsement and neither do they represent the view of
review and redesign it to better support
systems’ (bit.ly/2RWIlIt). the Royal College of Anaesthetists.
embed a perioperative care
our patients in being prepared for
surgery, and to think about how and by Anaesthesia-led perioperative care and a population health © 2019 Bulletin of the Royal College of Anaesthetists
whom the decision is made that they are
and a population health
management approach, offer a route forward that puts All Rights Reserved. No part of this publication may be reproduced,
optimised for surgery. patients at the heart of service design and delivery both stored in a retrieval system, or transmitted in any form or by any other
nationally and internationally. Working collaboratively, we means, electronic, mechanical, photocopying, recording, or otherwise,
approach into clinical and
We can build on existing tools, and without prior permission, in writing, of the Royal College of Anaesthetists.
have an opportunity to improve the lives of patients and
develop new ones for coding and
populations, across the life-course, for generations to come. ISSN (print): 2040-8846
patient pathways
measurement to enable tracking of
essential perioperative and preventative You can read more about the aims of CPOC, its scope ISSN (online): 2040-8854
activity, supporting our staff who and multidisciplinary ethos on page 29.
are directly involved in measuring
6 | | 7
Bulletin | Issue 117 | September 2019 Bulletin | Issue 117 | September 2019
NEWS IN BRIEF
News and information from around the College
RCoA and Macmillan Cancer launch Book now for
prehabilitation guidance Anaesthesia
Research 2019
Dr David Selwyn appointed as Director of
The College, Macmillan Cancer Support, and the National Institute for Health
Research (NIHR) Cancer and Nutrition Collaboration have launched a report calling
for changes to the delivery of cancer care across the UK, with a greater focus on
prehabilitation including nutrition, physical activity and psychological support.
the Centre for Perioperative Care
The College is delighted to announce the appointment of Dr David Selwyn as the inaugural
Seventy per cent of the 1.8 million people in the UK living with cancer are also Director of the Centre for Perioperative Care (CPOC).
living with one or more other long-term health conditions. The guidance report,
Prehabilitation for people with cancer, promotes evidence that when services are The CPOC is a cross-specialty centre dedicated to the promotion, advancement and development of perioperative care. CPOC
redesigned so that prehabilitation is integrated into the cancer pathway: will facilitate cross-organisational working on perioperative care for patient benefit, in partnership with patients and the public,
other professional stakeholders including Medical Royal Colleges, NHS England and the equivalent bodies responsible for
■■ patients feel empowered and quality of life is improved
healthcare in the other UK devolved nations.
■■ physical and psychological resilience to cancer treatments is maximised
■■ long-term health is improved. David brings a wealth of expertise to his new role as a highly experienced consultant in Adult Critical Care Medicine and
The College is pleased to announce the
Anaesthesia and Deputy Medical Director at Nottingham University Hospitals NHS Trust. As Director of CPOC, David will
Teams from Macmillan Cancer Support, the College and NIHR have worked launch of Anaesthesia Research 2019, a
take the lead on facilitating and encouraging cross-organisational and new ways of working to help shape the development of
together to develop these principles and guidance together with an action plan. new two-day event, which will take place
perioperative medicine (www.rcoa.ac.uk/cpoc). You can read more about the aims of CPOC, its scope and multidisciplinary ethos
This sets out how NHS organisations across the UK can replicate some of the at The Principal Hotel in York on 2–3
on page 29.
pioneering work already taking place at a limited number of trusts – all of which December 2019.
have demonstrated how prehabilitation has improved outcomes and reduced the Led by the National Institute of
risk of disease progression. Academic Anaesthesia (NIAA), the event
The document aims to provide guidance to people living with cancer, care providers, will incorporate the Anaesthetic Research Applying to be an FRCA The FRCA exams in brief
examiner
commissioners and policy makers. Read the full report at: bit.ly/RCoAMacmillan Society and BJA Research Forum, and
The Primary FRCA OSCE/SOE took place week commencing
all NIAA-affiliated activities including
14 May 2019. 409 candidates sat the exam with an overall pass
the UK Perioperative Medicine Clinical
rate of 54.3 per cent which is in the normal range.
Trials Network (POMCTN), the Health
Services Research Centre (HSRC), and The Final FRCA SOE took place from 17–21 June 2019. 413
experimental/discovery medicine. candidates attended the exam achieving a pass rate of 67.3 per
cent overall, which is in the normal range.
The single day rate is £87.50 or £175
for both days of the meeting. There From September 2019 Constructed Response questions
is a reduced rate of 25 per cent for (CRQs) will replace Short Answer Questions (SAQs). The
anaesthetists in training and allied health September paper will consist of 6 x SAQ and 6
professionals (£130 across the two x CRQ. With effect from March 2020,
days) and a 50 per cent discount (£90 the paper will consist of 12 x CRQs.
across the two days) for quality audit and The examiner recruitment round is now open until Monday Example CRQs can be found on
research coordinators. 21 October 2019, recruiting examiners for the academic year the Final Written page of the
2020–2021. Applicants are recruited to the Primary and Final College website at:
This event promises top speakers and
examiner boards. bit.ly/ExampleCRQs
dedicated work streams to provide
you with maximum value, for more The application form and a full list of essential criteria, which
information and to book your place, go must be met on application, are available on the College
to: bit.ly/RCoAResearch2019 website at: bit.ly/RCoAExaminer
8 | | 9
Bulletin | Issue 117 | September 2019 Bulletin | Issue 117 | September 2019
NEWS IN BRIEF
News and information from around the College
Fitter Better Sooner
resources nominated for WINTER SYMPOSIUM
10–11 December 2019
BMA Patient Information
Award
ELECTION TO COUNCIL
The Fitter Better Sooner patient information toolkit on
Nominations open: election to RCoA Council
preparing for surgery, has been highly commended for the
2019 BMA Patient Information Awards. Nominations for election to the Council of the Royal College
Timetable
of Anaesthetists are now open. Council comprises 24 seats,
Endorsed by the Royal College of General Practitioners ■■ 22 July 2019: nominations open via our election
made up of:
and the Royal College of Surgeons, the Fitter Better website: www.ersvotes.com/rcoa20
■■ 20 consultant seats
Sooner resources were developed to advise patients on
■■ 30 September 2019 at 12.00 noon: nominations close.
how to prepare for going into hospital and encouraging ■■ 2 SAS doctor seats and
All completed nominations must be received on the
them to improve their health before surgery. The toolkit ■■ 2 trainee seats.
online platform by this date and time. Any nominations
consists of one main leaflet, six specific leaflets on some of The vacancies and timetable for 2020 are as follows: received after this date will not be accepted.
the most common surgical procedures and an animation The theme of the 2019 Winter Symposium is patient safety,
■■ 3 consultant vacancies: Those eligible for nomination are ■■ 30 September 2019: members’ ballot contact details
designed to be shown in clinic and surgery waiting areas. health and wellbeing. In an increasingly pressurised NHS,
those who are on the specialist register and are Fellows by finalised. Fellows and members who have changed
how can anaesthetists take care of their own health as well
The BMA Patient Information Awards were established Examination or Fellows ad eundem their email address are requested to give notice to the
as the safety of their patients? The Symposium will be a
in 1997 to encourage excellence in the production and ■■ 0 anaesthetist in training vacancies: There are no trainee membership team by emailing subs@rcoa.ac.uk by
lively mixture of updates, debates and panel discussions.
dissemination of accessible, well-designed and clinically vacancies this year this date to allow time for updating.
Hot topics will include the new junior doctors’ contract.
balanced patient information. ■■ 0 SAS vacancies: There are no SAS vacancies this year. ■■ 16 October 2019: announcement of candidates
Experts will bring you up to speed with changes in
anaesthetic practice and explore what the next five years standing. The names of the candidates will be published
The awards aim to reinforce the BMA’s commitment to Information for those standing
may bring. on the College website.
support good educational practice and acknowledge Consultant members of Council are elected for a maximum
new approaches and technologies intended for the ■■ 30 October 2019: ballot emails distributed. Ballots
Enjoy the opportunity to ask questions, participate in of two terms and an aggregate of ten years. The first term of
public audience. will be sent electronically by ERS to the email address
discussions and network with your peers. office is six years and, subject to re-election, the second term is
registered at the College. The ballot process will be
up to four years. Terms of office can be extended if a Council
Up to five resources have been shortlisted for each award managed and verified by ERS.
The Symposium was fully booked last year so book early to member becomes a president or vice president, subject to the
and the winners will be announced at a ceremony and
avoid disappointment (bit.ly/RCoAWinter19). maximum terms of those offices. ■■ 2 December 2019: election closes at 12:00 noon.
reception on the afternoon of Tuesday 10 September
■■ 3 December 2019: result announced. The election
2019 at BMA House. The ‘Duties and Responsibilities of Members of Council’ can results will be declared via the College website as soon
You can view the toolkit at: bit.ly/RCoAPI-FBS 2019 SALG SAFE
be found at: bit.ly/Councilduties. All those wishing to be
elected to Council are asked to read this document prior to
as possible following the ballot count. The results will
also be published in the president’s e-newsletter and
Patient Safety
ANAESTHESIA
LIAISON GROUP
seeking nomination. the College Bulletin.
Conference ■■ 11 March 2020: new members will be admitted to their
Fitter The annual SALG Patient Safety
first council meeting.
Better Conference will be held on the 31 October this year at the
Sooner College. As in previous years, we are running an abstract
competition for anaesthetists in training to submit their projects
www.rcoa.ac.uk/fitterbettersooner for consideration. Further information about the conference
and the competition can be found at: bit.ly/2xNZvQN Contact Information: Rose Murphy, CEO Office Manager,
10 |
Telephone: 020 7092 1612 or Email: ceo@rcoa.ac.uk | 11
Bulletin | Issue 117 | September 2019 Bulletin | Issue 117 | September 2019
The ACMD will be conducting a This sounds very similar to the issue Anaesthetists and the British Pain
long-term review on the medicinal of opioids being used for patients Society, are already taking a lead
use of cannabis, and the National with chronic pain, and here we are in role in disseminating information
Institute for Health and Care the middle of a worldwide epidemic. for doctors so that they are better
Excellence (NICE) has been The evidence for cannabinoids informed and can help patients to
commissioned to provide advice for indicates that some of the most answer their queries and help in
clinicians by October 2019.3 The consistent effects are their adverse further research. As the research
government will monitor the impact effects, especially in the cannabinoid base improves we will get a
of the policy closely as the evidence naïve patient.6 The oral forms often clearer picture, and, if and when
base develops, and review the have erratic absorption, whereas clear therapeutic indications are
policies when the ACMD provides its the inhaled form leads to rapid recognised, guidelines will probably
final advice. increases in plasma levels which may be formulated, and the current
lead to intoxication, and addiction. legal restrictions on prescription
The situation is complex, with two
Also, patients with chronic pain may for cannabinoids by general
products containing cannabinoids
benefit from sustained release rather practitioners may be relaxed. But
already having product licenses
than rapid increases and decreases.7 until then, the prescription can only
– nabilone (a synthetic form of
There is some evidence of benefit be by specialists, and should be in
tetrahydrocannabinol (THC))
in patients with neuropathic pain8 the context of multidisciplinary teams
for PONV associated with
when a decision is made.
but good quality trials are needed to
Guest Editorial chemotherapy, and nabixomols
confirm this.
(a 50:50 mixture of THC and As more patients are prescribed
CANNABINOIDS: WHERE ARE WE? cannabidiol in a spray form for
mucosal absorption) licensed for
use in spasticity in multiple sclerosis,
although not supported by NICE.
All the above may result in increased
use of cannabis, and for us as
anaesthetists and pain physicians
this may have implications for our
cannabinoids and long-term reviews
are conducted by ACMD and
NICE, we hope to get a clearer
picture regarding the effectiveness,
indications, adverse effects and the
Dr Rajesh Menon A licence for Epidiolex (cannabidiol) is practice. With further research, the
Dr Sanjay Bhandari addiction potential of the various
likely to be issued shortly for its use in pressures and possible indications
Consultant in Anaesthesia cannabinoids.
ST5, Leeds General infirmary certain resistant epilepsies in children. are likely to increase. Anaesthetists
and Chronic Pain,
West Yorkshire may see more patients on medicinal Watch this space.
Calderdale and Huddersfield The prescribing of other products cannabis, and will need to understand
NHS Trust under the new guidance is for References
the various interactions between
substances that have no licence. anaesthetic drugs and cannabinoids. 1 Independent, 16 July 2018.
Further research with the use of 2 The Global Cannabis Market, London,
There has been plenty of recent publicity regarding the medicinal use of The situation for long-term non-
cannabis is very important if we are July 23 2018, PRNewswire.
cancer pain is complex. The
cannabis,1 particularly around children being denied access to medicines statement of the FPM4 indicated not to find ourselves in a similar 3 Further advice on scheduling of
cannabis-derived medicinal products
containing cannabinoids and also around their use for long-term pain problems. that the evidence base at present position to the current opioid
situation, where the adverse effects
ACMD (bit.ly/2FhxXYp).
is too weak, on both safety and
Some cannabis containing products have been rescheduled, and since November efficacy, to recommend the use of of using them are significant and
4 Cannabis position statement. Faculty of
Pain Medicine. October 2018.
2018 can be prescribed, with certain limitations, in the UK. A 2018 report by BDS cannabinoids. This view is supported accompanied by high addiction 5 European Pain Federation (EFIC) position
by the Royal College of Physicians potential. We also need technologies paper on appropriate use of cannabis-
Analytics (who provide data related to the cannabis industry) estimates that the and the British Pain Society. Less to tease out THC from the hundreds based medicines and medical cannabis
for chronic pain management Eur J Pain.
legal cannabinoids market could be worth $57 billion globally by 2027.2 restrictive guidance from the of other chemicals to improve the 2018 Aug 3. doi: 10.1002/ejp.1297.
European Pain Federation, indicated safety profile of the medications. 6 Systemic review of medical
An initial review by the Chief Medical should be able to prescribe medicinal potential for abuse which may lead that it ‘should only be considered by cannabinoids. Canadian Family Physician,
More patients with chronic pain will Vol 64, February 2018.
Officer concluded there was evidence cannabis provided those products meet to severe psychological or physical experienced clinicians as part of a
have questions about cannabinoids, 7 Cannabinoids in the management of
that medicinal cannabis has therapeutic safety standards.3 The ACMD also dependence, such as opioids and multidisciplinary treatment’.5
benefits. The Advisory Council on the recommended that cannabis-derived ketamine). These drugs are subject to the and it is important that good quality difficult to treat pain. Ther Clin Risk Manag
2008 Feb;4(1):245–259. (bit.ly/2IIKbvm).
Misuse of Drugs (ACMD), which carried medicinal products should be placed full controlled drug requirements relating There is considerable public patient-orientated information
8 Mücke M et al. Cannabis-based
out the second part of the review, in Schedule 2 of the Misuse of Drugs to prescriptions, safe custody and the enthusiasm in the area of pain is easily available. The various
medicines for chronic neuropathic
recommended that specialist doctors Regulations 2001 (drugs with high need for a controlled drug register. management, with many viewing societies, namely RCoA/Faculty pain in adults. Cochrane Database of
cannabinoids as a definitive answer. of Pain Medicine, Association of Systematic Reviews. 2018(3).
12 | | 13
Bulletin | Issue 117 | September 2019 Bulletin | Issue 117 | September 2019
Dr Peter Hersey
Chair, FICM Education Sub-Committee
Faculty of Intensive Care Medicine (FICM)
FICM education
The FICM has recently decided to set up an Education Subcommittee (ESC) to
Dr Barry Miller expand its educational activities. By the time this article is published it will have
Dean, Faculty of Pain Medicine
met for the first time and will, we hope, be hard at work.
Faculty of Pain Medicine (FPM) At first much of the activity will be and admission to critical care and more areas in need of ‘refreshment’.
Be seeing you
behind the scenes, but we hope it will induction of anaesthesia in the critical Where possible we are updating
not be too long before we launch a care unit. sessions, but if that’s not possible
collection of high-quality, open access new content will be produced in
educational resources. The idea is not Revision of content due course.
to replicate the excellent FOAM (Free, We launched e-ICM with much shared
‘And the sky, full of stars’ Open Access, Medical education) content from several other e-Learning Allied Health Professional
J M Straczynski resources already available, but to for Healthcare programmes. This has engagement
particularly highlight the work of the left us with some sessions that we are We are about to start work on
faculty and address any specific needs unable to update, and some areas where ensuring that e-ICM is useful
This is my final piece as Dean of the Faculty of Pain Medicine – by September or requests of fellows and members. the content isn’t as specific as we’d like. for the whole critical care team
there will be a new person in the post and I wish them all the best. It is a The ongoing revision of ICM content by producing new content and
The ESC will also oversee continued in e-LA is helpful, but we are aware of creating more learning paths.
great position and gives a unique perspective to the profession: I am already development of e-Learning for
envious of my successors. Intensive Care Medicine (e-ICM:
www.e-icm.org.uk). Current areas of
Royal Colleges and their faculties are more information) and we are looking to is important for fellows to reach out development include:
evolving bodies, taking the demands of welcome non-anaesthetic secondary- to CCGs, GPs and secondary-care
the profession and the environment in colleagues with educational messages, Learning paths
care practitioners in the near future.
which they practise, and aiming to make which it is clear they are often looking for. Learning paths are collections of the
it all work better in some way, and to set We also face external fragmenting most useful sessions for a particular topic
pressures from the 2012 Health & Social My final words are simply a big thank or need. Two of the new learning paths
it up to meet the unknown challenges of
Care Act, and, more recently, from you to Daniel Waeland (Head of address the curriculum-mapped needs
tomorrow and beyond.
concerns over the issues of opioids, Faculties), Emmy Kato-Clarke (Manager), of ACCS and core anaesthesia trainees
Over the last few years we have worked cannabinoids, gabapentinoids, and other Claire Driver, Laura Owen and Anna in ICM.
to improve the franchise to include interventions. Ripley. These are the people who work
acute/inpatient practitioners, and behind the scenes to make the faculty New content
so help to develop educational and We are placing ourselves as the principal work, and who email, encourage, Following a successful bid for funding
professional materials. This also nicely professional body, looking at our cajole and ring me to get things done. from Health Education England, we have
slipstreams with the new Centre for therapeutic role in national conversations As with any organisation, it is the started work on new sessions. Sessions
Perioperative Care (congratulations with government, NICE, MHRA and multidisciplinary team that makes it work, currently in development include
to Dr David Selwyn – see page 31 for others. To complement this locally, it not one individual. maternal critical care, decision-making
14 | | 15
Bulletin | Issue 117 | September 2019 Bulletin | Issue 117 | September 2019
Dr Kirstin May
RCoA SAS Member of Council,
Horton General Hospital, Banbury
SAS and Specialty Doctors
IN PRAISE OF APPRAISAL…
‘Being interested is more important than being interesting’
Ann Landers
My colleague Lucy Williams and I have held a number of SAS meetings and
engagement sessions since we joined Council in 2016 and 2015 respectively.
We will continue to hold these, alongside educational events, as part of our
role. If you haven’t met us yet, please come along to one of these events, or
approach us individually.
We are often told that in some hospitals Personally, I have had a multitude of company. All other attendees were
SAS doctors are not encouraged to take appraisers and diverse experiences over consultants, mostly not known to me.
What is difficult? causing diary difficulty, but we have view of someone else’s professional
The most challenging aspect is worked hard to spread appraisal timings life. This often extends into their private
on non-clinical roles. Often doctors the years. Some of my appraisers were Considering that all attendees had many
attempting to understand the details of across the calendar, which is a significant life with surprising candour. Over the
themselves are not sure if they are consultant colleagues who knew me years of experience as appraisees, the
the professional lives in other specialties. improvement. course of three consecutive years, plans
‘allowed’ to be clinical or educational well, and some were relative strangers. training was quite basic and the trainer
Most of my meetings have been with and aspirations – professional and
supervisors, appraisers, rota-masters, I usually felt I benefited the most from without any clinical background. Most I have not had any difficulty with
pathologists and radiologists, which private – can really come to fruition and
etc, or sure what skills or qualifications appraisals with senior anaesthetists who of the limited benefit was derived from consultants openly objecting to an
limits understanding of continuous difficulties can be overcome. It makes
are required. Sometimes concern is knew me well, and always came away discussing difficult potential scenarios SAS appraiser. Sometimes one senses
professional development, incidents me realise how many highly motivated
expressed over the time commitment with good suggestions and ideas, and among ourselves. In contrast, the surprise when contact is first made, but
or complaints. On the other hand, it is and enthusiastic people work in the
required, particularly in a climate of relevant feedback. One of my appraisers ongoing support from my trust is very so far that has been easily overcome.
interesting to learn how other specialties NHS. Background, age, seniority, and
reducing SPA time. Some colleagues was even from a different specialty, as in good, with regular appraiser network One doctor that I have never met asked
think differently, for example in specialty – they all vary, and that makes
want to expand their roles, and indeed my trust appraisal is organised on a cross- meetings and an excellent annual for a different appraiser to be allocated
benchmarking individual performance. it fascinating. Appraisal meetings always
their horizons, but wait for opportunities specialty basis. Years ago I even had a clinician-led training day. Ongoing CPD for a spurious reason, though the
leave me with a spring in my step and
to come to them rather than actively traumatic experience with an appraiser focuses on potential difficulties, pitfalls grapevine told me that the individual
The administration of appraisal has grateful for the many amazing people
seeking or even demanding them. who knew nothing about my clinical skills and challenges. objected to an SAS appraiser.
become significantly easier since my giving their best every day!
I often recommend becoming an and competence – I work in a large multi- trust introduced an online appraisal
After initial training I was supplied with a
site organisation – but seemed to have a system. There is no longer the need What’s in it for me – and
appraiser. list of appraisees. Our local agreement
mindset doubting the competence of an
stipulates 10 appraisals per appraiser per
to bounce new versions of large potentially for you?
My personal experience SAS doctor from the start. documents backwards and forwards, This is the most uplifting aspect of my
year. Allocations are made regardless of
only to find the inbox full. There used job, alongside obstetric anaesthesia. I
Before becoming an appraiser, I I was invited by my trust’s appraisal lead grade, resulting in me having to appraise
to be an appraisal season in the spring, am always thrilled to get an in-depth
had many years of experience as an to become an appraiser approximately an eminent academic as one of my first
appraisee myself. During the early days of four years ago. interactions. Over the last few years
revalidation I represented SAS doctors in most of my meetings have been with
a local policy group for implementation, Initial training was provided in a small consultants, with a few specialty doctors
‘Every human is like all other humans, some other humans and no other human’
so I was already very well informed. group setting by a commercial training or clinical fellows thrown in. Clyde Kluckhons
16 | | 17Bulletin | Issue 117 | September 2019 Bulletin | Issue 117 | September 2019
Chris Kennedy
RCoA CPD and Revalidation
Coordinator
Dr Douglas Justins Revalidation for anaesthetists
RCoA Chair, Senior Fellows and Members Club
Updated guidance for
CPD event providers
SENIOR FELLOWS
AND MEMBERS CLUB For a number of years the College has been offering a CPD approval scheme
The Senior Fellows and Members Club met at the College on Tuesday 28 May for courses and events which is based on overarching criteria set by the
2019. This was the first meeting fully organised by the new team of Emily Academy of Medical Royal Colleges (AoMRC). The criteria appear in the
Worth and Ewelina Kolaczek from the Membership department. In addition, AoMRC document ‘Standards and criteria for CPD activities: a framework for
the caterers were new. As expected everything went very well indeed. accreditation’, which has recently been updated; the RCoA guidance for event
Thank you to Ann Ferguson, who has description of College membership the significant long-term savings that can
providers has been modified in response to this.
compiled the ‘What to do in London list’ – now at an all-time high, and of the be gained by early intervention in social
Many doctors will attend or participate ■■ an annual quality assurance report The guidance for event providers highlights
attached to the programme for many College’s healthy financial position. and economic affairs and compared
in CPD activities run by regional, national of the CPD approvals process is the importance of reflection that focuses
meetings. this to the benefits of preoperative
The main lecture was delivered by or international providers, and these will produced which includes information on learning outcomes and the impact on
interventions in anaesthesia.
The President, Ravi Mahajan, highlighted Lord Gus O’Donnell, who was Cabinet be selected and judged appropriate by on how a sample of event providers practice, and also strengthens the criteria
the leadership that the College is showing Secretary and Head of the British Civil The autumn meeting will be held in the doctor and that judgement confirmed have taken action based on their required for reporting conflicts of interest.
in the field of perioperative care. The Service from 2005 to 2011. In 2010 Liverpool on Thursday 7 November 2019. by their appraiser. However, the benefits delegate feedback received.
With in excess of 1,000 CPD event
CEO, Tom Grinyer, gave a detailed he oversaw the introduction of the The topic will be ‘Burma Railway Medicine’, of RCoA approval (for which there is no
The above is underpinned by the applications being received per annum
first coalition government since the and the lecture will be given by Professor charge to NHS trusts and hospital boards,
role of the AoMRC as the national – a number which has significantly
Second World War. Prior to this, he was Geoff Gill from the Liverpool School registered charities, specialist societies
authority recognised by the European increased in previous years, we welcome
Permanent Secretary of the Treasury of Tropical Medicine. After the Second and associations) include the following:
Accreditation Council for Continuing new applications from doctors willing
from 2002 to 2005, and served on the World War, the LSTM cared for a large
■■ event reviews are completed by Medical Education for setting standards to act as CPD Assessors. For further
boards of the International Monetary number of Far East POWs, and it possesses
independent, specialist CPD assessors, for the approval of CPD activities. information about this role please
Fund and the World Bank. He was a vast fund of information about the
who are clinicians experienced in contact cpd@rcoa.ac.uk.
appointed to the House of Lords in 2012, diseases suffered by the prisoners and the
the subject area. The reviews are
sitting as a crossbencher. The title of his miraculous feats performed by the doctors
only sent to a CPD assessor after an
talk was ‘Building a better nation’ and he and dentists who were also POWs. By
initial administrative check has been
was able to draw on his wide experience, coincidence, in a nearby art gallery, there
completed by the College revalidation
including working as Cabinet Secretary will be an exhibition of painting done in
with four Prime Ministers. It was a hugely secret by the Far East POWs. and CPD team
enjoyable and enlightening masterclass, ■■ approved events are included and
mixing personal reminiscences with searchable in the Lifelong Learning
Lord Gus O’Donnell rational analysis of the current state of Platform, and are also included on the
the nation. Lord O’Donnell emphasised College website
■■ the RCoA’s revalidation logo, which is a
registered UK trademark, can be used
The autumn meeting will be held in Liverpool on in the promotional material and on the
Thursday 7 November. delegate attendance certificates for
approved events
18 | | 19Bulletin | Issue 117 | September 2019 Bulletin | Issue 117 | September 2019
Dr Sian Jaggar Dr Ewen Forrest
RCoA Joint AAC Lead Assessor RCoA Joint AAC Lead Assessor
APPOINTING A NEW COLLEAGUE
One of the most important responsibilities of clinical directors is recruitment
of consultants and SAS colleagues. It is also one for which they will be
remembered for good or ill if problems arise later. Many aspects attract
candidates to apply for posts in a particular department, including timing,
departmental reputation, geography, and experiences as an anaesthetist
in training. If unfamiliar with a department, one of the most important first
impressions is the job description, including job plan and person specification.
consultants covering general depending upon the job plan, as may Ultimately, departments will appoint
Good job descriptions, like good CVs (expected of candidates), should be ●●
and maternity on-call rotas formal experience (eg, ALS instructor) the consultants/SAS colleagues that
accurate, up-to-date and well presented. should have completed higher or qualifications (eg, postgraduate they stipulate in their job descriptions.
obstetrics training (or equivalent). certificate in medical education) If specifications are basic, there will
Most HR departments have generic have a minimum of two programmed of a prospective colleague. This is Declaring on day one that they inevitably be a greater chance of
■■ clinical governance involvement,
templates for permanent medical posts activities every week allocated to this unsurprising as needs vary, but providing are incapable of covering an inappropriate appointment. To minimise
including audit/quality improvement,
which provide trust information. This is area. Those requiring a ‘specialist’ should specific requirements aids applicants and expected area of practice is this risk, all aspects of the person
is vital to trusts’ development of safe
helpful, but can lead to inaccuracies if have a minimum of three PAs per week. helps in shortlisting and the making of specification should be SMART –
embarrassing and unhelpful! clinical practice
information is not regularly updated. robust decisions at interview. In general specific, measurable, attainable, realistic
Job plans should have a timetable ●● similarly, a specialist post ■■ management and/or leadership,
Anaesthetic departmental details are the person specification should meet and time-bounded (by date admitted to
showing all expected commitments. containing ‘an interest in’ including change implementation
often cut and pasted from previously these requirements: the specialist register).
It is in everyone’s interests for a job requirement should have and the appreciation of resistance to
advertised posts and can be out of date. ■■ qualifications should be specified in
plan to contain at least three regular experience detailed in terms of change To attract the best candidates, make the
This may cause delays in post approval the first section and, for consultant
sessions, allowing new colleagues to advanced training (or equivalent). professional development with or job description, job plan and person
by RCoA Regional Advisors. The posts, (prospective) presence on the ■■
build relationships, confidence and a This should probably be essential without research allows trusts to specification attractive, detailed and
RCoA offers guidance on preparation specialist register
reputation with theatre teams. Advertising to ensure that relevant checks appoint candidates who engage in precise. Everyone then has clarity: the
and approval of job descriptions.1
a completely flexible job plan may be ■■ training/abilities and experience are included as part of the
Submissions for approval should include evidence-based practice candidates of the post for which they
unattractive to candidates, potentially should be covered in the next section.
post title, job plan (including timetable of appointment process are applying, and the department of
This is often where expressions ■■ personal attributes/qualities/expected
implying that ‘anyone will do’. Moreover, the calibre of colleague that they
commitments) and person specification, ■■ teaching and educational experience values of employees are increasingly
it fails to demonstrate what a department including ‘wide experience’ or ‘interest
in addition to descriptions of the trust. expect to appoint.
in’ occur. These are subjective and should normally be specified. The specified by trusts. These are difficult
really wants from a prospective
may lead to disagreements. The minimum standard for departments to measure but are very important.
The post title should accurately reflect colleague (apart from a bum on a seat!). References
curriculum provides expected levels with anaesthetists in training should be Good candidates can usually provide
the contents of the job plan. This Any person specification for such a post 1 Guidance for Advisory Appointments
of competence, and should be evidence of GMC clinical supervisor evidence around non-technical skills,
encourages the right candidates to will inevitably be very generic. Committees. RCoA 2018
used as a guide wherever possible. recognition.2 GMC educational so particular requirements should be (bit.ly/RCoA-AAC-RA-DRA).
the post, and reduces numbers of
There is little detailed advice on writing This should cover both clinical and supervisor recognition and local noted in the person specification 2 Recognising and
inappropriate applications. Posts labelled
a good quality person specification approving trainers. GMC 2012
as including a ‘special interest’ should supporting professional activity or regional teaching experience ■■ other sections can be added to suit
(bit.ly/2LmCLiX).
to accurately reflect what is required domains. For example: may also be desirable (or essential) particular posts.
20 | | 21Bulletin | Issue 117 | September 2019 Bulletin | Issue 117 | September 2019
RCoA: Tell us a bit about yourself. Did However, for me, one of the most At interview, they suddenly realised that
you know much about being an AAC important things about working with what they really wanted to do was to
assessor before you started? the College is the new friends I make appoint both candidates. I was stumped
Sian Jaggar (SJ): I’ve been interested in around the country. It is so easy to get – I hadn’t faced that situation before.
helping anaesthetists in training develop stuck in your own little patch feeling Fortunately, the College were on the
and achieve their dream jobs since overwhelmed by the stresses and end of the phone to help. If I could
starting as a consultant at the Royal strains of NHS work. Gaining another speak to the local regional advisor about
Brompton Hospital, London. I initially felt perspective (be it anaesthetists from whether a second (near-identical) post
involvement in education was the way to other trusts, or other consultants and was appropriate, and the chief executive
go. However, one of my Anaesthetists as senior managers) brings the positive could confirm availability of funding,
Educators colleagues mentioned that he experiences that led me to my own post then this was not a problem. This all
thought he perhaps achieved more to back to the front of my mind. took time, but was achieved, providing
change trainee experience when he was both candidates and trust with the best
RCoA: What would you say are the outcome. As an AAC assessor, knowing
clinical director. I had also developed
important qualities an AAC assessor that there will always be someone at the
a management exposure programme
should have? College available, and being able to be
within my trust, leading me to interact
For me the most important thing is an flexible oneself should the need arise, is
with a broader range of senior people
than I might have otherwise. These interest in helping both anaesthetists in a great help.
experiences led me to consider what training and trusts gain the consultant
colleagues they hope for. A happy, RCoA: If you could give one piece
help I might give anaesthetists in training
engaged department will provide great of advice to someone thinking about
if I got involved with the AAC process. I
Dr Sian Jaggar patient care – and who knows when and becoming an AAC assessor what
definitely saw my initial involvement as a
RCoA Joint AAC Lead Assessor learning experience. where my loved ones or I may need this! would it be?
SJ: If you are interested in helping either
RCoA: How long have you been RCoA: Can you share your most
your anaesthetists in training, or your own
an AAC assessor? Why did you put interesting experience from your time
department or trust, this is a really good
AN INSIDER’S VIEW yourself forward for appointment as an as an AAC assessor so far?
SJ: I think it is really important to
way to gain knowledge and perspective.
AAC assessor? Just do it!
Being an Advisory Appointments
Seven years now, and I continue to remember that there are ‘unknown
learn about the differing needs trusts unknowns’ in all parts of life, and we We would like to thank Sian for her
have of consultants. In that sense, I need to plan for this – just as we would paticipation in this interview.
Committee assessor
definitely achieved what I had hoped for unexpected anaesthetic events.
for when I applied. Early in my time as an assessor I went
to an interview where the department
RCoA: Can you share any experiences, had clearly decided
professional and personal learning, or beforehand who
More than 1,700 of our fellows and members selflessly and enthusiastically skill sets that you have gained through they were going to
your work with the College?
contribute their time, energy and skills to the work of the College through appoint – a really
To find more about being an
SJ:There is no doubt I’ve learnt more great candidate. On
roles ranging from examiners and committee members, to ACSA leads and about employment needs, both from the day, they were AAC assessor, or see what other
Advisory Appointments Committee (AAC) assessors. Our 2018 membership AAC training days and from people I suddenly faced with possible involvement you can have
meet at consultant interviews. However, another exceptional
survey results showed that many more of our fellows and members would also with the College please go to the
I’ve also had the opportunity to watch individual they hadn’t
‘Get Involved’ section of the
like to get involved in the work the College undertakes. and learn from a wide variety of skilled had the chance to
interviewers and panel chairs from many meet personally, RCoA website:
To highlight these roles further and the series is with Dr Sian Jaggar, one decide which, if any, of the applicants walks of life. Non-executive directors because they had bit.ly/RCoA-Involved
to provide you with a true taste of of the College’s AAC lead assessors. is suitable for employment and to make have such breadth of non-NHS (and been abroad on a
what they involve, the Membership Advisory Appointments Committees a recommendation to the employing often non-healthcare) experience that fellowship – flying
Engagement team has created a regular are legally constituted interview panels body. AAC assessors are individuals you cannot help but learn. While this is in specially for the
series of ‘Insider’s view’ interviews convened by an employing body who have volunteered to act as RCoA occasionally ‘I wouldn’t do it like that’, it is interview.
that will be appearing in upcoming when appointing consultants or SAS representatives on these panels. more often ‘what a good idea’, and I take
Bulletin issues. The first interview of doctors. The remit of the AAC is to these skills back to my own trust.
22 | | 23You can also read
