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Page 18 | Bulletin 93 | September 2015 www.niaa-hsrc.org.uk ■■ Patients under the care of an anaesthetist undergoing general, regional or local anaesthesia and/or sedation. ■■ Reactions occurring between administration of the first drug by the anaesthetist up to the time of discharge from the recovery room. ■■ Allergic and non-allergic (anaphylactoid) reactions. ■■ All ages. ■■ England, Northern Ireland, Scotland and Wales. There are four components to NAP6: 1. Baseline Survey for Anaesthetists: 5 November 2015 In this survey we will ask all anaesthetists to provide a limited amount of specific information about their experience with perioperative anaphylaxis during the previous 12 months. Data will be anonymised. 2. Baseline Survey for Allergy Clinics: 5 November 2015 Allergy clinics in the UK will be asked to provide information about the services they provide to patients with suspected perioperative anaphylaxis. 3. Main data collection: 5 November 2015 for 1 year Detailed, anonymised information will be collected about every case of suspected Grade 3-5 perioperative anaphylaxis in the UK, including presentation, initial management, investigation and long-term adverse sequelae. 4. Activity (allergen) Survey: April 2016 As with the NAP5 activity survey, every anaesthetist will be asked to collect data for each patient they anaesthetise during a specified two-day period. The survey will not duplicate data collected in NAP5 but will collect numerical information about perioperative exposure to potential allergens, including certain anaesthetic drugs, antibiotics, IV colloids etc. This survey will act as a denominator to inform conclusions regarding the relative risks of anaphylaxis. The important role of Local Coordinators The format of NAP6 will be similar to previous NAPs: in every UK hospital, anaesthetists will report their cases to a Local Coordinator (LC), a consultant colleague who has volunteered for this role. The RCoA is extremely grateful to LCs, without whom these important national audit projects would be impossible. LCs will be responsible for coordinating the reponses to the baseline survey and the activity survey, as well as publicising NAP6 within their hospital. Every UK anaesthetic department will be asked to nominate a consultant anaesthetist for this role. This could be someone who has fulfilled this role during a previous NAP, or a consultant who has a particular interest in perioperative anaphylaxis, for example. What will happen to the data? Only anonymized data will be collected at all stages of the project. Data will be held on a secure server with passwordprotected access with the appropriate regulatory approvals. The NAP6 team extracting the data and the NAP6 reviewing panel will be unaware of the identity of the patient, the hospital and the anaesthetist(s). The reviewing panel will include anaesthetists, allergists, immunologists and patient representatives. Each case reported during the main data-collection period will be discussed by the reviewing panel with reference to the presenting clinical features, suspected trigger agent, management, referral for subsequent investigation, eventual diagnosis, and the advice given by the allergy clinic to the patient and the anaesthetist. Where published guidelines exist, comparisons will be drawn, but the main purpose of NAP6 is descriptive. Publishing the results A comprehensive report will be published in early 2018. The results of the baseline surveys may be published at an earlier date. The report will include detailed analysis of the pattern of UK perioperative anaphylaxis, as well as pointing to potential improvements in avoidance, diagnosis and management. Please look out for further information relating to NAP6, and be prepared for the start of this exciting project on 5 November. We would be delighted to receive your comments and answer any questions you may have about the project.
ROYAL COLLEGE OF ANAESTHETISTS Page 19 | Bulletin 93 | September 2015 ACCREDITATION acsa@rcoa.ac.uk www.rcoa.ac.uk/acsa The history of QMSG Simon Fletcher, RCoA Chair of QMSG The Quality Management of Service Group (QMSG originally QMSC) has responsibility for the ACSA process within the College, and reports directly to the Professional Standards Committee (PSC). QMSG was formed in September 2011 to develop and refine the ACSA process, and has since seen its remit expand as more and more departments gain accreditation. I was appointed Chair of QMSG in September 2014, and have enjoyed the challenges so far. This is my third year as an elected member of Council, and prior to this my roles were almost exclusively in education and training. I spent two years as lead Regional Advisor and thus had some knowledge of College committees, but not in professional standards and the Clinical Quality directorate. I took part in a pilot ACSA review and was appointed as chair of QMSG following Dr Peter Venn’s election as Vice President of the College last summer. I currently also edit the College Bulletin. ACSA was officially launched on 18th June 2013, but from 2008 the notion was being developed, discussed and piloted. It was indeed a grand piece of work. Accreditation is fast developing throughout the medical specialities with schemes such as the Radiologists (Imaging Services Accreditation Scheme), Pathologists (Clinical Pathology Accreditation) and ACSA leading the way. QMSG, as mentioned above, answers directly to the PSC. The Group’s role is therefore to manage all aspects of ACSA for the College. Membership of the Group includes nominated Council members, Clinical and Lay reviewers and College staff from the Clinical Quality directorate. The Group meets formally on a bi-monthly basis, but much work is undertaken, both electronically and through teleconferencing between formal meetings. Ultimately it is the responsibility of QMSG to review, discuss and formalise a decision on ACSA review visits. The ACSA standards are under a rolling review, and are formally updated yearly in line with the annual iteration of the Guidelines for the Provision of Anaesthetic Services (GPAS). This update is undertaken by QMSG members, supported by ACSA reviewers. QMSG also reviews and approves applications from potential ACSA reviewers and a member is involved with initial discussions with departments considering engagement. An on-site presentation, if requested, is also supported. If you are interested in becoming an ACSA reviewer, please visit our website www.rcoa.ac.uk/acsa or contact the ACSA team directly on ACSA@rcoa.ac.uk. As Chair of QMSG I am a member of the PSC, to support ACSA and related matters. We have recently set up a GPAS Editorial Board both to begin the process of reviewing the standing document and any proposed yearly updates from chapter editors. I will represent QMSG on this Board to reflect any changes in ACSA standards. The ASCA scheme is a long term partnership. We continue to build a comprehensive library of good practice, open for all members to access. Standards will be current, relevant and based on the best available evidence. Indeed GPAS will soon be submitted for NICE accreditation. We aim to support the delivery of care to the highest standard across the UK. GUIDELINES FOR THE PROVISION OF anaesthetic services (GPAS) 2015 The Royal College of Anaesthetists is currently looking for anaesthetists to take part in the development of the Guidelines for the Provision of Anaesthetic Services document. What’s new? We are updating the process by which we develop the chapters for our guidelines so that they fulfil the standard criteria for accreditation by the National Institute for Health and Care Excellence (NICE). As part of this process, we are looking for anaesthetists to join our Chapter Development Groups (CDG). What does being a CDG member involve? One to two face-to-face meetings and email correspondence to discuss the existing literature on the chapter topic and to provide any suggestions or comments to the author as the updated chapter is being developed. How do I get involved? Send us your CV, a short statement of interest, what your chapter preference is (see www.rcoa.ac.uk/node/20151 for details of which chapters are being included in the current cohort) and any special interests that you have. CDG Members will be able to claim CPD points for their contribution. For further information please contact: gpas@rcoa.ac.uk or go to: www.rcoa.ac.uk/node/20151.
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