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Page 2 | Bulletin 92 | July 2015 <strong>BULLETIN</strong> of The Royal College of Anaesthetists Churchill House 35 Red Lion Square London WC1R 4SG 020 7092 1500 www.rcoa.ac.uk info@rcoa.ac.uk bulletin@rcoa.ac.uk Registered Charity No 1013887 Registered Charity in Scotland No SC037737 VAT Registration No GB 927 2364 18 Design and layout by The Royal College of Anaesthetists The President’s Statement Page 4 Guest Editorial Page 6 Revalidation for anaesthetists Page 9 Patient Perspective Page 10 The Faculty of Intensive Care Medicine (FICM) Page 12 The Faculty of Pain Medicine (FPM) Page 13 Society for Education in Anaesthesia (SEAUK) Page 14 National Institute of Academic Anaesthesia (NIAA) Page 17 Sprint National Anaesthesia Projects (SNAPs) Page 19 Anaesthesia Clinical Services Accreditation (ACSA) Page 21 Updates to NAP5: Anaesthesia Awareness Support Pack Page 23 Methoxyflurane may be returning to the UK Page 25 Should the NHS WHO surgical safety checklist be updated? Page 26 Differential pass rates in the FRCA Page 29 Plastic recycling from the operating theatres, working towards a circular economy Page 32 Intraoperative handovers: do we have a problem? Page 35 Sub-specialty training in pre-hospital emergency medicine (PHEM) Page 38 Adventures in anaesthesia: the theatre of theatre Page 44 Stretching the boundaries: London anaesthesia in 1955 Page 45 As We Were and Letters to the Editor Page 48 Conserve our Collections scheme – first year’s report Page 49 NIAA Small Grants, Awards and Research Grants Page 51 Report of meetings of Council Page 53 Senior Fellows Club Report Page 55 Programme of events 2015 Page 56 Notices and advertisements Page 64 The Royal College of Anaesthetists is grateful for the contribution to the production of this publication by Laerdal Medical Ltd and Dräger Medical UK Ltd. © 2015 Bulletin of The Royal College of Anaesthetists All Rights Reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any other means, electronic, mechanical, photocopying, recording, or otherwise, without prior permission, in writing, of The Royal College of Anaesthetists. Fellows, Members and Trainees are asked to send notification of their changes of address direct to the College Membership Department (subs@rcoa.ac.uk) so that their copy of the Bulletin is not misdirected. Articles for submission, together with any declaration of interest, should be sent to the Bulletin Editor via email to: bulletin@rcoa.ac.uk. All contributions will receive an acknowledgement and the Editor reserves the right to edit articles for reasons of space or clarity. VIEWS AND OPINIONS expressed in the Bulletin are solely those of the individual authors, and do not necessarily represent the view of The Royal College of Anaesthetists. ISSN (print): 2040-8846 ISSN (online): 2040-8854
Page 3 | Bulletin 92 | July 2015 From the Editor I intend to start this month with the indulgence of three farewells. Firstly to Kevin Storey, an innovative and unflappable Chief Executive. He leaves the College in an excellent position. The finances are sound and the staff, support and working environment unrivalled. Kevin actively encouraged me to stand for Council – this may account for his early ‘retirement’! I have known our President, J-P van Besouw, for many years through the hustlings of programme director and RA. A leader who has not micromanaged, he is only now showing a little fatigue after three years in the traces. His articles for the Bulletin have proven so insightful and thorough that I no longer need to consult The Daily Mail! And finally to Irene Dalton who comes to the end of her time as Lay Committee Chair. Through irrepressible enthusiasm, energy, insight and knowledge she has cemented the Lay Committee into the College fabric; hard as I have tried I have had no headmistresses’ detention. I will miss all three of you. We have a new government and the posturing is starting. All those hollow promises to keep, all that money to be saved and found by 2020. Not actually £30 billion extra for the NHS, but £22 billion to be found from savings! In this Bulletin, J-P discusses ‘Choosing Wisely’ and NHS England’s revelation that if you are honest with people they might baulk at what’s offered. Irene’s, ‘gloves-off’, tribute to political honesty tells us why there will be little change. There are opportunities though, and perioperative medicine in just the right flavour; more about that in September. For those of you who wish to know all about pre-hospital emergency medicine but dare not ask, help is at hand. Dr Birks and Major Chinery detail their positive experience in becoming the first anaethetists to complete PHEM training in the UK. They describe both the structure of the training and importantly the ‘value plus’, the life skills if you like, acquired during their two-year secondment. Helen Hobbiger is the College representative on the PHEM training board and HOS for Anglia. Helen’s guest editorial is essential reading for those considering an application for PHEM training and for those who may need to advise them. Lucy Grimes and colleagues revisit the WHO checklist, adopted six years in the UK. Originally designed to be short and simple, considerable local modifications have occurred. The value of these changes is unclear given that evaluation after implementation reveals considerable variance and indeed discrepancies between perception and reality. Not withstanding this, the article describes one process and five checks that merit consideration. Hopefully this article will support local debate and change. An area fraught with risk is intraoperative handover. Sioned Phillip’s outlines the issues here and measures, including the development of an aide memoire to reduce risk. The College has a public sector equality duty, and this extends to all areas of our work where a public function exists. Differential examination results were the trigger for a case testing compliance at the RCGP. In response to the judgement, we have reviewed our own practice in this and all relevant areas and the examination findings are published here. Towards the end of the journal, are two articles for amusement. Ellie May has written and published a short book addressing many of the issues and frustrations of anaesthetic life – the ‘red top’ newspaper and Casualty representation. Her article is a brief introduction. Also, Bernard Brandstater, not new to these pages, describes his experience of nitrous oxide, hypoxaemic anaesthesia at the Eastman Dental hospital in 1955; he became an expert! Methoxyflurane, a potent volatile anaesthetic, was first used clinically in 1960 but withdrawn in the mid 1970s. A licence application has been lodged to reintroduce it, and Les Gordon’s short article is a heads up. Please read. Tom Pierce was awarded the President’s Commendation at the Spring Symposium. Tom is the College advisor on sustainability, and is our social conscience. He co-authors an article on moves to recycle some high-grade plastics. The article is informative and readable, and the initiative is long overdue for those of us who mourn the demise of the red rubber ET tube and black facemask! Dr Simon Fletcher, Editor President Dr J-P van Besouw President Elect Dr L Brennan Vice-Presidents Dr L Brennan Dr P J H Venn Vice-Presidents Elect Dr R Marks Dr J Langton Editorial Board Dr S Fletcher Editor Dr P J H Venn Vice-President Dr J Fazackerley RCoA Council Member Dr R Marks RCoA Website Lead Professor D J Rowbotham Faculty of Pain Medicine Professor M Mythen Faculty of Intensive Care Medicine Dr D Lowry Lead Regional Advisor Dr K Ramachandran Lead College Tutor Dr N Joshi Trainee representative Mrs L Hart Lay Committee representative Mr M McLaughlan RCoA Director of Clinical Quality Communications Ms S Larsen Director of Communications Mrs M Kelly Website and Publications Officer Ms A Trivedi Website and Publications Officer
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