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ROYAL COLLEGE OF ANAESTHETISTS ROYAL COLLEGE OF ANAESTHETISTS Page 22 | Bulletin 92 | July 2015 ACCREDITATION acsa@rcoa.ac.uk www.rcoa.ac.uk/acsa ACSA Engaged Departments Date: 21 September 2015 Location: RCoA, London ACSA/ART Reviewers Training Day Date: 29 October 2015 Location: RCoA, London Patient Safety Conference Date: 4 November 2015 Location: Thinktank, Birmingham Please contact our ACSA office via acsa@rcoa.ac.uk or 020 7092 1697 for further information. The Clinical Quality Directorate (CQD) at the College encompasses all aspects relating to professional standards, quality improvement and safety in anaesthesia. AAC Advisory Appointments Committee ■■ An AAC is a legally constituted interview panel used when appointing consultants. Its remit is to make a recommendation to the employing body ■■ We receive approximately 300–400 AAC requests a year To become an AAC Assessor, please contact: 020 7092 1571 AAC@rcoa.ac.uk www.rcoa.ac.uk/aac THE ROYAL COLLEGE OF ANAESTHETISTS APPROVED POST ACSA Anaesthesia Clinical Services Accreditation ■■ ACSA is a voluntary scheme for NHS and independent sector organisations that offers quality improvement through peer review. It is recognised by the Care Quality Commission ■■ We need clinical reviewers to provide a fair and objective assessment of departments that wish to become ACSA accredited To become an ACSA Reviewer, please contact: 020 7092 1697 ACSA@rcoa.ac.uk www.rcoa.ac.uk/acsa ACCREDITATION ART (Anaesthesia Review Team) Invited Reviews ■■ The ART is offered to trusts/boards who would benefit from an independent professional opinion and recommendations to improve their anaesthesia services or to assist doctors in trouble ■■ We welcome anaesthetists who feel they can provide their expert professional help to these trusts/boards To become an ART Reviewer, please contact: 020 7092 1571 ART@rcoa.ac.uk www.rcoa.ac.uk/art CPD Continuing Professional Development ■■ The College expects doctors to complete at least 50 hours of CPD per year. This can include attending meetings organised by national bodies and specialist societies ■■ We receive over 700 applications for CPD event approval each year and welcome doctors interested in acting as a CPD Assessor to review these events To become a CPD Assessor, please contact: 020 7092 1729 CPD@rcoa.ac.uk www.rcoa.ac.uk/revalidation-cpd If you would like further information on the department in general, please contact: clinicalquality@rcoa.ac.uk or visit www.rcoa.ac.uk/clinical-standards-quality.
Page 23 | Bulletin 92 | July 2015 Updates to NAP5: Anaesthesia Awareness Support Pack As readers will by now know, the 5th National Audit Project (NAP5) was completed and launched in September 2014. There were two core meetings held at the Royal Society of Medicine: a launch to the profession followed by a public meeting that was coupled with a public engagement exercise funded by the Wellcome Trust. Dr Andrew Morley, a consultant at Guy’s and St Thomas’ NHS Trust, led a collaboration with musicians and the poet Ruth Padel to create an artistic piece on ‘consciousness’ that has since also been performed at the Oxford Science Festival and the University of Birmingham. Jaideep J Pandit Consultant Anaesthetist, Oxford, Fellow of St John’s College, Associate Professor Oxford University, Clinical Lead, NAP5 2011–2014 Tim Cook Consultant Anaesthetist, Bath, Director of National Audit Projects, RCoA The report itself was summarised in three key papers, jointly published in Anaesthesia and the British Journal of Anaesthesia, 1–3 and in close proximity were the related papers from Ireland 4,5 and the Activity Survey. 6 In the same month, the AAGBI Annual General Meeting devoted a session to NAP5, and subsequent RCoA CPD days have aired the topic. Internationally, the NAP5 panel has delivered lectures in Europe, Japan, Australia and the United States. Media interest has been impressive with almost 500 articles and broadcasts, encompassing all the major UK newspapers, BBC and regional radio, radio interviews in Ireland, Germany and the US, and international papers such as the New York Times and Le Figaro. Yet there is much work to do. The report made 64 recommendations for practice and over 100 suggestions for research. We anticipate that many departments will already have made a start on implementing those recommendations which are locally relevant. To supplement local action the Safe Anaesthesia Liaison Group (SALG) are soon to produce additional advice on implementation. The research recommendations have been noted by national bodies, and some have become a research priority for grants offered by the AAGBI via the NIAA. The purpose of this article is to highlight an aspect of NAP5 of which readers might be unaware, namely the resources available on the website (www.nationalauditprojects.org.uk/NAP5home). For anyone planning further audits or studies, these resources include all the questionnaires used in the Baseline Surveys, the templates for data collection forms for both the prospective phase of NAP5 and the Activity Survey, and the supporting information provided to Local Co-ordinators. We have also added a section for patients and carers to the NAP5 website (www.nap5.org.uk/for-patients) which includes patient-specific summaries and updated patient information about awareness. Perhaps most importantly is the development of the self-contained ‘Anaesthesia Awareness Support Pack’. Although the information contained in this pack was already embedded in the NAP5 Report, this document brings together the key items in easy-to-download formats. It addresses the particular need (identified in the Baseline Survey 7 ) that few if any UK hospitals had a specific policy to manage a case of Accidental Awareness during General Anaesthesia (AAGA). Furthermore, a standardised pathway to offer psychological support to patients who had experienced AAGA was lacking. The key ingredients of psychological support include listening to the patient at the Meeting stage, and accepting the patient story as a genuine experience. Analysis involves seeking the cause of awareness, including checking the patient story with staff and medical records, describing the episode according to the templates developed by NAP5, and ideally obtaining an independent opinion. This last can be obtained from any source (ideally external to the hospital), and NAP5 panellists are prepared (albeit not exclusively) to assist if necessary. Then, follow-up and early support are recommended, with psychological/ psychiatric input where the symptoms meet
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