NovEMBER 2020 Remote pre-assessment for cancer surgery during the COVID-19 pandemic Transforming paediatric major trauma care Simulation training – ‘It’s just like flying a plane’ Research issue: The challenges COVID-19 has placed on the research community rcoa.ac.uk @RCoANews Bulletin | Issue 124 | November 2020 RCoA Events Anaesthetic updates % 4 March 2021 rcoa.ac.uk/events Bristol [email protected] AaE: Introduction EVENTS AND COVID-19 % @RCoANews 11 March 2021 FULLY BOOKED Due to the ongoing COVID-19 situation we have Developing World Anaesthesia moved the majority of our events on to virtual % 15 March 2021 platforms, where this is not possible some of these RCoA, London Developing World Anaesthesia Anaesthetists as Educators: events may be postponed or cancelled. NOVEMBER % November 2020 % Advanced Educational Supervision Global Anaesthesia Virtual event 26 January 2021 % Please keep up to date by visiting our webpage: RCoA and RA-UK joint webinar: 16 March 2021 Birmingham blocks for the many RCoA, London Airway Workshop rcoa.ac.uk/events (not just the few) % November 2020 Anaesthetic Updates Leadership and management: 10 November 2020 29 January 2021 % Virtual event The Essentials Evening webinar Southampton 16–17 March 2021 Clinical Directors Network DECEMBER Glasgow Meeting FEBRUARY Leadership and management: 16 November 2020 AaE: Advanced % Personal Effectiveness Virtual event Winter Symposium Presentation of Diplomates 26 March 2021 % 3–4 December 2020 Ceremony RCoA, London Educational Supervision Leadership and Management: Virtual event 1 February 2021 % Working well in teams and Central Hall, London Ultrasound Workshop 26 January 2021 making an impact Less than full time (LTFT) Invitation only % 29 March 2021 18 November 2020 Birmingham % matters webinar RCoA, London RCoA, London AaE: teaching and training in 9 December 2020 % the workplace Anaesthetic updates Virtual event Anaesthetic Updates 2–3 February 2021 % March 2021 % 19 November 2020 Primary FRCA Online Revision RCoA, London RCoA, London Virtual event % Course FULLY BOOKED Anaesthetists as Educators: December 2020 – February 2021 Innovations and interlectual APRIL % Anaesthetists’ Non Technical Virtual event % property conference Skills (ANTS) After the Final FRCA Final FRCA Online Revision Course 3 February 2021 20 November 2020 21 April 2021 % December 2020 – March 2021 RCoA, London Virtual event RCoA, London Virtual event Anaesthetic updates Anaesthesia Research % 24–26 February 2021 Cardiac Symposium 24 November JANUARY RCoA, London % 22–23 April 2021 Virtual event RCoA, London GASAgain (Giving Anaesthesia RCoA and BJA joint webinar: MARCH AaE: Teaching and training in the % Safely Again) how BJA Editors decide which % workplace 13 January 2021 Airway workshop papers to publish 28–29 April 2021 Bradford % 1 March 2021 24 November 2020 Edinburgh Evening webinar To be confirmed Discounts may be available for RCoA-registered Senior Fellows and Members, Anaesthetists in Training, Discounts may be available for RCoA-registered Senior Fellows and Members, Anaesthetists in Training, % Foundation Year Doctors and Medical Students. See our website for details. % Foundation Year Doctors and Medical Students. See our website for details. Book your place at rcoa.ac.uk/events Book your place at rcoa.ac.uk/events | 1 Bulletin | Issue 124 | November 2020 Bulletin | Issue 124 | November 2020 The President’s View 4 News in brief 8 Contents Guest Editorial 12 From the editor SAS and Specialty Doctors 14 Revalidation for anaesthetists 16 Dr Helgi Johannsson Faculty of Pain Medicine (FPM) 17 Faculty of Intensive Care Medicine (FICM) 18 Welcome to the November Bulletin. Patient perspective 20 As you open your November edition of the Bulletin, I sincerely hope we have managed to prevent a large second Society for Education in wave of coronavirus infection. But as I write we are finally seeing the increase in cases predicted of a second 22 Anaesthesia (UK) wave. Still, in my hospital there are no patients with coronavirus on the intensive care unit, which gives me some Creating capacity in a crisis 24 hope that we may be able to continue with the enormous task of getting the NHS’s elective work back on track Perioperative Journal Watch 28 and reversing the colossal disruption that has affected all our lives. Health Services Research Centre 29 COVID-19 has dominated the news and our conversations, and so it is no surprise that this month’s edition of Frailty and delirium 30 the Bulletin contains a lot of pandemic-related articles. It’s not all bad news however, and the articles on pre- assessment show how the pandemic has focused our minds and streamlined so many pathways. In order to Guest editorial 32 Perioperative cardiac arrest access an operation, a patient may previously have had to attend several face-to-face appointments at different What a difference a year makes! NELA: fellows past and present 34 times, many of which now occur remotely and at the mutual convenience of patient and clinician. It is also A year of two halves 36 wonderful to see the empowerment of nursing staff taking on extra roles, and the innovative use of technology. I Dr Lindsay Forbes gives a personal glimpse into personally found the tips on remote meetings very useful and hope that incorporating them will avoid humiliating In a changing landscape 38 the experience of undergoing bariatric surgery and technical glitches happening at awkward moments – as we have all witnessed on TV and radio just as the person A fellow in the field of rapid being interviewed is coming to the crucial point of the whole interview. explains why it’s not a ‘quick fix’ qualitative research 39 This month we showcase research in anaesthesia, and I am delighted to see that, after the first wave, research Page 12 Compassion through the activity is up and running again. The topics covered are as important as ever – COVID-19 cannot be allowed to COVID-19 crisis 42 stop our progress as a specialty. The same applies to education, where the article on remote simulation shows A practical guide to improving that it can be done. The President’s View Health Services Research teleconferencing 44 The challenges COVID-19 Centre (HSRC) Pop-up simulation suite Your representatives – the College Council members – feature again in this edition, where Dr Kirstin May reflects on where we have come, and how SAS-grade doctors have not only been indispensable in the response to has placed on the research HSRC share how their work has utilising Zoom videoconferencing 46 COVID-19, but still are as we try to get elective work back on track. In our ‘As we were’ article we hear from Janice community been affected by the pandemic in Training outside the box 48 Fazackerley, our previous vice-president. Throughout her tenure she was a sensible voice of reason with a passion Page 4 their 2020 Annual Report Simulation training – ‘It’s just like for the doctors and patients she represented. She will be much missed from Council, but I’m pleased to say that flying a plane’ 50 Page 29 she very much remains a friend and a source of excellent advice. Remote pre-assessment Transforming paediatric Meghana Pandit Safety Fellowship: for cancer surgery during patient-safety perspectives in a Finally, I want to extend my gratitude to Lyndsey Forbes for the moving and highly personal account of her major trauma care different healthcare system 52 experience of obesity and weight-loss surgery. What we say in the coffee-room and see as mere ‘banter’ can hurt. the COVID-19 pandemic We may forget what was said, but we will never forget how it made us feel. Substantial work has seen ‘New to the NHS’ national MTI A success story on delivering simulation programme 54 transformation of the paediatric Here’s hoping we’ll be able to spend Christmas in groups larger than six! cancer care during lockdown from trauma service from conception to Why become a the Royal Marsden hospital clinical practice College event speaker? 56 Page 26 Page 40 As we were... 58 New to the College 60 Notices, adverts and College events 63 2 | | 3 Bulletin | Issue 124 | November 2020 Bulletin | Issue 124 | November 2020 Professor Ravi Mahajan Professor Iain Moppett President Deputy Director, Health Services [email protected] Research Centre The COVID-19 pandemic has had significant impacts on research. Some have been positive, while some are causing short-term and possibly longer-term problems. Now is a good time to take stock of where anaesthesia and critical care research is and how it is placed to face challenges going forward. When the pandemic hit, most clinical research was the other hand, some researchers are highlighting halted or restricted to activities that were essential the benefits of enforced virtual meetings, with less to maintain participant safety or the integrity travel time and fewer barriers to collaborations with of the studies. Research-active clinicians and geographically dispersed colleagues. research support teams across the country shifted their work patterns to support their local clinical In addition to the changes it has prompted in services. Inevitably this has delayed development, clinical practice, COVID-19 has given a kick to recruitment, analysis and publication of research some perhaps overdue changes in research projects, but with the easing of ‘surge’ rotas, practice. Virtual/telephone consent and follow- colleagues are starting to catch up. There is a up is becoming much more the norm alongside double-hit of reduced and variable clinical work electronic data capture. impacting on the ability of studies to recruit in a The pandemic has highlighted an undoubted timely fashion. strength of the NHS research infrastructure and The limitations on face-to-face working have culture. Landmark studies such as RECOVERY changed the nature of research, from the laboratory (Randomised evaluation of COVID-19 therapy) through to large clinical trials.