News Archive

The Association would like to announce the release of Peri-operative Management of the Morbidly Obese Patient. Below is a summary of the recommendations.

All trained Anaesthetists should be competent in the management of morbidly obese patients and familiar with the equipment and protocols in the hospitals in which they work.

All patients should have their height and weight recorded. Where possible this should be measured rather than relying on the patient’s estimate. The Body Mass Index (BMI) should be calculated and recorded.

Although BMI is not an ideal measure of risk, it is the most useful of the currently available markers and is a simple measure to apply.

Every hospital should have a named consultant anaesthetist and a named theatre team member who will ensure that appropriate equipment and processes are in place for the peri-operative management of morbidly obese patients.

Protocols including details of the availability of equipment should be readily to hand in all locations where morbidly obese patients may be treated. Mandatory manual handling courses should include the management of the morbidly obese.

Pre-operative assessment is a key component in the assessment and management of risk.

Early communication between those who will be caring for the patient is essential and scheduling of surgery should include provision for sufficient additional time, resources and personnel.

The absolute level of the Body Mass Index should not be used as the sole indicator of suitability for surgery or its location.

Download a full version

Royal College of Anaesthetists and Association of Anaesthetists of Great Britain and Ireland Statement on assessing trainees and maintaining patient safety.

23 April 2007

GAT Rejects MTAS Review Group Recommendations
Over 90% of GAT members responding to a survey voted to reject the MTAS Review Group's latest recommendations. In a letter to Professor Neil Douglas, head of the Review Group, GAT Chair Sara Hunt and Vice-Chair Chris Meadows demand that the whole MTAS system is scrapped immediately, describing it as illogical, unfair and an appalling waste of time and resources.

> Letter to Professor Neil Douglas

5 April 2007

GAT Survey

The AAGBI is asking trainee members for their opinions about MTAS. An electronic survey is being sent out today that will allow GAT members to express their views about what the AAGBI’s stance on MTAS and the Review Group’s plans should be. GAT Chairman Sara Hunt says: “The situation regarding the Medical Training Application Service is at present dynamic, to say the least. GAT has been actively involved in pressing for the best deal for trainee anaesthetists. It is clear that the Review Group is approaching a final solution with their latest statement. It is essential that if we are to act now to influence the process we do so with the support of our membership."

26 March 2007

The Group of Anaesthetists in Training has today written to Dr Judith Hulf, President of the Royal College of Anaesthetists and a member of the MTAS Review Body, to present the overwhelming and united opinion of the trainee anaesthetists who have been the victims of the underperformance of the Medical Training Application Service (MTAS), and has asked for her support in putting an end to the MTAS process. A copy of the letter has also been sent to the other members of the Review Body.

> Letter to the President of the RCoA

AAGBI statement on Modernising Medical Careers and the Medical Training Application Service

The Association of Anaesthetists of Great Britain & Ireland (AAGBI) represents more than 90% of practising anaesthetists in the UK and Ireland. One third of its members are trainees and, through their representative section (the Group of Anaesthetists in Training – GAT), the AAGBI is the main national body representing the views of trainees in anaesthesia and its associated subspecialties. In the light of events surrounding the short-listing and interview process for Modernising Medical Careers (MMC) operated by the Medical Training Application Service (MTAS), the Association has issued a statement voicing serious concerns about a number of important issues.

> Read the full statement

AAGBI response to the Government’s white paper entitled Trust, Assurance and Safety

In a covering letter, Dr David Whitaker, AAGBI President says:

Last year, Sir Liam Donaldson, England’s Chief Medical Officer, published a report entitled Good doctors, safer patients, which contained proposals for changes to the way that the medical profession is regulated. A report from the Department of Health entitled The regulation of non-medical healthcare professions was published at the same time. After a consultation period in which the AAGBI participated actively, the Government has published a white paper called Trust, Assurance and Safety. I asked the Executive of the AAGBI to produce a paper that presents a brief summary of the recommendations in the white paper and makes comments on behalf of the AAGBI. The full response can be downloaded below. I would encourage members to read this document.

> Download full response document

If members have any comments on this paper or on the white paper, they should feel free to send these to us – please send an email to honsecretary@aagbi.org.

(5 March 2007)

Anaesthesia voted third  most important medical advance in BMJ Medical Milestones Poll

(18 January 07)

The AAGBI has issued a statement on the important issue of medical indemnity for anaesthetists when treating NHS patients in private hospitals. In it, the AAGBI raises considerable concerns about indemnity arrangements for NHS patients scheduled for treatment under the BUPA Hospital Panel scheme.

The statement can be downloaded below:

>Download a copy of the statement

(21 December 06)

Hospital Doctor Awards 2006 - Orchestrating Clinical Excellence

Hospital Doctor held their 2006 Awards - Orchestrating Clinical Excellence, at a ceremony at the London Hilton on Thursday 23rd November 2006.

The Winner in the Category 'Critical Care in Anaesthesia Team of the Year', sponsored by The Royal College of Anaesthetists and The Association of Anaesthetists of Great Britain and Ireland, was Dr Naresh Nandwani and Team from Derby Hospitals NHS Foundation Trust.

Teams entering the awards are assessed for their innovation, teamwork and effective use of resources. The Judges said of Dr Nandwani and his team, ' (they) have developed a highly integrated multidisciplinary approach to dealing with the challenges of providing critical care service. They have developed and excellent , cost-effective example of "progressive patient care" model, to the benefit of their trust and patients'. Further details on the winning entry are below.

The other finalists were Dr Rodger Stedman and his team - Heart of England NHS Foundation Trust, Birmingham and Dr Jim Watts and team - Burnley General Hospital, East Lancashire NHS Trust.

Category: Critical Care in Anaesthesia team of the Year

Winner: Dr Naresh Nandwani and Team from Derby Hospitals NHS Foundation Trust.

Hospital Type: Acute Teaching
Population Served: 700,000
Catchment Area: Southern Derbyshire

Challenge

In 1999, critical care was delivered across two sites, by two teams with different Philosophies, both units had strengths but there was a lack of cohesiveness and team spirit, and access to appropriate levels of critical care was limited. There were 11 level-three beds (advanced intensive support including ventilation) and five level-two beds with more than 1,000 admissions a year. The elective surgery cancellation rate was as high as 18 percent and non-clinical transfers were frequent, sometimes over long distances.

Action Taken

A 'step down' level-one facility was developed for surgical patients not requiring high levels of care, but who needed looking after in a suitable environment. Patients are admitted either from the ward or theatre, or from intensive care prior to their return to the ward. This enables the flexible use of beds to minimise surgical cancellations and non-clinical transfers. Together with outreach services, headed by a nurse consultant, this has helped bridge the gap between the critical care unit in the ward.

A multidisciplinary forum was established to ensure all team members have an effective input into developing services. The forum meets once a month and assesses the feedback from the multidisciplinary focus groups based at the two sites 'in this way, our cohesiveness across the two sites is ensured,' says Dr Nandwani.

Work has also begun to consolidate the critical care units into one site by 2008, with a 20 bed-space capacity.

Achievements

• The step-down system and strict-bed booking policy have cut the elective surgery cancellation rate from 18 percent in 1999-2000 to five percent in 2004-05.
• The multidisciplinary structure enables cohesiveness and effective team working.
• Seamless working across two hospitals thanks to merged working practices, rotating staff and unified policies.
  
  

To enquire about the Hospital Doctor Awards for 2007,
please email healthcare.enquiries@elsevier.com or visit the
website: www.hdawards2006.co.uk.

(24 November 2006)

The Association of Anaesthetists of Great Britain and Ireland's responds to the Chief Medical Officer's report: "Good Doctors, Safer Patients".

In a covering letter, Dr David Whitaker, AAGBI President says:

The Association of Anaesthetists of Great Britain & Ireland (AAGBI) has considered the document ‘Good doctors, safer patients’ and has submitted a response to the Department of Health to comment on the proposals it contains. The AAGBI has almost 10,000 members and represents over 90% of practising anaesthetists in the United Kingdom.

The AAGBI recognises the need to strengthen the system under which doctors are allowed to practise, and welcomes many of the proposed changes. The appended document details our full response. The main points can be summarised thus:

1. The separation of the investigation and assessment of doctors’ performance from its adjudication is a vital step to take in order to ensure that both the public and the profession have confidence in the way in which professionals are treated.
2. The AAGBI supports the formal testing of language skills for all overseas doctors.
3. The AAGBI supports the setting of clear standards for each area of specialist clinical practice
4. Changing the standard of proof required in all cases to that of the balance of probabilities is something that we would strongly resist. There are undoubtedly areas and situations in which the civil standard would be appropriate, but there are others for which the criminal standard of proof should be retained. Anaesthesia is a specialty in which a single clinical error can and has had catastrophic results for an individual patient. Such incidents can result in disciplinary proceedings and it is simply against the concept of natural justice to find against a doctor on the balance of probabilities after a single error. We could support a graduated system in which the seriousness of the charge, the evidence of continued or persistent underperformance or inappropriate behaviour and the consequences of the penalty determine the nature of the hearing and the standard of proof required.
5. The AAGBI does not support the introduction of GMC affiliates, as we feel that this would interfere with existing managerial arrangements where they function well.
6. The AAGBI does not support the proposed ‘recorded concern’ system unless it is modified sufficiently to allow for a proper appeal system to prevent abuse from malicious or inappropriate complaints.
7. The AAGBI would prefer to see the GMC supported in its efforts to improve its effectiveness and governance. We do not believe that transferring powers to others bodies that have yet to demonstrate their ability to undertake them would be wise.

The full response can be downloaded below:

>Download a copy of the full response

The Editorial Board of Anaesthesia, the journal of the Association of Anaesthetists of Great Britain and Ireland , is happy to report that its academic reputation is rising to match its pre-eminent clinical standing. The 2005 Impact Factor rankings, the Premiership of scientific journals, have just been released and Anaesthesia’s rating has leapt from a very respectable 2.16 to 2.51. It now lies in 5th position in the anaesthetic league table and, when predominately pain-related journals are excluded, is second only to Anesthesiology in the world rankings. It comes out top for half-life factor, which measures how long papers remain relevant, and shares top place with Anesthesiology for immediacy factor, the indicator of how quickly newly-published papers make an impact.

While none of these are as important as Anaesthesia’s clinical relevance and its value to the readership, it is good to see the journal take its rightful place once again as number one in the UK .