2011 News Archive

2011 News Archive

Results from the AAGBI Membership Survey 2011 (29 Dec 2011)

Man ticking boxIn this January’s edition of Anaesthesia News, Dr Andrew Hartle has reported on the results from the 2011 Membership Survey.

9,531 copies were distributed and we received 2556 responses (a 25% response rate).

We would like to thank all the members who took part. The results will ensure that our activities continue to reflect your needs, views and opinions so the AAGBI can continue to support you and your career for years to come.

Download the full survey results >

OFT to get Private Medical Insurers to tell patients about insurance shortfalls (9 Dec 2011)
The AAGBI has welcomed much of the report by the Office of Fair Trading (OFT) on its study of the private healthcare market and supports its referral to the Competition Commission.  However, the AAGBI does not accept the OFT’s criticism of Anaesthetic Groups (AGs) and points out that no objective evidence has been found that such groups distort local markets and that inadequate emphasis has been made of the advantages of AGs in promoting patient safety.

read the full press release »
AAGBI follow up letter to the OFT (29 Nov 2011)

After a meeting with the OFT, Dr William Harrop-Griffiths wrote to the Private Healthcare Team to reiterate the AAGBI’s views on the key issues discussed. These included:

  • PMI customers and restrictive policies: need for clear communication to policy holders
  • Anaesthetic Groups in “uncontested” areas may have benefits for patient care
  • The insurance benefit shortfall problem: historic factors
  • Private hospitals and incentives for surgeons

Read the full letter »

Statement on Health and Social Care Bill (18 Nov 2011)

The Association of Anaesthetists of Great Britain and Ireland (AAGBI) is the professional membership organisation representing more than 10,000 anaesthetists. The elected Council of the AAGBI wishes to express its concerns about the Health and Social Care Bill, currently undergoing its committee stage in the House of Lords.

The AAGBI remains committed to the fundamental principle that NHS care should be provided to all, free at the point of care, on the basis of need and will oppose any change that threatens this principle.  We believe that the Secretary of State should retain the ultimate responsibility for the provision of a comprehensive health service.

Our members are the frontline providers of anaesthesia, intensive care and pain medicine, and the Association strives continuously to improve patient safety and the quality of care our patients receive. The AAGBI strongly supports the quality agenda for the NHS, in particular that care should be personal, effective and safe.

It is essential that the quality of care and the professional standards of the staff that provide it are consistent across all “willing providers” of services within the NHS. This includes the qualifications and experience of the staff, outcomes, and clinical governance mechanisms that oversee care.

The AAGBI is concerned that the Health and Social Care Bill may result in inefficient fragmentation and costly reorganisation of the health service at a time when the NHS is required to make unprecedented savings in healthcare expenditure.

The AAGBI is concerned that if the NHS is based on competition and driven by market forces, providers will prefer to offer profitable services and will be reluctant to take on  patients with significant co-morbidities who will require more expensive perioperative care and rehabilitation.  

We invite politicians and policy-makers to engage with AAGBI for expert opinions and advice concerning the specialist services our members provide.

We welcome members' comments on the statement - info@aagbi.org

Independent Practice Committee contacts OFT re AAGBI's key priorities in the private healthcare market (10 Nov 2011)
The AAGBI's Independent Practice Committee has written to the OFT to make some key points about the approach that the AAGBI takes to professional practice in the independent healthcare sector.

Download the letter »
Policy on the distribution of surveys to AAGBI members (7 Nov 2011)

The AAGBI receives many requests to forward surveys to its members.  The AAGBI will rarely distribute external surveys directly to its membership, but will consider surveys in relation to their merit and relevance to the practice of anaesthesia and related specialities.

Please send a copy/link to your survey to secretariat@aagbi.org. If approved, a link to the survey will be placed in a fortnightly e-newsletter that is sent to all members.

Research Ethics Committee submissions must not specify distribution via the AAGBI without the agreement of the AAGBI. The collection and analysis of data is the responsibility of the survey’s author(s).

The Introduction of new neuraxial connectors into the NHS (28th Oct 2011)
Position statement

A Position Statement from the Association of Anaesthetists of Great Britain and Ireland, the Royal College of Anaesthetists, the Obstetric Anaesthetists’ Association, Regional Anaesthesia UK, the Association of Paediatric Anaesthetists of Great Britain and Ireland and the Royal College of Anaesthetists Patient Liaison Group. Updated 25th October 2011

Download the statement »

 AAGBI charity Christmas cards for sale (22 Oct 2011)
Xmas card designThe AAGBI is now selling charity Christmas cards with packs including two designs by Dr Anne Sutcliffe.  Proceeds from the sale of these cards will go to the AAGBI's Overseas Anaesthesia Fund, whose aim is to raise the profile of the specialty and promote safer anaesthesia in the developing world.

The cards are available to purchase as a minimum order of a pack of 10, containing five of each design. If you would like to purchase the charity Christmas cards, please complete this Christmas card purchase form >
AAGBI response to the Department of Health’s consultation on proposed changes to employee contribution rates (20 Oct 2011)

The AAGBI has now submitted their response to Department of Health regarding the NHS Pension Scheme consultation on proposed increases to employee contribution rates planned to take effect in April 2012.  The Department of Health and the Welsh Government invited views on the following:

  • their preferred approach to delivering the required savings; and
  • other ways of delivering those savings through increased employee contributions within the Government’s preferred scheme design parameters.

Visit the DoH website to find out more on the consultation. Find out more »

AAGBI response to DoH pensions consultation. Read response »

AAGBI's Response to the OFT (03 Oct 2011)

In June this year, the AAGBI launched online surveys of those of its members involved in private practice. The results of this survey formed the basis of a formal response to the Office of Fair Trading’s (OFT) market study of private healthcare, which contained answers to a number of questions that the OFT had specifically asked the AAGBI. The response can be downloaded here >

More than 440 members responded to the surveys, and the AAGBI is grateful to those members who did respond. We think that this large number of respondents makes the results of the survey truly representative of the current situation in the UK.

SIGNALS - Emerging patient safety issues from the Patient Safety division of the NPSA (03 Oct 2011)

September 2011 – Issue 7

Audience: medical directors, nursing directors, risk managers and all affected staff in all NHS organisations in England and Wales.

Following review of serious incidents reported to the National Reporting and Learning System (NRLS) in this issue we focus on:

Signal 1 – Risk of harm from acupuncture treatment including pneumothorax

Signal 2 – Risk of harm from retained guidewires following central venous access

Signal 3 – Risk of air embolism when removing central lines

Signal 4 – Rapid deterioration in patients with Systemic Lupus Erythematosus

Signal 5 – Tracking subsequent removal of intentionally retained swabs

Signal 6 – Risk of harm from ingestion of Vernagel

Signal 7 – Risk of bowel obstruction post orthopaedic surgery: “Ogilvie Syndrome”

Signal 8 – Prevention of harm with alfacalcidol preparations

Confidential Enquiries into Maternal Death to continue (26th Sept 2011)
The NPSA previously commissioned and monitored the Confidential Enquiry into Maternal and Child Health. It was confirmed in July 2011 that the Healthcare Quality Improvement Partnership (HQIP) will take over the commissioning of the confidential enquiries, with the new service provider in place by April 2012. In the meantime, any maternal or perinatal death should be recorded on the Maternal and Perinatal Mortalities Notifications website. Read Anaesthesia editorial about Confidential Enquiries into Maternal Deaths.
Clinical Excellence Awards 2012 AAGBI support for higher award applicants (17th August 2011)

Time to act!

The AAGBI is recognised by the Advisory Committee for Clinical Excellence Awards (ACCEA) as one of the professional organisations that can nominate anaesthetists, intensivists and pain physicians for national Clinical Excellence Awards (Bronze, Silver and Gold levels), and can provide supporting citations for Platinum level. The AAGBI has established an objective assessment and ranking process in accordance with strict ACCEA guidelines. The AAGBI will convene a group that will assess and rank the submissions for each award level. The group will include senior national award holders, local award holders and lay representation. The ranked list of nominations will be formally submitted to the ACCEA. Any anaesthetist wishing support from the AAGBI should follow the instructions and timetables below.

England and Wales

**It has yet to be confirmed by Ministers that the 2012 round will proceed but the following provisional arrangements have been put in place. **

ACCEA - Clinical Excellence Awards

The 2012 National Clinical Excellence Awards round for England and Wales will close this year at 5pm on Friday 9th December 2011. If you would like your application to be considered for support by the AAGBI, please email your completed and carefully checked application form to president@aagbi.org by 5pm on Friday 14th October 2011. Please note that the application and nomination process is conducted in line with regulations described in the ACCEA website (http://www.dh.gov.uk/ab/ACCEA/index.htm) – we recommend that you read the relevant guides published on the website before submitting an application form.

All CVQs will be considered and contribution to the work of the AAGBI will be recognised.

Please be aware that your employing hospital or regional committee may have earlier deadline dates for the submission of your application form – we cannot emphasise too strongly the need to read and follow application instructions closely as published on the ACCEA website.

For those seeking guidance for future years, the AAGBI will continue to run ACCEA workshops, the next being at Annual Congress Edinburgh (21st – 23rd September 2011).

Joint Statement on New Neuraxial Connectors (11 August 2011)

Please note: This risk assessment has been superseded by the position statement above dated 28 October 2011

By April 2012, clinicians in the NHS will be required to use new neuraxial connectors for spinal needles and by 2013 epidural and other regional applications.  This initiative is designed to prevent misconnection between standard vascular Luer connectors and neuraxial or other regional injections. 

Our Councils support the process of replacing the Luer connector for spinal, epidural and other regional anaesthesia applications, but believe that a single dedicated new connector is required to maximize efficiency and safety. 

The development and introduction of new non-Luer connectors has been a long process (1) and there are currently around 12 new, clinically untested, CE marked connectors being introduced to the NHS. In England and Scotland centralised testing of new connectors prior to introduction has not proved possible. However a full process of bench-top and clinical evaluation is planned in Wales organized by Mr Peter Phillips of the Surgical Materials Testing Laboratory, Bridgend. The purpose of this evaluation is to eliminate any poor quality devices before using new products on patients. The results of this evaluation will be available by July 2012.

The NPSA is providing guidance on the issue with a number of Neuraxial Update newsletters and a series of workshops are being held to allow manufacturers and clinicians to meet and review the new products. The Neuraxial Reference Group continues to promote communication between the NPSA, industry and the profession. 

In response to the deadline set by the NPSA, some hospitals are starting to test new connectors clinically.  We believe that any testing of this type should be organized and rigorous in design. The NPSA wishes to work with centres undertaking larger evaluations, and we suggest that these centres contact Professor David Cousins, NSPA Head of Patient Safety - Medication Practice and Medical Devices (david.cousins@npsa.nhs.uk)

How should members proceed?   We have developed a risk assessment to describe the issues in more detail - read the Risk Assessment. Please note: this risk assessment is no longer available it has been superseded by the position statement above dated 28 October 2011. Read the position statement >

The risk assessment explains our concerns that untested connectors may be less efficient than standard connectors for undertaking spinal anaesthesia and that anaesthetists, and hospitals, should consider carefully the value of small scale assessments of new connectors prior to the results of the Welsh testing being available.

We anticipate that many anaesthetists or hospitals will decide to await the outcome of the Welsh testing and would advise that the issue is discussed with Risk Management and entered into the Risk Register or equivalent as described by the NPSA. 

Dr Iain H Wilson
Dr Pete Nightingale
Mrs Kate Rivett
Dr David Bogod
Dr Nick Scott
   
Association of Anaesthetists of Great Britain and Ireland Royal College of Anaesthetists
Patient Liaison group of the RCoA
Obstetric Anaesthetists Association
Regional Anaesthesia - UK

1. Walker IA, Griffiths R, Wilson IH. Replacing Luer connectors: still work in progress. Anaesthesia 2010; 65:1059-63

NATIONAL AUDIT PROJECT 5 
Accidental awareness during general anaesthesia (AAGA) (5th Aug 2011)

Royal College of Anaesthetists (RCoA) and Association of Anaesthetists of Great Britain and Ireland (AAGBI)

The Royal College of Anaesthetists and the Association of Anaesthetists of Great Britain and Ireland are pleased to announce that the 5th National Audit Project will be on ‘Accidental awareness during general anaesthesia’. The RCoA and AAGBI wish to appoint a joint clinical lead to provide leadership for all aspects of the NAP5 project.

NICE Guidelines for Sedation in Children and Young People
RCoA/AAGBI response: July 2011  (5th Aug 2011)
The Royal College of Anaesthetists (RCoA) and Association of Anaesthetists of Great Britain and Ireland (AAGBI) strongly support the principle of developing national evidence-based recommendations on sedation practice in children, and we welcome the NICE Guideline ‘Sedation in children and young people’ (1). NICE are to be congratulated for publishing such a comprehensive document, in particular for emphasising the need for appropriate standards of training and monitoring, the avoidance of ‘operator-sedationists’, and the need for appropriate preparation, post procedure care and use of suitable discharge criteria after sedation in children. Download the full safety statement »
 The use of capnography outside the operating theatre

Updated statement from the Association of Anaesthetists of Great Britain & Ireland (AAGBI) May 2011

The AAGBI publications ‘Recommendations for standards of monitoring during anaesthesia and recovery’ (4th edition) 2007 (1) and ‘Capnography outside the operating room’ 2009 (2) recommend continuous capnography in all patients who are anaesthetised or intubated, regardless of their location in the hospital, or the type of airway device used. In addition, continuous capnography is recommended for all patients undergoing deep sedation or any sedation where the airway cannot be directly observed, and should be immediately available during the treatment of cardiac arrest. Download the full safety statement »

Management of Proximal Femoral Fractures draft guideline: we invite comments from members over the next two weeks

A new guideline on the Management of Proximal Femoral Fractures is in its final draft stage and we invite comments from members over the next two weeks. We would be most grateful if members would read the draft and submit any comments they might have to honsecretary@aagbi.org

All comments submitted will be considered before final version is brought before Council for approval. The closing date for comment submission is Tuesday 26th July 2011.

Download the guideline »

STOP BEFORE YOU BLOCK - a new initiative to prevent Wrong Site Blocks (20 June 2011)

Visit www.rcoa.ac.uk/WSB  to download a new initiative to prevent Wrong Site Blocks. STOP BEFORE YOU BLOCK is a scheme of work, summarised in an eye-catching poster, with an accompanying PowerPoint presentation and background information to ease implementation at a local level.

AAGBI members may be aware that in November 2010 SALG produced a safety notification entitled Wrong Site Blocks During Surgery. Following that notification we received feedback from safety network members all over the country on local protocols to prevent Wrong Site Blocks. Nottingham University Hospitals volunteered the STOP BEFORE YOU BLOCK scheme. The scheme was circulated for consultation and is now endorsed by SALG.

SALG is now working on a portfolio of other work carried out to prevent or measure Wrong Site Blocks and these will soon be made available on the RCoA website. If you have any work that you would like to share on this topic please get in touch with SALG via SALG@rcoa.ac.uk.

AAGBI responds to Office of Fair Trading (OFT) private healthcare enquiry (13 June 2011)

The AAGBI welcomes the OFT’s enquiry into the private healthcare market [1], and is assisting the OFT by providing it with key information on the role of anaesthetists in providing a safe, effective and professional service to patients seeking treatment in the insured and self-pay private health sectors. A survey is being undertaken to gather data from the AAGBI’s members who are involved in private healthcare.

In its response, the Association has already raised concerns that Private Medical Insurers (PMIs) are seeking to take a role in assessing the training, knowledge and skills of consultants providing private healthcare. The AAGBI is also concerned that new recognition processes recently introduced by some of the PMIs may have an adverse effect on patient choice.

The AAGBI supports the principle of competition in the private healthcare market and publishes guidance for its members on billing private patients. [2]. This guidance is clear that consultant anaesthetists should charge transparent and reasonable fees, and should make every effort to inform their patients of the fees as long before surgery as possible, thereby giving them the maximum opportunity to seek competitive fees.

1) http://www.oft.gov.uk/OFTwork/markets-work/current/private-healthcare/

2) http://www.aagbi.org/sites/default/files/code_of_practice_08.pdf

For further information contact AAGBI press office on 020 7631 8805

Enquiry into Private Healthcare Market (10 June 2011)

Man ticking boxSurvey for members involved in private practice

As you may well be aware, the Office of Fair Trading (OFT) has launched an enquiry into the private healthcare market, which was prompted in part by the AAGBI’s referral of AXA PPP and Bupa to the OFT. The AAGBI made the referral because of its concerns that the restrictive recognition agreements introduced recently by the two private medical insurance companies were having a significant adverse impact on patient choice and anaesthetists’ freedom to charge the fees that they feel are fair and reasonable.

As part of the study, the OFT has sent a detailed questionnaire to the AAGBI and a number of other representative organisations. It will come as no surprise that the AAGBI is asked specific questions about the role of anaesthetists in private healthcare. We need to gather some accurate data quickly so that we can respond to the OFT by its deadline of 24th June 2011.

We have therefore created an online survey which we would like all anaesthetists involved in private practice to complete as soon as possible, click here to complete this survey. If you work as part of a formal or informal group in private practice, there is an additional questionnaire within the survey to be completed by one representative within your group. This can be found after Question 15.  Both of these surveys are confidential – no record of the details of those completing the surveys will be sought or made.  We would be grateful to receive completed surveys by 17 June 2011.

We would be most grateful if you complete the surveys forward them to colleagues who are active in private medical practice – both surveys should take no more than 10 minutes.  The OFT will be looking at groups very closely and your information will provide us with valuable information that will be fed into the OFT enquiry.

We will also publish the results of the surveys in Anaesthesia News and on the AAGBI’s website: www.aagbi.org - If you have any questions about the OFT Enquiry or the AAGBI’s online surveys, please email secretariat@aagbi.org

With thanks for your help with this matter,

Bernie Liban, Chair, Independent Practice Committee
William Harrop-Griffiths, Vice President

Council, GAT and Officers election results (8 June 2011)
Council of the Association is pleased to announce the election of three Council members who will take up their posts after the Annual Members Meeting in Edinburgh on 22nd September 2011:

  • Dr Kathleen Ferguson (Consultant Anaesthetist, Aberdeen Royal Infirmary)
  • Dr Nancy Redfern (Consultant Anaesthetist, Newcastle upon Tyne Foundation Trust)
  • Dr Thomas Woodcock (Consultant Anaesthetist, Southampton University Hospitals NHS Trust)

Council is also pleased to announce the election of Dr William Harrop-Griffiths as President Elect and Dr Richard Griffiths as Honorary Secretary Elect. They will also take up their posts on the AAGBI Executive Board after the Annual Members Meeting in Edinburgh on 22nd September 2011.

The AAGBI GAT Committee is pleased to announce the election of six new members who will take up their posts after the GAT Annual General Meeting in Leeds on 30th June:

  • Dr Annemarie Docherty (ST4, Borders General Hospital, Edinburgh)
  • Dr Sarah Gibb (SpR3, Royal Victoria Infirmary, Newcastle upon Tyne)
  • Dr Ulka Paralkar (ST5, University Hospital of Lewisham, London)
  • Dr Kiran Tippur (ST6, Western Infirmary, Glasgow)
  • Dr Caroline Wilson (ST4, Wexham Park Hospital, Slough)
  • Dr Samantha Wilson (SpR, University College London Hospitals)
Safer spinal (intrathecal), epidural and regional devices part A Demonstration Day (24th May 2011)
This event will offer:

  • an overview of the range of new devices available
  • support for NHS organisations with purchasing for safety initiative
  • representatives from the medical device manufacturers to give advice, support and training
  • an opportunity to arrange future local trials and evaluations.

The event will be held on six different dates around the UK, you may send up to two representatives from your organisation. read more >

New Website Launched (12 May 2011)

The AAGBI has now launched its new look website! We have made many improvements, added features and functionality so now finding what you need should be quick and easy.

We’re hoping the website will provide you with essential up-to-date information on all areas of anaesthesia and will be your first port-of-call for professional news and information.

Some highlights of the new website include:

  • The Safety Section – in this section you will be able to find all the latest safety news from the AAGBI and the NPSA/MHRA, and you will also be able to report a patient safety incident, drug reaction or equipment problem directly from the website. Visit the Safety section »
  • Anaesthesia Tutorial of the Week – this weekly web-based tutorial is hosted by the AAGBI and the WFSA and provides a source of high-quality education ideal for exam preparation and for general CPD. We have an archive of over 200 tutorials covering topics in basic sciences, general anaesthesia, intensive care, obstetric anaesthesia, paediatric anaesthesia and pain/regional anaesthesia. View Anaesthesia Tutorial of the Week »
  • A new members’ area – in this secure members area you will be able to update your details, make a booking, print receipts and download your CPD certificates from AAGBI events.  The first time you log into the members’ area you will need your AAGBI membership number and password. You will then be able to log in with your email address and password. If you do not know these please contact members@aagbi.org and once logged in, don’t forget to change your password to something more memorable! Login to the members’ area »

Look out for new features over the coming months including a new members forum and an e-learning platform!

We would really like to hear your thoughts on the new website, please email website@aagbi.org with any comments.

Non-Luer Spinal Devices Evaluation (6 May 2011)

Please take part

OAA and SALG consider specialty input crucial to the ergonomic success of new equipment and urge you to take this opportunity to feedback on new kit. Information on the evaluation and the evaluation form can be found on the OAA website.
 
Please send all evaluation forms to spinal@rcoa.ac.uk
 
Key points on the evaluation project:

  • The identity of the person submitting the form or their hospital (if included) will not be displayed publically, although the OAA may request further details in the event that an equipment supplier wishes to comment on or query a specific result.
  • This evaluation does not replace incident reporting to NPSA or MHRA. Therefore please follow you and your Trust's normal practice of incident reporting in the event of a patient safety incident resulting from the use of these devices.
  • If a report has been submitted to MHRA or the NPSA, this must be specified on the OAA return.

Please pass this information on to colleagues.

Membership Survey: Call for Topics! (27 April 2011)
Hands in the airThe AAGBI will conduct a membership survey later this year.  It has been 5 years sinc we last conducted a survey so we would like to hear from you about the topics YOU want covered. Please email your suggestions to members@aagbi.org by 27 May 2011.
APA Position statement on Anaesthesia and the developing brain
(13 April 2011)

Concerns have been raised by the results of animal experiments that suggest that exposure to certain anaesthetics at critical stages of development could result in harm. The evidence was summarised in a recent article and letter in the New England Journal of Medicine (1,2), which were published in advance of a consensus meeting of the main regulatory authority in the USA. This is a very active new field of research with both animal and human studies in progress. The GAS study (regional v general anaesthesia for neonatal surgery) is progressing and is the only Randomised Controlled Trial in this field but the results will not be known until 2017 as testing must be continued until age 5 years.

Should our current clinical practice change as a result of this new knowledge?

The APA’s view is that, at present, the evidence is not clear enough to guide clinical practice for three main reasons:

  • It is very difficult to extrapolate from animal experiments to humans.
  • Studies in humans suggesting behavioural and learning difficulties linked to anaesthesia in early life have intrinsic problems with their methods. A study of twins, one of whom had anaesthesia in early life, showed no difference in educational performance later in life. A recent large Danish study showed that academic performance in adolescents was not impaired by a single short anaesthetic in early life.
  • It is unethical and harmful to deny anaesthesia to neonates and infants if they need it. There is not enough information to say what the contribution of anaesthesia is to outcome compared with other aspects of care and whether one anaesthetic is superior to another.

However, some paediatric anaesthetists are already adopting a precautionary principle of avoiding those agents highlighted in the animal studies in neonates and infants. Some units are delaying anaesthesia and surgery beyond the infant age group where it is possible to do so safely.  In the USA a large project (SmartTots www.SmartTots.org) has been set up to try to provide more information on the safest anaesthesia techniques for infants and young children.

References
(1) This article (10.1056/NEJMp1102155) was published on March 9, 2011, at NEJM.org.
(2) This letter (10.1056/NEJMc1102479) was published on March 9, 2011, at NEJM.org.

Neil S. Morton, President,  APAGBI 12/04/2011

Draft Malignant Hyperthermia guideline and accompanying documents - your chance to comment (01 April 2011)

The new edition of the 'Malignant Hyperthermia Crisis' guideline along with task allocations and recommended contents list are now in the final draft stage, and we invite comments from members over the next two weeks. We would be most grateful if members would read the drafts and submit any comments they might have to honsecretary@aagbi.org

All comments submitted will be considered before final versions are brought before Council for approval. The closing date for comment submission is Tuesday 19th April 2011.

Download the guideline (pdf)
Download the task allocations (pdf)
Download the recommended contents list (pdf)

AAGBI statement on the safety of starch solutions (04 March 2011)

The Association of Anaesthetists of Great Britain & Ireland is aware of the issues behind the stories in today's media about the safety of starch solutions.  Responsibility for the safety of medicines in the UK rests with the MHRA, and we remain in close touch with them.

Although there are allegations of research irregularity, there is no new evidence that starches are not safe.  Until any such information comes to light, anaesthetists and other clinicians should continue to do what they think is in their patients' best interests. 

The AAGBI is monitoring this situation carefully and is seeking further expert advice, which we will publicise via Linkmen, website and e-newsletter as we get it.

Andrew Hartle
Honorary Secretary

 AAGBI Guidelines and the Environment
Council keeps all AAGBI activities under review, looking particularly at relevance, usefulness, cost-effectiveness and environmental impact. 
In-house at 21 Portland Place we have decreased the use of utilities and paper, and initiatives such as repatriating the printing of Anaesthesia andAnaesthesia News to the UK have significantly reduced the Association’s carbon footprint.

AAGBI guidelines (‘glossies’) are a signature product and have been one of the key elements of Association activity for over a generation.  However, each print run costs approximately £11,000 and generates 11,000 copies, many of which are discarded, often because the electronic version is found to be more accessible.  All glossies are freely available on this website.  In addition, some guidelines are now published in Anaesthesia, which may mean that some members get multiple copies.

In February 2011, Council of the AAGBI decided that in the future, guidelines will have only a limited print run with automatic distribution to Linkmen, Clinical Directors, anaesthetic department secretaries, NHS Trust/Board Chief Executives and Presidents of anaesthesia societies abroad, and will be released electronically as soon as possible after approval by Council.  This will make guidelines available to members sooner, and will significantly reduce costs (borne ultimately out of membership fees) and wastage, contributing further to an environmental saving.

Any member who would like to receive a printed version of an AAGBI guideline should emailworkingparties@aagbi.org.  ‘New glossy’ notices will be placed in the e-newsletter along with links to the documents.  If you have yet to receive an e-newsletter please check your contact details via the members’ only section on this website.   

Andrew Hartle
Honorary Secretary
New AAGBI guidelines: 'Drug and Alcohol Abuse amongst Anaesthetists
Guidance on Identification and Management 2', 'Working Arrangements for Consultant Anaesthetists in the UK' and 'Blood Transfusion and the Anaesthetist - Management of Massive Haemorrhage'.

Although most anaesthetists will complete their whole career without any personal encounter with substance abuse, it remains a sad fact that some will.  Building on the experience of the AAGBI’s Welfare Committee, the Drug and Alcohol Abuse guideline provides useful guidance on the frequency of this problem, and describes risk factors, signs and symptoms.  Practical advice on the management of affected individuals is included, together with contact details for agencies that may help, including, of course, AAGBI’s Welfare Committee.  Substance abuse happens rarely in any one department, so few anaesthetists will have a detailed understanding of the problems.  This guideline will hopefully bridge that gap, and allow sensible and compassionate decisions to be made until specialists can be involved.

The current economic situation is placing great pressure on clinical and non-clinical managers to make savings, and consultant anaesthetists, representing the largest single-specialty in hospital medicine, may come under particular pressure to do more clinical work.  The guideline on Working Arrangements for Consultant Anaesthetists in the UK is timely help for consultants, and their managers, in how to deal with contractual matters.  Advice is available for all consultants, regardless of contract or country.  The AAGBI is particularly grateful for the contribution made by the BMA in writing this guideline.  The AAGBI is only able to give generic advice about contractual matters, and all consultants and other members are encouraged to be a member of one the organisations that can give personal advice and support.

Massive haemorrhage is an inevitable and often unavoidable complication of trauma or surgery.  The AAGBI’s latest Patient Safety Guideline on this topic provides a reference on the logistic and practical clinical management of patients who are bleeding.  It emphasises the need for close co-operation between all those specialties involved, and will help form the basis for local protocols where those do not already exist, or need to be updated.

Download Drug and Alcohol Abuse guideline (pdf)

Download Working Arrangements guideline (pdf)

Download Massive Haemorrhage guideline (pdf)

2011 Council and GAT elections
The AAGBI is now accepting nominations for the 2011 Council and GAT Committee elections. Please click on the links below to download pdfs of the relevant documentation. read more >
Neuraxial Connectors Alert Update
The NPSA announced on 31 January 2011 that implementation of Part A (Spinals) has been deferred to 1 April 2012. This should allow for proper evaluation of new products. read more >
Pulse oximeters breathe life into surgery in poorer nations
The Lancet reports on lifebox, the partnership programme lead by AAGBI, the WFSA and the Harvard School of Public Health.  President Iain Wilson talks about the work we are supporting to introduce pulse oximeters into hospitals in developing world countries and close the pulse oximetry gap. 
Click here to read the report
ESA: Invitation to participate in PAIN OUT euCPSP study
The European Society of Anaesthesiology (ESA) has issued an invitation to participate in PAIN OUT euCPSP: a European observational study on chronic post surgical pain. For further details, click here to download a pdf of the message.
ESA: Invitation to participate in PERISCOPE study
The European Society of Anaesthesiology (ESA) has issued an invitation to participate in PERISCOPE, Prospective Evaluation of a RIsk Score for postoperative pulmonary COmPlications in Europe: A 7-day data collection, prospective, observational study. For further details, click here to download a pdf of the message.
ESA: Invitation to participate in European Surgical Outcomes Study (EuSOS)
The European Society of Anaesthesiology (ESA) has issued an invitation to participate in a large epidemiological study of non-cardiac surgery which will take place during the first week of April 2011. For further details, click here to download a pdf of the message.
Clinical Excellence Awards in Northern Ireland
The AAGBI President, Dr Iain Wilson, released a statement on 2 November 2010 regarding Clinical Excellence Awards in Northern Ireland. Click here to download a copy of the statement (pdf)
Needlestick Injuries Working Party report now available to members

A report to the AAGBI Council from the Working Party for Needlestick Injuries is now available to members.

Since 2007 the Working Party has been gathering recommendations for legislative and policy change regarding the testing of patients for Blood Borne Viruses (BBV) after needlestick and other occupational injuries. This is in light of the recent legislative change (Human Tissue Act 2004 and Mental Capacity Act 2005), and the withdrawal of previous guidance from the General Medical Council (GMC).

The following report has been received and discussed by the AAGBI Council. The AAGBI will continue to work with the organisations represented on the Working Party, and others, to achieve resolution of the current legal position.

Download the Working Party for Needlestick Injuries report

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