The Operating Theatre Journal

New report from the Royal College of Anaesthetists

Effective workforce planning and investment, staff wellbeing, and increased critical care capacity remain vital to the recovery of the NHS

The Royal College of Anaesthetists has launched a report identifying 10 lessons the UK healthcare system can learn from the pandemic. The College is calling for the findings to be implemented in order to support the recovery and build back a stronger and more resilient NHS. The College will work with senior stakeholders to promote the application of these lessons across the healthcare sector.  

The risk of new COVID-19 variants coinciding with annual winter pressures and recurring peaks of infection from flu and respiratory diseases threatens to overwhelm healthcare services.  If critical care is once again pushed beyond capacity, this will jeopardise the NHS recovery. Our report outlines how the NHS must be better prepared for potential additional COVID-19 surges, with consideration of supply of PPE, pandemic skills maintenance, and the need for staff to be protected from burnout and given the opportunity to recover. The report also highlights the importance of innovation and new ways of delivering care, including the expansion of perioperative and enhanced care to optimise surgical activity.

Over the next few years, the biggest challenge for the healthcare service will be to tackle the backlog in planned surgery built up prior to and during the pandemic. With data from the College census¹ showing at least one consultant vacancy in 90 per cent of all anaesthetic departments, we argue that any recovery plans must be underpinned by an investment in staff and long-term workforce planning.

The RCoA’s 10 lessons learnt from the pandemic:

1. the wellbeing of NHS staff is paramount
2. staff shortages must not persist, now is the time to invest in workforce
3. we need increased critical care capacity across the UK
4. appropriate and timely supply of PPE is key
5. perioperative care has a critical role to play in the NHS recovery and beyond
6. we should maintain pandemic skills
7. collaboration and information sharing are critical for a successful pandemic response
8. local decision-making works
9. the healthcare system must be better prepared for future pandemics
10. there is huge potential for digital innovations

Professor Ravi Mahajan, President of the Royal College of Anaesthetists said:

“Anaesthetists, alongside other healthcare professionals, have adapted incredibly well during the pandemic to look after the sickest COVID-19 patients. Over half² of our members said they had acquired new, transferrable skills, and it is now crucial that staff are supported to maintain the knowledge gained so we can build a pool of ‘reservists’ who can quickly step up to support ICUs when needed.

“Alongside the positive lessons, the pandemic has shone a light on the underinvestment in critical care services which has contributed to the suspension of elective activity and a significant increase in waiting lists. While investment in facilities such as protected elective surgical units are part of the solution, without the workforce capacity to staff them we will never be able to make full use of any additional resources.

“Now is the time to invest in increasing training places for anaesthetists, surgeons, nurses, and others as they look towards tackling the extensive backlog. It is also vital that the NHS appreciates and retains the staff currently working in the system and provides them with the best physical and psychological support as they begin their journey to build back the NHS.

“The fortitude, dedication and adaptability of the NHS staff during the pandemic has demonstrated what they and the NHS are capable of when under pressure. There must be a commitment from the UK government to continue the move towards a more innovative and solutions-focused healthcare system. The NHS must not be left to return to business as usual. The government and the NHS must grab this opportunity to embed what has been learnt so far and continue to learn and improve so we can build a truly sustainable health service.”

Dawn Chamberlain, Director of Clinical Improvement, NHS England and NHS Improvement said:

“The way that the NHS has adapted in response to the pandemic has been phenomenal. We have seen changes to the way we work within our teams, across organisational boundaries and how we interact with our patients, carers and citizens. We must learn lessons from the pandemic to ensure that future generations benefit from these changes. I welcome the learning from the Royal College of Anaesthetists report to support the recovery of the NHS.”

References:

1. RCoA Medical Workforce Census Report 2020
2. COVID-19 Winter Survey. February 2021

PDF of the report:  Royal College of Anaesthetists – 10 lessons learnt from COVID-19.pdf

Link to the report: 10 lessons learnt from COVID-19