1. Anaesthetic Specific Information

2. Within the specialty in our Trust… Consultants in – Anaesthesia – Intensive Care Medicine and Anaesthesia – Pain Medicine and Anaesthesia – Pain Medicine SAS – Anaesthesia – ICM RCoA FICM FPM

3. Source Documents Anaesthesia – http://www.rcoa.ac.uk/system/files/REV-SUPPORTING-INFO- 2014_1.pdf http://www.rcoa.ac.uk/system/files/REV-SUPPORTING-INFO- 2014_1.pdf – http://www.rcoa.ac.uk/system/files/CPD-2013_0.pdf http://www.rcoa.ac.uk/system/files/CPD-2013_0.pdf – https://www.rcoa.ac.uk/revalidation https://www.rcoa.ac.uk/revalidation

4. Source Documents Pain medicine – http://www.rcoa.ac.uk/system/files/FPM- Good-Pain-Specialist-2014_0.pdf http://www.rcoa.ac.uk/system/files/FPM- Good-Pain-Specialist-2014_0.pdf ICM – http://www.ficm.ac.uk/cpd-and-revalidation http://www.ficm.ac.uk/cpd-and-revalidation – http://www.ficm.ac.uk/sites/default/files/CPD%2 0Matrix%20-%20Levels%201- 3%20Feb%202013.pdf http://www.ficm.ac.uk/sites/default/files/CPD%2 0Matrix%20-%20Levels%201- 3%20Feb%202013.pdf

5. Activity Quantitative or Qualitative – log book?  Anaesthetic outcome data difficult to differentiate from surgical  Currently limited outcome information availability from Trust IT service  PAS figures  Individual anaesthetists’ data collection  Pain and PONV score information (currently incomplete)

6. Clinical Supervision / Teaching  Feedback report from GMC, ARCP exit and Quality review panel – collected annually; minimum is once every 5 yrs  For CGH Consultants – specific individual annual feedback from trainees; being introduced at GRH  Formal teaching – individual event feedback

7. QI / Audit College suggestions: – Adverse effects, including post-operative nausea and vomiting and hypothermia after surgery. – Efficacy of lumbar epidural steroid injections. – Incidence of line-related sepsis. – Incidence of readmission within 48 hours following ICU discharge. – Outcome data. – Post-operative pain relief. – Rates of ventilator-associated pneumonia. – Regional block efficacy.

8. QI / Audit  Outcomes: none currently available from Department; individuals may collect their own  1x audit /clinical outcomes review every 5 years – may include personal audit eg records against standards  2x case reviews/discussion annually if no audit  Attendance at audit meetings plus reflection on audits – there are 6 a year  30 day mortality numbers & reflection – have asked if this is feasible but not currently?

9. CPD Minimum of 50 hours CPD (equating to 50 CPD credits) per year, though most doctors do more than this. Minimum 20 internal and 20 External Standard 250 points over 5 yrs All doctors in non-training grades should participate in CPD. You must remain competent and up to date in all areas of your practice. You are responsible for identifying and planning your individual CPD needs, bearing in mind: – your personal fields of practice, – anticipated changes and developments, and – the needs of the service. Your CPD should encompass a variety of activities, including – formal and informal learning activities, and – local and regional/national activities. Employers should help to facilitate CPD. You must regularly reflect on what you have learned. Verification

10. The College recommends that all doctors partake in a broad range of activities, including each of: External, e.g. regional/national/international educational meetings organised by national bodies, specialist societies or commercial providers. Internal (i.e. within the employing organisation), e.g. hospital mortality and morbidity and clinical governance meetings and locally organised teaching programmes. Personal study, e.g. private reading, e-Learning and other similar activities. This should be recorded as an internal activity when documenting your CPD, e.g. in the College online CPD system. Annual airway traing

12. RCoA CPD Matrix http://www.rcoa.ac.uk/system/files/CPD-MATRIX-2015.pdf Three levels – Level One: core knowledge areas for anaesthesia, including basic science and medico-legal issues. – Level Two: knowledge and skills that are relevant to an individual doctor’s ‘whole’ practice. – Level Three: knowledge and skills required by those whose clinical practice includes one or more special interest area in their routine clinical practice. The knowledge and skill areas listed are not exhaustive, and doctors may wish to participate in activities that fall outside of the CPD Matrix. The CPD Matrix is subject to periodic review.

16. Faculty of ICM CPD matrix http://www.ficm.ac.uk/sites/default/files/CPD%20Matrix%20-%20Levels%201- 3%20Feb%202013.pdf http://www.ficm.ac.uk/sites/default/files/CPD%20Matrix%20-%20Levels%201- 3%20Feb%202013.pdf

17. Faculty of Pain Medicine CPD Matrix

18. Possible questions  What does the RCoA expect you to provide for appraisal – and have you provided it?  If you had a query about patient management on a particular day – where would you find your answers?  What national guidelines are there in anaesthesia?  How many sessions per week do you need to do to keep current? Are you safe on what you do now? Are you safe in everything you do now?