12 June 2020
Dear Members and Fellows,
Another COVID week has passed and thankfully the number of new confirmed infections continues to fall and the Government has found it possible to further ease social restrictions. All of this is good, but it will come with the expectation that the health service can resume where it left off and will restore ‘normal’ service. Unfortunately the new reality will be far from this and as surgeons we face even greater challenges than during ‘lockdown’ in order to reestablish scheduled care.
The National Clinical Programmes in Surgery (NCPS) are working with the HSE to develop guidance regarding timely, equitable and cost-effective reintroduction in scheduled care. This and the proposed 'Care pathway for the management of day case laparoscopic cholecystectomy' have gone out for stakeholder consultation and feedback. Both documents are available to view on the new stakeholder consultation section of our COVID-19 resource hub.
There is much work to be done and each institution will differ in respect to the available resources. The answer cannot be an extended ‘winter initiative’ of cancellation of scheduled surgical care. Bespoke solutions must be found. NCPS is actively seeking stakeholder engagement and the feedback form, which should be returned to email@example.com, is downloadable here.
If we are to address the cumulative workload of existing waiting lists, cases deferred over the past three months and ongoing needs of the population, every possible effort must be made to efficiently use all available beds and every potential operating session. RCSI will use all opportunities to assist the HSE and Hospital Groups in meeting increased requirements due to COVID-19 and to facilitate timely delivery of safe scheduled surgery.
The decision to temporarily nationalise the private hospital sector was a force majeure necessary at the time to provide additional capacity at the peak of the COVID-19 surge. Now that the surge has passed, it may well be that the National Treatment Purchase Fund will be used to assist in dealing with surgical waiting lists.
The College is concerned that trainees may be disadvantaged by transfer of low and medium complexity cases out of the training environment. RCSI, through the Forum of Postgraduate Training Bodies, is making strong representation to the HSE and Department of Health to ensure that training opportunities will not be lost and that, in as much as is possible, trainees will continue to have the best access to those procedures essential to professional training.
RCSI is also acutely aware of the concerns that trainees have in relation to when our Membership and Fellowship examinations will recommence. I would like to assure all trainees that the four Royal Colleges will endeavour to deliver the membership and fellowship examinations as soon as is feasible. Work is progressing in the face of the challenges posed by COVID-19 to determine the timing of safe recommencement of professional examinations.
The newly-elected Council held its first meeting this week. Professor Ronan Cahill and Mr Keith Sinnott, both surgeons at the Mater Misericordiae University Hospital, were welcomed to the Council, along with 19 re-elected members. It was very encouraging to hear how much work is going on behind the scenes to ensure the continuity of surgical training and academic endeavour on the College campus. A new College Committee on Research, to be chaired by Professor Michael Kerin, was established with the remit of implementing the Surgical Research Strategy. The Committee will examine ways to implement an academic training pathway for surgical trainees.
A second committee was established to explore ways of increasing the relevance of RCSI to colleagues in Northern Ireland. The College is by Charter an all-Ireland institution and it is hoped that through engagement, a greater role can be found for RCSI in support of Fellows and Members working in Northern Ireland.
The weekly webinar series continued with an excellent programme on Wednesday evening. Professor Ronan Cahill presented recent work on aerosol generation in the operating theatre during laparoscopic and robotic surgery. It was fascinating to see the results of his work and the implications for technology development. Ms Claire Donohoe gave a truly fascinating insight into the social and economic effects of pandemics throughout history and how COVID-19 will define the next decade and beyond. Professor Desmond Winter, Editor in Chief of BJS, spoke of the enormous vehicle for change and opportunity for disruptive innovation offered by COVID-19.
During next week’s webinar, entitled ‘RCSI Fellows and COVID-19: Global Perspectives’, we will hear how our colleagues overseas are coping with re-introduction of scheduled care, with contributions from Honorary Fellow Professor Frank Frizelle, Professor of Surgery University of Otago and Editor in Chief NZMJ, and Fellow and Honorary Fellow Professor Conor Delaney, Professor of Surgery, Cleveland Clinic Lerner College of Medicine and Vice-President, American Society of Colon and Rectal Surgeons and other colleagues abroad. You can register for this webinar, scheduled to take place as usual next Wednesday at 6pm GMT, by registering here.
I look forward to a busy week ahead. Keep safe and do consider joining Wednesday evening’s webinar.
P. Ronan O’Connell