3 April 2020

Dear Fellows and Members,

I do hope that you and your family are staying well during this very challenging time for us all.

The COVID-19 pandemic is having a very significant impact on surgeons, trainee surgeons and surgical practice across the country. Those of you in practice face many challenging situations across every aspect of your work. On your behalf, we continue to engage with stakeholders across the health sector as part of the Department of Health Medical Leader Forum and the HSE COVID-19 Forum, ensuring that the needs of surgical patients and surgeons is considered as part of the COVID-19 decision-making process.

The situation is changing rapidly but the RCSI National Clinical Programmes continue their work with individual and institutional partners, and other interested parties, to develop publications and national guidelines on the management of patient and safety precautions to be taken by surgeons during the pandemic. As new documents are produced, they will be accessible here.

Our own RCSI Library is supporting this effort by collating a selection of resources on COVID-19 including search strategies for medical databases, government and national healthcare websites, and resources made available by publishers to facilitate international research. Details of the resources available to you were sent earlier in the week in Surgical Bulletin, and are available here.

This was a difficult week for our Fellows and Members as we learned with great sadness of the death of one of our Alumni Mr Amged El-Hawrani, RCSI Medicine Class of 1993. Mr El-Hawrani, who worked as a Consultant ENT Surgeon at Queens Hospital, Burton, was sadly one of the first NHS frontline workers to die as a result of Covid-19. We offer our deepest sympathies to Mr El-Hawrani’s family and colleagues.

We are particularly concerned about the safety of all surgeons. We are working with the HSE to find the safest and most pragmatic way of ensuring that the health of surgeons is not at risk. Through the National Clinical Programmes, RCSI will continue to promote safe barrier and aseptic techniques and the appropriate use of personal protection equipment (PPE).

With our intercollegiate partners, we have issued updated surgery guidance on COVID-19 in the light of new national recommendations in relation to PPE and aerosol-generating procedures.

Professor James Paul O'Neill has been actively involved in developing new international guidelines for ENT in relation to COVID-19, which have been accepted for urgent publication next week in JAMA Otolaryngology–Head & Neck Surgery. These guidelines are a useful resource for surgeons in practice, trainees and other professionals involved in frontline patient care during the pandemic. These guidelines can be viewed on the RCSI website here, along with other useful resources for surgical practice.

Scheduled surgical care and outpatient clinics are inevitably curtailed now for an indefinite period and we cannot overestimate the impact this will have on our patients. The RCSI National Clinical Programmes are leading our initiatives to measure and reduce the impact on patients.

GP-Surgeons Connect, an initiative by RCSI and the ICGP which aims to rapidly connect GPs with surgeon advisors to assist in the safe management of their patients, was launched this week. The service aims to minimise the number of hospital referrals during the COVID-19 outbreak and support GPs to manage patients with confirmed surgical conditions in the community. A panel of surgeon advisors – all of whom are on the Specialist Division of the Medical Register – have volunteered to provide phone advice directly to GPs to support them in the management of patients in the community or assist in the decision to escalate a patient's care to the hospital setting.

RCSI Surgical Affairs have launched a new weekly webinar series aimed at supporting and informing surgeons during the COVID-19 crisis. 140 attended the first webinar on Wednesday, 1 April, and a further 315 requested to receive a recording. This webinar, which dealt with managing surgical services during COVID-19, featured contributions from Professor Deborah McNamara, National Co-Lead for the NCPS, Professor Gerard Curley, Professor of Anaesthesia and Critical Care and myself. The next webinar will update us on the solutions our colleagues in Trauma and Orthopaedics are implementing across the system, and you can register for this webinar here. The webinar series will focus on the latest updates and examples of innovations and solutions being implemented by various surgical specialties across our hospitals.

Our Surgical Affairs team, together with the National Clinical Programmes in Surgery and Trauma & Orthopaedics, are all working together to ensure the information and guidance you need to support the delivery of safe care during this pandemic outbreak is readily available. They have created a valuable information source for Surgeons in Practice which is updated each day.

Finally, if you have not yet had an opportunity to watch last Tuesday’s night’s Primetime on RTE, I urge you to do so here. One segment, filmed at the Smurfit Building at Beaumont Hospital, explored the transmission mechanisms of the virus in healthcare settings, the importance of PPE and the challenges presented by seriously ill COVID-19 patients. It featured contributions from Professor Arnold Hill (surgery), Professor Ger Curley (critical care), Natalie McEvoy (ICU nurse) and Professor Eoghan De Barra (infectious disease). I am very grateful to everyone who took part. It was undoubtedly an interruption to their very busy days, but media engagement like this is a really important part of our efforts to help the public to understand the complexity of the situation we face.

Please, stay well. I will continue to provide you with updates over the coming period.

Mr Kenneth Mealy, President of RCSI