How Cardiothoracic Surgery started in Leeds.
National ACCEA Awards for NHS Consultants.
Thoracic Forum 2017 “Multum in Parvo”.
Cardiothoracic Surgery One Year On: A Medical Student’s Perspective.
President’s Report: Having maintained the same look and feel of the Bulletin for many years, we have given it a revamp. I hope that you like it. We have moved to a new publisher, Open Box, and this has resulted in the December edition arriving in January. I apologise for this but in future we will be back to an edition in July and December…
President’s Report: As I write this, although England seem to be on top in the 3rd One Day International against Sri Lanka, it is gloomy here. There is talk of rain in Bristol on Test Match Special, in Sheffield it is raining, yet again.
So I will start by lamenting the deaths of Mr Iain Breckenridge and Professor Geoffrey Smith. Both were senior and respected figures when I was a trainee. Indeed I owe much of my progress in the specialty to the support of Geoff Smith. I was one of many consultants who were privileged to have worked for him. I can still hear his voice as he strode into theatre; “Cooper, is the mammary taken to your complete satisfaction?” I never worked out how to answer that and of course there is no satisfactory answer. Geoff was President of our Society in 1992 and 1993 …
President’s Report: I am very pleased that we are again able to bring you a printed edition of the bulletin due to continuing support from Mr Marion Ionescu. The feedback we have had is that the July bulletin was more widely read than previous electronic editions and generally appreciated by the membership.
National clinical audits. The SCTS/NICOR national adult cardiac surgery audit for the period of 2011 – 2014 was completed during the summer and the nformation is available on the SCTS website for units and individual surgeons and also now on the consultant outcome programme / NHS website for ndividual surgeons….
President’s Report: This edition of the Bulletin is dedicated to training issues as for sometime now the Executive have felt that we should be highlighting this area of SCTS endeavour. Due to continuing support from Mr Marian Ionescu we are in a position to fund this issue of the bulletin as a paper published copy which many of us feel may be more widely read and appreciated by the members.
The last President’s Report was around the time of the December Board of Representatives’ meeting when there was an attendance of over 100 SCTS members. There was lively discussion and debate related to our national clinical audits and in particular how outcomes measures in adult cardiac surgery are being published at individual surgeon level in the consultant outcome programme of NHS England…..
President’s Address: I am aware that this is the first message from me as the President which will appear in the bulletin. I anticipate that hopefully many of you will be reading this during the forthcoming festive period and I hope that you all if possible take the opportunity for some relaxing holiday time with your family and friends. Around this time of year I think many of us take the opportunity to reflect over events of the past year and consider the up-coming year. Uppermost in many members’ and the executive’s considerations are with issues related to the clinical audit and publication of surgeons’ outcomes…..
Presidential Address: A surgeon requires mental ability, physical stamina as well as a highly developed set of psycho-motor skills. In this regard a surgeon is not dissimilar from a musician, a sportsman or an airline pilot – to whom we are often compared. I would like to draw upon these professions as well as others to look at the career of a surgeon. It can be argued that in any of these careers there are three phases; become good, stay good and get out while you are still good! I would like to look at these three phases using work by psychologists on a wide range of situations and then draw it together at the end to show how I think the NHS needs to change the way it deals with individuals…..
Report from The President: The information on outcomes and performance that Trusts are receiving is increasing in both volume and complexity. Since the Francis Report and the “Everyone Counts Initiative” this data is being looked at in a very challenging environment but with the assumption that Trusts have the knowledge to interpret it. Although HQIP and the Professional Societies are “front men” for the publication of this data they do it at the behest of NHS England and thus responsibility ultimately lies with the Secretary of State for Health. So what is this responsibility? The easy answer is that NHS England must ensure that Trusts have the knowledge to handle this data but this begs the much more difficult question as to how to do it. SCTS has been in discussions with the Professor Norman Williams, President RCS England, and we both agree that this should be done by the the College in conjunction with the Specialist Associations…..
Report from The President: Safe and Sustainable is definitely in the past and whilst we can learn from it we should not dwell upon its demise. We move on. When I joined the ACHD review panel it became very clear to me that the separation of the care of the congenital cardiac patient into paediatric and adult congenital was going to place constraints upon the review. As someone who is neither a congenital surgeon nor involved in the Safe and Sustainable review I could not understand the logic behind it but we had to play the hand we were dealt. It was therefore not a surprise when the Independent Reconfiguration Panel made it very clear that they felt that this was a fundamental flaw:
The proposals for children’s services are undermined by the lack of co-ordination with the review of adult services. The opportunity must be taken to address the criticism of separate reviews by bringing them together to ensure the best possible services for patients…..
Report from The President: Tiger Woods to borrow second hand clubs from Rory Mcllroy next season. Well, this is never going to happen but this is, in effect, what money saving in the NHS is leading to. In an era when our results as cardiac and thoracic surgeons are under increasing scrutiny it is somewhat bizarre that managers think that the instruments we use are not that important. In procedures which require a high degree of hand-eye coordination having the correct instruments is vital. Having a needle holder you are comfortable with is just as important as finding a putter that suits your particular style and probably costs about the same. All too often surgeons are compared to pilots when it comes to analysing the “near miss” but perhaps we should also consider how important it is to be in the correct mindset, or “in the zone” as sports psychologists would say, when it comes to operating…..
Report from The President: I first sat on the Executive as the Senior Registrar representative nearly 20 years ago. At that time the President only served for one year and the culmination of his Presidency was the annual meeting held at a venue of his choosing, often the President’s home town. My recollection is that the Executive had little dealings with external agencies and that without e-mail everything was done at a much more gentlemanly pace. It is now over 10 years since the Executive made the momentous decision to take over the running of the Annual meeting. I was an elected Trustee at this time and understandably the Annual meeting took up a lot of our time, but for the first time we were in total control of our financial future. It was also about this time that the role of the President changed. It became clear that if SCTS was to move forward and engage with the Department of Health, the Royal Colleges and become an asset for its members the President needed had to have a longer-term perspective…..
Over this period I have been privileged to be President during the publication of the Professionalism book and more recently, publication of the Thoracic Blue book. This very important publication has already been brought to the attention of the Health Minister and points out the increasing number of lung cancer resection operations, the decreasing mortality associated with this and the potential number of lives saved as a consequence of this surgery. Indeed the best estimates are that for every person who dies as a result of lung resection for cancer there are an additional 35 survivors. However, more still needs to be done as there are still substantial inequalities across the UK and perhaps there should be a further drive to increase the number done through video-assisted procedures…..
I start this report with a heavy heart having just learnt of the death of Mr Patrick Magee. Pat was one of the best respected cardiac surgeons in the UK and held in the highest regard by all who knew him. He was a clinician who genuinely cared about his patients, expressed great interest in trainees and was never scared of being on the side of the underdog. Although not a traditional academic Pat showed great interest in research and was very supportive of my studies, intellectually and financially, when I was his Senior Registrar at the London chest Hospital. Politically he was one of the most shrewd men I have come across and I frequently sought his advice on complex issues; his exceptional wisdom was matched by great commonsense and he always acted with the highest degree of integrity. As President of SCTS he exhibited these talents effortlessly and in abundance and was a great champion and ambassador of our Society. His untimely death is a real loss to all who knew him and in particular SCTS…..
One of the most challenging aspects of preparing one’s Presidential Address is choosing a topic or theme – and then having done that, to choose a title. Having looked in many places for inspiration, I came across Ecclesiastes, the 21st book of the Old Testament in the Bible. Written by King Solomon, the son of King David, towards the end of his career, he was reflecting on events and considering things which were important. As the Bible has always been an important point of reference in my life it seemed appropriate that I used quotations from Ecclesiastes as the structure for my address…..