From The President's Desk
Resilience and Preparedness
20 April 2026
Federation of Surgical Specialty Associations (FSSA)
Last week I attended the meeting of the Federation of Surgical Specialty Associations at the RCS of Edinburgh. It was a good look at surgery across the UK and Ireland rather than through the lens of a single specialty. The welcome, hospitality and facilities in Edinburgh were fantastic.
The discussion covered a wide range of topics relevant to all of surgery. What stood out was how much we share. Workforce pressures, increasing complexity, impact of innovation and the need to organise ourselves more effectively are common across all specialties. Also how to ensure value for our members.
At the same time, each specialty retains its own identity and specific challenges. This is just like cardiothoracic surgery, where our four domains each face distinct issues while working within a shared framework.
To me, it’s so important that clinicians lead the system, and the administration delivers the resources. I spoke clearly on this point.
How we work: from analogue to digital
There was good discussion around the balance between face to face and virtual working. It's becoming more widely accepted.
Face to face meetings do remain essential. They allow a different type of discussion and relationship building. At the same time, virtual working has improved access and efficiency. Embracing this in clinical practice can have major cost savings and when done well and appropriately enhances patient experience and outcomes.
Running our organisations well
Another clear direction of travel is the professionalisation of how specialty organisations operate.
More specialties are recognising the need for non-clinical operational leadership to support continuity and the business aspects of running a charity. This includes financial oversight, delivery of programmes, and maintaining momentum between elected leadership cycles.
This does not replace clinical leadership. It strengthens it. If we are serious about delivering at scale, we need the right structures in place. SCTS is moving towards the appointment of a chief operating officer.
Preparedness for major incidents and military activity
A particularly important area of discussion was preparedness for military conflict and its implications for national surgical services.
Through planning work on Reception Arrangements for Military Personnel (RAMP), specialties are being asked to consider how they would respond to an increase in complex trauma and surgical demand. This is not alarmist. It is about ensuring that, if required, we are better able to respond in a coordinated and credible way.
For cardiothoracic surgery, this raises practical questions. What injuries might we expect to manage. Where are the gaps in our current skill set. How would we scale services across our pathways. What support services would be critical. How will we maintain ‘business as usual’? How ready are we to support each other?
We have begun scoping this within our specialty. The intention is to define a clear, realistic contribution that reflects both our capability and how we address our limitations.
To support this, we will be holding a webinar to share the current position and to gather views from the wider membership. This is important work. If we do not shape our response, it will be shaped for us.
Preparedness is a professional responsibility.
My clinical week
After many lists dominated by minimally invasive surgery, I had an open surgery day! Chest wall resection & reconstruction; late rib fracture requiring plating and bone grafting; and a septic patient with a huge lung abscess who needed aggressive resection. To operate really is the best part of our roles. I will have to find a way to do more in the future!
Beyond the hospital
At weekends, we have been trying to build a routine of longer walks in preparation for a long-distance hike later in the year (after the SCTS bike ride). The pattern is to pick a long route and do it in parts over weekends. Currently we’re at the 20k mark and trying to build up.
At home, there is a different type of pressure, with three children all in the middle of university finals and back for Easter!
Aman Coonar
SCTS President
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