The President’s Message

January 2018

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I am over half way through my Presidency so it is a good time to reflect on what has been achieved and look at what the coming year will bring. As an ex-president said to me when I took on this role: “if you achieve one thing in two years you will have done well!”

We conducted a strategic review of our activities in October 2016 and concluded that AUGIS should continue to represent the needs of patients and clinicians in the generality of upper GI conditions and avoid becoming a super-specialist cancer and metabolic surgery group. I am confident that this was the right decision. Speaking to surgeons at the Cork meeting with a benign upper GI practice was particularly useful, identifying that there is currently a gap in representing relevant complex problems such as surgery for para-oesophageal hernias and GORD at our meetings.

With this in mind we have agreed to change the format slightly for our next annual meeting which will take place in Edinburgh from 19 – 21 September. The meeting will start at lunchtime on the Wednesday and run through to lunchtime on the Friday. This will allow us to include many more presentations and discussions but also get people off home at a decent time on Friday. The AHP programme will be re-vamped as per requests from members who attended Cork to include a series of workshops on the Wednesday morning followed by a multi-disciplinary symposium in the afternoon which will be part of the main meeting. Your feedback on these changes will be important for us to see what has worked and what needs changing.

Our IT systems have been upgraded which will improve our ability to communicate with members and cut costs. Traditionally, AUGIS paid ASGBI to manage all IT including our membership database. This arrangement has now ended; our broadband and hardware is provided by RCSEng and we have our own software to manage membership and meeting registration. This is already proving more efficient. BJS subscriptions will also be offered to AUGIS members at significantly reduced rates.. While the RCSEng building is being re-built we are housed in new offices in the old Nuffield Building next door. Click on the following link for contact details: www.augis.org/contact-us

AUGIS has contributed to the RCSEng Improving Surgical Training (IST) and the first Core Trainees will take up their posts in the pilot sites soon. The IST scheme is likely to change the way we deliver core training throughout the NHS, hopefully for the better. For more information go to: www.rcseng.ac.uk/careers-in-surgery/trainees/ist .

AUGIS has also been involved in the SAC curriculum review for General Surgical training. The GMC is now considering its response but all the indications are that the new curriculum will be adopted. Go to www.gmc-uk.org/education/29569.asp to find out more. There are fundamental changes which will affect trainees and trainers alike. The increase in consultant posts with an interest in Emergency General Surgery continues and AUGIS has been working with the ASGBI to develop guidance on appropriate job plans. The NHS has never been good at work-force planning and we are in danger of training far too many surgeons with super-specialist interests and not enough with broad general GI experience. This is a contentious issue which induces strong feelings, particularly from Trainees, but we ignore it at our peril. It is problematic that there is no agreed solution between the different Specialty Associations which are affected. Constructive engagement with all parties will be essential and compromises needed if we are to ensure patients are cared for by appropriately trained surgeons, and that a career in General Surgery does not become unattractive.

I recently attended the ACP Council Meeting to represent AUGIS and we shared our concerns on endoscopy training for surgeons. In our opinion, endoscopy is an essential skill for luminal gastro-intestinal surgeons. Increased accreditation requirements driven by JAG have made it increasingly difficult for young surgeons to get adequate endoscopy training. This must change if we are to avoid going the way of other countries where only Gastroenterologists wield an endoscope. AUGIS and ACP have agreed to work together on this issue.

AUGIS continues to provide clinical leadership for the national oesophago-gastric (NOGCA) and metabolic surgery (NBSR) audits. These show our commitment to improving outcomes for patients and are increasingly used to benchmark hospitals performance. The development of SWORD using HES data continues and now has an appraisal tool for members to use. Go to www.augis.org/sword for more information.

Lastly, we have just agreed to work with HCUK, a charity focusing on oesophageal cancer, to co-fund a Research Lead post administrated by the RCSEng. We are in discussions with other charities to develop additional posts in different sub-specialty areas. A founding member of AUGIS is now the RCSEng President and his commitment to research remains an inspiration to many. We look forward to developing this collaboration in the future.

Feedback, as always, is welcome.

Richard Hardwick
President