Older messages March 2007 May 2007 October 2007  January 2008 April 2008   October 2007 I would like to take this opportunity to thank the Conference Committee and Roz McMillan in particular for all the work they did to pull the ASM together at Torquay. I thought it was a brilliant venue and the programme had a real buzz that was not dampened by the rain. I also thank the members of the South West Ambulatory Group (SWAG) who as well as providing financial support worked incredibly hard to make the meeting a success. I hope everyone who attended the meeting had a great time. If you have comments about the meeting or any suggestions for areas you would like us to cover in the future then please let us know via the BADS Office or by the ‘Contact us’ section of the website. The members area of the website now has a live recording of the presentations available and also offers a new resource with a searchable bibliography of over 700 day surgery references. The bibliography is a another first for BADS and I would like to thank Dr Mark Skues from Chester for all the hard work he has put into this. I can now report the results of the Council Elections. We say good bye and a big thankyou to Roz McMillan, Kerri Houghton and Annette Thorpe and welcome to Miss Clare Tickner who manages the day unit at the Royal Surrey County Hospital in Guildford and Mr Rob Hart who is a Consultant Surgeon from the Royal Preston Hospital in Lancashire . I have also co-opted Dr Ian Armstrong from Edinburgh onto Council for a period of 1 year to represent our Scottish members. Annette has agreed to continue to act as our link to the Perioperative Care Collabarative to ensure continunity for this group. I was delighted to hear about the appointment of Lord Ara Darzi as a Health Minister as he is a strong supporter of both short stay and day surgery. Indeed much of his work and research has revolved around this field and in recognition of this we asked him to give the keynote address at our annual conference. He has commissioned a review of the NHS in called the NHS Next Stage Review under the banner ‘Our NHS, our future’. This is an excellent opportunity for short stay surgery and we will try and ensure that it stays high on the agenda of those involved. You can also get involved and have your say so why not contact them via ourNHS@dh.gsi.gov.uk. We continue to forge links with other organisations and support regional groups including the Glasgow and West of Scotland Day Surgery Association. They have just had their annual meeting which I was pleased to be invited to attend. It was an excellent day and I enjoyed the wide and varied subjects covered by the speakers. I am however sad that more anaesthetic and surgical colleagues did not attend and wonder how we can reach more of our colleagues. Part of this has to be by linking with other organsations and attending their annual meetings – so bringing day surgery to those who might not normally attend the BADS conference. Our President Elect Mr Doug Mcwhinne has helped forge strong links with the Association of Surgeons of Great Britain and and we now have a session at their ASM each year. We also have been working well with the Association for Perioperative Practice working on publications and attending each others annual meetings. I am trying to develop similar co-operation with the Association of Anaesthetists as I firmly believe that BADS should have a session at their ASM each year. If you have other ideas of how to reach resistant colleagues then please contact me.       May 2007 I started my Presidency by stating that we are the British Association of Day Surgery and so we must ensure we represent short stay surgery across the whole of the UK. I am therefore pleased to be able to report some success. Scotland is using co-operation across large health communities to plan services fit for the future that also take into account medical and nursing manpower. This follows the publication of the Kerr Report which was accepted in full by the Scottish Parliament. BADS is supporting this process through the Planned Care Improvement Programme being run by the Scottish Executive. Day and short stay surgery form one of the 5 keystones of this initiative, their relative importance is increased due to some of the sparsely populated and remote geographical areas involved. In Wales I have represented BADS at a meeting used to re-launch the Welsh Day Surgery Forum. It was good to see such an enthusiastic group (and some familiar old faces!) who are obviously working hard developing their links to the Welsh Assembly. In Northern Ireland we have made contact with surgical and nursing colleagues who are helping us plan a meeting there later in the year. Closer to home I met with Jane Reid who is currently the Chairman of the Association for Perioperative Practice. We agreed that our organisations should work more closely in areas where we have overlapping interests and so we plan to run the Northern Ireland meeting as a joint venture and to produce leaflets on safety when using local anaesthesia and sedation. The next challenge we face is delivering the 18 week patient pathway. This is an opportunity to redesign how patients are managed so as to provide a service that offers both quality and timely care. Day and short stay surgery will deal with over 85% of the surgical pathways of care and so we have started working with the national delivery team on ways we can help. There is a new 18 week section on the website where we hope to share successful projects from Council and our members. There will be a presentation from the national team at our Annual Scientific Meeting in Torquay and they will have a stand so they will be on hand throughout the Conference to answer your questions. I suggest you make enquiries now about the problems you face within your own service so you can make the most out of this opportunity. The full programme for the Conference has now been published and it promises to be one of the best meetings yet. I thank the Meetings Group led by Roz McMillan for their hard work in bringing this together. Finally I have previously mentioned that our membership service is now managed by the Association of Surgeons of Great Britain and Ireland. Those who have renewed their membership by completing a new Direct Debit mandate will have received their new membership cards by now. I am aware however that some members have experienced problems with this transition and I apologise for this. I hope any issues are being rectified quickly but please let me know if you are continuing to experience problems. Dr Ian Jackson BADS President March 2007 The management of our membership subscriptions will now be looked after by the Association of Surgeons of Great Britain and Ireland. This requires all members to complete a new Direct Debit mandate and these were sent out well before the Christmas rush. Many have now returned these but we still have a number outstanding. I organised to send issue 17.1 of the journal to colleagues who were registered as members in 2006 to act as a reminder, however the next issue will only be sent to those who have paid their subscription. Membership cards and your own membership number will soon be with you and this will allow us to move forward with the new members’ only area on the website. Indeed my membership card just arrived today (March 22nd) Members will soon have online access to the latest journal articles and recordings of the presentations from our Annual Scientific Meeting. We have already made a trial group of these presentations available on the website to help us assess how popular they are, please have a look at them and let us know what you think. Follow this link All the presentations from Glasgow are now available from the BADS Online Store on one CD that will operate on your computer – it is an excellent resource for your staff and I recommend you consider buying one for your unit. One area that continues to be difficult for all day units is the complex subject of managing children. It is frustrating that so much red tape seems to surround this issue though I fully realise the importance of ensuring that children are managed safely through their hospital stay. However I do feel that there is a lot of ‘misinformation’ about what is truly necessary by statute and what is merely ‘aspirational’. I believe there is a need for a BADS booklet on this issue and wonder if there are any paediatric specialist day units who would rise to the challenge? My idea is to have a simple guide to what is actually required and some examples of good practice. Please contact me if you feel you could help contribute to the production of this. I am surprised to hear from the Editor that colleagues have been slow to enter our competition which offers a free place at our next ASM in Torquay. I would have thought that many of you have dealt with a ‘challenging case’ through your day surgery unit and would value the chance to share your experience. In particular to explain how you managed the case and what (if anything) you would do differently the next time? We have extended the deadline for receipt of articles in the hope that some of you will have been inspired by the latest example in the journal. Finally having mentioned Torquay let me tell you that this promises to be a fantastic meeting, we have a great venue, a brilliant programme and it is at the seaside in June. Start organising your abstracts and travel plans now – see you there! Dr Ian Jackson BADS President.     January 2008 I can’t believe that another year is over and that my time as President of BADS will soon be over. I hand over to the reins to the capable hands of Mr Doug McWhinnie at the Annual Scientific Meeting (ASM). This will be held at the Spa Complex in Scarborough on the 19th and 20th of June. Hopefully by the time you read this the programme will be available on the website, however I can tell you that I believe the Meetings Group have excelled themselves this year. They have attracted some excellent speakers and North Yorkshire has beautiful scenery so I suggest you start making your plans to attend now. We plan to publish a BADS Day Surgery Unit Directory in time for the ASM and through the hard work of Dr Kate Williamson we are close to achieving this goal. It is important that you check that your unit is on our list so we have provided a link on the website so you can check your details are correct. Hopefully this will become a yearly publication so we can update unit details and add in anyone who finds they have been missed! I believe that 2008 will be a difficult year for the NHS in and that financial constraints will mean we will see an increasing postcode lottery for which treatments will be funded. Much newsprint is currently about the postcode lottery for expensive (usually cancer) drugs but it is interesting to see so little is mentioned about the non-availability of certain operations. Carpal tunnel surgery, arthroscopy, varicose vein surgery, tonsillectomy, forefoot surgery and even surgery for Dupuytren’s contracture have been or are being rationed in some areas across . I firmly believe that we should not provide surgery that has little or no proven benefit and I also agree that we need to balance the health budgets. However we must have equity of access across the and if certain procedures are seen to be no longer worthwhile then please let us ensure that this is applied across the NHS as a whole. It would be very useful for me to know what procedures are not being funded in your patch – perhaps this is another project that we should champion, please let me know what you think? In my last column I mentioned the Darzi Review. This should be well progressed now in your Strategic Health Authority and preliminary reports from each of the groups should be available for you to read. I have been heavily involved with our local Planned Care Group and it is becoming clear that both day and short stay surgery will play a fundamental part in the future of the NHS. It is also obvious that Primary Care and Secondary Care cannot continue as at present and that major changes in health services are likely. For example one interesting point being discussed is the viewpoint that 50% of all outpatient visits are not necessary and 50% of those remaining do not need to take place in the Secondary Care setting. If true this would cause major problems for Secondary Care due to the loss of a major income stream but it does start to change how health care should be provided. Having given you a little insight to what is happening with this review I would be grateful if you would check out the report from your local Planned Care Group to see that day and short stay surgery have been given suitable prominence. This is your opportunity to ensure that we continue to be at the forefront of the political process – remember you can also contribute to this review via the website ourNHS@dh.gsi.gov.uk. Happy New Year everyone.  April 2008 It hardly seems that a day goes by without an article about the NHS in the national press these days with the ‘Our NHS, Our future’ Review led by Lord Darzi being at the forefront (along with hospital acquired infections!). It appears to me that many colleagues are cynical about this review and often ask ‘why will things change? or what is going to be different this time round?’ To me there are many differences that may well ensure that this time things will change. The NHS has had levels of funding over recent years that it has never seen before and this has led to expansion of staff in many areas. With new appointments we have gained staff that are younger and more computer literate, and I believe these staff have a desire for change in the way they work. We now have Primary Care Trusts, Practice based Commissioners and Foundation Trusts that have had time to establish themselves and start to consider the way forward for the management of the health of their local populations. We also now have involvement of the ‘private sector’ within Independent Sector Treatment Centres and in Primary Care. It has also brought a large number of clinicians, nurses, General Practitioners, Pharmacists and many more staffing groups together to look at the way forward. This has never been done before in this way and there has also been attempts at public involvement – again at a level not seen before. There is now a large difference in the NHS compared to 10 years ago and I believe the review is well timed and could well bring about major change.  Indeed I am aware that within Strategic Health Authorities there is now talk not of the review itself but of how do we implement the local findings from the various groups. I am encouraged by this and so believe that things will change. This will be an exciting time for Day Surgery as this forms the backbone of elective care across the country and the need to develop it further has been recognised. I suggest you track down your local reports as these could provide support for development needs in your units. For those of you reading this in I wonder how you are getting on with the 18 Week pathway? My travels around the country suggest that a lot of us are ‘pedalling faster and faster’ but few are really trying to bring about major pathway change to provide sustainable systems. Perhaps I am wrong? If you have good examples of changes in clinical pathways for day and short stay surgery that have supported the move to 18 weeks then please let us know. This is a time for sharing and learning from each other and it would be just as useful to share details if something hasn’t worked. Winston Churchill once said ‘Those that fail to learn from history, are doomed to repeat it’, however if we have no shared history then I’m afraid we will all have no option but to learn from our own failures. The Annual Scientific Meeting is being held in The Spa Complex at Scarborough this year. This is an excellent venue overlooking the sea and the large area available for the Trade Exhibition has allowed us to attract more trade stands than we have had for many years. Therefore their will be much to look at during our breaks between the scientific sessions. I look forward to meeting and chatting to as many of you as possible during our time there.

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