News Archive
EACTS 2010 Geneva 11th 12th September
You are invited to Geneva for the 24th Annual Meeting of the
European Association for Cardio-Thoracic Surgery, currently the world’s largest
meeting in Cardio-Thoracic Surgery.
This year, for the first time, a special programme will be held on Sunday, designed
primarily, but not solely, for nurses, physician assistants and other allied health
professionals. On Saturday we also offer you the opportunity to attend Techno-
College, the event for learning the latest techniques in cardio-thoracic surgery. The
planned programme offers opportunities for you to develop practical skills, discuss
important issues in practice and education, exchange ideas and learn from experts.
Held at the Palexpo Conference and Exhibition Centre, walking distance from
Geneva Airport, the conference is ideal for health care professionals who are
dedicated to delivering and improving quality health care to cardio-thoracic surgical
patients.
We look forward to seeing you in Geneva
For all details please follow the following link
EACTS Nurses and Physicians Assistant Programme
Book before September 4th to benefit from the reduced rate.
Posted on 16/08/2010.
Mid-term outcomes for Endoscopic versus Open Vein Harvest: a case control study
Mid-term outcomes for EVH vs Open Vein Harvest: a case control study
.Bilal H Kirmani†, James B Barnard†, Faisal Mourad†, Nadene Blakeman†, Karen Chetcuti† and Joseph Zacharias*†
Published today JCTS
Posted on 11/08/2010.
ACSA Executive Appointments
I would first of all like to offer my thanks To Paul Yea, who is stepping down from the position of educational Co-ordinator this year. He has worked tirelessly for the last three years in this position and many candidates have benefited from the well run revision course that he has worked on at the Royal Brompton.
Paul Yea has been nominated the position of Paediatric Chair, which I am sure he will do equally well in.
Bhuvana Bibleraaj has been nominated to take over the vacancy as Educational Co-ordinator, shared with Peter Bhinda. Her work towards the SCTS abstracts and presentations in the past has set her in good stead for this position.
Posted on 07/08/2010.
ACSA Thoracic Symposia CANCELLED
Due to a lack of applicants the difficult descision has had to be made to cancel this meeting. It is a great disappointment at this time to all the team involved, however we will review our programme for the meeting in March and maybe able to feature some of the programme within this.
Posted on 08/09/2010.
SCTS Annual Meeting/ ACSA AGM
The
ACSA AGM will form part of this years Society Meeting on Monday 21st
March 2010. To help members to attend ACSA will support members by refunding their registration fee for the Monday of £40. This will be refunded on the day so you will need to register through the SCTS admission (see below for details).
If you would like to attend the Society
University on the Sunday 20th their will be an additional fee of £20 which
members will need to find themselves. PLACES FOR THIS ARE LIMITED so it is
recommend that if you are interested then you will need to register for
this as soon as possible.
Please see events page to see further details |
Posted on 19/11/2010.
NHS White Paper: ‘Equity and excellence: Liberating the NHS’
NHS White
Paper: ‘Equity and excellence: Liberating the NHS’
Dear
colleague
Over the last
six and a half years, I've met NHS staff in hundreds of hospitals, surgeries and
clinics. I have seen how enthusiastic you are for the work you do. Too often,
however, you have told me how frustrated you are by bureaucracy and tick-box
targets that get in the way.
No-one wants
upheaval in the NHS. But no-one believes things can stay as they are. Today, I
am setting out a strategy for the NHS which will create stability for the
long-term. It will let you focus on your patients, on how to deliver high
quality care, and on the results you achieve. For those responsible for services
for patients, it means much more control of what you do. And it means cutting
back on unnecessary administration, targets and bureaucracy. We know we have to
do this, to use money better to meet continually increasing demands on our NHS.
I know
phasing out PCTs and SHAs is a big step, but in reality I can't give more
control and responsibility to those closest to patients - General Practice,
community services, hospitals – without cutting back the tiers of management.
The objective is straightforward. Those responsible for caring for patients
should have more control of resources. Patients should share in decisions about
their care. Doctors and nurses should lead the delivery of care and be
accountable for the quality of care. Management should support this, not
override it. Nationally, we in Government should focus on what we aim to
achieve, not try to tell you how to do it. And the "what" is simple:
health outcomes that are among the best in the
world.
I do hope you
will read the White Paper, "Equity and excellence: Liberating the NHS", and that
you will engage in the consultation. The White Paper and supporting material can
be found at www.dh.gov.uk/liberatingthenhs
Posted on 13/07/2010.
Doctor hours law 'failed patients', surgeons say
The Royal College of Surgeons said creating a 48-hour limit on the working week had "failed spectacularly".
About 80% of 980 NHS surgeons and surgical trainees surveyed said care had worsened since the European Working Time Directive started last August.
A Department of Health spokesman said the way the directive was being applied was "clearly unsatisfactory".
The rules were designed to stop doctors working up to 80-hour weeks that were commonplace under the old system.
But the RCS - which surveyed surgeons and surgical trainees in all nine surgical specialties - warned the changes had left hospitals overstretched and much less safe than they were a year ago.
More than a quarter of senior surgeons said they were no longer able to be involved in all of the key stages of a patients' care, up from 18% in October 2009.
The survey also found two thirds of junior surgeons said their hours in training had been cut - a quarter more than a year ago.
More than 60% of consultants who used to do surgery assisted by trainees said they were now often forced to operate alone, while 45% of consultants and 37% of trainees reported "inadequate handovers".
In addition, more than half to those surveyed said they consistently worked more than the permitted hours because of stretched rotas.
'Great problems'
RCS President John Black said surgeons not only thought patient safety was worse, but doctors' work and home lives were also poorer for it.
"To say the European Working Time Regulations has failed spectacularly would
be a massive understatement.
"There is not a moment to lose in implementing a better system which would enable surgeons to work in teams, with fewer handovers and with the backup of senior colleagues," he said.
Charlie Giddings, president of the Association of Surgeons in Training, said "new innovative solutions" were needed, "rather than the minor short-term tweaks that artificially produced compliance at the expense of training and patient care".
Howard Cottam, president of the British Orthopaedic Trainees Association, said the directive had "largely failed" and the system "remained reliant on the professional integrity of trainees who continue to cover the gaps in the rota".
A spokesman for the Department of Health said: "The health secretary will support the business secretary in taking a robust approach to future negotiations on the revision of the European Working Time Directive, including maintenance of the opt-out.
"We will not go back to the past with tired doctors working excessive hours, but the way the directive now applies is clearly unsatisfactory and is causing great problems for health services across Europe."
The survey covered all Strategic Health Authorities in England as well as surgeons based in Scotland, Northern Ireland and Wales.
The RCS said it endorsed calls for a working week of up to 65 hours - including time spent on-call - to provide the ideal balance between adequate training opportunities, good patient care and work-life balance
Posted on 01/08/2010.
CHRE Response to managing Extended Practice
Please find below the CHRE’s latest report - Managing extended practice: Is there a place for ‘distributed regulation’:
The report examines how regulators manage the risks when health professionals extend their practice into another profession’s domain. More information on the work, including a synopsis, can be found using the following link:
CHRE WEBSITE
http://www.chre.org.uk/satellite/200/
CHRE Managing extended practice: Is there a place for distributed regulation
CHRE Letter to the UK Health Departments
Posted on 07/07/2010.
ISMICS 2010 EVH Update
This Summary was produced by
Mark Fitzpatrick, Business Development Manager in Cardiac Surgery from Maquet Limited.
The International Society of Minimally Invasive Cardiothoracic Surgery (ISMICS) met for its 2010 annual meeting last week (June 16-19) in Berlin, Germany. The following recap provides an overview of key activities and presentations.
Luncheon Symposium – June 17
MAQUET CS sponsored a luncheon symposium entitled, “Open Vein Harvest Is NOT Minimally Invasive Cardiac Surgery: Best Practices in Endoscopic Vein Harvest for Optimal Patient Outcomes.” In light of the recent discussion focused on EVH, the symposium was structured to meet two major objectives: (1) reinforce the enormous clinical benefits of EVH and (2) review and reinforce EVH “best practices” to support world-wide adoption of EVH as the standard of care. Symposium participants and their topics are listed below:
Faculty:
Anthony de Souza, MD (Moderator) – United Kingdom
“The Harefield EVH Experience – Implementation & Clinical Impact”
Toufan Bahrami, MD – United Kingdom
“Clinical Benefits of EVH – The Ludwigshafen Experience”
Udo Weisse, MD – Germany
“Best Harvest Practices To Optimize Conduit Quality and Patient Outcomes”
Robert Poston, MD – United States
The symposium was well attended and speaker presentations were extremely positive and supportive of continued practice and further adoption of EVH. Mr. Bahrami’s talk focused on key political and procedural challenges faced during adoption and provided compelling data on the dramatic reduction in wound complications experience at Harefield Hospital. Dr. Weisse presented information similar to what he presented at EACTS this past October, including reduction in complications as well as specific data addressing the learning curve and documenting no impairment in conduit quality. Following reinforcement of the clinical and economic benefits of EVH, Dr. Poston reviewed key elements of “best practices” (harvester experience, not pressuring the harvester about time, pre-administration of 2500 units heparin, and avoidance of vessel distension).
Members of the audience shared their EVH experiences and asked questions about technique and procedure. Consistent with prior discussions, need for additional data supporting long-term safety and durability of EVH was deemed important. In addition, the audience and panel discussed safely how best to negotiate the learning curve, including use of training simulators and imaging to document harvester proficiency.
Moderator, Mr. de Souza, reiterated the need to continue to improve EVH rather than return to open harvest; he closed the session by underscoring that cardiac surgery should not go backwards and that long harvest incisions were incompatible with ISMICS goals of reducing the invasiveness of CT surgical procedures.
EVH Data
Three EVH papers were presented in the June 19 scientific sessions:
The impact of endoscopic vein harvesting on outcome of first time Coronary Artery Bypass grafting surgery Niv Ad1, Linda Henry1, Sharon Hunt1, Paul Massimiano2, Jenny Lee1, John Rhee2, Lucas Collazo2. 1Inova Heart and Vascular Institute, Falls Church, VA, USA, 2Cardiovascular and Thoracic Surgical Associates, Falls Church, VA, USA.
Long-term (average ~ 2 years) clinical follow-up of 1,988 non emergent patients presenting for first time CABG surgery from 2006 to June 2009 (n=1734 EVH, n=254 open)
The use of endoscopic techniques to harvest the SVG did NOT result in increased morbidity or mortality as assessed by the number of vein closures, incidence of myocardial infarction or the rate of death. Consistent will all prior research, EVH patients had decreased leg infections. Investigators concluded that EVH is safe and effective.
These are additional data countering the PREVENT IV report of increased adverse clinical outcomes, including mortality.
Impact of the learning curve for endoscopic vein harvest on conduit quality Pranjal H. Desai1, Ashish Vyas2, Richard Tran1, Anthony Ng1, Tara Melillo1, Soorosh Kalani1, Robert Poston1. 1Boston University School of Medicine, Boston, MA, USA, 2Saint Vincent Hospital, Worcester, MA, USA.
OCT imaging study comparing “experienced” (>1000 total cases, >30/month) vs. “novice” (<100 cases, <3/month) harvesters.
On average, vein injuries were two times greater for novice harvesters than for experienced harvesters. Implication: training is particularly important as is close supervision to monitor harvester technique during training and early clinical application of EVH.
Finding the lowest possible dose of heparin that prevents intraluminal clot retention during endoscopic vein harvesting Pranjal H. Desai1, Ashish Vyas2, Alex Brown1, Richard Tran1, Pluen Ziu1, Dinesh Kurian1, Robert Poston1. 1Boston University School of Medicine, Boston, MA, USA, 2Saint Vincent Hospital, Worcester, MA, USA.
The lowest effective heparin dose for reducing retained clot is 2500 units.
Clampless Beating Heart Data
Avoidance of Aortic Clamping Is Associated With Fewer Intraoperative Cerebral Emboli Even In Patients Without Significant Atherosclerosis of The Ascending Aorta: Results of a Prospective Randomized Trial Hisham El Zayat, Scott Hwang, Michael Halkos, Vinod Thourani, Omar Lattouf, Patrick Kilgo, John D. Puskas. Emory Univ, Crawford Long Hospital, Atlanta, GA, USA.
A poster presentation by Emory University provided additional support for the effectiveness of avoiding aortic manipulation during OPCAB. Use of Heartstring was associated with significantly fewer solid emboli than partial clamping, even in a patient population with minimal/mild aortic atherosclerosis. Further, gaseous emboli associated with Heartstring use were significantly minimized with use of suction rather than blower-mister to maintain bloodless field for adequate visualization.
Regards
Mark
Posted on 02/07/2010.
New NICE Guidance for EVH
NICE have updated their guidance regarding Endoscopic Vein Harvest. You can download the document below.
Posted on 07/06/2010.
AfC Pay Circular
The NHS employers have issued the pay circular for the pay increase to be implemented on 1 April 2010 which is the final part of the three year pay deal. Download this below.
Posted on 23/02/2010.
Response to Council for Healthcare Regulatory Excellence
The Council for Healthcare Regulatory Excellence (CHRE) has appealed for a response to the proposal of 'Distributed Regulation' for SCP's. This means that essentially you will remain registered with either the NMC or HPC but annotations will be added to your entry on the register once the agreed training and practice standards have been met. The registering body would investigate any issues around fitness to practice, but might need to give due regard to professional advice and assitance from the bodies involved with setting training and practice standards.
ACSA has collected viewpoints from members and provided the response below.
CHRE Proposal
Posted on 11/02/2010.
Short and Mid term Outcomes of EVH vs OVH
An article in the Annals of Thoracic Surgery that has reviewed a series of patients between 1998 and 2007 looking at EVH vs Open vein harvest has recently been published. You can download a copy of this below.
EVH vs Open Review article ATS
Posted on 08/02/2010.
Vacancy Guys an St Thomas'
Surgical Care Practitioner Posted on 16/03/2010
Are you looking for an exciting challenge? An exciting opportunity has arisen for an experienced person to join an established team of experienced Cardiac Surgical Practitioners in... join five other Cardiac Surgical Care Practitioners... Based in the Cardiac Theatres complex within... surgical procedures within cardiac theatres. You will... broad spectrum of Cardiac diseases. With a... the management of Cardiac Surgical patients and...
http://www.jobs.nhs.uk/cgi-bin/vacdetails.cgi?selection=912446226
Posted on 16/03/2010.
Vacancy In Sheffield
Job Title: Cardiac Surgical Care Practitioner - South Yorkshire Regional Services Location: Sheffield Type: Permanent Salary: £24,831 - £33,436 pa/ £29,789 - £39,273 pa To view the full job description please click the link below:
http://www.jobs.nhs.uk/showvac/QDquil/2265690/912443090
Posted on 12/03/2010.
Vacancy Surgical Care Practitioner - Band 7 Cardiff
An exciting opportunity for an enthusiastic and skilled Cardiac Surgical Care Practitioner (SCP) to work in a busy, progressive Cardiothoracic Unit within a University Teaching Hospital. The Cardiothoracic Directorate at the University Hospital of Wales provides cardiology and cardiothoracic services to local as well as tertiary patients across South East Wales.
As part of our team of SCPs and surgical assistants, you will undertake conduit harvest (including training in endoscopic harvest techniques), assist in a full range of adult cardiothoracic procedures, and be involved in the training of junior staff. As a trained practitioner, the ability to plan, organise and prioritise your work, and be flexible in your approach to working in a fast-paced environment is essential. You must have completed a recognised training program as a Surgical Care Practitioner, have a current registration with either the Nursing and Midwifery Council or Healthcare Professions Council and have previous experience in assisting and conduit harvest for cardiac surgical procedures. There is future potential for the role to be developed outside the theatre setting, and support will be available for training in this area. The role requires someone with excellent communication and inter-personal skills, with the ability to work well within a multi-disciplinary setting.
Posted on 13/04/2010.
ACSA SCP/SA role survey
The Society of Cardiothoracic Surgery recently sent out a survey to try and capture the role of the advanced nurse practitioner roles. It was felt that this didn't represent the SCP/SA role in it's entirety. After discussions it was agreed that the SCP's would be surveyed separately in this modified questionnaire. Please complete before the 1st February 2010
Posted on 10/01/2010.
Reponses to NEJM EVH vs Open
In July the New England Journal of Medicine published an article which caused some controversy amongst the Cardiothoracic community. This article has been widely debated and will be discussed at our meeting in March. In the meantime the NEJM has now published the responses to this article.
You can download the original article and the responses here.
Posted on 15/12/2009.
WHO Checklist
The World Health Organisation has developed a surgical safety check-list for patients with the view that this is a mandatory procedure prior to anaesthesia, skin incision and the patient leaving theatres. The SCTS has taken this and added a few extra steps to fit in with standard Cardiac surgery (available here). Thoracic patients will follow the standard check-list.
Posted on 09/12/2009.
Congratulations to the successful candidates
ACSA would like to congratulate the 19 candidates that successfully completed the Royal College of Surgeons Exam for Cardiothoracic Surgical Assistants in November.
A special mention goes to Amy Bradburn from Papworth who succeeded in getting a distinction. This was the highest number of candidates ever taking the exam and is a testament to the growing size of SCP's in this speciality. Well done to all those who succeeded and commiserations to those that were referred this time.
Posted on 26/11/2009.
Want to join one of our Specialist Committees ?
We are looking for members of ACSA who are motivated to join one of our three specialist committees: Cardiac (Adult), Thoracic (Adult) or Paediatrics. A chair for each of the three specialities depending on applications will be appointed at our AGM.
To find out more go the Vacancies section under About Us (here).
Posted on 13/10/2009.
Reduced rate Indemnity cover
After several requests from members,
we have successfully negotiated a reduce rate indemnity
subscription with the Medical Protection Society (MPS) for ACSA
members.
The Medical Protection Society is
the leading provider of comprehensive professional indemnity and expert
advice to doctors, dentists and health professionals around the world.
They are a mutual, not-for-profit medical defence organisation,
offering more than 260,000 members help with legal and ethical problems
that arise from their professional practice. This includes clinical
negligence claims, complaints, medical council inquiries, legal and
ethical dilemmas, disciplinary procedures, inquests and fatal accident
inquiries.
You can download applications on line by clicking (here).
Posted on 13/10/2009.
SCTs 'Society University' Sunday 7th March 2010 Liverpool convention centre.
This coming March members for the first time have the opportunity to join with the surgical trainees' educational meeting. This will be held on the morning of Sunday 7th March, prior to our own AGM. This is an exciting opportunity to have access to society supported teaching, meet up with our surgical colleagues and share in this valuable experience. Lunch will be provided as part of the day prior to our AGM. For more details click events (here).
Posted on 13/10/2009.
Representation within the Society of Cardiothoracic Surgery
As many of you know we have been seeking to have more representation with the SCTS which until now has been turned down. However we have recently negotiated a change in this decision and as of November 2009 we will have representation within the Board of Representatives. This meets twice per year and gives the association opportunity to voice any concerns or issues directly to their executive. Please get in touch in writing if you have any issues or concerns that you would like to be discussed. The next meeting is 27th November 2009
Posted on 13/10/2009.
