From the President

Another year over but the challenge goes on

John Skinner

As we enter December, we hope to get some peace, rest and recharge time with family and friends over the holiday period. It has been another tough year for the orthopaedic community and for our patients. I would like to start by thanking everyone involved in delivering orthopaedic and trauma care, and who have supported the NHS and patients in so many ways during the pandemic.

Our consultants, SAS colleagues, trainees, therapists, nurses and practitioners of all aspects of musculoskeletal care are coming to the end of a uniquely difficult two-year period. And I fear that we are not out of the woods yet.

The orthopaedic community has continued to provide a quality service through the heights of the pandemic and some trying conditions. There are many examples of new ways of working and innovation that have been developed by surgeons and surgical teams, to improve efficiency, effectiveness and provide better patient care. It is highly likely that many of these could be shared and adopted more widely. As orthopaedic surgeons we are nothing, if not practical, resourceful, forward thinking and good at solving problems. I would love the BOA to be a focal point to gather these ideas and then between us, find the best way to refine and disseminate them. If you have an idea that you would like to discuss and develop further, then please let us know.

We are fully aware of the difficulties being faced by colleagues with delivering both elective and trauma care at the current time. The health system is running hot and the demand for our services, seemingly limitless. We preside over the longest waiting lists that are not of our making and in so many parts of the country we cannot get access to the resource needed to reduce them. I can assure you that I and the BOA Executive, Council and Committees remain focused on these issues. I continue to meet with the four National Clinical Directors involved in the elective recovery and MSK delivery programmes. I have met with the NHS England Medical Director and meet regularly with the President of the Royal College of Surgeons of England.

My message always focuses on the issues of: sites, staff and strategy. On sites, we must protect and prioritise elective care recovery and this starts with preventing the orthopaedic care pathway from being used as a reservoir of beds, wards, nurses, theatre lists, theatre teams and anaesthetists to be deployed elsewhere at the drop of a hat. For this to happen there must be enough surge capacity elsewhere in the system to handle peaks in demand, as has now been provided for ITU care. We need Green Hub sites across the country where we can separate elective from emergency care to allow year-round elective operating. Our patients need and deserve this.

On staff, our survey results highlighted some important issues (discussed in more detail on our website at www.boa.ac.uk/wellbeing-survey. I am particularly concerned about the pension taper Tax and Lifetime earnings Laws and feel this must change to allow surgeons and anaesthetists to deliver the extra work that the NHS so urgently needs.

On strategy, we need to have ways to ensure that surgery can be delivered efficiently, year-round. We need to foster strong local leadership and support for the whole workforce involved in MSK care. The NHS clearly needs more front-line staff in nursing and theatre roles and these staff must be supported in order to maintain morale across the workforce.

Elective surgery is not optional and trauma care is urgent. Our patients really need their operations. I and the BOA Team will continue to lobby on all of these issues, on your behalf. I know it is frustrating and we will continue to do all we can to improve the landscape for our members and our patients.

On behalf of all at the BOA may I wish you a merry Christmas, a happy new year and a peaceful and restful time over the holidays.

Another year over but the challenge goes on