High quality training will be required to deliver integrated perioperative care in the NHS. Postgraduate medical training shapes careers that will span 30 years or more and it is essential that this training reflects the organisation and conduct of clinical practice that will provide the best possible care for patients. Much of the infrastructure and mechanisms are already in place, and many of the skills required are already identified in the various medical CCT (Certiificate of Completion of Training) programmes.
Setting standards
Royal Colleges are responsible for defining the curricula for training, and ultimately for setting standards in the provision of perioperative care for patients. These curricula are currently under review and some, like the CCT in Anaesthetics, have already changed to incorporate more perioperative elements.
Training is embedded in the work of all hospitals in the UK, and underpins clinical standards, academic quality and innovation. By developing training in perioperative care, the colleges will support the development of a future consultant workforce that is able to provide the best possible care for patients in the NHS. Trainees themselves recognise this and its importance. Colleges also recognises the importance of training in perioperative care at undergraduate and Foundation level and we hope to work with medical schools and the Foundation Programme to develop this.
Workforce
In terms of workforce training, perioperative care provides both challenges and solutions. The Centre for Workforce Intelligence (CfWI) in-depth review on anaesthesia and intensive care medicine identifies a 25% under supply of anaesthetists and intensivists up to 2033. This projection does not include the need for perioperative positions, which may create further strain on workforce supply.
Conversely, improved patient pathways present an opportunity to use the acute care workforce more effectively. The work of the perioperative care team may reduce demand for anaesthesia and intensive care medicine in the future although this is difficult to model. CPOC will work together with its partner colleges and specialties, and workforce planners in Health Education England (HEE) and the devolved nations, to explore perioperative care solutions to create a better workforce for the future.
