President's annual report

'Advocacy, community and education are our key areas of work as we strive to strongly represent and support you, and to promote the perioperative safety of your patients.'

Ngā mihi nui kia koutou katoa,

In what has been such an uncertain, unpredictable, tumultuous year for all of us, but particularly those on the frontline of health, I thank our Executive Committee, subcommittees and networks, as well as our staff, for their commitment to our anaesthesia community. This commitment and hard work have enabled us to continue building on the momentum of constructing a strong, connected anaesthesia community. Our NZSA Conference is just one notable example of this commitment – even through the uncertainty of lockdown levels and case numbers, and not being sure what the future held, members of our Executive Committee stepped up and forged ahead to offer members a conference. Even though they knew it would be challenging to pull off organising a conference in just four months (when usually it takes at least a year, if not more) they have delivered a high calibre programme and speakers. The reasons were twofold: one, to give members an opportunity to gather CME points in a year where CME options were seriously curtailed; and more importantly as the conference name suggests, to give anaesthetists and the wider anaesthesia community the opportunity to connect. This of course aligns strongly with the NZSA’s wider strategic goals of supporting the profession and building a strong, connected community. I thank them for their sterling effort. 

In what was such a disruptive year, I am proud of the NZSA’s fortitude and solid platform which enabled us to effectively continue our three pillars of work – advocacy, community, and education. The plans that we had made at the beginning of the year were somewhat derailed as COVID took over these areas – however we did advocate on COVID issues to the Health Minister and the Ministry of Health, along with other stakeholders, continued, and even increased the frequency of our sub-specialty network meetings, and regularly kept members informed of COVID news and research.

We continued to see steady NZSA membership growth, which I think can in part be attributed to our continuing engagement in the anaesthesia community – especially through our sub-specialty networks, and regular hospital department visits. The latter enabled our Executive Committee to speak to colleagues about the value of being a member and supporting the distinct, and integral role that the NZSA has as an independent voice on issues unique to New Zealand anaesthesia.

My report of the year’s activities follows. It is a succinct summary and by no means exhaustive – however I trust that it provides a good overview.

COVID has shaken the foundations of our globalised world and shown us that we need to change the way we do things to ensure human survival; the status quo is no longer an option and we recognise there needs to be a new normal. This year we asked ourselves, how can we contribute to the new normal?

Our advocacy provides the specialty with a strong collective voice, which is evidence based and considered. This was arguably never more apparent than this year. We continued to strengthen our relationships with ACC, the NZ Private Surgical Hospitals Association, and the Health Ministry. We look forward to communicating our advocacy work to whoever the Minister of Health is after the election. We assisted the Ministry of Health through the initial phase of COVID response and liaised with top health officials over the uncoordinated procurement and distribution of Personal Protective Equipment (PPE). We were also in regular contact with PHARMAC on supply of core anaesthesia drugs and will continue to engage on their medical devices procurement project. This will be a big part of our advocacy work in 2021.

A key part of our advocacy is responding to proposed policies, legislation and standards from government and health sector organisations. This was a quieter year for submissions, however we provided input on issues such as professional behaviour of doctors, medicinal cannabis, anaesthesia assistant shortages and training, and proposed changes to RMO training start dates.  

 The NZSA is a strong advocate for anaesthetists working in the private sector. Our Private Practice Sub-Committee meets and communicates regularly with ACC and the NZ Private Surgical Hospitals Association, and we provide advice, updates, and resources to members on issues relevant to private practice. In the latter half of this year we have made good progress on our revision of the Relative Value Guide.

Fostering and supporting a strong anaesthesia community is integral to the NZSA’s vision and mission. Our subspecialty networks have raised their profile, and there is growing recognition of their value to individual practitioners, the Society and patient care. They are a forum for the dissemination of ideas, protocols, guidelines, and evidence-based medicine. When I began my Presidential term in late 2018, we had PANNZ (paediatrics), NOA (obstetrics), airway leads, private practice and the Global Health Committee (formerly NZSA Overseas Aid Committee). In the last year we formed and supported the Environmental and Sustainability Network and the Inpatient Pain Network. Many of these networks met frequently during COVID to share information e.g. what level of PPE we should be wearing in droplet or airborne precautions for labouring women.

Connecting newly qualified and more experienced anaesthetists creates the opportunity for the retention of institutional knowledge – about what has been tried, what has failed, and what has succeeded previously. Sharing information across the country means less reinvention of the wheel and more initiatives that are likely to succeed.

Our anaesthesia community of course reaches beyond New Zealand shores, and we have continued to build collegial, enduring connections with our overseas society counterparts – particularly through the Common Issues Group (CIG). We met regularly with the CIG this year and shared our experiences of COVID, and resources such as webinars, which we made available to members. Our connection with the WFSA also continued – unfortunately the World Congress in Prague was postponed but on the good news front we saw the election of Dr Wayne Morriss as WFSA President elect, and the successful candidacies of Dr Sue Nicoll (wellbeing committee) and Dr Indu Kapoor (paediatrics committee).

Supporting the wellbeing of anaesthetists remains a priority and it has certainly been a tough year placing many of us under more stress. Wellbeing is a complex and challenging issue, however I am heartened by the commitment of many in our specialty to de-stigmatise the conversation around mental health, to improve understanding of mental ill health triggers (individual and systemic), and to provide support e.g. Long Lives, Healthy Workplaces resource. The momentum of activity in this space did fall in 2020, however we will be looking to pick up this work in 2021, especially with mentor training which we began last year.  

I would like to thank our Global Health Committee for supporting our Pacific colleagues and I know they have many plans for next year (e.g. locum support, funding education) to build on this support and their dedication to grow the Pacific anaesthesia workforce. We are also investigating ways of increasing our profile and marketing our speciality to a more diverse medical student workforce; in the first instance recognising our Maori and Pasifika trainees and consultants as well as encouraging anaesthesia as a career choice to all junior doctors.

In 2020 many of our educational offerings, such as the CSC and AQUA, were either cancelled or postponed. However, many of us took part in webinars and other online offerings... We are extremely fortunate to be able to deliver our NZSA conference, and again thank you to the OC for pushing through despite the obstacles.  It is also very encouraging that a mini Part 3 course is being offered at this conference. Anaesthesia trainees have been under considerable stress, and I think in addition to hearing about the transition to becoming an SMO, it will be of great value for trainees to connect and share their experiences.

Closing remarks
I would like to thank all members for your support, and especially those who have contributed to the NZSA’s work – such as volunteering on our networks, attending our conferences, coming along to our hospital department visits, or providing input into our submissions, or resources e.g. the RVG revision. Your feedback and engagement are vital to the Society on many levels – it makes us more responsive, better informed, and more representative of you. This enables the NZSA to evolve, to move forward, and to be sustainable for a future generation of anaesthetists. And at the core of all this, and what ultimately drives us, is our patients and wanting a stronger, and more equitable healthcare system. 

As my Presidency comes to an end, I would encourage members to stay connected and engaged with their professional society. Read our publications, follow us on our social media platforms, and visit our new, revamped website to keep up with our work on your behalf. Talk to non-member colleagues about the society and help us continue the steady membership growth of the last four to five years.

I look forward to seeing you at next year’s ASM in Christchurch.

Ngā mihi mahana,

Kathryn Hagen

The NZSA provides a strong, credible and well-respected voice for the profession, and input on proposed policies, legislation and standards. We provided feedback on a broad range of topics via submissions and stakeholder meetings in 2019 including:

– Environmental sustainability (especially as it relates to the environmental impact of anaesthesia)
– Medical device procurement under PHARMAC
– End of Life Choice Bill
– Professional self-regulation
– Cultural competence and health equity
– Informed consent
– Recertification
– Fatigue management
– Training of anaesthesia assistants and working to bridge AA shortages.

The NZSA is also a strong advocate for anaesthetists working in the private health sector. Our Private Practice Sub-Committee meets regularly with ACC and the NZ Private Surgical Hospitals Association, and we provide information to members on issues relevant to private practice. We began a project to revise our Relative Value Guide, and an updated version will be released in 2020.

Forging information sharing and connection among our members helps to build a strong anaesthesia community. Our networks have been a major driver behind our progress in this area.

Our subspecialty networks provide collegial and professional support for members, especially those working in smaller, more isolated centres. They’re also a great source of information sharing and learning. In 2019, we added to our existing networks (paediatrics, obstetrics, airway leads), with the formation of the Inpatient Pain Network, and the Environment & Sustainability Network. Both networks hit the ground running from day one.  The Inpatient Pain Network, driven by Dr Mike Foss, held a very well attended event in November supported by the NZSA, which spoke volumes about the need for this network, while the E & S Network has provided a strong voice to help shape policy and legislation on environmental issues, such as the landmark Zero Carbon Bill passed last year. They are also educating anaesthetists on how we can reduce our carbon footprint – we now have a regular Q & A section on the environment and kickstarted this with one in December 2019 on waste disposal. Succinct and practical measures you can adopt to make a difference!

Mental health and wellbeing:
Our work to promote wellness amongst anaesthetists is at the forefront of much of what we do, and we continued to gain momentum in 2019. While this is a challenging area, we are committed to de-stigmatise the conversation around mental ill-health and to provide resources to assist our colleagues. In addition to sharing information on wellness in our member communications we held a mentor training day to build the pool of mentors available for New Zealand anaesthetists. We are also working collaboratively with others, including the ANZCA Welfare Advocates Network, and the Wellbeing Special Interest Group.

Overseas Aid:
Looking further afield, whilst our support for our anaesthesia colleagues in the Pacific is longstanding, I would like to highlight the support of our Overseas Aid Subcommittee for the Pacific Society’s Annual Refreshed Course in August. OASC organised for a record number of locums from NZ to work in the Pacific to enable Pacific Fellows to attend the Refreshed Course – thank you to Dr Indu Kapoor for leading this work and the others who assisted.

The NZSA facilitates and promotes education and professional development for anaesthetists at every stage of their career. Here are some highlights:

  • Hosting the combined AQUA + Annual Scientific Meeting (August) with NZNC and the JAFA Trust which reached full registration even faster than we predicted! We received incredibly positive feedback from attendees.
  • Hosting the Part 3 Course for advanced trainees to make the SMO transition easier.
  • Speaking at the Part O Course run by ANZCA NZNC.
  • Sponsorship of the Annual Registrars’ Meeting.
  • Providing education prizes (John Ritchie Prize and Poster Prize) at the ASM in Queenstown.
  • Co-administration of the Visiting Lectureships with ANZCA NZNC, which provides regional hospitals with the opportunity to hear top notch presentations from anaesthetists working in our country’s city hospitals.
  • Enabling trainees to complete fellowships overseas via the BWT Ritchie Scholarship, jointly offered with ANZCA NZNC. We have now expanded the criteria for this fellowship and encourage you to find out more on the Aotearoa New Zealand Education Committee website.
  • Support for the Anaesthesia and Intensive Care Journal to advance research and education.
  • Underwriting of the webAIRS platform, an online incident reporting system which captures data reporting of anaesthesia morbidity, mortality and near misses.
  • Trainee Grant for a trainee to attend the Pacific Society of Anaesthetist’s annual Refresher Course.

I would like to thank Dr Kerry Holmes who in 2019 concurrently held the roles of NZSA Education Officer, Chair of the NZ Anaesthesia Education Committee and co-convenor of the combined AQUA + ASM. He did a sterling job in all these roles and his passion and drive for education really stood out. We are sorry to see him and Dr Nicole Vogts leave our Executive committee, however we are very pleased to have welcomed Drs Renee Franklin, Jonathan Panckhurst and Michael Wadsworth onto the Executive.

Thank you again to all those who have volunteered their time, knowledge and expertise to support the NZSA and our specialty, to all our members for your loyalty, and of course to our dedicated staff at the Wellington office.

Ngā mihi

Kathryn Hagen