Anaesthesia specialty profile
Why you should deliver anaesthesia, perioperative medicine and pain management research in the UK
Anaesthesia, Perioperative Medicine and Pain Management is one of the fastest growing and most diverse research portfolios within the NIHR Clinical Research Network. Sixteen per cent of all hospital consultants are anaesthetists and the speciality has a well-earned and long-standing reputation for high quality patient care, research innovation and advocacy for patient safety. We care for paediatric, adult and obstetric patients, including patients who undergo elective and emergency surgery, and patients who require treatment of acute, and management of chronic, pain. Our diverse portfolio covers investigator initiated clinical trials, academic and industry sponsored studies as well as medtech research.
The NIHR Clinical Research Network provides researchers with the practical support they need to make research happen in the NHS and the wider health and social care environment. As well as providing research delivery staff, we also bring together communities of clinical practice to provide national networks of research expertise. The Anaesthesia, Perioperative Medicine and Pain Management Specialty Group is one of 30 such communities and our membership is made up of leading research-interested clinicians and practitioners at both national and local levels. Our job is to ensure that the Anaesthesia, Perioperative Medicine and Pain Management studies we support are delivered to time and target. We can provide rapid high quality protocol review, signposting to expert investigators in specialty areas, efficient and effective delivery of large and complex clinical trials, and direct links to: the National Institute of Academic Anaesthesia (NIAA), UK Perioperative Medicine Clinical Trials Network (POMCTN), Health Services Research Centre (HSRC) and patient engagement groups.
We can provide:
The Specialty Group includes highly engaged NHS consultants as well as clinical academics from top UK universities, bringing together both clinical expertise and vast expertise in academic and commercial clinical trials. In addition, representatives from the NIAA, POMCTN and HSRC ensure that the clinical community is well engaged. The anaesthetic trainee networks provide invaluable additional support with wide involvement from trainees in anaesthesia and perioperative care.
Access to participants
Anaesthetists care for a huge number of patients undergoing a wide range of procedures and over two thirds of hospital in-patients will see an anaesthetist. Patients may be undergoing treatments as diverse as chronic pain interventions, obstetric procedures, major cancer surgery or even sedation for radiological procedures - the one common factor is the presence of an anaesthetist. This provides a unique route of access to a wide range of patient groups.
Over 42,200 participants were recruited across England into 114 Anaesthesia, Perioperative Medicine and Pain Management NIHR Clinical Research Network Portfolio studies in 2018/19.
The Specialty have continued to deliver 100 per cent of commercial contract studies to recruitment target during their planned recruitment period, at confirmed Network sites since 2016.
The Speciality Group work closely with NIAA POMCTN - a network of local, chief and principal investigators who are active researchers in the field of perioperative medicine. Its focus is on large clinical trials but some smaller studies will be appropriate for POMCTN support, especially if these are likely to translate into subsequent larger trials. POMCTN supports research projects involving the recruitment of patients where the aim is to improve outcomes following surgical treatment.
Working with the Specialty Group, POMCTN builds working relationships between trial organisers and investigators in individual hospitals and promotes engagement with clinical trials. Studies in our specialty can apply for support and adoption by POMCTN. In addition, the highly effective trainee research networks across the UK provide invaluable support for the delivery of large-scale studies.
Research within our specialty is strongly supported by the NIAA HSRC. This is a hub for world-class anaesthetic research, including perioperative medicine, pain and anaesthetic sub-specialty research. The centre aims to help national and international anaesthetic communities improve patient care.
The specialty benefits from unique collaboration with the Research and Audit Federation of Trainees (RAFT), a trainee-led national group that networks together the multiple UK regional anaesthetic research groups. It aims to involve trainees in research studies within the NIHR Clinical Research Network Portfolio, facilitate research training and support national anaesthetic trainee-led projects.
Case study: The 2nd Sprint National Anaesthesia Project (SNAP2): Epidemiology of Critical Care provision after Surgery (EpiCCS)
This national prospective observational cohort study set up to describe the epidemiology of perioperative risk and outcome, and critical care referral and admission after inpatient surgery in the UK. A secondary aim is to estimate the clinical effectiveness of planned postoperative critical care admission as an intervention to reduce postoperative morbidity.
With the help of local CRN networks and co-ordinated efforts of R&D and trainee investigators, our teams were able to recruit 85 per cent of the total UK recruitment (33,424) participants across 203 sites in England.
Data has so far generated two journal articles. The first paper published in the BMJ highlights the problems of cancellations due to lack of hospital beds and critical care provision. The second paper provides in depth analysis on the availability of critical care beds for postoperative patients, and the latest estimates for postoperative critical care bed numbers in the UK, Australia and New Zealand.