AUGIS Newsletter Summer 2017
P. 1
President’s Message
Mr Richard Hardwick
A fair amount has happened surgeon. Only an organisation that
since my last missive. Most of the has these common clinical
important things relate to conditions in its sights can influence
politics, policy and service the provision of services and the
provision so I am going to focus quality of care for patients. AUGIS
on these in this newsletter. Stay produces guidance for its members,
with me, this is important stuff patients and provider organisations
that affects us all and, more on the full range of UGI conditions
importantly, our patients.
and is frequently invited to give
expert advice to policy makers.
Council met in January and
considered the future of AUGIS; This leads me nicely on to the
should it contract to become an recent discussions AUGIS has been
involved in looking afresh at the
association for upper GI cancer
and metabolic surgeons, or General Surgical training
continue trying to represent the curriculum. It currently pushes
entirety of upper GI surgery. The trainee surgeons into declaring a
conclusion was overwhelmingly in sub-specialty interest relatively early
favour of the later and I believe on (OG, HPB, Metabolic,
this is the right decision.
Colorectal etc.) and does little to
encourage General GI surgery as a
If you are a surgeon with in an specialty. The reality is that the way forward but have changed my
upper GI interest in a Hospital health service needs many more mind. This model may work in
which does not resect UGI cancers
general GI surgeons each year than large teaching hospitals serving
or perform obesity surgery, what is it does super-specialists. Many populations of 1-2 million but is not
your affiliation to AUGIS? My
trainees are consequently finding possible in most UK hospitals
answer to this question is that our that the consultant jobs available do serving smaller populations and the
focus needs to be on our patients not match their aspirations. The unintended consequences can be
and the clinical problems they majority of new Consultant posts negative (i.e. on call frequency). In
present with. Numerically, the currently being advertised are in addition, there is a strong argument
number of patients with gall
Emergency General Surgery +/- a
that GI surgeons dealing with
bladder pathology far outnumber special interest. The drive to undifferentiated abdominal GI
those with cancer. A poorly
improve outcomes for cancer emergencies should be able to
executed laparoscopic patients has been very successful confidently deal with all the
cholecystectomy can result in as and AUGIS is rightly proud of the common pathologies they might
much misery as a badly done part it has played in this. We now encounter. The balance between
gastrectomy. Gastro-oesophageal need to focus on the huge number being a specialist and a generalist is
reflux disease (GORD) is a very
of patients with non-cancer UGI difficult. As a patient, I would not
common problem but not every pathology who are struggling to get wish to have a “laparotomy and
patient gets symptom relief from proceed” done by a specialist who
timely, safe treatment. Some argue
medication; the surgical treatment that what is left of “general can only safely deal with half the
of GORD is complicated and the surgery” should separate even pathology they might encounter.
outcomes highly dependent upon
more and that each hospital should Likewise, I would not want an
patient selection and the have a different upper GI and under-trained generalist to “have a
technical skills of the
colorectal team on call. I will admit go” at something they have little or
that I used to think this was the
no experience of, in the day or
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