Dear <<First Name>>
Time is passing quickly as 2022 is half over and we have a new executive team for the state committee. Before we introduce ourselves, we would like to clarify our intent, structure and roles. The Queensland State Committee over the past 3 years has been working toward structuring its office bearer positions to better reflect the surgical environment in Queensland. The deputy chair positions are responsible for the metropolitan and regional/rural contact and reporting, have been in place for 2 years. Currently, the secretary position provides support to the Chair in internal advocacy within the College and external advocacy with the government and the hospitals and health services. Consultant Event and Education Activities support the Committee and Office to deliver engagement activities in Queensland.  

The Committee will send out two different newsletters, one focused on advocacy (we want you to know that we support you) and the other a Queensland activities newsletter (yes, these are activities we want you to attend, hint hint). This is the first of the Advocacy based newsletter.

To further enhance the Committee’s work, it has linked with the leads of the Specialty Societies in Queensland. A meeting was held on 15 June 2022 to gather a cross section of issues which are currently being experienced in Queensland. It is anticipated that these meetings will occur 4 times a year. The State Committee will work with the Specialties in advocating on specific issues to the College federally and to State government. 

Listed below are a range of advocacy issues which the Committee has been developing and advocating on across the 3 year period. The issues are many, but the Committee is keen to support the Fellowship in achieving positive outcome for surgical service delivery in Queensland. 
The Queensland State Committee recently heard a presentation from Dr Chris Conyard and Dr David Bade, our Orthopaedic colleagues regarding the impacts of burnout and professional behaviours particularly on trainees and newer Younger Fellows. The results of the surveys were concerning. In keeping with the BRIPS recent EAG recommendation regarding “words to action”, the Committee is looking very closely at these outcomes and looking to further engage around the issues that were raised.  

Below is information on the current state of advocacy issues in Queensland and if you wish to raise anything in relation to these matters, we invite you to please contact the relevant State Committee member indicated below. 

Queensland State Executive

Results of the recent Queensland State Committee Election and Election of Office Bearers. Please contact any of these members if you have matters you wish to raise with the State Committee.

Office Bearers:

Dr Sanjeev Naidu - Chair - General Surgery
Dr Emilia Dauway - Secretary - General Surgery
Dr Roxanne Wu - Deputy Chair (Rural/Regional) - Vascular Surgery
Dr Elizabeth Hodge - Deputy Chair (Metropolitan) - Otolaryngology Head & Neck Surgery
Dr Joshua Grundy - Consultant (Education) - General Surgery
Dr Harsheet Sethi - Consultant (Events) - General Surgery

Elected Members:

Dr Garrath Evans – Urology
Dr Damian Fry – General Surgery
Dr Wayne Ng – Neurosurgery
Dr Simon Platt – Orthopaedic Surgery
Dr Matthew Hope – Orthopaedic Surgery
Dr Samantha Peden – Vascular Surgery

Co-opted Members

Dr Raja Sawhney - Plastic & Reconstructive Surgery
Dr Gian Capati - Queensland Younger Fellows Representative - General Surgery
Dr John Quinn  - Executive Director of Surgical Affairs - Vascular Surgery
Dr John North - QASM - Orthopaedic Surgery 

Ex-officio RACS Councillors

Professor Owen Ung - General Surgery
Professor Christopher Pyke - General Surgery
Dr Rebecca Jack - Vascular Surgery
Dr Sarah Coll - Orthopaedic Surgery
Adj. Professor Deborah Bailey - Paediatric Surgery

SOSS Project linking Metropolitan and Regional Surgeons
“Coming together is a beginning. Keeping together is progress. Working together is success.” Henry Ford

Both, the Surgical Advisory and State Committees, have supported initiatives developed within the Healthcare Improvement Unit of Queensland Health known as Save our Surgical Services (SOSS). The SOSS program is being developed with Qld Health (Health Improvement Unit) by Dr Sanjeev Naidu with support of the Qld State Committee RACS. Dr Naidu has presented this program to the RACS Rural Section and Dr Bridget Clancy Chair of the Rural Section of RACS has recently shared the Rural Health Equity Action Plan with the State Committee. It is agreed that these two programs are very well aligned in tackling how to deliver equity of surgical services to remote and rural areas via a collaborative links to support rural surgeons within specialty services, as well improving the rural pipeline from medical school through surgical training.

To support regional surgical services, the Queensland State Committee is exploring ways of formalising the relationships and networks between metropolitan and regional surgeons of the same specialty. Through the Get It Right First Time (GIRFT) initiative a structure was established in Queensland’s Orthopaedics with regular supportive interface occurring at quarterly meetings. The group, Queensland Directors of Orthopaedic Group (QDOG), is an excellent example of such collaboration and has been an outstanding success. The Queensland State Committee seeks to encourage similar groups and collaboration in other surgical disciplines.

We must remember that collaboration is about compassion, support, kindness and what we gain in the collective when we share and empower one another.

For further information, please contact David Watson. 
Monitoring Elective Surgery during the Covid-19 Pandemic

“Flexibility is the key to stability.” John Wooden

Although, there have been many improvements in society regarding Covid, in health care we are still facing new and ongoing challenges. The major issue in Queensland has been with furloughed staff with many thousands of staff either with Covid or needing to isolate as a close contact, not to mention bed capacity pressures. The impact has varied across individual hospitals particularly major tertiary centres, compared to some of our smaller metropolitan and regional hospitals.

RACS would strongly recommend that a blanket ban is not applied, but that a nuanced approach is taken to match recommencing elective surgery in each health service depending on staffing, PPE and bed resources. As the wave recedes private hospital Covid admissions should be stopped to free up private resources to do complex elective surgery including public cases needing critical care beds. 

Lastly, the College produced guidelines two years ago about the resumption of elective surgery for hospitals that have been severely impacted recommending to preferably commence less complex elective surgery (E.g. day surgery), but for other hospitals that have been less impacted more rapid resumption of normal services. These challenges provide an opportunity to learn to become more agile in our workflow while meeting the needs of our patients now and in the future.

For further information, please contact David Watson. 
Chief Surgeon Position

“Anyone can steer a ship, but it takes a leader to chart the course.” John C. Maxwell

The College would support developing a senior surgeon position within Queensland Health which would provide constancy in the development and implementation of surgical initiatives by government. This role would provide authoritative leadership, influence and engagement between health services and the College as shown below:
o    Improvement of healthcare standards that lead to reducing the gap for Indigenous care
o    Give advice to the Director General / Minister on broad strategic and specific surgical matters such as:
  • Elective surgery
  • Emergency surgery
o    Specialist outpatient services
o    Rural and regional recruitment and surgical training.
o    Improving sustainability of regional services
o    Development of innovative models of care
o    Interface with other specialty bodies 
o    Anesthetic
o    Critical Care
o    Emergency Care
o    Specialist Medical-Colleges
o    Surgical advisory committee
o    Proceduralists including radiology, ophthalmology, gastroenterology.
o    Facilitating engagement with the surgical workforce statewide via College networks to achieve patient-focused outcomes.
o    Work with hospital and health services and Directors of Medical Services on clinician engagement and professionalism plans
o    Standardization and alignment of processes and models of care (Operating theater flow, perioperative care, 7-day hospital)
o    Telehealth and virtual beds
o    Expert oversight that balances technical innovation and safety with whole of population need and cost to treat.

For further information, please contact Dr Sanjeev Naidu and Dr Emilia Dauway.
Medicare Provider Number
The Queensland State Committee has been considering options that would enable more Fellows to be available to provide regional/rural surgical services. One identified barrier supported by data is that too many provider numbers leads to overservicing. An option that has been suggested within the Committee is placing conditions on the Medicare Provider Number relating to supporting regional services. The Committee is aware from attending the consultation on the National Medicare Workforce Plan and other sources that this is already being seriously considered by the Federal Government.

For further information, please contact Dr Roxanne Wu or Dr Elizabeth Hodge.
Meetings with Specialty Societies

“Communication leads to community, that is, understanding, and mutual valuing.” Rollo May

Meetings with specialty societies have been instigated to provide feedback on matters of concern and to facilitate specialty groups working closely with the Queensland State Committee. As discovered in our recent meeting, there are many common issues across all specialties. The common issues raised in this meeting include: 

Surgical Capacity and Workload 
•    Outsourcing of waiting lists to private is being done to the detriment of training registrars.
•    Covid cancer diagnosis drop-off possibly due to an increase in the use of telehealth. This is resulting in more complex disease and necessary treatment which is further exacerbating demand.
•    The ability to deliver services isn’t keeping up with growing demand with population increases, Olympics, etc.
•    An increasing pool of unaccredited registrars who will never become surgeons is an untapped resource.

Regional/Rural Surgical Services 
•    Access to services is difficult in the Metropolitan area but is much more acute in regional/rural areas.
•    Discussions occurred regarding the SIMG processes.
•    Smaller specialties such as Paediatric Surgery would benefit from hub and spoke services supporting regional/rural areas, in addition to joint appointments.
•    Large gap of plastic surgeons in public hospitals between Sunshine Coast and Cairns

For further information, please contact David Watson.
KPI for Emergency Surgery

“The most important clotting factor is the surgeon.” Moshe Schein

A recurring source of frustration to surgeons and an economic disruptor is the lack of adequate resourcing for emergency surgery which contributes to increased complications, length of stay and mortality. Hospital and Health Service executives have a KPI for elective surgery emanating from NEST targets yet, there is no KPI for emergency or trauma.  Recent studies in Queensland have shown that a consultant led emergency service with adequate daytime lists leads to improved efficiency, patient flow, and decreased length of stay. Additionally, there is greater supervision for training registrars with emergency surgery in daylight hours and reduction in surgeon and registrar fatigue.  This can have a positive effect on theatre efficiency for elective surgery lists and greater surgical satisfaction with less overtime which could ultimately create cost savings. 

For further information, please contact Dr Sanjeev Naidu and Dr Emilia Dauway.
Post Fellowship Strategy 
There are a significant number of new Fellows who are waiting in Metropolitan areas in Fellow positions to get onto Post Fellowship programs. Their time may be better utilised in supporting the regions. It may be a better option to allocate them points towards a post fellowship program if they complete some regional/rural service. This is similar to what occurs as a component of the current SET selection process.

For further information, please contact Dr Roxanne Wu. 
Trainee and Newer Fellows Survey

“As you grow older, you will discover that you have two hands, one for helping yourself and the other to help others.” Maya Angelou

After listening to the presentations provided by Drs. Conyard and Bade, the Queensland State Committee is considering surveying (in conjunction with specialty societies) all specialties in a similar manner to recent research undertaken by Dr Chris Conyard in Orthopaedics in Queensland. This was also supported by a broader survey undertaken by Dr David Bade AOA Queensland Chair. This research revealed that 1 in 5 Younger Fellows wished they had picked a career outside of Orthopaedics. 53% of trainees met the criteria of the (physician value index) for burnout. We have limited time to train registrars and it is critical to embed the tools to be resilient in a surgical career. However, that said we must also consider there are those of us who struggle to find balance to support our own mental and physical well-being as consultants. This survey will help gain a broader perspective and understanding with hopes of highlighting the changes that are needed for us to support one another in surgery.

For further information, please contact Dr Emilia Dauway.
NEW - Queensland's voluntary assisted dying scheme
A survey of Queensland healthcare workers' perceptions and knowledge of the incoming voluntary assisted dying scheme, and of their willingness to participate in the process, is open now (closes 4 August). If you are a healthcare worker working in Queensland, you are encouraged to participate.
Queensland Charity Ball

The primary reason for holding this event is to raise funds for our chosen charity for 2022 - "The Pacific Islands Program" The RACS Global Health Team is implementing the Pacific Islands Program or PIP which currently covers 10 Pacific Island Countries. Global Health deploy teams to PIP countries to conduct complex surgical procedures and also to provide a range of clinical training to Pacific Surgeons and other health workers in order to improve the surgical care in those countries. We invite you to the RACS Queensland 2022 Charity Ball to support this worthy course and to enjoy a great night out with your colleagues! For more information about the Charity Ball and the Pacific Islands Program, please visit our website.

Date: 10 September 2022, 6pm
Time: 6pm Arrival
Venue: W Hotel
Dress Code: Black Tie 
View Provisional Program
Discounts available for purchasing a full table of 8. Contact for more details.
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