This page showcases the Royal College of Surgeons of Edinburgh's commitment to advancing surgical practice through impactful reports, innovative campaigns, and rigorous research. Our annual reporting highlights the progress and achievements that contribute to enhancing patient care and fostering excellence in the surgical community.
RCSEd Reports & Campaigns
The Campaigns and Reports section highlights the key initiatives and publications of the Royal College of Surgeons of Edinburgh and its partners, focusing on their advocacy, research, and policy efforts to enhance surgical education, practice, and patient care globally.
The College is pleased to announce a new RCSEd report addressing the under-representation of Black surgeons. While 46% of NHS medical staff are from non-white backgrounds, only a small number of Black students pursue medical careers, and NHS data shows fewer than 900 Black surgeons and just 190 Black surgical consultants in England. This under-representation reflects longstanding socioeconomic, cultural, and historic barriers. Although the report does not offer specific solutions, it emphasises the need for collective action to promote a more diverse surgical workforce, and the College is committed to collaborating with all concerned parties.
In 2019, RCSEd carried out a survey which evidenced the extent of non-consultant hospital doctors’ concerns about different aspects of their ability to deliver out of hours care. The RCSEd Trainees' Committee have written a report which uses this survey data and examples of best practice to provide a proactive guideline to support trainee surgeons. The report considers the results of the survey to make recommendations on best practice that will support non-consultant hospital doctors' and protect patients out of hours.
In the 1990’s Leicester University established a link with Gondar University to promote healthcare delivery and education in Gondar, one of the larger Ethiopian cities situated in the Amhara region in northwest Ethiopia.
Launched in July 2017, the Royal College of Surgeons of Edinburgh published a number of critical recommendations to government to greatly improve safety in the delivery of surgical treatment and patient care, with seven simple recommendations for best practice.
Launched in June 2017, the College's Bullying and Undermining Campaign aims to challenge and change the culture of bullying and undermining in the surgical and dental workforces. #LetsRemoveIt campaign highlights that bullying harms the profession, and ultimately patients.
The RCSEd has partnered with the anti-smoking charity ASH (Action on Smoking and Health) to support surgeons in encouraging patients to improve their survival chances by quitting smoking ahead of surgery.
The RCSEd has also written to Secretary of State Jeremy Hunt to highlight this work and ask for his support in ensuring that all patients can access specialist smoking cessation support ahead of surgery.
Fewer postoperative complications, shorter hospital stays and better long-term outcomes are some of the evidence-based benefits the College’s members are being asked to highlight to patients.
The campaign urges all surgeons to view patient consultations as ‘teachable moments’, during which patients may be more receptive to intervention and more motivated to quit. To help facilitate this, a short information leaflet is being circulated to the College's membership.
To highlight this, members of the College’s Regional Surgical Adviser Network explained how they incorporate discussion about smoking cessation into patient consultations.
As part of the discussion of risks associated with a procedure, surgeons should outline the reduction in risk associated with smoking cessation, with the recommendation to stop at least two months before the operation.
During this period, surgeons should work with perioperative medicine teams to increase fitness for surgery and, in this case, encourage patients who smoke to stop. In 2014, the College launched a similar campaign to highlight the benefits of physical activity in preparation for surgery.
One 2011 study found that smokers were 38% more likely to die after surgery than non-smokers. Following their surgery, smokers have a higher risk of lung and heart complications, infection and emergency readmission.
The campaign follows a report entitled ‘Smoking cessation: Policy and practice in NHS hospitals’ from the British Thoracic Society, which found that 72% of smokers in hospital were not asked if they wanted help to quit, while more than a quarter (27%) of hospital patients were not asked about their smoking status.
Mr Pala Rajesh, Consultant Cardiothoracic Surgeon at Heartlands Hospital, Birmingham, and Council Member of RCSEd, said:
“Patients who are admitted to cardiothoracic departments for surgical procedures are routinely questioned about their smoking status. Patients who continue to smoke are counselled and seen by respiratory physiotherapists, introduced to an exercise programme and advised on smoking cessation prior to being offered their surgical procedure. They are informed of the risks and complications of continuing to smoke. Most patients comply with the pre-operative measures and in the immediate post-operative phase of their fast-track management.”
Deborah Arnott, Chief Executive of ASH, said:
“It is very encouraging to be working with the RCSEd to support its members in doing more to help sick smokers quit. A smoker’s admission to hospital provides an ideal opportunity to help them quit and stopping smoking should be seen as an essential part of a patient’s treatment. It is essential that clinicians are able to refer smokers to specialist smoking cessation services to give them the best possible chance of quitting.”
Michael Lavelle-Jones, President of the RCSEd, said:
“We are delighted to have joined forces with ASH to highlight the significant benefits of reduction or cessation of smoking in the months before surgery. It is important for all consultants to take a few minutes to explain to patients who smoke the risks of continuing to do so before an operation, and to refer them for ongoing support and encouragement through a formal cessation programme.”
In April 2016, the College contributed to a joint briefing providing health professionals and commissioners with clear advice and examples of good practice in relation to smoking and surgery. The current campaign has the backing of a number of other medical organisations, including the Faculty of Public Health and the Royal Colleges of Physicians, Anaesthetists and Surgeons.
In March 2016, the College reported on the delivery of surgical services in rural areas to improve support for consultants and trainees based in some of Scotland’s most remote hospitals.
Patients with low cardiorespiratory health are five times more likely to die during or just after a surgical procedure than their fitter counterparts, and on average an unfit person costs the NHS an extra £6,000 when they undergo an operation, due to longer recovery times in hospital.
Studies have identified anaerobic threshold (a measure of exercise intensity performance) as the single most significant predictor – much more accurate than age alone – of complications and mortality in surgery. To tackle this issue, for the first time ever the RCSEd is launching a UK-wide education campaign to get patients moving in the run-up to surgery.
Data published in the Annals of Surgery demonstrates that post-surgical mortality can be as high as 22% in patients with low levels of fitness, whereas patients who were fitter had only a 4% mortality rate. Many studies have also found an inverse relation between cardiorespiratory health and complications in heart, lung, colorectal and bariatric surgery.
Addressing this costly and avoidable matter, the College is asking patients to speak with their surgeon or GP to work out an exercise plan that suits their condition and the type of operation they will undergo.
Consultant orthopaedic surgeon and Regional Surgical Advisor for the RCSEd, Mr Jon Dearing is leading the campaign which comprises a variety of support materials including video content and an informational leaflet. He says:
“A simple 30 minutes of physical activity per day in the lead up to surgery not only can significantly reduce avoidable complications and mortality, but in some instances can even improve the chances of ‘borderline’ or unsuitable surgical candidates.
“We’re not talking necessarily about donning Lycra and getting sweaty at a gym – just straightforward measures such as walking or cycling instead of driving, taking the stairs instead of the lift and parking further away from the shops. Simple steps like this can improve surgical outcomes, aid the recovery process and even enhance the patient’s own psychological wellbeing as they get better faster. Most waiting times for surgery are around 12 weeks - this is plenty of time to work on increasing the likelihood of a successful operation."
In April this year, the Economics of Physical Inactivity Consensus (EPIC) Conference called for a globally concerted effort to improve physical activity, which could significantly reduce the length of hospital stays and use of services as well as having long term positive health economic outcomes.
Mr Dearing adds:
“Many people have asked me why this is the job of surgeons. My response is that it’s a healthcare issue and as good doctors it’s what we should be doing. Undergraduates are not taught about physical activity prescription, but as consultants we are expected to have all of the answers – it only takes about 30 seconds to give advice during a consultation and those are 30 seconds that could save lives and significantly reduce costs. Millions can be saved in prescription costs alone if the fitness levels of patients were improved.”
The RCSEd is committed to promoting greater awareness among patients and consultants about the benefits of physical activity before and after surgery. Support materials to be disseminated via consultants and patient groups include a short video presented by Jon Dearing and an informational leaflet, which includes a personal story from a patient who was encouraged to exercise as part of the recovery process following a heart attack.
In May 2012, a working group from The Royal College of Surgeons of Edinburgh issued a report examining the provision of care for victims of major trauma in Scotland. This report recommended the development of a trauma system across Scotland which focuses on reducing disability as well as mortality.
News & Resources
The latest news from the College and resources to support you at every step of your career.
News & Resources