has to wait for CT scan, CT-PET scans, endoscopic ultrasounds and MDT decisions - the CWT clock only starts when the patient accepts the treatment plan, usually just before start of treatment. At the then Welsh Health Minster’s request the clinical community was asked via the National Specialist Advisory Group (NSAG) to consider what the best measure of cancer waiting times would be. Their response was that waiting times were important (delays adversely affect patient outcomes and experience), and that 62 days should be the longest time any patient should wait for treatment. Patient focus groups said they wanted information on how long they would be expected to wait and they wanted assurance that they would not come to harm through waiting. Due to these concerns Welsh Government (WG) then indicated they would consider what a single CWT target for all would look like. This single suspected cancer pathway (SCP) would record and report all patients from the point of suspicion (PoS) of cancer be that through primary care suspected cancer referral or other routes to diagnosis (e.g. radiology, endoscopy, A&E, secondary care inpatients/ outpatients). It was clear therefore that the system is: • Not reporting the actual patient experience • Not reporting the pressures in the diagnostic system. • Not driving improved performance through improving the causes of delays Single Suspected Cancer Pathway (SCP): A single suspected cancer pathway would measure CWT from the point of suspicion of cancer. • For current USC referrals there is little change except the clock starts at the date the GP referred the patient rather than receipt of referral by secondary care. • For current nUSC routes to diagnosis the time the clock woustart is from clinical point of suspicion, when a clinician refers and/or requests a test thinking cancer, with as a minimum the point being the same as NG12 NICE Guidance on Suspected Cancer. CWT pathways and performance, and diagnostic workforce/infrastructure issues are similar in England and Wales as evidenced by respective Government statistical reports, National Clinical Audits and the International Cancer Benchmarking Partnership (ICBP). Whilst Wales is the first home nation to pilot the SCP, England is considering adopting the Faster Diagnosis Standard (FDS). The learning derived from this change to the SCP and from the FDS will support efforts across the UK to improve cancer outcomes. BSG UGIB (Upper GI Bleeding) EQIP (Endoscopic Quality Improvement Project) Dr John Morris is leading a quality improvement project for UGI bleeding on behalf of the BSG with involvement of AUGIS. This is a response to the recent NCEPOD report in 2015 and aiming to develop a bundle that helps to improve outcomes with regards to mortality, risk of re-bleeding, length of hospital stay and quality of life. I wish you all a great summer and see you in Edinburgh. Kind Regards, Ashraf Rasheed Professor Ashraf Rasheed OG Lead Over the last few months there have been a couple of pressing issues affecting surgical trainees that may or may not have taken your interest. AUGISt has been working with ASiT to try and improve the outcomes for trainees. ThemostobviousissuesthathaveaffectedupperGItrainees are that of endoscopy training. All AUGISt, Duke’s and ASiT members were invited to take part in a national survey of endoscopy training. The responses revealed a very mixed picture across the country, with some trainees gaining excellent training and others having few opportunities. We have been working to improve and standardise the access to training; the changes in the upcoming curriculum are a good opportunity to implement this, although there are a number of competing interests in the design of the new curriculum and it is likely to take considerable pressure to see this through. The new curriculum itself is well on the way through the development process and we can expect to see a draft documentproducedbytheSACfairlysoon.Itisnotyetclear how a new subspecialty of “Emergency General Surgery” will fit into this and whether this will impact on the ability of trainees to gain competency in the traditional complex upper GI work if that is their desired career. Changes in the curriculum may not affect you directly; however they may impact on your successors and potentially your future consultant colleagues, so it is worth giving some thought. An updated version of the eLogbook is in the development stage at present. I think you will agree that the current version is inadequate for the specialist upper GI trainee, in terms of the way our operations are broken down into stages. Hopefully the changes will mean that we will be able to more accurately represent the operations we do. The upcoming conference in Edinburgh has a fantastic scientific programme, and represents a significant departure from previous conferences. Please do look closely at the proposed programme and try to come along. This year’s conference has a diverse array of topics and speakers, providing interest to all breeds of Upper GI surgeon. Due to the logistics of travel the training day is in the morning of the first day of the conference. Whilst it is necessarily slightly shorter than normal, the opportunity to learn from some of the most experienced consultants in the country should not be missed and I would encourage as many of you as possible to make the trip. As ever the conference will not be all work and no play! The Gala Dinner represents a good opportunity to let your hair down and enjoy the company of your colleagues and the city of Edinburgh. Finally, I am coming to the end of my tenure as AUGISt president. It has been a great privilege to represent the organisation and I would recommend any of you that would consider it, to apply for the post in the forthcoming elections. Mr Matthew Mason Trainee Representative Report BOMSS Secretary AUGIS Summer 2018 Newsletter Report of the OG Lead Report of the Trainee Representative Report of the OG Lead Mr Matthew Mason AUGIS Summer 2018 Newsletter 10 11