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BRITISH ASSOCIATION OF ENDOCRINE SURGEONS

 

Minutes of the Annual General Meeting, held on Thursday, 6th October 2005,

in the Centre for Life, Newcastle upon Tyne.

 

1                    Greetings and Apologies for Absence

Apologies for absence were received from Mr P Maddox and Mr C Russell. The meeting sent their best wishes to Mr Maddox during this difficult time for him.

The meeting was also informed by Mr J Lynn of the sad death of Mr R Welbourne. The members stood for a minutes silence in respect and memory for him.

57 full members of the Association attended the meeting

2                    Minutes of the Previous Meeting in Lund, 2004

The minutes were accepted as an accurate record  

3                    Matters Arising from the Minutes

There were no matters not covered on the later agenda

4                    President’s Report

A summary of The President’s Report is attached at the end of these minutes.

5                    Financial Statement

This was circulated to the members with the other documents. In the last financial year the Association showed a surplus over the year of  £6344, although £5000 of this was money received from Johnson & Johnson for the establishment of the national endocrine surgical database which would be spent in the next few weeks.

RDB thanked J&J, Prof Z Krukowski and Hon Charles Harris for their support of the Association during the previous year which enabled the BAES to leave subscription rates for 2006 at the same level as this year.

The amount of money passing through the account was significantly more than previous years because of the generously sponsored travel fellowships.

6                    Election of New Members

During the previous year there have been 17 new full members, 4 affiliate and 1 corresponding member joining the Association

7                    Endocrine Training/MMC

BJH spoke to this in his role on the SAC Curriculum committee. He explained that training will be based upon assessed competency rather than duration of training. The expected duration of the training has not yet been agreed but the curriculum for Surgical Training was now almost complete.

Miss Doughty raised the possibility of endocrine fellows being supported by ABS@BASO, ie those completing breast training who would like  some further endocrine training and would be funded by ABS@BASO in a similar fashion to the breast onco-plastic fellows. This kind offer will be further explored and at the earlier executive committee meeting it had been decided to establish a liaison group to follow this up and try to take it further, bearing in mind some practical difficulties such as SAC recognition of these posts or affecting the training of other posts in the same hospital.

8                    Audit

The Dendrite audit database was now established and all members were encouraged to register for this at the Dendrite stand in the exhibition area of the meeting. Registration could also be achieved later through the BAES website. Access to the database would be through the BAES website. If any technical problems are experienced members should approach the help-desk supplied by Dendrite whose number is on the front page of the Audit page on our website.

9                    “Merit Awards” – recommendations to colleges and ACCEA

The BAES has been recognised as a body which may nominate people for “merit awards”. If a member of the BAES would like support for an application for a higher award, they must send a completed application form with CV to Prof Krukowski who will support their application with mention of activity within and for the association, e.g. working as an officer,  research presented at the meeting, etc. It is the applicants responsibility to ensure the form reaches Prof Krukowski and also sends the application itself to the ACCEA.

    10                Venue of Future Meetings

The 2006 meeting will be in Oxford on 14th-15th September, in St Anne’s College; for details watch the  Annual meeeting page of the website

Prof. Henry has kindly agreed to host the annual meeting of 2007 in Marseilles

 

11.              Any Other Business

No other matters were raised for discussion and the meeting was concluded at 5.45 pm

 

BAES   PRESIDENT’S   REPORT  October 2005

 

  1. It’s a pleasure to be in Newcastle again and we’d like to thank Richard Bliss, Tom Lennard and to Rachel Carr for organising it.

 

  1. We are delighted to see friends from overseas here especially Anders Bergenfelz who organised such a splendid and successful meeting in Lund last year. That meeting, as the accounts will show, made a profit.

 

  1. I demit office at this meeting . Its been an intriguing 2 years which has been very busy predominantly responding to the avalanche of changes engulfing the NHS, not all of them beneficial. I’m grateful to all the members of the Executive for their help. Having a formal structure to the Executive has been advantageous. No one has been idle. I particularly want to mention Paul Maddox, our Director of Education  for his hard work on the Masterclass and  with Barney Harrison on the curriculum. Unfortunately Paul is not here in Newcastle because of his son’s illness. Barney Harrison is taking over his education role temporarily and Mark Lansdown  will be organising the next Masterclass which will be held in London in February 2006.

 

  1. The curriculum for the SpR training in General Surgery nears  completion and will be available on the web. We are acutely aware that we need to ensure that there is comparability between the relevant sections in the General Surgical and ENT Head and Neck curricula. The Education sub- committees of the ASGBI and the SAC in General Surgery have merged so this has helped simplify a very complex process. We will need to debate how endocrine surgery training will occur in future but the curriculum envisages two levels; one just basic thyroid and parathyroid surgery, the other the full gamut of complex endocrine surgery. An acceptance of the principle of modules of training some of which may be concurrent will help on this and assist with the issue of comparability between General Surgical and  ENT curricula. To explore the options for crossover training between eg. Breast and Endocrine, ENT and Endocrine the Executive has established a subcommittee to explore this, consisting of  Tom Lennard , Barney Harrison John Watkinson and Rob Carpenter.

 

  1. I continue to sit on the SAC in general surgery but now sit having been selected in my own right. Speciality Organisations  no longer have their own representatives on the SAC but strong efforts are made to have each specialty represented. They can however only be selected from those who apply so I hope members of this Association will apply when I leave the SAC in 2007.

 

  1. This year’s most intransigent problems have been the sequelae of the NICE report. You should all be familiar with the BAES guidance on Multidisciplinary working (see Website) and the report does allow THYROID MDM,s  to be separate from Head and Neck MDMs. This fact has not however been understood by all cancer network managers who still have difficulty understanding that most thyroid surgery does not occur in the ambit of a Head and Neck Team  and that thyroid clinics can, and usually should, exist separately from “Neck Lump”clinics. A consultation process is underway on the implementation of  the guidelines and we are strongly involved in that. The Executive agreed yesterday to establish a subcommittee to ensure that we keep on top of what’s happening. Members having difficulties with the implementation or who feel this process is being used inappropriately need to contact The Executive.   In the first instance the President, Zyg Krukowski. In the meantime everyone needs actively to discover what the plans are in their own cancer network and be prepared to challenge them.

 

  1. We need to understand the positive sides of NICE, and their technology appraisal process is one. We are concerned about the uncontrolled introduction of  some forms of minimally invasive neck surgery and will be inviting NICE to undertake an appraisal of that; a process in which the BAES will be involved. 

 

  1. We apologise for the late arrival of the On Line Audit   arrangements which David Scott Coombes and Zyg Krukowski have been hard at work arranging. Thanks to Zyg we have attracted start up funding without it affecting your subscriptions and without being beholden to any government Dept. They will update you on the handover from paper to electronic recording. Please don’t let the difficulties put you off keeping up with your audit. It is an enormously powerful weapon.

 

  1. You may however be familiar with our spat with “Private Eye” (summarised on the website) which centred on what we should “Do” about “low volume surgeons”.It is a real issue which sooner or later this Association will ned to address.

 

  1. It is clinical awards time again; members who  think they have a realistic chance of a national  award and who have made a substantial and continuing commitment to this Association should send their CVQ and a letter to the President seeking the Association’s support as well as sending the CVQ through their Trust’s normal award machinery.

 

  1. Meetings.  We contributed to the ASGBI meeting in Glasgow and are grateful to our in house speakers. Only a handful of members attended the IAES meeting in Durban.  There will be an IAES  postgrad course in Endocrine Surgery to be held in Crete in  October 2006. ( details from barney.harrison). Although there has been a near total silence from ESES since the meeting in Pisa in 2004 Paolo Miccoli reassures me that the meeting in Krakow will go ahead on 20th May 2006. There will be another meeting on the “Key advances in the Effective Management of Thyroid Cancer” on December 9th of this year. Details on www.keyadvances.org.uk

 

  1. Zyg Krukowski is, as you know, your next  President and I wish him well. You will today be electing his successor. The next two years are going to be difficult ones for Endocrine Surgery as the basic concept that underpins it is under sustained attack from all sides. I hope you will give Zyg and the Executive Committee all the support you can and I know they will support you.”

 

 

 

BRITISH ASSOCIATION OF ENDOCRINE SURGEONS

Minutes of the Annual General meeting held on Thursday 16th September 2004, in Lund, Sweden

      Greetings and Apologies for Absence

      Greetings and apologies for absence were received from Mr Richard Collins, Prof. Malcolm Wheeler, Mr Paul Maddox. 44 full members of the association attended the meeting.

      Minutes of the Previous Meeting from Pisa

      The minutes were accepted as read as a true and accurate record of the meeting.

      Matters arising from the Minutes

      All matters will be covered in further agenda items

      Presidents Report

      The President welcomed the members of the BAES to Lund and expressed his thanks to Prof. Anders Bergenfelz for the organisation of this years annual meeting and his hard work in achieving the smooth running of the meeting.

      techchnic for agricultur The first report of the national audit as complied and published by Dendrite was now with members who should have received it in the post during the preceding week. Thanks were due to the hard work of Barney Harrison in compiling the report putting the results together with a commentary. Audit will, in the future, be organised by Prof. Krukowski and Mr Scott-Coombes. It is felt that the current paper system cannot continue and we need to change to an electronic format. Discussions were underway regarding the questions to be asked in future audits and the Executive Committee have agreed that Dendrite Clinical Systems Ltd will be asked to administer the audit via the BAES website and produce the reports. These will continue to be annual but may be published simply on the website or in the format of a CD-ROM.

      The second edition of the Guidelines are at the Printers and should be posted to all members during the next month or so. 1000 copies are being produced and so all members will receive two copies and further copies are being sent to interested parties

      NICE Guidance has already been discussed in the President’s presentation, which stressed the importance of thyroid/endocrine MDMs.

      The inaugural meeting of the ESES was held earlier this year in Pisa and was well attended, although very few British delegates attended. Interest in the organisation is still within the European community, although a few problems still need sorting out. Future venues for the meetings have been agreed as Krakow in 2006 and Barcelona in 2008.

      The IAES meeting which was postponed from last year because of the SARS outbreak in South East Asia was held in June in Sweden. The meeting was good but was smaller than normal. Next year the meeting is being held in Durban, South Africa.

      We have also participated in the Key Advances in Effective Management of Thyroid Cancer" with the BAHNO and BTA. This Key Advances meeting was well received and is to be repeated.

      Jobs for the Association continue to multiply within various bodies. Johnathan Hubbard has recently taken over the role of liaison with the BES from David Scott-Coombes.

      We would also members to nominate themselves for review of chapters from the Guidelines. If people could nominate themselves and then keep an eye on the literature, so that when the Guidelines are being reviewed in three years, then the job will be much more straight forward. If people who are willing to do this could let Richard Bliss know, he will contact them later.

      Relationships with the ASGBI are always under discussion, particularly the financial relationships. Currently we are within the ASGBI "umbrella" of speciality organisations and would like and need to remain so. We pay the ASGBI for the collection of subscriptions and for having a contact within the ASGBI – Bhavnita. She has also been loading the data from the audit onto the database, but with the electronic acquisition of data imminent; this will be a role she can forego. We will obviously require fewer hours of work from her. W are discussing this with the ASGBI at present.

      The BJS are changing their publication of our abstracts. This is being applied to all of the abstracts from the sub-speciality organisations. In future, the abstracts will be published in electronic form, but they will be in a citable format. We have also been criticised for sending abstracts in the raw texts, and so we feel obliged to change some of the abstracts. Apologies if you feel that your abstract has lost some of its impact when it is finally published.

      The BAES has gone electronic in that a lot of our work is carried out at distance. All abstract submission, abstract marking, bookings etc, are now electronic and this is being extended to the audit (vide supra). The website is now being run by the President acting as the Webmaster. We asked for comments from the members regarding the website when we sent our questionnaire round in the newsletter during the summer. As feedback from this, we do not feel that the website can be interactive or have a chatroom, due to expertise and, particularly, the cost. Items such as problem cases can be put on the website, although it should be noted that the IAES website has a monthly difficult case for discussion.

      The question of listing of members on the website was discussed and voted upon. 18 members for inclusion of members names, 8 against. It was felt that this should be included in the next newsletter but that it should be an "opt-in" option for your name to be listed. In the meantime, the President will discuss the implications with the MDU and the other Presidents of the sub-speciality associations within the ASGBI to find how they manage the problem. The Association will need to attach a disclaimer such that the members’ names are listed, but the Association cannot vouch for the standards of the members.

      Recognition of training centres for endocrine surgery will need to be formalised. In the past, this has always been an informal system, but with the new training scheme, specific centres will need to be identified. A questionnaire will be sent to members regarding the facilities available within their units.

      The next BAES/RCS(Eng.) Endocrine Masterclass is to be held in February at the College.

5. Financial Statement

      A balance sheet had been distributed to members with last year’s minutes. These show that the finances of the Association are healthy with a small surplus over the year of approximately £150.

      Future costs are expected, however, as the audit report and the new guidelines are to be paid for in the near future. The costs of the audit will change as we anticipate it will probably be more expensive to run the electronic data collection, but savings will hopefully be made in the running costs of the Association and the production costs of the report. Membership may have to be reassessed when the full implications of these changes are felt

      A reminder to members that subscription fees for next year are to rise by £10 per annum (agreed at the AGM last year). The BAES still has (by quite a long way) the lowest annual membership fees of any of the sub-speciality associations.

      Endocrine Surgery Tutor’s Report

      Unfortunately Paul Maddox has been unable to attend the meeting at short notice. He has asked that the Masterclass of 2004 be discussed. This was due to be held in Edinburgh, but had to be cancelled due to poor enrolment. This is felt to be due to a variety of reasons, including advertising, a change in staff at the RCS (Edin.) and local problems.

      The Masterclass will be held in February in London, next year (vide supra).

      A Training Day is to be held in Newcastle on the 5th October next year (the day preceding the start of the annual meeting). This will include demonstrations of live operating as well as a series of seminars on topics.

      Plans for changes in training are well advanced and discussions have been held with the ASGBI Education Committee as well as the SAC Curriculum Committee. Barney Harrison spoke to this as our representative on the SAC committee. Appraisal/assessment of specialist trainees will be held at the end of training and this may well be devolved to the sub-specialist associations. This may be in the form of a super-RITA but we may also have to combine this with the European exam. It was noted at this stage that Mr Johnathan Hubbard and Mr David Scott-Coombes had both sat and passed the European exam in previous day. Both were congratulated by the members.

      Guidelines

      A number of new guidelines published within the last year that may be relevant members were mentioned. NICE Guidelines had been previously discussed.

      Audit

      This had been previously dealt with in the President’s report

       

      DVT Prophylaxis Study

      This was address by Prof. Tom Lennard. A questionnaire had been previously circulated and the results announced. 42% of members felt that patients were at risk of DVT, 18% had a patient who had developed a DVT post-operatively. 75% of members were concerned about the risk of haemorrhage associated with the use of chemoprophylaxis, and 56% of members were interested in participating in a trial looking at the use of chemoprophylaxis for DVT in patients undergoing elective thyroid surgery. 18% of respondents had had to return a patient to theatre after heparin had been given for haemorrhage. It was felt that support for a study was not strong enough to pursue this.

      The Graves’ study, which was proposed as a multi-centre study in Europe including the UK, was updated. It had been sent for MREC approval in the UK but various problems were still to be sorted. Approval for the study has been obtained in Belgium, Spain, France and Sweden.

      Pallavi Mehrotra, who was given the BAES/RCS research Fellowship two years ago has submitted her thesis and been awarded an MD. Approaches are being made to the college regarding further collaborative support for endocrine research projects.

      Venue of Future Meetings

      The results of the questionnaire sent to all members were announced. From 54 replies

      55% would prefer Annual Meetings to be always in the UK

      76% would like occasional meetings in another European country

      91% are content with the current timing of the meeting to avoid a clash with ASGBI

      74% have logged onto the BAES website and suggestions were for to additional topics to be put on the website (vide supra).

      It was confirmed that next year’s meeting is in Newcastle on 6th-7th October

      2006 will be held in Oxford, 2007 remains undecided

      Any Other Business

      A discussion was held about wearing black tie at future annual dinners. The members voted against black tie.

      17 new full members have joined the association in the last year, together with 2 corresponding members and 4 affiliate members.

      The next AGM will be held in the Centre for Life, Newcastle on 6th October 2005.

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