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Thoracic forum

The Thoracic forum has been an event which is eagerly looked forward to by all practising thoracic surgeons and the trainees of the British thoracic fraternity. In the last two decades the event has evolved from a political talk shop to incorporating the needs and necessities of the thoracic surgical community.

Sri Rathinam, Consultant Thoracic Surgeon, University Hospitals of Leicester

Over the years with improvement The event has since then moved The event is always on the first in engagement with the society, between UK units taking into consideration weekend in February so that the surgeons as well as the Department the commute after the Fridays work to have the date in the diary with the only of health, the forum has become the ensure large attendances and the balancing exception being the event in Dublin which hub of discussions which have driven act to rotate around the country. Some was held in January to be held alongside agenda for change with regards to units have hosted the event more than the BTOG meeting. Thoracic practice. The event always once; each unit host has given the forum Members of the forum have debated starts with the networking dinner on his or her own perspective depending on and driven various issues varying from Friday followed by the national selection six hours of CME, drive, specialist thoracic political issues, service “Members of the forum have debated appointments, service development and finishing with the and driven various issues varying expansion in thoracic surgery, as well as service AGM. The unique nature of the Forum is from the national selection drive, specifications. From being a minority voice that it only has terms of reference, with no specialist thoracic appointments, which needed a collective resonance with the forum, written constitution or an elected council. service expansion in thoracic surgery thoracic surgery has a significant presence with The hosting surgeon as well as service specifications.” the current President and chairs the event SAC Chair being Thoracic and collates the surgeons. This led to an collective opinion, concerns and views what was the flavour of the nation that interesting debate at the last forum in of the thoracic surgeons in the United particular year. Some events have had Leeds which raised the question whether Kingdom and Ireland. interesting Fridays, Cambridge held a large there is still a need for the forum and the

The first event started in multidisciplinary education day alongside consensus was that there was still a need Birmingham and was hosted by David the thoracic forum attracting a large for the forum in the current format. Waller the newly appointed consultant number of students, nurses and doctors. thoracic surgeon in Leicester. The story of its inception goes that David Eric Lim, Babu Naidu and I as Registrars offered the concept of the forum as a hub Thoracic Forum Leicester 2018 Waller, Joseph Marzouk and Pala to popularise collaborative research in the I had the privilege of hosting the 20th Rajesh were discussing the need for a Nottingham event. This was in a way the Forum, on behalf of the Leicester unit thoracic fraternity forum in Hong Kong, precursor to the UK Thoracic Research which was involved in the first forum in whilst attending the VATS symposium. Collaborative under the leadership of Stapleford Park, Melton Mowbray. They felt Thoracic surgeons needed a Eric Lim and Babu Naidu. Ed Black in platform to voice opinions and to engage with the SCTS, which had a significant Nottingham invited a Martial arts expert and brought out the karate kid in us UK NETS SCTS Satellite meeting cardiac presence, and the BTS. David, to break wooden boards, which to our We were approached the UK NETS to a Birmingham trainee just appointed in surprise all of us did. Southampton had have a joint meeting with the Surgical Leicester, took the challenge and hosted Joseph Marzouk talking at the dinner about fraternity to streamline pathways. We the first event in the Forest of Arden. his journey in thoracic surgery. decided to have the SCTS-UK NETS

Symposium on the Friday proceeding the dinner to attract maximum participation. The afternoon had a variety of eminent experts on neuro endocrine tumours including Dr Was Mansoor, Dr Tahir Shah, Prof John Gosney and Prof Nick Reed discussing the various aspects of the NETS. Dr Tahir Shah introduced the concept of NETS and how the service has developed and pathways implemented in Birmingham. Professor Nick Reed offered a great overview of Lung NETS, followed by Professor John Gosney offering an insight into histopathology . Maninder Kalkat discussed the Surgical work up and Dr Was Mansoor discussed current approaches, oncological treatment and preliminary results of the LEAP Study. This was followed by a variety of cases with interactive discussions involving both the panellists as well as the surgical fraternity. There were discussions on setting up optimum follow up pathways with units learning from established centres.

Thoracic Forum Main Meeting

The First Session on Saturday meeting covered various contemporaneous issues as well as shared learning from various units. Prof Mike Morgan explained how Specialised commissioning works and its implications for Thoracic Surgery. Doug West presented the preliminary data of the National Audit, LCCOP and proposed plan to use HES data for Non Malignant outcomes. This was followed by experiences on best practice in increasing resection rates and clinical quality improvement presented by Elizabeth Belcher of the Oxford unit and Ira Goldsmith from Wales. Richard Page shared how Liverpool inspected themselves in response to the LCCOP report. Dr Richard Booton presented the Manchester experience of RAPID Optimal Lung pathway which may soon become the national benchmark.

The second session had the customary reports from Juliet King (Thoracic Sub-Committee), Sri Rathinam (SCTS Education) Thomas Tsitsias (Thoracic Trainee Representative). Rajesh Shah, as SAC chair, briefed us on curriculum change, changes to Exams

Table 1: List of Thoracic Forums since its inception and who has been the host surgeon on each occasion

Host Unit Venue

Leicester Forest of Arden

Host Surgeon

David Waller

Liverpool Mootram Hall Richard Page

Leeds Weetwood Hall

Andrew Thorpe Birmingham Belfry Pala Rajesh Cambridge Cambridge Garden Moat House Frank wells Sheffield De Vere Oulton Hall Roger Vaughan Birmingham Coombe Abbey Nottingham Breadsall Priory Hotel Richard Steyn John Duffy

Dublin The Burlington Hotel Kieran McManus

Manchester Mottram Hall Rajesh Shah Nottingham Rutland Square Hotel Ed Black Cambridge Double Tree Aman Coonar Glasgow Breadmore Hotel Alan Kirk Sheffield Conference 21 Jagan Rao Coventry Coombe Abbey Joeseph Marzouk Oxford Oxford Hotel Elizabeth Belcher Hull Cave Castle Mahmoud Loubani Southampton Botleigh Hall Aiman Alzetani Leeds Rudding Park Nil Chaudhuri Leicester Stapleford Park Sri Rathinam

as well as GMC discussions on future training pathways which led to robust discussions. The other major change was the Open Forum which had Graham Cooper, SCTS President and Richard Page, President Elect offering an open platform to address the needs of the Thoracic fraternity and responding to their questions. This was a very interactive and engaging session with the feedback concluding that we should have it in the future.

The final session focused on clinical trials, new collaborative studies, innovative procedures and an update on clinical trials in Thoracic Surgery. Tim Batchelor gave an update of the MARS-2, CELEB, VIOLET and HARP-2 Studies. The Hull group shared their experience on Spontaneously breathing Thoracic Surgery and the Session finished with Gianluca Casali emphasising the need for Mindfulness and Resilience in Surgeons.

The AGM reviewed the current contributions, there were a few industry partners who did not support this year but there were a few new partners to balance the loss in sponsorship. The Next meeting will be in London hosted by Juliet King and Carol Tan. n

“Some events have had interesting Fridays, Ed Black in Nottingham invited a Martial arts expert and brought out the karate kid in us to break wooden boards which to our surprise all of us did.”