British Orthopaedic Association provides education, training to more than 4,000 members
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Since the early 20th century, the British Orthopaedic Association has provided national leadership for the trauma and orthopaedic surgical community in the United Kingdom, charity for patients in need, and training and education for its members.
The British Orthopaedic Association (BOA) was founded in 1918 by 12 original members. The organization now has more than 4,000 members, most of whom are from the United Kingdom and Ireland, and these individuals represent more than 40% of the surgical workforce in Britain. The BOA also has more than 500 members in other countries.
The BOA membership consists of active and retired surgeons, staff and associate specialist grades, and surgeons in training.
In addition to providing education and training for its members, the BOA is the voice of the orthopaedic community at such levels as government, Whitehall, the National Health Service (NHS) and industry. The BOA is a strong contributor to and supporter of the European Federation of National Associations of Orthopaedics and Traumatology.
Period of sustained growth
A professional staff of 18 individuals supports the clinician volunteers who spearhead activity to deliver the BOA’s three strategic objectives of excellence in surgical practice, training and education, and research.
“As a surgical specialty association, the BOA is enjoying a period of sustained growth and has, in recent years, developed unparalleled national influence due to strong clinical leadership from within the orthopaedic community. This is in no small measure due to the enormous clinical impact that many orthopaedic interventions can provide for patients, and to the intense focus on measurement and improvement of outcomes that we have been leading in the last decade. The demand for these life-transforming interventions has never been higher, yet the United Kingdom NHS is facing unprecedented financial challenges,” BOA president T.J. Wilton, MA, FRCS, told Orthopaedics Today Europe.
According to Wilton, surgeons are uniquely placed to identify and implement evidence-based solutions that will ensure a high quality, sustainable and resilient service for orthopaedic patients. This is the BOA’s primary objective during the next 5 years and beyond as the health care delivery system continues to change and develop, he said.
Input from patient liaisons
According to Mike Kimmons, CB, chief executive of the BOA, the “jewel in the crown” of the association is its Patient Liaison Group (PLG) formed in 2004. The PLG consists of lay members and orthopaedic surgeons who gather lay input for the development of guidelines, patient pathways and commissioning.
“It provides an invaluable ‘red team’ for our major practice strategy initiatives: Getting It Right First Time (GIRFT), Beyond Compliance, MSK [musculoskeletal] Commissioning, clinical networks, trauma networks and orthopaedic pathway development. The patient or service user perspective is key to the effective development of all of these initiatives, and we actively encourage our PLG to hold us to account for all we do as a professional body,” Kimmons told Orthopaedics Today Europe.
The PLG meets three times per year and provides an annual report at the BOA council meetings. The committee typically remains active throughout the year through its support of trauma and orthopaedic patients and surgeons.
Educational opportunities
The BOA provides two main educational courses for its membership — an annual congress and an annual instructional course. The annual congress focuses on surgeons’ continuing professional development requirements for revalidation during a 5-year cycle, and the instructional course covers a 4-year syllabus cycle for trainees (residents) who are preparing to take the Fellowship of the Royal College of Surgeons exam, Kimmons said.
“Feedback from the congress is invariably insightful, and informs continuous improvement in the design and content of the program. Delegates cannot obtain a certificate of attendance without completing the feedback questionnaire. The same methodology applies to our instructional course, which has been extensively reshaped in response to trainee feedback and now focuses significantly on interactive case-based discussions in small groups with a minimum of didactic lectures. We also offer smaller, popular courses for trainers, clinical supervisors, educational supervisors and leaders. The content of all these is continually adjusted to take account of feedback,” he said.
The BOA also provides the “UK in Training Exam,” a trauma and orthopaedics curriculum app, and is developing an e-learning platform called “Wikipaedics.” The learning platform will be structured around the trauma and orthopaedics curriculum, Kimmons said.
Regional support
The BOA addresses orthopaedic issues at the regional level and takes the lead at the national level in providing answers and solutions for patients and surgeons who may be affected by the, according to the association website. For example, the BOA, the National Joint Registry (NJR) and the Medicines and Healthcare products Regulatory Agency worked together to identify problems related to metal-on-metal (MoM) hip replacement.
The BOA has a comprehensive MoM fact sheet in the patient information section of the BOA website and it has worked with manufacturers to ensure all patients are fully apprised of the facts and offered clear advice on steps to take should they have this type of implant, Kimmons said.
“Following the withdrawal of the Articular Surface Replacement (DePuy Orthopaedics Inc.), we took the lead, in conjunction with the regulator and the United Kingdom implant industry, in creating the Beyond Compliance Service, which uses independent surgeon scrutineers and live NJR implant data to enable the safer introduction into service and post-market surveillance of new or modified hip and knee implants. Effectively, this covers the information gap in the first 5 years of an implant’s service before the [Orthopaedic Data Evaluation Program] ODEP rating can kick in,” he said.
Reshaping orthopaedic practice
During 2016, the BOA GIRFT implementation will be among the association’s top priorities. Kimmons said he hopes GIRFT will reshape elective orthopaedic practice across the United Kingdom through a unit-level focus on outcomes using registry data, implant selection, infection data and other initiatives that are enabled by the provision of quarterly dashboards.
The association will further develop its hip fracture review service, which is becoming a major business as a consequence of the annual National Hip Fracture Database report of individual hospital performance, he said.
Kimmons noted there will be increased focus on the development of further commissioning guidance documents and pathway activities aimed at primary care, and the realization of the association’s NHS England-funded quality outcomes work stream. The overall goal, he said, is a more unified infrastructure within the BOA to support the eight orthopaedic registries developed by its specialist societies.
In addition, making “Wikipaedics” fully operational and providing more translational research to optimize the output of the British Orthopaedic Research Centre, which is based on the clinical trials unit at York University, are important goals for 2016.
Expanded membership
Membership opportunities are open with the association. To join the BOA, potential consultant members must be sponsored by two BOA fellows who need to certify the applicant is a surgeon in good standing. Trainees, SAS surgeons, medical students and affiliates only need to provide documentation of their status, Kimmons noted.
“The whole process is electronic, with the [chief executive officer] CEO as the registrar, or gatekeeper, if you will. When necessary, I refer any contentious membership applications to senior clinical colleagues, although in practice, this is a rare occurrence. We have placed a priority in growing our SAS membership as this important component of the United Kingdom trauma and orthopaedics workforce is currently under-represented in our ranks,” he said. – by Robert Linnehan
- References:
- British Orthopaedic Association. About BOA. www.boa.ac.uk/about-boa/. Accessed Nov. 18, 2015.
- British Orthopaedic Association. Metal-on-Metal Hip Replacements. The facts. www.boa.ac.uk/patient-information/metal-on-metal-hip-replacements-the-facts/. Accessed Nov. 18, 2015.
- British Orthopaedic Association. Patient Liaison Group. www.boa.ac.uk/patient-information/bon-summer-2012-issue-11-2/. Accessed Nov. 18, 2015.
- For more information:
- Mike Kimmons, CB, can be reached at British Orthopaedic Association, 35-43 Lincoln’s Inn Fields, London WC2A 3PE, United Kingdom; email: m.kimmons@boa.ac.uk.
- Timothy J. Wilton, MA, FRCS, can be reached at Derby Hospital, Rykneld Rd., Derby, DE23 4SN, United Kingdom; email: marie.sims@friargateconsulting.co.uk.
Disclosures: Kimmons and Wilton report no relevant financial disclosures.