Consulting the President’s ToDo list for December; “Write Christmas email – Be festive, extol achievements of BOA, rally the troops and end on a strong note”. So here it is the organisational equivalent of one of those carefully folded letters that fall out of a Christmas card and only serve to make other people’s lives seem more organised than yours. Some years in those personal Christmas letters instead of banal chatter there are real events; births, family losses or relationship tensions. This year an equivalent atmosphere has been replicated in so many aspects of our lives; nationally, professionally and personally. This email is written in a rapidly changing environment, a few days ago we were planning a “Merry Little Christmas” and the best strategy to accelerate a return to more normal pattern of work and now we have the potential for a very challenging few months. A major lesson from the first wave of the pandemic was that we should not stop doing our normal work until it is absolutely necessary; no prophylactic shutdowns. Following that principle, here is your Christmas email.

Over the last year we have been involved in and delivering on a wide range of work streams and activities, and I hope that you have noticed this and it has been of benefit and done something towards Caring for Patients and Supporting Surgeons. In this email it is worth replaying a few highlights and looking ahead to next year.

Our work on Covid-19 has undoubtedly been at the forefront of everything we have done over the past year. Early on we produced BOASTs for trauma care in the first wave of the pandemic, then as elective care resumed we published guidance for how to do so safely and effectively (at a time when central NHS guidance was very limited), and more recently the focus has shifted towards the escalating waiting times for elective care, which are a huge concern. We have also undertaken surveys in partnership with BODS, ‘Coping with Covid’ webinars, and worked on multi-partner guidance on issues from corticosteroid injections to urgent and emergency MSK care.  From the outset we have established very strong links with NHS England and other national professional and patient bodies related to MSK care, in order to work collaboratively and effectively across the sector in delivery of patient care. And there has been much more besides these highlights.

Communications has been another core theme of 2020. We have tried to keep all members up-to-date on rapidly evolving situations, and we have been regularly informing and updating via our website, emails, twitter and other social media platforms. At the time when I was the JTO Editor, I saw the need for a means of rapidly publishing Covid-related articles, and the ‘Transient’ JTO was quickly formed, and which has now morphed to fill an ongoing role for communication of Covid and non-Covid articles to members and others across our audiences. Next year we hope to develop this further with a new BOA App that will provide our members with information, news and opportunities in a new format, and we look forward to sharing that with you as it develops.

This is the first year in a very long time that we have been unable to hold a Congress where we can meet, learn, discuss, debate and generally catch-up with friends and colleagues both new and old. Most of the international and specialist society meetings too have not occurred in the usual way, but many like ourselves transferred to a digital format. Our member-only virtual Congress ran during 15th-25th September, and was very well attended - with nearly 6,000 registrations in total. We were incredibly grateful to all the session organisers (including many Specialist Societies), speakers, session chairs and sponsors, for all their hard work and enthusiasm to pull this off with a shorter than usual preparation time once we cancelled the face-to-face meeting. Among the Council and committees, we are all very much hoping to meet again in Aberdeen in September 2021, but we will also be working on contingency plans in case these are needed. The theme I have chosen will be ‘Tackling infection’ which fits into general category of the “Auld enemy” suited to a Congress in Scotland. We have already begun planning what promises to be an enjoyable and interesting meeting, in whatever format it occurs.

And as I look head to 2021, the challenges of elective care ahead are significant, and we are envisaging that this will be a substantial area of focus over the coming months. We were pleased to hear that £1bn has been allocated in the Comprehensive Spending Review to addressing waiting lists for routine care, but we are still awaiting detail on how this will be spent and to see whether it will really be enough to tackle the size and scale of the undertaking. There is also the important issue of trainees and access to training opportunities, as we know that many, many fewer training opportunities have occurred this year, which needs careful attention going forward.

We have lots more in the pipeline too – more BOASTs, new courses, more webinars, more support for the Curriculum that comes into effect in the summer. We believe that the BOA does deliver on its strapline of ‘Caring for patients, supporting surgeons’ and to find out whether you believe that too, and more, we will be asking you. So watch out for our member survey coming around very soon.

Final task; end on a strong note. I am going to say “Don’t suffer in silence.” Sounds negative? I don’t think it should, in these times in particular, there is a risk of isolation not just of individuals but of groups. There are problems for patients, for the wider team and as we discovered in our recent Webinar for individual surgeons too. Only when these problems are identified can they be solved, only when verbalised can they be rationally considered and only when communicated can we work together to find solutions. For the T&O community the BOA is the natural home for this sequence of resolution. So to 2021, we will no doubt be at the mercy of events but an uncertain environment will in addition to hazards present opportunities which we must be ready to grasp. In spite of everything have a Merry Christmas and a Happy New Year.

Bob