June 2025 - President's Update

Welcome to the inaugural BOTA Blog! Over the coming year we hope to bring you regular updates from the national committee on important topical issues in orthopaedic training in the UK.

For this first edition, I thought I’d give a president’s update on the year so far. It’s slightly hard to believe that it’s already been 6 months since the 2024 Congress in Manchester in November, and that I am already halfway through my term. They say time flies when you’re having fun, and it seems to go especially fast when it’s also busy at the same time!

When I ran for election, it was on 2 main issues: improving training through access to independent sector opportunities, and physician associates.

Work with BOA and RCS England on developing PA scope of practice dominated my 2023-24 year as Sustainability and Workforce Rep, but has essentially been put on hold awaiting the Leng Review, which is due to report imminently and early leaks are starting to suggest some of the themes we are to expect from this report.

The main thrust of my year therefore has been to work with the various necessary stakeholders to identify and address the barriers preventing trainees from accessing the low complexity NHS primary arthroplasty cases needed for training, which have increasingly been outsourced to the independent sector. I’ve had many meetings over the year so far with BOA, Joint Committee on Surgical Training (JCST), the T&O Specialty Advisory Committee (SAC), Confederation of Postgraduate Schools of Surgery (CoPSS), NHS England and the Independent Health Providers Network (IPHN) to work out how we unlock the training potential of the independent sector.

It will be obvious to many of you from personal experience not only how bad the situation is, but what is stopping you from being able to simply ‘hop across the road’ to pick up the cases you need. What is less obvious is how to combat these, and indeed where to begin from a local priority basis. We have made good progress getting on to the same page as a group of stakeholders, and are moving from ‘talking’ to ‘doing’, and this work so far is unpacked in more detail in this month’s JTO.

Beyond this, it’s been a fairly full-on year, and has seen me travel all across the UK and to Ireland on BOTA business, representing T&O trainees in a wide variety of fora. We have submitted to the aforementioned Leng Review, and also to the Medical Training Review (both in written form and in direct conversation as BOTA with Professors Whitty and Powis), and been heavily involved in the ongoing review of the MRCS examination. BOTA sit on the T&O Selection Design Group (SDG), who run the ST3 recruitment process, and it was a privilege to see both the quality of our future colleagues and the commitment of the interviewing consultants on show as we helped oversee the 2025 process. I have attended BOA Council and RCS England Council, both of whom dedicate a huge amount of time and effort to training issues and are key allies in our work to improve training, both now and for the future. We also work closely with ASiT on all things training, and it’s been great to see Raiyyan Aftab come in to the President’s role, as someone I have worked with over many years in Wessex.

The wider committee have also been busy, with a pilot journal club with Prof Banaszkiewicz hopefully transforming into a longer term project, and other educational resources planned with the specialist societies (watch this space!). We had the response to the ‘Skeleton Staff’ column in The Times, and have also been hard at work preparing for this year’s Congress in Leeds (25th-28th of November 2025) which promises to be excellent. Finally there have been the BOTA bursaries across multiple different levels which have been advertised for application, Trainer of the Year (in progress) and work to restructure BOTA for the future as its success and growth means the organisation needs to evolve with the times. As I said at the start, a busy 6 months so far!

We are always keen to hear about any issues, ideas of opportunities from around the country, so please do get in touch via your regional rep or directly with me (president@bota.org) if there’s anything you’d like to talk to us about or see us doing.

Yours,

Ollie Townsend