Undiagnosed cardiomyopathy in a young person with autism

Initial response

The Royal College of Anaesthetists (RCoA) welcomes the publication of the Healthcare Safety Investigation Branch’s report on Undiagnosed cardiomyopathy in a young person with autism and supports the recommendation made to the College.

In response, the College will establish a specialist working group with key stakeholders to evaluate current practices with the aim of developing clearer guidance on consenting patients for an MRI under general anaesthetic.

The College will then take forward any work recommended by the group, and embed the guidance within our accreditation scheme to ensure its application nationally.

The College is in the process of updating our Guidelines for the Provision of Anaesthesia Services for Preoperative Assessment and Preparation.

This document will be merged with the intraoperative and postoperative chapters to cover the perioperative pathway. The recommendations from this report will be addressed within the new guideline due for publication in March 2021.

Response received on 7 July 2020.

Progress update

The first recommendation asked the RCoA to convene a working group to provide additional guidance regarding the responsibilities for obtaining consent for MRI and other non-invasive diagnostic and/or therapeutic procedures under general anaesthetic in children. A working party was convened with representatives from the Association of Anaesthetists, the Association of Paediatric Anaesthetists (APA), the Royal College of Paediatric and Child Health, the Royal College of Radiologists and British Society of Paediatric Radiology. Guidance, endorsed by all of these organisations, has been produced and the Paediatric Imaging under General Anaesthetic guidance was published in November 2021.

The second recommendation asked the RCoA to review standards for pre-assessment services, including their purpose, the required observations and examinations, and competencies of staff undertaking this work. We identified that the gap in existing guidance related specifically to pre-assessment for children and asked the Association of Paediatric Anaesthetists of Great Britain and Ireland, as specialists in this area, to produce good practice guidance. The Best Practice Guidance: Preassessment Services for Children undergoing surgery or procedures, endorsed by the RCoA, was published in May 2022.

Both documents have been promoted to our members and will be incorporated into our accreditation scheme to promote implementation. We hope that this will satisfy you that we have taken appropriate steps to address the recommendations within your report.

Update received on 20 June 2022.