Perioperative medicine and UK plc

In March and May 2018, two open meetings were convened under the auspices of the National Institute of Academic Anaesthesia (NIAA) and National Institute of Health Research (NIHR) to consider how both clinical and non-clinical academics, research active National Health Service (NHS) clinicians, and industry representatives can continue to build on the investment underpinned by the NIAA in discovery science and experimental medicine. As an exemplar for drug discovery and experimental medicine, perioperative medicine has been transformed by extraordinary technological and pharmacological breakthroughs in both academia and industry, including Mapleson breathing circuits,propofol, the laryngeal mask airway, remifentanil, and sugammadex, to name a few. These advances have occurred, in comparison with many other specialties, at an astonishing pace. It is easy to overlook the impact of these huge technological leaps from the bench that have transformed anaesthetic—and wider—medical practice. Such innovation from industry, academia and the NHS are exemplars for the UK's ambition to secure health–life sciences as a pivotal industrial sector. Having reached, at least from a historical perspective, a likely plateau in progress in terms of technical equipment, there is an undeniable role for a new model of bi-directional, bedside-to-bench research contributing within the sphere of perioperative medicine, critical care, and pain medicine. As a potentially even more exciting era is emerging from both industrial and technological perspectives, here we consider the drivers that require discovery science and experimental medicine in anaesthesia to manoeuvre back into the fast lane of biomedical discovery.