GESA Newsletter

PRESIDENT’S MESSAGE 1-2

KNow youR CouNCIl AND

ThEIR PoRTfolIoS 3-4

AuSTRAlIAN GASTRoENTERoloGy

wEEK (AGw 2010) 5-7

AuSTRAlIAN GASTRoINTESTINAl

ENDoSCoPy ASSoCIATIoN 8

AuSTRAlIAN INflAMMAToRy

BowEl DISEASE ASSoCIATIoN 9

oNlINE SuRvEy: SuRvEIllANCE of

BowEl CANCER IN INflAMMAToRy

BowEl DISEASE 10

PoSITIoNS vACANT 10

IMPoRTANT INfoRMATIoN foR

uSERS of ThE STERIS SySTEM 10

lETTERS To TGA 11-12

1

welcome to the first GESA newsletter for 2010. we’ve made the decision

to move back to sending these in electronic format – for better or worse

we’ve decided to embrace our electronic enslavement. I hope these

regular updates will keep GESA members abreast of the varied portfolios

in which GESA is engaged, and we hope also to provide members

with the opportunity to provide direct feedback to the secretariat and

to Council through this medium. The focus of this issue is to introduce

you to your new GESA Council. It’s important that all of us know who

we can approach on issues of importance to individuals and the wider

membership, so memorise these names and photographs, and make

contact with us when necessary.

The next few years will be a time of exciting change and expanded roles

for the Society. Some changes are going to be forced upon us, there are

others where we can lead the charge. There will be substantial change

in the way we train and re-train in gastroenterology, and we are actively

leading development of endoscopic education through the National

Endoscopy Training Initiative (NETI). Professor Neville yeomans, former

GESA President, has agreed to take on a leadership role in this area.

The importance of this initiative is highlighted by its partial funding by

the Commonwealth Department of health and Ageing, and it will become

a vehicle for introductory and advanced training, as well as remediation,

in endoscopic skills.

NETI fits neatly into our increasingly formalised role in general training

of advanced trainees in gastroenterology. Geoff hebbard was elected

to Council on the basis of his strong and activist contributions in

this area, especially as chair of the Specialist Advisory Committee in

Gastroenterology. The Society’s relationship with the RACP will mature

most strongly around our involvement in the education of our advanced

trainees. I see a future in which we take on a formal role in all aspects

of gastroenterology and hepatology training, from selection processes

through to continuing professional development and recertification.

From the President

ContactsEditor: Anne DugganGastroenterological Society of AustraliaPo Box 508, Mulgrave vIC 3170Toll Free: 1300 766 176 Telephone: 03 9001 0279facsimile: 03 9802 8533Email: [email protected]: www.gesa.org.au

CONT’D NEXT PAGE

Michael GrimmPresident

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other areas where I believe the Society must take a

more active role are in its presentation to the community.

we remain the peak professional body in Australia for

gastroenterology and hepatology and that needs to be

reflected more publicly, whether it’s on issues to do with

the National Bowel Cancer Screening Program, equitable

access to hepatitis C treatments or interactions with

government through committees such as PBAC and MSAC.

The new Australian IBD Association has taken a lead on this

and has developed strong links with the PBAC, while the

Digestive health foundation will be prominent in several

of these activities.

In addition, there are issues for us to be involved in

outside our immediate areas of concern in Australian

gastroenterology. Some of these will be addressed through

the formation of the federation of Gastrointestinal Societies,

where we stand alongside our trans-Tasman colleagues from

the New Zealand Society of Gastroenterology and our surgical

associates in the colorectal, hepato-pancreatico-biliary and

upper GI fields. The most immediate and obvious role for

the federation is in bringing us together for periodic scientific

meetings, similar to the expanded and phenomenally

successful AGw in 2009, with the first planned federation

combined meeting in 2013. The federation also provides

a vehicle for managing areas of common concern, such as

endoscopic training and development, and some interactions

with government.

of course, we have longstanding strengths that we will

maintain. GESA Research is committed to supporting the

research activities of our members, through continued funding

of scholarships, fellowships and awards. These are peer-

reviewed funding supports that are hotly contested and they

remain a signal of the Society’s research achievements,

excellence and aspirations. Australian Gastroenterology

week remains the Society’s flagship endeavour. It’s a highly

successful, highly visible articulation of our research and

education. It continues to evolve and adapt to the needs

of GESA members as well as to others such as our friends

and colleagues in GENCA, and its continued popularity attests

to its ability to provide something for everybody.

So, GESA continues to have much to celebrate, but it has a

great deal to live up to and many new areas to explore. I hope

this newsletter gives you a more complete picture of your

Council and our broader activities. All members of Council will

welcome your comments, advice and, if necessary, brickbats,

so please contact us when the need arises. happy reading.

Michael Grimm

From the President (cont’d)

DHF Committee

looi Ee, Anne Duggan, Amanda Nicholl, vu Kwan

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Know your council And their PortFolios

The President-elect is elected by Council at the beginning

of the term of the current President and is required to have

served at least one term on Council before being elected.

This ensures a smooth transition and an incoming president

who is familiar with the significant issues facing the Society.

The President-elect acts as deputy for the President in

dealing with the many responsibilities facing him or her and

often provides a sounding board when difficult decisions

must be made. occasionally special tasks are assigned to

the President-elect (just to make sure they have enough

to do) and I have been given the job of heading the local

organising committee for Asia Pacific Disease week, which

will be held in Brisbane in September 2011, with the

support of the Secretariat and under the guidance of the

APDw steering committee

Clearly, as GESA’s Treasurer, my principal responsibility

is to make prudent recommendations to Council and, via

Council, the Society about GESA’s investment portfolio

and expenditure, with the aim of continuing to conduct our

core business in a sustainable fashion. like many doctors,

I can make no claim about having any particular financial

expertise. however, for more than 10 years, the Society has

been receiving financial advice from Stephen latham from

the financial services company, Centric wealth.

Prior to the recent GESA Council meeting, the finance

Committee met with Stephen and received a comprehensive

briefing about the recent performance of GESA’s investment

portfolio. This consists of a mixture of cash funds, short-

term “defensive” assets, medium term diversified assets

and long term equities. The returns of GESA’s portfolio

were presented to the finance Committee and compared

with relevant financial sector benchmarks. The committee

received recommendations about adjustments to the current

mix of assets, aiming as always to achieve a balance

between reasonable investment returns and financial

prudence. Stephen also provided a general report about his

assessment of the current overall financial market situation.

Based on this advice from a “competent expert”, the

committee made what it felt to be prudent recommendations

to Council about several changes to the Society’s financial

portfolio. Considering the estimated rate of return on

GESA’s investments for the forthcoming financial year and

income from membership subscriptions and AGw profits,

a recommended budget for the 2010/2011 financial year

was then put to Council seeking their approval. The main

categories of Society expenditure are research scholarships,

the administration of the Society and functioning of the

secretariat, and funding the activities of the Digestive health

foundation, Associations and Special Interest Groups.

William (Bill) SievertPresident-Elect

Cameron BellHonorary Treasurer

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Know your council & their PortFolios (cont’d)

The Digestive health foundation had its first meeting

for 2010 in March. The meeting welcomed Dr vu Kwan

to the membership and thanked A/Professor Simone

Strasser for her commitment and contribution as Chair

of Dhf and also thanked retiring members for their

hard work.

This year’s focus includes ensuring the Dhf website

provides readily accessible up to date information for

patients and their families. This includes updating and

improving the breadth of information on gastrointestinal

disorders available for clinicians to give patients to

improve their understanding and awareness. The

committee would like to hear from you if you believe

there are important gastroenterology topics for consumer

information leaflets that are not currently available.

The Committee also spent time planning the Dhf

symposium for this year’s Australian Gastroenterology

week. The Anti-litigation Toolkit is the theme of this

year’s symposium which promises to both enlighten and

promote debate and discussion.

I am responsible for professional affairs of GESA. This

mainly relates to liaison with professional regulatory

bodies such as PBAC, TGA, MSAC and MBS on matters

that relate to activities within GESA. I liaise with council

and sections within GESA on an “as needs” basis.

Members of the society wishing to raise matters at

the level of council in relation to these professional

regulatory bodies should initially approach me.

To date, a selection of members across the states and

spanning both clinical Gastroenterology/hepatology and

basic research have been co-opted to be members of the

research panel. The Chair or members can be contacted

through the GESA office.

Anne DugganChair – Digestive Health Foundation

John OlynykChair – Professional Affairs

Jacob GeorgeChair – Research

australianGastroenteroloGy Week 2010Gold coast convention & exhibition centre20–23 october

invitAtion to Attend

Australian Gastroenterology week 2010 will be held at the Gold Coast Convention Centre,

Broadbeach Queensland from 20 – 23 october. This meeting continues to grow and is acknowledged

as being one of the major scientific meetings in the region.

Conference partners this year will be the Australasian Society of Parenteral and Enteral Nutrition and

the Gastroenterological Nurses College of Australia.

The program has been designed to cater for the broad interest of members, with multiple concurrent

sessions with a strong faculty of international and national speakers from many disciplines.

This will be the premier event in 2010 for all Australian health professionals interested in

gastrointestinal disease. This meeting represents an unparalleled opportunity to interact with

colleagues involved in gastroenterology.

I look forward to welcoming you all to AGw 2010.

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australianGastroenteroloGy Week 2010Gold coast convention & exhibition centre20–23 october

internAtionAl FAcultyBushell Lecturer

Professor Bruce Sands

harvard Medical School,

Crohn’s and Colitis Centre,

Boston.

Trans Tasman Lecture

Dr Helen Evans

Consultant Paediatric hepatologist

and Gastroenterologist,

Starship Children’s hospital

and Senior Clinical lecturer

in Paediatrics at the

university of Auckland.

Other International Speakers

Professor Jean-Francois Dufour

Institute of Clinical Pharmacology

and visceral Research,

university of Bern,

Switzerland.

Dr Roland Valori

Consultant, Gastroenterologist,

Gloucestershire Royal hospital, uK.

Professor Olivier Goulet

Professor of Paediatrics,

Necker-Enfants Malades hospital,

Paris, france.

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australianGastroenteroloGy Week 2010Gold coast convention & exhibition centre20–23 october

Format

The Australasian Society for Parenteral and Enteral

Nutrition and the Gastroenterological Nurses College

of Australia will join us for this meeting.

The program will run over four days wednesday

– Saturday and is packed with interesting and

educational sessions including; Symposia, State-

of-the-Art lectures, free Papers, a debate, Poster

sessions and much more.

Some of the Highlights

Wednesday – Individual sessions presented by the

Associations and Special Interest Groups.

Evening Symposium – Early oesophageal Cancer

Thursday – Bushell lecture – Biologic therapies in

IBD – best use now and a look to the future.

young investigator finalists

Symposia – Coeliac Disease, ERCP, optimal use of

Anti TNf’s in IBD, hot Science in GI and liver disease,

Intestinal failure, Nutrition in liver disease

Friday – Dhf Symposium

the Anti-litigation Tool Kit

Recertification – Models for Australia

viral hepatitis – Current hot topics

Assessing outcomes and risks of IBD and its therapies

Saturday – AIBDA workshop

Symposia – Malnutrition, the skeletons are out of the

closet, Complications of cirrhosis and their management.

All this plus free Papers, Posters a debate,

and State-of the-Art lectures there will be something

for everyone. There will also be plenty of time to socialise

with the happy hour on Thursday and Dinner on friday.

So mark it in your diary and start training for

AGw 2010 20-23 october. See you there.

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Grant RammChair – Scientific Program Committee

Keep checking the website for program updates.Please note Abstract Submission and registration for this meeting are only available online at www.agw2010.com

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The current AGEA Committee took over the helm at the AGEA AGM at AGw 2009, Sydney. The members are:

Gregor Brown (Chair) Mark Appleyard

Robert Chen Luke Hourigan

Donald Ormonde Peter Prichard

Andrew Taylor

I am grateful to have such a competent and willing team to take endoscopy issues forward over the next 2 years. Already, through 2 teleconferences and subsequent volleys of emails, a range of projects and issues have been addressed.

AGW 2010 (Gold Coast)

The endoscopy program is nearly finalised, and promises to be both wide-ranging and of interest to all members. hot topics include:

• Theverypopularvideosession– send in your videos!

• UpdatesonTechnologyandTechniques, as well as the latest on luminal Surveillance

• Recertification,ledbyourInternationalVisitor, Roland valori, who has championed quality endoscopy in the uK

• CoeliacDisease,ERCP,andEarlyOesophageal Cancer, and PEGs

• EndoscopyFreePapers–comeandseeour rising stars present local evidence for your endoscopy practice

• PleasenotethattheAGMwillbeatAGW2010 on wednesday 20th october, at 12 noon

APDW 2011 (Brisbane)

AGw 2010 is amalgamated with APDw, so will be huge. luke hourigan and Mark Appleyard will put together a 2 day live Endoscopy workshop not to be missed.

NETI Workshops

AGEA is a vigorous supporter of NETI, and many of the committee have official roles in various capacities. we have been working with Judy Mitcham on the various workshops for 2009/2010, including Basic Colonoscopy workshops, TCT workshops, ERCP workshops, and, hopefully, Introductory workshops, as well as developing an Endoscopy Curriculum, which is an ongoing priority for the previous Chair of AGEA, Michael Bourke.

Conjoint Committee

AGEA noted with concern the threat to the continued good work of the Conjoint Committee brought about late last year, and lobbied hard behind the scenes to maintain the committee in its current form. AGEA was pleased that this was ultimately the case, with minor changes to the appointments and reporting processes. we understand that GESA will be consulted about future appointments to the 4 RACP seats on the Committee, which AGEA welcomes.

Quality Colonoscopy

The roll-out of the National Bowel Cancer Screening Program has focussed everyone’s mind (including Government) on quality colonoscopy, and AGEA intends to lead the debate on how quality can be improved, including better training, continued voluntary certification, and a suitable mechanism for recertification.

Endoscopy Infection Control Guidelines

Andrew Taylor has been beavering away at this behind the scenes for AGEA for around 2 years. The Guidelines were about to be released for comment when the “Steris issue” arose. we hope that the TGA response to our enquiries (see separate article in this Newsletter) will assuage concerns and allow the Guidelines to progress again. Changes include antibiotic prophylaxis recommendations and reprocessing requirements, so watch out for the release.

Your Views

The AGEA Executive is interested in your views – if you have an endoscopy-related issue you think GESA needs to know about, email me ([email protected]).

AustrAliAn GAstrointestinAl endoscoPy AssociAtion

Gregor BrownChair

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AIBDA became an Association of GESA in 2009.

Previously, it was known as IBD-A and had been a Special

Interest Group of GESA since 2003. Bill Connell was

elected the first Chair of AIBDA in June 2009, having

served on GESA Council since 2007. he is a visiting

Medical officer at St vincent’s hospital, Melbourne where

he is the Director of IBD Service. other members of the

AIBDA Executive are Michael Kamm, Jane Andrews, Rupert

leong, Don Cameron, Graham Radford Smith and Miles

Sparrow. This is an energetic group of IBD leaders, who

share a commitment to patient care, education and basic/

clinical research related to this condition.

Since its inception in 2009, the main activities of AIBDA

have involved discussions with the PBAC regarding PBS

regulations for topical 5 ASA therapy in ulcerative colitis

and anti TNf treatment in Crohn’s disease. following

these discussions, the PBAC granted approval in

November permitting prescriber’s one (1) repeat on topical

5ASA preparations (enemas and suppositories) in active

colitis. our association recognise that this is an important

development which will provide a substantial benefit to

patients who require more than one course of therapy.

Secondly, in March, a submission was presented to the

PBAC regarding infliximab in fistulising Crohn’s disease.

AIBDA have been strongly supportive of this submission,

and is pleased to learn that the PBAC have decided to

recommend listing for infliximab for this indication.

The decision must still be ratified by government, and

final details of the prescribing arrangements have not yet

been publicised. In any case, listing will not come into

effect until later in the year. Nevertheless, this decision

represents a significant advance in the therapeutic options

for patients with fistulising Crohn’s disease, especially

those who do not currently qualify on the basis of CDAI

scores.

GESA members may also be interested in a recent

article prepared by an AIBDA working Party regarding

Safety Guidelines for anti TNf therapy in IBD which was

published in february’s Internal Medical Journal. This

document is intended to help prescribers of anti TNf

therapy in IBD deal with the potential toxicity associated

with these agents, and provides practical advice regarding

precautions prior to and during treatment. hopefully this

article will be available on Dhf/GESA website in the near

future.

Miles Sparrow and Michael Kamm are to be thanked

for developing the IBD component of this year’s AGw

programming. This meeting promises to showcase the

work that Australian and New Zealand IBD clinicians and

researchers are involved with and will feature Bruce Sands

from harvard as this year’s Bushell lecturer.

AustrAliAn inFlAmmAtory Bowel diseAse AssociAtion

Bill ConnellChair

GESA Members receive a25% discount on Wiley bookslog into the GESA website and check online Journals for details. If you need a username and/or password, email the GESA admin office [email protected]

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Dr Ian fok, with the assistance of A/Prof Rupert

leong and Dr Ian Turner has undertaken a study of

surveillance attitudes of gastroenterologists and

gastroenterology surgeons in IBD. Dr fok is asking for

the assistance of GESA members to assist with this

study by completing an online survey.

The aim of the study is to look at the practices of

screening of colon cancer in Inflammatory Bowel

Disease within Australia.

The online survey consists of 20 questions over 2

parts. Part 1 looks at the surveillance characteristics of

gastroenterologists while part 2 looks that the practice

characteristics of the gastroenterologist

Please note that there might not be a true or false

answer to many of our questions.

The survey can be accessed through this web link:

http://www.surveymonkey.com/s/mrg2cvm

This survey has ethics approval from Sydney South

west Area health Service (SSwAhS). Any questions or

concerns regards the distribution of the survey can be

directed to [email protected]

Thank you

Dr Ian K C FokA/Prof Rupert LeongDr Ian Turner

following the decision by the united States food & Drug

Administration (fDA) to issue a “cease & desist” notice

in regard to the Steris System 1 Sterile Processing

System the following letters have been exchanged with

the TGA in Australia.

online survey: surveillAnce oF Bowel cAncer in inFlAmmAtory Bowel diseAse

Positions vAcAnt

imPortAnt inFormAtion For users oF the steris system

Staff Specialist Gastroenterologist – Expressions of

Interest Sought – position likely to become available at

St George hospital, Sydney in 6-9 months.

Contact: Dr Amany Zekry – [email protected]

or Prof Ian Cook – [email protected]

Ph: +61 2 9113 2817

Ambulatory and Medical ServicesDepartment of MedicalInterventional EndoscopistStaff Specialist Band 1-5, $132,363-$163,343

Senior Specialist $178,831, Canberra (PN. 13125)

Closing date: 6 May 2010

The appointee must be eligible for medical specialist

registration in the Australian Capital Territory (ACT).

Applicants should have high level training and

experience in all aspects of gastrointestinal endoscopy

including advanced skills in therapeutic upper

gastrointestinal endoscopy, colonoscopy and ERCP.

Experience in EuS would be an advantage.

Enquires about the clinical role may be directed to

A/Prof Tony Clarke, Director of Gastroenterology,

0418 967 994 or email [email protected]

Selection documentation may be downloaded from

www.health.act.gov.au/employment

Apply online at http://www.health.act.gov.au/

employment (preferred method), by post to the

SMo Recruitment officer, Medical Appointments and

Training unit, Building 6, level 1, Canberra hospital,

Po Box 11, woden ACT 2606.

Got a position vacant? Advertise with the GESA Newsletter, contact [email protected]

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letter to tGA

12 february 2010

TGA

Po BoX 100

woDEN ACT 2606

To whom it may concern

on behalf of the Committee rewriting “Infection Control and Endoscopy” for the Gastroenterological

Nurses College of Australia (GENCA) and the Gastroenterological Society of Australia (GESA), we

would like to ask you for an indication of the TGA’s response (if any) to the fDA’s actions regarding

Steris System 1 in the uSA.

A recent notification states:

The FDA is extending to 18 months from the date of this notice the total recommended time period

for transitioning from Steris Corporation’s modified System 1 processor (SS1) to legally-marketed

alternative devices. As FDA announced in its December 3, 2009, notice, the Agency has not

approved or cleared the SS1 for its labeled claims. Steris Corporation has chosen not to seek FDA

clearance of this device and, therefore, its use should be discontinued as soon as practicable.

The withdrawal of an established endoscope reprocessing system has significant implications for

any Australian endoscopy units currently using them. we wish to ensure that our guidelines contain

the latest information for the members of both organisations, and that our members are not using a

product that is no longer approved for its labelled claims. we therefore request any information you

can provide at this time regarding the TGA approval of Steris System 1 in Australia.

yours sincerely

Dr. Gregor Brown

Chair

Australian Gastrointestinal Endoscopy Association

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letter to tGA