Barnet General Hospital

(DGH) District General Hospital

Phase 1a opened in April 1997 and has 96 surgical beds, a Women and Childrens floor and a large day unit. The building of Phase 1b housing Medicine and Therapies was started in 1999 and is now complete.

No. trainees:-18

Transport

The hospital is set in a rural environment adjacent to and within the M25, with easy access by Underground and road to central London.

Clinical Experience

Within phase 1a of the new hospital building there is a main theatre suite of 5 operating theatres and a 10 bedded recovery area. The inpatient surgery undertaken includes: general, vascular, breast, orthopaedics, trauma and gynaecology. There are three day theatres, which in addition to the above surgical specialities, also cover ophthalmics adult and paediatric max fax and ENT. There is a fully staffed A & E Unit. Anaesthesia provides a service for elective and emergency work for all the above surgery and in addition to the obstetric unit, ITU and for acute and chronic pain. The obstetric unit has 3,400 deliveries a year. There is a chronic pain service run by 2 consultants, an associate specialist and a nurse specialist. There is an active consultant lead acute pain service. There is also an ITU/HDU with 6 ITU and 6 HDU beds which has recognition for providing basic and intermediate level ITU training.

Rota

SpR’s and SHO’s work a full shift compliant with EWTD currently Band 2B. 7 doctors per area , 3 areas covered on call - ITU, Obs and Theatres.

Teaching

Weekly teaching takes place usually organised on one afternoon.
The trainees have their own office, and there are PCs available (Including the RCA Logbook & internet access) , secretarial assistance is also available. The department has a library of books. The Postgraduate centre has a library with a good selection of books and journals and Medline facilities.

Research Opportunities

Loads of audit opportunities.
Dr Cohen is the audit leads.
National research opportunities via multi centre trials on ITU. Little opportunity for local research.

Further Information

Secretary Anna Godfrey
Speciality Director Dr Stephanie Watt
College Tutor Dr Madhurie Chakravarti

Chase Farm Hospital

(DGH) District General Hospital

The hospital is an expanding District General Hospital, currently with 536 beds, situated in Enfield North London on the fringe of the green belt.

No. trainees:-16

Transport

It is adjacent to and within the M25, with easy access by train, Underground and road to central London.

Clinical Experience

The Anaesthetic Clinical Management Group (CMG) is responsible for Anaesthetic, Intensive Care and Theatre Services Acute and Chronic Pain service. Apart from the usual Anaesthetic involvement with theatre and ward staff, Trainees will have contact with staff from the Intensive Care Unit, Surgical, Accident and Emergency, Obstetrics & Gynaecology, Radiology, Medical (including CAre of the Elderly) all of whom share the hospital site. The department administers 8,000 anaesthetics in the 6 main theatres and 2,000 anaesthetics in the self contained day surgical unit. Areas of interest include Maxillofacial reconstruction utilising free flaps, sub diaphragmatic and carotid vascular surgery, revision arthroplasties and oesophagectomies.There is an active teaching programme in airway management The self contained Obstetric unit has 3,325 deliveries per year with an epidural rate of 28% and a Caesarean Section rate of 26%. A twice weekly ECT service is supplied to the associated Mental Health Unit. A Saturday Day Case ophthalmic surgical service is provided. The ITU admits 370 patients per year and is run by SHOs with close supervision by the Director of ICU and with a separate tier of consultant cover.

Rota

All junior doctors hours are compliant to current EWTD(58 hrs) and work full shifts

Teaching

Weekly tutorials for Trainees are held on Tuesdays and Wednesdays(am). and Thursday . Monthly Audit meetings are held. All trainees get oppertunity to carry out one or more audit projects Generous study leave. Open all hours - there is a departmental library with reference books also kept in the ICU. The department has modern computer facilities, some shared but others dedicated to the trainees use, including Internet access, various teaching CD ROMs (including Anaesthesia, Epidurals etc), flatbed scanner and laser printers. Additional software can be supplied. The Department also has it’s own dedicated Seminar Room with the usual facilities for Power point/LCD projection system, OHP etc. The postgraduate centre can also supply additional educational requirements. The self contained Department consists of offices, on call bedroom for ICU , dedicated Trainees sitting room, kitchen and loo, all adjacent to ICU and theatres. Anaesthetic juniors have their own common room with their own dedicated computer with direct library access to the Postgraduate Library (Medline, MCQ tutor and on line Reference books).

Research Opportunities

Further Information

Dr Bernie Munro Lead Clinician (Chase Farm Site) Head of Obstetric anaestheisa or Dr Nick Hogg College Tutor Other Consultant Anaesthetists: Dr Julian Olver (annual and study leave), Dr David Harvey (rotameister),Dr Anthony Kitsberg (audit lead)

Colchester Hospital

(DGH) District General Hospital

Colchester is Britain’s oldest recorded town.The local population is expanding rapidly, but open countryside surrounds the town. The coast is within 10 miles and there are many excellent restaurants.Colchester General Hospital is a large and friendly district general hospital within the Essex Rivers Healthcare Trust. There are 692 beds of which 424 are for acute adult inpatient care.

No. trainees:-14

Transport

There are 6 trains per hour from London Liverpool street to Colchester. The journey time is 50 minutes. The hospital is a 5 minute walk from the station. Road access is via the A12.

Clinical Experience

We give approximately 20,000 anaesthetics a year.There are two inpatient theatre suites and a dedicated day surgery unit.Propofol TCI, Remifentanil and Desflurane are available in addition to older drugs. There is a brand new 11 bedded ICU and HDU adjacent to recovery.We offer contiuous veno-venous haemo filtration, non invasive and invasive ventilation. Oesophageal doppler and PICCO are available for cardiac output studies. Percutaneous tracheostomy is taught.There is an active outreach service and non invasive ventilation is also carried out on the wards. The Obstetric Department has approximately 3800 deliveries a year. There is an on demand epidural service, with an epidural rate of 22%. Spinal opiates and the CSE are used.More than 98% of the C/s are performed under regional block. Paediatric cases down to age 1 year are anaesthetised, primarily for general surgery, orthopaedics and ENT. We have a special interest in airway management and run a fibreoptic training course.We also regularly teach percutaneous tracheostomy techniques on pig tracheas.Spinal surgery provide opportunities to learn the use of the Arndt bronchial blocker for 1 lung anaesthesia. There is an active acute pain service with 3 sisters conducting daily ward rounds. Ward based epidurals,upper and lower limb nerve blocks are routinely used in addition to PCA and NCA techniques. We have an expanding chronic pain department providing a range of invasive and non-invasive techniques

Rota

3 staff are on call to cover Obstetrics, ICU and Theatres.The rota is a full shift.Pay is Band 1A.

Teaching

Wednesday mornings 0900 - 1200 are set aside for anaesthetic tutorials which take absolute priority over clinical commitments. Audit Meetings take place monthly on the Regional Audit Half-Day. There is a Grand Round on Friday lunchtime. One evening a month there is an Anaesthetic Club Meeting which involves talks on specific topics from either an outside or inside speaker. The Academic Postgraduate Centre is on site. Computing and Word-processing facilities are available for the Junior Staff in the well stocked postgraduate library.There is a computer aided learning room with a large selection of software available.

Research Opportunities

Further Information

Colchester has many recreational facilities including a plentiful supply of estuaries for sailing and water sports. For further details, contact Dr Lajos Zsisku, College Tutor

Great Ormond Street Hospital

Specialist Hospital

Great Ormond Street Hospital for Children NHS Trust is a postgraduate teaching hospital with 351 beds, and is a national centre for children with a wide spectrum of disease. The full range of medical, surgical and diagnostic specialities are available. There are close links with the Institute of Child Health.

No. trainees:-24

Transport

The nearest underground station is Russell Square.

Clinical Experience

More than 10,000 children are anaesthetised annually, including general and neonatal surgery, cardiothoracic surgery including transplantation, interventional and investigational imaging, urology,renal transplantation, plastic, orthopaedic and spinal surgery, ophthalmic, ENT, maxillofacial and craniofacial surgery, neurosurgery and neuroradiology. The paediatric Pain Control Service manages acute and chronic pain on an in-patient and out-patient basis. A majority of the trainees will undertake a full time three month training programme in the paediatric intensive care unit.

Rota

Approximately 1:8 with prospective cover. Annual leave is subject to a rostering schedule.Trainees work a shift system which is New Deal/EWTD compliant, Band 2B.

Teaching

Protected teaching takes place weekly at 08h00 to 09h00. The programme includes presentations by trainees, morbidity meetings, department audit, journal club and presentations by guest lecturers. There is a monthly half day programme of tutorials for trainees, involving consultant presentations and is an opportunity for case presentations by trainees. There is a small departmental library and a larger library in the Institute of Child Health.

Research Opportunities

There is an active research programme in the department in which trainees are encouraged to participate. There are opportunities for trainees to study for a higher degree.

Further Information

Contact Dr I Walker (College Tutor)

Harefield Hospital

Specialist Hospital

A well-known cardiothoracic centre of excellence.

No. trainees:-13

Transport

Harefield Hospital is situated in the grounds of an estate known as Harefield Park, situated just off the Rickmansworth Road and within the M25. Access is by road, with ample parking being available on site. Access by public transport is via bus from Uxbridge or Denham

Clinical Experience

Harefield contains the Regional Cardiothoracic Surgical Unit together with a Supra Regional Cardiac Transplant Unit. Harefield has the world’s busiest cardiopulmonary transplant programme. Heart,heart and lung and single lung transplants are performed in adults. There is also a very active artificial herat program. At present 20 left ventricular assist devise and 5 biventricular devises a year are implanted but it is anticipated that these numbers will rise to about 50 devices per year in the near future. Thoracic surgery casemix is varied, including all types of oesophageal surgery as well as pulmonary, mediastinal, chest wall etc. The number of annual anaesthetics given is as follows: Adult cardiac 1200, transplants 120, thoracotomies 650, intermediate and minor cases 1800. There is a adult Intensive Care, Recovery and High Dependency Unit with 1450 ITU admissions last year.

Rota

Teaching

Variable half day teaching , friday journal club. JCC with surgeons tuesday 8am. First Wednesday each month Grand Round. Audit meeting:Once monthly with afternoon dedicated to teaching. Office facilities include a fax machine and a number of audio visual aids. Computer equipment includes internet access. Teaching aids include Transoesophageal Echocardiography software and an interactive laser disc. Library facilities include a small library in the anaesthetic department seminar room. A fully staffed specialised library on site with a Medline CD Rom database is also available.

Research Opportunities

There is a very active research interest. The main topics are related to the inflammatory response to surgery,preservation of organ function(especially organs for transplantation) and thrombosis and haemostasis. There is a pain nurse in the department who is undertaking studies of different methods of relieving postoperative pain.

Further Information

King Georges Ilford and Queen’s Hospital Romford

(DGH) District General Hospital

Trainees rotate to the Barking Havering and Redbridge (BHR) Trust and work at both King George and Queens Hospitals. King George hospital is situated in Barley Lane, Goodmayes, Essex and Queens Hospital is situated in Rom Valley Way, Romford, Essex. BHR is a large acute trust with over 1300 beds, providing services of all the major specialties of large district general hospitals. A joint cancer centre with St Bartholomew’s Hospital in London and a regional neuroscience centre at Queen’s are offered in addition to these services.

No. trainees:-11

Transport

King George is easy access via main line stations and bus routes.
The closest Underground station is Newbury Park and the closest BR station is Goodmayes.
Queens Hospital is a short distance away from Romford BR station.

Clinical Experience

The Anaesthetic Department provides services for all elective and emergency inpatient and day surgery theatre sessions, Critical Care, Acute and Chronic Pain. There are 22 theatres across the two sites, two busy Obstetric units with over 10,000 deliveries per year and 4 Obstetric theatres. There are two General Critical Care units and Neuro-surgical ITU with total of 19 ITU and 14 HDU beds. Department provides emergency services to two busy A&E departments with over a quarter million attendances per year.
The following training modules may be arranged for anaesthetic trainees by rotation or for specific experience: Day Surgery, ENT, General (including some paediatric surgery), Intensive Care, Neurosurgery, Obstetrics, Orthopaedics and Trauma, Pain Medicine (including acute and chronic), Upper GI, Urology, Vascular.

Rota

Trainees work a 1 in 7 rota. Rotas are EWTD compliant with less than 48 hours per week. There are separate on-call rotas for Theatres, Critical Care Units and Labour Wards.

Teaching

Departmental CME meetings are held weekly on a Friday morning starting at 7:30. CT1 and 2 trainees attend centralised teaching on alternate Tuesdays and internal teaching for the final FRCA is held on Friday mornings (after CME meeting). All teaching is held at Education Centre, Queens Hospital, with exception of some monthly Audit meetings. There are medical libraries on both sites and access to KA24 is available. Department runs a number of specific training days (difficult airway, fiberoptic intubation, critical care, etc.), that trainees are encouraged to attend.

Research Opportunities

Further Information

Dr Tomas Jovaisa, College Tutor
Dr Kanthi Raveendran, College Tutor

Lister Hospital - Stevenage

(DGH) District General Hospital

The Lister Hospital is a 728 bedded district general hospital located in Stevenage.

No. trainees:-20

Transport

There is easy access to London and the North of England both via road and railway.

Clinical Experience

The directorate of Anaesthetics, Theatres and Intensive Care provides a range of
services to other directorates within the trust and directly to GP fundholders.
THESE INCLUDE RESOURCES TO PROVIDE: 6 bedded unit for Intensive Care patients and
those requiring haemofiltration, plus a 6 bedded HDU. 60 main elective surgical
sessions per week for all surgical directorates(plastics, ENT, general surgery,
Vascular surgery,Urology, gynaecology,trauma/orthopaedics) 20 elective day case sessions
per week for all surgical directorates anaesthetic support for obstetrics includi
ng 24 hour cover elective sessions for pain relief in acute and chronic conditions
, there is a dedicated session for acute pain services. anaesthetic sedation and
general anaesthesia for MRI patients anaesthetic support for ECT to the Mental
Health Unit. A service for day case dental surgery is provided.

Rota

StRs work a 1 in 8 full shift on-call rota with prospective cover(Band 1B).

Teaching

Weekly departmental meetings are held at lunchtime on Wednesdays. Friday lunchtime, and a dedicated training session on Wednesday afternoon from 13h30 to 16h30 which all junior members of staff are required to attend. Audit meetings are held every month at which presentations are given by consultant and junior staff. The anaesthetic department has its own tutorial room with a desktop PC for trainees use. There is a large library situated on level 2 which stocks a range of anaesthetic journals and text books with an excellent computer based resource.
There is regular Multidisciplinary simultion training in Difficult Airway management and Obstetrics.

Research Opportunities

Further Information

Dr M Chilvers Director of Anaesthetics/Theatres/ITU Dr Prasad and Dr Eckersall are both College Tutors Mrs Beverley Redman Principal Directorate Secretary

Moorfields Eye Hospital

Specialist Hospital

A postgraduate centre for ophthalmic surgery. The days can be extremely busy, with trainees giving many anaesthetics, both regional and GA, on high turnover lists.

No. trainees:-6

Transport

Moorfields Eye Hospital is situated on City Road a short distance from Old Street Underground / BR Station. The way to the hospital is well signposted.

Clinical Experience

About 23,000 patients are operated on per year. An increasing number of these have a local anaesthetic, currently about 10,000. Some of these anaesthetics are given by the anaesthetists and all junior staff are given the opportunity to learn local ophthalmic anaesthesia. A significant proportion of the work is paediatric. Practice at Moorfields for GA now includes a large proportion of TIVA, trainees get the opportunity to train in and use this technique.

Rota

There is currently a 1:6 prospective rota, currently non-resident on call. This varies if we have less trainees, or may be diluted by the fellow (when in post). Emergency operations do not take place at night. Trainees on call usually leave by 9pm and are not on call from home.

Teaching

Induction takes place on day one and includes tutorials on several relevant topics.Weekly meetings are held, most with educational content. Trainees are expected to present on one occasion during the three months.
There are anaesthetic journals and books available in the department. The main hospital library also has anaesthetic books, and the librarians will assist in obtaining other materials. We expect senior SpRs to attend the pan-London training days, and give as much support as we can to those sitting the final fellowship. Moorfields does not currently receive trainees who have not passed primary.

Research Opportunities

SpR rotations are 3 months. This does not allow time for fruitful research. However, we frequently have a fellow who pursues research and audit projects with support from others in the department. Please contact the college tutor for details.

Further Information

Please contact Dr Andy Presland, College Tutor.

National Hospital for Neurology and Neurosurgery

Specialist Hospital

The National Hospital for Neurology and Neurosurgery receves patients from a group of teaching and district general hospitals and provides neurological and neurosurgical services on a local, regional, national and international basis. The hospital has one of the largest neurological critical care facilities in the UK.

No. trainees:-12

Transport

The hospital is situated in the heart of Bloomsbury in Queen Square. Russell Square is the closest Underground station.

Clinical Experience

The National Hospital for Neurology and Neurosurgery is a 220 bedded hospital which has 4 operating theatres, performing some 2,000 procedures per annum. All aspects of Neurosurgery and spinal surgery are covered. There are two ITU’s and one HDU in the hospital with a total complement of 20 beds. The surgical ITU consists of 8 beds and the HDU has 4 beds, both units are staffed separately by the 3 SHOsand 2 clinical fellows. There is a very active interventional radiology and MRI department needing regular anaesthetic input. The UCLH Trust Pain Management Department is now located at NHNN. The department has 6 consultants and provides patients with all round care including blocks for pain relief.

Rota

The SpRs work a 1 in 9 on call rota with i in 9 second on call duties until 21.00 at night. The five SHOs and clinical fellows work a shift system in the surgical intensive care unit.

Teaching

Departmental meetings are held on a Thursday afternoon and coincide with the surgeons and theatre staff meetings so that the teaching time is protected. Audit meetings also occur during this time. There are regular joint audit meetings with the surgeons. In addition to the departmental library which holds the BJA and Anaesthesia, the Rockefellar Library stocks, Anesthesiology, Journal of Neurosurgical Anesthesiology, Critical Care Medicine, Intensive Care Medicine as well as a multitude of journals allied to the neurosciences. A multimedia computers are available in the trainees study room. The BMA library is within walking distance of the hospital. There are active research programmes within the department. Trainees are encouraged to participate in research during there tenure at NHNN There are close links with the Academic Anaesthetic Department at UCL.

Research Opportunities

There is an active reseach unit at the National Hospital and trainees are encouraged to become involved with a project during their time at NHNN.

Further Information

Dr Yogi Amin, College Tutor

North Middlesex University Hospital

(DGH) District General Hospital

The North Middlesex University Hospital (NMUH) is a busy DGH situated in North London. Situated on the North Circular Road, it has good transport connections. The nearest tube station is Silver Street. The hospital is now housed in a £120 million PFI facility with eight operating theatres, and a 12 bedded recovery bay with excellent facilities. There is a modern and well-equipped intensive care unit with 8 beds and facilities for multi-organ support.

No. trainees:-10

Transport

ONE Silver Street mainline station, originating from Liverpool Street, is a few minutes walk away. The hospital is on the North Circular Road (A406). Buses Nos. 491 and 318 terminate at the hospital. Bus No. 444 goes by the hospital. Bus W6 stops near the hospital on Silver Street (eastward) or N. Circular Road (westward)with a 12-minute walk.

Clinical Experience

The Department provides anaesthetic services for elective and emergency inpatient and ambulatory surgery sessions. Specialties include General surgery, Urology, paediatrics, day surgery, Orthopaedics & Trauma, Opthalmology, Dental, Obstetric & Gynaecology.
There is a busy Obstetric unit with 12 labour rooms and 2 dedicated obstetric theatres. There is a 24 hour obstetric anaesthesia and labour analgesia service.
Our A&E is one of the busiest in North London accepting a variety of Trauma cases.
There are 2 Consultants with Special interest in management of chronic pain offering a variety of chronic pain interventions.There is also good difficult airway management training by a group of experts in difficult airway management.

The following training modules are available at NMUH: ICM, Obstetrics, General surgery, Orthopaedics & trauma, Day surgery, ophthalmology and paediatrics and chronic pain. Senior trainees have opportunities for management and research.

Rota

Three tier 1 : 7 Rota(ICU rota 1:8) system with prospective cover supported by a General and Intensive care consultants.

Teaching

Dedicated weekly consultant lead teaching with presentation opportunities for trainees. With over 50% of consultants appointed in the last 5 years, there is good enthusiasm for teaching in the department. Exam oriented teaching is organised around FRCA exams.

Research Opportunities

R&D grants available on appllication.Please contact Dr.Jeromino Cuesta-Research lead

Further Information

Dr. Mohan Sivarajaratnam, College Tutor. Dr.Ah Fee Chan IBTICM Tutor
Ms Nandini Aplasamy, Anaesthetic Secretary . Tel.: 020 8887 2221/Email: nandini.aplasamy@nmh.nhs.uk

Princess Alexandra Hospital - Harlow

(DGH) District General Hospital

Princess Alexandra Hospital is situated in the new town of Harlow midway between London and Cambridge.

No. trainees:-12

Transport

The hospital is also 10 miles from Stanstead International Airport.

Clinical Experience

All acute services have been centralised at the Princess Alexandra Hospital site. Currently some 14,000 anaesthetics a year are given. There is a day care unit with 2 operating theatres and 2 endoscopy rooms. In the main inpatient operating theatres there are 9 theatres including a dedicated obstetric theatre and a dedicated emergency theatre. Surgery performed at the hospital includes: general surgery, vascular surgery, urology, gynaecology, orthopaedics and trauma. Specialist surgery includes: ophthalmology, ENT, plastic surgery and maxillofacial surgery (sub regional unit). The obstetric unit has some 3,000 deliveries per year. There is an on demand epidural service with a dedicated junior anaesthetist and there is also a dedicated obstetric obstetric theatre. The ITU has 5 beds and admits about 300 patients per year, the HDU has 5 beds.

Rota

Trainess work a 1 in 8 partial shift with internal cover. This is paid at a 2B rate

Teaching

Audit meetings are held monthly (sometimes multi-disciplinary). There is internal teaching for the FRCA. There is a departmental seminar room with journals and a small library. The Trust has a Postgraduate Centre with its own lecture room, library and CD ROM facilities.

Research Opportunities

Further Information

Dr J Phillips, Lead Clinician or Dr A Krishnamurthy, College Tutor

Queen Charlottes Hospital

Specialist Hospital

Queen Charlotte’s hospital has been located since November 2000 in a newly built facility next to the Hammersmith hospital on Du Cane road. It includes delivery suite, a ‘birthing centre’, ante and post natal and gynaecology wards.

No. trainees:-6

Transport

East Acton or White City on the central line are both a 10min walk to the main entrance.

Clinical Experience

There are currently approaching 5000 deliveries of which 30% are by Caesarean section. The majority (>98%) of sections are carried out in the two theatres on delivery suite. The current epidural rate on the unit is 69%. The proportion of medical and obstetric high risk patients cared for by the unit which is a tertiary referral facility has increased substantially since the move to the new site and partly accounts for the high intervention rate. Separate theatre staff, including an anaesthetic nurse/ ODA, are employed during weekdays to carry out elective sections. There are 2 on-site, dedicated obstetric theatres. Cases that require post-operative ITU care or involve simultaneous non-obstetric surgery are carried out in general theatres. High risk cases not requiring respiratory support are cared for in the obstetric HDU, staffed by specialist midwives and anaesthetic/ recovery nurses.There is separate on-site 24-hour ODA cover for the delivery suite.

Rota

The rota is arranged as a partial shift: The night on call is preceded by a free day and is followed by the day off. Out of hours cover is approximately 1 in 6 with internal cover. ‘1st On-call’ covers the Labour ward and attends a teaching round before going off for the following 24 hours.

Teaching

There are weekly academic meeting Friday afternoons. Every 3rd week the afternoon meeting is on an obstetric subject. Workload permitting, there is a journal club on one of the weekday mornings. A ½ day postgraduate forum involving the whole directorate of women and children occurs monthly. Every effort is made to grant study leave and priority is given to courses and meetings relevant to the subspeciality.

Research Opportunities

There are a variety of projects both clinical research and audit carried out. Trainees are encouraged to become involved, and given support and help with any projects of their own. (Each trainee is asigned an educational supervisor) The majority of SpRs are expected to complete one or more pieces of work during their attachment. All will be required to present at one of the academic meetings. Year 4 / 5 SpRs are expected to gain some administrative/ management experience through attendance at departmental meeting taking responsibility for the trainees’ rota etc.

Further Information

Royal Brompton Hospital

Specialist Hospital

The Royal Brompton is a postgraduate centre in which adults and children undergo treatment for a wide range of cardiovascular and respiratory disease.

No. trainees:-10

Transport

It is situated in South Kensington with the nearest tube station being at South Kensington on the District and Circle line. Multiple bus routes pass the area. Bike rails are available for those who cycle, as are showers.

Clinical Experience

The Anaesthetic Department is collectively responsible for anaesthetic services to five operating theatres, four catheter laboratories, The Adult Intensive Care, the Paediatric Intensive Care and the CT and MRI scanning suites. The work load for the year 2000 - 2001 comprised of approximately 1050 adult cardiac cases of which 70% were patients undergoing coronary artery bypass grafts, 20% valve repair or replacement, and 10% combined or complex procedures. In addition 450 paediatric cases were performed of which 250 required cardiopulmonary bypass. The thoracic surgeons performed 800 thoracic procedures including both adults and children, and the respiratory physicians require general anaesthesia for 150 paediatric flexible bronchoscopies.

Rota

A full shift system in place which is EWTD compliant

Teaching

Protected teaching is held every Wednesday from 8-11am. There is an intensive lecture programme in Cardiothoracic Anaesthesia, There are weekly Journal Clubs and regular morbidity and mortality, audit and adverse incident review meetings. Anaesthetic trainees are able to attend teaching programs of other Directorates and are encouraged to attend EPLS and ALS courses as appropriate. An SpR Reading Room is available. IT facilities including internet access & CD server. The department subscribes to relevant anaesthetic journals, and library facilities are available at the National Heart and Lung Institute and Imperial College. All trainees are expected to achieve a range of clinical & non-clinical objectives during their attachment.

Research Opportunities

Clinical research is encouraged. All trainees have the opportunity to carry out and present an audit project during their attachment.

Further Information

If you require further information, please contact Dr Sian Jaggar via the anaesthetic secretary Lindsay Price on 020 7351 8526.

Royal Free Hospital

Teaching Hospital

The Royal Free Hospital is a teaching hospital which is located in Hampstead (well Belsize Park)

No. trainees:-26

Transport

The closest stations are Belsize Park on the Underground and Hampstead Heath on the North London Line.

Clinical Experience

The department provides anaesthetic services for 3 day surgery theatres and 14 operating theatres, 2 obstetric theatres and an interventional radiology suite.

A wide range of specialist surgery is undertaken, including Neurosurgery, Ophthalmic, ENT, plastic, liver and renal transplantation. Other major commitments include the pain relief services, bone marrow harvesting, MRI and CT scanning, cancer chemotherapy and paediatric services.

There is a 24 bedded ICU.

The obstetric unit has over 3,000 deliveries per year, and the CSE technique is taught.

Rota

We have a full shift system, with separate rotas for the SHO years, and for SpRs in ITU, Obstetrics, Livers and General Duties.

Teaching

A half day teaching programme for all trainees is arranged, and a Friday morning meeting at which trainee presentation is encouraged. There is a weekly journal club for trainees.

Audit meetings are currently held four times per year.

There is a library within the anaesthetic department, which doubles as a seminar room.

The University Library is available on site.

There are a number of PCs in the department with internet access, and trainees are encouraged to use them.

An induction and orientation day is held on the day of commencement.

Research Opportunities

There are active research programmes on-going within the department with particular interests in obstetric analgesia, blood clotting, liver transplantation and fluid balance.

Further Information

Dr Mike Pegg, Chairman
or
Dr Jeremy Prout, College Tutor
or
Dr Rebecca Simons, College Tutor
or
Dr Adrian England, Unit Training Director (for Annual Leave requests)

Royal Marsden Hospital

Specialist Hospital

The Royal Marsden Hospital is a specialist oncology centre treating all forms of cancer. Major surgery and critical care are based at the Fulham Rd site, while paediatrics, haemoncolgy and some surgery is carried out at Sutton.

No. trainees:-11-12

Transport

South Kensington tube is 5 minutes walk from the Fulham Road site. The Sutton site is served by hospital shuttle buses, and local rail stations at Sutton and Belmont.�

Clinical Experience

We provide anaesthesia for a wide range of adult cancer surgery including head & neck procedures, sarcoma, major urology and gynaecology surgery, upper GI and liver resection, as well as breast and reconstructive procedures.

Other departmental commitments include anaesthesia for paediatric oncology procedures, and also vascular access and pain management (accredited for Higher and Advanced training in pain medicine)

The critical care unit provides care for complex post-op patients, and adult medical oncology patients, and is accredited for training up to Advanced Level.

We run an anaesthetic pre-assessment unit which now includes a cardiopulmonary exercise (CPET) system.

The following fellowships are also available to OOPE and post CCT trainees


Human factors and patient safety

Intensive care medicine

Medical education

Advanced pain management

Anaesthesia for upper GI surgery

Anaesthesia and perioperative medicine

Rota

We have a full shift EWTD compliant rota which includes ICU on-calls and evening anaesthetic cover

Teaching

We hold a teaching session and an educational departmental meeting on most weeks. Formal audit and M&M meetings are held 6 times per year.

Trainees are allowed access to the Institute of Cancer Research library system

Research Opportunities

The department undertakes research into cancer pain management, and has published a number of articles relating to oncology and anaesthesia. A research program for critical care and cancer is being developed.

Further Information

Dr Matt Hacking � Anaesthetic Department Lead

Dr Andrew McLeod � College Tutor

Dr Pascale Gruber � Critical Care lead

Ms Breeda Jenkins - Anaesthetic Office Manager/Coordinator

Breeda.jenkins@rmh.nhs.uk

Royal National Orthopaedic Hospital

Specialist Hospital

A specialised unit for orthopaedic surgery.

No. trainees:-9

Transport

The RNOH is situated in North West London on the A41 and next to junction 5 on the M1 motorway (exit only if travelling south). Ample parking is available on site. Access is also possible by underground: Stanmore (Jubilee) and Edgware (Northern). The bus service to the hospital is better from Edgware station.

Clinical Experience

The hospital performs elective orthopaedic surgery in a suite of 10 operating theatres. The RNOH is a tertiary referral centre and much of this is highly specialised surgery and includes: revision joint replacement surgery, bone tumour surgery, paediatric orthopaedic surgery, peripheral nerve injury, spinal deformity and spinal injury with their associated difficult airway management problems. Fibreoptic intubations are taught with a dedicated camera and monitor. An intubating manikin is available. Many regional blocks are performed for intra and postoperative analgesia. In addition there is: an acute spinal injuries unit, a large non-acute pain service, an ITU with 6 beds to support the elective theatre workload and the spinal injuries unit and a 6-bedded HDU.

Rota

The SpRs work a 1 in 8 resident shift pattern rota with prospective cover.

Teaching

There is a weekly departmental meeting on a Wednesday morning. Audit meetings are held bi-monthly. IBM compatible computers are available on site. A library is available in the Herbert Seddon teaching centre.

Research Opportunities

Further Information

Contact Dr Ruby Sharma, College Tutor.

Royal National Throat Nose and Ear Hospital

Specialist Hospital

This is a specialist centre for all types of ENT surgery,

No. trainees:-6

Transport

The hospital is situated close to Euston and Kings Cross stations and is very convenient for public transport.

Clinical Experience

The department provides anaesthetic services for elective and emergency ENT, major head & neck and neuro-otology in an operating theatre suite of 3 theatres and a separate day case theatre. In addition there is a 3 bedded PCU. Routine and difficult airway management, and hypotensive anaesthesia is taught. There is an active sleep laboratory.

Rota

SpRs work a 1 : 5 non resident on call rota with prospective cover, but may be resident to cover the HDU.

Teaching

There are weekly formal tutorials within the department and monthly audits jointly with surgeons. There is a new Pentium 3 PC with access to the RFHNET availabe in the department for the use of the trainees. The Institute and Hospital library is outstanding. Advanced audiovisual systems at the Institute are also at the disposal of the Anaesthetic Department.

Research Opportunities

Further Information

Contact Dr B M O’Donoghue

The National Heart Hospital

Specialist Hospital

This specialist cardiothoracic unit lies in the middle of the west end of London. It has 4 operating theatres and 17 ITU/HDU beds. We do about 900 cardiac cases per annum and a similar number of thoracic cases.

No. trainees:-4

Transport

The hospital is about 10 minutes walk from several tube stations(Baker Street,Bond Street or Oxford Circus)

Clinical Experience

All types of adult cardiac surgery inlcuding valvular heart disease and coronary artery bypass grafting. There is an increasing amount of aortic work being done, mostly by Mr Yap, and therre are expanding links with the UCLH vascular service under Prof. Harris. We have also recently started a percutaneous aortic valve rerplacement (TAVI) programme under Dr Mullen. On top of this we have an extensive adult congenital surgical and medical programme.

We offer a full range of thoracic surgical procedures with close links to the UCLH thoracic medicine department.

Rota

Rota is a full shift system with approx one week in 8 spent doing ITU days and a further week of nights. Rest of time is spent in theatres/cath labs. Numbers on rota are made up by clinical fellows, some from the rotation, many from abroad.

Teaching

Anaesthetic teaching occurs on Wednesday mornings (before the lists start). There is ample opportunity to get one to one cardiothoracic teaching in theatres with consultants or senior clinical fellows; there is also excellent opportunity to gain invaluable TOE skills. There is a formal week-long course run by the department 6-8 times a year, but gets booked up well in advance. Please contact Dr Sue Wright, course director, for details.

Research Opportunities

The hospital enjoys close links with the Centre for Anaesthesia at UCL with fellows regularly dividing their time between the clinical duties at the Heart Hospital and research at the Centre under the supervision of Professor Mythen

Further Information

University College Hospital (UCH)

Teaching Hospital

The new University College Hospital with its distinctive 16 storey Tower was opened in 2005. UCH is a state of the art building with a paperless (paper light) information system. The hospital has 540 inpatient beds plus 56 beds in the A & E department and a further 35 bedded ITU. The new obstetric hospital attached to the main hospital opened in 2008 with approaching 5000 deliveries per year.

No. trainees:-36

Transport

UCH is easily accesible and situated on the Euston Road between Warren Street and Euston Square underground stations

Clinical Experience

The UCH anaesthetic department supplies anaesthetic services to sites within the UCLH Foundation NHS Trust : The Obstetric Hospital site with its 5,000 deliveries per year. University College Hospital site which includes : The A & E dept and its 70,000 attendances per year. The unit has 56 beds to support the service. The main theatre suite at UCH with its 12 operating theatres. The surgery performed here includes : general, paediatrics, maxillofacial and major head and neck, bariatrics, orthopaedic, and urological surgery.A new Hybrid Vascular theatre has recently opened to support the expanding endoluminal vascular work. In addition there is a 2 theatre Day Care unit. There is a large 35 bedded ITU at UCH and both SHOs and SpRs are seconded to the ITU for a period of 3 months. During this period they work exclusively in the ITU and they work on a shift system. There is a busy and active Pain Management Centre specialising in pain investigation. This is joint with NHNN, Queen Square. The Anaesthetic Department also covers the heart Hospital which is on a separate site in Marylebone.

Rota

The trainees currently work a Full shift patten rota. A similar shift system operates during the 3 month ITU secondment. Our anaesthetic rotas have recently changed to 1 in 9, full shift 48 hour compliant rotas with fixed annual leave, two concurrent weeks in each 9 week period.

Teaching

Departmental meetings are held weekly on a Friday morning starting at 0800. Audit and and governance meetings are currently held 8 times per year. Internal teaching for the Primary and Final FRCA is held on Tuesday mornings. There are internal FRCA pts 1 and 2 courses run to coincide with the exams. The new educational center at the hospital includes a hi fidelity theatre simulator as well as state of the art conference facilities. There is a small departmental library and the Rockerfeller Libraries (part of the UCL School of Medicine library are next door. Access to KA24 is available through the Hospital library.

Research Opportunities

There are a number of research projects underway under the guidance of the UCL/Royal Free research group from the Center for Anaesthesia which is located on the UCLH site . This is guided by Professor Mythen, Brigita Brandner, Gareth Acland & Sarah Chieveley-Williams, together with many other members of the department.

Further Information

Viki Mitchell-Clinical Lead
Sarah Chieveley-Williams - College Tutor
Miriam Chapman - College Tutor
Roger Cordery - Training Programme Director ST 1,2
Craig Goldsack - Departmental Chairman

Whittington Hospital

(DGH) District General Hospital

The Whittington Hospital is a 580 bedded District General Hospital which is also one of the three University Hospitals of the UCL School of Medicine. A rebuild including an acute services hot floor with a 15 bed critical care unit opened in late 2004. There is also a dedicated day treatment centre with 4 day surgery theatres, interventional radiology and endoscopt suite.

No. trainees:-17

Transport

The Hospital is located on Highgate Hill and is close to Archway Underground station.

Clinical Experience

The anaesthetic department offers extensive experience in General, Orthopaedics, Urology, Bariatric surgery, Gynaecology and Day surgery (includes some day case ENT) . An emergency theatre is open throughout the day every day. The obstetric unit has more than 3,200 deliveries per year. The acute pain service is supported by a full time Acute Pain Nurse. There is a 15 bedded crticial care unit. We have bariatric and obstetric fellow posts (Drs Ziyad and Makinde are the respective leads for these)

Rota

1 in 7, EWTD compliant. Rota lead is Dr Sarah Ward, administrator is Oli Brady.

3 Trainees are on call at all times: 1st On-Call ST12 for theatres, acute pain service and cardiac arrests. 2nd On-Call ST3+/SpR covering 1st on and trauma bleep. Obstetric anaesthesia ST3+/SpR. The ICU has a separate resident ST12 and middle grade rota.

Teaching

Weekly - departmental meetings, which all members of the department are required to attend, are held at 0800 on Thursday. Monthly - training and educational afternoons are held which include audit presentations. Weekly - regular teaching sessions are held on Tuesday mornings. The anaesthetic rest room in theatres has reference bench books and a desk top PC with internet access for trainees use. There is a multidisciplinary library in the Whittington Postgraduate Centre which stocks a range of anaesthetic journals and text books together with an excellent computer based resource. A skills lab and simulator
centre is housed in the education centre. We have ATLS, APLS and ALS courses on site The
In addition, the Post Graduate Education department runs regular TIPs and other teaching courses. Dr Chekairi leads the course in clinical leadership, medical management and service improvement.

to Teach�

Research Opportunities

Further Information

Further Info:- Dr Samina Ishaq, Chairman of the Department or Dr Catherine Shaw, College Tutor (catherine.shaw5@nhs.net)
Oliver Brady is the departmental administrator Oliver.Brady@nhs.net