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Barts and the London Hospital

The Central London school of Anaesthesia has a long standing partnership with the Barts and the London School of anaesthesia – together forming the North Central and North East programme for anaesthesia.

We have training posts based at the London Hospital for paediatric anaesthesia, ICM and trauma management. In addition, we provide training in cardiothoracic and vascular anaesthesia in the Barts Cardiac centre.

Royal Marsden 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, haemoncology and some surgery is carried out at Sutton.

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. Trainees gain wide experience in perioperative monitoring, massive transfusion, and post op care of patients undergoing complex cancer surgery. There is also extensive opportunity to use Total Intravenous Anaesthesia.

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

Queen Charlotte’s Hospital

Queen Charlotte’s & Chelsea Hospital is world-renowned for its maternity and women’s and children’s services.

The hospital is a tertiary referral maternity unit with a nationally renowned centre for foetal care and has the largest neonatal intensive care unit in the country. It has a labour ward with two fully equipped operating theatres adjacent to high-dependency care facilities. It includes a delivery suite, a birthing centre, ante- and postnatal and gynaecology wards. Anaesthetic trainees have the opportunity to be involved in a wide variety of complex elective and emergency obstetric cases, as well as to attend high risk obstetric anaesthetic and obstetric medicine clinics and ward rounds.

Queen Charlotte’s & Chelsea Hospital is also home to the West London Gynaecological Cancer Centre and during their placement, trainees gain experience in anaesthesia for major gynae-oncology surgery including multivisceral resection procedures for advanced ovarian cancer. They also gain experience in sedation for IVF procedures.

Number acute beds: 127 inpatient beds (72 maternity beds and 55 neonatal intensive care cots)

Number operating theatres: 2 obstetric theatres on labour ward at QCCH, 8 operating theatres at Hammersmith Hospital, 1 operating theatre in IVF

Number ICU/HDU beds: 2 HDU beds on labour ward

Number of deliveries: Around 6000 per annum
Surgical specialties: Obstetrics, gynaecology

Royal National Orthopaedic Hospital (RNOH)

The RNOH is the largest specialist orthopaedic centre in the UK performing highly specialized surgery. The hospital has 220 beds and the theatre suite has 10 theatres.

A wide range of surgeries is performed both in paediatric and adult population. These include primary and revision joint replacement surgery, bone tumour surgery, peripheral nerve injury repairs, spinal deformity and spinal injury; urological procedures in patients with neuropathic bladders.

The ITU has 6 adult ICU beds, 6 adult HDU beds and 4 Paediatric HDU beds mainly catering for the post surgical patients.

The Chronic pain service provides interventional management therapies in addition to outpatient services. A well-supported Anaesthetic Consultant led acute pain service is also available.

The spinal injuries unit (40 beds) admits both acute spinal injuries and patients for spinal rehabilitation and has consultant anaesthetist support.

The anaesthetic department also provides anaesthesia in the two radiology suites for scans and interventional procedures and runs a long-term venous access (PICC line) service.

The pre-assessment unit is anaesthetic led and has consultant high-risk clinics.

There is no Accident and Emergency department in this hospital.

The RNOH is situated in North West London on the A41 and next to junction 4 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. RNOH courtesy car service (free) is available from Stanmore tube station to the RNOH (every 15 minutes Mon-Fri).

 

On call rooms: We are one of the few hospitals, which still have an on call room with shower facilities, free of charge for trainees. We do look after you!

Parking: one of the few hospitals where it is Free!!

Food: There is a shop and Starbucks in outpatients, Starbucks in the new hospital block and Staff restaurant (Broccles) – all are open only in daytime hours.

Free hospital wide wi-fi is available. Please use whatsapp/ FaceTime/ emails/free Wi-Fi enabled calls, as mobile signal is poor.

 

Hospital for Sick Children (Great Ormond Street)

Great Ormond Street Hospital for Children is a postgraduate teaching hospital with 350 beds, and is a national centre for children with a wide spectrum of disease. The full ranges of medical, surgical and diagnostic specialities are available.

Trainees in Paediatric Anaesthesia are integral members of the department of anaesthesia and work supervised (at various levels) and independently as appropriate to their skills.

It is the largest paediatric facility in the UK and has a unique surgical caseload including heart and lung transplantation, epilepsy surgery and cerebral vein embolization for vein of Galen malformation

Working at Great Ormond Street Hospital is an incredible opportunity to gain higher and advanced paediatric anaesthetic training in a complex group of patients. Posts are available for 6 and 12 months within programme, or fellowship (12 month) posts which are out of programme and open application. The 12-month posts include a 3 month rotation to either PICU or CICU. Trainees are selected through a formal interview process conducted jointly between the Schools and GOSH.

Within anaesthetic training, registrars rotate through subspecialties such as cardiac, plastics, ENT, and general surgery. The registrars are from all schools within London, as well as national and international trainees. All trainees are post FRCA, and as such the focus is on education within the post, and expanding extra-curricular interests in audit, research and academia.

Initially trainees are allocated to lists with a consultant, but as you gain competence and confidence there are lots of opportunities for independent practice. Towards the end of a rotation you should expect to be working solo for around 50% of lists, with support always available if needed. As a result, you will become confident in anaesthetising for a wide range of children with complex pathologies; a useful skill regardless of your career aims. All the consultants are supportive and approachable, and happy to teach as well as let trainees ‘run the list’.

There is a strong focus on teaching, and all trainees are expected to attend teaching sessions, and present at least once at educational meetings. Overall you can get a lot out of this job if you are willing to work hard and take opportunities.

Number of Operating Theatres 15 Theatres
21,500 Anaesthetics delivered per year

Number of ICU Inpatient beds /HDU Beds 36
PICU 13 / NICU 10 / CICU 20

Surgical Specialities General, Cardiothoracics, Neurosurgery, Urology, Orthopaedics, Spinal, Plastics, ENT, Craniofacial, Ophthalmology, Interventional Radiology, Dental

Royal National Throat Nose and Ear Hospital (RNTNE)

We are a busy specialist hospital located on Grays Inn Road. The department provides anaesthetic services for elective and emergency ENT and neuro-otology in an operating theatre suite of 4 theatres. We anaesthetise adults and children. We also provide anaesthesia for major head & neck procedures at UCH. Routine and difficult airway management, efficient day-case surgery and hypotensive anaesthesia is taught. There is an active sleep laboratory on site.

National Hospital for Neurology and Neurosurgery (Queen Square)

The National Hospital for Neurology and Neurosurgery receives 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 department provides anaesthesia for the largest number of neurological cases in the UK, which includes major vascular procedures, major spinal surgery, pituitary surgery, surgery for craniocervical disorders, stereotactic surgery, surgery for movement disorders, posterior fossa surgery and surgery for temporal lobe epilepsy. We also care for a large number of patients who have sustained intracranial haemorrhage especially subarachnoid haemorrhage.

There is also a busy Neuroradiology department with interventional radiology, MRI under general anaesthesia and a busy interventional operating suite. The department is also involved in the new Thrombectomy service with the Stroke Team.

The hospital has one of the largest dedicated neurological critical care facilities in the UK. There are two intensive care units, one medical and one surgical. The Neurosurgical Intensive Care Unit (SITU) has nine beds with a co-located High Dependency Unit with six beds and cares for acute admissions as well as those who have had major neurosurgery. There are facilities for state-of-the-art monitoring of neurosurgical patients with many on-going clinical research projects. The Unit is looked after by six consultants in neurocritical care, with input from the appropriate neurosurgical teams. There are consultant sessions to cover each weekday. There is a consultant led outreach team, supported by the critical care team.

The Batten Harris Unit is a six-bedded neuromedical ITU which admits approximately 350 patients per year with a wide variety of neuromedical disorders. These include patients with myasthenia gravis, Guillain-Barré syndrome, status epilepticus and encephalitis. In addition, the unit incorporates a sleep study unit which studies about 140 patients per year. Some of these are patients receiving domiciliary ventilation. The Unit is run jointly by Consultant Neuroanaesthetist Drs Radcliffe and Consultant Neurologists Professor Kullmann and Dr Howard. Daily rounds involve neurologists and anaesthetists. The unit has a designated neurology ST 1-2 and SpR who conduct the normal day to day business. The on call Anaesthetic SpR/ST3-7 is responsible for the ITU aspects of the patients’ care as well as contributing to the overall care.

The Anaesthetic Department has a responsibility to seven dedicated Neurosurgical Theatres, including the Interventional MRI theatre which was the first of its kind in the UK, an active Interventional Neuroradiology Department, a regular MRI list involving sedation and general anaesthesia, as well as both acute and chronic pain services. The department provides a 24-hour emergency service as well as routine scheduled theatre sessions. We have recently started an acute thrombectomy service to our local catchment area. There is an active consultant led Acute Pain Service and Tracheostomy Service.

Harefield Hospital

We are a tertiary adult cardiothoracic centre specialising in complex cardiac and thoracic surgery, including heart and lung transplantation, ventricular assist devices as well as both VA and VV ECMO programme. We have a primary angioplasty service with one of the fastest ‘door to procedure’ rates in the country. Lab services include complex devices such as ICDs, PFO closures and arrhythmia ablations. Trainees can expect an extremely interesting educational attachment with intensive consultant support, in both theatre and ICU environment, with opportunity to gain experience in advanced cardiac output monitoring, as well as developing skills in transoesophageal echo. We are a very approachable lot, consistently born out in our trainee feedback
We have a rich and diverse teaching programme, that is very much consultant led as well as a brand new educational centre with simulation model.

We have a body of in-trust Human Factor course instructors aimed at increasing the non-technical skills required in a multi-disciplinary team complex environment