7.2.2ii Higher Anaesthetics
Higher Anaesthetics
Guildford is a DGH with 420 acute and general beds + 112 specialist beds
serving a population of 320,000 in Surrey County. It is also a major Cancer unit
for the South East region. There are 12 operating theatres in main theatres.
Two theatres are modified for major laparoscopic surgeries with state of the
art technology and the facility to transmit live, locally and internationally.
The main theatres also offer the use of Oesophageal Doppler, fibreoptic
laryngoscopes and vascular ultrasound machine for vascular access and regional
blocks. The number of operations performed makes an annual turnover of
approximately 3500 inpatients and 5000 day cases. There is also an obstetric
theatre, two day surgery theatres, a procedure room and a high dose radiation
theatre where radiotherapy given under anaesthesia.
The Department space comprises two anaesthetic offices, a consultants’ office and
a seminar room. There is a small Department Library and the hospital has a Library
in the Education Centre. There is an active Sports and Social Club within the
hospital and Surrey Sports Park opposite the hospital
Grade:
ST3
Anaesthetic modules
Current modules for ST3 level includes Obstetrics, pain, Paediatrics and Intensive
Care Medicine. We do have Higher speciality trainees at ST5 and ST7 levels doing
ICM, General, Management, Hepatobiliary and major Head and neck surgery
modules.
It is well recognised that Guildford has become the Regional Cancer Centre, in
addition to being the tertiary referral centre for Maxillo-facial and upper GI
surgery. This has resulted in an increase in the number of major, complex
operations performed on the site and an increase in ITU/HDU capacity. In addition
there are a large number of surgical sub-specialties not found in other comparable
DGHs, all of which makes the RSCH a demanding and challenging arena for a
specialist trainee.
Obstetrics
The obstetric unit has about 3,500 deliveries per year, the majority of whom have
some form of anaesthetic intervention. The overall epidural rate is about 37%,
almost exclusively low-dose. The Caesarean section (CS) rate is about 24% and
there are elective CS lists each weekday morning, which are covered by a consultant
anaesthetist. Nearly 98% of elective CS and 85% of emergency CS are done under
regional anaesthesia. The obstetric population is generally low-risk and there is
7.2.2ii Higher Anaesthetics
consultant obstetrician cover during each weekday. Anaesthetic cover is usually
provided by a consultant with a trainee in the mornings, a SAS grade in the
afternoons and a registrar out of hours.
Intensive care
There is a 27 bedded Intensive Care Unit comprising level 2 and level 3 care and
has average 1000 admissions per annum covered by 3 consultants every day during
day time. There are 12 consultants with intensive care sessions providing 24 hour
cover on a separate rota. In the last three years the number of admissions has
doubled and the standardised mortality rate (SMR) has reduced by 35% at the same
time.
Anticipated duration of programme:
One Year
Commencement date:
Beginning of August
Standard rotation details:
There is a separate anaesthetic and obstetric 1:8 full shift rota which is EWTD
compliant at band 1A. The Intensive Care Unit also has a 1:8 trainee rota on a 1A
banding. An additional 3rd senior clinical fellow tier is now operational.
Education and Study Schedule
Regional ST3/4 and Senior Teaching programmes: organised by St George’s School
(study days are held on a rotational basis across the Region). As part of this the
Department hosts Anaesthesia for Cancer Surgery Day once per year..
Other courses offered by the Department: ATLS, ALS, CCrISP, APLS, Airway day,
Simulation training.
In addition the Anaesthetic Department offers quarterly educational half days
including morbidity and mortality discussions, a weekly journal club and M+M,
weekly regional anaesthesia teaching, two weekly exam oriented primary FRCA
tutorials, and all trainees are rotated through a day of MDT obstetric PROMPT
7.2.2ii Higher Anaesthetics
teaching. All teaching is consultant lead.. The ICU organises monthly morbidity and
mortality meetings and weekly teaching.
The department also has a 5 fellowship programmes in Upper GI, Gynee Oncology
and Colorectal, Regional anaesthesia, Advanced Airway and CPET which are taken
by the ST6 level trainees as OOPE/T.
Exam preparation
Trainees are always allowed to take revision study leave both for private study (a
maximum of one week per year) and for courses where possible. In addition the
Department provides a Primary FRCA Viva/OSCE revision/practice day for the
Region.
One of our consultants is one of only two Primary FRCA examiners in the region,
There are many consultants familiar with exam requirements and available for viva
practice. The department provides intensive viva practice for both primary and final
FRCA taking trainees.
Educational Supervision
All trainees are allocated a grade specific educational supervisor who is closely
involved with their development during their time at Guildford. Dr Amish Patel and Dr
Dow are the module supervisors for ICM and pain respectively. The department has
total of 38 consultants of varying special interest and educational supervision.
The Faculty Lead supervises the overall training and educational needs of all the
trainees.
Consultant Anaesthetists
Dr John Stoneham - Maxillofacial Anaesthesia
Dr Hamish Griffiths - Upper GI
Dr Gareth Jenkins
Dr Paul Saunders – ICU Clinical Audit
Dr William Fawcett - Acute Pain / Hepato-biliary Anaesthesia
Dr Nigel Payne - Acute Pain/Recovery
Dr Nial Quiney - Clinical Director Acute Medicine Hepatic Resection Anaesthesia
Dr Girish Dhond
7.2.2ii Higher Anaesthetics
Dr Snjezana Comara - Co Lead Obstetric Anaesthesia Gynaecology
Dr Tony Lucas - ICU, Clinical Lead for Day Surgery
Dr Mehrun Zuleika - ICU / OG
Dr Kristen Carter – ICU, ACCS lead
Dr Jane Tilley – Director of Medical Education,
Dr Pradeep Prabhu - HPB anaesthesia/Lead for Clinical Risk Management / CPX
Dr Harsh Saxena - Pre assessment/Equipment
Dr Visweswar Nataraj – Core Training TPD KSS
Dr Mike Carraretto - Clinical Lead ICU
Dr Mathew Berry – Head of Department, Trauma Lead, Rota master
Dr Amish Patel - ICU/ICU risk management
Dr Bhavesh Patel - Airway and Resuscitation, Paediatrics, Regional, Paediatrics
Lead
Dr Mark Way – Head and Neck, Regional, Obstetrics, Faculty Lead, Trainee’s rota
master, lead for Obstetric Anaesthesia
Dr Mathew Dickinson – Clinical Director, Upper GI surgery
Dr Gillian Foxall - Regional Anaesthesia Lead
Dr Allister Dow - Chronic Pain
Dr Catherine James - Chronic Pain
Dr Suzi Lomax- Simulation Lead Anaesthetics
Dr Daniella Tonucci- Chronic Pain
Dr Justin Kirk-Bailey – ICU, Research
Dr Chris Jones – Upper and Lower GI, Medical Student Lead, High Risk Fellows
Dr Ed Walter – ICU
Dr Wendy King – Airway, Max Facs, Obstetrics
Dr Piers Johnson – Governance Lead
7.2.2ii Higher Anaesthetics
Dr Alex Fletcher -ICU
Dr Rachel Savine - ICU
Administration
Hazel Still - Anaesthetic Manager
Anita Horne - Anaesthetic secretary
Nicky Millar - Anaesthetic secretary
Lucy Caple – Medical Education Coordinator
Clinical Leads
Dr Mark Way – Faculty Lead
Dr Visweswar Nataraj – Core Training TPD KSS
Dr Jane Tilley – Director of Medical Education
Dr Chris Jones – Medical Student Lead
Dr Amish Patel – RcoA Primary FRCA Examiner
Outcome
Progress towards completion of ST3 level to achieve Intermediate level of training.