Sunday 9 October 2016
Sunday 2 October 2016
3rd October 2016
Last Blogspot
This will be the last post from the blogger.com site as after the iOS 10 update it is finally giving up the ghost. I will be experimenting with other sites next week. Sad to see it go, it made it easy for a dinosaur like me to communicate!
See you on https://surgicaltutor.wordpress.com/?p=5
New Doors
New Doors have appeared at the entrance to Theatres. This is to encourage good practice and restrict the flow of unnecessary foot traffic into what should be a clean environment. 
It does mean entering the "long way round in order to leave outdoor shoes in the changing room but in fact there's nothing new about this policy. It's how it was done when I was a registrar here and we all must do everything we can to reduce harm.
If you have to enter through the front doors, overshoes and gowns are hanging up ready for you to use though clearly the size range hasn't catered for Mr Johnson... 
So please heed the notices and give extra time to your trip into theatres to get changed. 
Going to give up here as the site has crashed so many times doing this I am going a little insane.
Definitely more news next week
Sunday 25 September 2016
26th September 2016
Whistleblowing
What do you do if you believe harm has taken place? This week we heard from four experts on their interpretations on Whistleblowing.
Here is the GMC @gmcuk guidance on Whistleblowing:
Amongst the experts which included NCAS, GMC and Cathy Taylor our Industrial Relations Officer from the BMA, was Andrew Rowlands from Capsticks Solicitors.
A letter from Capsticks is never one you want to fall on your desk and Andrew's talk on protections for whistleblowers was sobering listening.
QASH Day
The 6 Quality & Safety half days we have a year contribute in small part to reducing harm and highlighting lessons learned through audit and M&Ms. In addition most surgical specialities @ASPHFT hold multidisciplinary team meetings (MDTs) where upcoming cases can be discussed in order to deliver the best care for patients. Communication and lack there of is cited as the biggest reason for complaints: communication & transparency at MDT level is key and perhaps the risks inherent in blowing the whistle will not need to be taken if an MDT approach is used as routine.
Directorate meetings take place on QASH days and here's a rare shot of most of T&O round one table. Split site working means we often only see each other as we pass on the M25 so it's good to enjoy these rare treats
Forthcoming Attractions
The closing date for Core Surgical Training is in 14 months' time. It's never too early to start Portfolio Preparation and mandatory courses get booked up quickly so now's the time to get on it.
Regional courses are always easier to get places on the dates you want rather than London. Check out:
You'll need BSS, ATLS and CCrISP and that's your three maximum points for courses right there.
Thursday 15 September 2016
19th September 2016
Busy week this one, so here we go...
Laurie has done so much to energise women surgeons to expand their roles, broaden their skill sets and take on leadership roles. She's now driving the Emerging Leaders programme at the College @RCSnews.
Follow my timeline @SurgicalTutor on social media for more encounters with inspiring women at the meeting where our speaker was the brilliantly articulate co-creator of the Women's Equality Party @sanditoksvig 
New Chair of WinS: Prof Farah Bhatti
Even Consultants need a boost these days and on Wednesday I raced out of clinic to get to the Senior Ladies Dinner held on this occasion at the Royal College of Anaesthetists, my mum's old College, in Red Lion Square (Holborn)
This is a gathering organised by Dane Carol Black, once a rheumatologist at the West Mid and now a senior policy advisor on work and health to the British Government. She is also Chair of the Board of the Nuffield Trust, the health policy think-tank.
Some truly astonishing & inspiring women leaders are there, and if I pluck up the nerve, they are so happy to share their advice & experience.
Two of my favourite Surgeons were there too: outgoing Women in Surgery (WinS) Chair Laurie Baxter @baxterlaurie and her successor Professor Farah Bhatti @drFBE
Farah is phenomenal: Consultant Cardiothoracic Surgeon, and Honorary Associate Professor at Swansea University, she was the first female CT consultant in Wales and fourth in the UK. She has delivered a Gresham College lecture at the Science Museum, was highly commended at the Asian Women of Achievement Awards and was one of only 3 surgeons named by the Health Service Journal in its inaugural BME Pioneers list. A force of nature and one of my very favourite people to catch up with at these events.
... and all this on a school night ...
Surgeon of the Week
A big @ASPHFT welcome to Francesca Lirossi who joins us as a Consultant Upper GI & Bariatric Surgeon (here with @humphrey_scott)
Francesca has come to us following research years in Ohio and it the first female general surgeon in this Trust. Can't believe it is 2016 and we're still having 'firsts' like this, but it is terrific to finally break that duck.
RCS Statement on Junior Doctors Contract
Forthcoming Attractions
Women in Surgery Conference 2016
Book now to attend the WinS Meeting on Friday 30th September @RCSnews 
Rates are variable according to grade and a great line-up of speakers is promised.
Surgical Careers Event for Med Students
Weds 19th October @RCSnews 
Good programme includes some Basic Surgical Skills as well as talks from Surgical trainees for a broad insight into a surgical career. A good certificate to add to your portfolio.
Future Orthopaedic Surgeons Conference
Saturday 10th December @RoySocMed: this is aimed at FY doctors and medical students 
Wednesday 7 September 2016
12th September 2016
This week it was business as usual as the September strike week was called off. This has given us time to put plans together for the next one in October where the five days falls across a weekend, but of course the contract roll-out rumbles on.
Away days
On Wednesday I visited Tunbridge Wells Hospital at Pembury for the Mock FRCS (Tr&Orth) exams. 
This is a PFI (private finance initiative) and a lovely light-filled open plan space. Visitors can refer to many TV screens giving airport-style information on the running of the clinics and areas of the hospital are colour-coded and clearly signposted. Lovely. 
The Mocks were organised by Mr Neil Slater @MTWnhs and as always we were grateful for the kind support of the public who allowed themselves to be poked & prodded by registrars of all grades.
Up to Date
Mandatory training is not just for junior doctors, consultants have to do it too. This week I joined a packed room full of healthcare professionals from O&G, Paeds and A&E for Level 3 Child Protection training. 
We listened to Eileen White our Safeguarding Named contact on best practice and heard some harrowing case studies.
Local Negotiating Committee
Friday saw the meeting of the LNC. This is a panel of elected BMA reps drawn from the Consultant body, Speciality & Associate Specialist (SAS) doctors and doctors in training. Together with Cathy Taylor, our BMA Industrial Relations Officer, we meet with representatives from the Board such as (on this occasion) the Deputy Medical Director Dr Imrie, the Deputy HR Director Phil Spivey and Kate Clarke also from Human Resources.
As it is so early in the academic year, junior doctor rep elections haven't happened yet but two volunteers Deborah Aldridge and Ellie James came along to share their thoughts 
We covered topics such as draft Study Leave policies, updates on the STP project (Sustainability & Transformation, with Epsom & RSCH) and our poor showing in the @gmcuk NTS Survey this year. As BMA members we are in dispute about the contract imposition, so we cannot talk about that.
Victoria Derbyshire debated the Junior Doctors' Strike on Wednesday: http://www.bbc.co.uk/programmes/b07tqb3y
Watch and you'll see our own T&O Consultant Ashwin Unnithan making his point: 
Ashwin starts formally in April 2017 but as he's helping us out you may see him around already. Or on the TV.
Forthcoming Attractions
Hurry now to book a place on the @RoySocMed orthopaedic introductory course First Steps on 24th Sept:
This is aimed at Foundation Years and CT1s, and has a great Faculty. 
Sunday 4 September 2016
5th September 2016
Summer's Over
Days are shortening, holidays are over and there's a chill in the air... Industrial action. Not much time to plan this time so it would be so appreciated if you could be as thorough in the run-up to Sept 12th as you were for the other days by preparing ahead as much as possible for safe discharges and making sure action plans are in the notes from the ward rounds.
Guidance on Industrial Action for those who are not junior doctors from @theBMA is found here:
Mind the Rota Gap
I'd like to say a massive thank you to everyone who has supported the wards and rotas by covering the gaps that have become apparent since Induction. In particular those who have helped out on their zero days in T&O: you're all superstars and it shall not go unrecognised.
T&O have at least three posts unfilled and it is inevitable this causes an extra burden. It's no comfort to know this situation is replicated across the country with some units closing their doors altogether. Horton Hospital has closed its maternity for example and more than one A&E is reducing opening hours.
Post-Francis it is heartening to see safe staffing taken appropriately seriously, including here at the former Mid Staffs where paediatrics has been suspended:
Rota gaps are being collated here: http://nhskeyhole.org/rotagaps/
Should the new contract go ahead, it will be the responsibility of the Guardian of Safe Working to collect this data and act on it.
This FREE event on Saturday 15th October @RCSNews is a must if you're an F1 thinking about Surgery as a career:
And Finally ...
In the days before National Selection could send you anywhere, it was not unusual to study, train and finally practice in a relatively contained area. By chance a particular couple of years' intake from (what was then) Charing Cross & Westminster Medical School produced a phenomenal number of orthopaedic surgeons and we have seem to have settled on Frimley, the Rowley Bristow and Royal Surrey to be consultants and have working relationships built up over approaching three decades.
It is therefore with tremendous sadness we learned this week of the passing of our Royal Surrey colleague, Neil Bradley,
one of the biggest personalities in the business. 
Our thoughts are with his family and his @RoyalSurrey colleagues
Thursday 4 August 2016
8th August 2016
And We're Off...
This week we welcomed a new cohort of doctors-in-training. In the surgical specialities we still have our Registrars until the start of October, and this continuity is vital as our new F1s, F2s, GP trainees and our Core Surgical Trainees get settled in.
Wednesday and Thursday were taken up with Trust and Departmental Induction which this year has undergone a revamp in response to previous years' comments. We'll see if we have got any closer to getting it right.
The Role of the Surgical Tutor is (solely) to look after the Core Trainees. This remit does get a bit forgotten sometimes by the powers that be, but this year I'm not going to get drawn in to peripheral issues and I started by bagging some time with all of them together before they got stuck into their placements 
So say a big @ASPHFT hello to (front row) Kamran, Gaj, Mohammed and Theo, (back row) Alex and Kwaku. Ahmed on the end there is one of the Urolgy trust grades.
Thank you to everyone who gave up their time to take part in T&O induction (Kieran Gallagher here helping to reassure in how to get through an on call). It's really helpful for our new colleagues to clap eyes on you, put faces to names and not feel hesitant to ask for your help as they get to grips with a new job.
New Appointment to the Rowley Bristow
I'm delighted to announce the appointment of a Medical Staffing Lisison Officer in T&O. This is a new post as we understand that looking after our doctors-in-training in these challenging times requires dedication.
In the next few weeks we'll be showing our new team member the many different aspects of the department, where our doctors-in-training take part and where their teaching opportunities arise.
It's part of the role to hold a forum for our doctors-in-training so that if there are issues we can deal with them in real time. They will also feed into the Surgical LFG to highlight problems and good practice
Trauma Meeting On The Move Again
As you'll know, the Trauma Meeting is going through an evolutionary process after we outgrew the Rowley Bristow seminar room. The aim is to get the meeting onto Swan Ward to hold a truly multidisciplinary meeting but not even the personal intervention of the Chief Executive @SuzRankin has been able to free up space there - yet. So as an interim step we're moving to Theatres commencing Monday August 8th.
It will be a purely business meeting, primarily addressing handover, with a core group of essential participants and with teaching opportunities kept separate.
Women in Surgery Conference 2016
This conference welcomes all women, from medical students to consultants, with an interest in Surgery. There's a poster competition which if you get in there instantly means a National meeting for your portfolio
"Are YOU Cut Out For It?"
This is the portfolio-boosting competition from @RCSNews for CT2s that I talked about at induction. Keep an eye out for the Regional Heats. I ran it last year so you'll forgive me if I take a step back this year but if Gaj @GajThiru, Mohammed @MohammedDeputy and/or Kamran want to step up and organise it (see link) I will certainly help you.
And Finally...
Anaesthetist of the Week?
Surgeons wouldn't be surgeons without the fantastic teamwork that supports our patients' pathway through theatres so this week in a slight departure from the usual surgical speciality superstars we're celebrating an Anaesthetist
🎉Happy 60th Birthday Jonathan Cooper!🍾👏🏻
Jonathan (seen here with the Small Child) has been a brilliant colleague who was really very kind and supportive to me even as a 4th year T&O registrar. Can't believe he's that old!!
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