30th November 2015

Here we go... 

At time of writing (Sunday night), it seems the Industrial Action is likely to go ahead. After three days of hopeful silence, a @theBMA email late on Saturday afternoon from Mark Porter sounded a despondent note:

"... As you will appreciate, given the importance of these talks to junior doctors and patients, since Thursday, we have concentrated our effort on the talks, hoping that we may have positive news to communicate to you about the outcome.  However, given the now almost inevitability that the action will need to proceed, I wanted to provide you with as full information as possible about our preparations for the action and how it may affect each of you..."

In point of fact, even if the strike was called off, the rescheduling preparations have already been made. At @ASPHFT in T&O alone, 450 patient episodes have been rearranged: that's operations and clinic appointments. It has been enormously encouraging to hear how our lovely patients have understood the situation and been accepting of the changes. Reversing them at short notice however is a completely different matter.

A question I've been asked a lot is 'can non-BMA members strike?'. Junior doctor rep Holly Ni Raghallaigh @unclehester has some useful thoughts at this time:

"... I think if I was a doctor who was not a BMA member, and who had not been balloted, but who wanted to take part in IA – I would phone the BMA today to ask about joining the BMA today and asking then if they become a fully fledged member by the time of the first/second/third strike (planned) days - if they will then be authorised to take part and thus protected. I would feel slightly exposed taking part in IA if I was not a union member..."

I am immensely proud of our management in T&O Cathy Parsons @CParsons007 and Jason Lane who very quickly recognised maintaining patient safety without our wonderful junior doctors would require bold thought and early planning. Bravo.

The action is being backed by none other than Vivienne Westwood @FollowWestwood who has designed a tshirt for the protest:

... which if you're interested can be found here: http://wearyournhs.com/ 

Local Academic Board

LAB met this week. What is it? This is our visit from @HE_KSS which takes place after the Local Faculty Groups have met, to see if @ASPHFT are maintaining their academic contract with the Deanery. In other words: are trainees receiving the teaching & continuing professional development that HEKSS is paying for by providing a significant proportion of doctors' pre-banding salary?

College Tutors from all the specialities, Foundation Programme directors and junior doctor representatives all attend together with representatives from the Deanery.

A great number of issues raised will be dealt with by a significant Medical restructuring around takes and the Acute Medical Unit, but these major changes are now planned to take place in January as whilst the strikes hang over us, December is not the time to mix things up.

Surgeon of the Week

This week @Humphrey_Scott has managed to pin Consultant Urologist Bill Dunsmuir to the floor. 

I love Bill. He is a brilliant pillar of the Surgical LFG and an amazing teacher who consistently demonstrates the highest praise in feedback. Bill is Programme Director for Urology, a speciality which @ASPHFT achieved green flags in the @gmcuk survey

Forthcoming Attractions

Online registration for this event via @RoySocMed closes Monday 30th November so get clicking on this link if you want in:

https://www.rsm.ac.uk/events/events-listing/2015-2016/sections/coloproctology-section/cog02-teaching-day-at-st-marks-hospital-colorectal-cancer-and-the-host.aspx

And some forward thinking for next year's BSS Courses:

And finally...

Best wishes to our own NHS Ninja @samlamb24 Sam Lamb for a speedy recovery from her appendicetomy this week (and for tweeting it all!)

Sam looked after all our trainees in the PGEC before become the Overseas Visitor and PP Manager. Get Well Soon!

23rd November 2015

Junior Doctors Industrial Action

On Thursday I was in the College @RCSNews at the Surgical Tutors Conference (listening to Bruce Keogh as it happens) when all our phones started buzzing with the news of the strike ballot result. 

Bearing in mind all the speakers in that room were politicians (medical politicians is no different from the regular sort) I was surprised at what they said in that room was at odds with what they put out in public. For example, the President of the RCS @claremarx described the leadership at the Dept of Health behaving with "ineptitude" and Sir Bruce Keogh deeply regretted ever saying "7/7 working" when what he meant was services should be available 7/7, that the SoS was "obsessed" with calling excess deaths "unnecessary deaths" and of the 11,000 deaths described that way, only about 4% were truly avoidable. 

So I was shocked to read the pre-prepared letter to the Press @DrBruceKeogh put out whilst he was talking to us suggesting that given the events in Paris he was concerned striking doctors might not react appropriately. It was utterly contrary to how he spoke with us and I still can't get my head round it.

We're on your side

Feedback in the room was strongly supportive of junior doctors and whilst everybody wants negotiations without threats, I want you to know that Consultant Surgeons support you. Stella Vig @svig2 Consultant Vascular Surgeon, Croydon organised this letter (which I am proud to have signed) published in the Sunday Times (paywall) http://www.thesundaytimes.co.uk/sto/comment/regulars/lettersandemails/article1635488.ece

Well over 1,500 Consultant Surgeons have put their name to it and more are adding every day.

I have circulated this letter to my fellow LFG members, but if you are a Consultant Surgeon and would like to add you name or, if you are a junior doctor who would like to read this letter of support or, if you just want a cogent, compelling account of Why the imposed contract is all wrong, the letter is here: Open Letter to Rt Hon MP Jeremy Hunt Voicing Concerns- from Consultant Surgeons 

Irritation of the Week

Every time I go to the College, this 'painting' outside the Lecture Theatre deeply annoys me:

It portrays the Council of RCS England when Bernard Ribeiro was Prez, so 2005-2008. It can be summed up as Pale, Male and Stale: two women and two faces of colour amongst the 29 heads.

Come on people. This does not represent me or My College. Four seats are up for election so colleagues - go for it. Some serious shaking up is required. And I hope this alleged painting becomes an historical oddity to be embarrassed about.

A New Surgeon Starts

A big @ASPHFT welcome to new starter Mr Rajesh Jain. 

Rajesh (left) is a Bariatric Surgeon and joins Sameer Humadi (centre) and Shashi Irukulla (right) in developing the Bariatric practice that Ashford Hospital is becoming renowned for.

Surgeon of the Week

Whilst we're on the topic of Bariatric Surgery, it is my pleasure to introduce Sameer Humadi, see here with the gorgeous Sr Louella Madrid Gabitas

Sam Humadi is an upper GI surgeon but with a focus on Bariatric Surgery. Ashford Hospiral has a really successful reputation in this field.

Forthcoming Attractions

Hard I know to keep focus when the first Doctors' Strike in 40 years is looming so another shameless plug for the Surgical Skills' Competition 'Are You Cut Out For It' two days after the planned first day of action.

I'm also running the Regional Training Day in T&O on December 11th where at lunchtime I will be holding  a "Portfolio Clinic" in prep for CST & HST interviews.

16th November 2015

MRCS Success

Huge congratulations to four @HEKSSSpeciality Core Trainees who sat the MRCS B: Sophie @sophiehfwrigley and Asad... 

... Kamran and Dan ...

Stunning results all round. The best part of getting that test out of the way is now you can enjoy the job, the experience of being a surgeon. Well done.

More success...

Last post, I told you we had no less than FIVE podium presentations at @britishtrauma British Trauma Society 2015 Meeting. 

The paper by Zu Nawaz, Sophie Wrigley and Arshad Khaleel "Follow up of 810 consecutive Ti-HA coated uncemented stem hemiarthroplasties" won First Prize as Best Clinical Presentation! Fantastic achievement, so pleased for you all

LNC Meeting

This week saw one of the quarterly meetings of the Local Negotiating Committee (LNC). LNCs are made up of elected local representatives who negotiate – and have the authority to make collective agreements – with local management on behalf of medical and dental staff of all grades. 

This group is not just made up of senior medical staff and BMA rep Cathy Taylor, but also your junior doctor representatives: Dominique, Beatrix @beatrixlv and Holly @unclehester

It was good to hear at the meeting that the Chief Operating Officer Bob Peet @bobpeet1 has started gathering senior managers and consultants to plan safe staffing dependent on how @theBMA vote turns out. 

Another important issue discussed was Diary Carding, just entering its second week. I cannot stress how important it is that these cards are filled in accurately. 

The Trust cannot change staffing levels or improve workloads without data, so this is key. If you overstay your shift time, you must, must ring your consultant. The reason for this is that every morning, the consultant is contacted to verify the diary card entries. So if you ring and they tell you <ahem> where to go you, write down exactly that in the notes. A text message will do. 

When I was a 4th year Reg @ASPH the first time round (ST6 in new money) accurate diary carding pushed us up to Band 3, and we were back paid really quickly. Returns in previous years have been so poor that no inferences could be drawn about work patterns or intensity: please don't let this opportunity slide.

Surgeon of the Week

So, Urology trainees have been asking "where are our bosses for Surgeon of the Week?" They are ELUSIVE and have been known to sprint down the corridor away from my camera (yes, YOU Mr Agrawal). Here we have a Urologist pinned down by Humphrey Scott @humphrey_scott, the Godfather Mr Robin Cole:

 

Forthcoming Attractions

Core Surgical Training applications are now OPEN (fanfares). Read the instructions, follow the checklist ...

... and please come and find me with your portfolio so we can buff & polish it. Had a very satisfying session with Christian @marshaisic creating a portfolio to be proud of. I will do a whole post on Portfolio Preparation soon.

Another plug for 'Are You Cut Out For It?', the competition for CT2s to test dexterity & skills. Winners go to the National Finals at the College @RCSNews in February for a chance to win the first prize, £1,000. Have you got what it takes? The X Factor?

9th November 2015

Olympic Gold Medallist opens MRI

Lots of news this week: starting with the opening of the new MRI scanner at Ashford. You may have seen my pics of it going up in a matter of days: well it's been up and running since 19th October and on Tuesday it was formally opened by double Olympic sailing gold medalist Sarah Ayton OBE @sarahayton, here with CEO Suzanne Rankin @suzrankin

Sarah was born in Ashford Hospital, learned to sail on Staines reservoir and has even had a head MRI after a bump with a boom so the perfect person to declare the new machine ready for action. It did raise the hilarious conundrum of how to ceremoniously cut the red ribbon if you can't take scissors into the magnet but that was neatly solved...

...by moving the ribbon...

Blowing our T&O trumpet

Hugely proud of Arshad Khaleel and the trainees he has energised with his infectious enthusiasm achieving FIVE podium presentation of their research projects at the British Trauma Society Meeting in Keele this week. Persuaded Arshad to take a @britishtrauma selfie with Ankit Desai @ankdes1 and Rob Boyd @mrbobramsay

This is an incredible achievement: our trainees are not only working their maximum hours to provide excellent patient care but they are also studying for exams AND putting the hours in on projects such as these. Immense.

*** BREAKING NEWS ***

I am BURSTING with pride for our Core Surgical Trainees: Every Single One of them who sat the MRCS B exam PASSED!

Huge congratulations to our junior doctors who have now shed that 'Dr' to become 'Miss' and 'Mr': Sophie, Dan, Kamran and Asad. Will do more on this next blog, but couldn't wait to share the glorious news as it broke Friday.

Surgeon(s) of the Week

Not long now before we formally fuse with the Royal Surrey @royalsurrey but close links have existed for years between the surgical specialities of both hospitals and this week Consultant Orthopaedic Surgeon Mike Lemon was the latest to come up the A3 to join with our own Paul Trikha in an exciting procedure, a meniscal transplant. 

Forthcoming Attractions

The date is set: the @HE_KSS Regional Heat of 'Are You Cut Out For It?' will be on Thursday December 3rd at 6pm in the Fracture Clinic of the Rowley Bristow Unit. All CT2s can enter and the winners will go forward to the @RCSNews Final where first prize is £1,000

And finally...

It's been a strange week for surprise emails. The GMC has written to us all regarding potential industrial action and some junior doctors have had a letter from Jeremy Hunt inserted into their eportfolio mailboxes (@JRCPTB are investigating as there could be a data breach). I add here the generous and thoughtful letter written by Professor Pandit, Chair of the Oxford Medical Staff Cttee. I hope it reproduces but if not, it is on twitter and I hope you take strength from it: https://twitter.com/doctor_oxford/status/662317129891467264

2nd November 2015

Short post this week, it's been a busy one. As the clocks fall back, the reality of winter pressures fall upon us and the 'black bed state' alert becomes a frequent occurrence.

Trauma Tales

This week saw an increase in arrivals to A&E with lower limb injuries. Wednesday started with more patients requiring surgery than available orthopaedic theatre time, a difficult situation for all to manage. 'Black bed state' meant no planned surgeries could go ahead and this left Theatre 6 without a list. 

What happens next?

Surgeons, as you've gathered, love to operate. A few calls later, Theatre 5 had CT Seok Cho, F2 Christian Asher and me...

whilst Theatre 6 had Arshad Khaleel with Trauma Fellow Tim Iliopoulos scrubbing up.

Clearly none of these guys were hanging around idly waiting for the call. Everyone has a fully occupied regular timetable. So this is where we should take our hats off to the people who make this mobilisation possible - meet Ronnie, Claire and Anju

Spreading the workforce thinly means a huge amount of work for these ladies, over and above their roles as schedulers. Clinics need covering or rearranging, staff need pulling from one area to another and patients need calm and complete explanations of what's taking place, where delays might occur and what contingencies are available should they wish to rebook. 

It's a big job and Anju and her team in the Rowley Bristow Orthopaedic Unit do it with good humour and compassion: thanks to you all this week. Buckle up: winter pressures are upon us and there'll be more of the same for a while to come.

Forthcoming Attractions

On Monday 2nd November, Dr Fluck is hosting a Junior Doctors Meeting with Suzanne Rankin to discuss issues arising from the #JuniorDoctorContract and mitigating the consequences to patients of potential industrial action

The meeting is in PGEC at 5.30pm. Please go: make your voice heard.