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.

26th October 2015

A Word of Thanks

The hospital has been under 'black alert' again this week, which means the pressure on beds has been enormous. In this situation, though frequent senior ward reviews make sure discharge plans are in place, it does mean that patients' surgeries are cancelled. 

In T&O, it is the 'walking wounded', those patients who don't need to be in hospital because of their injury (eg broken ankles or wrists) but do need a bed for a day for their procedure. It's meant some tough conversations have had to be had this week, for our Trauma Coordinator Hazel as well as our teams - and of course our patients. 

Thank you everyone involved in these individual human stories of injury, delay, restitution and rehabilitation. In a week where in-patient flow had been the focus of attention, they haven't lost sight of those at home receiving that call to say their op is delayed.

Trainee Talk

Higher Surgical Trainees swapped rotations at the beginning of the month so I thought it would be nice to meet some of them.

This week I am introducing Kieran Gallagher, T&O Registrar seen here with his current boss Arshad Khaleel. Kieran was with us as an SHO so it feels like the return of a member of the family. 

Kieran is now one of our more senior trainees (how time flies) and can focus a little more on his subspeciality choice of Foot & Ankle.

Surgeon of the Week

Big shout out this week for Oral Surgeon Alex Creedon, sporting magnificent but uncharacteristic facial hair. This is not a Movember stunt but instead preparation for @TheStrokeAssoc Stroke Association Half Beard Challenge in January. I hope I can update you then on his transformation

Forthcoming Attractions

This looks pretty excellent: the Future Orthopaedic Surgeons event @RoySocMed Royal Society of Medicine on Saturday November 7th

https://www.rsm.ac.uk/events/events-listing/2015-2016/sections/orthopaedics-section/org03-future-orthopaedic-surgeons-conference-2015.aspx?utm_source=twitter&utm_medium=social&utm_campaign=org03231015

19th October 2015

Thought for the Day 

Medicine is a fabulous profession. It is a privilege and a pleasure to be involved in people's lives in such a positive way. There is no bigger buzz than helping someone break free of pain, anxiety or illness. I have nothing but encouragement to give you to pursue a career in this direction. 

Please do not be disheartened by the contracts dispute. There is a bigger agenda going on here than any of us on the ground are party to. What we all do have is a degree in Medicine and it is professionally healthy to use it to gain the broadest experience we can, whether it be in the U.K. or abroad. It is a career without boundaries and few professions can say they have the opportunity that we have, to take our skills to wherever we find our best fit.

Junior Doctors Protest

Saturday was a Big Day... If you follow me on Twitter @SurgicalTutor or if you saw any on line news service, you'll already know what I got up to, but for those who don't...

20,000 junior doctors, supported by consultants, medical students and other health professionals gathered in Waterloo Place for a demonstration and march to Parliament Square. Surprisingly no lights on or signs of life, other than the police presence, as we went past Dept of Health, but I guess they don't work a seven day week...

HEKSS Showcase

Ahead of the march, I popped in on the HEKSS Showcase event at the Charing Cross Hotel. This event hosted stands from all the KSS Trusts, encouraging Medical Students and Foundation Doctors to take a look at what each Trust has to offer

I met the new Dean Director, Professor Graeme Dewhurst (left) here with our own Dr Michael Wood and I'm very keen he comes down to see us and see what we do

Surgical LFG

This week saw the last LFG of 2015. As I've explained in a previous post, this is where Educational Supervisors in a Surgical specialities meet to set our standards for the next quarter, plan training, support trainees in difficulty and address issues both positive and negative raised by everyone taking part in medical education

As many of you will be aware, Surgery, Urology and T&O has seen an expansion in trust grade posts at 'SHO' level and one of our goals is to ensure these non-training grade doctors are involved in an educational programme to support their continued professional development and revalidation. Senior Registrar Ben Carrick (bottom right) has joined us for six months and one of his goals is to establish a weekly teaching session for these doctors (and all who'd like to join if service provision permits). It was useful for us to brainstorm this and I look forward to letting you know about the programme as it develops.

Surgeon of the Week

This week we celebrated the appointment of our LFG colleague and Vascular Surgeon Abdullah Jibawi @abdjibawi to the post of Chief Clinical Informatics Officer (seen hear with Library manager Laura Stafford)

AJ eloquently outlined to us the current situation of IT networks put in place and evolved with apparently no clinical input. AJ is a programmer with a background of working with the Department of Health on IT project management he and explained how powerful a clinically directed IT service could be particularly in our new configuration as a merged Trust. The scope of his vision is huge and exciting and he has our whole-hearted support.

Forthcoming Attractions 

The @HE_KSS Regional Heat of "Are You Cut Out For It?" @RCSNews competition will be held on Thursday December 3rd at 6pm

This competition is open to all CT2s in HEKSS to choose dexterous trainees for the National Final to be held at the College with a substantial cash prize. Test your laparoscopic and open skills against your contemporaries under the eagle eye of Consultants and let's see what you're made of

12th October 2015

This week we said goodbye to most of our Higher Surgical Trainees at Registrar Changeover Day. Here are Zu, Mark and Evangelos on their last day:

Always a sad moment as teams that have worked well together for a year (or sometimes two) turn around and we start again with new faces. If we're lucky though, we see them back as Consultant colleagues and in our T&O department of 16, nine of us were registrars in the Rowley Bristow Unit which says something, I think.

Of course it is also the time we welcome a whole new cohort and over the next few weeks I hope to be able to introduce you to many of them.

I've been off on my own CPD this week. This time I was in Manchester at the Medical School Anatomy labs trying out a fracture-specific plating technique. Hearing Rob Medoff from University of Hawaii and Livio Di Mascio from the London talk about their experience and protocols was a great pick-me-up to get me excited again about the job we do

Surgeon of the Week

This week's celebrity is Colo-Rectal Surgeon Phil Bearn, seen here with outgoing HST Kiran Sran:

Phil has for a long time be the local Programme Director for the Surgical Registrars but this is a baton he has recently handed over to Shashi Irukulla. Heavily involved with research, Phil has forged great links with the Royal Holloway to take on MSc students and he is also involved with the training of Physicians Associates.

Forthcoming Attractions

So: I've cleared my diary, sorted out childcare and dragged out my white coat - this is where I'll be on Saturday October 17th. Do feel free to join me