Consultant Anaesthetist inCarlisle inCarlisle PUBLISHED 3 OCT 2024
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The department of anaesthetics works across the Trust, although all Consultants have a site base for their on-call. There is an expectation that all anaesthetists will be willing and able to work sessions in both hospitals to enable all to maintain a full range of anaesthetic skills.
The Anaesthetic department provides a service for elective and emergency surgery, intensive and high dependency care, maternity, acute and chronic pain, pre-assessment and resuscitation described in more detail below.
The anaesthetic department currently works a flexible rota; however areas of clinical interest, in terms of clinical theatre sessions, can be agreed. Fixed days of working can be agreed through the Trusts Flexible working policy.
Theatres
The anaesthetic department at CIC provides anaesthetic services for elective surgery in 6 inpatient, and 3 day surgery theatres, as well as a separate NCEPOD theatre and obstetric theatre.
In terms of emergency cover the department provides anaesthetic services for 24/7 emergency operating theatre, A&E, obstetrics, and intensive care, as well as ventilated patient transfers as required, most commonly to the North East.
The Clinical Director for Anaesthetics is Dr Geet Verma
ICU
There are 9 bed spaces, including a cubicle, with current staffing for up to 8 patients, admitting approximately 750 patients per year.
The unit has 10 consultants with daytime and on call sessions in ICU. Senior nursing is provided at band 7 and there is a Nurse Educator. Trainee resident staffing is provided by 8 anaesthesia trainees and 2 ACCS trainees from the Northern Deanery. Further expansion will involve recruitment of 2 trust grade doctors at CT1-2 level working similar patterns to the ACCS trainees. Trainees work a shift system and the additional two trainees will provide dedicated resident cover for the ICU from hours to 2hours seven days a week. Night-time cover is provided by an anaesthetic trainee.
The unit is approved by the FICM for all levels of intensive care training and has a Faculty Board Tutor. The ICU also has a 24/7 band 7 critical care outreach service to facilitate both admission to and discharge from the ICU as well as numerous educational and audit initiatives. ICU consultants and trainees also attend the Anaesthetic division monthly audit meetings.
The Clinical Director for Intensive Care is Dr Tom Sams
Staffing
The department currently comprises 24 full time Consultant anaesthetists, of who 20 participate in 2 separate on-call rotas to cover ICU, and theatres and maternity combined.
There are 8 anaesthetic trainees on rotation from the Northern Deanery across the full range of their training from CT1 to ST6, these trainees participate in an on-call rota to provide one resident anaesthetist in the hospital.
The department currently has 2 ACCS trainees, who are able to provide some additional cover for ICU some evenings and day-time at weekends. We hope to expand the numbers of ACCS.
Anaesthetic Services
All anaesthetic consultants at CIC work flexibly in time and theatre location, with rotas published 6 weeks in advance. This enables consultants to maintain their skills across a wide range of specialities. For more complex areas for example ICU, vascular, upper GI, and major ENT a smaller pool within the body of Consultants with special interests will work flexibly to provide cover for elective lists. This flexible working enables the department to provide a high quality out-of-hours service across the full range of specialities, including paediatric anaesthesia as required, despite there being only 2 Consultants on-call.
Surgical specialities
We provide anaesthetic services for a wide range of surgical specialities from day-case to complex surgery. Surgical specialities include general surgery, vascular, urology, ophthalmology, obstetrics and gynaecology, trauma and orthopaedics, maxillo-facial, ENT, and community dentals.
Obstetrics
There are approximately 1800 deliveries a year at CIC, with a Caesarean section rate of about 28%. There are 3 elective LSCS lists per week that are staffed by a Consultant anaesthetist. There is an antenatal anaesthetic assessment service, with a clinic once a fortnight. There is a 24/7 obstetric epidural pain relief service.
Paediatrics
Anaesthetic services are provided for straightforward paediatric surgery, mainly ENT and dentals down to an age of 1 year, or 10kg, this, along with CPD enables members of the department to maintain their skills for management of paediatric emergencies that inevitably present.
Pre-assessment
The department staffs and supports an active anaesthetic pre-assessment service, with a combination of nurse and Consultant led clinics
Emergency Theatre and Trauma
There is a staffed emergency list Monday to Friday 08:00-18:00, with a separate staffed trauma list all day 7 days a week.
Outside these hours there is an on-call service, with two resident trainee anaesthetists in the hospital covering all areas theatres, obstetrics, ICU, and A&E including transfers if an anaesthetist is required. They supported by 2 on-call Consultants.
Education and Training
Anaesthetic trainees at CIC come from the Northern Deanery, and we also have 2 ACCS trainees as well as regular foundation doctors and medical students rotating through the department. We have had good feedback for the training provided in the department, both by clinical and educational supervisors. There are educational supervisors within the department for anaesthetic trainees and foundation doctors. Intensive care is approved for intermediate level training. All new Consultants are encouraged to undertake the training provided by the Health Education North East to enable them to become Educational Supervisors.
Recruitment of international Medical Training Initiative doctors has been a success over recent years, with up to 5 MTI doctors working alongside deanery doctors in training.
A regular weekly tutorial is provided for trainees within the department, and all Consultants contribute to this programme. Consultants within the department also contribute to the Primary and Final FRCA courses run by the Northern Deanery, and are actively involved in trainee recruitment including short-listing and interviewing for all levels of trainee.
There is a regular monthly audit and governance meeting within the department, with a quarterly cross-site meeting with WCH. All members of the department are expected to attend and contribute actively to these meetings
Members of the department are involved in running, and instructing on locally provided ALERT, IMPACT, ACLS, EPLS, ALS and ATLS courses, as well as instructing on these courses and APLS elsewhere.
The department of anaesthetics works across the Trust, although all Consultants have a site base for their on-call. There is an expectation that all anaesthetists will be willing and able to work sessions in both hospitals to enable all to maintain a full range of anaesthetic skills.
The Anaesthetic department provides a service for elective and emergency surgery, intensive and high dependency care, maternity, acute and chronic pain, pre-assessment and resuscitation described in more detail below.
The anaesthetic department currently works a flexible rota; however areas of clinical interest, in terms of clinical theatre sessions, can be agreed. Fixed days of working can be agreed through the Trusts Flexible working policy.
About us
Theatres
The anaesthetic department at CIC provides anaesthetic services for elective surgery in 6 inpatient, and 3 day surgery theatres, as well as a separate NCEPOD theatre and obstetric theatre.
In terms of emergency cover the department provides anaesthetic services for 24/7 emergency operating theatre, A&E, obstetrics, and intensive care, as well as ventilated patient transfers as required, most commonly to the North East.
The Clinical Director for Anaesthetics is Dr Geet Verma
ICU
There are 9 bed spaces, including a cubicle, with current staffing for up to 8 patients, admitting approximately 750 patients per year.
The unit has 10 consultants with daytime and on call sessions in ICU. Senior nursing is provided at band 7 and there is a Nurse Educator. Trainee resident staffing is provided by 8 anaesthesia trainees and 2 ACCS trainees from the Northern Deanery. Further expansion will involve recruitment of 2 trust grade doctors at CT1-2 level working similar patterns to the ACCS trainees. Trainees work a shift system and the additional two trainees will provide dedicated resident cover for the ICU from hours to 2hours seven days a week. Night-time cover is provided by an anaesthetic trainee.
The unit is approved by the FICM for all levels of intensive care training and has a Faculty Board Tutor. The ICU also has a 24/7 band 7 critical care outreach service to facilitate both admission to and discharge from the ICU as well as numerous educational and audit initiatives. ICU consultants and trainees also attend the Anaesthetic division monthly audit meetings.
The Clinical Director for Intensive Care is Dr Tom Sams
Staffing
The department currently comprises 24 full time Consultant anaesthetists, of who 20 participate in 2 separate on-call rotas to cover ICU, and theatres and maternity combined.
There are 8 anaesthetic trainees on rotation from the Northern Deanery across the full range of their training from CT1 to ST6, these trainees participate in an on-call rota to provide one resident anaesthetist in the hospital.
The department currently has 2 ACCS trainees, who are able to provide some additional cover for ICU some evenings and day-time at weekends. We hope to expand the numbers of ACCS.
Anaesthetic Services
All anaesthetic consultants at CIC work flexibly in time and theatre location, with rotas published 6 weeks in advance. This enables consultants to maintain their skills across a wide range of specialities. For more complex areas for example ICU, vascular, upper GI, and major ENT a smaller pool within the body of Consultants with special interests will work flexibly to provide cover for elective lists. This flexible working enables the department to provide a high quality out-of-hours service across the full range of specialities, including paediatric anaesthesia as required, despite there being only 2 Consultants on-call.
Surgical specialities
We provide anaesthetic services for a wide range of surgical specialities from day-case to complex surgery. Surgical specialities include general surgery, vascular, urology, ophthalmology, obstetrics and gynaecology, trauma and orthopaedics, maxillo-facial, ENT, and community dentals.
Obstetrics
There are approximately 1800 deliveries a year at CIC, with a Caesarean section rate of about 28%. There are 3 elective LSCS lists per week that are staffed by a Consultant anaesthetist. There is an antenatal anaesthetic assessment service, with a clinic once a fortnight. There is a 24/7 obstetric epidural pain relief service.
Paediatrics
Anaesthetic services are provided for straightforward paediatric surgery, mainly ENT and dentals down to an age of 1 year, or 10kg, this, along with CPD enables members of the department to maintain their skills for management of paediatric emergencies that inevitably present.
Pre-assessment
The department staffs and supports an active anaesthetic pre-assessment service, with a combination of nurse and Consultant led clinics
Emergency Theatre and Trauma
There is a staffed emergency list Monday to Friday 08:00-18:00, with a separate staffed trauma list all day 7 days a week.
Outside these hours there is an on-call service, with two resident trainee anaesthetists in the hospital covering all areas theatres, obstetrics, ICU, and A&E including transfers if an anaesthetist is required. They supported by 2 on-call Consultants.
Education and Training
Anaesthetic trainees at CIC come from the Northern Deanery, and we also have 2 ACCS trainees as well as regular foundation doctors and medical students rotating through the department. We have had good feedback for the training provided in the department, both by clinical and educational supervisors. There are educational supervisors within the department for anaesthetic trainees and foundation doctors. Intensive care is approved for intermediate level training. All new Consultants are encouraged to undertake the training provided by the Health Education North East to enable them to become Educational Supervisors.
Recruitment of international Medical Training Initiative doctors has been a success over recent years, with up to 5 MTI doctors working alongside deanery doctors in training.
A regular weekly tutorial is provided for trainees within the department, and all Consultants contribute to this programme. Consultants within the department also contribute to the Primary and Final FRCA courses run by the Northern Deanery, and are actively involved in trainee recruitment including short-listing and interviewing for all levels of trainee.
There is a regular monthly audit and governance meeting within the department, with a quarterly cross-site meeting with WCH. All members of the department are expected to attend and contribute actively to these meetings
Members of the department are involved in running, and instructing on locally provided ALERT, IMPACT, ACLS, EPLS, ALS and ATLS courses, as well as instructing on these courses and APLS elsewhere.
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