Anaesthetics-LFG-Handbook-August-2016

6 How to complete the anaesthetic curriculumMandatory competencies and certificates during training Exams Your Educational Supervisor/Your Clinical Supervisor 8 Your role as a Learner Th

Aug 20161

ANAESTHETICS FACULTY

HANDBOOK

A GUIDE FOR POSTGRADUATE DOCTORS AND

STAFF IN SURREY & SUSSEX HEALTHCARE NHS

TRUST

Introduction

Welcome to The John Hammond Department of Anaesthesia at the Surrey and SussexHealthcare NHS Trust This Faculty Handbook is written for you as a postgraduate doctor and all who will be working with you during your time here Its purpose is to give you information about how your programme works, and who the key people are who will be working with you Please take the time to read it as it will help you

understand the Department’s and Deanery’s roles

Also you will need to be familiar with the following documents to ensure you get the most out of your time with us

6 How to complete the anaesthetic curriculum

Mandatory competencies and certificates during training

Exams

Your Educational Supervisor/Your Clinical Supervisor

8 Your role as a Learner

The Local Anaesthetic Faculty

Trainee Representatives on the

LAF Local Academic Board

9 Your School/Your Learning

Feedback

appraisal

Learning

12 Appeals process, Available

help Emotional support

Swapping shifts/ Other Leave

17 Shift Handover, Hospital at Night

18 GMC Registration/GMC Ethical Guidelines

19 Information Governance

Educational Resources Less than full time trainees

For trainees interested in teaching and training

20 Appendix A useful names and addresses

21 List of Permanent Staff in Department

B.7 Guidelines for acute pain relief in Children

B.8 Starvation for children undergoing elective surgery

B.9 Guidelines to paediatric resuscitation

B.10 Policy for obtaining consent

B.11 Regional Block 504/Fracture Neck of Femur Service, Emergency Bleep holders

B.12 Blood Competencies B.14 Awareness

54 Appendix C Car Parking Appendix D Your Contact Details for the Department

Location of Trust

During your time with us you will be working at East Surrey Hospital (ESH), Crawley Hospital (CH) and Redwood Elective Centre (REC) The REC is attached to the east end of the ESH The Postgraduate Centre is on the ESH site The Trust’s Website

is w w w s urr e y a ndsu s s ex n hs u k

Short cut to/from the Hospital if coming from the M25 J8 down the A217.

Turn right out of the hospital up the A23 towards Redhill At the traffic lights coming down hill into Redhill turn left into Mill Street Go along here and take the 4th (ish) right into Whitepost Hill- you will then be by a big church and you need to turn right then left onto main A25 (which runs between Reigate and Redhill)

Go left along here for about 100 yards then take a right turn into Wray Common Road Follow this to the end (the road does a big 90 deg bend at the start) At the end take aright onto Croydon Road and then a left turn down Raglan Road and go all the way to the end where you will meet

the A217 again (Reigate Hill) You need to turn right here up the hill which may be tricky and then you will find your self back at junction 8

This will cut of the whole of Reigate and Redhill and probably save you 10-15 journey time in the morning You can do the whole thing in reverse on your way to work!

The other good shortcut which you can only do on your way from work is instead of turning left into Raglan Road- instead keep going a bit further and then go left (at mini roundabout) into Wray lane Follow this all the way up- it gets v narrow and will bring you out right at the top of Reigate Hill (A217)- you can’t come down this way as it’s one way

Car Parking

Staf car parking is available in 2 hospital car parks (West and East) as well as on the Redhill

Football Ground car park (Three Arch Road)

Car parking charges were brought in during December 2011 Each member of staf will require a valid parking permit (available at the same time as the Staf ID

badge) and also will need to purchase scratch cards (available from the cashier’s office and the canteen) These will cost 75p per day and are available in strips of 5

These will need to be used for day and night staff Seasonal passes are also available

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Key People

There are many people who will help you during your time with us Their full addresses are in

Appendix A where there is also a list of permanent staf within the Department

This may all seem confusing due to the nomenclature changes for the training grades and also the organisation of training, but if in doubt please contact the College Tutor

Dr Claire Mearns who will attempt to advise you

Anaesthesia, East Surrey Hospital

Dr Fred Van Damme

Anaesthesia CT 1-2 Dr Natarajan VisweswarKSS Specialty School of

Anaesthesia

ST3-5 Dr Chetan Patel

Anaesthesia CT 1-2 Dr Peter Anderson

Local programme administrative arrangements

The administrative arrangements for the local management of your programme are managed by the College Tutor and Programme Leads and are constructed to support the RCoA Curriculum If you experience any local administrative issues your first

point of contact is the College Tutor

The Anaesthesia Curriculum

The curriculum for Anaesthesia specialty can be found at www rcoa ac.uk

The Local Anaesthetic Faculty which is chaired by the College Tutor and is responsible for ensuring that the Anaesthetic programme here is such that it will enable you to meet specific competences required in any given year by your speciality curriculum The local programme will be mapped to the national curriculum and includes

opportunities for you to work with other health care professionals such as intensive care, outreach, pharmacy and emergency medicine doctors

The aims and objectives of the Anaesthetics curriculum

These are stated in the THE CCT IN ANAESTHESIA I (h t t p:/ / w w w r c o a a c u k / d o cum e n t -

s t ore/curricul um - cc t - a n a es t h e t ic s - 20 1 0 ): General Principles: A manual for trainees andtrainers Edition 2: August 2010 states that the aims and objectives of the

Anaesthetic’s curriculum and the completion of the programme is to award of a CCT inanaesthesia thus producing high quality anaesthetists with a broad range of skills whowill enable them to practice as consultant anaesthetists in the United Kingdom

Duration of training

Indicative duration

To obtain a CCT in anaesthesia a trainee has to follow a competency based, specialty training (ST) programme covering basic, intermediate and higher and/or advanced levels of training in anaesthesia, pain management and Intensive Care Medicine (ICM).The indicative duration of training is 7 years, of which

• Basic level will normally last 2 years (CT 1-2)

• Intermediate level will normally last 2 years (ST 3-4) and

• Higher and/or advanced level will normally last 3 years (ST 5-7)

The actual duration of an individual’s training will be determined by the rate at which they achieve the necessary competences

Minimum duration

The minimum duration of formal training is normally seven years In exceptional

circumstances, if a trainee can prove that they have acquired all the necessary

competences in a shorter time and have the confidence and competence to be a consultant, the College may recommend to PMETB that a CCT should be awarded after less than seven years

How you complete Anaesthetics curriculum

This curriculum is competency based and leads eventually to CCT in Anaesthesia

You will be supported during your time at Surrey an Sussex Healthcare NHS Trust by your CollegeTutor Dr Claire Mearns, an allocated Educational Supervisor and Clinical Supervisors, all of whom will give you regular feedback about your progress You should never be

in any doubt about your progress and what you can do to improve this

Start of post Initial appraisal & Educational contract College Tutor

Trust’s Clinical skills evaluation College TutorKSS Deanery Form R College TutorApply/ Check for Registration of the

Meeting with Educational Supervisor Educational supervisor

Interim/mid point Interim/ mid point appraisal Educational

supervisor/Trainee End of post Final appraisal Educational supervisor

Annual Appraisal and Portfolio evaluation including completed log book, assessment tools and General

Educational supervisor

Annual Review of Competency (ARCP) Educational

Supervisor & College

Mandatory Competencies and certificates during training

Full details in document ‘CCT in anaesthesia’ on the RCoA website

Initial Test of Competency At 3-6 m during CT 1 issued by both

CollegeTutor and Educational SupervisorAssessment of Competency in Obstetric

Anaesthesia During CT 2 issued by Obstetric Module Director

Certificates

Basic Level Training Certificate End of CT 2 issued by both College Tutor

andEducational SupervisorIntermediate Level of Training End of ST 4 issued by Regional AdvisorAdvanced Level of Training End of ST 7 issued by Regional Advisor

Primary FRCA- MCQ (valid for 3y once passed)

max

5 attempts

Towards the end of CT 1

Remainder of Primary FRCA-OSCE & SOE (x 2)

must pass both but can ‘bank’ a pass and only

re-sit the failed part

By the end of CT 2

Final FRCA written-MCQ & SAQ (max 6

attempts but with guidance after 4

unsuccessful attempts) Valid

for 2 yrs MCQ questions will include 30 SBA

By the end of ST 5 after 30 months of training

Reminder of Final FRCA- SOEx2 which will

be merged together to make pass of fail After passing written part of exam

For full details htt p: // www.rcoa.ac.uk/examinations

MCQ-Multiple Choice Questions

OSCE-Objective Structured clinical examination

SAQ-Short Answer Questions

SOE-Structured Oral Examination

Induction

All new doctors Trust and The John

HammondDepartment of Anaesthesia

PGEC 3rd August 16

New CT 1-2 and ST3 KSS Anaesthesia School KSS Deanery – dates set by

KSS

Your Educational Supervisor – roles and responsibilities

Your Educational Supervisor is responsible for overseeing your training and making sure that you are making the necessary clinical and educational progress during your time at the Trust You will have regular feedback from your Educational Supervisor For your information the responsibilities of an Educational Supervisor are given in the

 Gold Guide

 Standar ds for Tr aini ng in the Foundation P rog ramme

 Operational Fr ame wor k for Foun dation

Your Clinical Supervisor – roles and responsibilities

Your Clinical Supervisor is responsible for your progress on a day to day basis eg theConsultant you are working with on that day You will have regular feedback on yourclinical performance

from your Clinical Supervisors The process by which information about your progress iscollated by your Educational Supervisor and from your Clinical Supervisors is via your completion of

assessment tools, participation in audit and teaching and feedback from Senior Staf

meetings and

the Local Anaesthetic Faculty-see below

Your Role as a Learner

You are responsible for your own learning within the programme with the support of key people as above You should ensure that you

 Have regular meetings with your supervisors

 Maintain your portfolio and Log Book (see Appendix D.2 re ICU and pain logbooks)

 Keep up to date with assessments as required and continue to have your

workplace assessments signed off

 Complete the contact details in Appendix C for the Department for the Major Incident

Folder

The Local Anaesthetic Faculty Group (LAF(G))

This Faculty consists of Senior Staf from the Department who are actively involved in training Its remit is to

 Ensure that the local Anaesthesia programme is fit for purpose and in line with curriculum requirements for the following bodies

o National (eg NHS, NICE)

o Professional (eg PMETB, RCoA) and

o Trust (see Work Force Development site on Intranet for timetable of Trust Mandatory

training on Trust Educational Half Days 14.00-15.00)

 Quality control the local programme and

 Ensure that trainee progression is tracked, supported and audited

There are also Trainee Representatives on this committee The LAF meets at least three times a year and reports to

 For CT 1-2 and ST3-5 to the Local Academic Board and ultimately the KSS

Trainee Representatives of the LAF

The LAF also has representatives from the trainees to convey the views of all thetrainees The representatives should meet with or contact the other trainees atleast 3 times a year to collect these views There should be representatives for

 CT 1-2

 ST 3-4

 ST 5-7

 Clinical fellows

The Local Academic Board (LAB)

The LAF reports to the Trust’s Local Academic Board for the trainees It oversees the whole of the Trust’s postgraduate medical trainees to ensure they receive education

and training that meets local, national and professional standards The LAB

undertakes the quality control of postgraduate medical training programmes It receives Annual Audit and Review Reports from Local Faculty Groups throughout the Trust including the LAF

Your Specialty School

Details can be found for

 CT 1-2 and ST3-5 at http ://kss deane ry.org/a naes the tics

 ST 6-7 at htt p:// www londonde ane ry.ac.uk /s pecialty -s chools /anae s thes ia

Learning in this programme

In this programme we adopt a variety of learning and teaching approaches These include

 Web-based (eg BMJ learning, Doctors.net, e-LA)

 CDs

 Ward based clinical teaching

 Exposure to outpatients, Emergency Department, ICU, delivery suite and theatresThe methods used will be

o protected Friday afternoon teaching

 Trust Educational Half Days

Feedback

This is a crucial aspect of your programme You can expect to receive detailed

feedback on your progress from your Educational Supervisor and from your Clinical Supervisors This will happen during on going review meetings with your Educational Supervisor You should have a clear idea of your progress in the programme at any given time and what you have to do to move to the next stage

At each Departmental Senior Staf Meeting which occurs approximately monthly,

each trainee is discussed This information is then fed back into the closed part of the LAF meeting where the trainees and their education and learning are discussed indetail In addition either a MSF or General Assessment is also done at the end of yourtime at the Trust The LAF will also feedback to the Trust’s LAB

The Department also values your feedback, this can be done directly with your

educational supervisor, the College Tutor or indirectly through the Trainee

representative on the LAF

Annual Appraisal

Your Educational Supervisor will go through your Annual Appraisal at the end of your time at the Trust The Training Portfolio for Anaesthetists in Training in the NHS can bedownloaded from the RCoA website The documents should be submitted to your Educational Supervisor at least 1 week before the arranged meeting Please note that the average time taken to prepare this document is

8 hours The meeting itself should take place in a quiet area where you are

unlikely to be disturbed and it may last for 1.5 hours

Learning E-Portfolio

This is incorporated into your Annual Appraisal document which will form the basis foryour revalidation It is your responsibility to maintain the evidence for your learning

on the e-portfolio

This is an essential and mandatory requirement as it provides an audit of your

progress and learning

Assessments

This 2010 Anaesthetic Curriculum is competency based

The assessment tools for CT 1-2 are

 Work Place Based

o ALMAT (Anaesthetic List Management Tool)

o ACAT (Ante-care Assessment Tool- ICM)

o MSF (1 for Anaesthetics, 1 for ICM in the 2 years)

 The Units of Training for Core Training are

o The Basis of Anaesthetic Practice (leading to the Initial Assessment of Competence)

o Sedation

o Transfer medicine

o Trauma and stabilisation

 Each Unit of training will require a sign of and this will require

o Appropriate numbers of WPBAs

o Completion of the core clinical learning outcome for that unit of training

o Appropriate numbers of cases in the log-book

o MSF if appropriate (ICM)

 Further details of these can be found in the 2010 CCT in

Anaesthetics ht t p:/ / w w w rc o a a c u k / C C T /Ann ex B

The assessment tools for ST 3+ (from August 2010) are

 Work Place Based Assessments

o DOPs

o

ACEXs o

CBDs

o ALMAT (Anaesthetic List Management Tool)

o ACAT (Ante-care Assessment Tool- ICM)

o MSF (1 for Anaesthetics, 1 for ICM in the 2 years)

These units of training are repeated in ST5-6 as part of the ‘spiral leaning’ process.

The assessments are collected into your Portfolio and also noted by the College

Tutor and Educational Supervisor on the ARCP/ RITA report It is your

responsibility to undertake the assessment process in accordance with your

specialty curriculum guidance

Intensive Care Training (ICM)

Core trainees will complete 3 months on ICM training in their CT2 year This will need tobe

passed satisfactorily (Work Place Assessments and new assessment tools) to obtainthe Basic Level Training Certificate There will also be an ICM e-log book which should

be kept by all trainees from August 09 t p:/ht / w w w rc o a a c u k /i bt icm/i n de x a s p ? In

t e rP a geID= 6 6

Assessments will be DOPS 3, CEX 2 CBD 1 and MSF 1

Intermediate ICM Training will include 3 months in ST4 at teaching hospital and 3

months in

ST5/6/7 at DGH (total of 6 months)

(More information can be obtained from the Faculty of Intensive Care

Medicine ht t p:/ / w w w ficm a c u k / t r a in i n g - icm)

Leadership

Trainees are expected to undergo a Leadership workplace assessment (CEX) within their time at the Trust This forms part of the evidence for professionalism for the

2010 Curriculum (Annex A in the CCT in Anaesthetics) The Leader Tool can be found

in the Appendix and on the Anaesthetic

Intranet site The Trust’s Lead for this is Miss Jean Arokiasamy (Consultant Obs &

(Grievance Procedure) and Equal Opportunities (Equal Opportunities policy) on the Trust intranet.

KSS Deanery has a lead for Trainees in Difficulty These can be fagged up by the College Tutor at

LFG Meetings or trainees can refer themselves Other organisations also ofer support for trainees:

e d N e t who ofer a confidential consultation service for doctors by doctors for

career or emotional support This covers areas such as depression, work/home

relationships, bullying/harassment, communication dificulties isolation, racism,

examination stress and bereavement support

Administrator and contact person (during ofice hours and 24hr messaging service) is Mrs Chris

Loizou, Tavistock Centre, 120 Belsize Lane, London, NW3 5BA

020-8938-2411, email me dnet@tavi -por t.nhs uk MedNe t we bsite

Career Support

Information about the KSS Deanery Career Service can be accessed at

ht

t p:/ / k ss de a n e ry o rg /e duc a t ion/ab o u t - c a r e e r s Locally careers information and

support can be accessed through the College Tutor and Educational Supervisors

initially

Department Administrative Support

Mrs Shirley Robson Office Administrator Ext 6046

ROTA Aug 2014

 This rota has been agreed by our current staff and has been passed as EWTD

compliant

The predicted hours are less than 48h per week

 Trainees will be paid at 1A This is because even though you work less than 48hrsper week, the frequency of weekend duties makes this a 1A This rota will bediary carded at 8 weeks to show (or not) compliance (As per Terms andConditions)

 Novice anaesthetists will be paid 1C for first 3 months too although they will only work

07.45-17.30 Mon to Fri, however at an appropriate stage in the 3 months they

can be doubled up with other trainees to have out of hours experience (eg

Long days, weekdays

and weekends) on the Theatre rota Once they have their Certificate of Initial

Competency, they will be allocated a slot on the Theatre rota and will then paid

at 1A

 24 Staff, 8 doctors on 3 identical rotas

 3 rotas covering ICU, Obs and Theatre

 Full shift system, EWTD compliant

 Internal cover for Annual and Study Leave

 Including a 30 min handover period

Out

of hours

% 35

By theatre cofee room

Theatre or ICU changing rooms

At all three rest facilities, the doctor using the room is responsible for

tidying away the bed after use and removing the used linen as these rooms are used during the day for

other purposes If this is not done then these rest areas are at risk.

Study Leave

Study leave Request forms are available from Shirley in the office The College Tutor will approve the leave dates Study leave should be relevant to the trainee’s current

release courses are encouraged in preparation for the Primary and Final FRCA You are entitled to

30 days Study Leave per year with a budget of £900 and leave should be booked at least 6 weeks in advance

The new rota (8 doctors) does not support internal cover for study leave therefore

you will need to swap your duties

 you do not have to swap D (08.00-17.30) shifts

but you have to swap the

 Eve portion of the LD (17.00-20.30) during the week

 Long days LD (08.00-20.30) at weekends and for Bank Holidays

 Night duties (20.00-08.30) whenever they occur

For Regional Study Days, please submit a form if you wish to go You are required to gain permission to go to these as this Trust still provides protected teaching Please

see Appendix D.1.

Annual Leave

Annual leave Request forms are available from Shirley in the Office The College Tutor will approve the leave dates In total two doctors can be away from each rota at one time for whole week and one other away for odd days or study leave Annual Leave will normally only be granted for complete weeks Leave should be booked at least 6 weeks in advance Approval of leave with shorter notice than this may be dependent

on whether suitable cover arrangements can be made (for urgent domestic difficulties

we will always try to accommodate reasonable requests) All completed leave forms must be given to Shirley for photocopying and she will then forward them

to medical staffing at ESH

All leave must be taken within the term of the contract Leave cannot be carried

over into your next post Payment may be made in lieu of outstanding leave only in

exceptional circumstances Please do not leave it until the last month of the post to take the bulk of your annual leave, otherwise you may be

disappointed It is also important that trainees do not take more than 1 week of

Annual leave during their ICU 3 month block

Annual Leave entitlements

Per annum Per 6 m

ST4/SpR 2 or 4th year after foundation

Regarding the swapping of shifts

The swaps need to be recorded on the Annual or Study Leave Request Form when the application for leave is made and on the Master rota for your shift The swap must be agreed by both parties (there is a place on the forms for the other party to sign) In the first instance a swap should be like for like unless both parties agree otherwise The swap should be done in a timely fashion

The responsibility for the duty remains with the doctor who it belongs to in the first place until the duty has started with the 'new' doctor The swap should not jeopardizethe staffing of the department ie deplete the number of trainees to an unacceptable level This is particular problem

when swapping nights as the doctor needs to have the day of before and after while you are away

on annual leave If you swap nights then please swap all of them and not just one, otherwise this depletes the department of more trainees than would otherwise have been absent If you swap night duties then in effect you are swapping your days of afterwards too If you have swapped

out of a night shift then you will now be rota-ed to work the day shift DON’T assume you get a

free days holiday! Any unauthorised absence from work will be taken seriously.

Other Leave

Full details of these are on the Trust’s Intranet site under Human Resources Policies

 Parental and Carer’s Leave

 Medical or Sick Leave

o If you are unexpectedly absent from work for a period of 2 hours or longer

then youwill be expected to ring ‘First Care’ who monitor all sick leave, (08454 372 601)

They will let Shirley know via email of your absence, HOWEVER you should still ring the department to let them know that you will be absent for dutiesthat day For any duration of medical leave you will be expected to

complete a ‘Well being in the workplace form’ This is available from the Ofice Administrator-Shirley or the Trust’s Intranet under forms and you will also need to have a back to work interview with

the Lead Clinician for Anaesthetics in line with this policy After your return to work you will not be allowed to undertake extra paid shifts for a period of 2 weeks

Shift Handover

In view of working patterns and more frequent shift changes, it is imperative

that good communication is maintained between members of the

department

T

h e at re H a nd o v e r

Occurs in CEPOD Theatre 7 at 8.00-8.30am and 8.00-8.30pm Please ensure;

 Do not send for a patient (or allow the theatre staf to) to coincide with shift change over unless you are prepared to stay for the anaesthetic induction or the patient has been seen by the in coming anaesthetist

 It is not appropriate to send for a child and expect them (and parent and nurse)

to wait in

Recovery for the anaesthetic room to be ready/handover to be done

 The anaesthetist coming on shift has a responsibility to introduce him or

herself to the patients away from theatre even if they have been

pre-assessed by someone else

Obs t e t ric Han d over

There is a 30 minute handover slot for the anaesthetist which occurs in the office on the delivery suite There is a Safe Obstetric Handover sheet available (see Obstetric Appendix)

Morning 08.00-08.30

Evening 17.00-17.30, if the evening anaesthetist is different to the

daytime one Night 20.00-20.30

The morning handover should include a joint review of patients (on labour ward and those for induction) with the Obstetric team in order to know their daily plan.Every session should review HDU patients with a review documented in the notes each morning This review may be joint with the Obstetric team and the follow-up then handed over to the next

anaesthetist

I C U H a nd o v e r

Formal sit down handover on ICU at 8.00-8.30am and 8.00-8.30pm There is also a ward round at 17:00 with the daytime team, evening ICU doctor (if different) and Consultant on for ICU Please ensure that no elective daytime tasks are left over for the night person to perform and all discharge summaries for potential

discharges to the ward have been completed during

the day

Hospital at Night Meeting

20:30 – Daytime Medical team handover to Daytime SpR (bleep 700) in AMU office with Clinical Site Practitioner (bleep 728) in attendance Patient issues to be entered into PTS tasks and taken to 21:00 meeting Daytime Medical team to ‘tidy up’ jobs and sort any outstanding tasks 21:00-

21:30

21:00 – Daytime and Nightime STs in Medicine, Surgery and Nightime ICU trainee

to attend meeting in Ops Centre (in corridor to the left of Boots)

 Reminder bleep to come from switchboard

 One junior doctor (CT level) to attend with both incoming Medical and Surgical SpR

 Individual team handover 21:00-21:15 and then all patients with concerns to be discussed

21:15-21:30 with Clinical Site Practitioner (bleep 728)

 This meeting will be minuted and an attendance record will be kept – a templatewill be given to the Clinical Site Practitioners, who are chairing the meeting If doctors need to be absent for a genuine clinical need, a phone call into the Ops Centre (x6131) is essential

We hope to bleep filter all essential medical calls during the 21:00-21:30 meeting to the Clinical Site Practitioner (bleep 841), who is not attending the meeting, but this

is still in discussion We will be asking the Wards to only limit all non-urgent calls to after this meeting

GMC Registration

Please ensure that your GMC registration is paid by direct debit from your bank This ensures that you remain registered as you change addresses as you move with your training posts A lapsed registration is a disciplinary matter

GMC Ethical Guidelines

These are available from the GMC website under ‘Guidance for good practice’ and

‘Supplementary ethical guidance’ Please read these documents again or for the first time

Non-encrypted sticks can be successfully opened on site for the purposed of

presenting power- point presentations etc but new data can not be saved on them

Log books /p ortfolios s hould not contain p ati e nt

iden tifiable dat a

Less Than Full Time Training (LTFTT)/Flexible Training

Please approach the College Tutor who will then be able to direct you to the LTFTT Lead

trainee wishes to go to a LTFT contract

For trainees interested in teaching and training

The London and KSS Deaneries ofers a range of educational support /

programmes which are frequently free of charge For details please go to the web sites and look up the faculty development areas

Appraisal and Revalidation

Every doctor in the Trust must undergo an annual appraisal For non trainee grades the documentation can be found on the following website

Appendix A-Useful names, addresses & numbers

Surrey & Sussex Healthcare NHS Trust www.s urre yandsuss ex nhs uk

KSS Deanery Website www.kss deane ry.ac.uk

Gold Guide http://www mmc.nhs uk /pdf/Gold%20 Guide

%2 020 08

%20 -%20 FINAL.pdfRoyal College of Anaesthetists www.rco a ac.uk

Association of Anaesthetists http://www a agbi org

St George’s School of Anaesthesia http://www s tgeorge s an aes thes ia.com/General Medical council www.gmc -uk org

Dr Fred van Damme fr e derick v a n -

d

a mm e @ s a s h.nh s uk

College TutorEast Surrey HospitalCanada AvenueREDHILL, Surrey,RH1 5RH

01737 768511 ext 6046

Dr Sarah Rafferty Sarah.raffe rty@s as h.nhs uk Director of Medical Education

(DME) The Postgraduate Education Centre

Dr Visweswar

Nataraj vn atar aj@nhs ne t The Department of Anaesthesia Royal Surrey

County Hospital Guildford

Dr Stellios

Panayiotou Ste llios Panayiotou@w s ht.nhs uk The Department of AnaesthesiaWorthing Hospital

Dr Chris Carey Chris Care y@bsuh.nhs uk The Department of Anaesthesia

Brighton and Sussex University

01273 696955

Dr Jo Norman joanne norman@s tgeo rges nhs

.uk The Department of AnaesthesiaSt George's Healthcare NHS

0208 672 1255

Dr Chet Patel che tan.patel@qvh.nhs uk The Department of Anaesthesia

Queen Victoria HospitalEast Grinstead

List of permanent staf within the department indicating there

speciality and also whether they are an Educational Supervisor

Consultants

Dr S Ali

Dr M Andorka Intensive Care Medicine, Lead for ICUIntensive Care Educational Supervisor

Dr A Bewaji Obstetric Anaesthesia Educational Supervisor

Dr B Bray Chief of Surgery Intensive Care

Dr P Bajorek Pain Management Educational Supervisor

Dr N Bolad Obstetric Anaesthesia Educational Supervisor

Gunasekera Regional Anaesthesia, Day case lead Educational Supervisor

Dr J Howard Clinical Lead for Anaesthesia

Dr R Kumar Intensive Care Educational Supervisor

Dr F J Lamb Intensive Care Medicine,

Dr C Locke Major Gynae oncology, paediatrics Educational Supervisor

Dr M Mackenzie Obstetric Anaesthesia, Lead for

Dr P Morgan Intensive Care Medicine, Outreach Educational Supervisor

Dr G Morton Intensive Care Medicine module

Dr S Parrington Regional Educational Supervisor

Dr S Rafferty Director of Medical Education

Dr S Ranjan Intensive Care Medicine

Dr A Riccoboni Obstetrics, Teaching lead Educational Supervisor

Dr A Stewart Obstetric Anaesthesia Educational Supervisor

Dr P Williams Airway lead, AAGBI linkman

Dr K Gandhi Dr E Syrrakou

Dr N G Kumar Dr H Wright

The Department expects all patients to be seen pre-operatively, preferably by the

anaesthetist who will administer the anaesthetic, and at an appropriate time

before surgery When trainees

are rostered in theatre with a consultant they should liaise to discuss preoperative assessment of patients

Anaesthetic charts should be completed for all patients Please fill in the pre-operativeassessment section as well as the operative and post-operative sections

Appendix B.2

INTENSIVE CARE UNIT

Orientation Notes for New Staf

Lead Clinician ICU Dr Syed Ali

Clinical Nurse Manager Mrs Caroline Allison

There is a weekly rota for the consultants

Multidisciplinary meeting - Monday & Thursday at 11.30 in the ICU seminar room (or

on Tuesday following a Bank Holiday Monday)

Morning handover at 08.00-08.30, Evening handover at 17.00-17.30 and/or 20.00-20.30

Useful telephone numbers

Major Incident Protocol

This is in a pink folder on the top shelf behind Shirley’s desk in the anaesthetic office Please read it

Computer and X-ray access

You will be given a Trust email address on arrival at the Trust Through this you can request a log in for the PACS system to look at x-rays PLEASE do NOT share log-ins

Expected Duties of doctor covering ICU

1 Attend handover from previous day’s team and daily consultant ward round

2 Examine all patients, record findings and daily treatment plans on daily progress chart

3 Follow progress during duty period Liaising with nursing staf and instituting appropriate therapy after consultation with senior staf as appropriate

4 Review patients who are referred by other specialities and/ or critical outreach team

5 Admit new patients if beds available on discussion with senior nurse on duty Inform the duty consultant of all proposed admissions and record admission details on admission sheet (irrespective of the time of day) Record reason for admission/ brief medical summary on Wardwatcher

6 Organise next day’s blood request forms according to the protocol Record accumulative fluid balance and fow sheets

7 Prepare discharge summary on Ward watcher for all patients leaving ICU

Communication

Please ensure you communicate with the medical/surgical admitting teams as

appropriate

1 All transfers from other hospitals must have an admitting team who should

accept the patient prior to transfer

2 All discharges/deaths/transfers out must be notified to the admitting team

as early as possible

GUIDELINES ON ADMISSION TO THE INTENSIVE CARE UNIT/HIGH DEPENDENCY UNIT

1 Patients are admitted to the Intensive Care Unit for multiple organmonitoring and/or support where the severity of illness and dependency of thepatient on nursing care precludes its delivery elsewhere in the hospital

2 The referring consultant, or on call consultant for that speciality, must beaware of the request for admission Where possible they should see thepatient prior to referral The consultant anaesthetist for the ICU mu s t beinformed of the referral and the admission discussed An admitting team(surgical or medical) need to be involved when patients are admitted from orreferred from A&E This is to ensure an admitting consultant is identified andnotified This also applies to patients being transferred from another ICU

3 Patients should be prioritized according to clinical need, however where possible patients in

A&E need to be rapidly assessed and decision made within the 4 hours A&E

target

4 The decision to admit a patient for intensive care should be discussed and

agreed with the

patient’s family/partners and where possible the patient

5 There must be the potential for the patient to benefit from intensive care i.e thepatient has a reversible condition and account is taken of co-existing morbidities

6 Where it is not possible to determine whether a patient will benefit fromintensive care the patient will be admitted and assessment made of the response

to treatment

7 Complete the admissions box on the Wardwatcher database on the ICU

computer with the

patient’s details to facilitate handover