Your Guide to the Rotation

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Your guide to the rotation

Oswestry T&O rotation induction booklet

OSWESTRY ROTATION 1st Edition May 2019

©OSCAR

TRAUMA AND ORTHOPAEDICS

Author

Mr. Salam T Ismael

Co-Authors

Mr. Andrew George Miss Catriona Heaver Mr. Gregory McConaghie Miss Hayley Lawrence Miss Hannah Meacher Mr. Kahlan Al Kaisi Miss Soha Sajid Miss Thumari Paavana Mr. William Gibson

Table of contents

1- Welcoming message from the Training Program Director 2- Welcoming message from OSCAR 3- Who’s who in the rotation 4- Teaching calendar and exams 5- ARCPs requirements, rotation milestones and new CCT checklist 6- Hospitals of the rotation 7- Introduction to OSCAR 8- Oswestry Society and membership 9- Important links

OSWESTRY

TRAUMA AND ORTHOPAEDICS ROTATION

Message from the program training director TPD

Dear Trainee

Welcome to the Oswestry / Stoke rotation. I am a children’s and adult orthopaedic surgeon at the RJAH and I am your Training program director. You have a fantastic training opportunity ahead of you, which I hope will result in a successful and rewarding career as a consultant.

We are fortunate in this rotation to have many keen trainers and other staff who will help you achieve this aim.

However, it is important that you take charge of your training and are proactive and motivated. You have a lot to give the rotation as well. Without the involvement of the trainees, our training scheme will suffer.

Working in the modern health service poses many challenges as a trainee, and not all things are within our control. If you are experiencing difficulties, though, please speak up early and contact your trainee, the post grad office, myself or the regional HEE department.

This booklet is designed to give you a working knowledge of the rotation and a guide to how things work. Please fell free to ask questions. The teaching calendar is busy, so please note important dates in the diary such as in house exams, ARCP’s and teaching afternoons.

Best of luck!

OSWESTRY

TRAUMA AND ORTHOPAEDICS ROTATION

Message from OSCAR

Dear Colleague

On behalf of the members of OSCAR executive committee , we would to welcome you to Oswestry / Stoke rotation. This rotation is a well-regarded historic rotation with great reputation both nationally and internationally. OSCAR is a research collaborative representative body newly formed by owestery rotation trainee and growing fast. This initiative is totally dependent on the essential contribution of its own members and trainee input in general.

This rotation has a renowned and well established historic theme of teaching that equip trainee with the knowledge and skills required to be a successful , prominent surgeons in their field and also pass their exit FRCS exam easily. On the other hand , as trainee we need to take the initiative and control of our training through active participation and planning. In our rotation , trainers are very supportive, approachable and always willing to guide and listen when needed.

At Owesetry rotation we have a coherent motivated bunch of trainee from different backgrounds and different skills that makes our rotation unique and rich in ideas. There are plenty of social activities and initiatives within the rotation that you may find useful.

If you come across any problem during your training OSCAR and the deanery will always be happy to listen and help when needed.

On behalf of the OSCAR committee we encourage you to get involve with us , share your ideas and make this training opportunity successful.

Wishing you all the success

OSCAR Executive Committee

Who’s who

in the rotation

Your guide to the main figures within our rotation at the present and in the past. This section will also provide you with information of the main contacts within

our rotation and deanery in general.

Mr David Ford FRCS, FRCS Ed (Orth)

Consultant Trauma and Orthopaedic Surgeon RJAH / RSH. Chair Regional Specialty Training Committee (Trauma & Orthopaedics)

Regional Training Program Director HEE Email:

Mr Nigel Kiely B Med Sci, BMBS, MSc, FRCS (Orth & Tr)

Consultant Children's Orthopaedic Surgeon RJAH. Training program director / Oswestry Rotation Email:

Mr Robin Banerjee MBChB, MRCS(Ed) , FRCS(Orth) ,Cert Med Ed

Director of clinical studies / Post Graduate Clinical Tutor Consultant Lower Limb Arthroplasty Surgeon RJAH. Email:

Mr David Jaffray

Consultant Spinal Orthopaedic Surgeon RJAH. Email:

SUPPORTING STAFF

Mrs Sandra Cank Postgraduate Secretary

Email: [email protected] Tel: 01691 404474

Mrs Judith Harris Postgraduate Administrator

Email: [email protected] Tel: 01691 404391

OSWSTRY / STOKE ROTATION TRAINEE LIST

Forenames Surname Grade

Alexander Michael Bolt ST6 Andrew George ST3 Ashley Brown ST5 Benjamin Chatterton ST4 Caroline Emily Dover ST4 Catriona Elizabeth Heaver ST8 Charlotte Louise Tunstall ST7 Davinder Bhachu ST6 Debashis Dass ST3 Edmond Chun Ying U ST7 Georgios Orfanos ST3 Gopikanthan Manoharan ST6 Gregory Martin McConaghie ST4 Hannah Annetta Meacher ST3 Hayley Jayne Lawrence ST3 James Arthur Geddes ST5 John Ross Blackwell ST7 John-Henry Rhind ST3 Kahlan Raheem Karim Al Kaisi ST3 Kieran Richard Bentick ST4 Matthew John Walker ST5 Neil Michael Eisenstein ST4 Nikhil Sharma ST5 Rohit Kumar Dhawan ST7 Salam Taha Ismael ST4 Sheethal Prasad Patange Subba Rao ST6 Siddharth Prashant Govilkar ST5 Soha Sajid ST7 Taushaba Hossain ST4 Thomas John Atthill Hunter ST7 Thumri Paavana ST3 William Go Wah Gibson ST4

Teaching calendar

and exams

This section will provide you with a brief

on teaching criteria , requirements and calendar

ALL MEETINGS IN THE LECTURE THEATRE, INSTITUTE OF ORTHOPAEDICS UNLESS STATED OTHERWISE

The teaching in Oswestry rotation is one of the best in the country and provide trainee from ST3 – ST8 with a lot of clinical and theoretical knowledge. We encourage you to attend this teaching and use the facilities provided within.

1. Friday Afternoon Teaching Teaching on Friday afternoons are structured by firms. This is originates from a historic prespective when surgeons from a particular area use to come up to RJAH hospital to discuss cases before operating over the weekend. Each Trainee contributes to his Firm's Weekend. Choose a case to present in agreement with the organisers, present the history and be prepared to examine the patient. Present x-rays and provide a literature review for your colleagues – all to be presented as a PowerPoint presentation.

2. Attendance at Friday Afternoon Teaching All Friday teaching sessions are held at Oswestry unless you have been advised otherwise. Please make sure you report to Judy or Sandra in the Postgraduate Office. They will ensure your attendance is recorded and make sure you record the time you leave. Remember to notify them too of any annual leave, study leave or absences prior to the teaching session. Teaching opportunities are provided for your benefit and the high success rate for the FRCS (Tr&Orth) can be attributed to attendance at such teaching sessions. Failure to attend will result in an adverse ARCP outcome.

3. Stoke Trauma Teaching. Approximately one per month there will be a trauma teaching session in Stoke for Years ST3 – ST5. Peri exam candidates remain at Oswestry on these dates for exam prep.

4. Spring Term: Paediatric Teaching - 5.30pm Lecture Theatre - Commences Tuesday 12th February 2019.

Check your monthly teaching calendar for updates

5. Morning Teaching 8.30 am There will be teaching every morning in the Plaster Room. Ensure you are there.

6. Daily viva teaching at Oswestry Daily VIVA meetings at Oswestry increasingly at all hospitals. Each day of the week is allocated to one individual. That person provides an x-ray on implant etc on which senior trainees are questioned. Where possible advance warning of the subject matter is given.

7. In Training Exams – Clinical and Written: Copies of the Clinical Examination Manual for the FRCS (Tr & Orth) are available for purchase from the Postgraduate Office (presently awaiting update). This format of clinical examination must be used on Fridays and at the bi-annual clinical examinations. THE NEXT IN TRAINING EXAMS WILL BE HELD on Friday 24th May 2019 and Friday 29th November commencing at 2 pm prompt in the OPD at RJAH. Further details will be circulated in due course.

8. Annual Research Day: Submission of a paper for presentation is compulsory. RESEARCH DAY in 2019 is

on Friday 26th April. Please mark the date in your diary. Further details will follow.

TEACHING FIRMS

Welsh Weekend – (Theme: Foot & Ankle / Paediatric ) – 1st Friday of the month

Mr A Roberts Mr R Freeman Mr N Graham Mr S N J Roberts Mr N Kiely Mr S Phillips Mr A Smith Mr S Karlakki Mr N Makwana Mr D Williams

Hereford Weekend – (Theme – Tumour/Spine) – 2nd Friday of the month

Mr P Cool Mr J M Trivedi Mr D C Jaffray Mr S Chitgopkar Mr A Bing Ms G Cribb Mr A Osman Mr N Davidson Mr M Ockendon Mr B Balain Mr S Chitgopkar Mr S Ahmad Mr DS Dheerendra

Shrewsbury Weekend – (Theme: Upper Limb/Arthroplasty) – 3rd Friday of the month

Mr S Pickard Mr D Ford Mr B Burston Mr C Kelly Mr R Roach Mr M Van Liefland Mr R Spencer-Jones Mr N Steele Mr R Potter Mr C Evans Mr P Gregson Mr S White Mr S Hay Lt Col C Meyer Mr P Moreau Mr R Dodenhoff Mr A McMurtrie Mr I Roushdi

Oswestry Weekend Consultants – (Theme: Hip & Knee) – 4th Friday of the month

Mr D Jaffray Mr S Hill Mr P Jermin Mr R Banerjee Mr S Lewthwaite Mr C Marquis Mr P Gallacher Mr A Barnett Mr J P Whittaker

The full timetable will be emailed to you separately by Judith Harris.

Rotation Milestones, ARCPs, CCT new checklist

Your guide to the main milestones you need to achieve during the years of training and explanation of new CCT checklist

RESOURCES https://www.iscp.ac.uk/ https://www.jcst.org/

All the documentation required is available on the 2 websites listed above. This includes

• the surgical curriculum, • the Gold guide (A Reference Guide for Postgraduate Specialty Training in the UK) • checklists during training, • CCT checklists

ISCP

It is important that you fully engage with ISCP. Make sure you know the website well and use all domains available to enter evidence of your training. If you have any queries you can ask your trainer or more senior trainees for advice. We expect a minimum of 20 work based assessments every 6 months. These should be spread across the different domains. Work based assessments should be completed in a timely fashion soon after the training event. Be proactive with your trainer and complete a work base assessment after case discussions, clinical examinations and operative cases. An MSF assessment is required once a year.

ARCP PROCESS

For the Oswestry / Stoke rotation, we hold face-to-face ARCP’s twice a year. Keep an eye out for the dates and make sure you attend your ARCP. One will be an interim and one an end of year ARCP.

We require you to upload all relevant information to your portfolio 2 weeks before the ARCP. Any data entered after that time will be discounted.

The ARCP panel usually consists of Mr David Ford, Mr Nigel Kiely, Mr Robin Banerjee and Mr Ashique Ali. Other consultants are present. There is also a representative from health education England.

We try to anticipate any non-standard outcomes at the interim ARCP. The possible outcomes are detailed in the Gold guide.

Health education England (West Midlands) has a professional support unit (PSU). We sometimes refer trainees to the PSU who needed extra support. This can be because of professional difficulties, stressful life events, or other challenges and affect are trainees ability to work. Trainees have been is the PSU often find it very beneficial.

EDUCATION AND TEACHING

Education and teaching

There is Friday afternoon core teaching for all registrars on the rotation which is mandatory. You will require a 75% attendance to progress at ARCP. It starts at 14.00 and runs until 17.30 with a guest lecturer. One in four Fridays are held at Stoke for trauma teaching for ST3 – 5 which is again mandatory. All aspects of the curriculum are covered over a 2 – 3 year period.

There are two in house examinations per year in May and November and again, these are mandatory and take place instead of Friday teaching. There is a written exam and a clinical session. Do not take annual leave at these times (which Judy can confirm) as the scores are used at your ARCP to assess your progress.

There is an annual Research Day in April which is mandatory. You will be expected to put forward one piece of research (or more if you so feel inclined) that will be accepted for podium or poster presentation.

In house teaching at RJAH occurs frequently and is for your benefit. Each morning VIVA sessions are held in the plaster room from 08.30 – 09.00 and this is protected teaching time.

If you have any concerns or encounter problems with being released from Friday morning duties in order to attend teaching at RJAH in a timely fashion you should speak to Mr Rob Banerjee, Director of Clinical Studies and Clinical tutor at RJAH who will sort them out for you.

JCST checklist for CCT

Clinical experience

• Clinical experience and exposure in T&O * • Timetables for each job – 3 theatre lists plus 2 clinics per week. • Annual statement of ‘no probity’ issues (GMC GMP domain 4) • Annual MSF • Level 4 WBA for ‘critical conditions’**

*There are 8 main areas in T&O as follows: • Hand & wrist • Shoulder & elbow • Spine • Hip • Knee • Foot & ankle • Paediatric • Major Trauma

** There are 14 critical conditions that require a level 4 work based assessment. This can be done by you with your trainees and then documented as a CBD (Case based discussion) on their portfolio:

• Compartment syndrome • Neurovascular injury • Cauda equina • Spinal trauma • Spinal infections • Inflammatory spinal conditions • Metastatic spinal compression • Painful spine in a child • Physiological response to trauma • Painful hip in a child • Necrotising fasciitis • Diabetic foot • Primary and secondary musculo-skeletal malignancy • Major trauma resuscitation

JCST checklist for CCT

Operative experience • Minimum 1800 cases • 1260 cases as first surgeon (STS/U) = 70% • Over 6 years (average 150 cases per job) • Cover indicative numbers • Multiple operations at same sitting must not be unbundled • Bilateral cases can count as 2 operations • Palmar fasciectomy, lumbar discectomy and injections now removed

Indicative numbers These are the MINIMUM numbers of specific operations they must perform during their training chosen to cover the specific skill set of orthopaedic surgery. They are divided into elective and trauma/emergency cases but there are some overlaps with regard to osteotomies and arthrodesis. See appendix.

PBA level • 3 x level 4 PBA’s in each indicative operation • Signed off by 2 or more trainers over a period of time • PBA’s to show progression over time • Simulated PBA’s may be included at PD discretion

We would suggest filling in a PBA for every case/part thereof carried out by your trainee which they should submit within a timely fashion. I tell my trainees to do so within 48 hours.

Research Essential: • GMP & research governance certification within 3 years of CCT • Evidence of research methods training – course? • Evidence of journal club activity

They must also have 2 of the following: • Higher degree completed during training – MSc, MA, MPhil, PhD • Authorship of 2 PubMed cited papers in orthopaedics* (case reports not included) • 2 national/international presentations • Evidence of recruiting >5 patients into RCT • Evidence or recruiting >10 into multi centre observational study

JCST checklist for CCT

* ICMJE BMJ p722 Vol 291 Sept 1985 – International Committee of Medical Journal Editors for PubMed papers. Advanced research evidence that may be used at the discretion of the Program Director: • Membership of trainee collaborative – lead or committee role for > 24 months • Membership of NIHR portfolio study management group • Co-applicant on a clinical trial grant application to a major funding body

Quality improvement • Audit and clinical governance • Minimum one audit per year • 2 completed cycles as evidenced by WBA of audit

Medical Education & training • Evidence of commitment to teaching • Training the Trainers • TOES for senior trainees • NOTSS • Human factors • 1 lecture/presentation per year of training – evidenced by written feedback (OOT)

Management and leadership • Management course • Involvement in Trust management – rota coordinator, service improvement etc. This should be accompanied by written feedback from the supervising Manager/Consultant and uploaded to the ISCP portfolio

Additional qualifications/courses • Up to date ATLS or instructor credential at date of CCT • Commitment to CPD evidenced by courses or meeting attendances – BOA, BHS, BASK, BOFAS etc

ISCP portfolio • If it’s not on it, it doesn’t count! • Reflection – relevant and contemporaneous • All documentation must be uploaded to portfolio 10 DAYS BEFORE ARCP • Anything after this will not be recognised and lead to an outcome 2

ARCPs

ARCP checklist

• At least 40 WBA's throughout the year: at least 50% must be by consultants • PBA's strongly recommended for every case • Complete 3 AED meetings each rotation • CS report for each rotation • Completed Learning Agreements • One audit per 6 months • MSF each year • JCST, JEST and GMC feedback surveys • Up to date CV • Upload certificates for all relevant courses e.g. ATLS ALS etc • Provide evidence of conferences attended and presentations • Provide evidence of research work and publications

All information to be uploaded 10 days prior to ARCP to avoid outcome 2.

ELogbook: • Must log every case participated in • If you perform a part of the procedure then log as 'supervised - trainer scrubbed/unscrubbed' • Assisted essentially means that you did not actually do any part of the procedure.

Clinical and Educational Supervisors • Please note that you not allowed to have AES and CS as the same person in your placement

Hospitals of the rotation

Your guide to the hospitals in our rotation with a brief on each hospital and its characteristics

Robert Jones and Agnes Hunt Hospital - Oswestry

A BRIEF HISTORY...

Roberts Jones was born in 1857 and went to Liverpool School of Medicine. He worked with his Uncle, Huw Owen Thomas, the infamous bonesetter from Anglesey (and inventor of the Thomas splint). He worked in and around Liverpool for the early part of his career both as Surgical Super- intendant for the Manchester Ship Canal and in the Royal Southern Hospital. It is here that he met Agnes Hunt in 1903, a nurse who and been crippled as a child and sought his help with her painful hip.

Agnes Hunt was born in 1867 and at the age of 9 became crippled with a hip condition. Despite this, she completed her nurse training in 1891. Alongside her friend Elsie Goodford, they set up Baschurch House, a convalescent hospital for children in 1901. After meeting Robert Jones, Agnes Hunt asked him to become the Honorary Surgeon to the home. He agreed and in 1907 Baschurch opened its first operating theatre. As the home expanded, space within the house was limited. Sheds were built in the garden, open on one side creating the first open air wards.

During the First World War, Baschurch Home became an Auxiliary Military Hospital caring for and around 100 soldiers, and 100 children at times.

The hospital was moved to its current site in 1921 and called the Shropshire Orthopaedic Hospital. The wards were initially number 1-11. Shortly before the hospital opened, Elsie Goodford died after a short illness. Agnes Hunt renamed one of the wards “Goodford Ward” in her memory. In 1932, the wards were updated and refurbished with money donated from the local after-care committees. The wards were renamed in thanks to the local area.

Sir Robert Jones died in 1933 aged 75. In his memory, the hospital was re-named to honour its founders, The Robert Jones and Agnes Hunt Orthopaedic Hospital. Dame Agnes Hunt died in 1948.

Robert Jones and Agnes Hunt Hospital Oswestry SY10 7AG

Switchboard: 01691 404000

Robert Jones and Agnes Hunt Hospital - Oswestry

THE HOSPITAL

RJAH is an elective hospital which also accepts tertiary referrals from Shropshire, Staffordshire, Cheshire and North Wales. Although there is no A&E department attached, emergency admissions may come from clinic or tertiary referrals.

RJAH is primarily an Orthopaedic hospital. It also houses the Midlands Spinal Injuries Unit (covered by medical/rehab teams), elderly care rehab (Sheldon Ward), Outpatient Rheumatology, midwife led maternity unit. It is also home to the Arthritis research centre.

DOCTORS MESS & ACCOMMODATION

There is on-site hospital accommodation in the Doctors Mess Rooms availability is limited and must be requested early. Please note that not all rooms are en suite but there are shared bathroom facilities available. Cost approx. £400/month Mess facilities There is a shared kitchen, computer room, TV room and pool table. Kettle and microwave available in Doctors Mess kitchen. Fish & Chips are served in the dining room on Friday lunchtimes (sign-up sheet and cost deducted out of your wages).

ON-CALL ROOM There is an on-call room available to the registrar on nights. Please see switchboard for the key.

CATERING FACILITIES Denbighs Restaurant- open Vending machines and microwave available 24 hours in Denbighs foyer. League of Friends café- open Serves drinks and cakes.

CAR PARKING There is ample staff car parking around the hospital. It is charged at approx. £10/month. At induction you will be given a temporary parking permit which will last 1 month. You will need to complete an application form to get your permit.

TRAVELLING EXPENSES You can claim back travelling expenses in line with the deanery guidelines. To do so, you will need to register for an E-Expenses account when working at the trust. The icon for E-Expenses is on all desktops. You can register here, but you will need your assignment/payroll number. Any problems, please contact Sue Pryce in medical staffing.

Robert Jones and Agnes Hunt Hospital - Oswestry

STUDY LEAVE Study leave budget can be granted as per the deanery guidelines. See Judy Harris in the post grad office for the relevant form.

LIBRARY The library at RJAH- The Francis Costello Library- is located upstairs in the Post-Grad Centre. It is accessible 24/7 with the door code. When starting at RJAH you can register with the library. You will be given a library card which you can use to borrow books 24/7. The library team are extremely helpful; they will register you for an Athens account and help with any queries, literature searches etc. There are 5 computers available for use as well as space for private study.

THE CONSULTANTS

ARTHROPLASTY FOOT & ANKLE Mr Richard Spencer-Jones Mr Andrew Bing Mr Chris Evans Mr Simon Hill Mr Niall Steele Mr Chris Marquis Mr Pat Gregson Mr Nilesh Makwana Mr Rob Banerjee Mr Simon Lewthwaite SPORTS KNEE Mr Ben Burston Mr Pete Gallagher Mr Niall Graham Mr Andy Barnett Mr Sudheer Karlakki Mr Steve White Mr JP Whittaker Mr Simon Roberts Lt Col Carl Meyer Mr Paul Jermin Mr Steve Phillips Mr Richard Roach Mr Tony Smith

SPINES Mr Birender Balain PAEDIATRICS

Mr Jai Trivedi Mr Nigel Kiely Mr David Jaffray Mr Rob Freeman Mr Matthew Ockendon Mr Derfel Williams Mr Sarfraz Ahmed Mr Shashank Chipgopker Mr Neil Davidson UPPER LIMB Mr Sujay Dheerendra Mr David Ford Mr Cormac Kelly Mr Stuart Hay TUMOURS Mr Simon Pickard Mr Paul Cool Mr Ron Dodenhoff Ms Gill Cribb Mr Piers Moreau Ms Karen Shepherd Mr Ibrahim Roushdi Mr Richard Potter Mr Marck van Liefland

Robert Jones and Agnes Hunt Hospital - Oswestry

DAY-TO-DAY WORK

The service is registrar led, there are no FY1/2 or CT doctors at RJAH. It is therefore down to you to do the ward round, write in the notes, do TTOs and organise any investigations. Depending on what firm you are in will depend on how that works; for example, arthroplasty registrars are ward based and so will look after all arthroplasty patients on that ward. Foot & ankle registrars will look after their boss’s patients and cross cover for leave, nights etc.

8am Ward round & ward jobs See pre-op patients if have theatre list

8.30am Teaching in plaster room

9am – 5pm Clinic/Theatres as per firm rota

End of Day Visit wards to ensure patients OK and no outstanding jobs.

ON-CALL COMMITMENT

1:24 rota covering...

Evenings: 5-8pm (Fridays 1-8pm) Weekends: 8am-8pm Nights: 8pm-8am

On-calls involve covering the wards and completing any appropriate ward jobs, including reviewing unwell patients. Please ensure each ward is visited (there is a sign in book on Alice ward).

There is an on-call medical middle grade who can be called to review and help manage patients with medical problems but you are expected to see the patient first. You are also expected to review any medical patients who have an acute abdomen.

Evening handover takes place on Powys ward at 8pm. If available, clinical outreach will also attend.

There is no official morning handover- if any concerns, please find or contact the relevant firm registrar at 8am.

Robert Jones and Agnes Hunt Hospital - Oswestry

COMPUTER SYSTEMS

You are provided training on all these systems on your induction day.

EPR Electronic Patient Record Ward Round Clinic Letter Operation Notes Blood Results Request plain XRs

Bluespeir Theatre Lists Will also link to EPR & PACS

PACS X-ray system

Bighand Dictation System

ROTAS

On-Call Rota Issued by Kim Herbert in Medical Staffing approx. 3 months prior to starting. If you need to swap an on-call, please email Kim and copy in the RSOs for that 6 months. If you swap any nights, please swap those as a block of 3 or 4, not individual nights.

Kim Herbert Medical Staffing Email: [email protected] Phone: 01691 404256

Firm Rotas Your day to day rotas. Each firm will have a firm co-ordinator... usually shown on the deployment list. They will be responsible for the day-to-day allocation of theatres, clinics etc. On the whole, you will work for your Consultant(s), but you may be asked to cross over within your firm if there are shortages.

Robert Jones and Agnes Hunt Hospital - Oswestry

Robert Jones and Agnes Hunt Hospital Site Map

University Hospitals North Midlands Royal Stoke University Hospitals and County Hospital (Stafford) INTRODUCTION

The University Hospitals North Midlands (UHNM) consists of two main hospital sites – Royal Stoke University Hospitals in Stoke-on-Trent and County Hospital in Stafford. Located in Staffordshire both hospitals are just off the M6 motorway. Staffordshire houses Cannock Chase AONB and has easy links to the National Forest and Peak District National Park.

Historically Stoke-on-Trent was the epicentre of the pottery industry since the early 17th century and was the home of world famous brands such as Wedgwood, Aynsley and Doulton. Sadly much of the pottery industry is now gone but parts still remain active and some of the previous factory sites are now museums or working shops worth a visit. The city consisted of six towns - Hanley(city centre), Burslem, Fenton, Longton, Stoke-upon-Trent, and Tunstall, which are accessible from the A500 which runs through the city. Other attractions include Trentham Gardens and Alton Towers.

THE HOSPITALS

UHNM is one of the country’s busiest major trauma centre, receiving patients from Staffordshire, Shropshire, Cheshire and North and Mid Wales. The hospital is split into the Royal Stoke site which is the main hospital, receiving all the major trauma and the County site in Stafford which is mainly now an elective centre although it still supports an A&E and an acute medical department.

RSUH ( ROYAL STOKE UNIVERSITY HOSPITAL )

The Royal Stoke is a large site and houses all specialities including neurosurgery, plastics and cardiothoracic. The hospital was previously split into two main sites – the Royal Infirmary and City General with Central Outpatients in the middle. However, since 2012 all clinical activities are now primarily based at what was previously the City General. As the hospital was built in different parts, the geography of the site is unusual. The hospital consists of three principal buildings – Main building, Lyme building and Trent building. The buildings do link up but only on certain floors! There are a number of other buildings such as the cancer centre/maternity which does have an underground link corridor, the West building as well as a number of administrative buildings too.

CATERING & OTHER FACILITIES

There is a main restaurant as well as a Subway Three Costas (main entrance, opposite Subway and a 24 hour outlet at the A&E entrance) There is WHSmiths. There is an ATM There is multi-faith prayer rooms.

University Hospitals North Midlands Royal Stoke University Hospitals and County Hospital (Stafford) COUNTY HOSPITAL

This is based in one building housing the wards, theatres, outpatients and A&E. The hospital has a restaurant, a WHSmiths and a much-liked patisserie. Again, there is an ATM available. There is also a Chapel and a Muslim prayer room.

ACCOMMODATION

Both hospitals have a doctors mess. Unfortunately there is no easy on call accommodation available, although working shifts which are usually busy there is often little time to use it!

Living accommodation is available but limited therefore try to book early. At the RSUH site there is only family accommodation available through the hospital. However, there is bachelor accommodation available at the County site, which can be leased long and shorter terms. Staffordshire council also have accommodation affiliated with the hospital but is a house share. There are a number of private rentals and house share available locally in Stoke so it is worth shopping around. Costs vary but on the whole it is not an overly expensive city to rent accommodation in.

CONTACTS

There are many administrative people involved and the roles are often changing therefore finding out who you need to talk to for what can be challenging. However, your main port of call is Natalie Lunt: [email protected] who is the main rota coordinator of the department. She is supported in this role by Olivia Fanthorpe: [email protected]. For most queries, ask them to point you in the correct direction. Any overtime/locum shift that you have worked has to be emailed to them and they will put this shift on the ‘MedicOnline’ system for managing rotas. This then as to be accepted by yourself before going to pay roll. Be aware – the trust are now no longer paying claims older than 18 months therefore get your claims in quickly! The claiming back process for study budget/travel costs/relocation costs is done through the EasyESR system available on the intranet home page under the ‘Favourites’ tab. Currently the lady I spoke to was called Deborah Gregory for accommodation costs but be aware this may be different for different claims.

TRAUMA & ORTHOPAEDICS DEPARTMENT

The T&O department is large and is currently expanding! The consultants are usually specialised in a particular area of orthopaedics and most (though not all) do trauma. Educational supervisor is usually the consultant that you work for. However, the work pattern is changing in the future so that the registrars either work in the trauma team or the elective team.

University Hospitals North Midlands Royal Stoke University Hospitals and County Hospital (Stafford) ON CALLS

There is a Consultant Of the Week (COW 1) who is on call for the weekend and week days. There is also a COW 2 who supports the COW 1 during weekends as there are usually 2 theatre lists at the weekend and covers County Hospital during the week. During weekdays there is a different consultant oncall during the night and who is nominally responsible for the patients admitted.

The current working pattern is a two-tier registrar system with a junior and a senior registrar. The junior registrar is known as the CALF (competent assessor of limb function) who carries the on call bleep and a senior registrar to support them. The senior registrar is responsible for patients going to theatre out of hours as well as overseeing the on calls. However, this system is due to change in the near future to a one tier system in the day and two registrars on call overnight. There is also a spine CALF during weekdays 08.00 to 18.00 who takes all the spinal referrals. Currently it is not possible to have a separate spine on call but this may also change in the future. There is also a junior doctor on call at all times and a F1 shift to cover the ward up to 22.00. the junior doctors are on call primarily for the wards which is their first responsibility. However, they are needed to support the calf as much as possible.

The on calls shifts are days from 08.00 to 20.00 with hand over in the trauma seminar room. And nights from 20.00 to 08.00 officially though the night team are expected to do the post take ward round which varies in finishing time. The on call shifts are busy! You will feel overwhelmed and calf phone can go off so much that you can spend a substantial portion of the shift just answering it. Please be patient and as polite as possible (even though you may not feel like it!) Anyone who has been calf will share your angst. You can only do as much as you can and things do have to be handed over. The day team does get inundated, particularly late afternoon/evening and the night team has the job of sorting out the lists for the next day and presenting the patients in the trauma meeting at 08.00.

There is a registrar handbook that goes into more of the finer details of the on call and the running of the department that I strongly advise you read at the start of the job. Helpful colleagues will also guide you. You will not be alone in feeling overwhelmed or frustrated so please talk to others. If you are unsure or need help on what to do please ask your seniors, we work as a team!

THEATRES AND WARDS

The main theatre hub is located in the main building LG2. This area is shared with the general surgeons, vascular, neurosurgery and cardiothoracics. Theatre 20 (main trauma theatre), 22, 23, 24 are the main T&O theatres, doing a mixture of trauma and elective as well as spines. There are also theatres in the Lyme building, specifically elective orthopaedic theatres 11 and 12 opposite ward 112 which is the elective orthopaedic wards. The trauma wards are 225 (hip fracture ward), 226 (main trauma ward) and 227 (polytrauma ward). ITU is located opposite main theatre hub as well as a section in the Lyme building too.

University Hospitals North Midlands Royal Stoke University Hospitals and County Hospital (Stafford) FRACTURE CLINICS Currently, junior doctors do not in general do elective clinics due to pressure in fracture clinic with the exception of spines. This may change in the future. • Fracture clinic RSUH – located in the main building just off main entrance. • Fracture clinic County – located in the main outpatient department and neighbours the back of A&E. The clinics are usually very busy with a high volume of patients. Both clinics are supported with a plaster room located in the clinic and with easy access to X-ray facilities. The staff will help guide you. There are also fracture clinic guidelines available, please familiarise yourself with these. More details of the clinics is available in the registrar hand book, it is worth knowing this as it can help you decide when to bring back patients to relevant clinics. Please ask if you are unsure and discuss relevant cases with consultants, particularly if you think the patient may need surgery. If there is no consultant in the clinic, discuss anyone needing surgery with the COW.

SOFTWARE More details are available in the registrar hand book but to summarise: • Bluespier: UHNM has recently started using Bluespier for patients going to theatre. The patient has to be added to the whiteboard and then moved to the relevant list. Unfortunately, the system is not integrated to allow access to the other software systems.

• iPortal: This system allows access to clinic notes, radiology images and reports, blood results, scanned notes/investigations, patient location, clinic attendance and also allows access to Winscribe to dictate. The system also allows you to add notes and type in operation notes too. Unfortunately, it does not allow you to order investigations.

• Midway Live : This system has to be logged onto in order to order investigations, refer to physio/OTs etc. It can also but used to view blood results and radiology/histology reports.

• Winscribe: All dictations have to be done on Winscribe, this can be accessed directly through Winscribe Author or through a link on iPortal when one is available.

• ReferAPatient: This is the main portal for other hospitals referring a patient either to spines or to the pelvic teams. There is an automated message that will come up on the on call phones each time a referral is made.

• Sectra: This is the full PACS system and more comprehensive than the Uniview available on iPortal. This system will have the images transferred from other hospitals initially.

There is also an online directory and an online on call rota watch system. For any enquires please call the Call Centre (switch) by pressing 0 and asking for the operator.

University Hospitals North Midlands Royal Stoke University Hospitals and County Hospital (Stafford) GOVERNANCE There are quarterly audit and M&M meetings with registrars expected to present. More information will be available from Natalie and Mr Mehta who is currently the audit lead.

This is an overview of UHNM, for more details please read the Registrar’s and fracture clinic hand-books on induction. There are also clinical guideline available on the intranet.

Enjoy your time and pray that you survive!

University Hospital North Midlands Royal stoke Hospital Sitemap

Wrexham Maelor Hospital

INTRODUCTION

Wrexham Maelor Hospital is a District General Hospital situated in the North East of Wales, with around 13% of the population being welsh speakers. It is part of the Betsi Cadwaladr University Health Board and contains Intensive Care and Surgical High Dependency Units as well as SCBU and paediatric wards. Other specialties such as plastics and Neurosurgery are referred outside the health board for treatment.

ACCOMMODATION Hospital accommodation is available and can be organised by contacting Derek Blythin at [email protected] to arrange a room. The rooms are basic, but are within a short walking distance of the site and some are situated on-site.

CATERING FACILITIES There are a few places to eat and get hot drinks, with the main Riverside Restaurant and a further MVS café and small shop at Entrance A, but small MVS tuck shops can also be found in the entrance to fracture clinic and at Entrance B. Alternatively there is the Atrium café in the medical institute, which serves hot food such as panini’s and jacket potatoes, but the menu changes regularly.

DOCTORS MESS & ACCOMMODATION The Doctors mess is £10 a month and comes with a number of rooms with comfy sofas, pool table, TV and computer facilities. There is another eating area where a selection of the canteen food is served, as well as sandwiches. There is also free tea, coffee and toast here whenever you wish and fridges to store your lunch.

CAR PARKING Parking is free at the Maelor, however spaces are scarce after 9am.

SWITCHBOARD Switchboard is found on the right as you enter the Cardio-Respiratory Ward (G2), where you can pick up your bleep and keys for accommodation.

LIBRARY The library has very helpful and friendly staff that will more than happily help with any literature searches or queries you may have. It has computer facilities and offers a number of different study environments including quiet study spaces and the new wellness and wellbeing room. It provides printing and photocopying 24/7 and binding and laminating during staffed hours, but these are charged.

Wrexham Maelor Hospital

OTHER SERVICES

Radiology - OOH MRI facilities are limited to urgent cases. - OOH Urgent CT between 9pm – 8am available 7 days a week are reported by an external organisation – Everlight Radiology. - Certain Cases (Unstable/Major Trauma/Paediatric USS/Technical Failure) may warrant discussion with local consultant colleague.

Micro - OOH Micro samples are sent to Ysbyty Glan Clwyd for processing. - Send samples OOH via the POD system to the Path lab and label “URGENT – for immediate transport to YGC”. Then contact the micro lab via switchboard AFTER the sample has been sent via the POD system. - On-call Clinical advice via switchboard.

Biochemisty - Available Mon-Fr 9am-5pm. - After 5pm, Weekends or Bank Holidays, call 07810636773 or Bleep 6255

Haematology - After 5pm, weekends or Bank Holidays 07785454307 or Bleep 6371 - On-call clinical advice via switchboard.

Relevent IT Systems - Welsh Clinical Portal for Investigations & GP Records - Synapse for Radiology - Myrddin CiS

Enjoy the placement !!

Wrexham Maelor Hospital

Wrexham Maelor Hospital Sitemap

Worcestershire Acute Hospital Trust

INTRODUCTION

Trainees allocated to Worcester Hospital are in fact employed by the Worcestershire Acute Hospital Trust. Although largely based at Worcestershire Royal Hospital, time will also be spent at the Kidderminster Treatment Centre and the Alexandra Hospital in Redditch.

The location gives a pleasant balance of rural and urban life. Worcester itself is a reasonable sized city with a cathedral, shopping centre and cinema. There are also good road and train links into Birmingham. Closer to Kidderminster is the West Midland Safari park, and the Severn Valley Steam railway if you have visitors to entertain. The Malvern Hills are also a short drive away if hiking is enjoyed.

Worcestershire Acute hospital serves a population of 580 000 in addition to the visiting tourists. Due to agricultural land, occasionally farm related accidents are also seen. There are 149 964 A&E attendances across the trust every year with 49 740 emergency admissions. The Worcestershire Royal Hospital has 500 beds and is a trauma unit. There is an onsite vascular team and general surgery team.

The Alexandra Hospital has 300 beds and is a considered a Local Emergency Hospital by the trauma network. Is has cancer unit status and an onsite urology team. This is where the majority of our elective work is undertaken.

Kidderminster Hospital and Treatment centre has a minor injuries unit but is also the location for many elective and trauma day case procedures. Arthroplasty is also performed for low risk patients, and there is an inpatient ward consisting of side rooms only for these patients. However, the future of arthroplasty being done at Kidderminster is currently under review.

ACCOMMODATION

Hospital accommodation is available on the Worcester site, and is managed by Rooftop housing group (see contacts below). A single room costs £558.77 and includes bills and council tax. Broadband is an extra £17 a month. 2 bed flat is £797 and a 3 bedroom flat is £859.14 and a 3 bedroom house is £932.07. It is understood that the accommodation is of good quality.

On call accommodation is available free of charge on site. There is also a doctors’ mess on site, but not within the main building itself.

CATERING FACILITIES & PARKING There is a canteen, costa and a hospital shop where food can be bought. There is also a fruit market stall at the main entrance. Application for car parking permit is included in the induction process, and the charge covers all 3 hospital sites. However, when going to the Alexandra, the card doesn’t swipe in, so use the visitors car park but use the intercom to give the code of the parking permit to the security officer so that they can let you through the barrier.

An additional card is available to give swipe access at the Alexandra site, but this can only be printed at certain times on certain days, making this difficult to arrange.

Worcestershire Acute Hospital Trust

TRAVEL & STUDY EXPENSES

Travel expenses is an online system found via the intranet (go to the staff room tab on the intranet home page and click on ePay in the left hand column).

Study leave is applied for on a paper form which is looked at by Mr Shahid. The expenses is claimed for on the ePay.

LIBRARY

There is an onsite library with good online access. The library card is valid at Worcester, Kidderminster and the Alexandra. The library team also deal with smartcard issues and elearning. There is an online service to help with literature searches.

ORTHOPAEDIC & TRAUMA DEPARTMENT / THE CONSULTANTS

There are two sets of consultants, registrars and SHOs for Worcester and for the Alexandra Hospital. Kidderminster has a House officer for entire site out of hours. The consultants cross cover the on calls between Worcester and the Alexandra, but registrars do not. Most time is spent at Worcestershire Royal Hospital, where exposure to trauma is gained and a lot work is done in clinic.

Elective work is done at the Alexandra Hospital and Kidderminster Hospital. A very big change to service is currently underway with regards to hip fracture patients. As of 2nd January, patients with suspected or proven hip fractures are being diverted to the Alexandra Hospital, where a hip fracture ward has been created. Exceptions to this are patients with severe co-morbidities or patients who trigger a trauma or silver trauma call. This will have an impact on elective services at the Alexandra, and due to logistic issues, the implementation of this plan has already been delayed a couple of times. The consultants are reviewing the rota to try and make arrangement to allow the Worcester trainees to go to the Alexandra Hospital once a week for the exposure to hip fractures.

The Trauma and Orthopaedic team look after patients with head injuries provided that A&E have contacted the neurosurgical team at Coventry for a clear plan, or the Queen Elizabeth in the context of polytrauma. We accept referrals from A&E and inpatients for spine related problems and will discuss these with the Royal Orthopaedic Hospital. GPs/community are not allowed to refer spine related problems, and they must discuss with the Royal Orthopaedic hospital themselves.

Diabetic foot infections are dealt with by the vascular team.

There are 9 Worcester based consultants and 8 Alexandra based consultants. 9 registrars at the Alex. 7 registrars at Worcester, and an Associate Specialist. The number of registrars fluctuates depending on locum availability. At Worcester, in addition to the Stoke/Oswestry trainee, there is a Birmingham trainee. There used to be a Coventry/Warwick trainee, but they haven’t send one for a few rotations. At the Alexandra hospital is another Birmingham trainee and a Coventry/Warwick trainee.

Worcestershire Acute Hospital Trust

ORTHOPAEDIC & TRAUMA DEPARTMENT / THE CONSULTANTS

Using the National Joint registry to get data for 2018, 47 arthroplasties took place at Worcester (47 hip and 2 knee) – the majority of these would be total hip replacement for neck of femur fracture, but some of this is revision for periprosthetic fracture or dislocations. At the Alexandra 955 operations took place – 488 hips, 469 knees, 2 ankle and 16 shoulder. At the Kidderminster 30 arthroplasties took place 13 hips, 16 knees, and one shoulder.

In the most recent 12 month data there were 394 hip fracture patients at Worcester and 296 at the Alexandra. There is a an all-day trauma list at Worcester hospital and an afternoon list at the Alexandra hospital, although again this is being reviewed now that hip fractures have transferred over there. Some of the ankle fractures are treated at Kidderminster, where the experienced associated specialist has the majority of his lists. There is also a specialised hand trauma clinic at Kidderminster on Mondays, with a hand trauma theatre list on the Tuesday. However, if there is a time dependent injury outside the scope of the on call consultant then hand trauma is referred to Queen Elizabeth Hospital. In the case of paediatric hand trauma cases, if neither of the two hand specialist consultants are working at the Worcester site, and again if it is beyond the scope of the on call consultant, then we refer to Birmingham Childrens’ hospital.

The SHOs have a shift rota, including night shifts. They do not cross cover any other specialty. The registrar on call is 24 hours non-resident with a normal working day following this. Also, the trainee registrars only work Saturday, whereas the middle grades have to work Saturday and Sunday continuous on call.

The consultant on call normally does an evening ward round to allow planning for the following day’s trauma list.

As a registrar, you work for two consultants, but when your consultant is on call you stick to your work schedule which is a monthly rolling plan.

Trauma meetings are at 8am every morning in the theatre seminar room, and on Tuesdays there is a journal club at 730am.

ROTAS

Rotas are managed by medical staffing, but they are relatively inexperienced compared to Mr Isaac’s secretary, Clare O’Brien. If medical staffing are unable to offer solutions to staffing issues, it has been many a time that Clare has been able to source a solution.

My advice is once allocated to Worcester, try and find out what consultant duo that you are assigned to. Easiest way to do this is most likely via Clare O’Brien. The work schedule can then be sent to you as it differs to the work schedule declared as part of the contract.

Worcestershire Acute Hospital Trust

THEATRES & WARDS

The ward at Worcester is split into A and B and consists of 32 beds. The Alexandra hospital has an elective ward and a trauma ward, each with 20 beds. There is also a newly opened hip fracture ward. The Kidderminster Hospital ward is side room only, and is shared with other specialties.

THE CONSULTANTS

More detailed information is available on the Worcestershire NHS trust website, and the following comments are by no means exhaustive on their interests.

Mr Docker Clinical director for Trauma and orthopaedics and facilitates journal club Hip and knee arthroplasty with interest in revision of knee replacements

Mr Aslam Hip and knee arthroplasty / Soft tissue knee

Mr Pearse Hip and knee arthroplasty / Soft tissue knee Total and unicompartmental knee arthroplasty / ACL recon

Mr Shahid Hip and knee arthroplasty Is the lead for trainee registrars and middle grades. First port of call for rota and department problems.

Mr Isaac Knee and hip arthroplasty Incharge of the SHOs and weekly departmental teaching

Mr Sadiq Knee and hip arthroplasty with interest in hip revision and limb reconstruction.

Mr Ratcliffe Upper limb specialist and runs the hand trauma clinic and theatre at the Kidderminster Hospital

Mr Munjal Shoulder and elbow specialist

Mr Akimau Foot and ankle specialist Helps to co-ordinate the journal club

Worcestershire Acute Hospital Trust

USEFUL CONTACTS Medical education Sarah Page : Senior Medical Education Administrator 01905 760604 [email protected] Sarah Page goes above and beyond her call of duty. She is absolutely brilliant in sorting out most issues, and knows who to talk to. For example even with security card issues, and payslip issues. It was Sarah who got me the information on the accommodation. First port of call for most hospital wide issues. Department issues Clare O’Brien Currently secretary to Mr Isaac and Mr Aslam. Knows the department really well, and has helped medical staffing find ways to help the registrars on numerous occasions. Ext 39730 / Clare.o’[email protected]

Medical staffing

Beth King Sarah Ashton [email protected] [email protected] 39917 30846

Accommodation

Rooftop housing group http://nww.worcsacute.nhs.uk/EasySiteWeb/GatewayLink.aspx?alId=37175 https://www.rooftopgroup.org/homes/nhs-and-keyworker-homes/worcestershire-royal-hospital/

The Keyworker Co-ordinator is Emily Brown who can be contacted Tuesday/ Wednesday 9.30-5 & Thursday/ Friday 9.30-2.30 and is usually on site in the Malvern View accommodation office during these times Phone 0800 0421 800 x1196 Mobile 07854 717553 Email [email protected]

Emily is now supported by an Accommodation Officer, Hilary Deakin, who can be contacted Monday - Friday 9-5 as follows: Phone 0800 0421 800 x1103 Mobile 07854 717495 Email [email protected]

Hilary is not always based within Malvern View and also works in the Rooftop Evesham office. However, she usually provides cover within the Malvern View accommodation office when Emily Brown is unavailable such as on Mondays and during periods of annual leave. This leaflet provides details of the accommodation available at Malvern View and the current 2018/19 rental rates. A range of accommodation is provided, including study bedrooms, flats and houses and rentals are updated every August. Further details can also be obtained from the keyworker section of the Rooftop Housing website - https://www.rooftopgroup.org/homes/nhs-and-keyworker-homes/worcestershire-royal-hospital/

Royal Shrewsbury Hospital

INTRODUCTION

Shrewsbury is a market town located 9 miles east of the Welsh border. It serves as the commercial centre for Shropshire and mid-Wales, with a retail output of over £299 million per year and light industry and distribution centres on the outskirts. The A5 and A49 trunk roads come together as the town's by-pass, and five railway lines meet at Shrewsbury railway station. Shrewsbury town centre has a largely unspoilt medieval street plan and over 660 listed buildings including several examples of timber framing from the 15th and 16th centuries; Shrewsbury Castle, a red sandstone fortification and Shrewsbury Abbey, a former Benedictine monastery. Most notably, the town is the birthplace of Charles Darwin and is where he spent 27 years of his life.

The town boast many attractions from the annual 'longest running flower show in the world' to monthly Farmers and local artisan markets. One can visit the many historical buildings and museums as well as Attingham Park, a national trust property right on the edge of town. Further afield, Shropshire offers plenty of other attractions. It is a hilly and rural county full of picturesque village & market towns. Given its proximity to Wales, these once tempestuous borderlands contain more than 30 castles, surviving from medieval campaigns against the Welsh. Later, the first sparks of the Industrial Revolution ignited in Ironbridge Gorge where multiple museums tell the tale.

Shrewsbury and Telford Hospital NHS Trust is mainly comprised of two acute hospitals: Princess Royal Hospital-PRH-(in Telford) [327 beds] and Royal Shrewsbury Hospital-RSH-(in Shrewsbury) [492 beds]. The trust also provides a number of services at Ludlow, Bridgnorth and Oswestry Community Hospitals. Combined, the two acute hospitals serve an approximate combined population of 420,000 in Shropshire, Telford & Wrekin and mid Wales; 90% of the area covered by the trust is rural.. The number of staff employed by the trust as of April 2018 was 5,053. The trusts’ services are commissioned by Telford and Wrekin Clinical Commissioning Group (CCG), Shropshire CCG and Powys Training Health Board.

The annual turnover (total income) for the trust was £326 million in 2015/16. The trust deficit was £14.6 million for the same period. During 2015/16, the trust had 116,154 inpatient admissions, 407,108 outpatient attendances and 121,105 attendances in the emergency department.

GENERAL HOSPITAL INFORMATION

Both acute hospitals with full emergency care facilities, however the DoH have recently approved funding for the two sites to be reorganised into one emergency care site and one planned care site. This is expected to take approximately 5 years to roll out once a decision has been made. For more information google Shropshire Future Fit.

Both hospitals run full Acute Med, Resp, Gastro, ITU, HDU, T&O [Trauma] departments, however some specialties are sight specific. ENT, Max Fax, Stroke, Elective Orthopaedics, Obs & Gynae and Paeds are based at PRH whilst Renal, Oncology, Haematology, Gen Surg, Vascular, Urology and Opthalmology are based at RSH. unit covering part of north Wales, however any serious polytrauma typically bypasses RSH and goes direct to Stoke.

Royal Shrewsbury Hospital

GENERAL HOSPITAL INFORMATION

Typically if a patient required a certain specialty not on their site, they would be transferred, however there are arrangements for the specialists to visit the patient if transfer is not appropriate or possible. With regard to general surgery, there is a dedicated registrar and consultant rostered to provide 24 hour cover at PRH.

RSH is the is the regional trauma unit covering part of north Wales, however any serious polytrauma typically bypasses RSH and goes direct to Stoke.

DOCTORS MESS & ACCOMMODATION

The accommodation has been relatively recently built and is quite good quality, albeit a bit expensive. It is managed by a third party company called rooftop homes. https://www.rooftopgroup.org/homes/nhs- and-keyworker-homes/royal-shewsbury-hospital/ When on-call, you are entitled to a [free] basic on-call room minutes from the hospital building. This has to be booked with [email protected] The rooms at RSH are within the same complex of recently built buildings managed by rooftop homes. The PRH site is more basic and slightly aged.

Each hospital has a large Mess room with computers & a TV. The RSH mess is next to the canteen. The PRH mess is currently outside the actual hospital, however there are plans to move this into the building.

CATERING FACILITIES & PARKING

Each hospital has a Canteen, WRVS shop & a Coffee shop. Unfortunately after 1800, the only catering facilities are vending machines around the hospital. Parking is monitored via CCTV cameras. One can apply for an electronic permit via the intranet on the first day you need it. The fee will come out of your pay slip and is currently 24 Pounds per month.

TRAVEL & STUDY EXPENSES

First, you need to get yourself set up on Sel expenses www.sel-expenses.com Email [email protected] Ext 1713 (Travel Expenses Department) Works Mon-Wed Relocation expenses—Pat Pedley [email protected] Ext 4069

For study leave, a paper form must be completed & signed by CS, AES, rota coordinator and medical staffing before it is submitted to the medical education department for processing. Once approved & the course has been taken, you can apply for the funds via the SEL expenses . Travel to the weekly RJAH/Stoke teaching can be claimed back without prior approval. Make sure you use the appropriate expense category or it will not get sent to Medical Education department and your claim will be rejected. Use:Deanery Course mileage / Deanery course expenses / Deanery course fees

Royal Shrewsbury Hospital

LIBRARY

The RSH, PRH & RJAH libraries together form Shropshire Health Libraries. Once registered with the library, you can make use of the RJAH library & vice versa. www.shelib.olib.oclc.org

SOFTWARE

• PACS Radiology software • Review system for requesting pathology/micro samples & checking results • Vital Pac electronic observations & VTE assessments • Clinical Portal A portal that ties together the above systems & also incorporates most of the typed communications from the hospital (clinic letters, discharge letters etc) • Escript an archaic system initially designed for ordering medications from pharmacy which has morphed into a discharge letter system

MEDICAL STAFFING

The medical staffing contact is Sarah Rashid who is based in Telford Ext 4984 [email protected]

ROTA

Mr Ford will assign a trainee the duty of Reg & SHO rota management. Typically this is someone who has worked in the department before & know how things should be run. Sometimes the CST2 is selected. Any leave/swap requests have to be signed off by the rota reg before it is passed to Mr Fords secretary who will get him to sign it & then passes it on to medical staffing. Training Reg’s are assigned a minimum of 3 theatre sessions a week (the remaining are divided between the CST2 & trust grades)

Saturday on-calls consist of a morning new patient fracture clinic followed by an afternoon theatre session. Sunday on-calls consist of a full days operating. Mr Hill & Mr Gregson are keen educators and provide an opportunity to see new elective orthopaedics. All fracture clinics are consultant led.

On-call Pattern:

o Consutlants-Monday (0800) to Thursday (2000) or Thursday (2000) to Monday (0800). o Reg-24 on-call’s on 6 week rolling rota. o SHO-13 hour day shifts & 12.5 hour night shifts. Monday to Thursday or Friday to Sunday.

Royal Shrewsbury Hospital

TRAUMA CONFERENCE

Usually attended by 1-3 Orthopaedic consultants as well as Dr Kumar, Ward nurse, Trauma nurse & physiotherapist. Meeting begins with a Medical board round of all the patients on 22TO with the plans documented in patient notes in real time. The Medical Board round is followed by discussing the intricacies of any new/interesting trauma admissions.

TRAUMA AND ORTHOPAEDIC DEPARTMENT

• RSH has a 24 bedded trauma ward (22TO) consisting of 4 bays (5pts per pay) & 4 side rooms. There are often outliers on the Day surgery unit or elsewhere in the hospital. • Staffing: o Ortho Cons: SATH have a contract with RJAH for them to provide consultant cover to run the trauma service at RSH. This is in the form of 9 visiting consutlants: ▪ Mr Ford—DJF—Generalist—Particular interest in Upper limb and peripheral nerve injuries [In charge of trainees] ▪ Mr Pickard—SJP—Upper limb and peripheral nerve injuries ▪ Mr Roushdi—IR—Hand ▪ Mr VanLiefland—MvL—Shoulder [Clinical Governance lead] ▪ Mr Steele—NAS—Arthroplasty ▪ Mr Burston—BJB—Arthroplasty ▪ Lt Col Meyer—CERM—Arthroplasty ▪ Mr Barnett—AJB—Knee ▪ Vacancy There are 2 other RJAH consultants that run a weekly clinic at RSH, these are Mr Gregson— PAG (arthroplasty) & Mr Hill—SOH (Foot & Ankle) o Medical Cons: Dr S Kumar is a ward based associate specialist hired by the T&O department to provide an orthogeriatric support 0800-1700 Monday to Friday. He is supported by Dr ____ who does ward rounds twice a week. o Middle Grades: 6 total (2 ST’s, 3 Trust grades and 1 CST2) o Juniors: 6 total-Pure T&O (2 trust grades, 3 F2’s & 1 CST1) • Each consultant has a half day follow up fracture clinic per week with an alternate week morning trauma list. o Clinic Timetable Monday Tuesday Wednesday Thursday Friday Saturday Sunday AM SJP NAS PAG-Elective CERM New # New # - New # New # New # New # PM MvL, DJF Vacant BJB IR, AJB - - - cons SoH-Elective o Theatre Timetable Monday Tuesday Wednesday Thursday Friday Saturday Sunday AM CERM/DJF Vancant BJB/MvL AJB/IR NAS - OC Cons cons/DJF PM OC Cons OC Cons OC Cons OC Cons OC Cons OC Cons OC Cons

Royal Shrewsbury Hospital

TRAUMA AND ORTHOPAEDIC DEPARTMENT

T&O sub-specialist support:

• RSH can deal with all adult trauma and is the regional trauma unit covering part of north Wales. This means there are occasional trauma calls, however any serious polytrauma typically bypasses RSH and goes direct to Stoke.

• Paediatric trauma typically gets referred to PRH, however they are occasionally sent to RJAH. • Poly trauma or pelvic trauma patients, will get referred on to Stoke

• Patient with isolated spine trauma/CES/Cord compression concerns, they are discussed with RJAH. • All hand trauma is dealt with in-house(or at RJAH) aside from anything requiring replantation. Such cases are sent directly to Birmingham QE.

• Occasionally if patients are well enough, they may get transferred to RJAH for their surgery (eg periprosthetic fractures) if there is specific kit/surgeon expertise required.

PECULARITIES

• Much of the upper limb trauma is often referred to the RJAH hand trauma list as all the RSH upper limb surgeons contribute to that and it helps relieve the workload on the RSH theatres.

• Occasionally O/P MRI & Ultrasound requests are sent to RJAH due to capacity issues within SATH. SATH has recently acquired a 2nd MRI scanner at RSH and have been making moves to prevent too many RJAH referrals.

• When any RJAH patient deteriorates too much for them to handle, they are usually referred to the necessary speciality at RSH who will take over the patients care, but as they are usually recently post-op from an orthopaedic procedure, the RSH T&O team will provide support on behalf of RJAH.

• Officially the RSH Reg rota is a NROC rota. That said the registrar is “1st on-call”. All referrals from the community or within the hospital go to the registrar. The expectation is that all patients should be seen by the T&O reg first (rather than a junior) so as to provide early senior decision making & input.

Royal Shrewsbury Hospital

Royal Shrewsbury Hospital Sitemap

The Princess Royal Hospital , Telford

INTRODUCTION

Telford is a large new town in the borough of Telford and Wrekin and county of Shropshire, about 13 miles (21 km) east of Shrewsbury, and 30 miles (48 km) north west of Birmingham. With an estimated population of 170,300 in 2010 and around 155,000 in Telford itself, Telford is the largest town in Shropshire, and one of the fastest-growing towns in the United Kingdom. It is named after civil engineer Thomas Telford, who engineered many road and rail projects in Shropshire. The town was put together in the 1960s and 1970s as a new town on previously industrial and agricultural land and smaller towns. Like other planned towns of the era, Telford was created from the merger of other, smaller settlements, most notably the towns of Wellington, Oakengates , Madeley and Dawley. Many of the New Town's newer inhabitants were originally from Birmingham or Wolverhampton. Telford Shopping Centre, a modern shopping mall, was constructed at the new town's geographical centre, along with an extensive Town Park. The shopping centre is near the hospital and has an extensive array of shops. The M54 motorway was completed in 1983, improving the town's road links with the West Midlands conurbation.

The main attractions within that region or city In Telford we’ve been treated to a meal at The Vineyard after journal club. It’s a Chinese restaurant and it feeds you well with 4-5 courses! Beyond this there is a large town park and an exotic zoo and outside of it there is the big wide countryside that is Shropshire that includes The Wrekin, a large hill which is visible as you drive towards Telford. It’s a nice walk. The town of Ironbridge is also nearby and as you might guess it has a historical bridge and a few tea rooms and raft tours! If that’s too pacey for you then apparently there is also a clay pipe museum in Telford – enjoy.

The annual turnover (total income) of £359 million in 2017/18: • 52,302 elective and daycase spells • 50,982 non-elective inpatient spells • 7,044 maternity and transfer admissions • 411,714 outpatient attendances • 111,332 accident and emergency attendances

The Princess Royal Hospital , Telford

GENERAL HOSPITAL INFORMATION

• Type of the hospital :Trauma unit DGH + elective + day case surgery • No of beds in the hospital: 327. The main wards for T+O are: • Ward 4: 4 bays of 4-6 patients and x4 siderooms accommodating 5 patients. It is primarily for the trauma patients. However medical patients get placed here crowding out our patients. • Ward 17: 3 bays of 6 patients and x6 siderooms. It is mainly for the elective patients or trauma patients that are MRSA tested and clear and operated on and expecting to be discharged soon. Do not admit a trauma patient to ward 17 or a single MRSA infection could bring down a whole bay of elective patients listed for surgery. There are also 2 ENT bays on this ward which T+O sometimes get placed on. The ENT SHOs are rota-ed to cross cover T+O some nights and weekends. They generally don’t enjoy it and their allegiance is understandably always to ENT. You can usually find them on ward 17 if they aren’t on ward 4. They often hand over first to ENT before T+O. • Ward 19: is the paediatric ward. You will need a pass for this. Get one! Many of the consultants don’t have a pass. Request it from estates. Bring ID of who you are and what you do. It has 4 bays (4-6 beds each) and numerous siderooms. If you go left into the ward there is a large electronic board with the patients listed. Underneath it are drawers with consent forms and VTE forms – paeds are keen on VTE forms being filled out. • DCU + TSAL: This is the day case unit and elective admissions area. Day case sometimes is used for overspill to find beds. Both are on the ground floor opposite fracture clinic and near A+E and you need to know where they are as you will be expected to go here in the mornings from 07:30am to mark and consent elective patients

Other specialities on site / support offsite (plastics , Neuro etc) Referrals for services

• Telford has Paeds and Obs + Gynae and ENT and Max Fax. • RSH has Renal, Gen Surg, Vascular, Urology, Haematology, Oncology and Opthalmology as well as T+O. • Neuro: you need to refer to Stoke. • Spines is also Oswestry or Stoke. Oswestry will respond more quickly. • Plastics: you have the choice of Stoke or Birmingham QE – the QE generally responds quicker also. • Major trauma won’t generally come to PRH but if it becomes obvious that your patient is more suited for a MTC then Stoke is your referral centre.

The Princess Royal Hospital , Telford

DOCTORS MESS & ACCOMMODATION

Residential accommodation is provided at both Shrewsbury and Telford Hospital by a local Housing Group Rooftops. Accommodation has no agency fees, 24-hour repair service (apparently but the one time I tried to contact this person I only got an answer phone and no response to my messages – ever) There is an on-site management team, they are friendly but not always available. They respond quite quickly to emails. Rachel Jones is a good contact and is an accommodation officer. 01386 420 800, ext 1207, [email protected]. The rooms vary in their price. The usual rooms are about £450/month but you have to share a bathroom with up to 2 others. Alternatively the top floor room is about £610 and you get an en suite. Space in the fridge and freezer is limited, but there are lockable cupboards for food in the kitchen. The doors slam, no one takes responsibility for emptying the recycling and the turnover of residents can be quite high and you can meet strangers moving in frequently. Car parking comes with the accommodation so naturally you don’t need to pay for parking at the hospital. Its like being in student accommodation but there is only a month’s notice, its on site and no deposit required so it has its benefits. On-call accommodation?: There are a number of on call houses with about 5 rooms per house, with a shared kitchen (fridge, microwave, hob and table) and ‘livingroom’ (think old people’s home without the glamour or TV!). The toilets and showers are shared and the rooms have a sink and a bed and wardrope and desk. They are about 1 minute’s walk out of the main entrance, and also have a car park. Booking rooms has changed recently with you having to request a room from: [email protected] . You need to tell them who you are and if you are PRH or RSH and when you want the room. They will email you back with confirmation. You then collect the keys from switchboard (just inside the main entrance and on the right). You need to sign the keys in and out. Top tip: bring your own towel and toiletries. Doctors Mess : They are in a single storey building to the right of the on call flats and HR offices 1 minutes walk out of the main entrance. Being disconnected they aren’t used much and Wi-Fi doesn’t reach out to it. There are sofas and a TV. Not much else to speak of. There are some offices that share the building and it has a key code entrance. You won’t use it much, if at all – mostly due to its location.

CATERING FACILITIES

Café Bistro does the best sandwiches and coffee and it is near the fracture clinic. Get a card to collect stamps for each coffee to eventually you get a free one. Open Mon to Fri 8am – 6.30pm (this is a lie! – closes by 16:30!) Sat – Sun 10am – 5pm (lie). Friendly staff but variable coffee making skills. Staff discount. Apley Restaurant: is a restaurant on the 1st floor, past ward 17 and turn left. Food is variable but hot. Mon-Fri 08:30am-19:30pm, Sat 10am-16:00, Closed Sundays. Not sure I really believe the closing times. Can close when it likes. League of Friends (Ground Floor – near the front entrance). Open Mon to Fri 8.30 am to 6pm Sat & Sun 10.30am to 4.30pm. Keen old ladies that sell big ready made sandwiches and will sell you a poor cappuccino and a whoopee cushion with a smile.

There is also a fresh fruit and veg stall once a week. You won’t get a bargain but you will get some nice produce. It is usually in the main foyer at the front. There are vending machines on the main corridor and in A&E, but they are frequently broken.

The Princess Royal Hospital , Telford

PARKING SERVICES

Parking is monitored via CCTV cameras and THEY will find you! You can apply for an electronic permit via the intranet on the first day you need it. The fee will come out of your pay slip and is currently £24/month. They are quick to respond by email and if you end up borrowing a car (normal car in garage) they are quick to respond to you highlighting a temporary car change. Email: Joanne Cronshey (Office manager – facilities), 01743 261 275 ext 1275, [email protected]

TRAVEL & STUDY EXPENSES

Travel expenses contact: (Relocating to the region or claiming travel from base to current hospital). First, you need to get yourself set up on Sel expenses www.sel-expenses.com Email [email protected] Ext 1713 (Travel Expenses Department) Works Mon-Wed Relocation expenses—Pat Pedley [email protected] Ext 4069 Study leave application process: For study leave, a paper form must be completed & signed by CS, AES, rota coordinator and medical staffing before it is submitted to the medical education department for processing. Once approved & the course has been taken, you can apply for the funds via the SEL expenses Travel to the weekly RJAH/Stoke teaching can be claimed back without prior approval via the SEL expenses www.sel-expenses.com Make sure you use the appropriate expense category or it will not get sent to Medical Education department and your claim will be rejected. Use:Deanery Course mileage / Deanery course expenses / Deanery course fees.

LIBRARY The RSH, PRH & RJAH libraries together form Shropshire Health Libraries. Once registered with the library, you can make use of the RJAH library & vice versa. wv-shelib.olib.oclc.org

MEDICAL STAFFING

Sarah Rashid who is based in Telford Ext 4984 [email protected]

SOFTWARE

The Princess Royal Hospital , Telford

SOFTWARE

The patient lists and the theatre lists are linked together by the Trauma Database, which was developed in 2000 by Mr Cool and run successfully at RSH. The PRH one was brought across and developed extensively by Will Gibson. Patients are added on the database, which is based in Access. You don’t need to press save. Once entered it automatically saves the data but it does have the habit of closing itself down after some time, but the data is still captured. Patients are put on the theatre list by double clicking on the patient number. The information can then be seen by opening this window in the database. Patients are taken off by double clicking on the patient number in the theatre list and writing DONE and clicking the large black arrow. Printing lists has been made easy for weekends and weekdays and you only need to click print and then follow instructions regarding what you want.

ROTA

Mr Choksey does the rota coordination for the registrars but it must be agreed by Hazel Hughes or Debbie Wareing unless Paul Jacobson is present. Paul has had time off with long term health issues. He’s very helpful at coordinating lists and annual leave but can be off sick for periods at a time. SHO rota coordination is usually organised by one of the registrar trainees!

Juniors(F1-CT2) work pattern (eg on-call rota shared with ENT) , are they team based. The F1s stick to their ward and swap at the halfway mark to the other ward. The ward 17 F1 also needs to go to Day case/TSAL downstairs first thing every morning to do the bloods + VTE in readiness for the elective surgeries. NOTE: If this F1 is off then they must nominate an agreed replacement to do this blood taking and online VTE. They are therefore usually a bit late to the trauma meeting.

Reg Rota pattern: typically on call once a week, except ahead of a weekend on call. On call is 24hours with the next day off, except for weekends which are 48hours on call and then 3 days off afterwards.

TRAUMA AND ORTHOPAEDIC DEPARTMENT

No of Juniors: there should ideally be 2 CTs and 2 F1s and 3 F2 equivalents. Middle grades: 2 trainees and 5 staff grades. Mr Choksey and Mr Saha have been there some time and are quite senior with Mr Saha running his own post-op follow up hip clinic. Mr Aftab has been there some time and only does on calls when necessary but is the clinic king.

Average no of trauma cases per year (you should easily get your 300 cases a year. Numbers of NOFs can vary widely but generally there will be about 3-4 a week. As the trainee you will be given the trauma list preferentially, and when on call you will be in the afternoon trauma list.

No of elective cases per year mainly hips and knees: hips and knees numbers on the elective list isn’t quite so abundant. If you are spread out over the different consultants it can be some time until you get to actually do a THR or TKR as primary surgeon. Your best chance is with Mr Perkins if you can make sure the nurse specialist assists you both. Mr Jain is keen to teach as well. Mr Roach will let you also do some arthroscopy. As with the upper limb job its best to ask for preferential time with 1-2 consultants. Time spent with one surgeon should help you get hands on sooner. Elective work is typically in Theatre 1 or 5.

The Princess Royal Hospital , Telford

TRAUMA AND ORTHOPAEDIC DEPARTMENT

Hand over happens between registrars at the morning trauma meetings. SHOs hand over at the trauma meeting and at 20:30hours, its usual best to supervise this. Trauma meetings happen in a designated room that is just down the corridor from the secretarys’ office. This can be found at the end of the corridor opposite ward 4. Entry code 2489. Straight ahead and before the turn right is the secretary’s door ahead of you and to the left is the trauma meeting room. The night SHO should collect the laptop (from the secretarys’ office) before the meeting and set it up in readiness with printed lists before the meeting. Ward rounds: the on call team goes around with the consultant plus the juniors for that ward. The outliers SHO should also accompany you to the outlying wards (DSU + paeds or any medical wards). The SHO in charge of the outliers is the Ward 17 SHO. The consultants like the ipad on and ready for accessing results or the computer on wheels to follow them around. Ward notes should also be open so entries form other specialities referred can be read, as well as plans written in. This appears to be very difficult to achieve with every set of juniors so far.

Consultant on-call pattern

JRE Jonathon Reading (Foot and ankle) – Secretary Emma SJR Jae Rhee (Shoulder + hand) – Secretary Gemma MC Mike Carmont (Foot and ankle) – Secretary Emma RMD Ron Dodenhoff (Shoulder + hand + clinical director) - RTR Richard Roach (Knees) RGT Rob Turner (elbows + hand and shoulders) WWW Wolfie Wagner (Hips) APM Piers Moreau (Hands) RDP Ralph Perkins (Hips – semi retired. Does not do on calls, only elective) MRJ Rahul Jain (Hips + knees – locum consultant, occasionally does an on call) Mr Bruce Summers (Special mention for Mr Summers who is semi-retired and doesn’t do on call but is a great resource at PRH for reviewing spinal cases as an in patient or out patient).

OPD info / fracture clinic info: Fracture clinic is near A&E opposite the day case unit. It starts at 09:00 but generally it doesn’t really get going until 09:30am and if you need to organise other stuff this is a good time to do it. You have a Dictaphone to capture your clinic notes and this is docked in clinic or with the secretaries so notes can be typed up from clinic or theatre. These are the only 2 places to dock the Dictaphone. (Reg lower limb code: 5471)

Xray cards are given to the patients in clinic and they wander off to get them done and notify the nurses when don’t You should paperclip your REG 1 or 2 to the notes and put to one side.

The Princess Royal Hospital , Telford

TRAUMA AND ORTHOPAEDIC DEPARTMENT

MRIs are signed by the consultant and you bring them round to radiology after clinic. They typically take 3-4 weeks as an outpatient and you need to push the priority button on the Dictaphone to mark these cases and say that the patient is to return once the MRI has been reported.

Physio forms are completed by you and given to the patient to give to the front desk. Plaster room requests are given to the patient and they hand them into the plaster room. I find it usually best to also tell the plater room technicians in person as well. They are very good and very friendly and it goes a long way to making it all work better.

Consultant contact for trainees (main educational supervisors – Mr Jae Rhee). Lower limb CS: Mr Wagner. Upper limb CS: Mr Dodenhoff or Mr Turner.

Trauma referral / cases referral process or any other specific issues. Referrals usually come through the SHO on call. But A&E and external sources don’t always know this. If you are in theatre you should give your bleep to the theatre secretary or if they are not there to the recovery desk.

Departmental teaching: frequently there are questions for the trainees at the morning trauma meeting (some consultants more than others). Mr Choksey does a 30minute Friday morning teaching 07:30-08:00. He has some very interesting cases and good questions. Mr Rhee organises a regular journal club which can sometimes run monthly and you will be expected to present on a topic.

HOSPITAL PECULIARITIES

2017/2018 was a rough year for PRH. T+O had a wrong side event and it was identified as an outlier on the 30 day mortality of NOFs. So be aware they are very particular about which side the operation is and an extensive review of the patients who died within 30 days of NOF surgery has been conducted. At the end of 2018 there was further controversy over maternity with allegations of dozens of avoidable deaths and injuries in its maternity unit. PRH went into special measures and it threatened to close it’s A&E between 8pm and 8am. This never happened and the CQC took urgent enforcement action when an inspection highlighted safety fears with A&E.

The Princess Royal Hospital , Telford

Bangor Hospital

INTRODUCTION

Bangor is a small coastal city situated in North West Wales. It has a population of approximately 14,000 which comprises mainly of students (11,000) enrolled at Bangor University. It is probably the furthest placement offered by the Oswestry rotation. However, there is a direct train from Bangor to London taking approximately 3 hours, meaning there’s always an opportunity to get back to civilisation. Traditionally, trainees will be placed in Bangor for 12 months before rotating to Wrexham and then on to Oswestry/Stoke. North Wales has a wealth of culture and scenery to explore. Notably, Snowdonia is right on your doorstep. There are a number of attractions to explore including Zip World, Bethesda which is home to the world’s fasted zip line (up to 100mph). There is even a Michelin Star restaurant (Sosban) on the Island of Anglesey but places are booked up months in advance. In addition, if you fancy a trip to Ireland, it is only a ferry away from Holyhead port (approximately 30 min drive).

GENERAL HOSPITAL INFORMATION

Ysbyty Gwynedd (Bangor Hospital) forms part of the Betsi Cadwaladr University Health Board which serves the North of Wales. It is a DGH/Trauma Unit covering both Trauma & Elective services with a total of 432 beds. The hospital receives both adult and paediatric cases. It serves a large, predominantly rural catchment area. You should note that this area has a high proportion of Welsh-speaking community. Although most will also speak English, you may find patients who are only Welsh-speaking!

North West Wales is a popular tourist destination, meaning there is a big surge in out-of-area visitors during the holiday periods. There is a variety of trauma that comes through the door including car and motorcycle trauma due to accidents on smaller A-road and nearby racing circuit (Trac Môn) on Anglesey. There are also trauma admissions due to the popularity of the area for hill walking and rock climbing. You will also find a higher proportion of agricultural and equestrian injuries from nearby rural areas.

Polytrauma patients with generally go directly to Stoke. Most open fractures will also be referred to Stoke as well as spinal trauma. Other spinal cases (i.e. cauda equina) are referred to The Walton Centre (Liverpool). There is a small Vascular department which is cross-covered with Wrexham hospital during on-calls. There is also no major plastics cover on-site and referrals are made to Whiston Hospital (Preston).

DOCTORS MESS & ACCOMMODATION

Hospital accommodation is available through the Accommodation Manager, Derek Blythin ([email protected]). He can sometimes be tricky to get a hold of as he currently covers 3 sites including: Glan Clywdd, Bangor and Wrexham. There is a mix of accommodation available on-site. The student accommodation is more modern and reasonable to stay in, however, the remaining accommodation is very much outdated so I would probably suggest finding a private rental for the year if you can. On-call commitments for Registrars are 24 hours, however, this is off-site out of hours. There is no specific provision for on-call accommodation.

Bangor Hospital

DOCTORS MESS & ACCOMMODATION

There is a Mess available free of charge within the post-graduate centre. There are modest provisions with seating and TV available.

PARKING SERVICES

There is adequate parking available on-site which is completely free of charge (and is the case for all Welsh hospitals). There is no problem to find parking around 08:00am.

TRAVEL & STUDY EXPENSES

There is a good system for travel expenses through E-expenses. You will need to be registered on this system and ensure that appropriate documents are uploaded (driving licence, car insurance etc.) before claiming. You need to ensure that your insurance policy covers Business travel. This allows availability to claim cost of travel to Llandudno hospital.

LIBRARY

There is a small library available with a reasonable selection of Orthopaedic books. Additional titles can be requested from the region which is linked to NHS Wales library & Cardiff University.

TRAUMA AND ORTHOPAEDIC DEPARTMENT

The Trauma & Orthopaedic department is composed of 11 Consultants + 10 Registrars (3 trainees with 1 from Oswestry and 2 from Wales Deanery). Consultant sub-specialities are as follows: • Hip & Knee – Mr Chawda, Mr Ganapathi, Mr Azurza, Mr Griffin, Mr Azam, Mr Goel • Shoulder – Mr Pydah, Miss Kurta • Hand – Mr Kanvinde, Mr Jesudason • Foot & Ankle – Mr Mumtaz (Clinical Director)

Orthopaedics have 2 wards: Ogwen ward for Trauma patients + Enli ward for Elective patients. Trauma meetings are carried out daily at 08:00am. There is a full day trauma list daily (09:00-17:00). A typical trauma list would include 4-5 patients with approximately 1 NOF per day. You will be rotored for 1 day a week trauma list where you are ‘buddied up’ with the current Consultant and registrar on-call that week. In terms of elective work, this is carried out at the main site. There are approximately 300 primary hip and 280 primary knee cases carried out per year across all consultants. There is a smaller peripheral hospital in Llandudno which mainly caters for small day case procedures.

Bangor Hospital

TRAUMA AND ORTHOPAEDIC DEPARTMENT

There is a large amount of departmental teaching happening. There is a monthly afternoon teaching session to include all SHOs and Registrars. There is a rolling rota with 2 Registrars organising the session each month and 1-2 Consultants chairing the session. There are also additional teaching sessions on Thursday evenings. These include sponsored kit demonstrations and complimentary meal! Occasionally these will be focussed more on FRCS examinations chaired by Mr Glynn Andrew (retired Consultant examiner).

ROTA AND WORKING PATTERN

There is a weekly rota sent towards the end of the previous week. You will generally be rotored for 1 elective clinic + 1 fracture clinic session per week with your Consultant. The remaining sessions will be used to cover any other elective theatre sessions/clinics and fracture clinics. There is normally a free half day session every week and research/audit session. Friday afternoon teaching in Oswestry is protected even if you are on-call, another registrar will cover the afternoon until you return. On-call commitments are very reasonable (approximately 1 in 10 for weekday and weekends).

SHOs will generally be attached to one Consultant, however, this is not always possible due to leave, nights etc. There is a possibility of the juniors’ work pattern changing in the near future to also cross-cover General Surgery, however, this is not currently the case.

Consultants have a weekly on-call rota, Monday – Thursday (08:00 – 18:00). A different Consultant will cover each evening on-call 18:00 – 08:00 the next day. When your Consultant is on-call during the week, you will be rotored for a week of Trauma theatre. You will have a different Consultant covering the ‘Enhanced Trauma’ session each morning whilst the on-call Consultant will do a ward round. The on-call Consultant will then join you for the remaining trauma list in the afternoon. There will be a full post-take ward round on Friday morning.

A different Consultant will cover the on-call Friday – Sunday with post-take ward round on Monday morning. 1st on-call registrar during the weekend will cover trauma theatre 08:00 – 17:00. After 17:00, you will cover the acute admissions on-call. There is a 2nd on-call registrar (available to sign up on a locum basis), to cover the ward round and acute admissions until 17:00.

Ria Lala is the Surgical rota co-ordinator ([email protected]) and Mr Pydah is the rota master for Registrars. The main educational supervisors are: Mr Mumtaz, Mr Jesudason, Mr Chawda, Mr Ganapathi & Mr Pydah. Most training issues can be discussed with Mr Mumtaz and/or Mr Jesudason as a first port of call. The departmental Audit lead is Mr Kanvinde.

SOFTWARE Clinical systems include Synapse for imaging and Welsh Clinical Portal for clinical results.

Bangor Hospital

Overall, you will find Bangor is a nice environment to work in with good opportunities for training and supportive Consultants.

Bangor Hospital Sitemap

Hereford County Hospital

INTRODUCTION

Hereford is a cathedral city, civil parish and county town of Herefordshire, England. It lies on the River Wye, approximately 16 miles east of the border with Wales, 24 miles southwest of Worcester, and 23 miles northwest of Gloucester. With a population of 58,896 it is the largest settlement in the county. It takes about 2 hours to drive from Hereford County Hospital to Oswestry and just over 2 hours to Stoke on Trent. It is known chiefly as a trading centre for a wider agricultural and rural area. Products from Hereford include: cider, beer, leather goods, nickel alloys, poultry, chemicals, and cattle, including the famous Hereford breed. The area offers a variety of lifestyles blending the traditional with the modern. Various outdoor activities can be experienced in the area such as cycling, hill walking, canoeing, clay pigeon shooting, and more. There are also theatres, galleries, and farm festivals.

GENERAL HOSPITAL INFORMATION

• Hereford County Hospital is a District general Hospital DGH. The hospital is part of Wye Valley NHS Trust which was established on 1 April 2011.

• The Trust provides community care and hospital care to a population of just over 189,000 people in Herefordshire and a population of more than 40,000 people in mid-Powys, Wales. The Trust’s catchment area is characterised by its rural nature and remoteness, with more than 53% of its population living more than 5 miles from Hereford city or a market town. The trust is the only secondary care provider for an area where the average age of the population is older than the national average.

• Hospital Capacity is 245 beds with A&E annual attendance of more than 55,000. The elective episodes in the hospital are around 26,000 per year. The annual turnover of the hospital is around £180 million.

• Elective Spine Service: Proxy clinic (Mr Ockendon/Mr Ahmed) from Oswestry every 1st and 4th Monday. • Emergency spine service: QEII Birmingham - NORSE referral pathway: https://nww.norse.uhb.nhs.uk/login.aspx - generic login can be obtained on your arrival.

• Plastic surgery: Either QEII Birmingham via NORSE or Bristol by calling the on-call plastic team. QEII plastic team runs a clinic in Hereford every Tuesday. Inpatient and ward referrals (via MAXIMS-software portal- or secretaries) would be reviewed on this day.

• Vascular surgery emergencies are referred to Worcester, inpatient referrals can be made via MAXIMS or Vascular secretaries.

• Medical Recruitment: The HR building is situation in Franklin Barnes Building which is about 5 minute walk from the Hospital’s main building. Tel: 01432383471/383487 Email: [email protected]

Hereford County Hospital

DOCTORS MESS & ACCOMMODATION

• Hospital Accommodation: Standard accommodation in a shared flat costs £360 per calender month. For details contact 01432384408/4404

• T&O on call room is #7 situated near the doctors’ mess on the second floor. Keys available from switchboard.

• Doctors Mess: On the second floor, there is a Doctors Mess and the on call rooms. (Door code to that section is C6230). Standard facilities include tea, coffee, bread, etc. Pizza for everyone is available every Monday Lunchtime.

PARKING SERVICES

Application forms would be included in the recruitment package email before the start of the placement. Onsite parking costs around £22 a month. As usual, coming early will guaranty a parking space, but late arrival means an offsite multi-storey park about 15 minute walk from the hospital (Garrick House park- NHS staff level 5 and above). There’s a £25 deposit for the park barrier card, this is refundable upon return of card at the end of the employment.

TRAVEL & STUDY EXPENSES

Application forms from Helen Pryce at the Education centre. [email protected] / Tel: 01432364025 If you want to claim mileage on your car, the insurance policy must include business coverage. The application form is different from the claim form, this will be explained to you when you apply.

LIBRARY

Situated in the education centre and provide a varitety of NHS database services. Out of hours access card can be obtained from library desk with a deposit of £10 refundable upon return of card.

CATERING

At the main entrance, there is Costcutter shop ( weekdays 7:00 – 20:00, weekends 8:00-17:30). Next to the shop there is Costa Café (Open all days 7:30-19:30). The café offers 10% staff discount at certain times of the day upon showing ID badge. Hospital’s restaurant is situated on the first floor and opens only weekdays from 9:00 to 14:30.

Hereford County Hospital

T&O DEPARTMENT

• The Trauma and orthopaedic department consist of 10 Consultants with their allocated middle grade. Usually there are 2 Specialty Trainees from Oswestry/Stoke Rotation and 1 from Birmingham Rotation. The Unit also has ward based junior doctors; 2 Foundation year 2 doctors and 3-5 Trust SHOs (depending on workforce availability). There is no core surgical or GP trainees in the department. There are also orthopaedic physiotherapist practitioners (upper limb/spinal).

• Mr Peter Shewell is normally the Educational Supervisor, and you can agree a Clinical Supervisor based on your training requirements. For more information you can contact [email protected]

• Most working commitments are based at The County Hospital, but certain Consultants have clinics at more remote sites (Ross, Llandrindod Wells, etc), and you will be expected to attend your boss’ clinic.

• Inpatient service is made of 2 wards: Redbrook Ward: Mainly Acute Trauma admissions, Situated on the first floor (At the end of the corridor, towards the Pharmacy and service lifts) Teme ward: Mainly Elective Orthopaedic admissions, Situated on the first floor (At the other end of the corridor near the patient’s lifts)

• Outpatient department: Oxford suite on the ground floor, near the main entrance.

• The rota administration and management is run by medical staffing. The draft rota produced on a 10 weekly bases but updated regularly, a confirmed version sent every Thursday for the week after. Medical staffing can be contacted at [email protected].

• Consultants do 7 day Trauma take/ on call- Friday to Friday, and you will follow your consultant in this week from Monday to Friday. This includes a daily morning Trauma round then Trauma theatre in the afternoon.

• On-call runs for 24 hours starting at 08:00 am, which means that you do your regular AM and PM clinical sessions then continue the oncall afterwards (non-resident after 9pm)

• Trauma meeting starts at 8 am, the meeting room situated on the first floor next to the restaurant (part of the staff Bank offices)

• There is an afternoon Trauma list every day (Theatre 3). The operating surgeon will be the Trauma take consultant and their registrar.

Hereford County Hospital

T&O DEPARTMENT

• Friday PM is a protected session for Oswestry trainees; don’t expect any clinical duties and you are not expected to do Friday on calls, if any, it will be from 8 am to 12 pm as you will be driving to Oswestry or Stoke for teaching in the afternoon. • If you do the 24 hr oncall, you are expected to present all patients at trauma meeting and attend the post take ward round. • The Electronic handover software for trauma is Bluespier – logins can be obtained from Teresa, Mr Oakley’s secretary ([email protected]) • There is a very friendly environment to work at and all consultants are supportive and approachable. You will receive good training in both elective and trauma service.

CONSULTANTS

• Mr Iain Bissell (foot &ankle) • Mr Darren Clark (Lower limb arthroplasty) • Mr Laith Majeed (lower limb arthroplasty, spine) • Mr Matthew Oakley (lower limb arthroplasty, knees) • Mr Peter Shewell (lower limb arthroplasty, hips) • Mr Frank Sibly (upper limb) • Mr David Powers (upper limb/hand and wrist)- Clinical Director • Mr Chandra Rao (lower limb including some foot and ankle) • Mr Chris Paliobeis (lower limb arthroplasty, hip scopes) • Tomasz Kowalski (upper limb/ shoulders)

Hereford County Hospital

Russells Hall Hospital – Dudley

INTRODUCTION

Dudley is a large town in the county of West Midlands, England, 6 miles (9.7 km) south-east of Wolverhampton and 10.5 miles (16.9 km) north-west of Birmingham. The town is the administrative centre of the Metropolitan Borough of Dudley and in 2011 had a population of 79,379. The Metropolitan Borough, which includes the towns of Stourbridge and Halesowen, had a population of 312,900. Dudley is sometimes called the capital of the Black Country.

Originally a market town, Dudley was one of the birthplaces of the Industrial Revolution and grew into an industrial centre in the 19th century with its iron, coal, and limestone industries before their decline and the relocation of its commercial centre to the nearby Merry Hill Shopping Centre in the 1980s. Tourist attractions include Dudley Zoo and Castle, the 12th century priory ruins, and the Black Country Living Museum.

Russells Hall Hospital is an NHS general hospital located in Dudley, West Midlands, England, managed by the Dudley Group NHS Foundation Trust. The hospital is situated south-west of the town centre on the A4101 road, which connects to the Kingswinford area of the borough.

Russells Hall Hospital is part of The Dudley Group NHS Foundation Trust. It is a medium sized hospital providing services to the population of Dudley, Stourbridge and the surrounding towns and villages. Located in the heart of the Black Country area, it covers a population of around 450,000 people in mainly urban areas. The Trust consists of Russells Hall Hospital with two smaller outpatient centres, Corbett and Dudley Guest, which are run as one main unit. The hospital has around 687 beds. It sees around 105,000 inpatients; 500,000 outpatients and almost 100,000 attendances at A&E each year. The area of Dudley is moderately deprived (83rd out of 326 local authorities, where 1 is the most deprived). Life expectancy is worse than that expected within the England average. The Trust gained foundation Trust status in October 2008, and was the first Trust to do so in the area.

THEATRES & WARDS

There are two wards as part of the trauma and orthopaedic (t&o) department B1 and B2. B1 is usually ring fenced elective orthopaedic ward. B2 is the trauma ward consists of 4 stations with two hip suits at the bottom (Station 3&4) where you find most of the NOF cases. There is one station at B3 also belonging to the trauma ward called B2 station 5. There are 3 T&O theatres at Russell Hall Hospital (8, 9 and 10) and one day case theatre at Corbett Hospital. No trauma or joint replacement procedures performed at Corbett Hospital.

Theatre 8 in RHH is a trauma theatre while the other two are elective. During out of hours we share the CPOD theatre which is theatre 4 with other specialties. You have to book any out of hour’s cases online and discuss with anesthetist in advance. You have to have good negotiation skills with the theatre 4 lead coordinator.

Russells Hall Hospital – Dudley

TRAUMA AND ORTHOPAEDIC DEPARTMENT

No of juniors: there should ideally be 2 CTs and rest are either FY1 or 2 equivalents. Middle grades: 2 trainees, 1 associated specialist, 1 arthroplasty fellow and 7 staff grades. Mr. Sajid who is a long serving AS is not part of the rota but he conducts clinics and has his own theatre list. One of the staff grades is a clinical teaching fellow and does not participate in the rota.

Average no of trauma cases per year: You will be assigned certain days or sessions for trauma, however you can always use your spare time to join Senior Registrars in trauma theatres. They are very nice and always happy to supervise you and give you as much trauma as you want. Ideally you will finish most of your trauma numbers in your 1 year placement. You will easily get 350 cases a year in Dudley so enjoy it.

CATERING FACILITIES & PARKING

RHH has a canteen which serves discounted food to staff daily. The canteen is situated near the main entrance of the hospital. They serve specific dishes each day of the week for example curry day is on Thursday and fish and chips on Friday. The food generally is not bad but it is still expensive so best to get your own food if you want to save some pennies. There is a starbucks coffee shop near the canteen too. There is a lovely fresh fruit and vegetable stand outside the hospital, open from 8am to 5pm. I used to get fresh raspberries and strawberries from them, they are worth it. There is a WHSmith shop at the hospital main entrance.

PARKING SERVICES

There is adequate parking available on-site. The main staff parking services is located at the back of the hospital in the multistorey car park. You need apply for a parking permit which is free when you start your placement. There are other parking spaces at the back of the hospital which is free for staff. However if you park at the front you will need to take a ticket and pay for it on exit.

TRAVEL & STUDY EXPENSES

There is an effective travel expenses system expenses through E-expenses. You will need to be registered on this system and ensure that appropriate documents are uploaded (driving license, car insurance etc.) before claiming. You need to ensure that your insurance policy covers business travel. This allows availability to claim the cost of travel to Llandudno hospital.

LIBRARY

There is a library available with a reasonable selection of Orthopaedic books. It has good connection with Birmingham libraries and they can obtain any book on loan from the sister’s libraries for you. You will need to apply for a BASE pass which will give you access to these advantages.

Russells Hall Hospital – Dudley

SOFTWARE

• PACS Radiology software • SORAIN System for requesting pathology/micro samples & checking results • SUNRISE electronic observations & VTE assessments • JAC an archaic system initially designed for ordering medications from pharmacy which has morphed into a discharge letter system

Handover: This happens between registrars/ SHOs at the morning trauma meetings. Evening handover between Registrars / SHOs takes place at the theatre orthopaedic room opposite Theatre 9 at 20:00.

Trauma meetings: These happen in a designated room ( The POD) that is just down the corridor from B2 and B1 section on the east side of the hospital on the 1st floor.

Ward rounds: Usually as a Registrar you are expected to do the ward round on your boss’s patients very frequently. But there are no specific ward round for an Registrar. During pressure times the rota changes sand the management free one Registrar of any clinical duties to do the wards round including outliers with the consultant on call. The outliers SHO should also accompany you to the outlying wards (DSU + paeds or any medical wards).

OPD info / fracture clinic info: Fracture clinic is on the ground floor near A&E and it starts at 09:00 am. The staff are very nice and in charge Nurse is Katrina who is very approachable. You have a Dictaphone to capture your clinic notes and this is docked in clinic or with the secretaries so notes can be typed up from clinic or theatre.

Trauma referral / cases referral process or any other specific issues:

Referrals usually come through the SHO on call. But A&E and external sources can approach you directly on your bleep. Poly trauma usually goes to Birmingham (QE) . Any hand injuries with skin loss can be referred to plastics in QE. Any spinal?? QES need to be assessed at RHH and referred to QE spinal team for advice through the NORSE system.

Departmental teaching/ Meetings and Audits: In the trauma meeting you can be asked some questions but in a very friendly matter. Not all the consultants do ask though. Frequently there are questions for the trainees at the morning trauma meeting (some consultants more than others). Mr. Jain coordinates the journal club on a monthly basis. There is a monthly audit meeting in the educational centre in the west block. Audits need to be approved first by Mr. Claire. Audits need to be applied for using a specific excel sheet form and to be approved by Mr. Claire first before sending it to audit department.

Russells Hall Hospital – Dudley

CONSULTANTS

Mr. Ed Bache Paediatrics Mr. Sohail Butt Upper limb Mr. Tom Clare Lower limb arthroplasty Mr. Ed Davis Lower limb arthroplasty Mr. Qutub Qadri Lower limb arthroplasty / Foot and Ankle Mr. Sohail Quraishi Lower limb arthroplasty ( Usual Trainer but has a fellow now) Mr. Maneesh Sinha Upper Limb ( Great Trainer but does not take trainee usually) Mr. Syed Subzposh Lower limb arthroplasty Mr. Matt Waites Lower limb arthroplasty Mr K Jain Foot and ankle Mr. R Bansel Upper limb Mr. A Ahmed Spinal (mainly micro discectomy / injections)

ROTA

• Mr. Muneer who is coordinating the rota. Raj is the rota and registrars coordinating member of staff. You can fill your study and annual leave and leave it with Raj. However you need to obtain approval from Mr. Muneer. The official time scale for any leave to be requested is 6 weeks but the department is cooperative and can help if there are not many registrars on leave. • Rota coordinators emails : Mr. Azher Muneer [email protected] / Miss Raj Sonsana [email protected]

• The rota is 1: 10 and it is nonresident on calls. The on call is 24 hours shift. You are expected to leave at night around 9pm to 10 if the SHOs do not need you. If the SHOs are junior or not experienced CT ortho trainee then you may be called at night. Generally the night on call is not that bad. For weekend on calls it is also 0ne in 10 and it starts from Saturday and end s Monday morning.

• Note: As registrars do not take off days after on calls, they have 4 days every 10 weeks added on top of your annual leave to use. Use it wisely and you can only take it in Block of 4. Do not accept 3 days as we calculated it and it is 4 days.

• Juniors (F1-CT2) work pattern (e.g. on-call rota we may have ENT SHOS doing T&O), the juniors are not team based and the rota published weekly. • There is a handover excel sheet at the shared M drive and need to request an access by IT. All admissions need to be registered and presented.

• Most working commitments are based at RHH, but certain Consultants have clinics at Corbett Hospital, and you will be expected to attend your boss’s’ clinic.

Russells Hall Hospital – Dudley

HOSPITAL ACCOMODATION & DOCTORS MESS

Doctor’s mess is located at the ground floor near the main entrance on the right side behind the WHSmith shop. You can access with your card but you will need to make a monthly contribution to use its facilities (which is not much). There is no on call accommodation because registrars are non residents. The hospital has selection of onsite accommodation and to find out more you need to email accommodation officer.

This rotation is a great one and I truly recommend it especially you end up finishing most of your trauma numbers.

Enjoy the placement

Russells Hall Hospital sitemap

OSCAR

OSWESTRY STOKE COLLABORATIVE FOR AUDIT & RESEARCH

This section will give you an over view of The group , committee , membership and how to get involved.

OSCAR OSWESTRY STOKE COLLABORATIVE FOR AUDIT & RESEARCH

WHAT IS OSCAR?

A trainee-led group that can deliver bigger, better, and more meaningful audit and research projects than any of us could achieve on our own. Who can get involved? Everyone who wants to be involved can be: trainees, middle grades, coretrainees, medical students, even consultants; but it will always be trainee-led. Anyone who contributes any patient data to audit or research projects will be granted co-authorship.

WHY SHOULD YOU GET INVOLVED ?

The latest JCST T&O checklist for CCT mandates that we all need to meet the following criteria research criteria:

Trainees must also complete two of the following: • Higher degree completed at any time (MSc, MPhil, MD, PhD). • Authorship** in any position (including corporate or collaborative) of two PubMed cited papers relevant to the specialty, not including case reports. • A minimum of two presentations at national or international meetings. • Evidence of recruiting ≥5 patients into a research ethics committee approved study or ≥10 patients into a multi-centre observational study.

Advanced research evidence (These may be used as alternatives to the requirements in the list immediately above):

• Membership of a trainee research collaborative demonstrated by either a committee role of ≥24 months or running a collaborative project on a steering group or as a local lead. • Membership of an NIHR portfolio study management group. • Co-applicant on a clinical trial grant application to a major funding body

So, by working together and contributing patient data or serving on the committee of this collaborative, we can all meet our research needs much more easily than trying to do so alone.

HOW WILL THIS WILL WORK?

We have an executive committee that meets regularly, and anyone who wants can come to these meetings to contribute or observe. Anyone with an idea for an audit or research project can submit it to the committee and it will be considered for further development. Selected projects are taken forward and everyone in the collaborative then works together to collect the data. We have only been going for about a year and have delivered some simple multi-centre audits. Ultimately, OSCAR will be designing and running multi-centre randomised controlled trials that have the potential to make meaningful differences to orthopaedic practice.

HOW CAN YOU GET INVOLVED?

This sounds great, how can I get involved? Please email any of the committee or just talk to us at Friday teaching. Get in touch if you think you want to be involved at any level, whether simply contributing data or if you want to become a committee member yourself. This is everyone’s group and everyone has a voice.

WHO ARE THE COMMITTEE ? This is a list of the new elected committee members 2019-2020. Official announcement will be at research day.

Name Position Email

Mr Salam Ismael Chair [email protected]

Mr Dass Debashis Vice Chair [email protected]

Miss Hannah Meacher Secretary [email protected]

Mr Grege Mccbiourgh IT [email protected]

Mr James Geddas Treasurer [email protected]

Old Oswestrians Club

An introduction to the Old Oswestrians Club , membership and awards given in the name of the society.

OLD OSWESTRIANS CLUB

HISTORY

The Old Oswestrians' Club has been in existence since 1952. The special bond felt by orthopaedic surgeons who had trained at Oswestry led to the idea of forming a society, with the following philosophy:

"Robert Jones and Agnes Hunt created a spirit of service so impelling that we have all been influenced by it".

Old Oswestrians must kindle the flame, and we hope to meet year by year in social and scientific friendship."

Its members consist of Consultant Orthopaedic Surgeons who have worked at Oswestry at some time in their career.

An annual meeting is held in June each year to which all members are invited, and consists of an afternoon of lectures, the Annual General Committee Meeting and the Gold Medal Lecture. The day is rounded off by an evening meal and award presentation. Medals and Certificates are presented to the trainee Orthopaedic Surgeons during the annual speeches after the meal.

The Old Oswestrians Club was founded in 1952. It was originally named "The Old Oswestrians Society" but this was later changed to The Old Oswestrians Club after it was discovered there was already an "Old Oswestrians Society" in the town for alumni of Oswestry Grammar School.

Our aims and objectives are broadly speaking, to meet annually in scientific, academic and social friendship and to perpetuate what might be termed "the Oswestry tradition" - Old Oswestrians' must kindle the flame!

Our first nominated president was Sir R Watkin Jones Our first ever members of our Executive Committee were: • John Bristow • John Charnley • Alexander Miller • Guy Pulvertaft • James Wishart John C Menzies was the first Honorary Recorder of the Society

The Chain of office was presented to the club by Mr W N Laurence and is displayed in the Institute of Orthopaedic at the Robert Jones & Agnes Hunt Orthopaedic Hospital, Gobowen, Shropshire which is the Headquarters of the Club.

OLD OSWESTRIANS CLUB

MEDALS On Oswestry registrars research day the following medals will be awarded

• The Professor's Medal Awarded for the best presentation submitted on the Registrar's Research Day

• The Lloyd-Griffiths Medal Awarded to a trainee for the greatest individual input towards the annual training programme

• The G K Rose Certificate Awarded to the highest achiever in the Bio-Mechanics training course

• The Gold Medal Awarded to the Gold Medal Lecturer

• The Rowland Hughes Medal Awarded for the most prestigious publication in Paediatrics

• The Alan Darby Certificate Awarded to the trainee with the best published Oncology paper

• The B T O'Connor Cup Awarded to the trainee with the highest score of the Statistics exam

Useful Links

• BOA ( British Orthopaedic Association) https://www.boa.ac.uk/ • BOTA (British Orthopaedic Trainee Association) http://www.bota.org.uk/ • JCST https://www.jcst.org/ • ISCP https://www.iscp.ac.uk/ • CCT Checklist https://www.jcst.org/quality-assurance/certification-guidelines-and-checklists/ • CCT Way Point https://www.jcst.org/quality-assurance/certification-guidelines-and-checklists/ • Orthopaedic Institute https://www.orthopaedic-institute.org/ • BOTA Twitter @bota_uk • AO Foundation https://www.aofoundation.org/Structure/Pages/default.aspx