Detailed job description and main responsibilities

Pre-Operative Assessment Clinic (POAC)

Anaesthesia Pre op Clinical Lead – Dr Egidio da Silva

The hospital has a well-established Nurse-led Pre-Operative Assessment Clinic.  Recently this has been expanded and is now staffed daily by a consultant anaesthetist.  Consultant Anaesthetists are also involved in the Preoperative assessment of children, ensuring that appropriate patients are selected for their procedures at the Royal Orthopaedic Hospital.  As part of our SLA with a local cardiology department, we also host an echocardiography clinic for our patients every fortnight.

Operating Theatres

There are ten operating theatres in our theatre suite.  All theatres have modern anaesthetic machines (GE Healthcare).  There are four ultrasound machines (sonosite) and one BK machine used for regional anaesthesia and vascular access.  TIVA is widely used and BIS monitoring available.  Cell salvage is widely used. Our current difficult airway equipment includes the Glidescope, disposable fibre optic scopes and ET view tubes.  The theatres will be increased in number this year with plans for a modular theatre build.

High Dependency Unit

Anaesthetic HDU Lead – Dr William Tosh

Speciality Doctor Lead - Dr Anil N Rao

In order to provide clinical continuity our consultant group has nine members at any given time that will provide Monday to Friday daytime cover of the high dependency unit in a five-day stretch.  Membership of this group is anticipated to change bi-annually, in order for us all to maintain clinical skill in critical care.  All consultants cover the HDU and theatre out of hours.

The High Dependency Unit (HDU) has 6 beds in line with CQC requirements.  The HDU is equipped with invasive monitoring equipment, TEG and other bedside tests for clotting and a blood gas analyser.  Non-invasive ventilatory support is available. However, elective post-operative ventilation is not carried out.

Any patient who may require post-operative ventilation is transferred to the parent unit from where the patient was referred or a local hospital with level three care available.  Careful assessment of cases reduces this to a minimum.  On occasion surgeons carry out surgery in the other hospitals if the condition of the patient demands elective post-operative ventilation.

Management Service:

The hospital has an established chronic pain management service with new appointments of two consultant anaesthetists who will also be part of the anaesthesia team and the acute pain service being created.  The service is completed with input from a multi-disciplinary team comprising of psychology, nursing, physiotherapy and occupational therapist.

Surgical Services:

Hand and Elbow Surgery: Most hand surgery is carried out using regional techniques with only a very low percentage of patients having general anaesthesia.

Spinal Service - There are eleven spinal surgeons.  Their work includes anterior and posterior stabilisation of cervical, thoracic and lumbar spine within deformity, degenerative and spinal oncology surgery.  Children under the age of five and those with a predicted requirement for post-operative ventilation are treated at the Birmingham Children’s Hospital.

Paediatric Surgery - Paediatric surgery is run jointly with the Birmingham Children’s Hospital.  Younger and more challenging children are treated at the Birmingham Children’s Hospital.

Joint Replacement Surgery - Arthroplasty involves primary and revision surgery.  There is an extensive rheumatoid practice, which is supported by on-site rheumatologist.  The successful candidates should be proficient in performing regional blocks for extremity surgery.

Foot and Ankle Surgery - General and regional techniques are used for adult and paediatric patients, some of whom may have global musculoskeletal morbidity.

Oncology Surgery - Covers adult and paediatric patients who may require diagnostic or treatment operative procedures, which can therefore be extensive in duration.  The catchment area is very wide and patients can be at any stage in their overall treatment plan.

Continuing Professional Development

The post holders will be expected to undertake continuing medical education along the lines recommended by the Royal College of Anaesthetists.  As a standalone surgical facility, all anaesthetists have current ALS and APLS certification.  We also undertake regular CPD at Birmingham Children’s Hospital or on paediatric anaesthesia related courses as well as updates in adult critical care.

Clinical Governance

The Specialty Doctor will practice within the framework of clinical governance and infection control; participate in clinical audit, morbidity and mortality meetings and report critical incidents. There is an active audit program at the ROH and the candidate is expected to participate in departmental audit.

Teaching & Audit

The candidate will be expected to take part in departmental teaching and audit activity.