IPSWICH HOSPITAL TRUST

Ipswich Hospital NHS Trust provides secondary (specialist) or acute healthcare to a core catchment population of approximately 356,000 people living in Ipswich and East Suffolk. It is a busy district general hospital with 631 beds in general acute, maternity, Paediatric and neonatal services

In June 2008, The Garrett Anderson Centre (GAC) was opened, which provides a new Emergency Department, a 22 bed Intensive Care facility, 40 elective surgery beds and 4 operating theatres with associated day case surgical unit. The Urgent Care Centre was rated as Outstanding by the CQC Inspection in April 2015.

ENT Department

There are 4 ENT Consultants. Mr. Andreas Hilger Consultant Head & Neck Surgeon is also the current regional Training Programme Director for ENT.

Mr. Matthew Yung (Otology)

Mr. Mahmoud Salam (Rhinology)

Mr. Andreas Hilger (Head & Neck Surgery)

Mr. Jim Fong (Head & Neck Surgery)

3 Trainee Registrars on rotation

3 Middle Grade Specialty Doctors

2 SHOs (1 FY2 and 1 GP VTS).

5 full and part time experienced Specialist Nurse Practitioners (SNPs)

Training structure and Rota

During the 12 months spent at Ipswich Hospital, ENT Registrars will rotate through 3, 4 month rotations (Otology, Head & Neck and Rhinology). Ipswich patients requiring major head & neck surgery are operated on at the Norwich & Norfolk University Hospital and during the Head & Neck rotation, trainees travel to Norwich every other Tuesday for these theatre lists. The Registrar timetables for each of the three rotations are below;

ENT Consultant Timetable (Reg1 – Otology – Mr. Yung)

ENT Consultant Timetable (Reg2 – Rhinology – Mr. Salam)

ENT Consultant Timetable (Reg3 Head & Neck – Mr. Hilger & Mr. Fong)

Registrar on calls

On calls are a full working pattern shift system (24 hour, non resident). The weekdays are a 1:4 rota (Tuesdays Reg 1, Wednesdays Reg 3, Thursdays – Reg 2). The Friday night and weekend rota is shared with the Colchester Hospital ENT Department on an alternating basis with the on call Registrar providing cover for both Colchester and Ipswich Hospitals. This works out as 1:8 weekends and 1:10 Fridays.

On an Ipswich weekend on-call, the Ipswich team (via the 1^st on call) take all emergency referrals (and new admissions as necessary) from Colchester A+E and GPs. On Saturday morning, the Ipswich on call Registrar does a ward round at Ipswich Hospital and then receives a handover of Colchester in-patients from the Friday night Colchester registrar once they have done the ward round at Colchester. On Sunday morning, the duty Registrar does an inpatient ward round at both Ipswich and Colchester Hospitals.

The majority of 1^st on call cover during nights and weekends is staffed by experienced Specialist Nurse Practitioners. This system is very successful and has gained national recognition.

ENT Courses at Ipswich Hospital

Each year, Mr. Matthew Yung runs a Mastoidectomy & Tympanoplasty Course and a Dacrocystrhinostomy Course both of which enjoy a distinguished International Faculty, clinical workshops, lectures and live surgery sessions. As staff of Ipswich Hospital, ENT trainees are invited to attend these courses free of charge, although may be asked to help out on the day. The annual temporal bone course also takes place at Ipswich Hospital, usually in November.

Useful contacts

Mr. Andreas Hilger (Training Programme Director): andreas.hilger@ipswichhospital.nhs.uk

Carol Bolton – Lead Secretary for ENT: carol.bolton@ipswichhospital.nhs.uk

Jan Rudd (Mr. Yung- secretary) –course related queries: jan.rudd@ipswichhospital.nhs.uk

LUTON & DUNSTABLE HOSPITAL
EAST OF ENGLAND ROTATION

The hospital was officially, opened by Her Majesty Queen Mary on 14th February 1939. The hospital has gone from strength to strength and today the L&D is a fully-fledged University Teaching Hospital.

The L&D has a team consists of highly qualified specialist Consultants dealing with all aspects of ENT from minor procedures, such as putting in grommets to complex head and neck cancer surgery.

They are supported by specialist ENT and Head & Neck Cancer nurses and healthcare professionals (SLT and Dieticians), all focused on ensuring that our patients have the best possible treatment and experience.

The ENT team members provide both routine and specialist clinics including some nurse clinics.

Ward 20 is the Head & Neck ward shared with OMFS and has the expertise and facilities to provide care for the patients with traches and free flaps.

The outpatient clinics consist of general ENT, Head & Neck Cancer, Neck Lump, Thyroid, Voice, and Paediatric Clinics. The theatre lists consist of day-case  procedures and inpatient adult and Paediatric cases.

ENT Department

The department has the following structure ;

 4 Consultants

1. Mr Prasaud Kothari – Clinical Director, Assigned Educational Supervisor, Consultant Head & Neck Surgeon
2. Mr Sanjeev Silva – Consultant Head & Neck Surgeon
3. Ms Jaan Panesar – Consultant ENT surgeon with interest in Paediatrics and Facial plastics
4. Mr Om Chawla  - Consultant ENT Surgeon with an interest in Otology
5. Mr Pranay Singh – Consultant Otologist
6. Mr Nick Clifton – Consultant Rhinologist

2 Associate Specialists – Mr Thambyrajah, Mr Aijaz

4 Clinical Fellows

2 Training registrars

1 CT1 and 2 FY2

Training structure and rota

The year is divided into a 6 months general and 6 months head and neck

On-calls

The on-calls are a full working pattern shift system (24 hour, non resident). The weekdays are a 1:4 rota. The Friday night and weekends are shared with Bedford on a 1:5. On Friday and weekend on-call, we also cover Bedford Hospital (on weekends you cover Bedford but this will soon change to L&D only for all inpatient activity at weekends)

Useful contact links

LUTON & DUNSTABLE HOSPITAL

Lewsey Road

Luton

LU4 0DZ

Telephone:  01582 49 11 66

Secretary: Yasmin  Jora,

Tel: 01582-497457

Email: yasmin.jora@ldh.nhs.uk

Fax: 01582-497031

West Suffolk Hospital

The West Suffolk Hospital is a vibrant, friendly and accessible hospital set in a 19-hectare parkland site on the edge of Bury St Edmunds. It has around 430 beds open at any one time and serves a population of around 275,000, within area of approximately 600 square miles. It is easily accessible by road via the A14 and is approximately 30-40 minutes from Cambridge. Bury St Edmunds in Suffolk is a unique and dazzling historic gem. An important market town with a richly fascinating heritage, the striking combination of medieval architecture, elegant Georgian squares and  the glorious Cathedral and Abbey gardens provide a distinctive visual charm.

ENT Department

The department has the following structure:

3 Consultants

• Mr Fahmy Fahmy (FF): Otology
  
  • Assigned educational supervisor
• Mr Marcos Martinez del Pero (MM): Head and neck,
  
  • Lead clinician
• Mr David McKiernan (DCM): Rhinology and facial plastics
  
  • Also works at Addenbrooke’s

3 Associate Specialists – Mr Skibsted, Mr Ahmed

2 Training registrars and 1 staff specialist

3 SHO's

Clinics and theatre are mainly at the West Suffolk site, but satellite clinics are held at Newmarket and Sudbury, and one half of the rota has one-day-a-week at Addenbrooke’s.

Training structure and rota

The year is divided into two, but on either half time is spent with all consultants.

On-calls

Mid week (0800-1700 at WSH) are shared between the two registrars and one staff grade. The overnight on-calls are non-resident based at Addenbrooke’s. These are shared with the 6 Addenbrooke’s registrars, which results in a 1:8 pattern. Mid-week evenings (1700-0800) the WSH registrar covers every other Thursday. Fridays (1700-0800) and Saturday to Monday (0800 – 0800) are also 1:8. If you live more than 30 minutes from Addenbrooke’s you will need to be resident (currently accommodation provided).

The Addenbrooke’s on call covers WSH, Addenbrooke’s and Papworth Hospitals so if ENT emergencies occur at these sites the registrar needs to travel to the emergency (therefore car essential).

Useful contact links

Marcos Martinez del Pero: marcos.martinezdelpero@wsh.nhs.uk

Fahmy Fahmy: fahmy.fahmy@wsh.nhs.uk

Sarah Smith (PA to MM and DCM): sarah.smith@wsh.nhs.uk

Jacquie Adie (PA to FF): Jacquie.adie@wsh.nhs.uk

BROOMFIELD HOSPITAL – ENT DEPARTMENT

Entrance at Broomfield Hospital

Mid Essex Hospital Services has seen major developments on the Broomfield Hospital site, which incorporated the former North Thames Regional Orthopaedic Centre from Black Notley Hospital, Braintree and the North Thames Regional Plastic Surgery and Burns Unit from St Andrew’s Hospital, Billericay.

Head and Neck services for South Essex have been centralised at Broomfield, and as part of the development of an Essex wide Head and Neck service the Trust has established a dedicated inpatient facility on the Broomfield site. This has meant that Head and Neck cases from Basildon, Southend and Colchester General Hospital relocate to Broomfield.

DAY TO DAY

The adult in-patient service is managed through Billericay Ward (E321), a dedicated ENT/MaxFax ward at Broomfield Hospital. The SHO level doctors will be responsible for the admitting and clerking of routine and emergency E.N.T. patients to the beds and assessing all emergency referrals.

Children are admitted to Phoenix ward if overnight stay required or for emergency assessment/ admission, and through the children’s day stay unit (Wizard) for day case procedures.

Day cases are managed through the TADSU, level 3 in the PFI.

Outpatient clinics are carried out in a dedicated ENT department in area 101 in the PFI. This is co located with audiology services and oral/maxillofacial services, and adjacent to paediatric outpatients.

HEAD AND NECK NETWORK

A new, centralised centre for Head and Neck services, including all ENT inpatient surgery and emergency admissions, has been established at Broomfield Hospital. This serves Basildon, Southend, Harlow and Chelmsford, a population of over one million, and provides a major centre for Head and Neck cancer services. On call duties are undertaken at the hub hospital (Broomfield).

Broomfield Hospital is the regional head and neck cancer centre with a wide range of surgical procedures in all sub-specialties, including complex head and neck surgery. There will be close links with Broomfield’s St Andrews Centre, which is a Plastic Surgery and Burns Centre.

The consultants currently working within the Head and Neck Network are:

Broomfield Hospital                       Southend Hospital

Miss Laura Harding                           Mr Gavin Watters

Mr Leon Fletcher                              Mr Jonathan Philpott

Mr Mark Puvanendran                     Mr Martyn Barnes

                                                          Mr Aaron Trinidade

Basildon                                           Princess Alexandra, Harlow

Mr Maged Abdelkader                      Mrs Eleftheria Kiverniti

Mr George Fayad                             Mr Ha Chau

Ms Montio Morgan                            Miss Ching

Essex Rivers

Mr Arcot Maheshwar (for cancer work only, Colchester is not part of the general ENT/Emergency service)

ON-CALL ARRANGEMENTS

Patients are referred from all A and E departments in the network, and from GPs. During daytime hours (8-5) emergencies are dealt with locally and only referred to Broomfield if admission is deemed necessary. Out of hours referrals from network A&Es and GPs come directly to the first on call SHO and are managed from Broomfield. The SHO cohort at Broomfield consists of 3 GP trainees, with a core surgical trainee (usually CST2). SHOs from other spoke hospitals do their on-call duties at Broomfield.

There are 8 middle grade doctors (SpR or SAS) in the network, providing a second tier of on-call, 2-3 doctors from each participating trust. The weekdays, Friday nights and weekends are worked on a 1:8 rota (non-resident). Accommodation is not provided by the trust, but negotiations are ongoing to obtain this. Out of hours emergencies at spoke trusts may have to involve the middle grade travelling to these sites to review the patient, if unsafe to transfer.

Registrar Level Trainee

Middle grade services at Broomfield Hospital are provided by 1 training registrar, and 2 staff grades (Dr Jain and Dr Hadi).

The training position is a 12 month job with a mixture of mainly head and neck surgery, with some general/paediatric experience. Major head and neck work is carried out in the hospital and you will be involved in all aspects of the management of these patients’ care. An example timetable can be seen here:

ANNUAL LEAVE

Entitlement is pro rata to 5 weeks (27 days per 12 month period with lieu days for Bank Holidays worked) or 6 weeks (32 days) if on the third point of the salary scale or higher.

Annual leave should not be taken during the on call weeks, or during the week of long days, unless duties can be swapped.Only one ST level doctor and one middle grade doctor may be on leave at any time.

It is not normally Trust policy to pay in lieu of any leave not taken, or to carry leave forward to subsequent appointments within the Trust.  It is therefore imperative that you liaise with your colleagues at an early stage to ensure that all outstanding leave is taken in accordance with departmental guidelines.  Six weeks notice of leave is required.  Annual leave forms are available from the Rota Coordinator, currently Leena Banerjee.