ITU

ITU

Overview:

  • The Intensive Care Unit has undergone recent expansion and now comprises 29 beds. There are 13 Consultant Intensivists and 3 tiers of junior doctors namely junior doctor tier, senior tier and senior SR tier.
  • The Royal Surrey County Hospital is a leading regional cancer centre linked to St. Luke’s cancer hospital and also provides tertiary specialist services such as upper GI (elective oesophagectomies and emergency management of ruptured oesophagus), HPB (liver resection surgery & pancreatic surgery), Head and Neck surgery (including free flaps) and gynae-oncology. The department has played a leading role in enhanced recovery programmes and perioperative goal directed therapy and CPEX testing is well established. The ICU admits approximately 1300 patients per annum, 55% of which are surgical and 45% are medical /haem-oncology.
  • There is a strong commitment towards education and training in Intensive Care Medicine within the department. Locally delivered, protected monthly educational afternoons providing 5 hours of curriculum mapped topics. The feedback from these sessions has been excellent.

 

Training Programme:

There are numerous educational opportunities which can be accessed including:

  • Formal ICU teaching – 6 sessions per 6-month rotation block.  Each session is 4 hours in duration with a 30 minute break.
  • ECHO – we offer dedicated ECHO training sessions with the expectation of gaining FICE accreditation
  • Ultrasound for Critical Care
  • Bronchoscopy Training
  • Weekly Consultant Radiologist led teaching sessions
  • ICM Journal Club
  • QI opportunities – previous trainees have been involved in projects such as the “National Emergency Laparotomy Pathway – ELPQuiC” (http://www.health.org.uk/programmes/scaling-improvement/projects/adoption-and-large-scale-spread-elpquic-improving-outcomes) The department strongly encourages and supports such projects.
  • Monthly Morbidity and Mortality meetings
  • ICM Simulation sessions – Monthly in-situ sessions which enable multi-professional teaching. The overall theme compliments the teaching session of the month.  The simulation set up involves the use of a 3G Laerdel Simman, full monitoring and level 3 support including but not limited to PB ventilators, infusions and invasive catheters and drains. The 10 scenarios have been extensively worked up and come with all relevant ICU paperwork and investigation results.
  • Management module for senior trainees
  • Exam support and preparation for the FRCA and the MRCP with access to surgical teaching for those undertaking MRCS.
  • Senior ICM trainees gain experience in leading the ICM team
  • Attend ICM Follow up clinics
  • In House Courses: ALS / ATLS /BASIC / CCrISP / ALERT

 

Within the rolling 8 weekly rota, there is a full week available for trainees to undertake an educational activity of their choice e.g. spend a week in theatre, undertake an audit etc.

Research activity within the directorate is well established. We are proud to have contributed to several large multi-centre trials that have changed practice, including: PROWESS-SHOCK, TRACMAN, OPTIMISE, CALORIES, ENIGMA-II and EuSOS; and others that are yet to be published including PROMISE, ISOS, LAS VEGAS, IOSWean, DREAMS and PROVENT. We’re currently recruiting to BREATHE, REPROVE, PREVENTT and have recently completed POM-HR and POPULAR. We have more than five clinical trials in set-up. We have a research office, 2 full-time research nurses and 8 senior research fellows – several of whom are registered for higher degrees.

In addition to recruiting to NIHR portfolio studies we conduct investigator-led trials across a wide range of subjects including enhanced recovery, microcirculation, difficult airway management, pleural/lung ultrasound in critical care, muscle wasting, cardiac output monitoring and optimisation of fluid resuscitation and analgesia. There’s also extensive experience of both small-scale quality improvement projects (surgical pathways) and large-scale quality improvement projects such as ELPQuic that have attracted significant funding. We’ve recently secured grants from industry, the Health Foundation, DAS and ICF.

The Surrey Perioperative Anaesthesia Critical care collaborative Research Group (SPACeR) group (www.spacer.org.uk @SPACeRGroup) is one of the founding Clinical Academic Groups (CAGs) within Surrey Health Partners, with the University of Surrey and Ashford and St. Peter’s Hospitals. Professor Lui Forni joined us in 2014 and is playing a key role in developing our academic strategy and research activity. Several clinicians hold honorary lecturer positions at the University.

 

Educational Supervision:

All educational supervisors have completed recognised educational supervisor training programmes and are enthusiastic and supportive in their roles. The department has an excellent reputation for providing clinical supervision and this is achieved through having two ICM Consultants every day (including weekends) covering the unit and a separate ICM Consultant covering outreach as well as Consultant presence on the unit between 8:00a and 22:30 with on-call Consultant input between 22:30 and 08:00.

Consultant Name – Role – Areas of interest

Dr Amish Patel – Clinical Director ICM – FICM Tutor / FRCA Examiner / Clinical Governance Lead /HPB anaesthesia

Dr Mike Carraretto – Clinical Lead ICM – Surrey critical care network lead / Psychology of Critically Ill Patients

Dr Michael Scott  – Intensivist & Anaesthetist – Research / Enhanced Recovery/ Paediatrics

Dr Mehrun Zuleika – Intensivist & Anaesthetist -Research / Audit / Upper GI Surgery

Dr Kris Carter – Intensivist & Anaesthetist -Organ Donation / Head & Neck Cancer

Dr Jane Tilley – Intensivist & Anaesthetist – Director of Medical Education

Dr Justin Kirk Bailey – Intensivist & Anaesthetist – Ultrasound / Echo / Trauma / Informatics / Research

Dr Ben Creagh Brown – Intensivist & Respiratory Physician – Research / ARDS / Respiratory Failure

Dr Ed Walter – Intensivist & Anaesthetist – Pre Hospital Care / Renal Therapies / Post ICU Care

Dr Lui Forni – Intensivist & Nephrologist – Critical care nephrology / Research

Dr Alex Fletcher – Intensivist & Anaesthetist – Echocardiography

Dr Rachel Savine – Intensivist & Anaesthetist – Education / High Risk Obstetrics

Dr Michele Bossy – Intensivist & Anaesthetist – Thoracic anaesthesia / Simulation / Regional anaesthesia / Ultrasound

 

Faculty Lead: Dr Amish Patel Amish Patel 2015

 Graduated 1998 from St. George’s Hospital Medical School. Post-graduate training in anaesthetics within the SW Thames (St. George’s School of Anaesthesia) and ICM training within the pan-London rotation. Appointed in 2008 as Consultant Intensivist and Anaesthetist. Interests include hepatobiliary anaesthesia, clinical governance and education. Author of 2 Primary FRCA revision books. Currently Primary FRCA Examiner for the RCOA. Clinical Director of ICM at the Royal Surrey County Hospital NHS Foundation Trust.

 

 

Trainee Biography

Beth Potter 2015

Dr Beth Potter

Senior Research Fellow, ITU

I am a senior research fellow at the Royal Surrey County Hospital undertaking research into peri-operative changes in the microvascular circulation. I also form part of the senior tier rota which provides support for the intensive care unit and anaesthetist in theatre and on labour ward at nights and weekends. There is a strong ethos of quality improvement, research, audit and training here at the Royal Surrey. Technical skills taught include echo, lung ultrasound and bronchoscopy and there are many opportunities and support for quality improvement programmes and strong research department.

I completed my undergraduate training at Imperial College, London and foundation training in North West Thames rotation. During the ACCS pathway I completed MRCP (UK) and gained experience in trauma and emergency medicine at the John Radcliffe Hospital. I have completed my FRCA and am currently taking time out of programme from my anaesthetic registrar training in the London Deanery (St George’s School) to undertake my MD at the Royal Surrey County Hospital & University of Surrey.

 

Click here for an example rota

 

Click here for the ICU Junior Doctor Handbook 20015-16

 

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