Visiting Professional Programme: Critical Care

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1 Visiting Professional Programme: Critical Care

2 1 Introduction The Guy s and St Thomas NHS Foundation Trust Critical Care Visiting Professional Programme (VPP) is designed to provide international visiting professionals with the opportunity to experience and learn from a multi-disciplinary Critical Care team working in a busy tertiary surgical and medical centre in London. All major surgical specialities are covered within the Trust excluding neurosurgery. Guy s Hospital is a major thoracic and renal transplant centre along with head and neck surgery (involving complex airway management), urology (including robotics) and orthopaedics (including major spine correction surgery). St Thomas Hospital is a major elective and emergency site with an A + E and associated emergency services. A full range of emergency and elective surgery is supported including cardiac (open and cardiac catheter cases), vascular (including hybrid theatre), upper and lower surgery, obstetrics and gynaecology (7000 births a year), reconstructive plastic surgery and orthopaedic trauma. The St Thomas site is one of five nationally commissioned ECMO (Extracorporeal membrane oxygenation) centres, accepting referrals from across South East England and beyond. Our Visiting Professional Programme is a unique development experience that allows visitors to observe our leading critical care team in all its settings. The attachment will be tailored to the learning needs of the observer and can be designed to deliver either a broad or highly specific set of experiences. We are dedicated to broadening international professionals clinical expertise and enabling them to observe new skills that can be transferred back to their work place. Who should attend? This programme is intended for non-u.k. advanced trainee clinicians at the level of specialist registrar or consultant looking for exposure to a leading NHS critical care team. Visitors can apply primarily for an observership (with no hands-on element) or a practical attachment programme. Those wishing to apply for the practical attachment must have GMC registration. You can apply for GMC registration directly through the main GMC website ( This is likely to take a considerable time to achieve and should be factored into an attachment application. Duration It is recommended to undertake a placement of between six weeks to three months for a typical observership Attachments could be form 3 months to one year. The experience can be tailored to the applicants needs from a generic overview of our critical care services to a specialised attachment to one specialised clinical area. Format The critical care programme is delivered to rotate through level 2/3 intensive care, level 1/2 high dependency care, Extra Corporeal Membrane Oxygenation (ECMO), the Outreach Team to manage deteriorating patients within the hospital, and the Post Critical Care Recovery Service. The programme will also provide exposure to relevant departmental teaching, multi-disciplinary meetings and research activities. The observer will be nominated a supervisor to coordinate their individual programme and mentor progress each week.

3 2 Overall aims The programme is aimed at those who wish to extend their experience within a leading critical care team and who wish to gain an understanding of the way this is practiced and organised within the NHS and how it integrates with patient care pathways. The programme aims to include: Direct experience and exposure to relevant areas within critical care that suit the applicants needs Opportunities to get involved with short quality improvement projects during your visit Opportunities to attend our in-house teaching sessions for intensivists Opportunities to attend our clinical governance meetings The opportunity to share knowledge and expertise with doctors, consultants and other members of the critical care multi-disciplinary team The opportunity to develop and extend visitors work portfolios by gaining experience of observing one of the largest teaching hospitals in Central London, whilst gaining direct insight into the workings of the NHS Sample timetable Day AM PM Week 1 Monday ST THOMAS INTENSIVE CARE UNIT ST THOMAS INTENSIVE CARE UNIT Tuesday PROJECT WORK TEACHING SESSION Wednesday ST THOMAS INTENSIVE CARE UNIT SEVERE RESPIRATORY FAILURE MULTI- DISCIPLINARY MEETING Thursday CLINICAL GOVERNANCE MEETING ST THOMAS INTENSIVE CARE UNIT Friday CRITICAL CARE RECOVERY CLINIC CRITICAL CARE RECOVERY CLINIC Week 2 Monday GUY S CRITICAL CARE UNIT GUY S CRITICAL CARE UNIT Tuesday PROJECT WORK TEACHING SESSION Wednesday HIGH DEPENDENCY UNIT SEVERE RESPIRATORY FAILURE MULTI- DISCIPLINARY MEETING Thursday OUTREACH OUTREACH Friday CRITICAL CARE RECOVERY CLINIC CRITICAL CARE RECOVERY CLINIC

4 3 Critical Care Critical Care at Guy s and St Thomas is one of the largest, most specialised and comprehensive critical care services in the NHS, providing a total of 29,371 bed days in 2016/17. The service cares for an unparalleled case mix; seeing patients from a wide range of socioeconomic groups and ethnic backgrounds with a broad range of critical illness and injury. It is a core service within the trust strategy and treats patients across a complete pathway, from outreach, through to the commissioned follow-up clinic. The critical care service is an enabler of many specialist pathways, with level 2 and 3 beds spread across both the Guy s and St Thomas sites. Guy s and St Thomas is one of five ECMO centres in the UK, with a 24/7 consultant-led retrieval service. The team have been able to build strong relationships with the 4 other UK centres that are commissioned to provide ECMO support, and engage closely with referring centres to inform of best clinical practice and service updates. Critical care also hosts the Outreach Team to provide assistance and care to deteriorating patients on the ward. This is medically staffed by senior trainees, and overseen by a consultant. The critical care service is recognised internationally for supporting patients beyond the walls of intensive care and taking a holistic view of their recovery back to health. The department runs a well-established recovery clinic and peer support group, led by a multi-disciplinary team of critical care professionals. The recovery pathway has continued to grow year on year, with the services being accessed by more patients than ever before. Critical Care Areas St Thomas hospital Intensive Care 1 (ICU1) 15 beds St Thomas hospital Intensive Care 2 (ICU2) 15 beds St Thomas hospital Intensive Care 6 (ICU6) 11 beds dedicated ECMO unit St Thomas hospital Victoria High Dependency Unit (VHDU) 10 beds St Thomas hospital Page High Dependency Unit (PHDU) 4 beds St Thomas hospital Doulton High Dependency Unit (DHDU) 10 beds St Thomas hospital Overnight Intensive Recovery (OIR) 11 beds Guy s hospital Guy s Intensive Care Unit (GCCU) 13 beds Adult Surgical services provided at Guy s and St Thomas ENT Head and Neck Maxfax Thoracic Endo-Urology Urology Renal Transplant Orthopaedics Pain Management Plastic surgery Gynaecology Gynaecology Oncology Cardiothoracic Vascular Upper GI Lower GI Breast Surgery Cleft Oral Surgery Ophthalmology Trauma services

5 4 Faculty Our team comprises 29 consultants and 60 trainees who work closely with a strong multi-disciplinary team of dieticians, physiotherapists, psychologists, occupational therapists and pharmacists. The department has a good working relationship with the other medical and surgical specialties within the trust. Critical care consultants Dr Richard Lead (Clinical Director) Dr Marlies Ostermann (Clinical Lead) Dr Nick Barrett (Clinical Lead) Dr Andrew Aswani Dr Andrew Retter Professor Richard Beale Dr Ros Tilley Dr Andy Jones Dr Angela McLuckie Dr Simon Sparkes Dr Chris Langrish Dr Duncan Wyncoll Dr Richard Paul Dr David Cain Dr Hina Pattani Dr Chris Meadows Dr Nick Ioannou Dr Peter Sherren Dr Stephen Tricklebank Dr Luigi Camporota Dr Manu Shankar-Hari Dr Marius Terblanche Dr Aimee Brame Dr Guy Glover Dr Helen Cahill Dr Joel Meyer Dr Andrew Slack Dr Kyra Dingli Dr Katie Lane Dr Jonah Powell-Tuck Dr Eshan Ahmadina Dr Helen Vollmer

6 5 Fees A course fee per week will be applied. This excludes accommodation and travelling expenses. Participants will be provided with a certificate at the end of their attachment. To find out the fee please contact us by ing vpp@gstt.nhs.uk. Registration and enquiries To register for the Critical Care Visiting Professional Programme please complete the application form at and return to: Education and Events Guy s and St Thomas NHS Foundation Trust vpp@gstt.nhs.uk Telephone: + 44 (0) extension 55865

7 6 Guy s and St Thomas NHS Foundation Trust Guy's and St Thomas' NHS Foundation Trust is one of the largest Foundation Trusts' in the UK. It consists of St Thomas' Hospital, Evelina London Children s Hospital and Guy's Hospital. The Trust provides a full range of hospital services, as well as specialist services including cancer, cardiothoracic, women and children s services, kidney care and orthopaedics. Guy s is a major centre for cancer and renal services with the UK s largest kidney donor programme, and is also a leading centre for genetics, stem cell and allergy research and cleft lip and palate. St Thomas is a leading centre for the treatment of cardiovascular disease, stroke, HIV and dermatology. The Trust has one of the largest critical care units in the UK and one of the busiest A&E departments in London. It has an annual turnover of 1.5 billion and employs around 16,200 staff. Last year, the Trust handled 2.4 million patient contacts, including: 1.28m outpatients 89,000 inpatients 111,000 day case patients 205,000 emergency and urgent care attendances 810,000 in community services 6,567 babies delivered The Trust has 665 beds at St Thomas', 288 at Guy's, 144 at the Evelina London Children s Hospital and 64 in the community. NHS statistics show that our patient survival rates are nearly 25 per cent better than the national average. This is one of the lowest standardised mortality rates in the NHS and provides an important indication of the quality of care provided by our clinical staff. In 2013, the Dr Foster Hospital Guide awarded us Trust of the Year for safe care. Care Quality Commission (CQC) rating Guy s and St Thomas achieved a Good overall rating by the Care Quality Commission (CQC) with several services rated Outstanding. CQC inspectors visited the Trust s hospital and community services from 7-10 September 2015 with further unannounced visits taking place later the same month. In its report, the CQC praises staff who its inspectors found to be highly committed to the Trust and delivering high quality patient care.

8 7 Guy s and St Thomas NHS Foundation Trust values Our values help us to define and develop our culture what we do and how we do it. Making people aware of the Trust values, making them part of our culture and demonstrating them through the organisation helps us develop a shared way of acting. Our values are a key part of everything that we do as an organisation, from being included in staff job descriptions and in our publications, through to our work on leadership development and performance management. Our five values are listed below: 1. Put patients first 2. Take pride in what we do 3. Respect others 4. Strive to be the best 5. Act with Integrity Every day we aim to provide the most exceptional care to our patients from dedicated staff who follow our five values. Take a look at our video at to see what our values mean to them.

9 8 Copyright Guy s and St Thomas NHS Foundation Trust All rights reserved. No part of this document may be reproduced without written consent from the author.

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