CCT in ICM - programme overview unit ... - London Deanery

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Four Consultants have sessions in Intensive Care Medicine and cover the unit for one week at a time. In addition there are daily Consultant-led radiology and microbiology meetings. Junior medical staffing comprises four Specialist Registrars and six Senior House Officers. The Specialist Registrars work a resident 1 in 8, 24 hour partial shift rota. There is an organised educational programme that includes regular teaching and journal club sessions, multidisciplinary intensive care meetings, departmental audit and morbidity and mortality meetings. Trainees are encouraged to contribute to audit, teaching and research projects and are allocated non-clinical time for these activities. The academic Unit of Critical Care of the National Heart and Lung Institute, Imperial College, led by Professor TW Evans, is located at the Royal Brompton Hospital and is active in both basic science and clinical research in the intensive care unit with a particular interest in vascular biology and the acute respiratory distress syndrome (ARDS). Research fellows participate in the registrar on-call rota. The Royal Free Hospital Contact: Dr. Julian Howard ( 020 7794 0500) The Royal Free Hospital has a total complement of 20 Level 3 Intensive Care beds. A further 4 beds are due to be commissioned in due course. All medical and surgical specialties, with exception of cardiothoracic surgery are covered. The Renal Unit at the Royal Free provides services for the whole of the North Central sector. Tertiary specialist services include liver transplantation, hepatobiliary surgery and neurosurgery. All modern treatment modalities are catered for with the exception of ECMO. The total throughput of patients is in excess of 1100 per year. Senior medical cover is provided by 8 consultants. These consultants provide a 24 hour per day 7 day per week service worked in blocks to provide continuity. Dr Steve Shaw is the Lead Consultant and Medical Lead for the North Central London Critical Care Network. Dr Julian Howard is the Deputy Lead and Educational Supervisor. The other consultants are Dr. Y Rajalingam Dr. B. Agarwal, Dr T. Berlet, Dr. A. Genahr and Dr K Dhadwal. Comprehensive ward rounds at 08.00hrs and 16.30hrs take place on a daily basis. All potential admissions to the unit be it day or night are discussed with the ITU consultant. There is a high level of support to the junior staff. There are weekly teaching sessions on Tuesday and Thursday mornings and on Tuesday afternoons. There is a daily microbiology ward round and X-ray meeting. We actively participate in, and regularly present at the medical ground round. Junior staffing is provided by 13 doctors working a full shift rota ( new deal and EWTD complaint). There six specialist registrars from the School of Anaesthesia, one NTN in respiratory medicine, one CSST post in intensive care and five Trust
senior clinical fellows and SHOs. The intention is to convert two of the senior clinical fellow posts into two NTN’s in acute medicine. There is a dedicated ITU Pharmacist, Dietician, Physiotherapist and Clinical Scientist. There is active participation in audit – nationally with the INCNARC Case Mix Programme and locally with generic and research data. We have also developed a successful patient risk and outreach team supported by a nurse consultant, (Dr. Carol Ball). The Royal London Hospital Contact: Dr Marie Healy (0207-377-7793, mob 07813 783725) The Royal London Hospital (RLH) forms part of Barts and the London Trust. The RLH ICU is a tertiary referral unit for neurosurgery, trauma, vascular and renal services, and caters for a large deprived local population. The RLH is the base hospital for the Helicopter Emergency Medical Service and the Accident and Emergency Department caters for 100,000 patients per year. We are currently funded for 16 ICU beds (this may soon increase to 18). There is a 12 bedded surgical HDU (currently staffed for 5 beds). A Patient at Risk Team (ICU Outreach Team) was set up in 2001 and consists of one medical and one nurse consultant, a senior physiotherapist and 2 F grade nurses. An ICU out-patient follow-up clinic has recently been established. The ICU has a dedicated laboratory, seminar room, X ray room / trainee office, consultant office, on call room and relatives room. There are ongoing research opportunities (clinical and laboratory based). We have approximately 700 admissions per year (most children are transferred). Bed occupancy runs at 92-95%. 14% of admissions are planned. 80% of patients are ventilated. Up to 10% of patients have had CPR in the 24 hours prior to admission. Case mix for the year ending Dec 2002 includes neurosurgery / neurology 222, general surgery 192 and general medicine 141. Other subspecialties include major head and neck, upper GI and hepatobiliary surgery. ICU mortality runs at 22-25%. Approximately 30% of the ICU patient bed days are trauma related, including those with head injury. There are 400 trauma calls per year and each is attended by an ICU doctor. We have extensive experience in ICU audit and participate in ICNARC. There are 2 consultant ward rounds per day and daily microbiology ward rounds. There is an active educational programme. We have weekly x-ray and trauma radiology meetings. We have a dedicated ICU teaching session each week and a weekly ICU journal club. We have 8 consultants who staff the Unit (3 senior lecturers and 5 NHS consultants). Dr David Goldhill, Director of ICU, Barts and the London Trust Dr Stuart Withington, Director of ICU, Royal London Hospital Dr Gerlinde Mandersloot , Lead Consultant Patient at Risk Team
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CCT in ICM - programme overview unit ... - London Deanery

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