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Anaesthesia, Critical Care and Chronic Pain

Clinical Director:   Dr Anne Scase
Lead Clinician for Critical Care:   Dr Roger Townsend
Lead Clinicians for Anaesthesia:   Dr Carl Hillermann & Dr Carol L. Bradbury
Group Manager:   Mr Amardeep Johal
Anaesthetic Resource Manager:   Charlene Allen

 

The Trust has a large anaesthesia department including about 100 anaesthetists of which 66 are consultants.  We receive all levels of trainees, who are rotating within the Warwickshire School of Anaesthesia.  We have regular monthly departmental meetings and QIPS meetings, along with extra sub-specialty Clinical Governance Meetings.

We have well established FRCA courses for both the Primary and the Final.  FRCA courses run by the UHCW team attract both national and international candidates and receive excellent feedback.  We also run Airway Management courses, SMART courses and Coventry Adult Transport courses.  These external courses are in addition to the internal educational programmes that are run for our own trainees.  We have a “state-of-the-art” Simulation Suite and a strong cohort of educationalists within the department.  Many of our consultants also have commitments to the undergraduate teaching programme at Warwick Medical School, in module delivery and examining.

As a department, we have a culture of supporting National Audits and research projects.  Several of our consultants are actively involved in research, either working collaboratively with other specialties or undertaking solely anaesthetic research.

The main anaesthesia department and support services are located on the first floor, central wing, next to the theatre suite of University Hospital. This is a new hospital built to 21st century standards, and equipped as new, mostly with Datex Avance machines. The general adult critical care unit, labour ward and cardiothoracic unit (including scan and catheter rooms) are all next to main theatres. There are five theatres for day surgery downstairs.

We have excellent support services, including our internationally acclaimed fully digitised pathology service, CRRS, PACS and electronic issue of blood products.  We were one of the first centres to use cell salvage routinely in our obstetric unit and have achieved excellent results with our Belmont Rapid Infusers, particularly in vascular surgery.

Our new hospital provides extensive facilities for the anaesthesia department which includes a seminar room, extensive ICT network access, on call rooms, formal and informal meeting rooms all within the anaesthesia suite. There are sufficient network PC desks for consultants on SPA sessions to work simultaneously. This is situated next to the main theatre suite. There are also administration and management offices within the department.

There is also an anaesthesia office in the theatre suite at the Hospital of St Cross in Rugby. This is a smaller general hospital in which extensive elective work, principally orthopaedics and general surgery, is undertaken.

Anaesthesia

The Anaesthetic Department delivers perioperative care to around 44,000 elective and emergency patients.  University Hospital offers tertiary surgical services to trauma, cardiothoracic surgery, neurosurgery, vascular surgery, hepatobiliary and upper GI surgery, major maxillofacial reconstructive surgery, robotic surgery and renal transplant services. We have recently set up a combined orthopaedics and plastic surgery hand service with selected lists occurring solely under regional anaesthesia.  Our interventional radiology suite and service is being expanded and we have an around-the-clock PCI service.

We have a large Obstetric Unit undertaking about 6,000 deliveries per year, with a 25% caesarean section rate and an 18% epidural rate.  We also anaesthetise about 3,000 children per year and have a separate paediatric on call rota.

University Hospital is the Major Trauma Centre for the Central England Trauma Network and receives patients flown in by the local Air Ambulance.  Our Emergency Department has an around-the-clock, dedicated ODP to support resuscitation and anaesthetic services.  There is also a CT scanner within the resuscitation area of the Emergency Department to facilitate safe and prompt diagnosis and treatment.  Independent data from the Trauma Audit and Research Network (TARN) reports our outcomes to be above expected, with 1.2 extra survivals in every 100 trauma patients admitted.  We have also received national recognition for creating the cement curfew which is designed to improve patient safety.

The department has an excellent national and international profile in the management of difficult airways.  We hosted the 2014 Difficult Airway Society Annual Scientific Meeting in the nearby Stratford-Upon-Avon.  The meeting was a resounding success, breaking all records in terms of delegate attendance and being rated by these delegates as having the best scientific programme that they have attended so far.   We have a dedicated Airway Lab with an abundance of different difficult airway equipment and run regular educational courses.

General Critical Care

The General Critical Care (GCC) Unit has thirty beds and manages over 1600 admissions per year.  The background of our ten critical care consultants is predominantly anaesthesia but include acute medical specialties. These consultants manage the GCC, caring for acutely unwell medical and surgical patients, including neurosurgical patients.  Support is currently provided by seven senior trainees and ten junior trainees. However, there are plans to expand the critical care service which will include more medical and specialist nursing staff.

There is a separate Cardiothorcic Critical Care (CTCC) Unit which is covered by both cardiac surgeons and critical care consultants. Each day, separate critical care consultants are responsible for the GCC and the CTCC with separate wards rounds being undertaken.

The department actively engages in research and is supported by critical care research nurses.

Chronic Pain

The specialist chronic pain management service is run by four consultants, with secretarial and nurse support.  Our specialist pain nurses and physiotherapists assist in the care of patients with both short and long term pain conditions.  Most of the care is delivered on an outpatient basis with outpatient clinics predominantly taking place at the University Hospital site.  However, some consultants also deliver the service at the Hospital of St Cross in Rugby.  The chronic pain management service includes treatment room and theatre sessions, which are supported by ultrasound and x-ray guidance.

For more information about the department of anaesthesia, please visit the departmental website by clicking here

Nurses at University Hospital, Coventry, and the Hospital of St Cross, Rugby, have contributed to a prestigious new manual for trainee and practising nurses.