Summary of Activities
Clinical Practice
Pain Medicine
For 32 years, I had been responsible for the major development and running of the chronic pain service at Charing Cross Hospital until my retirement. During that time the activity of the service expanded enormously. Some 550 new patients were seen each year and in addition there were over 4,500 clinic attendances for treatment. I was able to develop a purpose-designed unit, which offered exemplary services for those patients with chronic pain. As well as a fully integrated administrative unit we had our own imaging and recovery suite for undertaking invasive procedures. The service dealt with all types of pain conditions and offered a comprehensive service. There was a strong commitment to alternative therapies including acupuncture. I pioneered the introduction of this aspect of care into hospital practice. I provided a training facility for junior staff and introduced three week speciality module for undergraduates so that they could learn about non-conventional therapies like acupuncture. I supported the expansion of our nursing team to include a number of clinical nurse specialists and organised the appointment of a nurse consultant. I explored new initiatives to reduce wait times and achieved greater convergence with practitioners in primary care. I established an integrated multidisciplinary pain service to manage patients with complex pain issues. Since my retirement I have continued to practice and see private patients with chronic pain issues. I have regularly attended meeting and conferences to maintain skills and knowledge within the discipline
Medico-Legal Activity
This has increased enormously in the last few years and I now provide between 100 and 200 reports per annum on all aspects of Pain Medicine including personal injury and clinical negligence.
I have provided reports for defendants (45%), Claimants (45%) and joint (10%) on all matters related to pain management. In addition I am also invited to provide opinion for the Medical Defence Organisations and through them the GMC.
I have regularly attended court and presented oral evidence. In 2015 I was in court on 6 occasions.
I have also been retained in court as a single joint expert
I have attended educational courses relevant to all aspect of my clinical practice (Specialist info, The 7 Group, The Cambridge Medico-legal conferences, CLIP).
These have included:
- Court Room Skills (2010,)
- Report writing (2004)
- Clinical Negligence Issues (2011 2013)
- Personal Injury (2011, 2013, 2014)
- General meeting (2010, 2011, 2012, 2013, 2015).
My practice includes:
- Clinical negligence reports
- Personal injury reports
- Coroner’s cases.
Activities undertaken:
- Causation reports
- Condition and Prognosis reports
- Joint opinions
- Part 35 Responses
- Case conferences
- Court Attendance.
I do not deal with cases involving children under the age of 16
Anaesthesia
I retired from active anaesthetic practice in March 2015 but maintain my interest by attending lectures and conferences
Education
Education is my passion. For 26 years I sought to improve education in pain management both for the clinician and the patients. I established PANG as a forum whereby physicians could gain greater understanding. There were over 3500 health care professionals on the mailing list. I established and ran a series of symposia each year. These meetings provide education on all aspects of acute and chronic pain and regional anaesthesia. Each year I invited over 60 speakers to participate and had overall attendances in excess of 1000.
PANG was also invited to host satellite symposia for the 5th World Congress of Pain and the 7th World Congress in Paris.
Following the formation of the Faculty of Pain Medicine within the Royal College of anaesthetists and the development of the College Education programme PANG elected to discontinue the education service so that the College facilities could be fully supported.
Lecturing
During the past few years I have been an invited speaker at meetings arranged in Malaysia and the Middle East, Czechoslovakia, Greece, Cyprus, Spain and Finland. In the last 2 years I have been a guest speaker at The Danish Pain Society, The Irish Pain Society and The International Coalition for Neuropathic Pain (ICNeP). In March 2004, at the request of the Royal College of Anaesthetists I organised and ran a 5 day symposium on acute pain and anaesthesia in Kuwait. In addition I give around 20 lectures a year to invited audiences and regularly present papers at meetings.
During 2005 I visited Brazil and was one of 4 invited International Speakers to present a series of lectures at the 7th SIMBADOR Pain Symposium in Sao Paulo, Brazil. In the same years I was also invited to present at the Annual Neuro-electrical Modulation Society held in Monterey, California.
In 2008 and 2009 I gave national presentations at postgraduate events on the subject of neuropathic pain.
In 2012 I was invited to present on the medico legal context of low back pain, neuropathic pain and complex regional pain syndromes.
Management
I maintained a major interest in NHS management until my retirement from the NHS. I hold a DMS in NHS management studies. I held a number of roles including Chairman of Anaesthesia and Clinical Director of Anaesthetic services. At a strategic level l led the Risk Management Service and was part of the Clinical Governance framework. My achievements included:
- Integrating services across a multisite Trust
- Establishing a framework for consultant recruitment
- Developing flexible models of clinical practice
- Responding to initiatives on junior staff working hours
- Providing leadership at Trust and national level
- Ensuring good fiscal policy
- Meeting standards agreed by external authorities
- Developing strategic planning and accountability
- Introducing audit half days for all employees
- Developing an electronic clinical incident reporting system
- Developing staff appraisal.
- Leading the operating theatre redevelopment programme
- Underpinning the redevelopment of Critical Care Services
- Being a mentor for staff and investigating staff performance issues
- Providing leadership for Professional Societies and organisations.
- Participating in National Committees and review panels on all aspects of pain and anaesthesia.
- Marketing clinical service and ensuring that appropriate representation of clinical needs and services are appreciated by other health professional groups.
- Developing and monitoring audit and risk assessment criteria.
- Having financial control for large organisations
- Controlling budgets and managing expenditure.