Consultant Anaesthetist

The chronic pain service is a small, busy, friendly & cohesive department with good clinical outcomes well regarded by the local population. We are looking to recruit an enthusiastic individual who will take part in the high quality delivery and development of chronic pain services on the Isle of Wight. We are currently 3 part time consultants (including this post), 3 physiotherapists, 1 specialist nurse. The team has recently undertaken a restructuring exercise and is aiming to increase the psychology and movement based services offered those with intractable pain on the island and so are looking to increase our staffing within these disciplines.

The Earl Mountbatten Hospice provides malignant pain control, respite services and terminal care and cooperates closely with the Hospital CPS. The Anaesthetic Department The department provides anesthetic services for general, ophthalmic, maxilla-facial, ENT, urological, orthopedics and gynecological surgery. We have 7 operating theatres (4 main, 2 in a separate days case unit, 1 eye satellite unit) and a dedicated obstetric theatre. We also provide anaesthetic and resuscitation services to obstetrics, paediatrics, radiology, ECT and the ED.

The relative geographical isolation means that all anaesthetists must maintain a wide range of core skills in order to be able to safely deliver these low frequency but high impact services We are currently 15 consultants (including this post) and 18 specialty doctors. We have a single training post in anesthesia (which is at present occupied by a FY2 post in Intensive Care) and have a training commitment to several ED doctors undertaking consultant accreditation via the CESR route as well as a constant influx of medical students. The Department operates a mentor scheme for all new appointees. Operating Theatres We have 7 operating theatres (4 main, 2 in a separate day care unit, 1 satellite eye theatre) and a dedicated obstetric theatre.

Pre-Assessment The nurse led pre assessment process of all elective patients is well established at St Marys Hospital. There is a daily consultant anesthetic clinic available to review anticipated difficult cases and to communicate potential problems to colleagues. We run an Enhanced Recovery Program for orthopedic, colorectal and gynecological surgery. Obstetrics The Maternity unit has about 1200 deliveries per year with an epidural rate of approximately 25% and a caesarean section rate of around 17%.

The Anesthetic department provides Consultant cover in hours to the labor ward. Out of hours there is a dedicated specialist doctor to provide anesthesia for obstetrics. Acute Pain Service (APS) The APS is provided by a consultant anesthetist and a full-time acute pain nurse, supported by ward-based link nurses. Apart from the clinical service, it provides teaching and education for medical and nursing staff.

Post-operative pain is managed in a variety of ways including PCA and PCEA. Ultrasound guided nerve and plexus blockade are also commonly employed techniques. We have recently invested in several state-of-the-art ultrasound machine and developed a protocol for local anesthetic wound/nerve catheter infiltration postoperatively. Intensive Care Unit (ICU) The unit admits about 400 patients a year.

The majority (70%) are critically ill adult medical patients. Paediatric ICU services and the regional neurological unit are based in Southampton. Initial assessment and resuscitation of these patients involves the anaesthetic team. Critical care outreach is well established, and this nurse delivered service also lead the hospital at night team.

In hours the medical staffing of the unit consists of one of six dedicated ICU consultants supported by a resident specialty doctor. Out of hours the resident speciality doctor staffs the unit and is supported by the general on call consultant in anaesthesia. Weekend ICU ward rounds are undertaken by dedicated ICU consultants.