Areas of Interest

Since being appointed as a consultant there have been a number of key areas that I have developed within the trust:

There was no nutrition team when I started at the trust. I developed the nutrition team with motivation and leadership, encouraging colleagues to come on board. As a result of this hard work, we now have a multidisciplinary nutrition team consisting of two consultant gastroenterologists, gastroenterology SpR, a nutrition nurse, pharmacist, dietician and speech and language therapist. This team meets twice per week. As the team has developed, in tandem with this, a nutrition steering group has formed.

In addition to the nutrition team and closely allied to this I have developed the PEG care pathway that is now in use across the trust. This came about as a result of a PEG audit which demonstrated that the indications were poor and complication rates of PEG insertion were high. Re-audit has demonstrated clear improvement with much lower complication rates and much lower 30 day mortality.

As lead for endoscopy from 2001 – 2006 I was involved in the development of the endoscopy unit related to the Global Rating Scale (GRS). In the first two years of the GRS ratings, we were one of the most improved endoscopy units nationally and contributed on a national level to solve some of the problems associated with the GRS.

Endoscopic ultrasound (EUS) was an embryonic service when I was appointed as a consultant with no one to actually use the kit that had just been purchased. Single handedly I have developed the service. I have spent my spare time going to various units in Europe to learn EUS and now provide a comprehensive diagnostic service. With appointment of a new colleague two years ago, I have trained up this individual to do EUS thus providing a continuous EUS service that does not founder when I am on leave. More recently, I have secured £90 000 of funding for the purchase of a therapeutic echoendoscope to further develop EUS services across the trust.

I have been a key member of the team which has successfully bid for the national bowel cancer screening programme. We are now a recognised center for bowel cancer screening and the screening lists started at the beginning of April. I am one of two accredited clinicians within the trust who undertake the bowel cancer screening colonoscopies.

The Birmingham Treatment Centre (BTC) was opened in 2004 with the intention of providing a more seamless ‘one stop’ approach to outpatient services. This facility had a purpose built endoscopy unit which was never opened due to issues around access to the facility out of hours. As gastroenterology lead for the trust from 2006 – present, I have secured £200 000 of funding to open the endoscopy unit in the BTC which is additional capacity to the fully functional endoscopy unit in the main hospital at the City site.

I have recently reached an agreement with Birmingham Children’s Hospital to provide a comprehensive endoscopic retrograde cholangiopancreatography (ERCP) service for them. This will mean transferring of older children to City Hospital where they will have their ERCP. This has required negotiation with the anaesthetists to provide cover for these children. For younger children and those under 50Kg, I will go and do the ERCPs at the Children’s Hospital.

All these developments have been achieved while running a very busy clinical practice.