Bringing Excellence to Life

The Anaesthetic Department of Barts and The London NHS Trust

In 1994 Barts and The London NHS Trust was established, combining the teaching hospitals at St Bartholomew's Hospital, the Royal London Hospital, London Chest Hospital and Queen Elizabeth Hospital for Children. These hospitals now operate as one Trust.

The Barts and The London Trust provides a two year SHO programme which rotates with our hospital through the Homerton Hospital and Newham General Hospital, providing the trainees with a balance of teaching and district general hospital experience.  Our SpR training is based on a School wide rotation in conjunction with the other hospitals of the Barts and The London School of Anaesthesia.

The first pre-registration house officers in anaesthesia commenced in 1999.

As a large teaching hospital to the East of Central London we provide anaesthetic services to the communities of the inner city, the suburbs of London and parts of Essex.  All of our SpRs move around the Trust for their various modules and so you will normally expect to spend three or six months at each site within the Trust. This allows you to experience different environments and work with several different consultants whilst remaining within a single large Trust.

We have a large and varied workload, acting as both general hospital and specialist unit for all major specialities.  We have a major accident and emergency department which is very busy serving the local population of the East End but also further afield through the use of the Helicopter Emergency Medical Service (HEMS).

The consultant establishment has recently been greatly increased to deal with the clinical workload, the reduction in junior doctors hours and to ensure that training of SHOs and SpRs can be given a high priority with high supervision levels. 

On-Call

At the moment on-call varies slightly but all rotas are compliant.

Teaching and Training

Barts and The London NHS Trust provides a varied teaching programme, with regular weekly half-day teaching for the SpRs and SHOs.  As well as one to one teaching in theatre and within the specialist modules there are other formal teaching sessions across the sites.  These include, weekly Friday departmental teaching (0800 –0900), multi-disciplinary trauma teaching (Thurs lunchtime), M&Ms, journal clubs, half-day cardiac and audit.

The regular half-day teaching at Barts and The London Trust for SpRs is primarily aimed at the pre-Fellowshp SpRs and specifically around the time of the Final exams, concentrates on SAQ technique and viva practice .  There is a large group of consultants who are willing to provide extra viva practice and wherever possible trainees are freed up to facilitate this.  SpRs are also encouraged to attend outside courses relevant to the exam.  Our pass rate for the Final FRCA is approximately 70%.  SpRs from the Homerton and Whipps Cross also attend this teaching.

At The London Chest a teaching session is held on site every Friday morning.  There are regular Morbidity/Mortality meetings. 

SHOs attend a bi-monthly all day teaching day, coordinated within the Barts and the London NHS Trust.  The pass rate for Primary FRCA is approaching 100%.

Each trainee is allocated an Educational Supervisor with whom, and/or the Director of Teaching, they can discuss problems etc related to the exam.

Trainees are encouraged to participate in teaching and will be expected to take a role in teaching and audit.

St Bartholomew’s Hospital, West Smithfield, London, EC1A 7BE

Transport, Parking and Accommodation

St Bartholomew's Hospital
St Bartholomew's Hospital

There are limited parking spaces within the hospital grounds (usual Trust charges) and meters in nearby streets.  The nearest underground stations are Barbican, Farringdon, St Paul’s and Blackfriars (allow 15 to 20 minutes to walk).  The nearest mainline stations are Blackfriars, City Thameslink and Farringdon.  Buses 4, 8, 25, 56, 172 and 242 stop outside, or close to the hospital.

Maps and more details of getting to Barts hospital.

Accommodation is available on site or within the Trust.

The London Chest Hospital, Bonner Road, Bethnal Green, London, E2 9JX

Transport, Parking and Accommodation

The London Chest Hospital
The London Chest Hospital

There are limited parking spaces within the hospital grounds (usual Trust charges) and meters in nearby streets.  The nearest underground station is Bethnal Green which is on the Central Line and there is also a mainline station (one stop from Liverpool Street).  Bus No 309 stops directly outside the hospital, but other buses in close vicinity are 8, 26, 48, 55, 106, 253, D3 and D6.

Maps and more details of getting to The London Chest Hospital.

Accommodation is available on site or within the Trust. 

The Royal London Hospital including Barts and The London Children’s Service, Whitechapel, London, E1 1BB

Transport, Parking and Accommodation

The Royal London Hospital
The Royal London Hospital

There are limited parking spaces within the hospital grounds (usual Trust charges) and meters in nearby streets. The nearest underground station is Whitechapel (opposite the hospital). The nearest mainline station is Liverpool Street.  Buses 25, 106, 253, 115 and D3 stop outside, or close to the hospital.

Maps and more details of getting to The Royal London Hospital.

Accommodation is available on site or within the Trust.

Barts and the London Children’s Service

Queen Elizabeth’s Hospital for Children was a well established Unit in the East End of London.  The Hospital was closed in 1998 and the Children’s Services moved to the Royal London Hospital. 

Modules at Barts and The London

Paediatrics

The three month paediatric module at the Royal London is one of the most popular modules in the Schools training programme.  We have eight trainees who work a full shift system.

During your time with us the number of cases you are involved with varies from 220 to 280.  The age range is from neonates up to 16 year olds, covering general surgery, orthopaedics, ENT surgery, eyes, oncology, radiotherapy, dental and anaesthesia for investigations such as MRI and CATS.  Trainees are also heavily involved in the Acute Pain Team and in the resuscitation of children in casualty and on the wards.  There are daily pain rounds and also HDU rounds which our trainees attend.  There are also opportunities to attend the neonatal ward rounds at the Royal London and to attend the PICU rounds at Great Ormond Street.

There are teaching sessions on Wednesday lunchtimes.  We have a monthly morbidity and mortality meeting and there is resuscitation training as well.

At the end of your period with us there is a competency based assessment, which involves three parts:

  1. an assessment of basis and advanced life support
  2. clinical case assessment
  3. summative assessment

Further paediatric training can be done at Great Ormond Street either for six months or one year.

Together with the rotations to Great Ormond Street, the specialist paediatric work at Moorfields and St Andrew’s (the Regional Burns and Plastics Unit) and the paediatric module at Southend Hospital the School is able to offer a very broad based training for those who wish to pursue a special interest in paediatric anaesthesia.

Cardiothoracic Anaesthesia and Intensive Care

This all takes place at the London Chest Hospital and St Bartholomew’s Hospital. We perform approximately 2000 adult cardiac and 400 adult thoracic procedures per year.  The plans are that the two units will eventually merge on the Barts site. 

The London Chest Hospital is a tertiary referral centre for cardiac and respiratory disease.  It is a 109 bedded hospital, with three operating theatres, a 10-bedded cardiothoracic intensive care unit for post-operative care and a 10-bedded High Dependency Unit.  There are also three cardiac angiography labs and a ten bedded coronary care which allows direct access for acute myocardial infarcts.  There is a designated RCA College Tutor for the London Chest Hospital.

St Bartholomew’s is a tertiary referral centre for cardiology, cardiac surgery and oncology with some other specialities.  The cardiac anaesthesia department is staffed by eight cardiac anaesthesia consultants, five consultant intensivists and eight SpRs in training.  It is equipped with 3 cardiac theatres, 15-bedded intensive care unit, of which five beds are for oncology patients, and an eight-bedded High Dependency Unit.  There is also a twelve-bedded coronary care unit and three angiography labs  managed by the cardiology department.  Cardiac surgery is performed by a group of nine cardiac surgeons with a range of sub-speciality interest.  The cardiology department at Barts is world renowned for its expertise in cardiac electrophysiology (mapping and ablation of accessory pathways in the treatment of supra-ventricular arrhythmia).

Cardiothoracic anaesthesia is a key unit of training for SpR Years 1 and 2.  We are commited to providing competency based training and the trainee will be required to pass a workplace assessment at the end of the module.  All trainees will rotate through either of these units for three months in their second year.  We offer all forms of adult cardiothoracic anaesthesia (except transplants) and intensive care.  The training includes pre-operative assessment, cardiopulmonary bypass, intra-aortic balloon pumps, one lung anaesthesia etc.  The trainee will be exposed to echocardiography (transthoracic and transoesophageal) and fibreoptic bronchoscopy.  Post-operative management on intensive care is a vital component.

Further training is available to those who wish to spend a longer period in either hospital during years 3, 4 or 5.  There is ongoing research and audit projects which trainees are encouraged to participate in.

Whilst at St Bartholomew’s in the cardiac module, your training is overseen by the St Bartholomew’s College Tutor.

Neuroanasthesia

SpRs rotate through two months of neuroanaesthesia at The Royal London and can request more experience if required.  There are also links to further neuroanaesthesia at Oldchurch and links can be arranged with Queen Square.

Experience will be provided in all aspects of neuroanaesthesia including interventional neuroradiology, including carotid stenting.  There is a broad range of elective and emergency neuroanaesthesia and registrars will benefit from extensive exposure to traumatic neurosurgery including head and spinal cord injury as this is the largest trauma centre in Britain.  There is specialised neurovascular and neuroendocrine work and extensive exposure to cranial and complex spinal procedures.

All theatres have consultant based elective lists and so there is ample opportunity for theatre teaching.

Audit and research projects are encouraged and will be supervised.

Intensive Care Medicine

Our Intensive Care Units offer considerable experience in the care of complex postoperative cases, cardiac work, oncological work, major trauma patients and neurosurgical patients.  Two of the most popular ITU text books for the FRCA have been produced from this department recently.

There are numerous research projects ongoing and ample opportunity to carry out audit within the department. The Barts & The London School of Anaesthesia offers a superb training in intensive care medicine at both intermediate and advanced levels and is fully recognised for training under the joint intercollegiate (anaesthesia and intensive care medicine) guidelines.

Medical Simulator

A sophisticated, life-size dummy which breathes, blinks, moves and talks is the centrepiece of the Medical Simulation Centre, a state-of the-art training facility for doctors and other healthcare professionals. The Medical Simulation Centre, reproduces as closely as possible the actual experience of treating a patient for healthcare professionals.  www.bartsandthelondon.org.uk/simulationcentre

The London Medical Simulation Centre is in the Basement of our Prescot Street site, near Aldgate station.  Although not mandatory we encourage all our anaesthetic trainees to attend one day per year.

Pain Service

The Barts and the London School of Anaesthesia truly boasts a diversity of pain training from molecules to philosophy.  Acute and chronic pain are well represented at most hospitals within the rotation, with some notable luminaries within the pain world too!

Within the Barts and The London NHS Trust, the Pain Department comprises:

  • An active acute pain team with consultant led ward rounds most days, where a variety of challenges are met, for example, complex abdominal surgery.  In addition, there is a paediatric pain team, who address the specific needs of this group.
  • The chronic pain team (who work in close conjunction with the acute team) provide services for the inner urban area of East London. This unique patient group ensures a diversity of conditions not usually encountered elsewhere.  Regular pain clinics and block sessions are well established and take place most days. There are also combined clinics (psychiatry, rheumatology and spinal surgery), physio led back management programmes, and palliative care and hospice rounds.
  • Research opportunities abound with an active analgesic research unit, and a cross speciality pain interest group, drawing together the skills of maxillofacial, psychiatry, rheumatology and chronic pain.

The School runs a pain fellow programme, which attracts excellent candidates from other schools of anaesthesia.

Outside of the School, pain services are equally impressive.  Of particular note, neurostimulation at Basildon hospital is led by one of the UK opinion leaders in this field, similarly, radiofrequency  lesioning at Whipps Cross Hospital.

For those interested in pursuing a career in pain, or just wishing to sample, the Barts and the London School of Anaesthesia can accommodate your needs.

Further information can be obtained by contacting:

Lucy Hamer, Anaesthetic Training Co-ordinator Barts and The London School of Anaesthesia
Tel:  020 7377 7793 (direct line)
Fax: 020 7377 7216
Email: lucy.hamer@bartsandthelondon.nhs.uk

The Royal London

Dr J McNeill, Chairman - Department of Anaesthesia

Dr S Hallworth, College Tutor – Department of Anaesthesia

Dr D Kennedy, College Tutor - Department of Anaesthesia

  • Tel: 020 7377 7135
  • Fax: 020 7377 7153

St Bartholomew’s

Dr M Pead, Chairman - Department of Anaesthesia

Dr R Bhagrath, College Tutor - Department of Anaesthesia

  • Tel: 020 7601 7518/7519
  • Fax: 020 7601 7520

London Chest

Dr C Broomhead, Chairman - Department of Anaesthesia

Dr S Stacey, College Tutor - Department of Anaesthesia

  • Tel: 020 8983 2445
  • Fax: 020 8983 2252

Consultant Anaesthetists at Barts and The London