This website is designed primarily for patients. Patients often ask for information about their treatment, and it can be difficult for surgeons and their secretaries to provide answers about anaesthesia. I hope this site resolves this problem and invite you to give the site address to your patients as early as possible
If we have not worked together before, a little bit about the practice. I have been a consultant at Barts since 1986 and in private practice for the same length of time. I can be contacted 24 hours a day - please ask for my direct numbers. I am happy to receive bookings by email, fax or telephone, whichever is easiest for you..
I do not work in an agency or group - I believe patients value a one to one service and like to know the name of their anaesthetist in advance. I recognise that your secretary does not like making multiple calls, so I will be happy, if you wish, to try to find someone else if I am unavailable, using a list of colleagues whom I am happy to recommend.
I always see patients on admission and whilst in hospital - if patients need ITU, I provide this personally. In my experience, this produces not only a good outcome but also a content patient.
Please ask patients to visit this website at booking. We can send you compliment slips to enclose with your letters. Although UK insurers still prevent the universal anaesthetic preassessment now commonplace in the NHS, they will meet the costs of preassessment for patients with specific questions. This website uses a questionnaire to identify patients who need preadmission workup. Frequently it can be undertaken on the day of admission, and I will be pleased to do this myself. If you have a patient with significant concommitant disease, a brief email or telephone call will enable me to sort it out.
Some of you have asked for guidance on investigations. In general, fewer and fewer patients need any investigations, although I do ask for an ECG over 40. We no longer undertake routine sickle testing unless there is a personal or family history of sickling. There is a link on the left to my chart which gives you all the information you will require.
For oncologists and physicians
The most common request I receive is for lines and other vascular access, although I am happy to help with enteral feeding and sedation for investigations. Please also contact me for intensive care or ward management.
Lines are most commonly used for chemotherapy link but other uses include longterm antibiotics for SBE and orthopaedic infections, dialysis lines for renal failure and plasmapheresis plus short term coated lines for poor access. The last two can be inserted in a patient's room under sedation and the short term lines are particularly successful for access for 2-4 weeks.
All lines are inserted using ultrasound - no exceptions because this is the only safe method. We have complete sets which simplify line insertion on the floors and if lines are inserted in theatre, I will make all the arrangements.
If a patient is not in hospital, I will make contact and explain the procedure in advance. I try to insert lines to fit in with your treatment, but if the patient does not have treatment on the day of insertion (for example if they are having outpatient chemotherapy) all hospitals allow admission in my name - I realise you too are busy so once we have a name and time we try not to bother you again.
Patients are sent home with the line booklet and their X ray. Line patients also get flushing instructions and Ann will arrange for them to come back to out patients or the hospital according to your preference. I am always happy to see the rare patient with a line problem, and finally I will arrange to remove the device when you no longer need it.
Several years ago I was asked to set up an anaesthetic service for radiotherapy at the Harley Street Clinic, building on my experience at Barts. This has been particularly successful and we regularly have several children undergoing radiotherapy under general anaesthetic. The Harley Street Clinic has superb facilities, including paediatric nutritionists and play leaders. The paediatric ward, Linac and recovery are all adjacant. A paediatric ITU is reassuring although we have never needed it.
Once again I try to provide a total service. I will liase with the radiotherapy team to set a timetable for planning and treatment. Children are normally allowed out each day.
We have had several adolescents who have done well with sedation, as well as an occasional adult patient with claustrophobia. Sometimes we are able to wean the anaesthetic when children become confident enough to be treated awake.
For embassies and overseas institutions
I welcome referrals relating to overseas patients. Most referrals are for intensive care treatment. I use the London Clinic www.thelondonclinic.co.uk which has a modern ITU and on site trainee doctors. I am able to call on trusted colleagues from every specialty to provide a comprehensive programme of care for the critically ill patient.
The improvement in medical facilities overseas makes local treatment increasingly feasible. I am happy to provide a second opinion be it by fax or telephone, or by travelling to see the patient, normally over a weekend.
Through my appointment at St Bartholomew's Hospital, I run Careflight, the UK's only dedicated interhospital ITU service which transfers patients worldwide. I am able to review patients to see if they are fit to fly by scheduled aircraft, arrange ground transportation and air ambulances. If you are considering medical or surgical treatment abroad, I can help identify the most suitable doctors, nurses or paramedical staff and advise you on the best way forward.