NW Thames Foundation School
Individual Placement Description
Placement
F2 Renal Transplant & Vascular Access Surgery
The department
The ICHNT RTC brought together the two existing renal and
transplant units within West London previously based at St
Mary’s Hospital NHS Trust and the Hammersmith Hospitals
NHS Trust. Over the previous 10 years, both units
developed extensive networks linked with satellite units
providing outreach dialysis and outpatient services covering
northwest London.
The ICHNT RTC network now consists of 8 satellite dialysis
and nephrology outpatient facilities in Watford General,
Northwick Park, Central Middlesex, St Charles, Charing
Cross, Ealing, West Middlesex Hospitals and the Hayes
Satellite Unit. We also run nephrology outpatient clinics and
provide in-patient renal support for Chelsea & Westminster,
Edgware Community, Harefield, Hillingdon and St Mary’s
Hospitals and provide renal support for the Royal Brompton
Hospital. The St Charles Unit has been expanded to 66
stations in 2010, and the Northwick Park Unit extended by a
further 10 stations.
The ICHNT RTC is a purpose built and state of the art
inpatient renal centre on the Hammersmith Hospital Site,
which opened in November 2005. The centre consists of a
12-bed Level 2 high dependency unit (de Wardener) and 3
other wards (Handfield Jones, Kerr, Peters). Handfield Jones
(21 beds), Kerr (23 beds) and Peters (16 beds) are stepdown wards both managing a mixed case-load of
nephrology, dialysis and transplantation. Kerr ward has an 8bed rehabilitation area for patients after stroke, amputation
etc. A new 18-bed Programmed Investigation Unit has been
opened in April 2011. There is also a 25-station dialysis unit
for higher dependency patients (the Auchi Unit), a clinical
research and therapeutic drug monitoring laboratory (the
Leslie Brent Laboratory), and a rapid assessment unit (open
Monday to Saturday).
A new renal and transplant outpatient facility is in A Block
(50m from the ICHNT RTC] and there is a large, newly
modernized office and secretariat complex on the 4th floor of
Hammersmith House, again next to the ICHNT RTC. The
kidney and pancreas transplant programme are based in the
ICHNT RTC with a dedicated operating theatre within the
main hospital. Most renal and transplant laboratory research
is carried out within Imperial College facilities on the
Hammersmith site and the clinical, translational research is
based in the Leslie Brent Laboratory in the ICHNT RTC. The
unification of renal and transplant services around a central
base at the Hammersmith site brought together a highly
skilled multi-professional team pooling together the
considerable amount of existing expertise.
This clinical service draws upon best practice from the
previous constituent units enabling the development of
common protocols. The configuration of the service allows all
patients in West London access to sub-specialist expertise
where necessary. Critical clinical mass, an important factor
for quality, particularly in transplantation, is being achieved
and a centre of excellence has been created in West
London, which has the highest incidence of end stage renal
failure in the United Kingdom.
Trust & Site
Imperial College Healthcare NHS Trust - Hammersmith
Hospital
The type of work to
expect and learning
opportunities
The post holder will work under the direct supervision of the
Consultant – Mr Jeremy Crane
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Excellent exposure to both renal and pancreas
transplantation
Clinic and theatre time for vascular access (AV
fistula) surgery
Opportunity to learn how to place central venous
catheters for dialysis and peritoneal dialysis
catheters
Live related transplant work-up clinic
Community exposure with visits to satellite dialysis
units with Mr Crane
Opportunities to learn duplex ultrasound
Be a part of a genuine MDT clinical environment
F2 to be very involved in the vascular access audit
and there is huge scope to be involved in associated
research.
There is a weekly seminar (Thursday pm) usually conducted
by an outside invited speaker, a weekly renal staff round and
research forum (Thursday pm), and a hospital grand round
(Wednesday lunchtime). Additional, optional, research
seminars are run on Thursday mornings.
The ICHNT RTC has a formal Radiological and Pathological
MDT on Wednesday mornings, a biopsy review meeting on
Thursday afternoon and a case review on Thursday
evenings.
There will be absolute priority for the F2 to attend Foundation
teaching and to constantly update their e-Portfolio
Clinical
Supervisor(s)
for Mr J Crane, Prof V Papalois, Prof N Hakim
the placement
Inpatient care of the renal and pancreas transplant patients.
Main duties of the
Inpatient care of renal patients with surgical problems.
placement
Inpatient care as part of multidisciplinary care with the renal
physicians. Be present in clinics, particularly on Friday at the
very dynamic ‘one-stop’ vascular access clinic. Visiting
dialysis patients in the community satellite units.
Typical
working There are theatre lists running every day that are manned by
pattern
in
this the 5 registrars. The F2 will be supernumerary in theatre and
can attend where learning opportunities are present.
placement
Monday
am. Grand round
pm.Theatre
Tuesday
Alternate vascular access/urology theatre
Wednesday
Am. MDT x ray meeting, outpatients – live related pairs
Am/pm alternate week fistula lists
Thursday
am. Visiting satellite units
pm grand round education/MDT
Friday
Vascular access one-stop clinic
On Call Commitments:
on-call with the renal team admitting renal patients, no
nights.
Employer
information
The employer for the post is Imperial College Healthcare
NHS Trust www.imperial.nhs.uk
It is important to note that this description is a typical example of your placement and may be
subject to change.