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  • Present

  • Consultant General Surgeon
    Special interest in Day and Short Stay Surgery in children and adults, including minimally invasive (Laparoscopic) surgery
    North West London Hospitals NHS Trust

  • Associate Specialist

  • General/ Ambulatory/Vascular Surgery 1.08.1996-31.03.2004

    During this post I ran two clinics on my own, one General and vascular surgery clinic with my Consultant and one General and Paediatric surgery clinic for patients suitable for Ambulatory surgery and short stay surgery. I had four operating lists a week, three were done by myself independently and one with the consultant during which we did the major vascular reconstructions. My independent lists were for day and short stay surgery during which I undertook operations like hernia repair (open and Laparoscopic), including those in children, orchidopexy, orchidectomy including synthetic implants, cholecystectomy mainly laparoscopic and open if necessary, haemorrhoidectomy, fistula operations, pilonidal sinus surgery, lateral sphincterotomy, primary and recurrent vein surgery. I am well trained in the art of majority of the surgical techniques that fall in the field of a general surgeon. In addition, I was on call for General Surgery once every week and every 6th weekend. We also provided cover for colleagues on holidays. I provided cover for Emergency lists once a week. These are run as CEPOD lists. During my on call commitment I looked after all the surgical patients admitted and on regular basis performed operations like repair of perforated duodenal ulcer, bleeding D.U, strangulated hernia, colonic and small bowel resection, primary anastomosis with or without the use of stapling guns, exploration of torsion testis, embolectomy, repair of leaking aortic aneurysm, toe, transmetatarsal, B.K and above knee amputation and deal with trauma patients.

    In the last five years, I have maintained less than four weeks waiting time for all paediatric surgical patients and the urgent patients particularly with breast lesions. I undertake over 70% of the Trust’s Day and short stay surgical work, besides doing some of the major general surgical and vascular operations. My work is well recognised for its neatness, extremely low complication and admission rate and speed. I regularly presented my work audit at local surgical meetings.

    In 1990, I started the First Day Surgery unit at NWLH. This possibly was the first in the NHS
    I showed a saving of nearly £400,000 in less than six months by doing operations conventionally done as inpatients, in the Day Care Unit, with a very high level of patient and GP satisfaction and very low levels (well below national average) of infections and complications.

    In May 2004, I started a ‘Walk In Walk Out Hernia clinic’. Working with the local General Practitioners and based on a fixed Performa, I have arranged for the patients to be sent directly to my clinic, where they are examined, have their assessment done by a dedicated nurse, have their operation under local anaesthesia and go home by the afternoon. This is the First such clinic in the National Health Service in the United Kingdom, where patient have been given a chance to book their own appointment and make only one visit to the hospital for consultation assessment and operation and have their operation done under local anaesthetic. It has significantly reduced the administrative workload, cost on posting letters, DNA and last minute cancellation rates and waiting time for the patients to be seen in the clinic and then the wait for the operation date. This I feel will reduce the workload on other General Surgical clinics and by doing these operations under Local Anaesthesia; I will be able to reduce some of the extra load on the Anaesthetic Department and inpatient beds. I intend to use this clinic to train Scrub Technicians, medical students, SHO and registrars in the art of Day Surgery. I aim to save a significant amount of money for the trust by treating hernia patients in this clinic, besides giving patients the choice and reducing waiting list and waiting time.

  • Consultant Accidents and Emergency

  • Northwick Park Hospital, Harrow 30.5.1993-31.7.1996

    Due to the pre-mature retirement of the previous Consultant, I was appointed Honorary Consultant in A&E department of Northwick Park Hospital. I had to reorganise the unit as the morale of the doctors and the nursing staff was very low, the expenditure on agency locums was very high and patients had to wait for up to 2 hours for triage by a nurse and the number of complaints were at an unacceptably high level. With the help of the senior nursing staff and involvement of all in the Department, I was able to organise and initiate a teaching programme and introduced a Nurse Practitioner in the unit to see to the minor cases. Once I had gained the confidence of the staff by working alongside them, I was able to reduce the need for Locum doctors and nurses by nearly 60% and the triage time to less than 5 minutes within a year. The complaints fell to 15% of their original level. I reduced the level of written, time-consuming complaints by talking to the patients or the relatives within the department and resolving the majority of the problems on site, so that the patients left satisfied without a need to write a complaint. Once the new consultant was appointed I continued to work with him, until he had settled in the unit. Although very challenging, this job added a great deal to my experience in the management of acute medical and surgical patients and gave me an insight into the management aspects and running of a unit effectively and efficiently.

    Staff Grade Surgeon 15.9.1990-30.5.1993
    To Mr J D Lewis FRCS
    General/Vascular/Day Surgery
    Northwick Park Hospital, Harrow

    Registrar to Mr J D Lewis FRCS 1.10.1988-14.9.1990
    General and Vascular Surgery
    Northwick Park Hospital, Harrow
    I gained most of my advanced vascular surgery experience during this post, which I have continued to use and advance further. As my consultant Mr J.D.Lewis was mainly interested in Vascular surgery and I had shown that I was and am a safe and competent surgeon, I was allowed to do majority of elective and emergency general surgical, paediatric and vascular operations including embolectomy and leaking abdominal aortic aneurysm surgery. The reference to this aspect of my work can be best obtained from the Consultant Anaesthetist who had watched me operate during that period and since, both on elective and emergency cases, as Mr Lewis unfortunately passed away a few years ago. From the time Miss Renton took over the job as a Consultant, I have been working under her supervision.

    Registrar to Mr J Lennox MS FRCS 1.10.1985-30.9.1988
    Mr D M Hancock FRCS and Mr A. Warrington FRCS

    General Surgery with special interests in Colorectal, Vascular and Upper G.I surgery
    Sunderland District General Hospital

    Research Registrar to Prof. A Cushieri 1.4.1984-30.9.1985
    And Mr A D Irving MRCP MS FRCS (Ed) FRCS
    Ninewells Hospital and Medical School
    Dundee, Scotland

    Registrar to Mr J. MacIntyre FRCS 15.3.1981-30.3.1984
    General Surgery with special interest in Gastrointestinal Surgery
    Perth Royal Infirmary, Perth, Scotland

    Visited India on annual leave 1.1.1981-14.3.1981

    SHO to Mr W W Wilson FRCS 1.7.1979-31.12.1980
    And Miss K Fussell FRCS
    General Surgery with special interest in Breast and Endocrines
    Wigan Royal Infirmary
    I passed my part II of FRCS during this post in November 1979)

    SHO to Mr M Bromley FRCS 1.1.1979-30.06.1979

    General and Vascular Surgery
    St Mary’s Hospital, London

    SHO to Mr A Benjamin FRCS 1.11.1977-31.12.1978
    And Mr M Sullivan FRCS
    Accidents and Emergency and Orthopaedics
    Watford General Hospital, Watford
    (I passed my part I FRCS during this post in November 1978)

    Resident Registrar/Post-Graduate Student 15.7.1975-14.7.1977

    Department of Surgery
    Irving Hospital, New Delhi
    During this post I was a Junior Resident in Accidents and Emergency, Burns and Plastic Surgery, Paediatric Surgery, General Surgery, Urology, Cardio thoracic Surgery and Orthopaedic Surgery. During this period, I gained the main clinical and surgical skills in the management of acute and elective surgical patients.

    Resident Registrar 1.3.1975-14.7.1975

    Dr N S Dixit MRCP and Mr R P Gupta MS FRCS FRACS
    Cardiology, Cardio thoracic Surgery and CCU
    Sir Ganga Ram Hospital
    New Delhi

    During this post, I learnt the management of Acute cardiac patients, assisted in cardio thoracic surgery and managed the post-operative patients.
    Prepared for the entrance examination for M.S 1.1.1975-28.2.1975

    SHO to Prof. S K Nair 1.7.1974-31.12-1974
    General Surgery
    Irving Hospital, New Delhi

    SHO to Prof P Padmawati 1.1.1974-30.06.1974
    General Medicine and Cardiology
    Irving Hospital, New Delhi

    I qualified and obtained my basic medical and surgical training at Maulana Azad Medical College and Irving Hospital in New Delhi. It is the biggest teaching hospital in South East Asia with nearly 3000 beds and serving a population of over 10 million people. It provides all the medical and surgical services besides encouraging clinical and experimental research in well-staffed and equipped laboratories.

    Rotating Internship (House Officer) 1.1.1973-31.12.1973
    General Surgery, Burns and Plastics 3 months
    General Medicine and Cardiology 3 months
    Obstetrics and Gynaecology 2 months
    Anaesthesia and ITU 2 months
    ENT and Ophthalmology 2 months