High Quality Service Delivery
- Setting up and developing a dedicated colorectal surgical team
- Setting up a Rapid Access One Stop Colorectal Clinic
- Lead Clinician for Colorectal cancer since 1997 and set up a multi-disciplinary team
- Provision of a modern and effective colorectal service for the local population with recognition at local, regional & national level. Some of the evidence for this includes: Reduction in:
operative mortality from 11% to <3%, anastomotic leak rate from 9% to 1%, permanent stoma rate from 55% to 29%, median length of stay in hospital from 10 to ≤ 2 days in some selected laparoscopic cases), reduced waiting times, Increase in detection of early cancers from 10% to 22 %, All RCS Guidelines met or exceeded – (validated and published data).
- Specialist Laparoscopy – one of few surgeons in the UK providing laparoscopic surgery for over95% of colorectal cancer patients and recognised by the Royal College of Surgeons as a Preceptor
- Clinical Lead and Director for Cancer Services (1997-2004), provided clinical leadership for the management of cancer services in the Trust- meeting all required standards and improving services across all specialities.
As Clinical Director
- Improved clinical governance arrangements.
- Achieved consistently high levels of performance in external assessment processes of risk management such as the HIW and WRP assessments.
- Improved clinical incident reporting awareness across all grades of staff.
- Introduced major changes in service provision in General Surgery and T&O including the introduction of the Surgeon of the week, Assessment Unit, Formal Pre-operative assessment service, re-structuring of the elective/ emergency workload, introduction of structured compliant junior doctor rotas without compromising ‘team working’ and continuity of patient care, etc.
- Expansion in the role of various specialist nurses.
- Achieved significant expansion of staff and services in various departments including consultant, junior doctors and senior nurses.
- Established collaborative links with Powys LHB and other neighbouring LHBs.
- Improvements in Day Surgery rates, LOS, Theatre utilisation, maximising bed utilisation etc. All waiting list targets met with minimal waiting list initiatives.
- Improvements in Human Resource utilisation.
- Implementation of Shared (pooled) waiting lists across all specialities.
- Achieved annual under-spend helping to mitigate the effects of Trust deficit.
- Extensive involvement and time commitment around implementation of the Amended Consultant Contract and Consultant Appraisals and Job plans.
- Extensive involvement around Trust integration & reconfiguration of services and the future service provision in the Trust and the Region
- Established laparoscopic cholecystectomy in the Trust – January 1997.
- Established a combined multi-disciplinary clinic with oncologist – Feb 1998.
- Established Laparoscopic surgery for colorectal disease – April 1998, (One of earliest centres in Wales & UK – published data).
- Establishing Nurse-led colorectal clinics (first in the UK – published data).
- Led the cancer services in the Trust from 1997 to 2005
- Fund Raising Examples include: Equipment (>£50,000) for the 1 stop clinic, negotiated sponsorships >£750,000 for clinical and research activities, Successful Capital & Revenue bids for >£1M for cancer services, Secured charitable funds for dedicated cancer services facility (£1.7M).
Managing Health Care Delivery
- Chair of various Medical Education & Revalidation committees – since 2013
- Deputising for Medical Director
- Chair – South East Wales Colorectal Cancer Network (2002 – 2006).
- Chair – Trust Cancer Services Strategy Group (1997 – 2004).
- Chair – Elective & Emergency Theatres Working Group.
- Chair – Surgical and Medical Products Advisory Group (1997 – 2000)
- Chair of various committees within the Combined Surgical Directorate (2004 – 2008).
- Chair of the ‘Prevention of Surgical Complications’ work stream of the 1000 lives campaign (2008 – 2010)
- Various National committees for Medical Education, Revalidation, etc. – since 2013
- The All Wales Colorectal Cancer Steering Group (2002 – 2007).
- Advisory Sub-committee for Surgery (Wales) – 1997 to 2009
- All Wales Laparoscopic Colorectal Surgery Steering Group – 2008 to date
- Trust Executive Board (2000 – 2008).
- Trust Research and Development Committee – 1998 to date
- Cancer Services Advisory Board Bro Taf (1998 – 2003).
- Endoscopy Users Group – 1997 to date
- Audit & Clinical Effectiveness Committee (1997 – 2001)
- Chair various Education Boards and Committees as Assistant Medical Director (Education) – since 2013