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Hospital Trust

King George Hospital

King George Hospital, Ilford is a modern local hospital providing acute and rehabilitation services for the residents of Redbridge and Barking, and a ‘planned care centre’ serving the whole catchment area. It opened on its current site in 1995 and has 450 beds. The hospital is part of the Barking, Havering and Redbridge University Hospitals NHS Trust – one of the largest in the country, serving a diverse population of around 750,000, also operating Queen’s Hospital in Romford. Some commitments occur at Queen’s Hospital. King George has not yet been inspected by the CQC.

King_George_Hospital

Consultant speciality interests

  • Dr Banka – lead consultant, EBUS, sleep medicine
  • Dr Gupta – TB
  • Dr Kumar – EBUS, lung cancer
  • Dr Menon – EBUS, integrated care

The department is well supported with specialist nurses in TB, COPD and sleep.

Meetings

  • Weekly lung cancer MDT
  • Monthly radiology meeting
  • No departmental meeting/journal clubs
  • Mortality and morbidity meetings are rare

Bronchoscopy

  • Training in bronchoscopy is good, with more than adequate experience gained in diagnostic bronchoscopy, including endobronchial biopsy. There is also access to training in EBUS. Transbronchial biopsy is rarely done, and there in no interventional bronchoscopy.
  • This is a good place for training in bronchoscopy for an ST3 or ST4.
  • Training is said to be ‘excellent’ by recent trainees, with protected time for bronchoscopy lists and a dedicated EBUS list.

Clinics

  • General clinics
  • TB clinics

Typical week

Weeks are alternately done at King George (KGH) and Queen’s (QH). During KGH weeks, you have 2 protected bronchoscopy lists, an EBUS list, 3 unselected general clinics and the remainder of time is spent seeing ward referrals. During QH weeks, you are based on the ward. During both weeks, you are expected to attend the lung cancer MDT at Queens’s. On call shifts fall in both QH and KGH weeks. Trainees are expected to prioritise King Georges over Queens so the split between the two is about 80:20.

Procedures (estimated per year done by each Resp SpR)

  • Chest drains: 20-25
  • NIV initiation: 15-20

Pleural USS

  • Dedicated Respiratory department machine
  • Level 2 trained Consultant able to sign off trainees as Level 1 competent
  • Good support for sign-off with trainees reporting no problems in logging cases and being observed
  • A new pleural procedures clinic has been set up at King Georges. Some weeks have no patients, but is likely to offer good training opportunities in the future

GIM

  • GIM acute take shifts are done at Queen’s hospital, Romford. The rota is approximately 1/5.
  • 3 SpRs are on call during the day, 2 at night. Staffing has been chaotic in the past with frequent rota gaps and a high number of admissions. Queens on call shifts were notorious in the past for being a ‘baptism of fire’. However, recent trainees paint a different picture of good management, much fewer rota gaps and a well supported take which is not excessively busy.
  • Lots of experience can be gained at Queens in decision making for acutely unwell patients, and the challenges of managing a large acute care team.

Teaching

  • Observed postgraduate teaching
  • Contribution to PACES which is run at Queens

Management/leadership

  • Rota co-ordination
  • Opportunity to act as lead SpR in running PACES at Queens (quite an undertaking but rewarding and is an opportunity to demonstrate leadership and management skills. Talk to a Consultant for more details – or LJ who has run it a number of times at The Whittington).

Specialist training opportunities

  • EBUS – dedicated list. Great training opportunity.

Research

  • No specific opportunities in this post, but always opportunities for QIP.

Stage of training best suited to this rotation

  • ST3

Recent trainee comments:

“An excellent ST3 placement with good opportunities for learning general respiratory knowledge and skills. Particularly good for procedural sign-offs – bronchoscopy, EBUS, pleural ultrasound. General medicine experience is very busy but useful in learning how to cope with a huge patient volume.”

“Good ward experience in chest drain insertion and pleural aspiration.”

“The pleural USS list is now up and running and often gets 2-3 patients for diagnostic and therapeutic aspirates.”

About drlj

Respiratory Registrar in North East London

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