Princess Alexandra Hospital

The Princess Alexandra Hospital is a 489 bedded District General Hospital in Harlow, with a centrally located Costa! There is one 28 bed respiratory ward which is split between two consultants and their teams. Currently there are two SpRs (the other being from East of England Deanery). The latest CQC rating was “inadequate“, although it was rated “good” in the domain of ‘caring’.

Consultant speciality interests

• Dr Naik (lead respiratory consultant): pleural procedures
• Dr Russell: lung cancer
• Dr Ekeowa: lung cancer (runs MDT)
• Dr Anwar (clinical/educational supervisor): TB

The department also has two supportive respiratory nurses

Meetings

• Weekly lung cancer MDT (Monday evenings)
• Weekly radiology/ILD meeting (Thursday lunch)
• Weekly departmental meeting (Monday lunch – with sponsored lunch)
• Monthly TB meeting
• Mortality and morbidity meetings from time to time

Bronchoscopy

• There is a bronchoscopy list every Wednesday morning (usually 3-5 bronchoscopies) which you do on alternate weeks

Clinics

• All clinics are general respiratory clinics

Typical week

• Monday: Ward Round, Departmental Meeting, Referrals, MDT
• Tuesday: Clinic, Referrals
• Wednesday: Bronchoscopy (alt. weeks) / Ward Round, Clinic (alt. weeks) / Referrals
• Thursday: Ward Round, Radiology Meeting, Ambulatory Care pleural procedures
• Friday: Ward Round, Referrals

Procedures (estimated per year done by each Resp SpR)

• Chest drains: 30-40
• NIV initiation: 0 (all go to HDU)

Pleural USS

• The Respiratory Department does not have a dedicated USS machine, but a machine is on almost permanent loan from the clinical skills centre
• There is no clear process or named person to get level 1 sign off

NIV

• There is no ward based NIV. Patients have to go to ITU/HDU so there is little experience for Resp SpRs here.

GIM

• GIM acute take shifts are busy but well supported with juniors that are rostered to come & go throughout the day. Currently a nurse takes the referrals from 9-6pm and, as she has done this for many years, she is very strict and also streamlines referrals well. She alerts you to any resus patients immediately and queries any concerns she has with you or the acute take consultant. On average weekday take is 40-60 with a further 20 overnight. At weekends numbers are reduced.
• The on-call SpR is alone during weekdays and nights (covering both take & wards). During the weekend days there is an additional ward SpR (and sometimes a discharge SpR).

Teaching

• There are opportunities to teach juniors & medical students

Management/leadership

• No specific opportunities highlighted

Specialist training opportunities

• General respiratory training, with no specific specialist opportunities highlighted

Research

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

Stage of training best suited to this rotation

• ST3/4

 Recent trainee comments:

“The best thing about the hospital is that it is a small & friendly place. The worst thing is there is no ward based NIV (patients have to go to ITU/HDU so little involvement from Resp SpR) and car parking is a nightmare (arrive 40 minutes early every-day and you’ll be ok).”