Part 1 to be completed by the applicant Forename:

Transcription

1 ACCEA FORM A (Application Form) Employer-Based Award CLINICAL EXCELLENCE AWARDS SCHEME APPLICATION FORM 2012 Round It is the consultant s responsibility to ensure that this form is fully completed all boxes to be completed Surname: Grunshaw Employer(s) name(s) with number of sessions per employer (Lead NHS employer first) University Hospitals of Morecambe Bay NHS Trust 11PA Part 1 to be completed by the applicant Forename: Professional Title: Nigel Dr List of consultant appointments in date order Consultant Radiologist University Hospitals of Morecambe Bay NHS Trust 25/7/11- Consultant Radiologist Co Durham and Darlington NHS Trust 03/02-17/07/11 Consultant Radiologist Airedale General hospital NHS Trust 06/99-10/01 Consultant Radiologist Furness General Hospital NHS Trust 12/93-05/99 Application type: Level applying for: New CEA Level 5 Accredited Specialties (main first) Radiology Year appointed to the consultant grade 1993 Primary Medical Qualification (Date and Institution) MBBS 1983 University of Newcastle upon Tyne Current level CEA LEVEL 4 Year awarded 2008 Ethnic origin British GMC/GDC Reg No Work tel (Direct Line) Subsequent Qualifications (Date and Institution) MRCP 1986 RCP FRCR 1991 RCR FRCP 2009 RCP Preferred address for correspondence RADIOLOGY DEPT FURNESS GENERAL HOSPITAL You cannot fill this form out without using the Guide to the Scheme, to which you must adhere strictly PERSONAL STATEMENT Give up to four examples that summarise your achievements. These should be since your last award. (Box limited to 1350 characters). In 20 years as a Radiologist I have developed and maintained high quality services valued by clinicians and patients. My previous work in my first appointment had major impact on patient care including developing Cumbria s first MRI /interventional radiology and ERCP service though these acheivements were not recognised by the awards system I am committed to proactive problem solving to improve diagnosis. I believe in clear prompt communication to clinicians and patients and that the essence of effective imaging is a multidisciplinary team approach I have maintained my track record of introduction and innovation of new techniques to improve patient diagnosis and management. I deliver high quality services despite severe staffing shortages working flexibly to provide interventional / fluoroscopic procedures and ultrasound outside my job plan to maintain patient care My work with Gastrointestinal ultrasound is recognised nationally 4 Acheivements Scientific organising committee member /session organiser / lecturer British Medical Ultrasound Society 2013 Plenary session organiser / invited lecturer BMUS/ Euroson Edinburgh 2009 (Europe's premier ultrasound meeting) Organiser of 4 national ultrasound training courses in GI ultrasound. Obtained funding for ultrasound probes to introduce small bowel ultrasound to the Trust 1

2 JOB PLAN List agreed programmed or other activities relevant to the NHS. The Plan should itemise the number of remunerated direct clinical care PAs, the number of remunerated supporting PAs (SPAs), the number of other remunerated sessions / PAs for activities described in this application with a description of what these are, and also list unremunerated activities. (Box limited to1350 characters). I have an 11 PA contract split into 9 direct clinical care PA's including 1 PA for on call and 2 Supporting Professional activities. My DCC sessions are split across a number of modalities and vary weekly due to the needs of the service but broadly split into a mixture of sessions in Ultrasound plain film reporting CT MRI nuclear medicine fluoroscopy and intervention. By splitting sessions I manage to cover multiple modalities allowing more flexibilty at a time of staff shortage I provide Radiological cover for both Upper and Lower GI MDT's. I provide 1 st on call with no junior support on a 1:16 rota for acute radiological investigations. I attend Governance audit and Departmental meetings. I provide regular teaching for medical students and supervise SAMP student attachments.i have additional roles as a Consultant appraiser and Imaging Governance Lead for FGH I am directorate Managed service lead and missed fracture task group member. These roles are outside of my job plan. Though my job plan is based on 4 working days I frequently attend work outside of this in delivering other roles. I also regularly work nationally for the British Medical Ultrasound Society as faculty member and scentific organising comittee member. I deliver national training courses in GI ultrasound these roles are all outside my job plan. Domains If you are applying for levels 1-9 you can include additional information for Domain 3 OR Domain 4 OR Domain 5. Please provide additional information for one domain only. DOMAIN 1: DELIVERING A HIGH QUALITY SERVICE (see Guide) (Box limited to 1350 characters). Departmental data demonstrates that my reporting figures for all modalities exceed national benchmark standards being almost double the expected numbers in CT Bowel cancer peer review shows that I report the highest numbers of colonography in the Trust. Feedback from the peer review was highly complementary of procedural techniques patient preparation and patient orientated service Completed audit of 8 years ultrasound in equivocal acute RIF pain shows reduction in false negative appendicetomy to 3% amongst the lowest rate reported worldwide significantly improving patient care by reducing unnecessary operations and CT scans Audit of my percutaneous gastrostomy service demonstrates no procedural mortality and only 1 minor procedural complication with only 1 replacement tube required in line or better than national standards Gatropexy related pain was in line with expected results but has led to post procedure change Completed audit of percutaneous ultrasound guided biopsies has demonstrated no significant complications, 0% bleeding rate (<3% expected) with minor procedural pain rate of just 13% well inside the 30% expected from international data with diagnostic accuracy in line with published data In my pevious post external audit of MRI reporting indicated my accuracy was only 1 of 2 of 10 acceptable to the provider 2

3 DOMAIN 2: DEVELOPING A HIGH QUALITY SERVICE (see Guide) (Box limited to 1350 characters) I introduced small bowel ultrasound by obtaining charitable funding to purchase 2 additional ultrasound probes. This allows rapid non invasive assesment of Crohns and other small bowel diseases and is one of only 3 UK centres offering this service. This has improved throughput allowing 300+ cases / year and is 4 times quicker than other techniques such as MRI with improved patient acceptability whilst maintaining accuracy I developed ultrasound for appendicitis allowing rapid non invasive diagnosis reducing need for CT scanning. Audit demonstrates reduced negative appendicectomy to < 3% and CT use <14% I introduced contrast microbubble ultrasound for assessment of liver lesions in patients unsuitable for MRI and provide information in conditions such as bowel ischaemia I modified patient preparation for CT Colonography introducing faecal tagging to improve diagnosis in line with national guidelines and introducing hybrid tagging providing more gentle colonic cleansing in the frail patient I introduced a percutaneous gastrostomy service allowing feeding in patients unsuitable for endoscopic insertion due to oesophageal obstruction or respiratory compromise I have introduced procedure forms for intervention to improve peri procedure care and safety I developed local IBD MDT to improve patient management DOMAIN 3: MANAGING AND LEADING A HIGH QUALITY SERVICE (see Guide) (Box limited to 1350 characters) If a candidate at any national level completes form F to illustrate their leadership and management achievement it is not necessary to fill in domain 3; simply enter see form F. As Lead Radiologist in my previous post I pioneered the development of weekend working to provide seamless consultant cover at weekends - this was well received at board level and became a core element of the Radiology redesign process for 7 day working I improved primary care links visiting GP practices updating the best use of Radiological services using an interactive seminar based approach, excellent feedback received I developed a nurse led follow up service for interventional procedures improving care and providing closer links between Radiology and the Wards I instituted Radiographer skill mix in to the Videofluoroscopy Service to improve access more effective use of Consultant sessions and improved the liason with dietetic service for gastrostomy patients extending role of Radiology nurses to provide a seamless placement and follow up service My current roles include Imaging Governance lead at FGH, I have introduced primary radiographer vetting for CT and MR by protocol freeing up consultant time reducing delays and improving saftey by preventing duplicate examinations I introduced post surgical take imaging review to triage patients for investigation and to review scans I mentored development of Radiographer led Barium swallow service freeing up Consultant time providing a more flexible service 3

4 DOMAIN 4: CONTRIBUTING TO THE NHS THROUGH RESEARCH AND INNOVATION (see Guide) (Box limited to 1350 characters) If a candidate at any national level completes form D to illustrate their research achievement it is not necessary to fill in domain 4; simply enter see form D. Since my last CEA I have completed an 8 year retrospective review of the primary use of ultrasound in equivocal RIF pain. This has demonstrated reduction of false negative appendicectomy rates to 3% in the imaged vs 19% in the non imaged patients. These are amongst the lowest figures ever reported worldwide. This has significant implications for patient management by reducing unneccessary operations and shortening hospital stays. This work has been presented at Europe's premier abdominal radiology meeting- European Society of GI and Abdominal Radiology (ESGAR) currently being written up as a paper. I have also presented the results of a review of efficacy and safety in CT Cholangiography at a major international meeting - ESGAR 2009 this was very well received and demonstrated excellent diagnostic utility and safety profile providing diagnostic scans even in the presence of abnormal liver function in patients unable to undergo MRI. I have presented a poster at British Medical Ultrasound Society on clinical utility of Ultrasound in right iliac fossa pain. I was invited to submit a review article 'Ultrasound of the acute right iliac fossa' RAD Nov 2013 Abstract accepted Association of surgeons of Great Britain and Ireland - Use of ultrasound in clinically equivocal appendicitis - pilot results from a DGH 2014 Within the last 5 years, indicate how many publications you have had, how many of these were in peer reviewed journals and list the 3 most important ones. No other text is allowed. (Text limit 1350 characters) Ultrasound in clinically equivocal appendicitis: the real world experience: N.D. Grunshaw, P.L.S. Cheong ESGAR 2012 Vol 3 Suppl 2 May2012 Ultrasound in Clinically equivocal RIF pain British Medical Ultrasound Society (poster) N D Grunshaw P L S Cheong Brighton May 2010 Safety and Efficacy of CT Cholangiography: KP Lim N D Grunshaw ESGAR 2009 European Radiology Vol 19 suppl2 s658 DOMAIN 5: CONTRIBUTING TO THE NHS THROUGH TEACHING AND TRAINING (see Guide) (Box limited to 1350 characters) If a candidate at any national level completes form E to illustrate their teaching and training achievement it is not necessary to fill in domain 5; simply enter see form E. I teach 4th yr medical students in plain film/ ultrasound / intervention. Feedback excellent rated 9-10/10 SAMP student supervisor for Radiology, despite workload pressures excellent feedback last student now wants to become a Radiologist! Course organiser / senior lecturer 'Introduction to bowel ultrasound ' UK s only Bowel ultrasound training course which I devised and developed oversubscribed with excellent feedback Invited Lecturer: BMUS Summer School York June 2009 Northern Regional IBD group -' Imaging in Crohns Disease' June 2010 Plenary session organiser / lecturer US of the bowel BMUS / Euroson 2009 Edinburgh responsible for session design /speakers at Europes premier ultrasound meeting. Fantastic feedback lecture theatre full delegates locked out! Co organiser / lecturer BMUS Summer School Darlington June Lectures + practical workshops 4

5 Faculty member BMUS Sept 2010 Brighton - Abdominal workshops Organised training at FGH for SPR from the Leeds Radiology training scheme giving practical training in bowel ultrasound unavailable in Leeds Member scientific organising comittee BMUS Organised GI plenary session for the UK s premier Ultrasound conference 3 lectures and live demos fantastic feedback received! Visiting lecturer University Leeds Verification of Completion I declare that to the best of my belief this information is accurate and I am not aware of any disciplinary or professional conduct and performance issues against me Full Name Signature : (The applicant needs to print a hard copy, which needs to be signed and retained.) Assessment by domain For each of the domains please indicate your assessment of the candidate in terms of contribution to work for the primary employer and the wider environment of health care locally, eg in the SHA or Deanery. You are not asked to judge national or international contributions, for which ACCEA will receive advice separately. X No contribution in this domain U Has not delivered contractual obligations at a level expected C Delivers contractual expectations at a level expected P Some aspects of delivery have been clearly over and above expectations E Outstanding delivery of service Domains Please give your reasons if you have marked any domain U, P or E (box limited to500 characters) 5

6 GIVE YOUR ASSESSMENT OF THE CANDIDATE OVERALL FOR THIS LEVEL OF AWARD (Please give your reasons for your assessment of the candidate box limited to 500 characters) a) Is the consultant to the best of your knowledge working to the standards of professional and personal conduct required by the GMC and/or the GDC? Has the consultant during the last 12 months b) had a formal appraisal c) agreed his/her job plan d) fulfilled his/her contractual obligations e) complied with the private practice code of conduct? f) Are you aware of any actual or potential disciplinary or professional proceedings inside or outside the Trust? If the answer to (a-e) is No or the answer to (f) is Yes, further details must be supplied. (Box limited to about 500 characters) Name of person completing this form: Position Held: I, as Chief Executive, certify that the contents of Part 2 are accurate. The comments represent the considered opinion of the employer. Chief Executive Name: Direct Line tel: Direct address: Date: Chief Executive of: Signed by Chief Executive Note to Chief Executive: Please sign personally and date the copy which the candidate will retain. 6