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The Anaesthetic department provides a service for elective and emergency surgery, intensive and high dependency care, maternity, acute and chronic pain, pre-assessment and resuscitation described in more detail below.

The anaesthetic department currently works a flexible rota; however areas of clinical interest, in terms of clinical theatre sessions, can be agreed.  Fixed days of working can be agreed through the Trusts Flexible working policy.

Theatres

The anaesthetic department at CIC provides anaesthetic services for elective surgery in 6 inpatient, and 3 day surgery theatres, as well as a separate “NCEPOD” theatre and obstetric theatre. 

In terms of emergency cover the department provides anaesthetic services for 24/7 emergency operating theatre, A&E, obstetrics, and intensive care, as well as ventilated patient transfers as required, most commonly to the North East.

ICU

There are 9 bed spaces, including a cubicle, with current staffing for up to 8 patients, admitting approximately 750 patients per year.

The unit has 10 consultants with daytime and on call sessions in ICU. Senior nursing is provided at band 7 and there is a Nurse Educator. Trainee resident staffing is provided by 8 anaesthesia trainees and 2 ACCS trainees from the Northern Deanery.  Further expansion will involve recruitment of 2 trust grade doctors at CT1-2 level working similar patterns to the ACCS trainees. Trainees work a shift system and the additional two trainees will provide dedicated resident cover for the ICU from 0800 hours to 2030 hours seven days a week. Night-time cover is provided by an anaesthetic trainee.

The unit is approved by the FICM for all levels of intensive care training and has a Faculty Board Tutor. The ICU also has a 24/7 band 7 critical care outreach service to facilitate both admission to and discharge from the ICU as well as numerous educational and audit initiatives. ICU consultants and trainees also attend the Anaesthetic division monthly audit meetings.

 Staffing

The department currently comprises 24 full time Consultant anaesthetists, of who 20 participate in 2 separate on-call rotas to cover ICU, and theatres and maternity combined.

There are 8 anaesthetic trainees on rotation from the Northern Deanery across the full range of their training from CT1 to ST6, these trainees participate in an on-call rota to provide one resident anaesthetist in the hospital.

The department currently has 2 ACCS trainees, who are able to provide some additional cover for ICU some evenings and day-time at weekends.  We hope to expand the numbers of ACCS.

Anaesthetic Services

All anaesthetic consultants at CIC work flexibly in time and theatre location, with rotas published 6 weeks in advance.  This enables consultants to maintain their skills across a wide range of specialities. For more complex areas – for example ICU, vascular, upper GI, and major ENT a smaller pool within the body of Consultants with special interests will work flexibly to provide cover for elective lists.  This flexible working enables the department to provide a high quality out-of-hours service across the full range of specialities, including paediatric anaesthesia – as required, despite there being only 2 Consultants on-call.

Surgical specialities 

We provide anaesthetic services for a wide range of surgical specialities from day-case to complex surgery.  Surgical specialities include general surgery, vascular, urology, ophthalmology, obstetrics and gynaecology, trauma and orthopaedics, maxillo-facial, ENT, and community dentals. 

Obstetrics 

There are approximately 1800 deliveries a year at CIC, with a Caesarean section rate of about 28%.  There are 3 elective LSCS lists per week that are staffed by a Consultant anaesthetist. There is an antenatal anaesthetic assessment service, with a clinic once a fortnight.  There is a 24/7 obstetric epidural pain relief service. 

Paediatrics  

Anaesthetic services are provided for straightforward paediatric surgery, mainly ENT and dentals down to an age of 1 year, or 10kg, this, along with CPD enables members of the department to maintain their skills for management of paediatric emergencies that inevitably present. 

Pre-assessment 

The department staffs and supports an active anaesthetic pre-assessment service, with a combination of nurse and Consultant led clinics

Emergency Theatre and Trauma 

There is a staffed emergency list Monday to Friday 08:00-18:00, with a separate staffed trauma list all day 7 days a week.