Welcome to the ENT department at the Countess of Chester Hospital, we hope you find your experience with us to be enriching and educational.

Contributions and acknowledgements

Dr Laura Roberts

The Department

The ENT offices can be found in OPD4, ground floor, with clinic directly above on the first floor

Consultants – when in hospital, can be found in clinic, theatres or downstairs in ENT offices

Mr Robert Temple (contact via his secretary Sarah Growney on secretary.mrtemple@nhs.net or ext 6374)

Vacant post ( secretary Elaine Nickson on secretaryto.mrtahery@nhs.net or ext 6322)

ENT Specialists:

Mr Usama Alkhaddour

Mr Kalyan Chakravarthy

Mr Georgios Charalampidis

Other members of the team:

2 Registrars, 2 F2/ CST level

Secretaries:

Sarah (Temple)

Ann (Luff)

Elaine()

Margaret

Pat

Sue

Clinic Staff:

Nurses - Marie, Andrew, Maria, Naomi, Bindu

HCAs - Sue, Julie, Sam

Audiology:

Jackie, Hillary, Jane, Susan

JDSC – Green Theatre – Nurses - Iolen, Angelita

JDSC - White Theatre – Nurse - Stephanie

Rota

• Please provide your NHS email address and mobile number to Mr Temple’s secretary
• Collect timetable from Mr Temple’s secretary showing your schedule of work (There will be a change every 2 months for F2/ CST level)
• *On-call rotas for the ENT/orthopaedics/plastics cross-cover are sent out separately via medical staffing

Bleep

• Must be collected from switchboard at the commencement of your post and be returned at the end (note: often the bleep has been left in the junior doctors’ office and not returned to switch)
• PERSONAL BLEEP MUST BE CARRIED ON YOUR PERSON AT ALL TIMES
• To bleep: call 82 followed by bleep number, followed by extension of the phone you are bleeping from
• On call bleep for ENT 2538
• On call bleep for ENT/ortho/plastics 2387

Working Hours for Junior Doctors (Below SpR level)

• 8.00am to 5.00pm Monday to Friday
• Ward round starts at 08:00-08:10 every day and is led by an SpR – meet in ENT junior doctors office (handover list can be printed next door in secretaries’ office). It is the responsibility of F2/ CST level s to ensure the handover list is up to date
• Bleep the night F2/ CST level (2387) to take handover of any patients admitted overnight. Note that cross
• -cover F2/ CST level s will be in the orthopaedic trauma meeting 08.00-08.30, so it can be helpful to arrive 5 minutes earlier to take the handover and update the list
• Day on-call for ENT 08:00am to 12:30pm and 12:30 to 5:00pm
• Out of hours ENT/ortho/plastic cross cover: Evening 16:30 to 21:30; Night 20:30 to 08:30
• Remember to handover patients to the evening F2/ CST level at 16:30
• Registrar on call 08:00-17:00 weekdays and 08:00-08:00 (48 hours) on weekends

Education time on the rota is NOT to be considered as off time and the presence of the doctor in the hospital is required.

General Duties

• Attend ward round and complete ward jobs. There is no designated ENT ward but most inpatients are admitted onto the general surgical wards
• Once ward jobs have been completed, it is expected that you help out in either theatre or clinic (unless seeing patients in A&E)
• E-Discharges MUST be completed within 24hrs in line with Trust policy – the ENT secretaries will print a list of outstanding discharges for you each day which must be completed immediately
• All clinic letters must be dictated on the day and will be left in your tray to be signed. All letters MUST be signed immediately (no longer than 10 days, as Trust incurs penalty)
• Please record morbidity and mortality patient data in the red book found in the ENT junior doctor’s room (usually the registrars/consultants will inform you if they want a patient added) – it is the responsibility of the SHOs to present M&M slides at the RHD

F2/ CST level - Day On-Call

• Carry 2538 bleep – referrals may come from wards, A&E, single point of access (SPA) and local GPs (if requesting review, ask them to send the patient to A&E with a letter and to ask for ENT when booking in)
• If wards are making referrals directly, ask them to put in an electronic request on Meditech – these are reviewed daily by the registrars/consultants who will triage the referral
• The instrument box, head light and flexible endoscope can be found in the nurses’ station in ENT OPD. They should be kept in the ENT Department and returned after every use. Please do not leave the equipment in any ward or A&E and make sure to report any damage
• PLEASE MAINTAIN A LOG OF ALL PATIENTS SEEN IN A&E AND THE WARD REFERRALS (EXCEL DATABASE ON THE COMPUTER IN JUNIOR DOCTORS ROOM FOR AUDIT PURPOSES)
• For any patients that require follow up in ENT clinic, please provide patient details to the ENT secretaries ASAP
• For out of hours on-call, please see cross-cover handbook

Clinics and A&E

• PLEASE MAINTAIN A LOG OF ALL PATIENTS SEEN IN A&E AND THE WARD REFERRALS (EXCEL DATABASE ON THE COMPUTER IN JUNIOR ROOM FOR AUDIT PURPOSES) – please also copy information for any A&E patients seen to the ENT secretaries asap
• Please note that the instrument box, head light and flexible endoscope is the responsibility of the SHO on call. They should be kept in the ENT Department and returned after every use. Please do not leave the equipment in any ward or A&E and make sure to report any damage.
• SHO’s please maintain a log of all patients seen in clinic by you and get it signed by a senior at the end of every clinic. This should be signed off by your educational supervisor at the end of your post
• E-Discharges MUST be completed within 24hrs in line with Trust policy – the ENT secretaries will print a list of outstanding discharges for you each day which must be completed immediately
• All clinic letters must be dictated as per the clinic letter template, attached, to keep letters brief and to the point
• All clinic letters in your tray MUST be signed immediately (no longer than 10 days, as Trust incurs penalty)
• Please maintain or record Mortality and Morbidity patient database in the red book found in the doctor’s room

Departmental Meetings

• ENT Radiology MDT meeting, this runs every month on the first Wednesday between 12:30 and 13:30 at the Radiology seminar room. F2/ CST level s are encouraged to attend and to present cases for discussion
• Rolling Half Day – list kept on notice board in junior doctors’ office. F2/ CST level needs to present M&M figures for every month. F2/ CST level s are encouraged to present interesting cases, articles or presentations.

Leave Policy

Please see Intranet for Trust policy

All leave requests must be given to Sarah, Mr Temple’s secretary, to be actioned. Please contact Medical Staffing for annual leave forms – forms should be given to Mr Temple’s secretary in the first instance who will arrange for Mr Chakravarthy and Mr Temple to authorize. This will then be sent onto Medical Staffing and an email sent to you confirming this.

All leave including sick leave and swaps MUST be informed to the Rota Manager Mr Chakravarthy. The ENT secretaries must also be informed of sick leave.

Study leave is booked via the Tracker system – all study leave dates MUST be given to the ENT secretaries – this is your responsibility as otherwise your timetable commitments will not be dealt with for your absence.

Important links/ Checklists

Please fill/follow the following form/checklists available on the trust intranet:

PARATHYROID CHECKLIST

Patients having parathyroid surgery need to be prepared preoperatively as per the protocol list on the checklist

TRACHEOSTOMY PATHWAY

To be completed in theatre on the day of the surgery

BAHA TEMPLATE

Data needs to be collected for the ongoing database for BAHA patients - please hand over to Mr Chakravarthy

ANTIBIOTIC POLICY

Refer to the Trust Intranet http://doclib.xcoch.nhs.uk/Documents/Antibiotic%20Guidelines%20for%20the%20Countess%20of%20Chester%20Hospital.doc

SPECIALTY GUIDELINES http://doclib.xcoch.nhs.uk/Pages/Specialty.aspx

Medical Students

Medical students rotate through the department every 2-4 weeks. They are usually 3^rd/4^th year students. They are timetabled to attend theatre/clinics with the registrars and consultants but are usually appreciative of any additional tutorials the department can offer.

It is expected that they cover/gain experience in the following topics during their placement:

• Acoustic Neuroma
• Epistaxis
• Hearing loss
• Otitis media/ glue ear
• Tonsillectomy
• BPPV
• Meniere’s Disease
• Vestibular Neuritis
• Thyroid nodules/ goitre
• Parathyroidectomy