University Hospitals Plymouth NHS Trust

• Plymouth Hospitals NHS Trust is one of the largest providers of acute care in the country.
• It is the tertiary referral centre and Major Trauma Centre for Devon, Cornwall and part of Somerset serving a population of almost 2 million.
• All services are provided on a single site at Derriford Hospital. These services include neurosurgery, maxillofacial surgery, upper and lower GI surgery, plastic surgery, renal transplantation, hepatobiliary surgery and cardiothoracic surgery. Over 1600 patients are admitted per annum in a purpose built 28 bed combined general and neuro intensive care unit.
• There is a separate 4 bed paediatric HDU adjacent to the paediatric wards and a 16 bed cardiac intensive care unit for patients following cardiac surgery.
• The general unit admits a small number of children a year, but most are retrieved to the PICU in Bristol following stabilisation in Plymouth.
• Over 50% of admissions are non-surgical from the full range of medical specialities (including acute medicine, neurology, hepatalogy, endocrinology, cardiology, haematology, renal and respiratory) providing an excellent training environment for trainees preparing for the FFICM exam.
• The general/neuro ICU ICNARC standardised mortality ratio is consistently less than one and we were rated as ‘Good’ in our most recent CQC inspection.
• There is no split site working within this Unit

University Hospitals Plymouth is the largest recruiter to NIHR CRN studies in the region, benefiting from embedded research nurses and active principal investigators. The lead for CRN studies is Dr Nikitas, who has overseen a major expansion in the range of NIHR portfolio studies. These include UKROX, VitDalize, Genomic, RemapCap, SOS, MARCH, MAST, MAC-ROX, iRehab and others.

We offer an academic SSY for ICM trainees, training for academic ACFs and can offer Associate Principal Investigator to appropriate candidates, and supervision of phDs. There is opportunity to work with the Perioperative and Intensive Care Research Group, in developing new research studies and there is support for publishing in major journals and books.

https://www.plymouth.ac.uk/research/perioperative-and-intensive-care

For further details, please discus with Prof Dan Martin or Associate Prof Jess Welbourne.

Daytime senior staffing comprises 2 Consultants on General ICU and one on Neuro ICU. Working alongside them are stage 3 ICM trainees (working a separate supernumerary consultant-style on-call rota).

Middle grade cover is provided by ICM (stage 2) and Anaesthesia Specialist Registrars (intermediate and higher ICM modules).

Resident cover is provided by a mix of ACCS and medicine Core Trainees plus Foundation Year 1 & 2 trainees with occasional respiratory and acute medicine registrars. We also have an expanding number of trained and trainee FICM Associate Advanced Critical Care Practitioners (ACCPs) who contribute to the resident staffing.

• Training in point of care ultrasound 
• Opportunity to attend theatre for airway experience 
• Exposure to paediatric emergencies
• Interhospital transfers 
• Opportunity to attend a Cardiac Catheterisation lab 
• Acting up as an ICM Consultant (for Stage 3 trainees) 

There are fantastic opportunities for gaining new intensive care skills at Derriford. Having all major specialties and the major trauma centre on one site ensures that the unit case mix is very diverse and the volume sufficient to gain vital experience in a wide range of pathologies that present to critical care. Consultant-led ward rounds occur at least twice daily on the general and neuro intensive care units providing excellent learning opportunities.

Further experience can be gained in the range of therapeutics available in intensive care. This will include training in mechanical ventilation, fibreoptic bronchoscopy, percutaneous tracheostomy, non-invasive ventilation, advanced haemodynamic monitoring including echocardiography and pulmonary artery catheterisation, intracranial pressure monitoring and External ventricular drains (EVDs), EEG, intra-aortic balloon counter pulsation, continuous renal replacement therapy and ultrasound imaging.

The unit has an extensive programme of dedicated teaching and clinical meetings designed to enhance learning opportunities. There is a resident training program that includes simulation and practical skills workshops (approximately once a month), regular FICM exam focused registrar training days, weekly echo teaching. We have a dedicated ICU room for simulation equipped with a high fidelity ICU manikin and a state of the art echo and ICU ultrasound simulator.

There are also daily scheduled meetings on the unit with a consultant radiologist and consultant microbiologist, and a weekly session with a consultant neuroradiologist, which provide valuable training in these important areas.

We are an enthusiastic and hands-on team of consultants who are committed to delivering the best intensive care service, and the best ICM training possible.

Daily Meetings:

• Radiology
• Microbiology

Weekly Meetings:

• Mondays         Neuroradiology
• Tuesdays         Journal Club, Current Cases Review
• Friday              Echocardiography, CME lunchtime meeting

Monthly Meetings:

• Mortality and morbidity review meeting
• Resident training program (1 whole day every 5 weeks)

Monthly Morbidity and Mortality meetings

Weekly consultant safety, risk and governance meetings for stage 3 trainees only.

• Limited parking is available on site, preference given to out of hours working. There are other parking arrangements including park and ride facilities.
• We have a general ICU staff room, night registrar rest room, hot food available 24hrs a day, library facilities on site.