Welcome to the West Suffolk Hospital. Whilst with us there are lots of opportunities to progress both clinically and academically. You will be supported and given a mix of opportunities in theatres and clinics. As a group, we will support and prepare you for the FRCS and your life in orthopaedics.

We are:

• 18 consultants and 1 associate specialist
• 10 lower limb arthroplasty
• 2 foot and ankle surgeons
• 5 upper limb surgeons
• 2 paediatric orthopaedic surgeons
• Spines are covered by Ipswich

• Foundation / GP trainees on 4-month rotations covering wards & on-call
• Consultant orthogeriatrician + Registrar
• 3 trauma nurse practitioners
• 1 advanced care practitioner
• Surgical nurse practitioners
• Fracture clinic physiotherapists
• Plaster team
• Children's nurses
• Fracture clinic nurses
• Physiotherapists & Occupational Therapists … and many, many more

Consultant on-call blocks: Monday 8am – Thursday 5pm, and Thursday 5pm – Monday 8am.

During on-call, elective operations for that consultant surgeon are cancelled — but clinics continue.

Registrars work 24 hours on-call with on-call accommodation provided and a compensatory rest day the following day. There will be cross-covering of clinics to account for leave.

The on-calls are 24hr and non-resident after 10pm. The registrar should remain on site until 10pm and then let switchboard know to contact you on your mobile, should you choose to turn off Alertive.

As the on-calls are non-resident, an on-call room is available on site as you will be expected to be available to come into hospital if needed within 20 minutes.

There is one SHO overnight covering orthopaedics, general surgery and urology — they start at 8pm. The following day is given off as a rest day. The rota is a rolling rota and therefore is as fair as possible in terms of cover for weekends and bank holidays.

As there will be rest days off during the week following on-call, some regular commitments may be missed from time to time — however, due to the rolling nature of the rota the same things should not be missed all the time.

You are welcome to swap on-calls to balance your commitments. To ensure the rota is updated, please flag up any swaps to our rota co-ordinator and these can be accommodated on the rota.

Email all swaps — including the swapping registrar — to Debbie.

If you wish to take leave when you are meant to be on-call, it is your responsibility to swap out of those on-call shifts. For longer periods (e.g. honeymoons, long travel) please give as much notice as possible and discuss with the rota team.

Annual leave can generally be taken when suits the individual. It is, however, important to ensure not too many SpRs are off at any one time — usually 2, but exceptions can be made if it is possible to cover all clinical work.

Leave should be booked through contacting orthopaedicsecretaries@wsh.nhs.uk. As the rota is planned 6 weeks in advance, it is necessary to give 6 weeks' notice and ensure commitments are covered.

There are fracture clinics and orthopaedic elective clinics.

Fracture clinics are usually done with a consultant but can be SpR-led if your consultant is on leave or on call. There is usually at least one consultant in clinic should you have any queries.

You will need to cross-cover clinics occasionally to accommodate leave, post on-call etc. — this will be scheduled on Loop.

Orthopaedic elective clinics are usually not cross-covered by registrars.

This is a patient-free clinic that runs on Mondays, Wednesdays and Fridays starting at 07:30, and will consist of a named consultant and fracture clinic team member.

Both A&E and GPs refer to this clinic for patient referrals. Patients are triaged to determine whether face-to-face review in clinic is required, and how soon.

Trauma meetings take place at 8am every morning in the discussion room on the F3/F4 corridor. These should be attended by everyone whenever possible.

All patients seen during the on-call, awaiting surgery, requiring results follow-up, immediately post-op, or with any concerns that need to be shared with the juniors/consultant team are included. These patients are added to this Trauma list via e-Care.

The SpR should have marked and consented the patient. They will need to book the patient for theatre by E-Care as a 'TRA' trauma case or 'EMER' emergency case.

1. In PowerChart, go to Patient List on the 2nd top bar.
2. Click the spanner icon.
3. Select New.
4. Select Care Team.
5. Pick "Trauma List" under *Care Team.
6. Leave Discharge Criteria as None — otherwise you will not be able to see patients on the trauma list after they have been discharged from ED.

Follow steps 1–3 above (Patient List → spanner → New), then:

1. Select Provider Group instead of Care Team.
2. Select your consultant's name under *Clinical Staff Groups.
3. Select Inpatient in Encounter Types.
4. In Discharge Criteria, select "Only display patients that have not been discharged".

1. Click Patient on top of the screen.
2. Go to Add patient to a patient list on the dropdown menu.
3. Click the list that you would like the patient to be added to.

Tip: To see the change immediately, click refresh at the right-hand top corner.

1. Go to Doctors lists' on the 2nd top bar.
2. Click Establish Relationships — otherwise you will see shaded grey in some patients' This Visit Problems or Jobs.
3. Click Select All.
4. There are 4 columns in Doctors lists': Patient · Jobs · This Visit Problems · Location.
5. To customise the columns, click the 3 lines (right-hand top corner) → Layout Configuration → tick the columns you want.
6. To enter or change a diagnosis: click This Visit Problems → Problems and Diagnoses → Add (or Modify once highlighted). Also accessible via the left-hand menu Problem and Diagnosis or Visit Summary.
7. Edit the "Display As" field and write which side — this is what actually appears on Doctor Lists'.
8. Click Jobs to type in what needs to be done.

1. Go to Doctors lists' on the 2nd top bar.
2. Make sure Trauma list is selected on the left-hand side.
3. Click the 3 lines (right-hand top corner) → Print.
4. In Print Options, select Simplified and Select all, then click Print at the bottom.
5. A Doctors Worklist is generated in DiscernReport View.
6. Select the Preview icon.
7. In the top bar of Print Preview, select the landscape icon.
8. Select Print → highlight F3WARDA printer → click Preferences.
9. Go to Layout → select "Flip on short edge" to print double-sided.
10. Select the number of copies and click Print.

1. Select Request/Care Plans on the left-hand side menu.
2. Click + Add.
3. Type "EPARS" in the Search box.
4. Select "For CPR" or "DNACPR" — and fill in the details if DNACPR is selected.

1. Select Request/Care Plans on the left-hand menu, click + Add.
2. Type "VTE" in the Search box and select "VTE assessment (once only)".
3. Fill in the details.

1. Select Request/Care Plans on the left-hand menu, click + Add.
2. Type "VTE prophylaxis" in the existing list.
3. Select Support devices and/or Tinzaparin — enter the dosage when ticking Tinzaparin (4500 units for normal weight).

Complete the WHO surgical safety checklist on the paper form provided. Hand it to theatre staff alongside the Concentric consent form prior to transfer.

1. Select Request/Care Plans on the left-hand menu, click + Add.
2. Type "tra Exe" in the Search box and select "(TRA) Exeter Trauma Stem"  (TRA = trauma).
3. Fill in the details.
4. For elective patients, type the name of the procedure directly.

1. Go to Home on the 2nd top bar.
2. Type the consultant's name in Resource and choose the date.
3. Two columns will show: Name and Comments. In Comments, right-click the space and select Modify.
4. Click Details and type whether the patient should have XOA or COA. (For a new patient you can enter anything in Details.)

1. Go to Document Search in the left-hand menu.
2. Type "operation" in the Keyword field.

Tip: Clinic photographs can be found in Clinical Photography on the left-hand menu.