Cheltenham General Hospital
The Cheltenham department provides services to the populations of East Gloucestershire, together with some work for adjoining geographic areas. There is a major commitment to cancer imaging for the on-site 3 Counties Cancer Centre. Interventional cardiology (diagnostic and therapeutic) is located within the department.
There is a county-wide GE PACS supported by HSS RIS, with Cheltenham Radiology acting as a hub for the remote sites on the eastern half of the county. These systems were supplied as a part of the Connecting for Health program so are the common platform across the Southern Cluster group.
Equipment
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CT x 2 Multi-slice systems (4 & 32 slice with cardiac capability)
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MRI 1.5 Tesla GE
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Interventional Toshiba ‘C’ arm installed 2005
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Digital Fluoroscopy
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4 Ultrasound rooms new scanner soon
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Nuclear medicine – 2 γ cameras
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Recently commissioned DR room
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Current build for additional DR room
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2 x dedicated Cardiac investigation and intervention rooms
Radiology services are provided for a wide range of specialities, with inpatient, day-case and outpatient facilities. These include general and vascular surgery, urology, orthopaedics, oral & maxillofacial surgery, orthodontics, ENT, ophthalmology, general medicine, paediatrics, gynaecology, obstetrics, rheumatology, clinical oncology and clinical haematology.
There is also service provision for general practice, much of it on an open access basis. Multidisciplinary meetings (including cancer MDTs) take place on a weekly basis and in which trainees are encouraged to actively participate.
Examinations
During 2004/5 approximately 116 000 examinations (983 700A equivalent Korner units) were undertaken in the department.
Total CT examinations were 14 500, of which 4000 were on oncology patients. CT guided lung tumour biopsies are performed weekly.
4000 MRI examinations were carried out, of which 1000 were on orthopaedic patients and 600 for oncology.
A total of 11 000 non-obstetric ultrasound examinations were undertaken. There is a weekly session dedicated to Ultrasound guided intervention.
Fluroscopic guided intervention includes both diagnostic and therapeutic vascular procedures with cases discussed at a weekly Clinico radiological meeting. Regular Urological procedures are performed including nephrostomies and antegrade ureteric stent insertion.
There are approximately 1900 Nuclear Medicine examinations performed each year. There is opportunity for trainees to gain experience in PET/CT which is performed at a nearby facility.
Staffing Resources
Existing Consultant Staff with PA commitments and special interests (in descending order of preference) are as below:
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Dr M Brock
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7 PAs
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Ultrasound, Musculoskeletal
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Dr P F Brown
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11 PAs
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Ultrasound, Cross-sectional, Mammography
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Dr M Gibson
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10.5 PAs
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Intervention, Cross-sectional
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Dr J Green
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11 PAs
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Musculoskeletal, Nuclear Medicine, Cross-sectional
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Dr I Hagan
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11 PAs
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Cross-sectional, Nuclear Medicine, Ultrasound
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Dr R Hopkins
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11 PAs
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Ultrasound, Cross-sectional, Musculoskeletal
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Dr I Lyburn1
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11 PAs
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Cross-sectional, Mammography, PET/CT
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Dr G McGann2
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11 PAs
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Intervention, Cross-sectional
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Dr C P Robinson
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11 PAs
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Paediatrics, Head & Neck
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Dr M Shaw
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11 PAs
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Ultrasound, Musculoskeletal, Cross Sectional
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1 Commitment to Breast Screening Service as Clinical Director
2 Clinical Director
There are 52 WTE radiographers, 7 WTE radiography helpers and 245 WTE clerical staff working in the departments and adequate nursing cover is shared with the on-site cardiac facility.
Teaching, Research, Audit & Quality
There is a programme of regular postgraduate meetings. Teaching is offered to registrars on both a formal and informal basis. There are opportunities to be involved with teaching of junior medical staff as well as medical students from the University of Bristol.
Registrar trainees are encouraged to perform an audit study during their placement. There are also good opportunities for participation in publication work.
Year 4/5 Training Rotations Available at Cheltenham General Hospital
General Radiology
All aspects of general radiology are available for trainees at CGH, including ultrasound, multi-slice CT, MRI, fluoroscopy.
Oncological Radiology
With the recent appointment of two new oncologists, the cancer centre at Cheltenham now is one of the largest in the country, with eight consultant oncologists. A high volume of diagnostic and follow-up MRI and CT comes through the department. Trainees are exposed to and encouraged to run the relevant MDTs. Oncological biopsy, imaging and intervention for complications of cancer and palliative renal oncological intervention are all available for trainees to become involved with.
Breast Radiology and Intervention
CGH is the site for Gloucestershire screening and symptomatic breast service. With high-quality support and MDTs, trainees can be exposed to a variety of imaging and intervention, including MRI and localisations.
Radionuclide Radiology
CGH has three gamma cameras, dealing mainly with oncology and cardiac patients. Three consultants have an interest in this specialty and trainees’ participation is encouraged.
Registrars wishing to have major interest in Radionuclide Radiology or Nuclear Medicine should apply for a years dedicated training (see rotation based in Bath) However, nuclear medicine in Cheltenham would combine well with an interest in Radiology Oncology, or as an addition to the experience gains on the dedicated Training Scheme
Ultrasound Intervention
We have three colour Doppler machines; and perform interventional procedures mainly biopsy, chest drainage and venous access. This experience would combine well with any of the above rotations