This month, InterSurgeon had the pleasure of speaking with Professor Antony Narula who is our ENT champion. Professor Narula has been a consultant and head of department at St Mary’s Hospital Paddington, Charing Cross Hospital and Hammersmith Hospital and Leicester Royal Infirmary. He was also an Honorary Consultant at Chelsea & Westminster and Royal Brompton Hospitals. He was Chief of Service for Neurosciences/ Head & Neck until 2015 at Imperial College Healthcare Trust. Until 2017, Professor Narula was also honorary professor at Middlesex University.

In 2000, at Leicester Royal Infirmary he was appointed Medical Director for the hospital and, in 2001, Assistant Medical Director for the newly formed unified Trust, University Hospitals of Leicester. From 2002 to 2004, he was appointed Medical Director of “Action On” ENT under the NHS Modernisation Agency. Additionally, he is a Past President of ENT UK and a Past President of British Society for Otology, The Association of Otolaryngologists and Young Consultant Otolaryngologists. He served as an elected member of Royal College of Surgeons Council from 2004 to 2014, including 5 years as the honorary treasurer (2008-2014) and RCS Revalidation lead (2009-12).

He took early retirement in 2014 to concentrate on his medical charity work and his private practice. In 2015, he co-founded The Global Tracheostomy Collaborative, a global multidisciplinary collaborative of doctors, nurses, allied health professionals, patients and families committed to improving care for all children and adults with tracheostomies. They provide educational materials, change strategies and an international outcomes database.

My main involvement in international collaborations …has been in a charity called the Global Tracheostomy Collaborative, which is mainly USA, UK, and Australia-based. That was set up more than 10 years ago to provide advice and teaching on how to better look after tracheostomy patients and give advice about postoperative care management of the patient until the tube is out and so forth. Through our international collaboration we have demonstrated, in scientific journals, not only how we can get much better patient outcomes, but also in health economic terms save money because by giving the right treatment you reduce the risk of complications enormously. Certainly, in tracheostomy surgery, complications can be fatal and or lead to brain damage, so it’s an important topic. I was one of the founders of that and was involved in it for about 10 years, recruiting 50 or 60 hospitals around the world to take part.

Professor Narula has been involved with InterSurgeon for some time as ENT champion;“I first got involved in InterSurgeon through one of its founders, William Harkness, whom I’d known for 40 years. And it seemed like such a brilliant idea as he described it – like a dating site for surgeons where no costs were incurred, and no profit was made. And a brilliant opportunity to reach out to people in less developed countries and vice versa, to perhaps; make online buddies, ask for opinion and advice, and maybe meet up at international conferences where often people meet up and they meet their friends rather than perhaps widening their circles. It seemed like such a good idea, and I presented to the British Association of ENT Surgeons where I was a past president, and they thought it was a great idea and asked me to be their lead for this project.”

He sees the great benefit of InterSurgeon to facilitate global partnerships; “I think William’s vision [for InterSurgeon] was to reach out to people in less developed countries and use the internet as the means for that. Which of course is a brilliant insight because even in poorer countries, they do have internet access and they do have healthcare and many of the surgical team perhaps struggle. They have very poor resources in some countries, very, very few people in some countries. And I know from the surveys in Africa in ENT surgery, there are some countries where there’s one ENT surgeon for a million people. So, I think reaching out and bonding with people in the less developed world, is important… even in less developed countries, as I mentioned earlier, sometimes they are able to come to big international meetings and if they have been in touch with somebody through InterSurgeon, then they get a bit of face-to-face time and then their networks can broaden. I’m very much in favour of it in principle.

He sees global collaboration as extremely important for both the surgical team and patients. Through his own international collaboration, they have achieved great changes for tracheostomy patients globally; “The main thing is that, without doubt, if you are interacting with people in highly developed healthcare systems, you are going to be able to get advice on how to treat people more effectively. You can do better surgery, maybe make better decisions. Because one of the things that InterSurgeon is set up for is to allow for people to ask for advice…it’s a linking site. And so, you can have a partner or a mentor in the US or in Europe and you can say, here’s a very difficult case I’ve got to deal with; any advice on how to handle the situation, what imaging to do, where should I send the patient, so they are going to get better care… And I think also that it’s not just the patients and their families who benefit but also the surgeons and their team because they will be exposed to new, and hopefully, good ideas. In our own project in tracheostomy care, we can show with numbers that lives have been saved through complications prevented. In the UK prior to our tracheostomy project, a national three-month survey showed that there were three severe brain damages and one death, which were considered avoidable by the expert team. With our project over a two-year period in 20 hospitals, we reduced the number of complications enormously. But of course, it takes time and commitment. So, if you are linking with an advanced unit somewhere or a famous surgeon somewhere, I think that helps your morale. It makes you feel probably a bit better about yourself and I hope that that feeds through to better patient care. Personally, I’m convinced of it, in my own field.

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