I currently practice at Taunton and Somerset NHS Trust. I was appointed there in November 2007. I also have a small private practice at the Nuffield Hospital in Taunton. I am a general cardiologist, and I look after patients with all types of heart conditions, although I have a number of particular interests.
I have a particular interest in the diagnosis and management of heart failure and cardiomyopathies (see "Heart Failure") which reflects my training and I am the clinical lead for heart failure in West Somerset.
My second interest is in permanent pacing, including the more complex devices (see "Pacemakers") - ICDs (Implantable cardioverter defibrillators) and CRT (Cardiac Resynchronisation Therapy). I am the clinical lead for pacing and devices in West Somerset.
Finally I treat patients with all forms of heart rhythm problems. I am the cardiac network lead for arrythmias. The most common form of heart rhythm problem I see is atrial fibrillation. An increasing problem are so-called inherited cardiac conditions which can also result in heart rhythm problems.
Although we can manage most forms of heart problem in Somerset, it is often necessary to seek specialist help and advice from regional and national centres.
In particular, we do not have facilities for cardiothoracic surgery at Taunton, and although specialists visit, we tend to send most patients to the Bristol Royal Infirmary (BRI). They provide us with an excellent and high quality service. For specific procedures in certain patients I will refer onto the Royal Brompton and Harefield NHS Trust (RBHT).
The modern management of heart rhythm problems increasingly involves certain procedures both for diagnosis and therapy (an electrophysiology study and ablation). We do not offer these procedures at Taunton, but again there are excellent specialists at the BRI and also at RBHT who I know well.
Both cardiac MRI (Magnetic Resonance Imaging) and cardiac CT (Computed Tomography) are very valuable tools for the diagnosis of particular heart conditions (see "Imaging"). We do not currently offer these tests at Taunton (but are close to doing so) and so I refer patients to the Royal Devon & Exeter NHS Trust for MRI scans and to Plymouth Hospitals NHS Trust for cardiac CT scans.
For a few patients, advanced heart failure treatments such as cardiac transplantation or ventricular assist devices are necessary, and I typically refer such patients on to Harefield hospital.
Taunton and Somerset NHS Trust - http://www.tsft.nhs.uk/
Bristol Royal Infirmary - http://www.uhbristol.nhs.uk/
Royal Brompton and Harefield NHS Trust - http://www.rbht.nhs.uk/
Royal Devon and Exeter NHS Trust - http://www.rdehospital.nhs.uk/
Plymouth Hospitals NHS Trust - http://www.plymouthhospitals.nhs.uk/