The Royal United Hospital Bath
Overview
Dept of Anaesthesia, Royal United Hospital, Combe Park, Bath BA1 3NG / 01225 428331
The Royal United Hospitals Bath NHS Foundation Trust provides acute treatment and care for a catchment population of around 500,000 people in Bath, and the surrounding towns and villages in North East Somerset and Western Wiltshire. The Trust occupies a 52-acre site about 1½ miles from Bath city centre and became a National Health Service Trust in 1992.
We provide a wide range of services including medicine and surgery, services for women and children, accident and emergency services, and diagnostic and clinical support services.
We also provide specialist services for rheumatology and complex persistent pain via the Royal National Hospital for Rheumatic Diseases which we acquired in 2015.
In 2021, we acquired Sulis Hospital Bath, an independent hospital that provides care for both private and NHS patients.
The department has 51 consultants, 10 SAS doctors, and around 50 resident doctors.
There are 4 tiers of on call operated within the trust.
1st On Call - Covering emergency theatre and the acute pain service
2nd On Call – Covering obstetrics
ICU – Covering the ICU, ICU-outreach overnight and cardiac arrest
3rd on call – Overarching support to the other tiers of on call.
There are two separate dedicated Consultants on call for General theatres/obstetrics and for Critical Care.
The hospital carries out a full range of services including:
24 Hour Emergency theatre – This runs 24 hours a day and is supported by three additional elective NCEPOD lists a week. It is Consultant led in working hours (0800-2000 weekdays and 0800-1800 at the weekend) and out of hours covered by the 1st On call anaesthetist. The emergency service has been enrolled in the NELA project for many years and has been heavily involved in reducing the mortality in Laparotomy patients.
An Obstetric unit which is responsible for over 5,500 deliveries, over 1,000 LSCS and over 1,100 epidurals a year. It is a Consultant/Associate Specialist delivered unit in daytime hours and is covered by the 2nd on call anaesthetist out of hours.
Intensive Care Medicine – The Intensive Care Unit, at the Royal United Hospital (RUH), is a 16-bedded unit which opened in March 2025. There are approximately 1000 admissions per year, with 95% of these being emergency cases and 5% elective. The case mix includes 42% surgical and 58% non-surgical patients. The average patient is 60 years old, stays for 3.8 days and 31% are ventilated. Most patients (82%) have a clinical frailty score of 4 or better, and the unit maintains a standardised mortality ratio of 0.89. All care is provided on a single site, with no split-site working.
The unit has a strong staffing structure, including two resident doctors or ACCPs providing 24/7 cover. During the day, a senior resident (either a specialist doctor or SpR) is present every day, while overnight coverage is provided by a senior anaesthetic registrar. An FY1 doctor supports weekday shifts, and two consultants offer senior supervision seven days a week.
Trainees working in the unit have access to a broad range of educational opportunities. These include training in point-of-care ultrasound, airway management in theatre, exposure to paediatric emergencies, interhospital transfers, and the chance to attend the cardiac catheterisation lab. There are also opportunities to act up as an ICM consultant for Stage 3 trainees, participate in the ICU follow-up clinic, and shadow the outreach team.
Teaching is well structured, with weekly sessions including a FUSIC club, teaching for junior residents, and rotating sessions on clinical governance, M&M, journal club, simulation, or visiting lecturers. Monthly clinical governance and M&M sessions are standard, with occasional joint M&M meetings involving specialties such as Emergency Medicine and Stroke.
The unit is also research-active, currently recruiting patients into national trials including UK-ROX, MARCH, SHORTER, and AIRWAYS-3. Specialty skills years (SSYs) are offered in Critical Care Echo and Education, with the possibility of Palliative Care in the near future.
Staff areas are well catered for, with secure bicycle storage, showers, changing rooms, rest areas on ICU, a comfortable coffee room, and access to non-clinical workspaces.
Paediatrics – There are several thousand anaesthetics carried out a year in under 16 year olds. Paediatric specialties covered in the hospital are Urology, General Surgery, ENT, Max fax/ dental, Orthopaedics and MRI. There are a dedicated group of consultant paediatric anaesthetists. The RUH also transfers around 20-30 children per annum to PICU so exposure to the initial stabilization and transfer of the sick child is relatively common.
Regional Anaesthesia – There are numerous opportunities within the field of regional anaesthesia including upper arm “Block only” lists and one of our registrars operates as the “Block Fellow” for 3 months to increase their exposure and proficiency at providing blocks such as Interscalene, Supraclavicular, Axillary and forearm blocks. All residents should expect to become proficient at US guided limb blocks. Sulis Hospital is a particularly good resource for regional block exposure.
Acute Pain Service – The acute pain service has a dedicated team of nurses attached to it. We run a daily acute pain round which is consultant/SAS led several days per week.
Chronic Pain Service - The Chronic pain unit is a multidisciplinary service serving the needs of the local population. In addition to the consultant pain specialists, there is a dedicated team of nurses, psychologists and administrative staff, based in a stand-alone pain unit with integrated interventional facilities. The service sees over a thousand new patients a year. The majority of patients have long-term non-cancer pain and are seen as outpatients. The service performs several hundred xray guided procedures per annum, and is active in teaching, training and research.
Academic and research- The department has two professors within the consultant ranks. Residents of all grades are actively encouraged to get involved in either their own original ideas or help with work already ongoing in the department. The department is a strong supporter of STAR driven projects. The department actively wishes to increase its involvement in NIHR portfolio research and resident involvement in this is a huge help. The department aims to actively support trainees in service evaluations and research and welcomes doctors who wish to discuss this before arriving in Bath.
Quality Improvement. The department is active in QI, the trust QI lead is in the department and there are frequent opportunities for residents to be involved in QI projects. The department has been active in the emergency Laparotomy Collaborative (ELC) for three years and is taking part in PQIP. The department takes an active part in numerous national audits.
Audit. The department runs monthly audit meetings and residents are actively encouraged to get involved. Much audit is multispecialty or multidisciplinary and targeted at QI or quality assurance.
Management and leadership – A senior resident is appointed in an associate college tutor role.
There are multiple management and leadership opportunities within the trust, coordinated by Dr Jay Sunthralingam. These are regularly advertised, and residents are encouraged to be involved.
Consultants in the department of anaesthesia currently act as divisional leads for both the Surgical and Family and Specialist Services divisions. The day surgery lead is an anaesthetic consultant, and the Intensive Care Network Clinical Director for the Southwest Critical Care network is a member of the department. All these individuals are a great source of management experience and expertise.
If you require any further information about the department please contact our administrator Stacey King or either of the College Tutors, Tim Cominos or Pete Steed . The Intensive Care Faculty Tutor is Charlie Pope