Mr Ashok Bohra
Consultant Surgeon and Honorary (Cons.) Assistant Professor (Nottingham University)
Clinical Experience
Mr. Bohra is a Consultant Surgeon at University Hospitals of Derby and Burton NHS Foundation Trust and Hon. (Cons.) Assistant Professor with Nottingham University. Along with Surgery in General, his special interest is Upper GI Surgery including oesophago gastric pathologies, Bariatric Surgery, and advanced laparoscopic procedures for benign and malignant conditions. He is a Fellow and Examiner of the Royal College of Surgeons, Edinburgh. Earlier, he was an Honorary Associate Professor of Surgery for St George's University, Grenada and Senior Clinical Lecturer in Birmingham University. In his clinical practice he covers most General Surgical emergencies and traumas along with a broad spectrum of general surgical problems. He routinely performs most elective general surgical and GI (gastro-intestinal) procedures like hernia repairs, cholecystectomies and endoscopies, along with his sub specialty procedures. His surgical training and experience spans over 30 years. He did surgical research from Newcastle University. He was awarded the CCST after successful completion of Higher Surgical Training and entered the GMC Specialist Register to start working as a substantive Consultant in the NHS, in 2005.
He is a member of the BMLS (Birmingham Medico Legal Society), Federation of Forensic and Expert Witness and the National Expert Witness Agency (NEWA). He has also worked for NHS LA and has been an invited speaker for NHS LA in the past.
He provides reports for a variety of General and Gastrointestinal Surgical cases, Accident claims, and Negligence claims. He has experience of providing report for claimants, defendants and joint representation and joint reporting. His current claimant to defendant ration is about 90:10.
The medico legal interest in surgical issues includes medico legal reports, case management reporting, injury or trauma including hernia, abdominal injuries, accident claim, emergency surgery, medical errors, medical negligence, clinical negligence and accident claims pertaining to general health care, symptoms, major and minor general surgical procedures and complications, and subspecialty issues related to abdominal, laparoscopic, bariatric and gastrointestinal surgery. Reports will be addressed to the court.
SKILLS AND EXPERIENCE
General and Upper GI surgery
- Skills and knowledge from years of surgical training in India, England and N. Ireland has equipped me with very wide general surgical experience as well as a special interest. I have been a substantive Consultant in the NHS since 2005.
- My sub-specialty interest is Upper GI surgery with emphasis on radical oesophageal and gastric cancer surgery and advanced laparoscopic procedures including obesity surgery including gastric bypass, sleeve gastrectomies, bands, mini-bypass; biliary and hiatal pathologies (hiatus hernia, achalasia), body wall herniae.
- I have had a wide range of experience in most aspects of surgery including colorectal, breast, endocrine, vascular, upper and lower gastrointestinal endoscopies, laparoscopic and bariatric surgery.
Leadership and management
- I was the Lead for Upper GI Cancer Services at University Hospital Derby and Burton NHS Foundation Trust.
- I underwent formal training in clinical leadership and service improvement in the National Clinical Leadership Fellowship Programme, leading to a Post Graduate Certificate from Manchester Business School in 2013.
- I was the Lead for the Upper GI Surgical Services at Dudley Group Hospitals NHS Foundation Trust and previously the MDT Lead.
- I was the Audit lead for the Department of Surgery
- I was the Surgical Lead for the Clinical Guidelines Committee
- I was a member of the New Interventions Committee of the Trust.
- I am a PEER reviewer for the National Cancer PEER Review process and have reviewed the Upper GI Cancer Services at various centres.
- I was the chairman for the surgical Service Improvement Team (SIT) at Wigan.
- I was the surgical lead for the Critical Care Group at Wigan.
- I represented the Surgical Directorate in the Trust Drugs and Therapeutic Committee in Wigan.
Teaching/ Training
- I have a Post Graduate Diploma (PG Dip) in Clinical Education. I regularly teach medical students from Year 3 to 5.
- I was the Royal College Tutor for the Surgical Department. This entailed looking after the Training, work schedule and general well being of all surgical trainees. In the process I had to link with the Postgraduate centre, The Trainers and trainees, The Deanery, Human Resources and the GMC. I developed links with the Sri Lankan Royal College to facilitate Senior Clinical Fellow experience for their trainees to be gained by coming to our centre for 1-2 years clinical fellowships.
- I have served as Honorary Assistant Professor at University of Nottingham, Honorary Senior Clinical Lecturer for the University of Birmingham while working in Dudley and Honorary Associate Professor of Surgery for the University of Grenada.
- I am on the panel for MRCS and FRCS Examiners for the Royal College of Surgeons.
- I am regularly involved in training Higher Surgical Trainees and other surgical juniors as an Educational and Clinical Supervisor.
- I was the Coordinator for Year-5 medical students for surgical placement at Russells Hall Hospital.
- I was a Senior Clinical Teacher and Examiner for Final MB students for University of Birmingham.
- I have sat on the interview panel for National Core Surgical Training (CST)
- I have the experience of teaching at all levels in the medical hierarchy.
- I enjoy teaching elective and emergency surgery to middle grade doctors
- Previously, I was involved in the teaching sessions for MSc Courses held by Lancashire University and teaching Specialist Registrars.
- Junior Doctors: I have taught in the Intercollegiate Basic Surgical Skills course. I am an educational supervisor for trainees from FY1 to ST7.
- I have taught at surgical skills courses for Consultants, junior doctors and nurses.
Clinical governance
- National Guidelines: As a member of the NICE Quality Standards Advisory Committee (QSAC) I was actively involved in discussing, drafting and approving National Clinical Guidelines’ quality standards. I was also invited to an All-Party Parliamentary Group Meeting at House of Commons in Westminster.
- Recently I drew up the Guidelines for the East Midlands Bariatric Centre on Gastric Balloons.
- I was the Audit Lead for my department and Chair the mortality-morbidity meetings at Dudley.
- As a Consultant I have participated, when required, in risk management, PALS questions, Critical Incident reporting and 360 degree Feedback.
- As a Consultant Surgeon, I have been regularly involved in the Appraisal Process, both as an Appraiser and Appraised. My last appraisal was in April 2017. I have been awarded Clinical Excellence Award points from both the Trusts I have worked for.
- I have the experience of putting up ‘business cases’ for various service developments. I have prepared the business case for Bariatric Surgical services. Previously, I have successfully set up advanced laparoscopic set-up in Wigan
- I am regularly involved in clinical governance actively as an NHS consultant. For the Upper GI services, I have set up a review protocol, information leaflet, consent information leaflets, tracking system, and also instrumental in modifying the MDT proforma.
- As Chairman of the Service Improvement Team for the department of Surgery at Wigan I was involved in clinical governance issues concerning the department including risk management, handling complaints, running audit and research, drawing various clinical protocols and in general providing a common platform for the surgical team to meet regularly and discuss any issue concerning the directorate.
- I have contributed to patient safety, clinical risk management, complaints process, making protocols and approving hospital guidelines for the management of various conditions as part of the Clinical Guidelines Committee.
CURRENT APPOINTMENT
From 19th March 2015
Consultant General, Laparoscopic, Upper GI Surgeon, Royal Derby Hospital, University Hospital of Derby and Burton NHS Foundation Trust.
The job plan includes main theatres operating (Oesophago-Gastric cancers, Bariatric Surgery and benign laparoscopic and general surgery), Day Surgery, Endoscopy, MDT (Cancer and Bariatrics), Upper GI OPD, Cancer OPD, Bariatric OPD, 1 in 10 General Surgical on-calls, audit, and teaching. I have just embarked on a sabbatical but plan to return to Derby soon.
PREVIOUS SUBSTANTIVE CONSULTANT APPOINTMENTS
1. March 2009 to March 2015 - Consultant Upper GI Surgeon, Dudley Group Hospitals NHS Foundation Trust
I joined this hospital when it was a provider for Oesophago-gastric cancer surgery for majority of the Black Country population. However, the cancer services moved to Birmingham as part of a centralisation process, which prompted my move to Derby. I did sessions as Honorary Visiting Surgeon as part of an SLA, at The University Hospital Birmingham for almost a year to perform Oesophago-gastric cancer resections and later at University Hospital of Coventry and Warwickshire as Hon Visiting Surgeon before moving. I was also a Visiting Honorary Consultant at Walsall for Bariatric Surgery.
2. October 2005 – March 2015: Consultant Surgeon, Upper GI/ General surgery, Royal Albert Edward Infirmary, Wigan, Lancashire (Wrightington, Wigan and Leigh NHS Foundation Trust)
As a substantive Consultant General and Upper GI Surgeon at Wigan my responsibilities included Upper GI (Oesophago-gastric) cancer work, MDT, providing advanced laparoscopic services, and general surgical on-call cover (1 in 9). I was instrumental in setting up the Advanced Laparoscopic Unit in the hospital. I moved from the Trust when cancer services moved to Manchester.
Publications
As a member of NICE Quality Standards Guidelines Committee (QSAC) I had been instrumental in drafting a series of guidelines, listed below. NICE quality standards are a concise set of prioritised statements designed to drive measurable quality improvements within a particular area of health or care. They are derived from high quality guidance, such as that from NICE or other sources accredited by NICE. This quality standard, in conjunction with the guidance on which it is based, should contribute to the improvements outlined in the outcomes framework published by the Department of Health.
NICE Quality Standards Guidelines:
1. Peripheral Arterial Disease (QS52) – January 2014
This quality standard covers the diagnosis and management of lower limb peripheral arterial disease in adults aged 18 years and over. It does not cover acute ischaemia of the lower limb.
2. Cancer services for children and young people (QS55) – Feb 2014
This quality standard covers the provision of all aspects of cancer services for children and young people with cancer. For this quality standard, children are defined as aged 0–15 years and young people as 16–24 years, though this is not a formal upper age limit because the needs and circumstances of individuals will vary, including their need to access age-specific services. 11
3. Sickle Cell Acute Painful Episode (QS58) – April 2014
The primary goal in the management of an acute painful sickle cell episode is to achieve effective pain control both promptly and safely. The management of acute painful sickle cell episodes for people presenting at hospital is variable throughout the UK, and is a frequent source of complaints. This quality standard covers the management of sickle cell acute painful episode in people in hospital from the time of presenting to hospital until the time of discharge.
4. Varicose Veins in the legs (QS67) – August 2014
The quality standard is expected to contribute to improvements in the following outcomes: quality of life for people with varicose veins, progression of venous leg disease, which includes complications from varicose veins and varicose vein recurrence.
5. Acute Coronary Syndromes (including myocardial infarctions) (QS68) – Sept 2014
This quality standard covers the diagnosis and management of acute coronary syndromes (including myocardial infarction) in adults aged 18 years and over. The quality standard is expected to contribute to improvements in the following outcomes: deaths from cardiovascular diseases, length of hospital stay, adverse effects of interventions (for example, bleeding and stroke) and incidence of further heart attacks.
6. Head Injury (QS74) – October 2014
The quality standard is expected to contribute to improvements in the following outcomes: mortality after head injury and recovery after head injury with guidance on CT scan timings, Cervical spine imaging, early reporting by radiologist within 1 hour of scan and rehabilitation.
7. Fertility Problems (QS73) – October 2014
This quality standard covers the assessment and treatment of fertility problems in people with explained or unexplained infertility or people preparing for cancer treatment who may wish to preserve their fertility.
8. Urinary Incontinence in Women (QS77) – January 2015
This quality standard covers the management of urinary incontinence in women aged 18 years and over.
9. Pressure Ulcers (QS89) – June 2015
This quality standard covers the prevention, assessment and management of pressure ulcers in all settings, including hospitals, care homes with and without nursing and people's own homes. It covers people of all ages: neonates, infants, children, young people and adults (including older people).
10. Urinary tract Infections in Adults (QS90) – June 2015
This quality standard covers the management of suspected community-acquired bacterial urinary tract infection in adults aged 16 years and over. This includes women who are pregnant, people with indwelling catheters and people with other diseases or medical conditions such as diabetes.
11. Obesity in Children and Young People: prevention and Lifestyle Weight Management12
(QS94) – July 2015
This quality standard covers a range of approaches at a population level to prevent children and young people aged less than 18 years from becoming overweight or obese. It includes interventions for lifestyle weight management. These statements are particularly relevant to local authorities, NHS organisations, schools and providers of lifestyle weight management programmes.
12. Cardiovascular Risk Assessment and Lipid Modification (QS100) – September 2015
This quality standard covers identifying and assessing cardiovascular risk, and lipid modification for preventing cardiovascular disease, in adults (aged 18 years and over).
13. Secondary Prevention after a Myocardial Infarction (QS99) – September 2015
This quality standard covers secondary prevention after a myocardial infarction (MI), including cardiac rehabilitation, in adults (aged 18 years and over).
14. Learning Disabilities: Challenging behavior (QS101) – October 2015
Evidence based statements to deliver quality improvements in the care of people with a learning disability and behavior that challenges
15. Intrapartum care (QS105) – December 2015
This quality statement covers the quality aspects of intrapartum care
16. Obesity in Adults: prevention and lifestyle weight management programmes (QS111)– Jan 2016
The NHS Five Year Forward View (October 2014) sets out a vision for the future of the NHS with a specific focus on the prevention of ill health due to sharply rising burden of avoidable illness. This quality standards guidance addresses the issue of tackling obesity in adults, in the community and utilisation of lifestyle weight management programmes.
17. Chronic Heart Failure in Adults (QS9) – Feb 2016
This quality standard covers the assessment, diagnosis and management of chronic heart failure in adults (18 and older).
18. Breast Cancer (QS12) - June 2016
The quality standard is expected to contribute to improvements in the following outcomes: mortality, 1- and 5-year survival, stage at diagnosis, quality of life.
19. Diabetes in Adults (QS6) – August 2016
This quality standard covers, preventing type 2 diabetes in adults (18 years and older), structured education programmes for adults with diabetes, care and treatment for adults with diabetes, preventing and managing foot problems in adults with diabetes.
20. Obesity: Clinical Assessment and Management (QS127) – Aug 2016
The quality standard is expected to contribute to improvements in the following outcomes: change in weight, BMI and waist circumference, functional status, long- term mortality, maintenance of weight loss, obesity-related co-morbidities, quality of life, and remission in people with type 2 diabetes. 13
21. Contraception (QS129) – Sept 2016
Evidence based statements to deliver quality improvements in all methods of contraception for young people and adults.
22. Children’s attachment (QS133) – Oct 2016
Covers identification, assessment and treatment of attachment difficulties. It focuses on children and young adults up to age 18, who are either on the edge of care, looked after local authorities in foster homes, in special guardianship, adopted from care or in residential units and other similar accommodation.
23. Transition between inpatient hospital settings and community or care home settings for adults with social care needs (QS136) – Dec 2016
Evidence based statements to deliver quality improvements in admissions into, and discharge from, inpatient hospital settings for adults and social care needs.
General Publications:
▪ Al Shakarchi J, Bohra A. Endometrioma in a Virgin Abdomen Masquerading as an Intramuscular Lipoma. JSCR 2015; 3, 1-2
▪ Moussa G, Thomson PM, Bohra A. Volvulus of the liver with intrathoracic herniation. Ann R Coll Surg Engl 2014; 96(7): e27-29
▪ Shipman K, Bohra A, Labib M “Caecal Volvulus as a Rare Complication of Laparoscopic Adjustable Gastric Banding”. JSCR 2012; (10):5-5.
▪ McArdle K, Leung E, Latif S, Bohra A, Ishaq S ‘Management of Lower GI Bleeding: Endoscopist or Radiologist? GUT 2010; 59(12): 1605
▪ Bohra AK EWTD in the European Capital. BMJ. 2009; 339:b5141
▪ Wong PF, Kumar S, Bohra A, Whetter D, Leaper DJ Randomized Clinical Trial of Perioperative Systemic Warming in Major Elective Abdominal Surgery. British Journal of Surgery 2007; 94: 421-426. This was the winner of 2007 John Farndon Award (Award for the best BJS manuscript for the year which had previously also been presented at the ASGBI)
▪ Bohra AK, McKie L, Diamond T Transduodenal Excision of Ampullary Tumours. Ulster med j 2002; 71(2): 121-7
▪ Bohra AK, Doyle T, Harvey C. True Aneurysm of Femoro-popliteal Vein Graft. Int J Clin Pract 2001; 55(10): 725-726
▪ Bohra AK, Diamond T. Endometrioma of the Liver. Int J Clin Pract 2001; 55(4): 286-287
▪ Pitale A, Bohra AK, Diamond T. Management of Symptomatic Liver Cysts. Ulster Med J 2002; 71(2): 106-110)
▪ Anand A, Parmeshwar R, Bohra AK. Pyrexia of Unknown Origin: A diagnostic Challenge. Gut 2008; Published online for the British Society of Gastroenterology conference March 2008.
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Abstracts:
▪ Hatt J, Ramasamy G, Neophytu C, Bohra A. An Abscess in Hiding – An Unusual Cause for an Infected Gastric Band; Obesity Surg 2017; 27 (Suppl. 1) P.408: 739
▪ Moussa G, Thomson P, Bohra A. Laparoscopic repair of herniation of a liver volvulus through the diaphragm. Br J Surg 2013; 100 (Suppl. 7): 115-225
▪ Patient's Rights In The New NHS – Evaluation from a DGH. British Journal of Surgery 2011; 98(S3): 1-80
▪ Who to Operate – Does Patient have a Choice? . British Journal of Surgery 2011; 98(S3): 1-80
▪ Long Term Outcome Following Open Mesh Repair of Inguinal Hernia and the Impact on Daily Activity – British Journal of Surgery 2010; 97(S2): 76–202
▪ Does Body Position Affect the Intra-Abdominal Workspace During Laparoscopic Surgery in the Obese Patient? - British Journal of Surgery 2010; 97(S2): 76–202
▪ Shaw S, Capozzi P, Chohda E, Bohra AK A Snapshot of UK Practice in the management of Acute pancreatitis. British Journal of Surgery 2008; 95(S3): 1-84
▪ Anand A, Parmeshwar R, Bohra AK Pyrexia of Unknown Origin: A diagnostic Challenge. Gut 2008; 57 (Suppl 1):A43
▪ Chohda E, Bohra AK Can Anastomotic Leak be pre-empted by dye test during surgery for oesophago-gastric resections? British Journal of Surgery 2007; 94(S5):11
▪ Bohra AK, et al. Systemic Perioperative Warming in Elective Major Abdominal Surgery– A Prospective Randomised Control Trial. European Surgical Research 2003; 35: 312
▪ Bohra AK, et al The Influence on Wound Healing and Infection in Major Elective Abdominal Surgery Due to Systemic Perioperative Warming - A Prospective Randomised Controlled Trial. Wound Repair and Regeneration 2003; 11 (5): A43
▪ Wong P, Bohra AK, Leaper DJ The Value of Perioperative Warming in Major Abdominal Surgery. British Journal of Surgery, 2004; 91 (9): 1217-18
▪ Wong PF, Bohra AK, O'Dair GN, Baker EA, Leaper DJ .Preliminary results of randomised controlled trial of systemic warming in peritonitis: using APACHE II as outcome measure. British Journal of Surgery 2004; 91(9): 1222
▪ Wong PF, Kumar S, Bohra AK, Leaper DJ Effects of Perioperative Systemic Warming on Morbidity and 30-day Mortality After Elective Major Abdominal Surgery: outcome measures using POSSUM score. British Journal of Surgery 2004; 91(suppl 1): 13
▪ Wong P, Kumar S, Bohra AK, Leaper DJ. Does Systemic Warming Have Any Value in Peritonitis? An Interim Analysis Using Predicted Mortality Rate of APACHE II Score. European Surgical Research, 2004. 36 (suppl 1): 12.
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▪ Kumar S, Wong PF, Bohra AK, Leaper DJ Perioperative systemic warming reduces morbidity and 30 day mortality after elective major abdominal surgery. European Surgical Research, 2004. 36 (suppl 1): 99-100
▪ Wong P, Kumar S, Bohra AK, Leaper DJ. Does Systemic Warming have any Value in Peritonitis? An interim Analysis Using Predicted Mortality Rate of Apache II Score. European Surgical Research, 2004. 36 (suppl 1): 12
▪ Wong P, Kumar S, Bohra AK, Whetter D, Leaper DJ Perioperative Systemic Warming Reduces Morbidity and 30 day Mortality after Elective Major Abdominal Surgery. Surgical Infections, 2004. 5 (1): 131
▪ Wong PF, O’Dair GN, Bohra AK, Baker EA, Leaper DJ Systemic Warming as an Adjunct to Standard Antibiotics and Fluids in Peritonitis. Wound Repair and Regeneration 2003; 11 (5): A42
▪ Bohra AK, McKie L, Diamond T. Transduodenal Excision of Ampullary tumours. HPB 2001; 3(11): 126
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