CUH Theatres, which is included in both Addenbrooke’s Hospital and the Rosie Hospital, employ over 600 staff who work across a total of 37 operating theatres with two operating rooms based at The Princess of Wales Hospital in Ely. In main theatres there are 22 theatres split into three units.
Unit One covers Trauma and Orthopaedics, Unit Two receives Emergencies, Transplant, Vascular and General Surgery and Unit Three covers Max Fax, Plastics, ENT and Paediatrics. In addition to this there are 6 theatres in the ATC (Addenbrooke’s Treatment Centre) covering Day Surgery, Gynaecology and Urology, 5 Neurosurgery Theatres, 2 Rosie Theatres for Maternity Surgery and 2 Ophthalmology theatres. In 2018/19 we performed over 38 thousand operations.
The Recovery Departments at CUH are located in three main areas; we also have specialist recovery areas at Ely Day Surgery Unit, Cambridge Eye Unit, Neurosurgery Theatres and the Rosie Theatres. Main Recovery is located alongside the main operating theatres. It has 13 recovery bays and six overnight intensive recovery bays. Orthopaedic Recovery is also found in Main Theatres and has 6 bays that are close proximity to our Orthopaedic and Trauma theatres. Within ATC there are also 12 recovery bays which offer care to patients who have undergone Urology, Gynaecology or Day Surgery procedures.
What roles exist in Theatres & Recovery?
There are a range of roles within theatres and recovery including Nursing, Operating Department Practice (ODP) and HCSW/TSW (Theatre Support Worker) roles. All of these professions are integral to support the smooth running and utilisation of our theatres and to optimise patient care and experience.
Nursing and Operating Department Practitioners
There are a wide range of roles and responsibilities our theatre nurses and operating department practitioners (ODP) undertake; these range from scrub (selecting and passing sterile instruments to the operating surgeon, ensuring all swabs, sharps and instruments are collected and accounted for at the end of the procedure), recovering patients from their surgical and anaesthetic procedures in our Post Anaesthetic Acute Care Unit (PACU) and assisting the anaesthetist with safely putting our patients to sleep for their surgical procedures.
Theatre Support Workers
A Theatre Support Worker (TSW) is a vital role in theatres. assisting with patient care and other departmental related duties as directed by Registered Theatre Practitioners. TSWs escort and support the patient prior to surgery (showing good communication skills, kindness and empathy); assist the surgical and anaesthetic teams during the operations by helping preserve the sterile field and ensuring equipment is available and working. In addition, TSWs help the team provide asafe and clean environment for all patients.
Assistant Scrub Practitioners
Assistant Scrub Practitioners (ASPs) help setup and close down theatres, they ‘circulate’ during the operation, assist the anaesthetic/scrub practitioners as required and/or scrub in to assist the Surgeon (under supervision as not registered with a professional regulatory body).
What development and learning opportunities are there for someone joining the Theatres’ team?
We have a wide range of development and learning opportunities available for all of our staff.
For Theatre Support Workers
Once completing theatre competencies packages and receiving a Peri-op Care Certificate, TSWs can learn how to perform a link role. In this role TSWs will support the department by teaching others, for example how to uphold policies and procedures such as infection control standards. There may also be the opportunity for TSWs to apply for a Band 3 role as a senior TSW in Theatres or Anaesthetics. TSWs can also attend various training workshops, including ‘Confidence Building’, ‘Assertiveness’, ‘Resilience and You’, ‘Application and Interview preparation’ and ‘Maths and English/Functional Skills’ sessions.
To develop further we also have the opportunity for TSWs to apply for a Higher Apprenticeship (2 year training course) to become an Assistant Scrub Practitioner (ASP).
For Assistant Scrub Practitioners
ASPs can then apply to become registered by completing an Allied Health Professional/ Nursing Degree Apprenticeship Pathway (2 year training course). The Operating Department Practitioner apprenticeship is available exclusively to TSWs. They are thoroughly supported to complete while working in Theatres.
For newly qualified registered practitioners
Newly qualified Nurses/ Practitioner are supported by the Preceptorship programme and, in their first year of practice, attend: mandatory training, educational theory and study skills days, preceptorship workshops with tailored in-house training delivered on education ‘audit’ morning which supports continual personal and professional development for all roles and specialities.
Workshops attended as part of Addenbrooke’s Preceptorship Programme include:
- Inter-professional preceptorship workshop 1
- “Patients first and always” Improving patients’ and staff experience
- Inter-professional preceptorship workshop 2
- Delivering safe patient care
- Inter-professional preceptorship workshop 3
- Improving the Patient Journey at CUH
- Inter-professional preceptorship workshop 4
- Career development at CUH
- Management of the Deteriorating Patient Scenarios (MODS) – Study Day
Nurses and ODPs
Newly Qualified Practitioners and Operating Department Practitioners that new to the Trust receive development pathways and competency packages to complete as part of their induction and orientation of the department, with rotation programmes covering all of our surgical specialities.
We support continual personal and professional develop with our established 36 month band 5 development pathway. These are the training courses our nurses and practitioners attend and accomplish:
- Assertiveness Training
- Improving Personal Impact Training
- Resilience Training
- Confidence building
- Operating List Management
- Preparing for Difficult Conversations Training
- Recruitment and Selection Training
- Preceptor Training
- Edward Jenner NHS Academy Foundation in Leadership
- Leadership and Management Development Level 2
- Appraisal Training
In order to gain a broad understanding of different roles in our operating theatres, we also offer rotational roles such as scrub and anaesthetics, with a proportion of our practitioners most commonly working in 50/50 roles practising and maintaining their extensive knowledge and skills in both fields.
Our band 6 practitioners follow a development pathway that focuses on enhancing their leadership credentials, this includes attending training sessions on:
- Co-ordinating the Operating Theatre List
- Managing mental health in yourself and others
- Exploring Strengths workshop
- Trauma and Emergency surgery scheduling management training
- Managing in a coaching style
- Managing Conflict at Work
- Effective delegation
- Performance Management Training
- Introduction to Project Management
- Managers’ Toolkit to Employee Relations
Additional Development Opportunities
This is a 3 month course that allows the scrub practitioner to develop skills under the supervision of surgeons, assisting them in surgery whilst also fulfilling the scrub role for selected cases. The aim of the course is to enhance the scrub practitioners practice and sphere of competence.
Surgical First Assistant
This is a 6 months course that allows the scrub practitioner to develop skills to be able to act in the first or second assistant role for surgical cases. This course is based around the AfPP (association of perioperative practitioners) Surgical First Assistant Competency Toolkit, including an online theoretical element and the requirement to complete a minimum of 100 hours in the role as well as reaching competence in a number of assisting competencies such as camera holding and retraction.
Trainee Anaesthetic Nurse Course
This 6 months in-house course, endorsed (2019-2022) by the Cambridge University Health Partners department of Postgraduate Education, follows the Association for Perioperative Practice’s (2011) recommendations for the training of anaesthetic practitioners. This training fully complies with the: Association of Anaesthetists for Great Britain and Ireland (2011) ‘Recovery competencies’, NHS Education for Scotland 2011: Core competencies for Anaesthetic Assistants and the Royal College of Anaesthetists guideline 1.14.
The aim of this course is to guide professional development and form a foundation for safe anaesthetic practice. The work in setting up and running this internal programme has been recognised by Health Education England, granting the Theatres’ department with the HEAT Award ‘Delivering tomorrow’s workforce’ in 2019.