A typical day...

50% of my working week I spend working for the NHS, the other 50% I spread between the Injured Jockeys Fund, the British Equestrian Federation world-class program and the Federation Equestrian International.

I frequently wake wondering where I am off to as every day takes me to a different place. Today I’m off to Basingstoke and North Hampshire Hospital to do my NHS job. I arrive by 8am so I can log onto a Teams meeting with orthopaedic surgeons, physiotherapists and radiologists to discuss a selection of interesting or complex cases and review the x-rays and scans. My clinic normally starts at 9 am and continues through to 5pm. I see up to 20 patients who have been referred by their GP’s with anything from plantar fasciitis (painful heels), frozen shoulder to tennis elbow and arthritic knees. As a physician rather than surgeon my job is to ensure that the patients referred into orthopaedics have tried all non-surgical treatments before they see a surgeon. I try to provide a one-stop shop so patients are seen, examined, investigated and treated all in one appointment. This is better for patient satisfaction than sending them away for investigations, another appointment for the results and a further appointment for treatment. If I can provide this all in one visit, it leads to better patient satisfaction and is more cost-effective for the NHS. Fitting this into a 20 minutes appointment can be pretty hectic, but I’ve been doing it for quite a few years now and it certainly gets easier. I also do my own diagnostic ultrasounds and ultrasound guided joint and tendon injections and shockwave therapy in these appointments. I have 1 or 2 junior doctors in clinic with me and another consultant running a parallel clinic so there is a lot of teaching and discussion between patients.

Away from direct patient contact I’m also involved with promoting the use of exercise as medicine for patients with chronic diseases and we are looking at setting up a service within Hampshire Hospitals to improve the management of patients with concussion. This work is normally fitted in between and after clinics.

Inevitably, I am running late and don’t normally leave before about 6 pm. On the way home I have a call with a physiotherapist from one of the 3 Injured Jockeys Fund rehabilitation centres to help advise on management of a retired jockeys and discuss some of the injured current jockeys. Once I have picked up various children up from after school activities and fed hungry humans and animals, I find myself back at my desk making amendments to the concussion policy for the British Equestrian Federation. In a couple of days this is due to be shared with all their member bodies, which include the Pony Club, British Eventing and the British Horse Society. It isn’t controversial, but for many particularly in the equestrian world, will seem over the top, but letting riders get straight back on their horses without being sure they haven’t got concussion isn’t acceptable, and we are planning a big education programme in Spring 2023.

After over 25yrs working as a doctor in the NHS and despite all the current funding and staffing difficulties, I still love my job, enjoy coming to work and the people I work with are amazing. The icing on the cake is being able to work within the sporting world as well as the NHS and the skills that I bring from managing elite athletes help me to improve the management of my NHS patients.