Career

My Consultant Career

A lifetime of learning

The last 15 years...

I joined the department of gastroenterology in 2002 as one of three consultants, in view of my interests in nutrition and immunology.   

I have listed the themes of my subsequent career below:

Service development:  
Improving the safety and accessibility of artificial nutrition.   
  • I have developed new, safer techniques for inserting feeding tubes into patients at high risk of complications. 
  • I pioneered a decision-making forum, the 'feeding issues multidisciplinary team' for assisting in difficult artificial nutrition decisions.
  • I have led nationally on extending the use of intravenous nutrition, particularly for palliative indications in advanced malignancy
During this time I have seen my team grow from 1 nurse specialist and a part time dietitian to 7 nurse specialists and 3 dietitians, and the number of patients receiving intravenous nutrition has grown from 20 to 130...

Improving the management of coeliac disease and other small intestinal diseases.
  • I have developed a new pathway for the management of coeliac disease  
  • I have introduced flow cytometry in the diagnosis of coeliac disease and refractory coeliac disease in the UK
  • I have established Cambridge as one of two centres in  the UK rare disease collaborative network for refractory coeliac disease
  • I have  identified chronic infection with norovirus as a cause of severe intestinal disease in immunodeficient individuals, which led to a successful treatment

Developing the role of intestinal transplantation in the management of intestinal failure
  • From a slow start with just two intestinal transplants in my first five years, Cambridge is now the busiest intestinal and multivisceral transplant centre in Europe and the unit has just completed its 100th operation
  • During this time improvements in technique and management  have led to significant improvements in survival after transplant
  • I now promote this operation for quality of life as well as survival benefits, and raise awareness nationally about the importance of timely referral in high risk indications
Development of video capsule enteroscopy ('Pillcam')  service:
  • I  established a video capsule enteroscopy service in Cambridge in 2004 which I ran until 2014
Development of specialist pancreatic medical and endoscopic service:
  • I established a medical clinic for benign pancreatic disease
  • I developed a regional service for endoscopic ampullectomy, pancreatic endoscopy and duodenal polypectomy
Teaching and training:
  • I lecture on nutrition and intestinal pathology in Cambridge University medical school
  • I am a communications skills facilitator in Cambridge University medical school
  • I teach physiology to undergraduates in Christ's College, Cambridge University
  • I am a core member of 'NNERG' - the Need for Nutrition Education Review Group 
  • I have been invited as guest speaker to international conferences in Spain and New Zealand
  • I am a trainer in gastroscopy, colonoscopy and ERCP
  • I ran the Eastern region gastroenterology training program from 2012-2017 

Qualifications

  • MA, MB BChir   1990        Basic medical qualification.  BA (Bachelor of Arts) is the basic Cambridge 'Tripos' qualification that I was awarded in 1987 (First class honours), and is upgraded to MA (Master of Arts) after 3 years...the MB BChir (Bachelor of Medicine and Bachelor of Surgery) was also awarded from Cambridge.  Although I underwent clinical training in London, at that time it was necessary to sit the final exams in Cambridge.  I was awarded honours in medicine and pathology.
  • MRCP  1993    Membership of the Royal College of Physicians is a pre-requisite for undertaking specialist (registrar) training.  I passed this examination on my second attempt...
  • PhD  2000   I joined the thymus biology laboratory in the Department of Anatomy in Birmingham University to undertake research on the ontogeny (differentiation/development) of lymphocytes within the epithelium of the intestine.  Professors John Owen and Eric Jenkinson kindly took me on for this 3 year project for which I was funded by a MRC (Medical Research Council) Training Fellowship.  
  • FRCP 2003   The MRCP qualification is upgraded to FRCP on recommendation from colleagues.

Professional roles

  • Departmental head of Gastroenterology (from 2019)
  • Departmental lead clinician for Quality and Safety (from 2019)
  • Establishment and lead clinician of a regional specialist centre for nutrition support and intestinal failure from 2002 until 2019.
  • Lead clinician for nutrition in Cambridge University Hospitals NHS Foundation Trust (co-chair nutrition steering group).
  • Core member of NNERG (Need for Nutrition Education Review Group). 
  • Founder chairman of Anglia Nutrition Network 2007. 
  • Eastern region gastroenterology trainer – 2012-2017.
  • Previous member of British Society of Gastroenterology Small Bowel and Nutrition committee (3 terms).
  • Member of Department of Health HIFNET committee 2007-2011
  • Member of the Royal College of Physicians Nutrition Committee (2005-2019)
  • Member of the British Intestinal Failure Alliance committee.
  • Member of Coeliac UK Research Strategy Board (from 2017)
  • Member of Coeliac UK Health Advisory Council (from 2020)
  • Member of NICE clinical guideline development group for Coeliac Disease 2015-6.
  • Co-founder of the Refractory Coeliac Disease UK Rare Disease Collaborative Network 2018
  • Associate editor BMJ Nutrition, Prevention and Health (from 2018)


Memberships

  • British Society of Gastroenterology
  • British Association of Parenteral and Enteral Nutrition
  • European Society for Parenteral and Enteral Nutrition
  • European Pancreatic Club
  • The Transplantation Society
  • Intestinal Rehabilitation and Transplant Association
  • European Society for the Study of Coeliac Disease 



  • Associate of the Royal College of Music (ARCM) 1984 flute performance

Publications

To see a list of my recent publications please click here.

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