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Phillip Johnston

Hand and Wrist

My medical training began in 1990 at Cambridge University where I graduated with a 2:1 Bachelor of Arts degree in Medical and Neurosciences in 1993. I continued clinical training at Addenbrooke’s Hospital graduating in 1995 with Bachelor of Medicine and Surgery degrees. I continued surgical training and was made member of the Royal College of Surgeons of England in 2000. My specialist training in Orthopaedics followed during which I was made Fellow of the Royal College of Surgeons of England in Trauma and Orthopaedics in 2007 and completed research leading to the award of MD from the University of East Anglia in 2008. In the same year I was included on the GMC Specialist Register and was appointed Consultant Orthopaedic Surgeon at Addenbrooke’s Hospital in Cambridge in 2009. My current clinical practice includes emergency, or urgent, treatment of patients with all aspects of orthopaedic trauma, reconstruction after the same and elective treatment of conditions affecting the upper limb.

I specialise in treatment of conditions of the upper limb, especially of the hand and wrist. Common procedures include carpal tunnel decompression, trigger finger release; trapeziectomy and other operations for hand and wrist osteoarthritis, and treatments for Dupuytren's contracture. I also undertake treatments for traumatic conditions including fixation of wrist fractures (distal radius and scaphoid) and reconstruction following these injuries (osteotomy for distal radius malunion and bone grafting and fixation for scaphoid non-union). The British Society for Surgery of the Hand (BSSH) collects surgeon-specific outcome data for trapeziectomy and my scores are better than the national average compared with all other contributing hand surgeons in the UK. Similarly my BSSH scores for Dupuytren's surgery are on par for the national average.

In total over the past 6 years, I have performed or supervised approximately 3500 operative procedures, or just under 600 operations annually. Within this, on average per year, are 95 carpal tunnel decompressions, 12 trapeziectomies; 65 Dupuytren's procedures, 20 trigger digit releases, 11 scaphoid procedures (acute fixation or treatment of non-union) and 35 procedures for distal radius fracture.

I have held the role of clinical lead for Upper Limb services in Cambridge University Hospitals NHS Trust since 2014. I work as part of the executive management of the Orthopaedic department to streamline service delivery both in upper limb elective work and provision of trauma on-call cover; workforce planning and allocation is a key part of this role. This links in also with my position as deputy director of the regional Orthopaedic registrar training rotation. This role encompasses designing and implementing the regular instructional sessions and annual assessment of trainee progress towards their completion of training.

Between 2012 and 2015 I have held the position of Caldicott Guardian for Cambridge University Hospitals NHS Trust. This role involves acting as patient-centred "conscience" for the organisation and links in with Information Governance trying to steer a course balancing patient confidentiality and information sharing for patients' benefit. I have lectured on this topic both locally and recently at the British Orthopaedic Association annual congress, alongside Dame Fiona Caldicott herself. In addition I am an associate lecturer in Orthopaedics at the University of Cambridge and contribute to the undergraduate curriculum in terms of lecture delivery, work experience in clinic and operating theatre, and in projects for students to study in depth and put forward for publication or presentation at international meetings.

I maintain my up to date knowledge base by acting as faculty for two major international courses: the BSSH Instructional Series, which provides a complete curriculum for postgraduate hand surgery for senior trainees and Consultants and on the AOUK Advanced Principles in Fracture Management course, arguably the best specialist fracture fixation course in the world, again aimed at senior orthopaedic trainees and Consultants. In addition I co-organise and deliver the Cambridge University School of Clinical Medicine course for the medical students in Orthopaedics and direct the East Anglian specialist trainees' 9-term lecture circuit in Orthopaedics. Finally, I am regular faculty on several regional Orthopaedic courses.

I maintain my up to date knowledge base by acting as faculty for two major international courses: the BSSH Instructional Series, which provides a complete curriculum for postgraduate hand surgery for senior trainees and Consultants and on the AOUK Advanced Principles in Fracture Management course, arguably the best specialist fracture fixation course in the world, again aimed at senior orthopaedic trainees and Consultants. In addition I co-organise and deliver the Cambridge University School of Clinical Medicine course for the medical students in Orthopaedics and direct the East Anglian specialist trainees' 9-term lecture circuit in Orthopaedics. Finally, I am regular faculty on several regional Orthopaedic courses.