Reza Nouraei

S. A. R. Nouraei

MA (Cantab) MBBChir PhD

FRCS(ORL-HNS) DO-HNS

Specialty Registrar (ST8) in Otolaryngology – Head & Neck Surgery

 

PERSONAL INFORMATION

Name: Reza Nouraei

Date of Birth: 9th of March 1977

Nationality: British (Married with two children)

 

EDUCATION

 University of Bath

 PhD Thesis: “An investigation of the surgical physiology of adult laryngotracheal

stenosis (awarded Jan 2013)

 MD Thesis: “Impact of clinical coding subjectivity, variability and error on theaccuracy of hospital episode statistics: implications for a knowledge-driven NHS”

 Royal College of Surgeons of England

 Fellowship of the Royal College of Surgeons (FRCS-ORL-HNS) (July 2015)

 Membership of the Royal College of Surgeons (MRCS) (November 2007)

 Diploma in Otolaryngology – Head & Neck Surgery (DO-HNS) (April 2007)

 University of Cambridge (Gonville and Caius College) (’96 till ’02)

 Bachelor of Medicine and Bachelor of Surgery (MBBChir) (June 2002)

 Master of Arts in Physiology (Sensory-Motor Physiology) (MA; 2i) (June 1999)

 St. Cuthberts’ Roman Catholic Boys’ School, Newcastle upon Tyne (’93 till ’95)

 4 Grade A’s at A-levels: Physics, Chemistry, Biology, and Mathematics (June 1995)

ACADEMIC APPOINTMENTS

Honorary Senior Lecturer in Otolaryngology – Head & Neck Surgery

October 2014 to date The Ear Institute, University College London

London, UK

June 2013 to Oct 2014 Postgraduate Medical Institute, Anglia Ruskin

University, Chelmsford, Essex

Research Associate in Otolaryngology – Head & Neck Surgery

April 2008 to The Ear Institute, University College London

October 2014 London, UK

MEDICAL APPOINTMENTS

Higher Surgical Training in Academic (ACF) Otolaryngology – Head & Neck Surgery

Oct ’15 to date University College Hospital NHS Foundation Trust

(Messr O’Flynn & Vaz)

Oct ’14 to Oct ’15 Imperial College Healthcare NHS Trust

(Messr Clarke, Mace & Sandhu)

Oct ’13 to Oct ’14 Royal Free Hospital NHS Foundation Trust

(Messr Quiney and Kotecha)

Oct ’12 to Oct ’13 Barking, Havering, Redbridge University Hospitals

NHS Trust (Messr Chatrath, Kotecha & Kaddour)

c

Oct ’11 to Oct ’12 Imperial College Healthcare NHS Trust, London

(Mr G Sandhu, OOPR Airway Fellow)

Oct ’09 Oct ’10 Barts and the London Hospitals NHS Trust, London

(Messr Paun & Eynon-Lewis)

Oct ’08 to Oct ‘09 West Middlesex University Hospital, London

(Mr J Almehda, Mr N Daly & Mr A Robinson)

Oct ’08 to Oct ‘09 The Royal National Throat Nose & Ear Hospital,

London (Mr J Rubin & Mr G Sandhu)

Apr to Oct ’08 Charing Cross Hospital, London (Mr G Sandhu)

Management/Research Registrar

Aug ’07 to Apr ‘08 Ear, Nose and Throat Surgery

Charing Cross Hospital, London

Basic Surgical Training

Feb ’07– Aug ’07 Ear, Nose and Throat Surgery

Charing Cross Hospital, London

Aug ’06 – Feb ’07 Ear, Nose and Throat Surgery

Royal National Throat Nose and Ear Hospital, London

Feb ’06– Aug ’06 Neurosurgery

Charing Cross Hospital, London

Feb ’05 – Feb ’06 Ear, Nose and Throat Surgery

Charing Cross Hospital, London

Aug ’04 – Feb ’05 General Surgery (Breast Firm)

Royal Marsden Hospital, Sutton & London

Feb ‘04 – Aug ’04 Trauma & Orthopaedics

West Middlesex Hospital, London

Aug ’03 – Feb ’04 Accident and Emergency

West Suffolk Hospital, Bury St Edmunds

SHO to Mr M. Sach and A. Sauvage

Pre-Registration House Officer

Aug ’02 – Aug ’03 Medicine (Cardiology and Endocrinology)

Surgery

 

CLINICAL SKILLS & INTERESTS

I have received broad training in managing patients with ENT conditions and can provide ageneralist service. My principal subspecialty interest is in the field of benign head andneck/thyroid disease and laryngology. My second subspecialty interest is in managing adult and paediatric sleep disordered conditions.

 

Head & Neck Sugery

I am competent and confident in the assessment and conservative and surgicalmanagement of benign head and neck conditions, diagnostic evaluation and treatmentof head and neck cancer, including transoral laser surgery, neck dissection, andtreatment of benign and malignant head and neck and airway emergencies.

 

Laryngology / Airway Surgery

I have had a longstanding interest in managing patients with laryngological conditions.

I have received training in laryngological diagnostics including stroboscopies. I am experienced in the multidisciplinary management of the professional voice in the context of a voice clinic, and am competent in managing oropharyngeal dysphagia. I am competent in performing advanced adult and paediatric laryngoscopies offer a wide

range of minimally-invasive interventions. I am competent in performing

laryngofissure and adult laryngotracheal reconstructions and tracheal resections.

 

Surgery for Snoring & Sleep-Disordered Breathing

I have received full training in the diagnosis and management of patients with sleepdisordered breathing under the supervision of Mr Bhik Kotecha, and am able to offer the full range of diagnostic assessments, as well as different surgical treatment approaches to treating snoring and sleep-disordered breathing. I would be very happy to clinically and academically support a multidisciplinary sleep service.

 

Rhinology & Facial Plastic Surgery

I have received two years of training in rhinology and facial plastic surgery. I am skilled in the management of nasal obstruction and deformities and have developed a methodology for objective assessment and treatment stratification for nasal obstruction (the NASION method) whilst at Queen’s hospital. I am competent in performing maxillary, ethmoid, and basic sphenoid sinus endoscopic surgery. I would be happy to provide a supporting role to the service if required.

 

Otology

I am competent in managing patients with otological disease and would be able toperform ‘generalist’ otological surgery including grommets, myringoplasty and mastoidectomy.

 

General ENT Surgery

I am comfortable in managing adult and paediatric patients with general ENT

conditions and can offer a generalist operative service.

ACADEMIC SKILLS & INTERESTS

I was among the first surgeons to be appointed into academic clinical training in ENT

surgery. I have secured charitable and industry funding and have successfully supervised

undergraduate and postgraduate research. I have devised a 5-year academic plan and look

to discus and implement a collaborative research programme once appointed.

Transnasal Humidified Rapid-Insufflation Ventilatory Exchange (THRIVE)

I helped develop a new technique for increasing anaesthesia apnoea time from 3-4 minutes to 25-30 minutes. This has profound implications for the practice of anaesthesia especially in relation to difficult airways and in preventing “cannot intubate cannot ventilate” deaths. This contributed to Fisher and Paykel, a $2bn a year company, augmenting their business structure and create a division to service this space. I am

responsible for creating the research programme in this field which comes with transferrable equipment and research salary support.

Selective Inspiratory Loading used as Vocal Examination Record (SILVER)

This ethics-committee approved, NIHR-badged study uses a novel physiological method for diagnosing unilateral vocal palsy especially in the perioperative thyroid surgery settings. At present, fewer than 10% of patients receive postoperative laryngoscopy, and we have recently shown, through big data research, that this more

than double the risk of fatal pneumonias over the subsequent ten years.

The North American Airway Collaborative / Great Ormond Street Airway Home Care

I am a core member of the NoAAC which consists of 14 US Ivy league centres and Charing Cross Hospital, London. I am responsible for developing the outcomes and measurement framework for creating a shared dataset across institutions. We have

recently secured a grant of $2.7m to advance understanding of idiopathic subglottic stenosis. I am also developing a paediatric/transition complex airway registry for Great Ormond Street Hospital which we intend to roll out internationally.

 

Health Informatics, Big Data, and Clinical Coding

Over 90% of the NHS budgetary flow is dependent on data generated through clinical coding. My work aims at developing practical approaches for improving the accuracy of clinical coding. I have also created bespoke data linkages and have been able to perform national disease surveillance studies. I collaborate with Dr Foster and we have a programme of work covering all aspects of ENT surgery. My own clinical domain

expertise is in laryngology and I would like to involve colleagues with different subspecialty interests to provide input to expand this research field collaboratively.

 

Perioperative patient protection and outcome assessment

As a medical study I helped design the first-in-man randomised control trial of remote ischaemic preconditioning as a perioperative protective strategy (Ali et al, Circulation 2007). I believe, and have been able to infer through big data research, that ‘excessive perioperative physiological stress’ manifests itself in end-organ injury (e.g.

postoperative ‘asymptomatic’ troponin or retinol-binding protein release) and, since, these exceedance of the physiological capacity are known to worsen long-term survival, they can be used as surrogates for the quality of perioperative care. This work would lend itself well to recent efforts to improve patient safety and reduce length of stay

through enhanced recovery programmes and I would be well-placed to help develop combined research/clinical strategies to improve patient outcomes (short-term complications are now known to worsen long-term prognosis) and reduce length of stay.

 

MANAGEMENT EXPERIENCE

I have had the opportunity to be engaged in healthcare management for a number of years. I have undertaken multiple successful service-improvement projects. Specifically, I designed and implemented a Trust-wide informatics/coding strategy at Imperial College

Healthcare NHS Trust which led to significant improvements in coding accuracy, including an improvement in the HSMR, and contributed over £5m to the Trust baseline. The results of this work have been published in peer-reviewed literature (http://goo.gl/LvG0JV).

 

Head and Neck Business Case, West London Cancer Network (2007)

I was responsible for researching, collecting and analysing data, and writing a £2.4m business case which underpinned the re-organisation of head and neck cancer services in West London in 2007 and established dedicated wards and support services.

The TVoS Project, Imperial College Healthcare NHS Trust (2008)

I proposed, designed and implemented a multi-dimensional project which involved

redesigning the clinical coding process, perform bottom-up costing of surgical services across several surgical specialties and undertake appraisal of the clinical process to improve efficiency. I was responsible for managing six specialist registrars seconded to the project, and liaising with clinical chiefs of services and senior trust management. I

was also responsible for bringing together and analyzing project data and produce the project’s final report and recommendations. The project has resulted in 3 international presentations, 3 peer-reviewed publications to date and received a Health Services

 

Journal award. This project also contributed to the development of ‘shared-learning’ secondments (e.g. Darzi fellowships).

Head and Neck Business Case, Barts and London NHS Trust (2010)

I was the principal analyst and author of a business case for expansion of head and neck cancer services at Barts and the London NHS Trust.

Mortality and Patient Safety Review, Imperial College Healthcare NHS Trust (2011) I was asked by the medical director to set up and quality assure a process for ensuring

that Trust mortality data most accurately reflects the complexity of care provided. I developed software and created a process which remains in use. More recently, I have been involved in improving the quality of the morbidity and mortality meetings and am in the process of developing a reporting and learning software for this purpose.

National Institute for Health and Care Excellence (NICE) Scholar (2013)

I was one of 6 people appointed to work with NICE and to learn about its evaluation

technology and act as a local NICE champion. This role involved instructional and

hands-on training and the ability to attend NICE evaluation and deliberation sessions,

and to learn about health economics. My scholarship project involved investigating the

underlying accuracy of the administrative data to support NICE commissioning and

guideline recommendations. This work resulted in 3 peer-reviewed publications and

has continued in my current role as a member of the NICE National Commissioning

 

Reference Panel.

Acute Kidney Injury Quality and Safety Project (2015)

I am currently involved a project to operationalise NCE CG169 guideline on the prevention of acute kidney injury. The work involves integrating routine biochemistry data with NICE injury identification algorithms to create early warning of renal complications in general medical and surgical settings.

 

COMMITTEE POSITIONS & ACTIVITIES

 Member of the National Institute of Health and Care Excellence National

Commissioning Reference Panel (June 2014 to date)

 Founding Chair of the Otolaryngology Trainee Investigators’ Collaborative

(OTIC; a trainee-led research collaborative) (March 2015 to date)

 Member of the National Expert Panel on Adult Tracheobronchomalacia (June

2015 to date)

 Subject Matter Expert on the use of Big Data for disease surveillance and rare

disease identification, Shire Pharmaceutical (June 2013 to Feb 2015)

 National Institute of Health and Care Excellence Scholar (April 2013 to April 2014)

 Member of the ENT-UK Clinical Audit and Practice Advisory Group (CAPAG)

(June 2014-17).

 Member of the American Academy of Otolaryngology’s Airway and

Swallowing Committee (the only UK and non-consultant member) (Oct 2011-15).

AWARDS & DISTINCTIONS

 Winner of the British Laryngological Association/Clinical Otolaryngology

best research paper: British Academic Conference in Otolaryngology (BACO)

(July 2015).

 Winner of the Best Oral Presentation Award (Laryngology): British Academic

Conference in Otolaryngology (BACO) (July 2009).

 Winner of the Hartopp-Dixon Prize: The Royal National Throat Nose and Ear

Hospital (April 2009).

 Winner of the Young Investigator of the Year Award: The British Lung

Foundation (December 2008).

 Winner of the Angel-James Prize: Otorhinolaryngological Research Soceity

(ORS) (September 2008).

 High Commendation: Health Services Journal (HSJ) Award in the Category of

“Data-driven service delivery as the project lead for the True Value of Services

(TVoS) project at Imperial College Healthcare NHS Trust (July 2008).

 GlaxoSmithKline Young Fellow Award, The Royal Society of Medicine (January

2008).

 Winner of the Young European Investigator of the Year Award: Interventional

Pulmonology Group, European Respiratory Society (September 2007).

 Winner of Resident Travel Award; The Triological Society (February 2007).

 Winner of the Angel-James Prize: Otorhinolaryngological Research Soceity

(ORS) (September 2006).

 Co-winner of the Sol-Cohen Prize: The Vascular Society of Great Britain and

Ireland (2004 Annual meeting).

 Winner of best vascular presentation: Association of Surgeons of Great Britain

and Ireland 2004 Annual scientific meeting.

 Winner of best presentation: British Association of Head and Neck Oncologists

2004 Annual Scientific Meeting.