I started to take instructions for medico-legal reports towards the end of my time as a senior orthopaedic registrar and as the lecturer at University College in London. I have developed my medico-legal practice steadily since moving to Nottingham, having been appointed as a consultant orthopaedic surgeon in 1999.
Over the years I have prepared a large number of personal injury medical reports, initially being instructed by both the plaintiff and claimant. More recently, however, with changes to medico-legal legislation, the vast majority of personal injury instructions relate to independent reports to the Court.
Over time, in addition to my personal injury practice, I have developed a specific interest in medical negligence reports. As such, and in line with my clinical practice and specialist practice, I have been instructed to and have prepared both ‘condition and prognosis’ as well as ‘causation and liability’ reports relating to medical negligence on all matters surrounding hip surgery.
Within that practice I have been instructed to comment on indications for surgery, adequate consent for surgical procedure and the quality of procedures performed, specifically relating to soft tissue exposure, component alignment, orientation and bearing surface choice. I have been instructed to comment on the aetiology of complications and poor outcome following routine and complex surgery.
More recently, I have been asked to comment on matters surrounding biomaterials and implants, specifically matters relating to implant failure and excessive or unusual wear. In this regard I have also taken a number of instructions relating to the issues that surround metal-on-metal hip replacements and hip resurfacing.
The areas within which I accept medico-legal instructions are entirely in line with my clinical practice at University Hospitals NHS Trust in Nottingham.
In that regard, and as detailed in my CV, I am invited on a regular basis to lecture on all matters surrounding hip arthroplasty and hip revision surgery. I have performed demonstration surgical procedures widely throughout Europe. I have chaired meetings and given instructional lectures at regional, national and international meetings ranging through Europe, USA, South Africa and Australia.
In addition to my lecturing away from Nottingham, I have run a specialist ‘hip revision master class’ twice a year here in Nottingham since 2007. This course has gained popularity and has received excellent evaluation scores. The courses are attended by surgeons with a specialist interest in hip and hip revision surgery from throughout the world.
These lecturing activities have enabled me to keep abreast of a number of topical issues surrounding hip surgery which I have found helpful in providing what I hope are thorough, balanced and referenced reports from a position of extensive clinical and academic experience.
Away from my clinical practice I have also developed a specialist interest in implant design and have been and continue to be involved in implant design and development with a number of companies worldwide. Specifically, I was a design surgeon on a multi-bearing uncemented socket system, performing the first implantations of this new device in 2009 in Nottingham. This again is an area of my practice I feel enables me to have a good understanding of matters that relate to implant design, development and safe introduction to clinical practice.
In 2013 I was elected to the position of editorial secretary of the British Hip Society. As such I sit on the executive committee of the British Hip Society, discussing all matters relevant to the provision and practice of hip surgery in the United Kingdom. Within that executive I have specific responsibility to the organisation for the scientific content of our annual congress.