Involvement of patients and front line medical staff in the ongoing processes of developing NHS services is crucial. Mr.Nash's involvement in medical leadership and quality improvement projects reflect a desire to improve the quality of care his patients receive. He has a number of current and previous leadership roles:
Responsibility for Registrars (middle grade doctors) in his department
Sight and Sound Hospital Project Board member
North Central London ENT Delivery, and also Transformation Group Commitee Member
North London Paediatric Network ENT Committee
AOT President (2015-6)
Junior Doctor Lead, Royal National ENT Hospital - including clinical governance, theatre utilisation, responsibility for registrars, ENT committee (2016-7)
He has extensive experience of quality improvement projects including development of a guideline that is being adopted nationally. Examples of completed projects include:
Development of Cochlear Implant Service at Great Ormond Street Hospital. Including introducing surgical techniques for hearing preservation surgery, daycase cochlear implantation, and reducing radiation exposure to children by rationalising pre-operative imaging.
Introduction of active insertion monitoring (AIM) to Great Ormond Street Hospital to optimise hearing preservation in cochlear implantation.
Introduction of a multi-disciplinary meeting to discuss children with conductive hearing loss, allowing a wider range of options for management of children with this condition.
Development of a protocol and pathway for management of patients with necrotising otitis externa at UCLH. This protocol improved the care of patients this severe infection, and has been adopted nationally.
Analysis of the effectiveness of diffusion weighted MRI in the assessment of cholesteatoma showed that is dependent on the context in which it is used. This allowed refinement of imaging for cholesteatoma.
Analysis and refinement of referral pathway for '2 week wait' suspected head and neck cancer at Imperial NHS Trust reduced delays to treatment of cancer.
Teaching
Mr.Nash trains junior surgeons in ear surgery and children’s ENT as part of his routine day to day work. He is a clinical supervisor and educational supervisor. He is also a certified appraiser for other consultants. He has been a member of the national and regional ENT training committees (Specialty Advisory Committee and Surgical Training Committee respectively).
He is part of the faculty of a number of a number of courses involving teaching junior surgeons ear surgery. He also regularly lectures otologists, ENT surgeons, GPs, junior doctors and other health professionals on topics relevant to ear surgery, particularly ear surgery in children. Examples or recent lectures given include:
Royal Society of Medicine / British Society of Otology - Setting Up Paediatric Otology Outpatients in COVID
National Training Day - Management of Paediatric Otologic CSF Leaks
National ENT Grand Round - Otitis Media and Retraction Pockets in Children
London ENT Training Day - Cochlear Implantation
London ENT Training Day - Paediatric Otology
British Association of Paediatric Otolaryngology - Middle ear reconstruction
British Society of Head & Neck Imaging - Imaging Cholesteatoma
Portland Update Conference - Otology and Paediatric ENT Update