Mr Revell is a Consultant Orthopaedic Surgeon at the Royal Orthopaedic Hospital NHS Trust (ROH). He trained at Guy’s and St. Thomas’, London and his early post graduate training was in the Southeast of England. His surgical interests are joint replacement surgery including revision joint replacements. He spent many years doing computer navigated joint surgery, the precursor to current day robotics. Last year his Medical Director portfolio expanded to included medical education and research; two areas he cares about very much.
OPN: What drove you to choose surgery as a career – and joint replacement surgery in particular?
MR: When I qualified as a doctor, I still wasn’t sure what I wanted to be. Others in my peer group seem to know they were born for surgery. I had a boss at St Thomas’ called Professor Fred Heatley and two great senior registrars, Jon Compson and Albert Bonici. They had me in theatre most days. Whilst it meant the ward work stacked up and I had to do it in the evenings, everyone was supportive, so it was safe. I got a buzz out of getting a nice row of stitches on a toe and thought it must be so rewarding to do a whole operation.
Joint replacement again was a late-ish decision in my training. I loved it as a Senior House Officer (SHO) and again, found role models who inspired me.
OPN: It is clear that the healthcare industry has been greatly impacted by the pandemic, what has been the greatest impact for you within the orthopaedics specialism? Is the specialism rebuilding itself in a more efficient way now do you think?
MR: I think two things. The obvious thing is waiting lists went up. But the other was that the contribution and importance of specialist and ringfenced elective centres has been well and truly recognised.
OPN: What’s the best part of your job?
MR: I think it’s all about working with people. As a clinician, you can help someone become free from pain or improve their mobility. Or if you are teaching and you manage to create an insight or link that works in somebody else’s head, it’s a marvellous thing to see.
Boiling it all down, it’s also feeling like you have done some genuine good, doing right by individuals, and helping people to make connections – whether that’s in learning or leadership.
OPN: … and the worst?
MR: Sometimes the most difficult moments have a happy ending. For example, it’s hard when things don’t go how you planned in surgery. At the ROH we have a strong restorative culture and a focus on human factors, so that goes a long way in helping to maintain trust and supportive teams which means we navigate difficulties together.
OPN: What has been the highlight of your career so far?
MR: I’ve been really proud when appointed into my current roles. I noticed quite early on how much of a boost it gave my day if my first outpatient came into clinic with no crutches, independent, and happy – especially if they were really struggling before. Not to blow our trumpet too much, but that happens quite often at the ROH with the exceptional team we have!
In the Medical Director role, we have been in situations where I wasn’t sure how we were going to sort something out, and we did. Working through challenges as a team boosts confidence for the future and makes you realise it’s always worth hanging on and finding that path forwards.
OPN: Are you currently involved in any research or work with emerging technologies within the MD portfolio?
MR: Innovation is something that is very close to our hearts at the ROH. Recently we have made ground by understanding that boundary between research and the role out of other new technologies better. We realise that (other than the ability to answer a research question) most of the controls you need to look after patients well can be planned in a good service evaluation, good written information for shared decision making, and good follow up and recall schedules.
Maybe there is a project waiting in the wings (through the National Orthopaedic Alliance (NOA) or a similar body) to standardise, or even co-process, new technology applications across organisations so we are more consistent about these things.
OPN: Please can you tell us more about the research and what it could mean to patient experience and outcomes?
MR: When we look at grant attractions, I think we are especially strong at the ROH in the areas of oncology research, spinal research, and research around robotics. We have a radiology department who can’t stop publishing academic and solid performers across most services.
So, I think patients get earlier access to innovation here. Often research is aimed at breakthrough changes in the standard of care. Sometimes I think you can get there as fast with serial incremental changes from audits and service evaluations like I have mentioned earlier.
OPN: Tell us more about your connection with the National Orthopaedic Alliance.
MR: ROH, where I am based, is a founding member organisation of the NOA and our Chief Executive, Jo Williams, is currently the Lead CEO for the alliance.
I first got involved many years ago when a certain Professor Briggs was wanting us to try and come up with an accreditation scheme for orthopaedic units. In those days they were looking at bronze, silver and gold award. I’d love to say my contribution was the cornerstone of Getting It Right First Time (GIRFT) but I fear my efforts at that stage had no measurable impact as far as I can tell on the current paradigm. Must see if I can trace my notes now I say that…
More recently, I get involved in different aspects of NOA activity such as work with industry partners around breakthrough technologies, sharing outcomes data more easily and collaboration around clinical audit.
OPN: The NOA Annual Members’ Conference takes place in October this year. Who should attend and what are the highlights you are looking forward to most at the event?
MR: The wonderful thing about the NOA is that it is a celebration of MSK care that includes all and indeed emphasises the partnership between patients, clinical and non-clinical colleagues. Anyone from across NOA’s member organisations should come!
OPN: If you weren’t an orthopaedic surgeon, what would you be?
MR: I’d have done English at university, and I’d be a writer of some sort.
OPN: What would you tell your 21-year-old self?
MR: Get properly fit and find a sport or two. Learn how to keep body and mind connected.
OPN: If you were Health Minister for the day, what changes would you implement?
MR: Strikes etc notwithstanding. I would make sure that elective care is properly ringfenced and protected. And I’d want to understand more about the structure, function and future of primary care in the UK.
OPN: Away from the clinic and operating theatre – what do you do to relax?
MR: I’ve got a few hobbies. Some are quiet and mindful, but most are activities where you have no choice but to be pulled into the moment and things where I have to master new skills.
OPN: How do you think the future looks in the field of orthopaedic surgery and what are your predictions for 2024 and the next decade?
MR: More pressure to push productivity, more collaboration. So orthopaedic surgery will be the same next year, but more of it!