Appointments and Contact
Mr Lucas - 020 7403 3501
Mr Lam - 020 7403 4516
Mr Ember - 020 7234 2385

Thomas Michael Ember
Consultant Orthopaedic & Spinal Surgeon

Guy’s & St Thomas’ Hospital Foundation Trust

Appointed December 2006

POST GRADUATE QUALIFICATIONS
  • FRCS (Tr & Orth) (2004)
  • Diploma in Orthopaedic Engineering (University of Cardiff 2003)
  • MRCS London and Glasgow (1998)
PRIZES AND AWARDS

Kate Charles Prize for Obstetrics & Gynaecology (1995)
Certificate of Merit Obstetrics & Gynaecology (1995)

MEMBERSHIPS
  • Royal College of Surgeons (England)
  • British Scoliosis Society
  • British Association of Spinal Surgeons
CURRENT APPOINTMENT

Consultant Orthopaedic and Spinal Surgeon
Guy’s & St Thomas’ Hospital Foundation Trust

Clinical duties in the Unit
  • Weekly all day spinal elective operating sessions (deformity and degenerative)
  • Weekly deformity and degenerative clinics
  • One fracture clinic
  • One trauma list
  • Teaching
  • Multi-disciplinary Spinal Meeting (weekly)
Administration
  • Teaching medical students
  • Presentations at audit
  • Spinal meeting
  • Foundation Year 1 Facilitator
  • Fellowship Programme

I was appointed to the post of consultant at Guy’s & St Thomas NHS Foundation Trust in 2006.  My specialist interest is scoliosis, kyphosis, spinal trauma, spinal tumours, degenerative cervical and lumbar work.  I am currently also part of the on call rota for general orthopaedics.  I have worked closely with my two spinal colleagues to develop the spinal service at GSTT.  Paediatric deformity numbers have increased from approximately 40 to over 100 cases per year.  The oncology service at Guy’s Hospital is the source of five plus referrals per week to the Spinal Service.  The demographics of the local population means that I have gained considerable experience in spinal infection, particularly tuberculosis. 

During the two years since my appointment, I have been actively involved in developing the spinal service:

  • Increase in paediatric deformity numbers from forty to over one hundred cases this year.  My paediatric and adult practices are compliant with the Trust’s waiting list targets.
  • Opening of a dedicated orthopaedic bay within Evelina Children’s Hospital (spinal patients were previously on an open ward)
  • Appointment of a full time paediatric orthopaedics clinical nurse specialist
  • Funding for the expansion of neurophysiology (spinal cord monitoring) services
  • Securing funding for the creation of a central London Spinal Fellowship Programme (and to be coordinator for the eighteen month rolling Fellowship Programme)
  • Creation of a weekly spinal on-call rota and development of referral pathways for trauma and oncology patients within the Trust
  • Co-author (with CNS) of Spinal Deformity Care Pathway
  • Team-working – a much overused word on CVs but as three spinal consultants, we have established a highly supportive (and hence enjoyable) working environment
Research Experience

Completion of a two year self-funded Diploma in Orthopaedic Engineering at the University of Cardiff and passed the final exams.  Much of the course was directly relevant to spinal surgery with coverage of all aspects of spinal biomechanics and material properties of implants currently employed.

My current post is a clinical one.  My remit on appointment was to develop the paediatric deformity service within the relatively recently opened Evelina Children’s Hospital.  With my spinal colleagues, we are making very real progress in this respect.  However, I am fully cogniscent of the need to publish in peer reviewed journals.  I have been rigorous in ensuring collection of outcomes data for my paediatric and adult cases.

Areas of specific interest include:

  • Fixation to pelvis in neuromuscular scoliosis.  I am fortunate to have a cohort of patients from my predecessor who did not fuse to pelvis.  This will form the comparison group against my patients on whom I typically fuse to pelvis.
  • Use of standing frames in NMS.  I have long felt the use of standing frames is protective against the development of malignant curves and am collecting data on all NMS cases to investigate this.
  • Anterior and staged posterior versus posterior only surgery for King I double major curves
  • Use of skeletal traction during correction of neuromuscular scoliosis

During two years as a consultant, I have created systems allowing for outcomes measures data collection which on maturation will provide the foundation for analyses and publication. 

Teaching Experience
  • SpR weekly spinal teaching
  • South East Thames SpR teaching programme (cervical spine trauma)
  • Foundation Year 1 Facilitator (twelve FY1 meetings monthly for non-didactic teaching on a wide spectrum of medicine related topics including governance, risk management, prescribing skills, the history of medicine).  The Facilitator position is also a pastoral role providing support when required for the young FY1 doctors during their first year of work.
  • Regular nurse, physiotherapy and affiliated specialities teaching session on spinal deformity related topics
  • MRCS STH Course Teaching (spines)
Audit

I have actively participated and regularly presented at Unit Audit Meetings.  I believe the process of audit has evolved from being a rather token gesture into a lively and vital opportunity for a unit to come together.  I consider a meticulous audit process to be the cornerstone of good clinical practice/governance and an invaluable learning tool at all levels of experience.

I have presented several audit projects during my training including an audit of removal of spinal instrumentation at the Royal National Orthopaedic Hospital over a one year period, ATLS protocol adherence at trauma calls and numerous notes audits.

Audit continued

I am currently reforming the structure of the GSTT Orthopaedic Department monthly audit meetings.  This involves the creation of templates such that audit data can be presented by juniors in a more useful format.  I consider the use of comparative data from month to month of critical importance, especially when reviewing productivity and complications.

Management Experience

I have experience in organising teaching timetables for different groups and co-ordinating this with the Medical School, rota management and organising cover for absent colleagues.

I have valuable experience in the complexities of organising a comprehensive spinal service and the support required from all facets of the multi-disciplinary team.

I am part of a working group meeting on a monthly basis with a remit of developing the orthopaedic services within Evelina Children’s Hospital.

FELLOWSHIP: PAEDIATRIC AND ADULT SPINAL DEFORMITY

Mr H Noordeen and Mr S Tucker (January 2005-January 2006)
Great Ormond Street Hospital
Royal National Orthopaedic Hospital, Stanmore
The Princess Grace Hospital
The Portland Hospital

A one year fellowship based primarily at Great Ormond Street but with operating sessions at Royal National Orthopaedic Hospital, Portland and Princess Grace Hospitals.

Training summarised below:

  • Complex, predominantly tertiary case mix encompassing the full spectrum of paediatric idiopathic, congenital and neuromuscular deformity
  • Revision tertiary paediatric deformity
  • Combined cases with paediatric neurosurgeons
  • High volume (over 200 cases during the year) due to daily operating lists
  • Adult degenerative and deformity work at RNOH
  • Cross discipline teaching sessions and ward based teaching of juniors
  • Weekly outpatient clinics where there was ample opportunity to discuss management planning of complex cases with supervising consultants
  • Multi-disciplinary neuromuscular clinics (with paediatric neurologists, physiotherapists and occupational therapists)
  • Creation and maintenance of a spinal deformity database that yielded several national presentations and continues to produce research by subsequent fellows
  • Development of spinal care pathways