Qualifications | Biography | Current Appointment | Previous appointments |National Organisations | International Organisations
Postgraduate Education | Editorial Boards | Examiner | Advisory Board | Medical Journal Referee | Society Membership
Management Experience | Ethics Courses | Sabatical Leave | Visiting Consultant | Charity Work | Clinical Research | Publications
QUALIFICATIONS:
MB.BS 1970
MRCS.LRCP 1970
MRCP (UK) Paeds 1973
FRCP (London) 1989
FRCPCH 1997
GMC Number:
1460438
MDU Number
090963D
BIOGRAPHY:
With more than thirty five years of clinical experience of working with children with kidney disease I am one of the most senior / experienced paediatric nephrologists, in clinical practice in the UK. Having been appointed as a Consultant in 1983 I was responsible for establishing the Paediatric Nephrology Department at The Royal Free Hospital (RFH) and for developing the first renal transplant programme in North London for children over the age of five years. Within three years I had established a dialysis and renal transplant programme for children aged between one and five years old at Great Ormond Street Hospital (GOSH). For logistic reasons the two units were subsequently sited together at GOSH and what would ultimately become the largest children’s centre for dialysis and renal transplantation in the UK was opened in 1986.
As lead clinician in nephrology for ten years between 1990 and 2000, the renal unit at GOSH developed an international reputation and became one of the largest and most active departments for treating children of all ages and with all types of renal disease in Europe and North America. As clinical lead for renal transplantation for twenty five years more than 650 children had successful renal transplants. The overall success improved dramatically over this time with patient survival almost 100 percent and graft survival improving with each decade reflecting the better medical care given to children and growing experience with immunosuppression. I was the principal investigator (PI) at GOSH for three major international randomised clinical trials of immunosupression in children receiving renal transplants. These trials remain unique in the literature.
Reflecting my interest for transplantation in children I have been an active member of the International Pediatric Transplant Association and am a Past President of this society dedicated to the care of children and their families who are in need of solid organ and bone marrow transplantation. It was a privilege to have been elected to this prestigious position by my colleagues.
Interests within paediatric nephrology are not limited to transplantation. I have been an enthusiastic clinical and academic researcher of children with glomerular disease, specifically nephrotic syndrome (NS). At GOSH I set up the only special out- patient clinic for children with this condition in the UK in order to study demography and epidemiology. Before retiring from clinical practice at GOSH I was co - recipient of a National Institute Of Health Research (NIHR) grant awarded to investigate the preferred induction treatment corticosteroid regimen for children presenting with nephrotic syndrome for the first time
Having received grant funding, in 2009, a transition clinic for young adults with NS as well, as other types of chronic kidney disease (CKD) was established at the RFH Centre for Nephrology. This clinical service remains innovative in that patients and families are seen jointly by an adult nephrologist, paediatric nephrologist and young adult worker.
As a paediatrician my goal has always been to represent the interests of children and child health care. As a member of the section for Paediatric and Child Health and as a Past President of the section I was responsible for organising a series of educational courses designed to engage with and update both general paediatricians and trainees.
I have been actively involved in medical management. I was Clinical Director of the medical unit at GOSH for ten years with responsibility for increasing the number of specialities within the directorate. Similarly as Clinical Director of the International and Private Patient Directorate the remit was increase income from private practice. I was involved with the planning for the new Private Patient wing at GOSH and the need to offer child care services to a much wider community both within the UK and overseas.
As Chairman of one of the first UK Clinical Ethics Committees, at GOSH, I was able to promote the subject to a wide medical and non-medical audience. As result a Department of Clinical Ethics was established at GOSH. I have served as a trustee of the UK Clinical Ethics Network and have been a member of the Ethics Committee of The British Transplantation Society and The European Renal Association, The Transplantation Society, The International Paediatric Transplant Association of which I was also the initiating Chairman.
Extensive clinical experience in caring for infants and children with congenital, hereditary and acquired renal disease is reflected in publications i.e. in excess of 100 original peer reviewed contributions, book chapters and reviews.
I have an active private paediatric clinical practice in the UK and work closely with colleagues in paediatric urology, transplant surgery, radiology and histopathology reflecting the diverse nature of the speciality and the need to have the close support of key clinicians and laboratory based specialities.
CURRENT APPOINTMENTS:
Emeritus Consultant Paediatrician & Paediatric Nephrologist
International Patient Centre
Great Ormond Street Hospital for Children NHS Trust
Great Ormond Street
London WC1N 3RD
Honorary Reader in Paediatric Nephrology
Institute of Child Health
University College
London
Honorary Consultant Nephrologist (Sessional. Appointed 2010)
UCL Centre for Nephrology
The Royal Free Hospital
Pond Street
London NW3 2QG
PREVIOUS APPOINTMENTS:
Pre-Registration
1970-1971 House Surgeon, Guy's Hospital,
House Physician, St Mary Abbots Hospital
Senior House Officer
1971-1974 Royal Free Hospital. Renal Unit; Guy's Hospital, Paediatrics; The London Hospital, Paediatrics;
John Radcliffe Hospital, Neonatal; Great Ormond Street, Paediatrics.
Registrar
1975-1977 Great Ormond Street Hospital & Queen Elizabeth Hospital.
Research Fellow
1977-1978 Department of Immunology,
Institute of Child Health
Hon. Senior Registrar
1979-1983 Lecturer in Paediatrics, Guy's Hospital Medical School
Senior Lecturer & Consultant
1983-1989 Senior Lecturer in Paediatrics,
Royal Free Hospital School of Medicine;
Consultant Paediatric Nephrologist,
Royal Free Hospital
Consultant Paediatrician & Paediatric Nephrologist
1989-2009
Great Ormond Street Hospital for Children NHS Trust, Honorary Reader in Paediatric Nephrology, Institute of Child Health, Senior Clinical Lecturer, Institute of Urology & Nephrology, University College London.
NATIONAL ORGANISATIONS
Royal College of Physicians Standing Committee of Members
Member 1976 - 1979
British Paediatric Association Council
Junior Staff Representative 1982 -1983
Conference of Medical Academic Representatives
Clinical Representative 1982 - 1983
Inner London Education Authority, Royal Free Hospital School
Governor 1985 - 1989
University of London, Board of Studies in Medicine
Member 1986 - 1989
Renal Association, Executive Committee
Member 1989 - 1993
Association of Paediatricians of North Thames (East)
Secretary 1995 - 1997
British Medical Association
Local Negotiating Committee - Great Ormond Street Hospital for Children NHS Trust
Chairman 1996 - 1997
Royal College of Paediatrics & Child Health
i. Finance Committee 1998 - 2002
ii.Clinical Director’s Sub-Committee - Member 1998 - 2002
iii.Membership Panel 1999
British Transplantation Society
Ethics Committee 2002 - 2006
Royal Society of Medicine, Paediatric Section
Council Member 2005 - 2013
President 2008 - 2009
Royal Society of Medicine, Education Committee
Member 2012 - 2016
British Association for Paediatric Nephrology
Treasurer 2006 - 2009
United Kingdom Clinical Ethics Network
Board of Trustees; Committee Member 2006 - 2008
INTERNATIONAL ORGANISATIONS
International Paediatric Transplant Association
Past President 2013 - 2015
President 2011 - 2013
President Elect 2009 - 2011
Secretary/Treasurer 2007 - 2009
Education Committee. Co-Chair 2004 - 2007
Councillor 2005 - 2007<
Chair Ethics Committee 2017 - 2019
European Renal Association
Ethics Committee 2010 – 2015
The Transplantation Society
Member Ethics Committee 2016 – 2019
POST GRADUATE EDUCATION
Seminars and meetings held at:
The Institute of Child Health London
Advances in Paediatric Nephrology 1990 – 2001
Paediatric Nephrology and Urology, Continuing Education Programme
Co-Organiser – Annual Meeting 2001 – 2007
Nephrology for the General Paediatrician
Regular Contributor 2000 – 2006
MSc Course for Paediatricians
Regular Contributor 2000 - 2009
International Paediatric Transplant Association
Co-Chairman Education Committee 2004 – 2007
Fundamentals of Paediatric Transplantation
Course Organiser – Innsbruck, Austria 2005
Fundamentals of Paediatric Transplant Immunology
Course Organiser – Cancun, Mexico 2007
Scientific Advisory Committee Chair
6th Congress on Pediatric Transplantation
Montreal, Canada 2011
EDITORIAL BOARDS
Pediatric Transplantation. Elected 2000 - 2010
UK Clinical Ethics Network. Elected 2003 - 2008
Pediatric Nephrology
Section Editor – Transplantation. Elected 2004
The Peter Morris Centre for Evidence in Transplanation
Expert Reviewer The Transplant Library. 2013 -
Frontiers in Medicine - Nphrology 2015 - 2017
EXAMINER
University of London – MB Final 1983 – 1995
Royal College of Physicians - MRCP 1996 – 2000
Royal College of Paediatrics and Child Health – MRCPCH 2000 – 2004
RCPCH – Senior Examiner 2004 – 2009
ADVISORY BOARD
Novartis Pharmaceuticals UK Ltd (Transplantation) 2000 – 2006
MEDICAL JOURNAL REFEREE
Archives of Disease in Childhood, Lancet, European Journal of Paediatrics, Nephrology Dialysis and Transplantation, British Journal of Radiology, Bone Marrow Transplantation, Pediatric Nephrology, Pediatric Transplantation.
OTHER
Editor – Guy’s Hospital Gazette 1969 – 1970
Festschrift Programme Organiser and Chairman for Professor Martin Barratt CBE 1997
SOCIETY MEMBERSHIP
British Medical Association
British Association for Paediatric Nephrology
European Society for Paediatric Nephrology
The Renal Association
European Renal Association
International Paediatric Nephrology Association
International Paediatric Transplantation Association
International Society of Nephrology
British Transplantation Society
The Worshipful Society of Apothecaries of London
Livery Committee Member 2001 - 2004
Freeman of the City of London
Royal Society of Medicine: Paediatrics & Child Health Section
Medico- Legal Society
Independent Doctors Federation
Young Persons Health Speciality Interest Group
The Transplantation Society
MANAGEMENT EXPERIENCE
ROYAL FREE HOSPITAL AND SCHOOL OF MEDICINE 1984-1989
Academic Staff Association
Member 1984-1987
School Council
Member 1986-1987
Education Council
Member 1984-1989
Library Committee
Member 1986-1989
Hampstead Health Authority, Division of Child Health
Member1984
Chairman 1988-1989
Hampstead Health Authority, Medical Executive Committee
Member 1988-1989
Hampstead Health Authority, Division of Physicians
Member 1984-1989
GREAT ORMOND STREET HOSPITAL FOR CHILDREN NHS TRUST
Medical Unit/Urology Directorate
Clinical Director 1990-1997
Department of Nephrology
Lead Clinician 1990-1999
International and Private Patient Directorate
Clinical Director 1997-2002
Clinical Ethics Forum
Member 1995-1999
Clinical Ethics Committee
Chairman 2000-2005
Member 2000-2008
NATIONAL
NHS Kidney Care
Evaluation of Models and Approaches to Supporting Young Adults with Kidney Disease
Advisor to Matrix Knowledge Group 2010-2012
MANAGEMENT COURSES ATTENDED
Management Course (Special Health Authorities)
Kings Fund 1992
Information Needs for Clinical Directors
Sharpening The Focus
Front-line Management for Consultants
British Association of Medical Managers 1994
Taking Tough Decisions
British Association of Medical Managers 1994
Approaches to Medical Management
BHK Consultancy 1995
Medical Managers: Challenges & Solution
BMA/British Association of Medical Managers 1996
Top Manager Programme
Kings Fund 1999
Institute of Healthcare Management: Medicine for Managers 2000
(Invited speaker: specialised renal services – managing the
interface between secondary and tertiary services)
The NHS Confederation
Workshop: Consultants as Leaders for Care Improvement 2001
ETHICS COURSES/SYMPOSIA ATTENDED
Difficult Decisions: Ethics support in the delivery of Healthcare 2001
BMJ/Nuffield Trust/Ethox
Approaches to Medical Ethics 2002
Ethox
UK Clinical Ethics Network 2002
ICH London (Convener)
Guest Lecture: Caring for children. Professor Sir Ian Kennedy
UK Clinical Ethics Network 2008
Annual Conference: Value of Life – Value of Death
Sheffield
Pediatric Deceased Donation 2014
Transplantation Society Meeting. Geneva
Pediatric Deceased Donation
The MDU Medical Ethics and Law Workshop 2017
SABBATICAL LEAVE
February – April 2002
Objectives:
Review of the molecular genetics of congenital nephrotic syndrome
Completion of research studies on nephrotic syndrome
Review of function of Clinical Ethics Committee
CHARITY WORK
Trustee of Kids Kidney Research: Appointed 2002
Chairman of Trustees 2008
Trustee of Transplant Games and Recreational Fund (GOSH) 2002 - 2008
Advisory Committee – Tuberous Sclerosis Association. Appointed 2005
Norwood Children and Families Trust - Council Member. Appointed 2007
Royal Medical Benevolent Fund – Medical Liaison Officer. Appointed 2010 - 2015
Trustee of Association of Medical Registered Charities. 2012 - 2017
CLINICAL RESEARCH
RENAL TRANSPLANTATION - GRANTS AWARDED
A. CLINICAL TRIALS
RANDOMISED CLINICAL TRIAL
FUJISAWA. £23K. (1996 – 1999)
Randomised trial of tacrolimus v. Cyclosporin microemulsion in renal transplantation.
RANDOMISED CLINICAL TRIAL
FUJISAWA. £60K. (2001 – 2003)
An open, multicentre, randomized, parallel-group study to compare the efficacy and safety of tacrolimus/azathioprine/steroid triple regimen with and without the induction of the monoclonal antibody basiliximab in children after kidney transplantation.
RANDOMISED CLINICAL TRIAL
ASTELLAS. £25K. (2005 – 2007)
A multicentre, randomised, open, clinical study to compare the safety and efficacy of a combination therapy of Tacrolimus, Mycophenolate Mofetil (MMF) and Daclizumab with early steroid withdrawal versus Tacrolimus, MMF and steroids in children after kidney transplantation.
B. PHARMOKINTETIC STUDY
PHARMACOKINETICS
NOVARTIS. £32K. (2001 – 2002)
A study of the pharmacokinetics of Neoral in paediatric de-novo renal transplantation.
C. LONG TERM FOLLOW UP STUDY
LONG TERM FOLLOW UP OF CHILDREN POST RENAL TRANSPLANTATION (1973-2003)
NOVARTIS £5k (2004).
Royal Free and Great Ormond Street Hospital
NEPHROTIC SYNDROME – GRANTS AWARDED
LONG-TERM TAPERING VERSUS STANDARD PREDNISOLONE THERAPY FOR INITIAL EPISODE OF NEPHROTIC SYNDROME. NATIONAL NATIONAL MULTICENTRE RANDOMISED DOUBLE BLIND TRIAL.
PREDNOS 1
l
Pilot Study: National Kidney Research Fund £50K and Kidney Research Aid Fund £50K (2004 – 2008)
Definitive Study: NETSCC Health Technology Assessment £850k (2010 – 2015)
SHORT COURSE DAILY PREDNISOLONE THERAPY AT THE TIME OF UPPER RESPIRATORY TRACT INFECTION IN CHILDREN WITH RELAPSING STEROID SENSITIVE NEPHROTIC SYNDROME
PREDNOS 2
NIHR £800k (2012 – 2014)
TO ESTABLISH A TRANSITIONAL CLINIC FOR YOUNG ADULTS WITH NEPHROTIC
SYNDROME AND OTHER FROMS OF GLOMERULAR DISEASE AT THE ROYAL FREE
HOSPITAL
Garfield Weston Foundation & Kids Kidney Research £213k (2010 – 2012)
TO INVESTIGATE THE MOLECULAR GENETICS OF STEROID RESPONSIVE NEPHROTIC SYNDROME: UCLH/ROYAL FREE HOSPITAL
Kids Kidney Research, Equipment Grant £100K (2011)
MEDICO LEGAL
I have received instruction for expert opinion regularly since 1990. My specialism is restricted to the kidneys and urinary tract to include congenital and acquired disorders affecting all ages of infants, children and young adults.
Cases on which I have been asked to provide expert opinion include;
Urinary tract infection
Structural abnormalities of the kidney and urinary tract
Neuropathic Bladder
Acute kidney failure
Neonatal acute kidney failure
Acute glomerulonephritis
Metabolic disease of the kidney
Nephrotic Syndrome
Kidney Biopsy
Hypertension
Chronic Kidney Disease
Dialysis
Kidney Transplantation
The number of instructions received is approximately 25 per annum and invariably will require meeting with Counsel. The majority of legal work undertaken is on behalf of the plaintiff and it is rare for cases to require a Court Hearing.
My professional qualifications are listed in both the Expert Witness Directory and the UK Register of Expert Witnesses.
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