Keshav Singhal MBE, MS, M.Ch, FRCS

Consultant Orthopaedic Surgeon

ABM University Health Board (teaching)

Rhiwau, Old port road

Wenvoe, Cardiff

CF5 6AL, UK


Biography

Current Positions (Medical)

Consultant Orthopaedics ABM University Health Board
Chair BAPIO (Wales) – British association of Physicians of Indian origin
Editor in Chief British Journal of Healthcare Innovations
Fellow Royal College of Surgeons of England
Fellow AO International, Switzerland
Fellow British Orthopaedic Association
President College of Healthcare Innovations
Visiting professor University of South Wales

Research Interest

Biomechanics of hip
Hip resurfacing
Pathway innovations
Enhanced and rapid recovery
Day Case knee replacements
Joint replacement without tourniquet
Joint replacement without transfusion

Scientific Activities

Current Positions- Charity and community

Trustee National Museums of Wales
Governor India Centre Cardiff (Wales)
Board member Care and Repair, Bridgend
UK Director Pratham Shiksha (NGO providing free education to poor in Jaipur)
Secretary INJAS trust (NGO registered in UK, providing medical relief in Third world)
MEMBERSHIP AND FELLOWSHIP

Fellow Royal College of Surgeons of England
Fellow British Orthopaedic Association
Member British Medical Association
AO Fellowship AO International
General Medical Council Full registration 3553707


Professional Experience

Orthopaedic Residency Jiwaji University Teaching Hospitals 1984-1986
Basic Surgical Training Newcastle region 1986-1987
Merseyside regional training scheme 1987-1991
Higher Surgical Training Birmingham regional training scheme 1991-1994
Consultant in Orthopaedics Dudley 1994-1996
Consultant in Orthopaedics Princess of Wales Hospital, Bridgend 1996- date

Innovations, Patient education and interaction

Working to the principles enshrined in the concept of Prudent Healthcare,
• Organised the first ever Hip Walk in Wales raising thousands of pounds of research funds on behalf of the British Orthopaedic Association, followed by a second Hip walk in 2003 presided by the Health minister both times. (1)
• Set up the First ever dedicated patient education scheme (Joint school) of Wales, in Princess of Wales hospital in 2005 facilitating early discharge and improved bed utilisation.
• Set up fast track clinic and one stop clinic speeding referral to treatment time and increasing throughput by 50%.
• Set up and rolled out Enhanced recovery scheme in South Wales, reducing the length of stay by 40% and enhancing patient experience.
• Devised the process of Enhanced Consent, making the patients equal partners
(co- production) in the whole process.


Research and Training

• Initiated a research partnership with BIOMET, an internationally renowned implant manufacturer ( with production facilities in Bridgend) to fund a £1100000 research program over three years, facilitating world class research on Hip Resurfacing, a technique he pioneered in South Wales. (2)

• Hip Unit at the Princess of Wales hospital designated as an International Centre of Excellence and learning by implant giant Biomet due to the world class research and teaching provided to International surgeons (3)

• Ground-breaking research in the field of hip biomechanics and hip resurfacing presented in over 15 International conferences.

• Invited as Faculty or keynote speaker in many countries including United States, Russia, Germany, Denmark, Dubai, Saudi Arabia, Turkey, Sweden, Norway, India .

• Trained over 50 international surgeons from Europe, Middle East, Asia and Americas in the technique of Hip Resurfacing (4)

• Devised and invented patented KS alignment device in use worldwide which has shortened learning curve, surgical time and taken away the need for expensive and time consuming navigation machines.(5)

• Produced 3 training videos for surgeons which are in mass circulation over many countries.

• Invited to be a Visiting Surgeon to the Anatomy department of the Medical University of Vienna in 2008 in recognition of his immense contribution to teaching and research.

• Clinical Teacher in Cardiff University 2006 onwards

Service Delivery and Improvements
• Lead clinician for training the first batch of Surgical Nurse practitioners in Wales. 2005-2008Set up the first One Stop clinic in Wales providing consultation & minor surgery in the same sitting in 2005 increasing the throughput by 50% & reducing unnecessary hospital visits by 66%.
• Set up the first Rapid recovery program in Wales in 2005, followed by Enhanced recovery scheme in 2012, reducing the length of stay by over 50% and enhancing patient experience, allowing them to walk independently 2 hours after their operation.
• Pioneered office surgery for upper limb problems devising protocols for performing complex upper limb surgery as day case safely. Over 1000 patients have had the benefit of this pioneering concept so far.
• Pioneered and embedded Enhanced recovery in 2013 with a multidisciplinary team educating the patients in all aspects of their surgery to make them better understand the process and be prepared for the surgery with a more positive frame of mind. This has led to early discharge doubling the throughput for Hip and Knee replacements for the same number of beds.
• The enhanced recovery techniques introduced by him have reduced the blood transfusion rate from 30% to under 2% from 2013 onwards.
• Designed and published hip and knee replacement booklets for patient education in 2013. This is being revised every year to ensure that the guidance stays current.
• Devised enhanced consent process (2016) to make it simple, effective and involving the patients in decision making as co producers in their own well being. The process provides for a positive reaffirmation from the patient about their desire to undergo the surgery and provides multiple stops for them to consider the surgical risks and opt out at any time if they are uncomfortable.
• In 2016, through his leadership and initiative, BAPIO signed MOUs with all health boards in Wales to utilise the spare training capacity in Wales by identifying bright candidates in India to train and serve in Wales for a fixed two year period followed by their placement in India. The first lot of candidates are due to start in 2017 and over 100 highly motivated and bright trainees have been identified.

Administrative

As Clinical Lead for Orthopaedic
• Successfully integrated the departments at Bridgend and Neath –Port Talbot
• Rationalised the work force bringing about recurring savings of over £100000 per annum.
• Pioneered the use of bulk purchase of implants in the Trust saving 40% to the NHS.( recurring savings of approx. £40000 pa)
• Successfully achieved compliance with all waiting list targets, surgical site infection targets and met all benchmarking from external agencies like CHKS.
• Chair of BONE fund (Bridgend Orthopaedic, nursing and educational fund) which facilitates further education for nurses and provides various aids for the patients. The fund has helped over 20 nurses to attend higher courses. ( 2005 to date)
• Chair of BAPIO Welsh division ( British Association of Physicians of Indian origin), which facilitates the training and mentoring of overseas origin doctors.( 2008 to date)
• Regular contributor to BBC on issues related to medicine and the Indian community.
Voluntary work

Community Work

1996 onwards
• Secretary Injas Trust involved in providing medical relief to the poor in third world. The trust organises cataract camps, surgical treatment for cervical cancer, and promotes research in tropical conditions.

2004-2006
• Secretary India Centre, Cardiff - reformed the constitution to make the association more broad based and representative.

• Instrumental in setting up the only inclusive Hindu temple in Cardiff in the India Centre . The temple is all inclusive and a place of spirituality for all people regardless of denomination.

• Organised numerous classical Indian dance and music programs to showcase Indian culture and values in Wales.

• Initiated a partnership between the India Centre Cardiff and National Museum Wales in 2006 to celebrate the popular Indian festival of Diwali in the museum. (12)


2006-2008
• Vice Chair India Centre Cardiff – forged links with other faith based and community groups with a view to improving cohesion and increasing tolerance and mutual understanding.

• Worked towards increasing bilateral ties between Wales and India, organising the visit of various highly placed Indian dignitaries to Cardiff including Cabinet Ministers, numerous visiting artists, spiritual leaders.

2008- to date

• Instrumental in getting the Indian Visa Centre opened in Cardiff in the India Centre Splott in 2009. This has boosted tourist exchange between Wales and India and is very convenient to the Welsh tourists. (7)

• Initiated and organised the Nehru memorial lecture series in Cardiff, the first one being delivered by Lord Bhikhu Parekh to great acclaim in June 2009. The lecture series has improved mutual understanding and boosted bilateral ties between India and Wales. (8)

• Organised a number of cross cultural events celebrating the diversity of faith and culture and promoting better understanding between various sects in the city. A concert of renowned Sufi singer Anita Singhvi from India brought together hundreds of fans from all over the Indian subcontinent in June 2009. (11)

• Appointed as a Trustee for the National Museum Wales (2009) by the Welsh Assembly Government for 4 years and subsequently renewed for another 4 years till 2018. (13)

• Appointed to the Board of Directors of Pratham Shiksha (2009). a charitable school in Jaipur, India which provides free education to over 300 street children thereby enhancing their future. (14)

• Chair of BONE fund (Bridgend Orthopaedic, nursing and educational fund) which facilitates further education for nurses and provides various aids for the patients. The fund has helped over 20 nurses to attend higher courses. ( 2005 to date)

• Chair of BAPIO Welsh division ( British Association of Physicians of Indian origin), which facilitates the training and mentoring of overseas graduates ( 2008 to date)

• Governor India Centre, Wales

• Board member of Care and Repair Bridgend and of Hafod Corporate services, helping the disadvantaged by providing social housing and home improvements for the elderly to assist them in independent living.

AWARDS

• MBE: 2013

• Bharat Gaurav ( Pride of India) Award presented at the British Parliament 2014

• Professional Excellence Award by BAPIO 2015

• Singhal Travelling Fellowships
Presented by the British Orthopaedic Association recognising his contributions

• MDA Wales Role Model Award 2015
Presented to recognise his work for disadvantaged children, providing them with a positive role model

UNIVERSITY ACADEMIC AWARDS AND DISTINCTIONS
Medical School
University Gold Medal for standing First in MB.BS

Nagraj Rao Gold Medal for General Proficiency in MB,BS

Gold Medals for standing first in Surgery, Obs & Gynae, Preventive Medicine

Distinctions in Anatomy, Physiology and Preventive Medicine
AO Fellowship

Awarded AO Fellowship to undertake further training in Trauma and upper limb surgery 1992

At St. Vincent’s Hospital and The Indiana Hand Centre,Indianapolis
Achieved valuable experience in TRAUMA and upper limb surgery including shoulder and elbow arthroscopy and shoulder replacements etc. Worked with renowned surgeons like Dr. Jim Strickland and Dr. Hill Hastings II.


Previous Appointment
1-9-94 to 30-11-96 (2 years and 2 months)
Locum Consultant Orthopaedic Surgeon
Dudley Group of Hospitals, West Midlands
Corbett Hospital (Elective Orthopaedics)
Russell’s Hall Hospital (Trauma)


Previous Training Appointments (UK - 6/12/87 till 31/8/94)


1-4-91 to 31-8-94
Higher Surgical Trainee
Birmingham Orthopaedic Training scheme.

Royal Orthopaedic Hospital
Birmingham General Hospital
Birmingham Accident Hospital
Birmingham Children’s Hospital
Selly Oak Hospital


16-6-88 to 1-12-90
Basic and Higher Surgical Trainee
Liverpool Orthopaedic training scheme

Broad green Hospital
Alder hay Children’s Hospital
Royal Liverpool Hospital
Chester Royal Infirmary

7-12-87 to 14-6-88 (6 months)
Senior House officer in Orthopaedics and A&E
Shotley Bridge General Hospital, Co. Durham


Previous Training Appointments (INDIA- 1/7/84 till 1/12/87)

1-9-87 to 1-12-87
Senior Orthopaedic Resident
Batra Hospital and Research Centre New Delhi

1-7-84 To 31-8-87
Orthopaedic Resident 1 year
Chief Resident 2 years
J.A.Group of Hospitals, Gwalior.

Publications

PRESENTATIONS AND PUBLICATIONS

Presentations:
SICOT Hyderabad, India November 2012
Short term results of Needle Fasciotomy for Dupuytren’s Contracture

Combined SICOT and 33rd Orthopaedic World Conference- Dubai
“Results of One Stop Clinic in Orthopaedics” November 2012

BAPIO Annual Conference London, November 2012
Enhanced Recovery after Surgery
European Hip Society, Madrid June 2008, The exceed acetabular system a minimum 5 yr follow up study. A Phadnis, AJ Ward, SP White, K Singhal, EJ Smith
European Hip Society, Madrid, June 2008. A multicentre study comparing navigation to KS Alignment device. A Phadnis, H Delport, D Whitwell, K Singhal.
EFORT Congress, Nice France May2008. Who needs Navigation? A comparative study of Computer navigation and a standard alignment device. A Phadnis, H Delport, D Whitwell, K Singhal.
British Orthopaedic Association Manchester 2007
The Exceed Acetabular Cup a minimum 3 yr follow up study. A Phadnis, SP White, K Singhal, E J Smith.
Computer Aided Orthopaedic Society International. Heidelberg 2007
Multi Centre Evaluation of the ReCap KS Alignment Device using Computer Aided Navigation. A Phadnis, D Whitwell, H Delport, K Singhal.
IMECHE, Surgeons and Engineers joined at the Hip, London April 2007. “Comparison of the guidewire position in resurfacing arthroplasty of the hip using a new alignment device and computer aided navigation.” A Phadnis, V Pitakannen, AM Turner, K Singhal.
British Association for Study of the Knee Belfast March 2007, Arthroscopy of the knee under local anaesthesis is it safe and practical? A Phadnis, A Khanna, D Griffiths, A Chandratreya,
Computer Aided Orthoapedic Society, UK. Navigation in resurfacing arthroplasty of the hip- A useful tool. A Phadnis, K Singhal
Rome Hip Symposium- Rome 4th-6th October 2006 “Navigation in RHR-Who needs it?” A S Phadnis, V. Pitkanen, A Turner, K Singhal
South West Wales Orthopaedic Meeting, Bridgend Feb 2006 “Office carpal tunnel release.” A Phadnis, K Singhal,
South West Wales Orthopaedic Meeting Bridgend Feb 2006 “Re-do Carpal tunnel releases.” A Phadnis, K Singhal,
Biomechanical aspects of Hip Resurfacing- Barcelona 2005

Hip resurfacing workshop Indian Arthroplasty Association 2004

Early results of Oxford Unicondylar Knee Replacement
Presented to South West Wales Orthopaedic Club March 2000

Early results of Birmingham Hip resurfacing
Presented to South West Wales Orthopaedic Club March 2000

A new Translateral approach to the hip for hip resurfacing
Presented to South West Wales Orthopaedic Club March 2000

A new External Fixator for Distal Radial Fractures
Paper presented at "International symposium on Minimally Invasive Trauma" Salzburg Austria 1996

Critical factors in shoulder hemiarthroplasty
(an analysis of factors responsible for bad results)
Presented to the Naughton Dunn Club Birmingham 1991.

The diagnostic role of external fixator of spine in low back ache cases
prior to spinal fusion. Presented to the University of Liverpool 1990.

Results of Shoulder hemiarthroplasty. Presented to the University of
Liverpool1990.


Publications:

Rupture of Distal end of Biceps tendon in a horse rider; an nusual occurrence INJURY March 1991.

Radiographic assessment of cup migration in bipolar hip arthroplasty.
Intraobserver and inter observer error and tolerance limits.
Archives of Orthopaedic and Trauma Surgery 1992; 230-231
Total hip replacement infected with Mycobacterium tuberculosis. A case report with review of literature.
Acta Orthop Belg. 2007 Apr;73(2):268-74.

Bilateral simultaneous extensor mechanism disruption following simultaneous bilateral total knee replacement.
Arch Orthop Trauma Surg. 2005 Jul;125(6):396-8. Epub 2005 Jun 18.
Cancellations of elective orthopaedic procedures: Compliance with NHS Modernisation Agency guidelines Clinical Governance: An International Journal2007 Volume: 12 Issue: 2 Page: 78 – 84
WRIST INJURY WITH NORMAL X-RAYS – WHICH IS BETTER INVESTIGATION? Journal of Bone and Joint Surgery - British Volume, Vol 88-B, Issue SUPP_I, 186-187. 2006

IS NAVIGATION NECESSARY FOR HIP RESURFACING ARTHROPLASTY? Journal of Bone and Joint Surgery - British Volume, Vol 90-B, Issue SUPP_III, 550. 2008

Who Needs Navigation? A Comparision Of Position Of Femoral Component In Resurfacing Hip Arthroplasty
Journal of Bone and Joint Surgery - British Volume, Vol 92-B, Issue SUPP_II, 307. May 2010
Phadnis A, Whitwell D, Delport H, SINGHAL K

The Early results of Enhanced Recovery after Surgery
The Physician November 2012, Volume 1 Issue 1

One stop Orthopaedic Clinic- A novel and cost effective approach for today’s austere NHS
The Physician June 2013, Volume 2, Issue 1

Enhanced recovery protocols reduce Transfusion rates in hip and knee replacements
British Journal of Healthcare Innovations January 2016 1(1) 24:30

Post Operative wound management- A step forwards
British Journal of Healthcare Innovations January 2016 1(1) 24:30

Prudent Healthcare “ A Surgeon’s perspective”
British Journal of Healthcare Innovations July 2016 1(2) 5:8

Patellofemoral arthroplasty: Current Status- A review article
British Journal of Healthcare Innovations July 2016 1(2) 19:24

Going forwards with Reverse Shoulder Arthroplasty
Review Article
Journal of Clinical Orthopaedics and Trauma ( To be published in January 2018)

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