Dr Simon Howell

Profile

I received my undergraduate training in medicine in Cambridge and London and qualified from St. Bartholomew’s Hospital, London in 1984. Between 1992 and 1997 I was Clinical Lecturer in Anaesthetics in the Nuffield Department of Anaesthetics in Oxford. In 1995 and 1996 I was seconded to study Epidemiology at the London School of Hygiene and Tropical Medicine. I moved to the University of Bristol 1998 and to the University of Leeds in 2001.

I have served as an examiner for the Royal College of Anaesthetists Fellowship Examination and as a member of the Research Council of the National Institute of Academic Anaesthesia.  I was Clinical Director of the NIHR West Yorkshire Comprehensive Local Research Network. (2012-4) and of the Yorkshire and Humber Clinical Research Network (2014–17).

I am a member of the Editorial Board of the British Journal of Anaesthesia and Treasurer of the Charity.  I am the current Chairman of the Vascular Anaesthesia Society of Great Britain and Ireland (VASGBI).  My other roles include membership of the Scientific Committee of the European Association of Cardiothoracic Anaesthesiology (EACTA) and of the Cardiovascular Subcommittee of the European Society of Anaesthesiology (ESA).

My clinical and research interests meet in the fields of Vascular Anaesthesia and Perioperative Medicine and I was awarded a Royal College of Anaesthetists Macintosh Professorship in Anaesthesia in 2015 in recognition of my contributions to perioperative medicine and quality improvement in vascular anaesthesia.

Responsibilities

• Co-Director EXSEL Scholarship Programme
• Manager Year 4 Acute and Critical Care Integrated Course Unit

Research interests

My research is in the area of assessing and managing the impact of cardiovascular fitness and frailty on perioperative risk. The past decades have seen a significant increase in life expectancy in the UK.  This is a triumph for healthcare and for society as a whole but brings with it major challenges.  As people age they often become frail. Frail people are up to nine times more likely to suffer major complications following such surgery.  They are slow to recover from major operations with up to 50% having an incomplete recovery at six months after surgery.  In a series of studies funded by the National Institute of Academic Anaesthesia (NIAA) my colleagues and I have demonstrated that current methods of identifying frailty in surgical patients give inconsistent results and are not effective at identifying the highest risk patients. 

We are now conducting a study (MET-REPAIR-FRAILTY) to test two simple frailty identification tools for risk stratification of patients undergoing major surgery.  As part of a larger programme of work developed in Leeds and funded by Yorkshire Cancer Research, we are examining the recovery of physical fitness in patients after colorectal surgery.  In a study funded by the Vascular Anaesthesia Society of Great Britain and Ireland, we are examining the multidisciplinary decision-making process before major surgery and how this is influenced by information flow within the hospital system.  In work funded by the British Journal of Anaesthesia and the Royal College of Anaesthetists, we are applying artificial intelligence techniques to primary care data to support the risk assessment of patients referred to hospital for major surgery.

I am a member of the Standardised Endpoints in Perioperative Medicine (StEP) initiative with is working to achieve international consensus on endpoints for trials in perioperative medicine.  My previous work includes the study of cardiovascular risk in patients undergoing major vascular surgery.  I was the lead anaesthetic investigator for the IMPROVE study of the management of patients with ruptured abdominal aortic aneurysms.  The data from this study suggested better outcomes for patients managed with regional anaesthesia.  I was the Chief Investigator of the pan-European OBTAIN (Occurrence of Bleeding and Thrombosis during Antiplatelet therapy In Non-cardiac surgery) study which demonstrated that, for patients who have undergone coronary stenting, dual antiplatelet therapy in the perioperative period is associated with an increased risk of bleeding whilst not offering protection from cardiac events.

Qualifications

• 1981 MA (Cantab.) 1984 MB BS (London)
• 1985 MRCP(UK)
• 1991 FRCA
• 1996 MSc Epidemiology, London School of Hygiene and Tropical Medicine
• 2001 MD University of London

Professional memberships

• Fellow of the Royal College of Anaesthetists
• Vascular Anaesthesia Society of Great Britain and Ireland
• European Society of Anaesthesiology
• European Association of Cardiothoracic Anaesthesiology
• Faculty of Medical Leadership and Management

Student education

I set up and manage the School of Medicine 4th Year Acute and Critical Care (ACC) undergraduate teaching programme.  This delivers teaching in anaesthesia, critical care, acute medicine and emergency medicine and gives students a strong grounding in the management of the acutely unwell patient.  The innovative ACC curriculum makes extensive use of medical simulation, equips students to use technologies such as bedside ultrasound, and is high-regarded by both students and hospital staff.

I am the Joint Director of the Leeds EXSEL Scholarship Programme. This unique scholarship scheme receives support from charitable donors and alumni and nurtures undergraduate medical students with research ambitions to become academic clinicians. 

I am a member of the Royal College of Anaesthetists Undergraduate and Medical Schools Advisory Group which advises the College on its strategy to support undergraduate education in anaesthesia and perioperative medicine.

Research groups and institutes

• Leeds Institute of Medical Research at St James's