MBBCh MRCP FRCA FFICM
reflective • measured • conscientious
01792 828121
pa@intensive-care-expert.co.uk
Graduating with Honours from the University of Wales College of Medicine in 2004 he undertook rotational training in general medicine specialties and awarded Membership of the Royal College of Physicians (MRCP) in 2007.
He has worked within the specialties of intensive care medicine and anaesthesia since 2007. Awarded Fellowship of the Royal College of Anaesthetists (FRCA) in 2011 and Fellow of the Faculty of Intensive Care Medicine (FFICM) in 2013. He is one of few, if any, intensive care expert witnesses to have achieved FFICM by examination.
He was appointed at Morriston hospital, Swansea, as a consultant intensive care physician and anaesthetist in 2015. Morriston hospital is a university affiliated tertiary centre and his clinical work is predominantly in a busy 28 bed mixed critical care unit. The unit admits 1200-1300 critically ill patients each year, a quarter of this workload is specialised/regional and the case mix acuity is higher than the UK average.
Anaesthetic practice is predominantly major vascular surgery and pre-operative input to high risk patients. He does not undertake paediatric or neurosurgical critical care practice.
He was Clinical Director of Critical Care between 2019 and 2023; associated with this role included service development of Enhanced Care Units (ECU), Post Anaesthetic Care Units (PACU) and integration planning with the supra-regional Swansea Burn ICU (serving population ~10 million).
Specific clinical, teaching and governance interests include:
External roles:
He is happy to to receive instructions for clinical negligence (claiment, defendant and single joint expert), Court of Protection and Coroner inquests. He is able to provide expert opinion on most matters relating to intensive care medicine including the deteriorating patient and many elelements of anaesthesia including peri-operative care.
Demonstrated ability to give verbal evidence in court including Court of Protection and criminal proceedings.
He has most recently undertaken Bond Solon training in expert report writing and courtroom skills in 2022 and 2023 respectively.
All medico-legal work is covered with specific professional indeminity insurance.
His recently ended tenure as clinical director (2019-2023) involved investigation of serious incidents, responding to complaints and scrutinising expert reports relating to litigation and Coronial proceedings. This has given him insight to what makes a high quality report from different perspectives.
The period as clinical director of the ICU included the COVID pandemic. Therefore, he is uniquely placed to give expert opinions on cases from this difficult period given his insights of being an 'on the ground' clinician coupled with wider service delivery knowledge at a ICU, hospital, regional and national basis.
All expert reports are proof read by another General Medical Council registered doctor, who is not an ICU or anaesthesia specialist, to ensure readability to a wider audience whilst maintaining confidentiality.
Ensuring the privacy, security and safety of client data is of upmost importance. The terms and conditions, which include the privacy notice, can be supplied in advance upon request.
Services are fully compliant with relevant regulations including GDPR and the NHS Records Management Code of Practice. Some of the processes that are adhered to whilst data is in our possession and transit include:
Terms and conditions are available on request and are based on the British Medical Association model document.
As a guide, a desktop only expert medical report on an average intensive care case takes approximately 10 hours. However, all cases are unique and the estimate of time can be discussed prior to instruction.
Able to travel throughout the UK for court attendance or any necessary patient examination. Fees for expert witness reports are £250 per hour; other costings are indicated in the terms and conditions.
Instructions on a reduced price or pro bono basis would be seriously considered for instances when a patient/family may be left at a disadvantage through lack of funds to access to an expert e.g. Court of Protection and Coronor Inquests.
Cases that require an intensive care expert witness often have themes which traverse peri-operative care, emergency department, medical specialties and the deteriroating ward patient.
Dr Gorst has an active anaesthesic practice and can draw from years of experience of working in many specialties inluding acute medicine, cardiology, ED, respiratory and gastroenterology. This experience is recognised through Membership of the Royal College of Physicians.
There are a minority of medicolegal cases that require an ICU sub-specialist opinion such as neurosurgical or cardiac surgical ICU practice. Most cases require an expert who can draw from a high volume of general intensive care practice.
Dr Gorst spends the majority of his clinical time on a large general ICU that admits a whole spectrum of patients.
His anaesthetic practice is additional to full-time ICU.
Intensive care medicine is one of the last remaining 'generalist' specialties; a competent practitioner is required to manage acutely ill patients from most specialties. An expert with a deep clinical/research interest in a very specific area may not be the most appappropraite expert to make judgements on standards of care.
Consider an expert with applicable 'generalist' expertise.
The Academy of Royal Medical Colleges guidance states that expert witnesses must be in, or sufficiently recently in, clinical practice. Medical knowledge is said to change so frequently that up to 50% has expired in 18-24 months.
Why risk instructing an expert who is not in active, high volume and full-time ICU practice?
Dr Gorst strongly encourages making contact for a commitment free discussion. He is often available at short notice.
Contact will allow exploration of the main issues of the case, to establish if he is a suitable expert and to discuss the complexity and therefore indicative time and costs. He is often available to produce reports to a short timescale if required by the court.
pa@intensive-care-expert.co.uk
If leaving a message contact is usually made the same or next working day. Please indicate potetnially convenient times to recieve a return telephone call.