Tristram Lesser ENT Consultant ORL-HNS Ltd

Professional services in Otorhinolaryngology, Head and Neck Surgery

I have carried out medico-legal work for the last 27 years.

This has been in the fields of Personal Injury and Medical Negligence.
Personal Injury work has mainly been in Noise Induced Hearing Loss and Accidents. This has been 40% defence and 60% claimant instructions. Medical Negligence work has been in all aspects of ENT this has been 60% defence and 40% claimant.
Currently I take on 22 Medical Negligence cases a year. This consists of note review, report compiling, and advice to council and court appearance. I have been undertaking NHS LA reviews and advice.
I have also provided reviews for NHS trusts on case series and external review of consultant practice and complaints.


Undergraduate teaching has been carried out throughout my career. I taught students in Aintree Hospitals as well as on the lecture course for E.N.T. Liverpool has undergone a dramatic change in the undergraduate course and I have helped to shape this as well as being trained in tuition.

Postgraduate teaching has involved both the practical surgical training of registrars and senior house officers and the more formalised tutorials and coaching for fellowship examinations.

I teach on the annual Liverpool FRCS clinical course for surgery in general.

I am Joint lead for the Otology Module for Liverpool University MSc in medical Sciences In ENT I teach on the Postgraduate course in Liverpool, I am part of the Faculty of The National Course in Head and Neck Oncology and the Faculty of the West Midlands Basic Temporal Bone Course and I run the annual Merseyside Otology Course.

Teaching also includes lectures to nurses, ODA’s and laypersons as well as running courses on practical procedures in ENT for General Practice.
I set up the training for Advanced Nurse Practitioners in ENT and ran this for three years.

I have trained fellows in Skull Base Surgery. Overseas funding from the British Council.


I have been the Clinical Director/Lead Clinician for ENT/H&N Surgery in Aintree for the last 4 years. This has involved the usual responsibilities of running a big department with job planning; Medical Appraisal; Ward Theatre and Outpatient Management: Participating in the Clinical Liaison Groups regular GP/CCG meetings. Representing the acute trust in meetings and committees with other trust and encouraging integrated care.
During this time I have also;

    I have been Lead Clinician and member of the Medical Management Committee for the department in Southport for 23 years. Lead Clinician for Medical Audit and for Audiological Services in Aintree. I have served on the Ethics Committee for Sefton (Merseyside). I have contributed to the Head and Neck Project Group towards the re-organisation of North Merseyside Head and Neck Surgery, been part of the advisory group for the commissioning of Cochlea Implant Services for Merseyside and Cheshire and on a national level part of the MRC focus group on the Acceptability, Benefit and Costs of Early Screening for Hearing Disability.

    Nationally I sat on the DH working party for revamping the structure of Balance and Vertigo services for the UK.

    The main national Management responsibilities that I have undertaken are the Chairmanship of the SAC in Otolaryngology and the Assistant Hon Sec for ENT.UK

    In the latter post I set up the Medical Training Initiative (MTI) for overseas doctors to come to the UK and learn ENT. The aim was to get ENT.UK to be an official GMC approved sponsor and set up the program with interviews and start getting trainees into UK posts to both provide the service and give them training. This continues to run well.


    The service I have provided, since being a consultant, is based in University Hospital Aintree with outpatient clinics and day case surgery in Southport. The Southport service covers all aspects of general ENT from neonatal screening for sensory neural hearing loss, through rapid access head and neck cancer diagnosis to vestibular rehabilitation for elderly fallers. The Aintree service consists of inpatient and emergency general ENT and a sub-specialist in Skull Base Surgery. During the last 10 years of consultant service I have carried a very large workload. Each year I have been responsible for over 1000 operations and seen over 5000 out patients. This is more than twice the expected amount of an ENT consultant and his team

    As a Senior Registrar in Otolaryngology I was the third most productive academic Otolaryngologist in the United Kingdom. I was the only junior doctor to make the top ten and the first and second were already Professors. In 1993 I was offered to the Chair of Otolaryngology, Head and Neck Surgery in the University of Nottingham. This was following a head hunting exercise and after being asked to submit my CV and attend 2 days of interviews I was offered the Chair. I was unable to accept this for personal reasons.

    I have created a Skull Base Surgery service for Merseyside. Prior to my appointment this service had not been provided in Merseyside and the Trust was able to secure a large amount of extra funding, initially on a year-to-year basis for 12 Skull Base cases per annum. This was consolidated into the permanent funding. The service has continued to expand and we now do 30 Skull Base operations per annum. I have now taken a supervisory role mentoring the two new consultants who are taking over from me and continuing this service for the future. Last year we were the 3rd busiest Skull Base Unit in the UK.