Clinical Fellow (ST1 level) in General and Acute Medicine

Job description

Job responsibilities

Principle Job Purpose

To provide in conjunction with colleagues, clinical services to the Virtual Ward and SDEC services, along with general medicine on-call commitment

New or Replacement Post

New post

Accountable to

Supervising Consultants

Other Responsibilities

Subject to the provisions of the Terms and Conditions of Service, to observe the Trusts agreed policies and procedures drawn up in consultation with the profession on clinical matters and to follow the standing orders and financial instructions of the Trust.

To observe local and national employment and personnel policies and procedures, and to comply with Regional and Trust Health and Safety policies.

To assume responsibility for and facilitate contact from members of staff with delegated duties for personally accountable patient care.

Division of Medicine, Diagnostics and Clinical Support Services

The post holder will be employed within the Division of Medicine, Diagnostics and Clinical Support Services of the James Paget University Hospitals NHS Foundation Trust. General Medicine, Acute Medicine and Acute Care of the Elderly services are fully integrated within the Emergency Division.

Assistant Medical Directors Dr Paul Banim & Dr Al Green

Divisional Operations Director Phil Weihser

Clinical Lead Cardiology Dr Sunil Nair

Clinical Lead Respiratory Dr Andrei Kisseljov

Clinical Lead Diabetes, Endocrinology Dr Jo Randall

Clinical Lead Care of the Elderly Dr Mazhar Zaidi

Clinical Lead Stroke Dr Hilary Wyllie

Clinical Lead Gastroenterology Dr Matt Williams

Clinical Lead A&E Dr Jon Baldry

Clinical Lead ICU Dr Michael Karlikowski

Clinical Lead Acute Medicine Dr Dom Giles

Department of Acute medicine

EADU

• Three six bed & one four-bed level 1 care bays (22 beds)
• Four single bed on-suite side rooms (4 beds)
• Two, four bed level 1+ Acute Care Bays (8 beds)

Ambulatory Care Unit

• The Ambulatory care Unit has been recently expanded and now accommodates up to 60 patients per day. It has consultant presence 9-5 Monday to Friday and is open 8-8:30 Monday to Sunday, supporting same day emergency care and reducing the need for admission
• Utilises point-of-care testing
• Average length of stay for acute admissions is 120 minutes
• Incorporated within the unit is a 4-trolley GP assessment bay, aimed to fast-track acute medical admissions by front-loading investigations and senior decision-maker opinion

Ward 16 Short Stay Unit

• In April 2017, the Short Stay Medical Unit moved location to be incorporated within the Emergency Floor
• This is a 16-bedded unit (plus 6 cohort beds; which are used to manage patients with c.difficile infection): 3 x 4-bedded bays and 4 side rooms in the main unit plus 4 x side rooms and 1 x 2-bedded bay in the cohort unit.
• The unit admits patients with acute diabetic problems (e.g. Diabetic Ketoacidosis) and admits patients with an expected length of stay of <3 days. It is supported by a daily consultant ward round 5 days per week. The average length of stay is around 2.3 days; with 5-14 discharges per day (average 7).

There are 5.5 FTE Acute Medicine Consultants who are supported by General Medical Consultant Colleagues for some daytime and mainly out-of-hours shifts.

The current average rate of medical admissions is around 40 per 24 hours, with a further 40 seen daily in the Ambulatory Unit. The unit accepts general surgical patients from time-to-time but these are managed by the surgical teams.

The unit has priority access to radiological and laboratory investigations. The PACS system is accessible within the EADU enabling the recall of all existing radiological images for any given patient. The intranet provides a wide range of guidelines, contact numbers and other useful resources.

EADU services are fully equipped to support the management of patients on Level 1+ care; including the use of NIV, CPAP, High flow nasal oxygen, central venous catheters and chest and abdominal drain devices.

EADU has its own point-of-care ultrasound device (Phillips Sparq). We encourage the expansion ultrasound applications in emergency medical care.

The James Paget University Hospital operates a Hospital at Night team, the aim of which is to provide a safe and supported framework to optimise patient care and junior doctor supervision. The Hospital at Night team relies on generic working of team members. This means that a team of doctors and nurses will have appropriate skills as a whole to manage most problems arising overnight. Hospital at Night covers five specialties: Medicine, Surgery, Urology, Orthopaedics and Obstetrics & Gynaecology. The EADU takes a central role in the Hospital at Night Programme.

The unit is also a very important area for the teaching, training and assessment of Junior Doctors as well as an important area for the teaching and training of Medical Students and other staff.

During the normal working week, two Consultants attend the unit in the morning in order to review all patients followed by a dedicated Consultant for the rest of the day to allow timely review of newly admitted individuals.

Geographical proximity with the Emergency Department allows a close working relationship with this clinical area.

The admitting team consists of at core of three doctors (Specialty Registrar/Specialty Doctor, Junior (Core Trainee/Foundation Year 2 Doctor) and Foundation Year 1 Doctor; supported by the Acute Medical Team (further FY1 doctors x 3; further FY2/core trainees x 1-2 and further AIM SpRs (x1-2).

The post holder will be responsible for the providing immediate clinical assessment and management for patients presenting to the unit and appropriately liaising with other specialists.

There is a rich source of issues suitable for auditing and it is expected that the post-holder will exploit this opportunity.

The James Paget University Hospital is a busy district hospital and this post will provide good exposure to a wide range acute medical presentations. There will also be opportunities for more specialised training in keeping with the ACCS curriculum.

Department of General Medicine

The department of medicine consists of the following sub specialties:

Emergency Admission and Discharge Unit (EADU), Cardiology, Respiratory Medicine, Gastroenterology, Diabetes and Endocrinology, Care of the Elderly, Stroke Medicine, Rheumatology and Haematology.

As well as excellent training in a district hospital environment there is a weekly Grand Round as well as a rolling weekly programme of medical topic lectures and specialty meetings in cardiology and respiratory medicine and case presentations.

He/she will be required to work a full shift system and undertake clerking of patients, initiate routine and emergency care of patients in consultation with the Specialty Trainees, Specialty Registrars, Specialty Doctors and Consultants.

ST1 Trainees supervise and assist the Foundation Year 1 and 2 Trainee with day to day Management of inpatients including Consultants and Non-Consultant Ward Rounds. Participation in the out of hours rota. When on duty the ST1 is part of the Cardiac Arrest Team.

Person Specification

Education and Qualifications

Essential

• Full Registration with Licence to Practise
• IELTS etc level 7.0 overall
• MBBS

Experience & Knowledge

Essential

• Evidence of achievement of foundation programme competencies
• Knowledge & understanding of UK Hospital systems & practises and value: awareness of current issues in the NHS.
• Clinical Knowledge & Expertise: appropriate knowledge base and ability to apply sound clinical judgement to problems.
• Able to prioritise clinical needs. Aware of own limitations and knows when to consult senior colleagues

Key Skills

Essential

• Good oral and written presentation skills.
• Able to establish good working relations with patients, carers, and multidisciplinary colleagues.
• Good organisational skills and time management

Other

Essential

• Commitment to personal and professional development
• Professional integrity: Capacity to take responsibility for own actions. Demonstrates respect for all.

Disclosure and Barring Service Check

This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.

Certificate of Sponsorship

Applications from job seekers who require current Skilled worker sponsorship to work in the UK are welcome and will be considered alongside all other applications. For further information visit the UK Visas and Immigration website (Opens in a new tab).

From 6 April 2017, skilled worker applicants, applying for entry clearance into the UK, have had to present a criminal record certificate from each country they have resided continuously or cumulatively for 12 months or more in the past 10 years. Adult dependants (over 18 years old) are also subject to this requirement. Guidance can be found here Criminal records checks for overseas applicants (Opens in a new tab).

UK Registration

Applicants must have current UK professional registration. For further information please see NHS Careers website (opens in a new window).

Employer details

Employer name

James Paget University Hospitals NHS Foundation Trust

Address

James Paget University Hospital

Gorleston

NR31 6LA

Employer's website

https://www.jpaget.nhs.uk/work-for-us/ (Opens in a new tab)