Job summary
Guy's & St Thomas' NHS Foundation Trust
Acute & General Medicine Directorate
Locum Consultant in Acute Internal Medicine & General Medicine
Full Time - 10 PAs , LTFT arrangements will be considered also!
Main duties of the job
To provide high quality, innovative and cost-effective acute medical care for patients in the 56-bedded Acute Medical Admissions Ward (AAW) on the St Thomas' site.
To provide a major contribution to the Same Day Emergency Care (SDEC), ambulatory and admission avoidance aspirations of the Trust.
To work with clinical colleagues in the ED, GIM, Medical Sub-Specialties and Community Services to deliver seamless medical care throughout the UEC pathways.
To participate in clinical and other service activities with the aim of ensuring high standards of patient care and delivery of the National Emergency Access Targets and the London Quality Standards of Care.
To contribute to the educational, management, development and governance needs of the clinical service as requested.
To establish, promote and contribute to the research base through working collaboratively to answer key questions about service design, delivery and development.
Workload follows RCP guidance for Acute Internal Medicine & General Medicine.
About us
Guy's and St Thomas' NHS Foundation Trust (GSTT) is one of the largest and most successful hospital trusts in the country, including two of London's oldest and best known teaching hospitals. The hospitals have a long history, dating back almost 900 years, and have been at the forefront of medical progress and innovation since they were founded. Our hospitals have built on these traditions and continue to have a strong national and international reputation for clinical excellence, teaching, research and innovation.
We are part of King's Health Partners (KHP), a pioneering Academic Health Sciences Centre (AHSC) collaboration between one of the world's leading research-led universities and three of London's most successful NHS Foundation Trusts. See www.kingshealthpartners.org
We provide a full range of world class hospital services for our local communities, as well as a large number of specialist tertiary services for patients from further afield, including cancer, cardiovascular, cardiothoracic, infectious diseases, renal, women's and children's services. We have one of the largest Critical Care Units in the UK and one of the busiest Emergency Departments in London.
Our reputation for safe, high quality care is among the best in the UK and we strive to put patients at the heart of everything we do. We pride ourselves on ensuring the best possible patient experience, and are proud to have one of the lowest mortality rates in the NHS.
Job description
Job responsibilities
Acute Internal Medicine (AIM) at Guys and St Thomas Hospital NHS Foundation Trust (GSTT) is an expanding and innovative team with a vital role in the delivery of expert acute medical care of the highest quality to the urgent and emergency care (UEC) pathways. The service is instrumental in supporting the delivery of Medical Same Day Emergency Care (SDEC).
The AIM Physicians at GSTT have a pivotal role in the medical acute-care interface of AAW, SDEC, the Emergency Department and Local Community Services. Theyactively support the acute medical take working with a wide range of Physicians who contribute to the General Medical take at GSTT.
The medical model aims to utilise the acute medical assessment and admission avoidance skills of the Acute Physician team in conjunction with the Ageing and Health Acute Frailty team, to help optimise SDEC outcomes, and reduce length of stay for those that are admitted. The plan is to ensure this approach is sustained 7 days a week, and consolidation of the AIM team will support this.
The AIM Team run the Daytime Acute Medical Take on the Acute Admissions Ward (AAW) daily (Mon-Fri) from 08.00-17.00hrs, and also split the weekday morning overnight Post-Take Ward Round caseload on AAW with the Overnight on-call GIM Consultant. The AIM team maintain responsibility and continuity of care for all patients admitted under their team whilst the patient remains on the AAW. High acuity Level 1 patients, or those who are predicted to be dischargeable will preferentially remain on AAW as bed status allows. There is pro-active support from the Critical Response Team (CRT) for escalation to Level 2 or Level 3 Care. Those patients who are stabilised but require a longer inpatient stay are stepped down to the General Medicine wards on the North Wing.
Nationally, there is increasing focus on Same Day Emergency Care (SDEC). The AIM SDEC team accept Acute Medicine patients who would likely otherwise have required inpatient hospital admission under General Medicine in the absence of SDEC, but could potentially avoid full overnight admission with early input from the Acute Medicine team.
SDEC is currently provided within the Multi-Specialty Assessment Unit (MSAU). There is a consultant-led AIM team dedicated specifically to seeing appropriate acute medical patients in this area daily, and the AIM team make a significant contribution to the MSAU, currently seeing 40-50% of all weekday patients in this area, with exciting potential to expand further. Referrals are accepted from ED, local GPs, and increasingly from LAS 999 & 111 services if they meet the agreed Directory of Service (DoS) criteria, which are based on the National SDEC Directory, NHS Improvement, SAM, RCP and RCEM guidance, as well as the NHSE/London SDEC Gold Standard pathways which members of our team have been involved in co-creating.
The overall aim is to provide seamlessly efficient and effective acute medical care of the highest quality and safety across the emergency floor, inpatient and ambulatory pathways; to continue to build new partnerships and strengthen existing relationships with GP & LAS colleagues and community teams working within the wider South East London (SEL) Integrated Care Systems (ICS).
The department has a large educational component providing training to junior, middle grade and senior physicians and to medical undergraduates from Kings College London (KCL), including educational leadership, and high-fidelity simulation training in the state-of-the-art Simulation and Interactive Learning (SaIL) Centre. The Acute Physician team lead the Final Year Undergraduate Acute Care block for KCL School of Medicine.
Several members of the clinical team hold designated senior educational leadership roles, both internally and externally.
AIM physicians also currently make a significant contribution to the Trust Medical Examiner Office, Clinical Governance, Mortality Review and Digital Platform Development processes. In addition, our team members actively contribute to collaborations and initiatives across SEL, as well as at a pan-London and National level.
Job description
Job responsibilities
Acute Internal Medicine (AIM) at Guys and St Thomas Hospital NHS Foundation Trust (GSTT) is an expanding and innovative team with a vital role in the delivery of expert acute medical care of the highest quality to the urgent and emergency care (UEC) pathways. The service is instrumental in supporting the delivery of Medical Same Day Emergency Care (SDEC).
The AIM Physicians at GSTT have a pivotal role in the medical acute-care interface of AAW, SDEC, the Emergency Department and Local Community Services. Theyactively support the acute medical take working with a wide range of Physicians who contribute to the General Medical take at GSTT.
The medical model aims to utilise the acute medical assessment and admission avoidance skills of the Acute Physician team in conjunction with the Ageing and Health Acute Frailty team, to help optimise SDEC outcomes, and reduce length of stay for those that are admitted. The plan is to ensure this approach is sustained 7 days a week, and consolidation of the AIM team will support this.
The AIM Team run the Daytime Acute Medical Take on the Acute Admissions Ward (AAW) daily (Mon-Fri) from 08.00-17.00hrs, and also split the weekday morning overnight Post-Take Ward Round caseload on AAW with the Overnight on-call GIM Consultant. The AIM team maintain responsibility and continuity of care for all patients admitted under their team whilst the patient remains on the AAW. High acuity Level 1 patients, or those who are predicted to be dischargeable will preferentially remain on AAW as bed status allows. There is pro-active support from the Critical Response Team (CRT) for escalation to Level 2 or Level 3 Care. Those patients who are stabilised but require a longer inpatient stay are stepped down to the General Medicine wards on the North Wing.
Nationally, there is increasing focus on Same Day Emergency Care (SDEC). The AIM SDEC team accept Acute Medicine patients who would likely otherwise have required inpatient hospital admission under General Medicine in the absence of SDEC, but could potentially avoid full overnight admission with early input from the Acute Medicine team.
SDEC is currently provided within the Multi-Specialty Assessment Unit (MSAU). There is a consultant-led AIM team dedicated specifically to seeing appropriate acute medical patients in this area daily, and the AIM team make a significant contribution to the MSAU, currently seeing 40-50% of all weekday patients in this area, with exciting potential to expand further. Referrals are accepted from ED, local GPs, and increasingly from LAS 999 & 111 services if they meet the agreed Directory of Service (DoS) criteria, which are based on the National SDEC Directory, NHS Improvement, SAM, RCP and RCEM guidance, as well as the NHSE/London SDEC Gold Standard pathways which members of our team have been involved in co-creating.
The overall aim is to provide seamlessly efficient and effective acute medical care of the highest quality and safety across the emergency floor, inpatient and ambulatory pathways; to continue to build new partnerships and strengthen existing relationships with GP & LAS colleagues and community teams working within the wider South East London (SEL) Integrated Care Systems (ICS).
The department has a large educational component providing training to junior, middle grade and senior physicians and to medical undergraduates from Kings College London (KCL), including educational leadership, and high-fidelity simulation training in the state-of-the-art Simulation and Interactive Learning (SaIL) Centre. The Acute Physician team lead the Final Year Undergraduate Acute Care block for KCL School of Medicine.
Several members of the clinical team hold designated senior educational leadership roles, both internally and externally.
AIM physicians also currently make a significant contribution to the Trust Medical Examiner Office, Clinical Governance, Mortality Review and Digital Platform Development processes. In addition, our team members actively contribute to collaborations and initiatives across SEL, as well as at a pan-London and National level.
Person Specification
Professional Qualifications
Essential
- Full GMC Registration
- CCT in Acute Internal Medicine (AIM) and General Internal Medicine (GIM) with entry on the Specialist Register or within 6 months of CCT
- ALS Provider accreditation
Desirable
- Relevant Bachelors, Masters Degree or Doctorate
Clinical Experience
Essential
- Specific background in Acute Internal Medicine (AIM) as a specialty
- Current core member of a dedicated AMU and SDEC team
- Sustained & current experience in leadership of the acute medical take and care of GIM inpatients
Desirable
- Registrar (or above) level experience in ICU and/or as a senior clinician in a CCRT
Clinical Skills
Essential
- Proven track record and ability to work as a senior member of an AMU team
Desirable
- Echocardiography
- Ultrasonography
- Additional AIM curriculum subspecialty skill/interest
Teaching
Essential
- Experience of delivery of undergraduate teaching and postgraduate training
Desirable
- Wide-ranging teaching or training background
- Development of teaching and assessment programmes
AUDIT, QUALITY IMPROVEMENT & MANAGEMENT
Essential
- Suitable track record in audit and quality improvement
Desirable
- Demonstrable service development or quality improvement experience in the NHS
- Experience of leading innovation in clinical care or education & training
- Postgraduate training in clinical leadership (e.g. Chief Registrar, Darzi Fellowship) or equivalent
Other
Essential
- Strong commitment to Acute Medicine
- Record of high level communication & interpersonal skills
- Ability to develop and motivate staff, and enhance trainee experience
Desirable
- Experience in clinical guideline development
Person Specification
Professional Qualifications
Essential
- Full GMC Registration
- CCT in Acute Internal Medicine (AIM) and General Internal Medicine (GIM) with entry on the Specialist Register or within 6 months of CCT
- ALS Provider accreditation
Desirable
- Relevant Bachelors, Masters Degree or Doctorate
Clinical Experience
Essential
- Specific background in Acute Internal Medicine (AIM) as a specialty
- Current core member of a dedicated AMU and SDEC team
- Sustained & current experience in leadership of the acute medical take and care of GIM inpatients
Desirable
- Registrar (or above) level experience in ICU and/or as a senior clinician in a CCRT
Clinical Skills
Essential
- Proven track record and ability to work as a senior member of an AMU team
Desirable
- Echocardiography
- Ultrasonography
- Additional AIM curriculum subspecialty skill/interest
Teaching
Essential
- Experience of delivery of undergraduate teaching and postgraduate training
Desirable
- Wide-ranging teaching or training background
- Development of teaching and assessment programmes
AUDIT, QUALITY IMPROVEMENT & MANAGEMENT
Essential
- Suitable track record in audit and quality improvement
Desirable
- Demonstrable service development or quality improvement experience in the NHS
- Experience of leading innovation in clinical care or education & training
- Postgraduate training in clinical leadership (e.g. Chief Registrar, Darzi Fellowship) or equivalent
Other
Essential
- Strong commitment to Acute Medicine
- Record of high level communication & interpersonal skills
- Ability to develop and motivate staff, and enhance trainee experience
Desirable
- Experience in clinical guideline development
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.
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).
Additional information
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.
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).
