Job summary
Guy's & St Thomas' NHS Foundation Trust
Acute & General Medicine Directorate
Consultant in Acute Internal Medicine & General Medicine
Full Time - 10 PAs
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
These are exciting times for Acute Medicine at Guys and St Thomas NHS Foundation Trust!
We are in the process of increasing and enhancing our Acute Medicine service at the Trust to optimise the workstreams provided both for the Same Day Emergency Care aspects of the role but we are also embarking on a reorganisation and restructuring of the whole Emergency Floor to ensure our processes and interactions between the Emergency Department, inpatient Medicine and other inpatient services are fit for the coming decades.
Since the Covid-19 pandemic, the role of SDEC has seen a large upsurge and the benefits of expedited, specialist yet holistic medical assessment has been proven, with improvements in bed-days, length of stay, patient satisfaction and healthcare associated morbidity. Wherever possible, we aim to ensure that excellent medical care is provided to patients as an outpatient and to do this, we are expanding our SDEC services.
We are currently in the process of a geographical move to allow medical SDEC to benefit from a larger footprint within the Emergency Floor and to allow a modernisation of our ways of working, accepting and assessing referrals and providing more streamlined and frictionless care.
We were one of the first providers in the country to provide a separation of SDEC workstreams to maximise efficiency and space, with an admissions avoidance and facilitated discharge separate stream. We are aiming to increase capacity for both of these streams to enhance reliability and robustness of the services. In the years ahead we envisage further improvements to the locations, ways of working and acceptance criteria to better serve our population and to reflect our changing work/life balances.
We are working with community providers including GP practices, the London Ambulance Service, NHS 111, the ICB and the local @Home service to standardise and expand pathways and routes of access for suitable patients and to increase the breadth of conditions we can see on a same-day or subacute basis. This includes a formalisation of virtual ward functions and the development of urgent and emergency automated follow up pathways (such as our in-development abnormal chest x-ray interval imaging pathway).
We have a reasonable conversion rate of SDEC attendance to medical admission, reflecting the acuity of the patient flow, and the Acute Medicine team contributes to the week-day running of the medical take by forming 2 in 5 of the Admission Ward medical team complement. This five team model is assisted by daily frailty and toxicology ward rounds as well as psychiatry in-reach where needed.
Expansion of the AIM service is vital to national healthcare strategic drivers aligned to the NHS Long Term Plan, and in supporting the Trust in delivering the NHSE SDEC Direct and Think SDEC campaigns, NHS SAMEDAY strategy and national SDEC benchmarking standards, with key collaborations across SEL.
Job description
Job responsibilities
These are exciting times for Acute Medicine at Guys and St Thomas NHS Foundation Trust!
We are in the process of increasing and enhancing our Acute Medicine service at the Trust to optimise the workstreams provided both for the Same Day Emergency Care aspects of the role but we are also embarking on a reorganisation and restructuring of the whole Emergency Floor to ensure our processes and interactions between the Emergency Department, inpatient Medicine and other inpatient services are fit for the coming decades.
Since the Covid-19 pandemic, the role of SDEC has seen a large upsurge and the benefits of expedited, specialist yet holistic medical assessment has been proven, with improvements in bed-days, length of stay, patient satisfaction and healthcare associated morbidity. Wherever possible, we aim to ensure that excellent medical care is provided to patients as an outpatient and to do this, we are expanding our SDEC services.
We are currently in the process of a geographical move to allow medical SDEC to benefit from a larger footprint within the Emergency Floor and to allow a modernisation of our ways of working, accepting and assessing referrals and providing more streamlined and frictionless care.
We were one of the first providers in the country to provide a separation of SDEC workstreams to maximise efficiency and space, with an admissions avoidance and facilitated discharge separate stream. We are aiming to increase capacity for both of these streams to enhance reliability and robustness of the services. In the years ahead we envisage further improvements to the locations, ways of working and acceptance criteria to better serve our population and to reflect our changing work/life balances.
We are working with community providers including GP practices, the London Ambulance Service, NHS 111, the ICB and the local @Home service to standardise and expand pathways and routes of access for suitable patients and to increase the breadth of conditions we can see on a same-day or subacute basis. This includes a formalisation of virtual ward functions and the development of urgent and emergency automated follow up pathways (such as our in-development abnormal chest x-ray interval imaging pathway).
We have a reasonable conversion rate of SDEC attendance to medical admission, reflecting the acuity of the patient flow, and the Acute Medicine team contributes to the week-day running of the medical take by forming 2 in 5 of the Admission Ward medical team complement. This five team model is assisted by daily frailty and toxicology ward rounds as well as psychiatry in-reach where needed.
Expansion of the AIM service is vital to national healthcare strategic drivers aligned to the NHS Long Term Plan, and in supporting the Trust in delivering the NHSE SDEC Direct and Think SDEC campaigns, NHS SAMEDAY strategy and national SDEC benchmarking standards, with key collaborations across SEL.
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.
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.
UK Registration
Applicants must have current UK professional registration. For further information please see
NHS Careers website (opens in a new window).
