Locum Consultant in Acute Medicine

Job responsibilities

1. SUMMARY

Applications are invited for the post Consultant in Acute Medicine Department at Whittington Health NHS Trust

Whittington Health has a thriving and innovative acute medicine department located within the Whittington Hospital. Successful applicants will join a dedicated and passionate team committed to providing a first class service in terms of quality, safety, innovation and education. The department cover 2 acute wards and an ambulatory care centre and serves as the hub of acute medical care in the hospital.

As an Integrated Care Organisation, Whittington Health is commissioned to provide acute and community services to meet the needs of our diverse population. This means the Trust is well placed to deliver 21st century healthcare that crosses the traditional boundaries between primary and secondary care. Our mission is Helping local people live longer, healthier lives.

The successful candidate will join a team of eight consultants. Applications from applicants with additional specialist interests will be welcomed. The Acute Medicine Department is also supported by sessions from other specialist consultants.

The person(s) appointed will have experience of a broad acute medical training and will be capable of handling the range of medical problems that occur within the setting of an acute hospital. The appointee must be an effective team player and will be flexible in approaching new ways of working.

Applicants must have the MRCP (or equivalent specialist qualification) and hold a Certificate of Completion of Training (CCT) in General (Internal) / Acute Medicine, or be within six months of award of CCT, or equivalent, by date of interview.

Applicants must also be on the Specialist Register of the General Medical Council (UK) with a Licence to Practise, (or be eligible for full and specialist registration within six months of interview).

2. THE DEPARTMENT

The Acute Assessment Unit (AAU) comprises a 34-bedded purpose-built unit located in the main hospital adjacent to the Emergency Department (ED), ITU and all other pivotal diagnostic departments. It is divided into two separately managed wards; Mary Seacole North and Mary Seacole South.

The primary role of the AAU is to provide early assessment, diagnosis, stabilisation, and treatment of acute medical patients who are admitted to the hospital. The AAU operates in close association with the ED, ITU/HDU, the ambulatory care service and the medical wards. The majority of acute medical patients admitted to the Whittington will spend their initial period of admission on the AAU under the care of the AAU consultant.

Patients will normally stay on the AAU for up to 48 hours, during which time a management plan will have been initiated by the acute medical team. Patients will be discharged from the AAU either: a) back into the community, b) transferred to virtual ward to be monitored prior to formally being discharged, c) to the care of an appropriate specialty or medical team on one of the main hospital wards, d) transferred to a different hospital for specialist or tertiary care.

The ED will continue to provide emergency triage, assessment and initial therapy including resuscitation for patients presenting to the hospital but an increasing number of medical patients will be directed to the Ambulatory Care Unit or AAU directly, promoting same day emergency care (SDEC), to avoid unnecessary delays within the ED. The new appointee would be expected to participate and support ongoing developments of robust pathways to deliver a maximally clinically effective model of care.

Our Ambulatory care centre opened in 2014 and provides innovative and transformational care that best serves our local community. It is one of the largest ambulatory care centres in the country and aims to provide rapid senior decision making and advanced diagnostics within Whittington Health. Under the leadership of acute and emergency medicine consultants, we assess and treat patients who are referred from Acute Medicine, the Emergency Department, GPs and community services.

As part of delivering a robust medical admissions unit and extended working hours, all patients are seen post take within 14 hours of admission by the AAU consultant (at weekends, other consultants on the rota will also carry out this role). All patients on the AAU have consultant-led care to aid rapidity of diagnosis and ensure that the most up-to-date and evidence-based management is instituted early during their admission and before transfer to a specialty bed.

3. CURRENT ESTABLISHMENT

Acute Medicine Staff Whole Time Equivalents (WTE), 5.9

Consultant Staff Contributing to AMU WTE

Dedicated AMU consultants currently 3.9

COOP/G(I)M 0.3

Diabetes/Endocrinology/G(I)M 0.5

ITU/G(I)M 0.225

ED/AEC 0.4

New Recruit 1

Junior Doctors rotating through AAU:

ST3+ 1

CT1/2 (GIM, ACCS, GP) 10

Medical FY2 2

Medical FY1 4

Management structure

In 2015 the Acute Medicine Department became part of the Emergency & Integrated Medicine Clinical Service Unit (ICSU), which is led by Dr Rachel Landau, Clinical Director. The Emergency & Integrated Medicine ICSU includes areas in the organisation delivering acute, unscheduled and urgent care, such as the Emergency department, Ambulatory Care, the acute medical wards and community nursing. This allows for close working and innovation across the acute pathway. This is one of five ICSUs that make up the clinical management structure of the Trust.

4. JOB PLAN & DUTIES OF THE POST

This is a full time appointment with 10 programmed activities to include 7.5 programmed activities for patient care (DCC) and 2.5 for supporting programmed activities and other work for the NHS. Less than full time applicants will be considered. The Trust is committed to all basic job plans reflecting a 2.5 SPA: 7.5 DCC split for all full time post with part-time posts having similar spilt recognising that some of the SPA cannot be reduced on a pro rata basis, such as educational supervision, continuing professional development (CPD) and appraisals.

Supporting programmed activities are activities that underpin direct clinical care and include participating in mandatory training, undergraduate & postgraduate medical education, continuing professional development, audit, appraisal, research and clinical governance.

Acute Consultant 4-week job plan

In a 52 week year, you are entitled to:

• 32 days of annual leave per year
• 8 bank holidays (or TOIL for bank holidays worked) per year
• 10 days of study leave or professional leave per year
• This combined leave totals 10 weeks per year

For the remaining 42 weeks of the year, you will be on the GIM on call rota at a frequency of one in 18:

• On weekday on calls, you will attend the morning handover meeting at 8am and then post take a maximum of 5 outlying patients. From 8pm to 8am the next morning, you will be on call from home by telephone
• On weekends or bank holidays, you will be resident on call from 8am-8pm

The reimbursement for the GIM on call rota is as follows:

• These arrangements are by local negotiation and will be revised if the national consultant contract is changed
• From 8pm-8am, you will be paid a non-resident on call supplement
• From 8am-9am (weekdays) and 8am-8pm (weekends and bank holidays) you will receive TOIL equivalent to 4 hours TOIL for every 3 antisocial (i.e. weekends and bank holidays) hours worked. This equates to 5 days of TOIL after every weekend worked or approximately 3 weeks of TOIL per year

For the remaining 39 weeks of the year, your weekly rota will approximate this:

Week

Mon

Tue

Wed

Thu

Fri

Sat

Sun

1

MSN/MSS

MSN/MSS

MSN/MSS

MSN/MSS

MSN/MSS

2

AEC

Late Take

SPA

Late Take

Late Take

3

MSN/MSS

MSN/MSS

MSN/MSS

MSN/MSS

MSN/MSS

4

Late Take

AEC

Late Take

Late Take

SPA

5

MSN/MSS

MSN/MSS

MSN/MSS

SPA

AEC

MSN/MSS:

• Shift is 0800-1620 with 20 minutes (unpaid) lunch break
• Nominally 0800-1400 ward round, non-patient facing clinical admin, clinical supervision (DCC) + and extra half hour DCC for a board round ~1530
• DCC 1.625 PAs, SPA 0.375 PAs

Late Take:

• Shift is 1200-2000 with 20 minutes (unpaid) lunch break
• Work load, 30 patients in 24 hours, supported by 4 junior doctors in the day (2 of those starting at 2pm, mirroring peak medical admissions) and 2 junior doctors at night.
• SPA/lunch 12-2pm
• Post-taking (DCC) 2-8pm
• DCC 1.58 PAs, SPA 0.42 PAs
• Working alongside ED and medical take team. Reviewing admitted medical patients. There is one medical registrar covering the acute take. The usual number of admitted medical patients over a 24 hour period is in the range 20-30

AEC:

• Shift is 0900-1720 with 20 minutes (unpaid) lunch break
• Work load, 25-30 patients in AEC (new to follow up ratio 2:1), 1 consultant and 3 junior doctors.
• Virtual ward 9 patients discussed with consultant once or twice daily with GP face to face in reach if clinical indicated.
• DCC 2 PAs, SPA 0 PAs
• Promoting SDEC, same day emergency care, and assessing new patients referred from GPs and ED

SPA:

• Shift is any 8 hour shift with a 20 minute (unpaid) lunch break e.g. 9am-5.20pm
• DCC 0 PAs, SPA 2 Pas

Qualifications/Training

Essential

• Full GMC Registration, MBBS, MRCP or equivalent
• Entry on Specialist Register in Acute Medicine or General (Internal) Medicine (or entry expected within 6 months from the date of interview)

Desirable

• MSc, PhD
• CCT in Acute Medicine
• Specialty Training in General (Internal) Medicine who have demonstrated a firm commitment to a career in Acute Medicine

Skills & Abilities

Essential

• Ability to take full and independent responsibility for the care of patients.
• Able to organise and prioritise workload effectively
• Able to plan strategically and to exercise sound judgements when faced with conflicting pressures
• Able to offer accurate, timely and evidence based acute medical opinions.

Teaching and clinical supervision

Essential

• Able to provide effective clinical supervision to trainees
• Experience in organising teaching, educational activities or journal clubs.
• Participate in teaching, undergraduate/allied healthcare professionals.

Desirable

• Formal accreditation/training in educational and clinical supervision of junior doctors.
• Medical education diploma or MSc

Research

Essential

• Participated in research and understand research governance procedures.

Desirable

• Publish in peer reviewed medical journals.
• MSc, PhD.

Management and leadership

Essential

• Able to motivate and develop the multi-disciplinary team, balancing departmental and personal objectives
• Participate or lead departmental activities such as rota, mortality and morbidity meeting, audit and QIPP.

Desirable

• Formal training in management and leadership
• Participated in guideline and pathway development

Audit/QIPP

Essential

• Conducted clinical audit
• Led a quality improvement initiatives

Desirable

• Projects showed sustainability (through re-audit or completing the cycle).

Other Requirements

Essential

• Excellent communication skills, both oral and written, and an ability to relate to staff and patients.
• Able to work in a multi-professional and multi-disciplinary framework.
• Team player

Desirable

• Ability to support and motivate staff during periods of pressure

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).