Job responsibilities
JOB TITLE: General Practitioner with
an Extended Role in gynaecology (GPwER)
REPORTS TO: Juliet Gordon (Operational
lead)
ACCOUNTABLE TO: Dr Karin Schachinger (Clinical
lead)
HOURS: Minimum of 2 sessions per week
SALARY: £12,000 per session
About the Gynaecology Collaborative
The Gynaecology Collaborative was
launched by Islington GP Federation (IGPF), on 1st October 2020. It is a
collaborative of multiple providers, including University College London
Hospital, Whittington Health and North Middlesex University Hospital joining up
primary, secondary and community care. IGPF
takes the role of lead provider The aim of this service is:
To provide a robust single point of access
for gynaecology referrals
To ensure the patient is seen by the right
clinician with the right skills in the right environment through effective
triage
To support management of adult gynaecological
conditions in a non-acute setting
To ensure there is access to diagnostics to
enable effective management
To improve the patient journey
through the development of safe and effective integrated
care pathways between primary, community and secondary care
services.
To enable consistent
standards in the management
of gynaecological conditions and improve health outcomes.
Develop and provide a feedback mechanism
to improve the skills and knowledge of referring clinicians and so
increase the proportion of patients managed in primary
care.
Job Summary
Gynaecology GPwER
will be required to:
Provide clinical
consultations which may be virtual or face to face
Be competent in
managing common gynaecological conditions such as: abnormal bleeding, pelvic
pain, PCOS, Endometriosis, Menopause, etc
Optimise the
medical management of women with common gynaecological conditions in the community
and discharge them back to their GP
Refer to other
Community services and secondary care as appropriate
Complete
comprehensive notes, request the appropriate investigations and develop a
management plan with the patient
Support the administrative
team with clinical and non-clinical queries
Participate in
regular clinical meetings, clinical governance, audits, quality improvement,
training and education.
There are several
sites identified for the service and these may evolve as the services develop. The
current community sites are located across the boroughs of Haringey and
Islington and are currently based at:
Hornsey Central Neighbourhood Health Centre, 151 Park Road
London N8 8JD (Clinics run on Monday, Tuesday, Wednesday, Thursday)
Bingfield Primary Care Centre, 8 Bingfield Street London N1
0AL (Clinics run on Tuesday, Wednesday and Thursday),
Lordship Lane Primary Care Centre, 239 Lordship Lane London
N17 6AA (Thursday)
GPwERs are expected
to work at any of the sites; working days and locations are to be agreed with
the individual GPwER; but are dependent on clinic space availability.
Job
Responsibilities
Clinical Triage
There are currently
dedicated triage sessions for some GPwERs. The new GP might be asked to support
these if necessary.
Clinics
Once a
patient has been triaged and felt appropriate for the Community Gynaecology
Service, the patient is booked in for an initial consultation, either in clinic
or via telephone. These clinics have been set up as virtual/face to face
clinics so that they can be modified depending on thecurrent demand and
clinical need. The clinics are supported
by Consultant Gynaecologists who are, dependent on the day, available on site
or remotely via tasks/telephone.
Clinicians
document their consultations on EMIS which is the primary care electronic record.
This ensures that they have access to the patients medical records and enables
GPs tosee the outcome of the consultation in a timely manner. There are
templates set up on EMIS to try to make the process easier and each clinician is
expected to use them. Each clinician will have an induction so that they can
familiarise themselves with the IT system.
Clinicians
will be expected to review results that come into EMIS and action those that
are abnormal and are expected to respond to any clinical queries that are put
forwardas a result ofavirtual/f2f encounter.
Should a
procedure be required, local pathways are agreed and this will include clarity
around consent and pre-operative investigations.
Clinical
sessions are 4 hours and 10 mins long. First consultations are booked into 20
mins slots, follow up consultations are 10 mins. Additional time is given for
procedures, use of interpreters or for patients with additional needs. Blocksare
built into each session to allow a catch up for delays, complicated or
difficult procedures, technical issues with video/phone.They
alsoallow time fortheConsultant to supportGPwERqueries
in clinic. F2F appointments have been staggered across the session to
avoidcrowding in waiting areas and to allow the HCA to assist the
clinicians and to effectively maintain infection control measures.Admin
timeis includedat the end of each session for dealing with results,
referral letters, tasks etc
Other
duties include:
To provide the full range of NHS Primary Medical Services to the
patients attending the Gynaecology Collaborative including clinical
examination, diagnosis, treatment and referral as appropriate.
To be personally accountable for professional and ethical actions
and practices within a legal and ethical framework that adheres to the GMCs
requirements and local policies and procedures.
To ensure that prior to any course of action involving
individuals/groups, their informed consent or other valid authority has been
obtained.
If a procedure is carried out, consent will be obtained and
documented within the gynaecology template
To ensure that record-keeping is managed through the creation and
maintenance of concise, contemporaneous computerised records, and that all care
is recorded accurately and in a timely fashion. Notes should include a Problem
READ coded, history, examination where appropriate and a clear management
plan.
Completion of the gynaecology clinical template is mandatory for
each consultation this allows for monitoring of KPIs and ensures the admin
team are aware of any outstanding actions.
To interpret and explain complex facts in relation to a patients
condition, taking appropriate action and giving advice in a professional manner
to team members, and when appropriate to family and other carers, in such a way
that protects and preserves the patients dignity.
To have continuing responsibility for Adult Safeguarding in all
cases of suspected or confirmed abuse, including FGM, and to ensure compliance
with local and national guidelines, policies and procedures.
To ensure that concerns and identified potential risks are
referred to the appropriate Agency immediately.
To assess and diagnose across a wide range of gynaecology
conditions, order investigations, plan and provide treatment as needed and
discharge patients.
If an examination is required, a chaperone will be provided should
the patient request one. It is expected that all patients undergoing an
examination will be asked if they would like a chaperone.
Be aware of where the emergency equipment and medication are kept
at the start of each clinic
To record in the medical record why investigations are being
undertaken. To analyse the results and record in the medical record what
actions are required.
If a referral to secondary care is required, the clinician will
complete the relevant referral letter and ensure the onward referral is
completed or tasked to the admin team depending on agreed guidelines
If the patient needs a 2 week wait referral, the clinician will
complete the referral form in clinic and send an urgent task to admin team on
EMIS to ensure that the 2WW referral is processed booked on eRS within 24hours
and that the patient notified.
To assess, tolerate and manage risk and deal with uncertainty
To seek advice from the Consultant Gynaecologist in clinic or via
tasks on EMIS if needed
To use evidence-based practice to develop and maintain high
quality, clinically effective and cost-effective primary care.
To prescribe in accordance with regulations and with the post
holders training and registration and in accordance with CCG, NHS England, NW
London Prescribing Team, Practice Based Commissioning and local formulary.
To follow the agreed PPA pathway for Mirena and pessary
prescriptions.
To maintain full registration with the General Medical Council at
the employees own expense.
To maintain professional indemnity which covers the scope of work
within the community gynaecology service
Attendance at quarterly clinical meetings
All
clinicians meet quarterly and there is an expectation that all GPwERs within
the service are expected to attend and contribute to governance procedures.
