MEDICAL CARE GROUP ST HELENS & KNOWSLEY TEACHING HOSPITALS NHS TRUST

Transcription

1 MEDICAL CARE GROUP ST HELENS & KNOWSLEY TEACHING HOSPITALS NHS TRUST CONSULTANT PHYSICIAN IN GERIATRIC MEDICINE AND GENERAL MEDICINE WITH SPECIAL INTEREST IN FRAILTY SERVICES August 2013 Job Description

2 Introduction This is one of three new full time NHS posts which will enable the Department of Medicine for Older People to run a proposed. The (FU) is a new twelve-bed unit being set up to provide rapid comprehensive geriatric assessment for frail older people admitted as medical emergencies. This is just one component of a radical redesign of acute medical servicesat St Helens and Knowsley NHS Trust, making the service fit for the provision of healthcare in the twenty first century. It is the vision of St Helens and Knowsley NHS Trust that a Consultant led service for frail older people will be provided 7 days a week, with the support of appropriate junior medical staff. The postholder will be responsible for assessing older people admitted to the Monday to Fridayand providing clinical leadership in the development of frailty services. The postholder will participate in a rota to provide post-take weekend cover for the, Stroke Unit and three acute Older People s wards. The postholder will also participate in weekday out-of-hours General Internal Medicine on call providing telephone advice. There will be opportunities for the postholder to be responsible for some patients on the acute Older People s wards, on a rotational basis, if they wish. The St Helens &Knowsley Teaching Hospitals Trust is one of a tiny minority to be designated Double Excellent by the Healthcare Commission in 2008 and The Trust also featured in the final list for Acute Trust of the Year award in 2009 by HSJ. It is one of the most sought after teaching venues for medical students from the University of Liverpool and is a popular choice for the University s graduates ensuring a succession of high quality enthusiastic trainees. Applicants are required to hold Membership of the Royal College of Physicians (UK or equivalent qualifications), to be fully registered with the General Medical Council, and to be on the Specialist Register for General and Geriatric Medicine or due to obtain their CCT within three months of the date of interview.

3 Life in Merseyside Merseyside is close to North Wales, the Lake District and the Peak District and provides an interesting mix of rural and urban life with the rolling countryside of Wirral, Lancashire and Cheshire surrounding the City of Liverpool. Liverpool is a vibrant city which has undergone a renaissance in recent years and has recently been the EuropeanCity of Culture. High quality schools are available in the Liverpool, Wirral and Rainhill areas. The area has many sports facilities including championship golf courses, several sailing clubs and one of the finest windsurfing venues in Britain. Merseysiders are renowned for their friendliness and quick-witted humour and the region sports two of the finest football teams in the premier league. St Helens is known for its glassworks and rugby. The hospitals are in easy reach of the City of Liverpool (10 min by car), including the University and access to the motorway network (M62, M6, M57 and M58) is within easy (2-3 min) reach. St Helens and KnowsleyHospitals St Helens &KnowsleyHospitals Trust has a catchment area with a population of 340,000. The district is of mixed residential, industrial and rural character situated on the edge of Merseyside between the open countryside of Cheshire to the south and Lancashire to the north. The new Whistonhospital was completed in spring 2010 with 875 beds including 516 medical beds and state of the art CT and MRI on both Whiston and St Helens hospital sites. WhistonHospital This is a Teaching Hospital that provides a comprehensive range of Acute Medical and Surgical Services, Emergency Department Services, Maternity Services, Paediatrics, and the Regional Burns and Plastic surgery unit. There is a Critical Care Unit with ICU, HDU and CCU. There is also a 30 bed Acute Stroke Unit.

4 St HelensHospital This has been recently rebuilt and opened as an Ambulatory Care Centre with intermediate care and day surgery in autumn This is the site of the Allen Day Unit which provides specialist clinics in Medicine for Older People including Movement Disorders and Stroke. The Medical Care Group The Medical Care Group comprises general medical specialties, Emergency Medicine, Critical Care, and Paediatrics. In addition to General Medicine, the following medical specialist services are offered: Cardiology, Medicine for Older People, Dermatology, Diabetes & Endocrinology, Acute Medicine, Gastroenterology, Genitourinary Medicine, Haematology/Oncology, Nephrology (Hub and Spoke arrangement with RLBUH Renal Unit), Neurology (Hub and Spoke with Regional Neurology Unit), Neurophysiology, Respiratory and Rheumatology. The Medical Directorate The work of the Directorate includes the management of medical emergencies and elective (mostly outpatient) work. The Trust admits approximately 24,000 patients per year, including approximately 15,000 acute medical admissions. On average, there are 50 emergency medical admissions per day. All emergency medical admissions pass through the Emergency Department and the majority are subsequently transferred to the Acute Medical Unit (AMU). Patients referred for emergency medical assessment by their GP are seen direct on a GP Assessment Unit, where they are triaged by a nurse and then assessed by a doctor. Those with high clinical acuity are assessed on trolley beds, with the more stable patients using a seated waiting area and assessed in consultation cubicles. Around 30-40% of the GPAU referred patients are admitted for further investigation.

5 Acute Care Consultants are currently available to review the AMU and GPAU patients Monday to Friday 9am until 5pm, and from 5pm until 8pm Monday, Tuesday and Friday. In the near future, changes to job plans and consultant numbers will allow delivery of acute consultant care seven days a week over an extended working day. The Department of Medicine for Older People Consultant Staff Dr V K Gowda (Clinical Director) Dr S Allsup (special interest in falls and orthogeriatrics) Dr J Bussin (special interest in delirium and dementia in the acute hospital) Dr A Capewell (special interest in continence and community geriatrics) Dr A Hill (special interest in stroke) Dr S Mavinamane (special interest in stroke) Dr S Meenakshisundaram (Clinical Lead, Stroke Services) Dr T Smith (special interest in stroke medicine) Ms M Honey (consultant nurse for Older People and clinical lead for dementia) The Department of Medicine for Older People currently provides: acute medical care to frail older people on three acute wards (5A to C) at WhistonHospital (96 beds) acute and rehabilitation stroke care on the Stroke unit (1A) at WhistonHospital (30 beds) joint orthogeriatrics care on the hip fracture unit (3 alpha, 16 beds) intermediate care on Duffy Suite at St HelensHospital (24 beds) outpatient clinics for both general and geriatric medicine on the Whiston and St Helens sites specialist clinics in falls, movement disorders and stroke at the Allen Day Unit at St HelensHospital supervision and training for medical students and junior medical staff

6 The The will be a twelve-bed unit that aims to provide rapid access to comprehensive geriatric assessment and therapeutic interventions for frail older people admitted to Whiston hospital as medical emergencies. The unit will facilitate discharge or transfer to appropriate settings, according to the needs of the individual.patients whose length of stay is expected to be longer than 48 hours will be transferred to the acute Older Peoples Wards (5A, B and C) as soon as possible. Access to early outpatient review will be arranged to promote early discharge when appropriate. Admissions will be accepted from the Emergency Department, Acute Medical Unit and GP Assessment Unit. Some patients may be admitted directly from care homes after discussion with their GP or a community geriatrician. The postholder and two colleagues will be responsible for providing twice-daily ward rounds from Monday to Friday between 9am and 5pm.The three consultants are expected to cross cover each other for absences to fulfil clinical duties. At the weekend, the geriatrician on call will provide a ward round between 9am and 1pm. The unit will have dedicated nursing, therapy and social work staff and junior medical support. The Unit will use the Bournemouth criteria for frailty to identify patients suitable for admission. The Bournemouth Criteria for Frailty - 65 years or above and from a 24 hour care facility - 75 years or above and with two or more of the following pre-existing conditions o o o confusion acute or long standing history of falls urinary or faecal incontinence o multiple pathologies - 90 years or above

7 Indicative Job Plan Time Monday Tuesday Wednesday Thursday Friday Outpatient clinic Outreach to Acute Medical Unit/other medical wards Prospective cover Outpatient clinic Outreach to Acute Medical Unit/other medical wards Prospective cover Outpatient clinic Patient related administration Prospective cover Medical directorate meeting once a month Grand Round Journal club or Management meeting, Department of Medicine for Older People team Meeting Clinical or Management meeting, Department of Medicine for Older People Multidisciplinary team meeting Ward Round Patient related administration Multidisciplinary team meeting Prospective cover Relatives Ward Round Relatives Ward Round Patient related administrati on Ward Round Patient related administrati on

8 On call commitments Rota: Medicine for Older People 1:8 (weekend) Rota: GIM 1:25 (weekday 5pm-9am) Agreed category A On call supplement 3% Weekday on call commitment The proposed weekday in call rota (GIM) will be a 1 in 25 providing telephone advice between the hours of 5pm and 9am. During the hours of 9am to 5pm the appropriate specialty team will be the point of contact. Weekend on call commitments. The proposed weekend rota will be a 1 in 8 with structured daily commitments both Saturday and Sunday. The on-call geriatrician will provide a ward round on the and post-take review of patients on the Stroke Unit and wards 5A to C. He or she will also be available for phone call advice (including out of hours). We anticipate that the weekend post-take ward round will take approximately 6 hours (2 PAs). Average Hours / Sessions per Week Activity Hours per Week PAs per Week Direct Clinical Care PAs Prospective cover Direct Clinical Care on call 2 1 s Total Activities per Week Times for some activities are indicative), but worked flexibly within the week according to demand. All activities with the exception of study leave and some professional leave are routinely undertaken on site. Based on indicated job plan, 1 PA is allocated for prospective cover for weekly direct clinical care. Full secretarial support, office space and a personal computer will be provided for the post holder.

9 Mentoring: The new consultants will be appointed a named mentor for their initial 12 months in consultant post. The post holder will be expected to act as clinical/educational supervisor for one or more trainees. The trainees will usually be at FY2, ST1 or ST2 level. It is a requirement of the post that post holders comply with Trust policies and procedures, have (and maintain) GMC registration / licensing and participate in a formal CPD programme. The Trust supports the requirements for continuing medical education as laid down by the Royal College of Physicians and is committed to providing time and financial support for these activities. The post holder must also participate in regular medical audit and in annual appraisal and job planning. Audit and Education The hospital has a clearly defined programme of medical audit to which the appointee will be expected to contribute. All specialities spend one notional half dayevery two months on audit and clinical governance. This occurs at the same time for all specialties, allowing an exchange of views between specialties and encourages multidisciplinary audit. The hospital has a weekly Grand Round held in the Postgraduate Centre on Tuesday lunchtime. All disciplines take part on a rotational basis. The centre has a purpose built lecture theatre, 3 seminar rooms and a library including electronic databases and internet access. The Trust has for decades been one of the three major providers of clinical training for undergraduate medical students from the University of Liverpool. There is a varied programme of lectures and seminars and sub speciality educational meetings. Residence The successful candidate will normally be required to live within 15 miles of Whiston Hospital. Where a successful candidate already resides over 15 miles from the hospital they will usually be required to move their home unless they obtain written consent from the Medical Director to the contrary. The Terms and Conditions of Service state that removal expenses shall be reimbursed and grants paid when the employing authority is satisfied that the removal of the practitioner s home is required and that the arrangements proposed are reasonable. Therefore, successful candidates are advised not to enter into

10 contractual arrangement for the removal of their home until such time as the formal approval of the authority is confirmed in writing. Visiting Candidates may visit Whistonand St Helens Hospitals by arrangement withdr V Gowda,Clinical Director for Medicine for Older People,Medical Directorate, Third Floor, Whiston Hospital, Warrington Road, Prescot, L35 5DR. Telephone number: address: vinod.gowda@sthk.nhs.uk