Consultant in Acute Medicine

Job overview

The following is a non-exhaustive list of the duties of a consultant. The appointee is expected to:

• Deliver day-to-day clinical care and leadership in the acute medicine wards, SDEC and on the medical take in ED.
• Look at current acute medicine practice and patient pathways within North Middlesex Hospital and in conjunction with the Clinical Director further develop the service in line with best practice.
• Lead in on-going development of clinical guidelines in acute medicine, audit and other key aspects of the clinical governance agenda.
• Show flexibility and undertake different appropriate clinical tasks at the request of the clinical manager, as the need arises.
• Actively participate in the Unit’s Teaching Programme and undertake supervision, teaching and training of medical trainees and other multi-professional staff, in line with guidance from the relevant Royal Colleges or specialty bodies.
• The successful applicant, as per trust policy, will take part in an active mentoring programme within the trust. The appropriate mentor/mentors will be discussed and decided by the Divisional Director and Speciality lead, in conjunction with the successful applicant.
• SPA activities will include:
• Service Development – Acute medicine protocols and guidelines.
• Developing joint protocols/pathways and clinical governance with ED and other specialties.
• Teaching/Training including clinical and educational supervision.
• Individual CME/CPD.

Main duties of the job

CLINICAL RESPONSIBILITIES

• Participate in clinical governance activities.
• Provide senior clinical leadership and expert management for patients.
• Contribute to safe discharge planning in partnership with community and primary care services.
• Provide clinical supervision and training to resident medical staff.
• Show flexibility to undertake different appropriate clinical tasks at the request of the clinical manager.

RESPONSIBILITY FOR PATIENTS

• Support discharge planning and follow-up care in collaboration with primary care and community services.
• Ensure patients are fully informed about their conditions and treatment options, supporting shared decision making.
• Respond promptly to changes in patient condition, clinical risk or safeguarding concerns.

RESPONSIBILITY FOR POLICY AND SERVICE DEVELOPMENT

• Support the development of care pathways with community services and speciality teams
• Participate in the development of acute medicine services to improve patient flow and quality of care.

RESPONSIBILITY FOR FINANCIAL AND PHYSICAL RESOURCES

• Participate in the management and utilisation of clinical areas and resources.
• Support cost-effective prescribing treatment in line with the Trust’s and national guidelines.

RESPONSIBILITY FOR LEADING AND MANAGING

• Support the development and supervision of resident doctors and other team members.
• Assist in managing performance against key targets and standards, including patient flow.

Detailed job description and main responsibilities

Indicative job plan

An indicative job plan/timetable for this post with indicative Programmed Activities (PAs) is provided in the document attached, but this will normally be re-assessed after 3 months of appointment to ensure it meets the needs of the service.

For a whole-time 10 PA contract: the baseline split is:

• Direct Clinical Care: 8.0 PAs on average per week (Clinical activity, clinically related activity, predictable & unpredictable emergency work)
• Supporting Professional Activities: 1.5 core SPAs (CPD, audit, teaching & training) and 0.5 Quality and Service SPAs to be agreed with appointee (assumed to be educational supervision).

An additional 0.5 SPA is available to all Consultant Staff subject to review and agreement for quality and service roles which must be approved prospectively by the Clinical Service Lead, or by the Medical Director for Trust-wide roles.

Job plans are reviewed annually, and applicants are encouraged to study the provisions of the Consultant Contract for England 2003 under which this post is offered.

Supporting Professional Activities (SPAs):

Delivery of the highest quality service possible is the main priority of this department. This means integrating evidence-based practice, research, audit, and other aspects of clinical governance, particularly the delivery of quality training and risk management.

There are a number of different shifts within the annualised acute medicine consultant rota: the following description covers the shifts duties, the average workload and the shift frequency.

• AMU: 0800-1700 (1.75 DCC PAs + 0.5 SPA PAs Mon-Thu, 2 DCC PAs + 0.25 SPA PAs Fri): 8-12am AMU ward round (up to 16 patients), 12-13 MDT, 13-15 SPA, 15-17 board round and afternoon reviews [frequency: 65 shifts per year].
• HOT SDEC: 0800-1700 (2.0 DCC PAs + 0.25 SPA PAs/day): named consultant for SDEC (new patients) supporting ANPs and resident doctors, holding referral & advice hot phone [frequency: 16 shifts per year].
• COLD SDEC: 0800-1700 (2.0 DCC PAs + 0.25 SPA PAs/day): 8-10 am Post-Take Round in ED, 10-17 named consultant for SDEC (follow-up patients) and Virtual follow-up clinic [frequency: 16 shifts per year].
• PTWR & Day Take: 0800-1700 (2.25 DCC PAs): 8-10 am Post-Take Round in ED then named consultant for the medical take; 11am and 3:30pm MDT huddles. The average medical take is 50-70 patients/24h. [frequency: 33 shifts per year].
• Additional standalone SPA activity (up to 2.25 SPA PAs/day), or otherwise combined with the Adult Hospital at Home shifts (0.75 DCC PAs + 1.5 SPA PAs/day).
• Weekday Evening Take: 1700-2000 (0.83 DCC PAs) [frequency: 1 shift per month (on a fixed evening between Monday and Thursday), plus 1 in 14 Fridays].
• AMU weekend:
• Saturday 0800-2000 (4 DCC PAs) and Sunday 0800-1700 (3 DCC PAs) alternate with:
• Saturday 0800-1700 (3 DCC PAs) and Sunday 0800-2000 (4 DCC PAs).
• Post-take round in ED then responsible for half of AMU (up to 16 patients), medical take in the afternoon until the end of the shift. AMU A consultant supporting SDEC.
• 1.75 of SPA PAs for the rest of the week, on a day of own choice.
• Compensatory time off/zero hours is included following a weekend displacing normal clinical activity.
• [The weekend frequency is 1 in 8].

We have adopted annualised job plans and the exact timetable of shifts are allocated to take account of annual leave requests and other agreed specialty activities whilst maintaining cover in all clinical areas. There are opportunities to swap with colleagues where the need arises after the rota is written. The exact allocation of shifts on the rota also takes into account individual skills and preferences across the Consultants contributing to the Acute Medicine Rota, eg some consultants contributing to a higher proportion of SDEC or take shifts. Acute Medicine covers 50% of the Adult Hospital at Home weekday rota: the workload is shared between interested consultants.

Dedicated time for DCC admin duties (reviewing results, attending MDT meetings, dictating letters, virtual clinics, etc) is included in the AMU and SDEC shifts (0.25 PA per shift).

On Call Duties

There is evening and weekend scheduled working as per above shifts description.

Applicant requirements

You must have appropriate UK professional registration.

This post is subject to the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (Amendment) (England and Wales) Order 2020 and it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service.