Senior Clinical Fellow for Respiratory Same Day Emergency Care (SDEC)

Job overview

Fixed term contract till 3rd of August 2027.

This is an exciting time to join the department of respiratory medicine at the Royal Sussex County Hospital Brighton. Our department moved into the brand-new state of the art Louisa Martindale Building in June 2023. The respiratory ward is located on level C9, and we have two dedicated bays and a clinic room for our Respiratory Same Day Emergency Unit.

The aim of the Respiratory SDEC are for people with respiratory symptoms to be rapidly assessed by a specialist multi-disciplinary respiratory team and have increased access to rapid diagnostic respiratory tests (i.e. spirometry, FeNO, thoracic ultrasound etc) and thoracic Radiology. This will enable prompt diagnosis and start of the correct therapeutic pathway in an ambulatory setting.

Main duties of the job

Patients presenting to ED with a respiratory complaint and clinically stable to be assessed in an SDEC unit will be transferred to the Respiratory SDEC. They will be fully assessed by the clinical fellow; necessary investigations will be organised and when results available the patient will be discussed/reviewed by the respiratory physician of the day. Treatment and management plan will be decided, and patient will either be admitted for inpatient care or discharged with appropriate follow-up.

Detailed job description and main responsibilities

• Admission avoidance clinics Patients known to the respiratory consultants /CNS will contact the team when they are unwell. These patients may have complex respiratory infections, airways disease, or interstitial lung diseases. They will be booked to attend the respiratory SDEC where a clinician will assess them and discuss with the respiratory physician of the day.

Pleural clinic

Patients presenting to A&E/GP with a new unilateral pleural effusion will be seen directly by a member of the respiratory team. After a thorough history and examination, a thoracic ultrasound will be performed. When there are no contra-indications, a diagnostic pleural aspiration will be performed the same day. Patient will then be appointed to the correct follow-up pathway.

Ambulatory primary spontaneous pneumothorax management

Patients presenting to A&E with a spontaneous primary pneumothorax will be directed to the respiratory SDEC for their management. We plan to implement an ambulatory chest drain pathway for patients requiring intercostal drainage but well enough to be managed in an ambulatory setting. The clinical fellow will have the opportunity to participate in setting up this pathway and evaluating its implementation.

Pathway for faster diagnosis of lung cancer

Patients presenting to the radiology/A&E department with chest x-ray findings suggestive of a lung malignancy will be directed to the respiratory SDEC.

They will be seen directly by a member of the respiratory team, the correct investigations (CT chest, diagnostic aspiration, bronchoscopy, PET, EBUS) organised and prompt follow-up in the lung cancer clinic will be arranged.

Earlier intervention with the correct test means patients are diagnosed earlier and are therefore fitter for treatment. This is increasingly important with newer anti-cancer treatments such as immunotherapy and targeted therapy.

We expect to develop further ambulatory respiratory care pathways as the service develops.

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.