Senior Clinical Fellow

Job overview

Northampton General Hospital NHS (UHN) Trust is seeking a skilled and motivated anaesthetist to join its Anaesthetics & Critical Care department as a Senior Clinical Fellow. This is an exceptional opportunity for a doctor at ST3-equivalent level, or above, to work in a high-performing, supportive department with genuine breadth of clinical exposure across a fully equipped modern theatre suite, a busy obstetric unit, and a brand new 16-bed Level 3 ICU.

Main duties of the job

The department offers more than a clinical post. With 11 dedicated ICM consultants, a strong culture of education and mentorship, and an explicit commitment to supporting post holders in long-term career progression, including transition to SAS roles and the CESR pathway, this is a post designed for doctors who want to invest in a department that will invest back in them.

The post is offered on a fixed-term basis, initially for 2 years, subject to satisfactory performance, with a 6-month probationary period. Clinical time is divided across theatres, labour ward, and the ICU, with rotations typically organised in 3-month blocks. Initially, for the first 6 months, clinical time will be based on the ICU with support from the consultant faculty to integrate into the department and the trust. While this is a locally employed (non-training) post and does not count towards CCT, the department provides a structured, supervised, and educationally rich environment with genuine opportunities for subspecialty development.

Detailed job description and main responsibilities

The post holder will function at senior trainee-equivalent level across theatres, labour ward, the intensive care unit, and on the on-call rota, with consultant support available at all times. Clinical time is divided into 3-month rotations across these areas; the first 6 months will be ICU-based to support integration into the department.

Intensive Care Unit (ICU)

• Attend twice-daily ward rounds as the senior resident, reviewing all Level 2 and Level 3 patients, generating and documenting management plans, and identifying patients requiring escalation to consultant level.
• Initiate and titrate ventilatory support, sedation and analgesia regimens, vasopressor and inotrope therapy, and renal replacement and other organ support in conjunction with the consultant team.
• Perform and supervise core ICU procedures including central venous access, arterial line insertion, bronchoscopy, and chest drain insertion, using an appropriate safety and consent framework.
• Act as the first senior clinical responder to acutely deteriorating ICU patients, initiating management of sepsis, respiratory failure, haemodynamic instability, and multi-organ dysfunction, and escalating appropriately.
• Contribute to escalation discussions and goals-of-care conversations with patients and families, with consultant guidance, including in the context of end-of-life decision-making.
• Coordinate safe intra-hospital and inter-hospital transfer of critically ill patients, including full pre-transfer assessment, stabilisation, documentation, and handover.
• Contribute to ICU governance: attending M&M and clinical governance meetings, completing audit and QIP work, and engaging with departmental quality improvement priorities.

Theatres

• Conduct pre-operative anaesthetic assessment of elective and emergency surgical patients, formulate an appropriate anaesthetic plan, and identify and escalate high-risk cases to consultant level.
• Deliver general, regional, and combined anaesthesia for cases of varying complexity across vascular, colorectal, maxillofacial, ENT, major gynaecology, urology and orthopaedic surgery, adapting technique to patient comorbidity and surgical requirements.
• Manage intra-operative physiological instability, including haemodynamic compromise, airway difficulty, and acute deterioration, with the judgement and skill expected of a senior trainee.
• Provide post-operative handover to the recovery team and initiate immediate analgesia planning, including referral to the Acute Pain Service where appropriate.
• Assess and manage emergency surgical referrals out of hours, including pre-operative workup and conduct of unplanned or urgent cases overnight and at weekends with consultant support available.
• Contribute to peri-operative care of high-risk patients, including those with significant cardiorespiratory comorbidity, in liaison with the consultant team.

Labour ward

• Conduct obstetric anaesthetic assessment of women referred for epidural analgesia or anaesthetic review, including those with significant medical or obstetric comorbidity, and formulate an appropriate management plan.
• Site and manage labour epidurals, including troubleshooting of inadequate or patchy blocks, conversion for operative delivery, and recognition and management of complications.
• Deliver spinal and general anaesthesia for elective and emergency operative deliveries, including category 1 caesarean section, with the speed, competence, and composure expected at senior trainee level.
• Respond to obstetric emergencies including major obstetric haemorrhage, eclampsia, cord prolapse, and maternal collapse, taking an active clinical lead with consultant guidance as appropriate.
• Provide anaesthetic input to the management of high-risk antenatal patients in liaison with the obstetric and midwifery teams, including pre-operative review and planning for women with complex medical histories.
• Participate in multidisciplinary review and handover of complex or deteriorating obstetric patients.

On-call responsibilities

The post holder will provide resident registrar-level anaesthetic and critical care cover overnight and at weekends as part of the department’s on-call rota, with an approximate frequency of 1 in 5. Consultant support is available at all times, on-site or by immediate telephone, but the post holder is expected to exercise independent senior clinical judgement.

• Provide senior resident anaesthetic cover for emergency theatre work overnight and at weekends, including pre-operative assessment, conduct of anaesthesia, and post-operative care for unplanned and urgent surgical cases across all specialties.
• Provide senior resident cover on labour ward out of hours, including response to obstetric anaesthetic emergencies, category 1 caesarean section, and major obstetric haemorrhage, with consultant backup available.
• Conduct senior review of acutely deteriorating ward and ICU patients out of hours, including initiation of immediate management and escalation to the on-call consultant where indicated.
• Provide clinical oversight and supervision of more junior resident medical staff on the on-call rota, including foundation doctors and core trainees.
• Attend and contribute to crash calls and cardiac arrests as a senior member of the resuscitation team.
• Maintain clear contemporaneous documentation and ensure safe clinical handover at the end of each on-call period.

Hours of work are 48 per week on a full shift pattern, compliant with the Resident Doctor Contract 2016 and the European Working Time Directive. Rota patterns may evolve over time; changes will be implemented fairly and with appropriate notice.

Teaching, education and supervision

• Attend and contribute to the department’s FRCA teaching programme.
• Participate in simulation and skills workshops.
• Support and supervise more junior doctors on the shop floor and on-call.
• Maintain a clinical logbook and engage with annual appraisal in line with GMC revalidation requirements.

Clinical governance and quality improvement

• Contribute actively to the department’s governance agenda: reporting incidents and near misses, participating in audit and QIP cycles, contributing to M&M reviews, and maintaining compliance with NICE guidelines, RCoA and FICM standards, and Trust policies.
• Ensure all clinical practice reflects the principles of GMC Good Medical Practice.