Trust Grade Registrar LED - Community Hospitals

Job overview

This post is a ward-based Locally Employed Doctor (LED) position within inpatient Healthcare of Older People (HoP) and Community services.

Main duties of the job

Totnes Community Hospital

• Dart Ward (16 beds, 18 in escalation)
• 18 medical inpatient beds in a modern purpose-built unit
• Predominantly frail older patients requiring rehabilitation, ongoing medical care or complex discharge planning
• Mix of step-down transfers and direct admissions (e.g. IV therapy, end-of-life care)
• Since April 2022, the HoP team has led the development of a new community care model at Totnes. The ward is supported by a weekly consultant ward round and middle-grade support.
• Blood courier twice daily; anticipated point-of-care testing expansion.

Newton Abbot Community Hospital

• Teign Ward (30 rehabilitation/general medical beds)
• Templer Ward (20 stroke/neuro rehab + 10 general medical beds)
• Mix of direct admissions from Harbour, step down rehabilitation, and specialist stroke/neuro rehabilitation
• Specialist GP and Specialist doctor (daily) supported by stroke consultant ward round (weekly)

Harbour Unit (hospital at home and frailty SDEC)

• Expanding service with 12 hospital at home beds and 6 SDEC spaces for type 5 and type 6 SDEC work.
• Senior medical cover from a mix of Trust GP’s, consultant practitioner, and consultant geriatrician
• This is a rapidly developing service with many opportunities for QIP.

Detailed job description and main responsibilities

Newton Abbot Hospital is a busy community hospital which as well as having 60 inpatient beds also has an Urgent treatment Centre open 8-8,7 days per week, a Planned Infusion Unit and hosts multi-specialty out patient clinics.

Patients are predominantly transferred from local acute hospitals for ongoing medical care and rehabilitation, but patient may also be admitted directly from home following discussion with senior doctors on site. The majority of patients also require complex discharge planning.

Evening and weekend medical cover is provided by the Out of Hours Service for urgent reviews only.

Nursing staff within the hospital are trained to a  high level to ensure that patients are assessed, treated and referred appropriately if required to the out of hours service. They are skilled in phlebotomy, intravenous cannulation, Intravenous drug administration and complex wound management.

There is also a Ward Pharmacist who supports both wards and a pharmacy technician. There is a stroke/neuro Consultant ward round every Thursday morning.

The new Harbour frailty service runs from it’s own dedicated space on the first floor of Newton Abbot Hospital. This sees patients in an evolving frailty-attuned SDEC space, as well as at home under the Harbour at Home (virtual ward) caseload. There is a large shared office space with workspaces for clinicians and the opportunity for daily MDT working and links with a senior clinician. The team is made up of Frailty GPs, Consultant Practitioners, ACPs, tACPs and nurses.

Totnes Community Hospital has 18 medical inpatient beds in a modern purpose-built unit. The unit is run by the Healthcare of Older People Team.

The HOP Team currently have 8.9 WTE Consultants. We also have a Nurse Consultant in Frailty and a range of Physicians Associate, Advanced Clinical Practice and Specialist Nurse roles. We work very closely with our colleagues in stroke and in addition to Totnes Hospital we support 3 acute wards, orthogeriatrics service, and host the Parkinson’s Disease service. There may be opportunities for this post to gain experience in other areas of the service if this aligns with their PDP.

Roughly eighty percent of the patients are step down transfers from acute hospitals for further rehabilitation, ongoing medical treatment or complex discharge planning whilst the remainder are direct admissions from home, usually for intravenous therapies (antibiotics, fluids and transfusions) or for end of life care.

Nursing staff in all Community Hospitals are trained to a uniform very high level and are skilled in intravenous cannulation, initiation of IV antibiotics and phlebotomy.