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Detailed job description and main responsibilities

The Post

The Department

The Shrewsbury and Telford Hospital NHS Trust is the main provider of district general hospital services for nearly half a million people in Shropshire, Telford & Wrekin and mid-Wales. Our main service locations are the Princess Royal Hospital (PRH) in Telford and the Royal Shrewsbury Hospital (RSH), which together provide 99% of our activity.

Working Within The Department

On both sites we have a dedicated Acute Medical Unit (20 beds at RSH and 17 on PRH) and SDEC (chairs & trolley spaces). RSH also has a 26 bed Medical Short Stay Ward (26 beds) with imminent plans to develop a Short stay ward on the PRH site (28 beds).

There are General Medical and Speciality wards on both sites with Cardiology and Stroke Medicine based at PRH and Gastroenterology based at RSH with speciality in reach on the other site. Respiratory medicine, Diabetes and Endocrinology and Care of the Elderly and Frailty are equally represented on both sites. The General Internal Medicine ward base is based on the RSH site.

You will be supported by a team of junior doctors (of training and non-training grades), advanced practitioners, nurses, therapists, and in reach of specialists across the hospital. Higher Specialty Trainees working toward Single specialty CCT and Senior Clinical Fellows working toward a CESR in GIM via our internal training programme will be attached to the department. Our aspiration is to provide a team able to meet the needs of complex, comorbid patients, that is patient centric in an environment that is rich with educational opportunities for the entire team resulting in a happy and valued team.

Developing a Formal Department in General Internal Medicine

The medical needs of the population are changing. The increasing number of elderly patients as well as the growing number of co-morbidities has led to an increase in the number of patients admitted with complex general medical care needs who don’t fit easily into a single specialty.

The Joint Committee of Shropshire and Telford & Wrekin Clinical Commissioning Groups has approved plans for the NHS Future Fit. Funding has been approved to develop Acute and General Medical services and modernise facilities with RSH becoming a centre for Specialist Emergency Care and PRH becoming a dedicated Planned Care site.

The national response to this trend towards an ageing population with complex needs and obesity linked multi-pathology has been for training and services to regress from early specialisation and instead emphasise the importance of internal medicine being an integral part of a physician’s core role to manage the evolving patient needs.

In creating Internal Physicians, we would provide a more definitive structure for managing unselected medical inpatients beyond the timeframe of an Acute Medicine physician. This in turn would also release current Speciality Consultants providing base ward care in to delivering a mixture of In Reach, Same Day Emergency care and Outpatient clinics instead. Our model includes in house training to ensuring we focus on developing a more robust strategy for creating a strong future workforce.
We are therefore very excited to be developing a formal Department of General Internal Medicine to better care for this cohort of patients. At present we have one Consultant General Internal Physician supported by several competent locum consultants and aim to recruit substantively to build a thriving department. This is a very exciting time to join the team as Health Education England (HEE) funding has been secured for trainees in general internal medicine who will be training towards either their CCT or CESR in General Medicine (a three-year training programme).

Directorate

This is a new department that will be supported from within the directorate:
Dr Saskia Jones-Perrott- Divisional Medical Director
Dr Gordon Wood- Respiratory Physician, Lead physician RSH site, Lead for General Internal Medicine
Dr Jaydip Mukhopadhyay- Consultant in General Internal Medicine

General Medical Clinics

Consultants will offer 2 outpatient clinics a week. Referrals will come from 2 key sources- directly from GP’s and directly from patients being discharged requiring early follow up before being completely discharged or assimilated into specialty follow up. For a standard 4-hour clinic the clinic template would 3 new patients and 8 review patients with 30 minutes to complete paperwork.

Direct referrals from primary care should include patients where the primary disease is unclear e.g. breathless patient who would of previously been referred to cariology and respiratory.
These clinics will be excellent training opportunities for IMT doctors and consultants should expect to support an IMT stage 1 and 2, GPVTS or SCF doctor in their clinic.

Community

Opportunity to increase community links with community in reach clinics and potentially symptom based triaging clinics. That link could include the support of virtual wards.

Clinical Governance

• - Participate in the handover of patients within the service and when leaving the service
  - The post-holder will be expected to participate in our monthly morbidity and mortality meetings, departmental and directorate meetings including preparation of cases for review in these governance settings
  - Participate in audit and quality improvement work that is ongoing in the department
  - Participate in mortality review process
  - Research interests within Internal Medicine will be encouraged
  - Participate in Appraisal and Revalidation
  - Ensure their mandatory training is kept up to date

Job Plan

A formal job plan will be agreed between the successful candidate and their Clinical Director and consultant colleagues, on behalf of the Medical Director within 3 months of starting in post. A full-time job plan is based on a 10 PA working week. The job plan will be reviewed annually and is a prospective agreement that sets out the consultant's duties, responsibilities, and objectives for the coming year. It covers all aspects of a consultant’s professional practice including clinical work, teaching, research, education and managerial responsibilities. It will provide a clear schedule of commitments, both internal and external and will include personal objectives, detailing links to wider service improvements and trust strategic priorities.

For a full-time contract, the job plan will be divided on average per week (pro-rata for a part time post) as:
• 7.5 Programmed Activities (PAs) of Direct Clinical Care - includes clinical activity, clinically related activity and predictable and unpredictable emergency work.
• 2.5 Supporting Professional Activities (SPAs) - includes CPD, audit, teaching and research.

The allocation of PAs is reviewed and may be subject to adjustment when a further diary exercise is undertaken or if the service demands a review of the team job plan.

Any applicant who is unable, for personal reasons, to work full-time will be eligible to be considered for the post. If such a person is appointed, modification of the job content will be discussed on a personal basis with the Trust in consultation with other consultant colleagues.