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

Indicative Job Plan/Timetable

An indicative job plan/timetable for this post with indicative Programmed Activities (PAs) is provided below, 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:

• 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).

• Direct Clinical Care:  8.0 PAs on average per week (Clinical activity, clinically related activity, predictable & unpredictable emergency work)

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 Director, or by the Medical Director for Trust-wide roles.

Detailed job description and main responsibilities

Indicative Job Plan/Timetable

An indicative job plan/timetable for this post with indicative Programmed Activities (PAs) is provided below, 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:

• 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).

• Direct Clinical Care:  8.0 PAs on average per week (Clinical activity, clinically related activity, predictable & unpredictable emergency work)

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 Director, 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 many areas for service development and requirements for working with all healthcare professionals and specialties.

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 A & B: 0800-1600 (1.75 DCC PAs + 0.25 SPA PAs/day): 8-10 am post-take round in ED then named consultant for half of AMU each (15-16 patients) [frequency: 65 shifts per year].
• PTWR & SDEC: 0800-1700 (2.0 DCC PAs + 0.25 SPA PAs/day): 8-9 am post-take round in ED then named consultant for SDEC supporting ANPs and junior doctors, holding referral & advice hot phone (in HOT SDEC) or carrying out virtual follow-ups (in COLD SDEC). [frequency: 33 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. The average medical take is 50 patients/24h. [frequency: 33 shifts per year].
• Additional standalone SPA activity (up to 2 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 (15-16 patients), medical take in the afternoon until the end of the shift. AMU A consultant supporting SDEC. Monday handover 0900-1000 (0.25 DCC PAs) followed by 1.75 of SPA PAs. Compensatory time off/zero hours is included following a weekend displacing normal clinical activity. [The weekend frequency is 1 in 8].
• 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 (15-16 patients), medical take in the afternoon until the end of the shift. AMU A consultant supporting SDEC.
• Monday handover 0900-1000 (0.25 DCC PAs) followed by 1.75 of SPA PAs.
• 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.

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.

This post does not currently include participation in the overnight or weekend out of hours on-call rota, therefore no on-call supplement applies.