Trust Doctor StR Lower – Geriatrics/Peri-operative Medicine

Job overview

To ensure older patients admitted with fractures and trauma, and undergoing Orthopaedic surgery or non-operative management, receive prompt and high-quality peri-operative medical care; timely access to surgery; and ensuring high standards are met such as those outlined in the National Hip Fracture Database aiming to achieve the best possible outcome for this frail patient group.

Main duties of the job

• Review all new older Fractured Femur patients ensuring background information available, seeking collateral history where necessary. Ensure appropriate medication review, VTE prophylaxis, analgesia, falls assessment and bone protection.
• Provide peri-operative ward-based care and continuity for these patients following initial review.
• Liaise with Orthopaedic teams to enable timely surgery.
• Liaise with Anaesthetic colleagues where appropriate.
• Liaise with families and carers, documenting discussions.
• Attend MDT to coordinate and contribute to discharge planning, rehabilitation progress and work towards set estimated discharge dates.
• Arrange and attend family meetings where necessary to improve communication, discharge planning and management of patients with complex issues requiring case conference.
• Take part in the Orthopaedic ward cover rota on a 1:5 basis at weekends.

• Attend the morning Trauma Meetings and liaise with Orthopaedic staff regarding elderly patients with Fractured neck of femur and other Fragility Fractures/Trauma.

Detailed job description and main responsibilities

Audit, Research, Teaching and Service Development

• Ensure elements required for achievement of Best Practice Tariff for Hip Fracture are recorded accurately and updated regularly.

• Review delays to theatre for audit purposes, to understand themes causing delay to surgery and instigate guidelines and changes in practice for future improvement.
• Participate in development of guidelines and pathways to promote good and safe practice and drive improvement in care.
• Review hip fracture database (NHFD) and oversee continual audit aiming to provide high quality care and assessment to this patient group.
• Present and participate in educational sessions for surgical and other healthcare staff on peri-operative topics such as delirium, falls, fluid management, acute kidney injury etc.
• Develop skills in local anaesthetic blocks with Lead Anaesthetic Consultant and Orthopaedic staff.
• Attend and participate in weekly Health Care of the Elderly Educational meetings and the Medical Grand Round.
• Attend relevant conferences, local and national, pertinent to educational needs/professional development.

Attend regular Fractured Neck of Femur Ward meetings as part of our Clinical

• Governance to identify areas for these patients where care, communication and protocols could improve outcomes and the experience for our patients.
• Attend regular teaching and clinical governance meeting within Trauma and Orthopaedics including CME for audit, and morbidity/mortality meetings.
• There are excellent opportunities for getting involved in service development in this ever-developing specialty of peri-operative and Ortho-geriatric medicine, including a wide variety of audit and quality improvement opportunities, of both local and national relevance, such as pain relief, delirium management, adherence to recommended guidelines and treatment etc.

The hours for the post are Monday-Friday 0800 – 1730, taking part in 1 in 5 weekends (0800-1730) providing cover for the three Trauma and Orthopaedic Wards. Opportunities to supplement the post via additional shifts may be possible via the rota co-ordinator.  There are Continuing Professional Development (CPD) days built in within the rota to support portfolio and clinical governance commitments. Off days are rostered in to ensure adherence to EWTD regulations.

Managerial and Leadership

The post holder will be professionally accountable to the Medical Director and managerially accountable to the Service Line Director – Mr Mark Brinsden, Consultant Trauma and Orthopaedic Surgeon via Dr J Davies, Consultant Ortho-geriatrician.