Senior Clinical Fellow in Thoracic Surgery - London, United Kingdom - Guy's and St Thomas' NHS Foundation Trust

Description

Job summary

Job Title: Senior Clinical Fellow in Thoracic Surgery

Location: Royal Brompton Hospital

To assist the consultant staff in the preoperative assessment, operative and postoperative management of patients under their care. In addition, clinical Trust fellows have a responsibility for administrative issues including staffing clinics, arranging operation lists, the organisation and staffing of lists and overseeing preoperative and postoperative care. This should include regular ward rounds and providing in and out of hours clinical cover when on-call.

Main duties of the job

To co-ordinate and supervise the admission and discharge of patients from the unit. Responsible for maintaining accurate notes, up-to-date cardiac and thoracic monthly audit and for recording patient details in the database. To take charge of all patients in the unit under the direction of the consultant surgeon to which you are attached. Co-ordinate and supervise the work of all the junior medical staff. Operating duties are directly or indirectly supervised and specific targets in operative experience as prospectively set out should be achieved.

The senior post holders will principally be assigned to one consultant but occasionally may be required to provide support to other firms. The junior post holders will rotate between the consultant firms and be fully involved in a range of cardiothoracic work. In addition to providing immediate cover to patients in recovery and on the general cardiothoracic ward, the postholder will provide cover for intensive care emergencies. Consultant cover will be available at all times.

About us

RBH's surgical programme makes it the largest cardiothoracic unit in the UK. RBH supports a wide catchment area having longstanding referral relationships with clinicians in Beds & Herts, Bucks, Berks, Surrey and the South West Peninsula, as well as providing tertiary and quaternary services to referrers across the UK.

At Royal Brompton there are currently 279 beds in the hospital: the surgical unit has up to 54 beds available, divided between 2 cardiothoracic wards with integrated HDU facilities. Of the remainder, 55 are dedicated to cardiology, 86 to respiratory medicine, 18 are adult ICU plus 4 further surgical overnight recovery beds, and for 50 paediatrics. There is also a 28-bedded private ward. There are 4 catheter laboratories, 6 operating theatres and separate bronchoscopy facilities.

At Harefield there are currently 137 beds in the hospital: the surgical unit has up to 44 beds available, divided between 2 cardiothoracic wards, and a 9 bed HDU. Of the remainder, 42 are dedicated to cardiology and respiratory medicine, 14 are adult ICU beds, and for 30 transplant patients. There is also a 10-bedded private ward. There are 4 catheter laboratories, 6 operating theatres (3 Cardiac, 2 Thoracic) and one bronchoscopy room.

Job responsibilities

Clinical

Attend and assist in the out-patient clinics, taking responsibility to ensure adequate staffing for the clinic and to facilitate its efficient running in any other way. Clinic letters must be dictated promptly.

Attend consultant ward rounds.

Make formal ward rounds daily including at weekends and holidays as part of the on-call responsibilities. These rounds should be considered a teaching opportunity for more junior staff.

Participation in the relevant rota will depend on clinical experience of the successful candidate. Out of hours responsibilities include:

Advise on the discharge of patients under the care of the cardiothoracic surgical consultants.

Theatre responsibilities

Ensure that the theatre cases are appropriately staffed.

Ensuring that junior staff are involved at an appropriate level wherever possible. Junior staff must be assigned to cases whenever ward responsibilities permits.

Ensuring that adequate junior level assistants are available to help open and close cases performed under the direction of, or with the assistance of, a consultant.

Ensuring that all cases are sent for promptly and facilitating the efficient transfer of patients if required.

Ensuring that communication is maintained with the relatives of patients.

Ensure that either the operating surgeon or senior level assistant involved in the operation complete all appropriate data entry tasks at the conclusion of the operation. In addition, the principal operator should be responsible for creating a suitable operation note, which accurately records the events of the procedure. If operations are delayed or cancelled, the post holders are responsible for communicating with the wards appropriately and explaining the situation to the patients.

Admission responsibilities

Communicate with the consultant staff regarding their respective theatre schedules individually and co-ordinate hospital admission in an integrated and coherent manner such that hospital beds are utilised most efficiently. This may require suggesting modifications to the planned admissions schedule to individual consultants on the basis of in-patient referrals, emergency cases or theatre cancellations. Participation in weekly planning meetings is required.

Waiting list management

Maintain knowledge of the active waiting list for your consultant and participate in their selection for admission and surgery in a manner that is equitable for patients as much as possible.

Be involved in the evaluation of patients referred to the service, particularly in-patient referrals.

Respond to queries from the patients and their GPs (both by telephone and letter) regarding their position on the waiting list and anticipated time of operation.

Administration of service

As part of their overall responsibilities for the patients, post holders must ensure that medical records are adequately kept by the junior medical staff including daily notes on in-patients and prompt dictation of discharge summaries. Notes must be representative and appropriate to the patients true condition.

Medical audit

Post holders must ensure that all junior staff are present at the monthly medical audit meeting. Opportunities to present cases for discussion from the firm will arise and should be prepared for and presented by post holders or assigned to a colleague for presentation.

Research

Research is an integral component of the training programme. Post holders are encouraged and expected to participate in clinical or basic science research.

Teaching

Post holders are expected to take an active role in the postgraduate teaching activities. In addition he/she may be required to undertake teaching of medical students, nurses and other paramedical staff. Clinical research is continuously undertaken within the unit and the post holder will be encouraged to participate.

This job description lists key components of the job, but is not in any way exhaustive. The post holder must accept that he/she will also perform duties in occasional emergencies and unforeseen circumstances at the request of the appropriate consultant, in consultation where practicable with both junior and senior colleagues. However, it is recognised that additional commitments arising this way are exceptional and in particular that junior doctors should not be required to undertake work of this kind of a prolonged period or on a regular basis.

Knowledge

Essential

Desirable

Skills

Essential

Experience

Essential