Clinical Fellowships in Physician Response Unit & Emergency Medicine
(12 months)

ST4-ST6+ Level

Start Date: Aug 22

Department of Emergency Medicine and Pre-hospital Care

Division of Emergency Care and Trauma

Royal London Hospital

The Physician Response Unit has been operated by London's Air Ambulance since 2001. It is a rapid response vehicle that is staffed by a doctor and a clinician from London Ambulance Service, and responds to 999 calls in North-East London. The clinical focus of the PRU is to 'take the Emergency Department to the patient', providing high quality care for patients where they need it. It attends a broad range of clinical presentations including illness and injury in adults and children, and where possible enables diagnosis and treatment of patients in the community without the need for subsequent ED attendance or hospital admission. The car is equipped with a range of diagnostic equipment and treatments enabling many conditions to be managed in the community. The service works closely with London Ambulance Service and community health providers to ensure that high quality care and patient experience are prioritised.

These fellowship positions provide an opportunity for appointees to work in an innovative model of care providing Emergency Medicine to patients in the community on the Physician Response Unit. They will gain clinical and operational Pre-hospital Emergency Medicine experience and skills by working as part of an emergency response team, and will gain eligibility to undertake the Diploma of Immediate Medical Care (RCSEd). They will be part of a small team working to make a large difference to local patients, looking to enhance clinical care and experience through accessing community-based pathways and stream-lining emergency care. Alongside work on the Physician Response Unit they will also gain experience by working in the RLH Emergency Department, and will have protected development opportunities in other related areas (Supported Professional Activity).

Fellows will undergo a period of training and supervised clinical working for several weeks followed by sign-off to work on the Physician Response Unit. They will then be responsible for the delivery of clinical care of patients that they attend, and will be supported at all times by telephone access to a duty consultant in pre-hospital care. They will be expected to practice within their own level of competence and training. They will also be expected to participate in clinical audit and governance work relating to the PRU, and will be afforded opportunities to represent the service at local management and development fora.

The Fellows will cover a rota which provides clinical cover for the Physician Response Unit (12hr shift) and ED shifts (whole shift pattern). There will also be protected non-clinical days and it is anticipated that these will vary between supported professional activity (governance, audit) and focussed relevant clinical training opportunities.

The proportion of shifts will be approximately. 50:50 between prehospital care and emergency department work. All rotas will be compliant with trust junior doctor contracting requirements.

The PRU has undergone expansion from in recent years to include three acute hospital sites across Barts Health and involving 2 vehicles thorough operational time periods. Appointees will spread the ED component of their fellowship across two out of the three acute sites at Barts Health (Royal London Hospital, Newham Hospital, Whipps Cross Hospital) through 2 six month placements which will be allocated according to a ranking at interview and candidate preference.

For further information contact:

• Dr Tony Joy, Consultant in Emergency Medicine and Clinical Lead for Physician Response Unit

tony.joy@bartshealth.nhs.uk

• Dr Adam Woodgate, Consultant in Emergency Medicine and Clinical Lead for Emergency Department, Royal London Hospital

adamwoodgate@nhs.net

Fiona Woodhall, telephone 07394402791, email fiona.woodhall2@nhs.net

BMJ Ref: BMJ-48032/259-MED00702RLH