We have an exciting opportunity to welcome a full-time Locum consultant to the newly developed Department of General Internal Medicine. The successful applicant will join our expanding team of motivated consultants. Those working towards the CESR qualification or already have experience working at consultant level are encouraged to apply as we would be keen to support the right candidate to obtain the CESR qualification and registration onto the specialist register.

The post-holders 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.

Main duties of the job

Clinical Duties Include:

o Diagnosing and treating a wide spectrum of clinical problems, ranging from the acutely ill young person to the elderly patients with multiple complex co morbidities.o Looking after patients that do not fall into the remit of a specific medical speciality or are deemed to have complex medical problems involving multiple symptoms and co morbidities.o Provide continued care both in the inpatient and outpatient setting for this patient group. The Internal Medicine physician would both direct treatment of such patients and the orchestrate specialist care where needed.o Clinics activity as outlines below.o Supporting a complex patient MDT.o Support our links into community care including supporting virtual ward environments.o Supervision of Higher Specialty Trainees in Internal Medicine, IMT stage 0ne trainees and Clinical fellows working towards CESR in GIM.o To develop enhanced clinical skills, especially in the assessment and management of acutely ill patients.o To have excellent team-working skills with the abilities and professional attitude to work well in a multi-professional team.o To deliver clinical and quality targets agreed both nationally and locally with clinical teams and commissioners.o To follow patients throughout their clinical pathways.

About us

The Shrewsbury and Telford Hospital NHS Trust (SaTH) is the main provider of acute hospital services for around half a million people in Shropshire, Telford & Wrekin and mid Wales.

Encompassing some of the most picturesque parts of England and Wales, the Trust's catchment stretches from the Cambrian Mountains in the west, to Newport and the fringes of the Black Country in the east. The main towns include: Bridgnorth, Ludlow, Market Drayton, Oswestry, Shrewsbury and Whitchurch (in Shropshire) Newport, Telford and Wellington (in Telford & Wrekin) and Newtown and Welshpool (in Powys) - all beautiful and unique.

Our main service locations are the Princess Royal Hospital (PRH) in Telford and the Royal Shrewsbury Hospital (RSH) in Shrewsbury which are located 20 minutes' drive apart. Together they provide 99% of our activity. Both hospitals provide a wide range of acute hospital services including accident & emergency, outpatients, diagnostics, inpatient medical care and critical care.

We also provide services such as consultant-led outreach clinics at the Wrekin Community Clinic, Telford, the Robert Jones and Agnes Hunt Orthopaedic Hospital, Gobowen and the Bridgnorth, Ludlow and Whitchurch Community Hospitals.

Job description
Job responsibilities

The Post

The post-holders 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.

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.

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 dont 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 physicians 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).

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.

The Job Plan

• 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.

On-Call Commitment

The post comes with a 1 in 14 on-call commitment for acute unselected take for weekdays and weekend working. The on call 1/14 template includes:

• Monday to Thursday on call on site from 5 to 8pm with overnight off site on call and post take ward round form 8 until 9:30am.
• Friday onsite on call 5-8pm, off site on call overnight and post take ward round 9am-1pm
• Saturday am post take ward round 8am-12pm to support Friday post take
• Saturday-Monday on-call, on site Saturday 2-8pm, Sunday 8am-2pm and 5pm-8pm. This shift includes a day off in lieu nominally Tuesday.

The Acute Unselected Take is supported daytime by Acute Medical Team and the evening by an Acute medical Physician covering SDEC and supporting rest of the take.

Other Activities

Additional opportunities will be available according to individual interests. These may include undergraduate teaching, postgraduate teaching, in situ sim development, MRCP and PACES teaching, quality improvement and research. Including supporting the right candidate to progress with specialist registration should this be of interest.

Person Specification
Qualifications
Essential

• MBBS or equivalent medical qualification
• MRCP

Desirable

• MD, PhD or equivalent

Entry Criteria
Essential

• Full Registration and a licence to practise with the General Medical Council (GMC)
• Broad exposure to medical diseases and their comprehensive management (acute and long-term conditions)
• Management of patients with multi-morbidity
• Skills in cross-speciality collaboration and/or liaison working

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