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Orthogeriatric Physician Associate, Band 7

Gloucestershire Hospitals NHS Foundation Trust
£43,742 to £50,056 a year pa pro rata
Closing date
22 Dec 2023

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Physician associate
Part Time
Orthogeriatric Physician Associate (22.5 hours a week, fixed term for 12 months)

This post offers excellent experience in Orthogeriatrics/ Hip Fracture peri-operative care, working under the supervision of the Care of the Elderly (COTE) team on the Hip Fracture Unit and Orthopaedic wards at Gloucestershire Royal Hospital. As a Physician Associate you will be acting within your professional boundaries, providing care for patients from initial history taking, clinical assessment, diagnosis and treatment under the supervision of the senior clinical team. You will liaise with other professionals and specialities as required and complete necessary documentation relating to their patients.

The post holder is expected to participate in all aspects of the patient pathway as appropriate and will be expected to perform delegated duties with a high degree of clinical skill and knowledge.

They will be mentored and supervised by a designated consultant who will oversee their career development. The level and type of supervision will be dependent on the post holders' skills and knowledge and determined by the trust clinical governance arrangements. The post holder will be expected to follow recommended annual appraisals and continuing professional development set out by the Faculty of Physician Associate (FPA).

Main duties of the job

The Orthogeriatrics team comprises: 1 COTE Consultant (Dr Andy Monro), an Associate Specialist (Dr Rachel Tarling), sessions from a COTE SpR, GPSTs, Foundation level doctors, a senior Physician Associate and a Hip Fracture ANP. The wards are also supported by the full range of multi-disciplinary and therapy staff and a dedicated nutritional assistant.

Following the reconfiguration of our Trauma & Orthopaedics services at the end of 2017 all trauma is routed via Gloucestershire Royal Hospital. We are now the 4th largest Hip Fracture Unit in the UK where approximately 800 hip fracture patients are treated annually. There is a dedicated Orthogeriatrician-led hip fracture ward (ward 3A). All hip fracture patients are under the joint care of the Orthopaedic and Orthogeriatric teams with very close collaborative MDT working.

The Orthogeriatric team also provide input to other elderly trauma patients as requested. The plan is to continue to expand the service in the future to provide joint Orthopaedic/Orthogeriatric care for all elderly trauma patients.

There is a Fracture Liaison Service consisting of 3 specialist Bone Health Nurses, who see all over 50 year olds presenting to any hospital in Gloucestershire with a fragility fracture. They are independent prescribers and are able to request DXA scans.

The postholder will be expected to support the daily Consultant ward rounds, attend the daily ward board rounds and 'huddles' and provide medical support and patient review.

About us

Gloucestershire Hospitals NHS Foundation Trust is the largest employer in the county and with over 8,000 staff, we are one of the largest NHS trusts in the UK. We offer a generous annual leave allowance, excellent bank rates, access to the excellent NHS Pension Scheme, discounts for local shops, restaurants and services, access to our health and well-being hub, access to our two on-site nurseries, flexible working options, discounted public transport, reward and recognition schemes, exercise and activity classes and membership to our popular hospital choir.

Job description
Job responsibilities

Development Opportunities

The Trust has employed Physician Associates across both the medical and surgical divisions since 2016 with upwards of 25 PAs currently working across the trust. The trust is committed to the long-term development and investment into the PA role and expansion of the profession in all clinical teams.

There are quarterly PA development sessions covering a range of generalist medical topics which all PAs are encouraged to attend. There are also regular opportunities for peer support and networking with other PAs across the trust. There is access to protected study leave hours and budget to support external development opportunities and CPD.

The orthogeriatric department runs its own weekly dedicated teaching programme and regular attendance and involvement in this would be expected. In the Medical Directorate there is a weekly Grand Round with lunch provided.

There is an active Post Graduate Medical Centre at Gloucestershire Royal Hospital with excellent library and skills facilities.

The department are keen to support the post holder in their professional development and would encourage further training in relevant areas of interest. Attendance at departmental specialty out-patient clinics (i.e. Dr Monros osteoporosis clinic, falls clinic) is encouraged as part of this development. The postholder would also be expected to get involved in audit and QIP projects being done within the team.

Duties and Responsibilities

Clinical Duties

- Supporting ward-rounds undertaking assessment and examination of ward based patients, ordering appropriate investigations, interpreting investigation findings, forming a list of differential diagnoses and recommending treatment accordingly. The expectation is that in time the PA will progress to leading ward rounds with indirect supervision.

- Performing diagnostic/therapeutic procedures, subject to training/experience. Including, but not exclusively:



Arterial blood gases


Catheterisation of male and female patients

- It is recognized that the successful candidate may not be able to perform all these tasks at the beginning and further individual training and supervision to acquire these skills will be provided the candidate should not take on a skill in which they do not have experience.

- Developing and maintaining specialist medical knowledge appropriate to orthogeriatric medicine, including, but not limited to:

Dementia and delirium




Impaired balance

Nutrition NGT insertion

Movement Disorders

- Keeping up to date with current guidelines and maintain best practice.

- Contributing to achieving and maintaining performance within the hospital and department.

- Contributing to the development of efficient pathways of care in accordance with current best practice and national guidelines.

- Helping to facilitate and improve Physician Associate student placements.

- Holding accountability for the care given and complying with the Fitness to Practice and Code of Conduct standard as established by the UK Managed Voluntary Register for Physician Associates (and subsequently the appropriate statutory regulating body, when this is in place).

- Working within the framework of the scope of professional practice.

- Working within the multidisciplinary team to ensure effective team working in the provision of medical care to patients on a day-to-day basis.

- Developing clinical guidelines to ensure best practice for the management of a wide range of medical conditions.

- Supporting and contributing to timely discharge planning including completing discharge summaries and support optimising bed capacity.

- Abiding by the Clinical & Corporate Governance policies of the Trust.

- Taking part in the administration of the department and the involvement in the management of resources.

- Fully documenting all aspects of patient care, and completing all required paperwork.

The Physician Associates role will initially be developed in collaboration with the Clinical Lead of the Department. The job plan will be subject to review in line with service developments.

Service Quality and Clinical Governance

- Develop standards, procedures and systems to ensure safe, high quality and efficient patient care from the point of entry to admission or discharge.

- Participate in relevant audit and quality assurance processes.

Communication and Representation

- Regular communication with family members regarding clinical updates or changes in condition.

- Liaise closely within the department, other in-patient teams and primary and community services to ensure collaborative working arrangements are in place which maximise benefits to patient care.

- Work collaboratively with the clinical team, e.g. consultants, junior doctors, nursing staff, therapy staff etc. to encourage and ensure good working relationships.

- Build effective networks with other departments, working in collaboration to support efficient patient flow.

- Promote a positive image of the department both externally and internally.

- Participate in and contribute to Trust wide initiatives and projects as appropriate

Research & Teaching

- Maintain knowledge and proficiency in medical practices through appropriate continuing professional development.

- Assist in the development and mentoring of Physician Associate Students as the profession progresses.

- Take an active role in the departmental clinical audit and governance activity.

- Teach and train junior doctors, multi-disciplinary staff and students.

- Assist with regular audit/surveys to support and inform service development.

- Preparing for, attending and contributing to teaching

The post holder is required to follow Trust policies and procedures, which are regularly updated including:


- To undertake any other duties that may be required and are consistent with the responsibility and grade of this post

- To be accountable for care given and to comply with the Fitness to Practice and Code of Conduct standard as established by the UK Managed Voluntary Register for Physician Associates (and subsequently the appropriate statutory regulating body when in place). To work within the framework of the scope of professional practice..

- Contribute to service improvements to benefit patients.

- All staff are required to be appraised by their line managers at least once a year at a personal development review meeting where progress made over the last year is discussed and agreed. Focus on the following years departmental and personal objectives will be identified, discussed and agreed. Where necessary, help and support will be provided and development opportunities agreed in line with service provision and knowledge and skills competency framework.

- To have responsibility for the Health, Safety and Welfare of self and others and to comply at all times with the requirement of the Health and Safety Regulations.

- To ensure confidentiality at all times, only releasing confidential information obtained during the course of employment to those acting in an official capacity in accordance with the provisions of the Data Protection Act and its amendments.

- To work in accordance with the Trusts policy to eliminate unlawful discrimination and promote good race relations and diversity in the workplace. To positively promote at all times equality of opportunity in service delivery and employment for patients and staff in accordance with the Trusts policies, to ensure that no person receives less favourable treatment than another on the grounds of sex, marital status, race, religion, faith, colour, nationality, ethnic or national origin, sexual orientation or disability.

- To be trained in and demonstrate fair employment practices, in line with trust policies.

- To comply with No Smoking Policies.

This job description is not intended to be exhaustive and is provided to assist you in the performance of your contract. Changes may be required from time to time in response to service requirements. Such changes will be discussed with you as part of the Individual Personal Review process.

All duties must be carried out under supervision or within Trust policy and procedure. You must never undertake any duties that are outside of your area of skill or competency level. If you are unsure you must seek clarification from a more senior member of staff.

Person Specification
  • Physician Associate qualification
  • BA/BSC level Degree
  • Registered with FPA
  • Previous orthogeriatric experience
  • Care of the elderly experience
  • Experience in audits
  • Research experience
Knowledge/ Skills
  • Take responsibility for clinical caseloads
  • Clinical leadership
  • Working in a team

Employer details
Employer name

Gloucestershire Hospitals NHS Foundation Trust


Gloucestershire Royal Hospital



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