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INTRODUCTION –The Acute Assessment Unit (AAU) is a day assessment unit where University Hospitals Plymouth (UHP) supports delivery of an integrated approach to avoid unnecessary admissions. The AAU provides same day emergency care (SDEC) for people with medical problems who do not require hospital admission.We link to community services and general practice to support the interface between primary and secondary care

Purpose of theAcute GP role

• Working alongside the acute physicians on the AAU: a dedicated space for patients to be appropriately assessed, close to the Emergency Department and with strong links with health and community services
• Support an MDT approach to urgent care to provide a better experience for the patients
• Enables Primary Care Streaming from ED by offering a dedicated function to treat and care for minor illness
• Deliver advice to enable ongoing care in the community and support discharge from the Emergency Department
• Support the advanced care team in community Urgent Treatment Centres (UTCs, includes Cumberland, Tavistock and Kingsbridge) to develop and deliver care in line withpublished guidance
• Provides a dedicated acute frailty service (AFS) enabling multi-professional and inter-agency assessments of needs of people with complex needs and frailty.
• The AAU aims to prevent unnecessary hospital admissions and to get patients back home/into the community
• Reduces unnecessary delays and create better flow
• Reduces overcrowding in the Emergency Department
• Support delivery of medical treatment of Ambulatory Care specific conditions
• Work to develop new pathways to optimise patient experience of same day emergency care

University Hospitals Plymouth NHS Trust is the largest hospital in the south west peninsula, providing comprehensive secondary and tertiary healthcare.

Our geography gives us a secondary care catchment population of 450,000 with a wider peninsula population of almost 2,000,000 people who can access our specialist services. The population is characterised by its diversity – the rural and the urban, the wealthy and pockets of deprivation, and wide variance in health and life expectancy. Population ageing is a recognised national trend, but is exacerbated locally by the drift of younger people out of the area and older people in. The proportion of our population aged 85 or over is growing ahead of the national average by approximately 10 years, giving Plymouth the opportunity to innovate on behalf the nation in services for the elderly.

Location of the AAU

The service will be provided within the new AAU which is on Level 06, Derriford Hospital, PL6 8DH , within the Emergency Department estate, the Acute Frailty Unit and the Urgent Treatment Centres at Tavistock Hospital, Kingsbridge Hospital and the Cumberland Centre.

Opening Hours

The aim of the unit is to be open from 08:00 – 23:00 hrs, 7 days a week.

DUTIES OF THE POST

Working within the Acute Assessment Unit and within various departments in the Derriford footprint depending on the future development of the service. Work at community Urgent Treatment Centres including but not exclusively detailed above.

At times the post holder may be asked to be flexible across other days of the week.

The GP will work as part of the AAU team, which includes GPs, Acute Physicians, nursing staff, allied health professionals, administrative staff and social workers.

The GP will need to work co-operatively with each other, the service manager, other clinical and administrative staff to maximise opportunities to improve patient pathways.

The post holder will be expected to develop good relationships with referring clinicians and with medical colleagues working within the secondary care setting. They will also need to liaise with other health professionals working in health and social care in the community.

Taking referrals from clinicians in the footprint of the acute hospital for a variety of specialties and appropriately exploring the request for admission from those clinicians.

Taking an active part in accepting referrals and communicating with the Emergency Department

Appropriately redirecting the patient if admission is not required by taking all relevant details and facilitating appropriate care elsewhere.

Being clear about the intended management plan for the patient once a referral has been accepted, and agreeing the onward care plan

Offering an on-site assessment facility for selected patients where the patient may require further investigation and diagnostics.

The GP would take a history, perform an initial examination and request any pertinent diagnostic tests, following which if admission was required, the relevant information would be passed to the receiving clinical team.

Communicating with other members of the multi-disciplinary team and planning for discharge at the point of admission.

Ensure that high clinical standards are maintained throughout the service.

Maintain a professional image of the organisation

Work with consultant and other clinical colleagues to improve non-elective care pathways in the hospital.

Work with GPs and other community colleagues to develop new pathways of care within the community as alternatives to hospital admission.

Contribute to the development and teaching of the team of GPs, nurses, Advance nurse practitioners within the organisation and with other partner organisations.