caregiver United Kingdom
Job description
These are new posts in which the successful applicant will be expected to work as middle grade doctors in anaesthesia and critical care. We are looking to expand our middle grade tier, and are looking for enthusiastic and able doctors to join our department. They will be expected to be autonomous in providing anaesthesia for a range of surgical specialties within the District General Hospital setting including obstetric anaesthesia, emergency and trauma surgery and critical care. It is desirable that the post holder would be confident and competent in theatres as well as the critical care setting.
The post holders job plan will consist of activity in theatres and critical care seven days a week, across a full shift pattern to a maximum of 12.5 PA/week. The post holder will be supported with 1 PA to develop interests and take on roles and responsibilities within the department and wider trust. Active support will be given to those wishing to sit the FRCA, where there is the opportunity to attend local and regional training sessions. Teaching and mentorship can be provided for those wishing to achieve competencies in point of critical care ultrasound, including FICE and CUSIC accreditation.
Each post-holder will have a dedicated clinical supervisor to facilitate their personal development and act as a mentor. The post holder will be expected to participate in the appraisal process for revalidation. Applicants are required to possess full GMC registration as well as appropriate visa requirements if coming from outside the EU Applicants should be aware that regardless of their country of origin their ability to communicate in written and spoken English to the standard required to carry out their duties and will be assessed during the selection process. Clinical- Anaesthesia To provide appropriate anaesthetic, obstetric and critical care services as directed.
The post-holder will be expected to be able to autonomously manage a surgical list of ASA 1-3 patients across a range of specialities, including obstetrics, with named supervision from the consultant for the day. The post holder will be job planned to work across theatres seven days a week with some extended/long days. This will be to provide anaesthesia to both elective and emergency cases. At all times there will be a named consultant supervisor.
Willingness to work flexibly to help cover absences due to study and annual leave To carry out pre and post operative assessments as required. Clinical- Critical care All patients in ICU/HDU and some patients in Post Anaesthetic Care Unit (PACU) are under the care of the critical care team. It will be the responsibility of the Critical Care doctors to provide direct care for the patients in these areas. There are consultant led multidisciplinary ward round twice every day and those assigned to work on critical care will be expected to be part of these ward rounds.
The following gives an overview of the departmental workload and the training opportunities that are available for the successful applicant. A new theatre has recently been opened and there is an expansion of services across the trust. A new hospital is also currently being designed with an expectation of an increase in workload and changing ways of working. General Surgery: There are currently seven surgeons whose specialist interest includes breast surgery, colo-rectal, minimally invasive surgery, upper GI and endocrine surgery.
The general surgical emergencies take priority in our Emergency Theatre during the afternoon, at which time Consultant Surgeons are available. Orthopaedics/Trauma: Three ultra clean theatres are operational for both elective and trauma surgery. Nine surgeons carry out a wide range of elective orthopaedics, including major joint revision. There are currently six trauma sessions each week, one being undertaken in the day surgery unit.
Increasingly, local anaesthetic blocks are performed under ultrasound guidance. Two of the consultant anaesthetists have organised in-house study days when nationally recognised experts have demonstrated and taught ultrasound guided nerve techniques on patients presenting for elective surgery. Gynaecology: Seven surgeons perform a wide range of open and laparoscopic surgery.. Day Surgery: Currently, 3 general theatres are in operation, along with 2 further ophthalmic theatres in a dedicated Ophthalmic Treatment Centre.
All the surgical specialities have access to theatre sessions. There is planned expansion of the day surgery capacity. Urology: Three Urologists perform diagnostic and therapeutic surgery. Otolaryngology: A joint department with Addenbrookes.
Five surgeons working in both hospitals, providing a wide range of surgery. Critical Care: The integrated Critical Care Service commits to providing a safe, efficient, high quality and flexible clinical service to those patients that are either critically ill or recovering from critical illness as well as many perioperative patients. ITU & HDU are located in the same clinical area with Post Anaesthetic Care Unit close by. Together these areas constitute the Critical Care Complex.
ITU & HDU provide an environment in which the general adult critically ill population is managed. Selected brain-injured patients are transferred to tertiary centres for specialist Neuro-Critical Care. Current Critical Care Unit bed provision: Level 3 = 6 Level 2 = 3 Post-Anaesthesia Care Unit (24Hr Intensive Recovery) = 2 All patients in ITU & HDU have a named consultant intensivist responsible for their care. The junior Critical Care physicians are resident on call and are supervised directly during the day by consultant intensivists.
Successful applicants may be required to work in this area and should be capable of working independently in critical care. Their role will include the daily assessment of all patients in the critical care area, managing investigations and ongoing care. From time to time they will be required to transport critically ill patients to other hospitals, mainly to tertiary care centres. Obstetrics: Currently there are 10 funded consultant anaesthetist led sessions for the delivery unit, in line with OAA, AAGBI and CNST requirements.
Seven Consultant obstetricians cover 60 hours per week. The unit has around 2500 deliveries per annum, with 60% booked under midwifery led care and 40% under the care of consultant obstetricians. The current LSCS rate is just under 20%, 85% of these being performed under regional blockade. A 24-hour epidural service has existed for over 20 years and currently 15% of labouring mothers choose to have an epidural.
Ophthalmology: The majority of work is done under under local anaesthesia, with virtually all work being carried out in the Ophthalmic Treatment Centre within the Day Surgery complex. There is one session dedicated to general anaesthesia. Community Dental Surgery: Two lists per week in the Day Surgery Unit, mainly for paediatric cases. Oral Surgery: Two Surgeons work in main theatres or in the Day Surgery Unit.
ECT: The Department of Psychiatry has a stand-alone unit within the hospital grounds. The two lists each week are serviced by Senior Anaesthetists. Pre Assessment Clinics: Currently there are ten sessions each week, each being consultant led. The implementation of these clinics has allowed a streamlined patient centred assessment process which has increased our ability to move towards more day of surgery admissions.
A number of nursing staff are running clinics and it is hoped that in the near future all clinics will be delivered by nursing staff. Radiology: A CT Scanner is staffed by the department for a paediatric general anaesthetic list. A Mammography Unit is well established, under the Forrest programme. There is a MRI Scanner on site and general anaesthesia cases have just started to be undertaken there, predominantly from ICU.
Department of Pain Medicine: The acute pain team aims to minimise pain and facilitate recovery especially in the perioperative patient. This is achieved with a formal and organised approach using the current best available evidence predominantly in protocol format. Two consultant anaesthetists lead this progressive team. The pain service manages PCA, epidural analgesia and other specialised forms of pain relief principally on the surgical wards and conducts daily ward rounds.
In addition to clinical care the acute pain service provides advice and education to medical, nursing staff and patients. The service accepts referrals from throughout the hospital. There are currently two Consultant sessions for acute pain. There are 5 WTE nurses within the Integrated Pain Service with secretarial support, who cover both acute and chronic pain.
The Senior Clinical Nurse Specialist has recently been awarded an MSc with distinction in Pain Management by Cardiff University. Chronic pain is funded by the Medical Directorate and is led by two part-time consultant anaesthetists (one of whom also covers some anaesthetic sessions) a full time Associate Specialist. An acupuncturist and a counsellor also form part of this team.
