Consultant in Acute General Medicine (AGM) and Gastroenterology Banbury, England
Job description
Applications are invited for a consultant post in Acute General Medicine (AGM) and Gastroenterology at the Oxford University Hospitals NHS Trust (OUHFT). The OUH NHS Trust comprises four hospitals: the John Radcliffe, Nuffield Orthopaedic Centre, Churchill Hospital and the Horton General Hospital. Applicants will be based mainly at the Horton Hospital with sessions at the John Radcliffe Hospital.
This is an exciting time to join AGM and Gastroenterology at OUHFT and become part of a consultant workforce with a reputation for excellence. We are seeking enthusiastic colleagues who are skilled in the delivery of acute medical care and the interface with the Emergency Department and other hospital specialties.
The appointments are on a full-time basis. Applications are welcome from those who wish to job share or work less than full-time, or from those looking to combine clinical work with a research career or teaching and training. Those with academic and subspecialty interests are encouraged to discuss the opportunities that are available.
The post-holder’s principal duties will be delivered at the Horton Hospital, but it is a condition of the appointment that the post-holder will be willing to work in any of the Trust’s locations. The post-holder will provide consultant physician services for the Oxford University Hospitals NHS Foundation Trust, including care of acute admissions, care of outpatients, leading ward rounds and other professional activities relating to Acute General Medicine and Gastroenterology.
The Horton General Hospital is located in the market town of Banbury and serves the growing population of North Oxfordshire and surrounding areas. The AGM department has recently transformed the way in which consultant-led care is delivered across the inpatient areas with a dedicated EAU consultant, ward based medical teams and increased Ambulatory care.
We work in a flexible and modular way that allows the opportunity for ongoing consultant career development. We expect the successful candidate to develop their subspeciulaty interests.
We will support new colleagues in developing teaching and leadership roles. The Trust is a clinically led organisation and AGM consultants play key senior management roles. Research activities are developing and new appointments may support this.
The Trust is one of the NHS Digital Exemplar sites and is already paper-light in many areas. New colleagues are expected to support this ongoing work; training will be provided.
Clinical
The post-holder’s principal duties will be delivered at the Horton Hospital, but it is a condition of the appointment that the post-holder will be willing to work in any of the Trust’s locations.
The post-holder will provide consultant physician services for the Oxford University Hospitals NHS Foundation Trust, including care of acute admissions, care of outpatients, leading ward rounds and other professional activities relating to Acute General Medicine and
Gastroenterology.
AGM at the Horton Hospital:
The department consists of an Emergency Assessment Unit (18 beds), short stay ward (18 beds) and 2 general medical wards (28 and 30 beds). AGM consultants also provide medical care for patients on a 4-bed Critical Care Unit (CCU) providing level 2 care, supported by
anaesthetic colleagues.
There is a team of at least 8 WTE general physicians delivering AGM at the Horton. The majority of consultants work across both JR and Horton sites which helps to maintain excellent levels of communication and cohesiveness across the sites. The current consultant
body consists of general physicians with specialist interests in Cardiology, Gastroenterology, Infectious Diseases, Diabetes, Endocrinology and Geratology.
The department receives regular specialist input from Respiratory, Acute Oncology and Palliative care. Inpatient teams are ward-based and consultants manage approximately 20 inpatients supported by a team of junior doctors comprising an ST3+, IMT/CMT/FY2/GPVTS and an FY1.
The Horton AGM consultant on call rota for this post is 1 in 16 (ie shared with a colleague). The current working practice is to work blocks of 2 months alternating between medicine 1:8 with reduced Gastroenterology committment and pure Gastroenterology with consults. The
unselected acute admissions equal approximately 20 per day with referrals from ED or following triage by the senior decision maker carrying the GP referral phone. Some specialist services (e.g. Stroke, ACS, oncological emergencies) may go directly to the John Radcliffe.
The AGM consultant on call is responsible for the full 24hr period and will undertake reviews regularly throughout the day. Following the post-take ward round, patients will be assigned to a consultant team based on their location. Handover occurs at 0900 and 2130 daily. All
documentation including medical clerking, post-take consultant ward round and subsequent ward rounds are on the Trusts electronic patient record.
Educational opportunities include regular journal club, case-based discussion sessions, formal reflection and SIM training sessions. There is an on-site postgraduate education centre and library.
Ambulatory Care
Ambulatory Care is delivered 7 days a week through the Ambulatory Assessment Unit (AAU) at the John Radcliffe and 5 days a week at the Rowan Ambulatory Unit (RAU) at the Horton Hospital. The ambulatory consultant in charge leads the unit for a whole day to support continuity and decision-making. Phone referrals are handled by consultants or senior registrars regardless of provenance (GP, paramedics, ED, advanced practitioners), with a heavy emphasis on decision support and risk shareholding, supplemented by an expanded spectrum of interface options including home-based care delivered through an established
Acute Hospital At Home model. Consultants are also expected to take a proactive role in interacting with the Emergency Department and other areas of the Trust under pressure, and deploy the AAU resources flexibly according to need. The ambulatory units are supported by a team of doctors in training and dedicated ambulatory fellows, as well as a skilled nursing team, integrated senior physiotherapist and pharmacy team.
Ambulatory Care consultants have backgrounds in Acute Medicine, Geriatrics, Endocrine, Renal, Stroke and Emergency Medicine and Primary Care. This broad background, together with a strong academic narrative, help drive a dynamic and innovative Unit. Consultants have a diverse portfolio of activities including BRC (Biomedical Research Centre) and NIHR (National Institute of Health Research) supported projects, point of care imaging and diagnostics, mixed methods and systems research and education. The department hosts the Trust’s RCP Chief Registrar Programme, ambulatory fellowship programme and founded the physician associate programme.
Gastroenterology
The post-holder’s duties will be primarily at the Horton Hospital in Banbury with 2 sessions at the John Radcliffe Oxford in Gastroenterology. It is a condition of the appointment that the post-holder will be willing to work in any of the Trust’s locations.
The Consultants provide a consult based service to the Consultants in Acute Medicine who manage the inpatients on the Horton site. There is complete integration with colleagues at the John Radcliffe Hospital allowing for complex patients to be managed across all sites with open pathways for transfer where necessary. The consultants at the Horton Hospital have access to all MDT’s for patients with cancer, advanced liver disease, and advanced IBD.
In addition there are regular X-Ray meetings and clinicopathological meetings which are based at the John Radcliffe and accessible by MS Teams. Clinics are a standard 4h duration with new (30min) and follow up (15min) patients. Endoscopy lists are a standard 12 units per list, with a mixture of upper gastrointestinal endoscopy (1 unit diagnostic, 2 units therapeutic) and colonoscopy (2 units diagnostic
including simple polypectomy, 3 units therapeutic). Consultants are allocated 0.5PA per clinic to manage the administration arising from clinics, and 0.2PA’s per endoscopy list to manage administration arising from endoscopy lists.
There are emergency endoscopy slots in hours Monday-Friday but no out of hours service. Patients presenting with active bleeding out of hours are directed to the John Radcliffe Hospital by the ambulance service and transfers arranged as necessary in the rare occasion that an in-patient develops bleeding at night/over a weekend.
The Gastroenterology department have a team of secretarial and administrative support. Office space will be provided, with access to a computer/laptop. IT support is available from the Trust IT support team. One of the existing consultant team will support as a mentor, any
new Consultant joining the team
Teaching/Research
The Dept of Gastroenterology at the Horton Hospital currently has two trainees in Gastroenterology. The postholder will contribute to their training and participate in the regional teaching programme, held on a Thursday afternoon.
Oxford University Hospitals NHS Foundation Trust is a Teaching Hospital. The post-holder is required to participate in programmes for teaching clinical students, training junior doctors and in clinical examinations. This is an integral part of everyday clinical activity. The postholder’s contribution to teaching, training and research will be included in the regular job plan
review. We are fortunate to have trainees and students of the highest calibre. There are many teaching, training and research opportunities within the department and the wider Trust and Universities. We have close links with two universities (Oxford University and Oxford Brookes University) that train many of our clinical staff and are actively exploring
interdisciplinary and multi-professional opportunities. We are at the centre of a new Academic Health Science Network. www.oxfordahsn.org
Clinical Governance
The post-holder will participate in all clinical governance activities, including clinical audit, clinical effectiveness, risk management, quality improvement activities as required by the Trust, and external accrediting bodies.
Personal and Professional Development
The post-holder will be required to keep himself/ herself fully up-to-date with their relevant area of practice and to be able to demonstrate this to the satisfaction of the Trust, and participate in annual appraisal and development of a portfolio to support revalidation. The
Trust has well developed systems to support Appraisal and Revalidation. All new consultant appointees are assigned a mentor. Professional or study leave will be granted at the discretion of the Trust, in line with the prevailing Terms and Conditions of Service, to support appropriate study, postgraduate training activities, relevant CME courses and other Appropriate personal development needs. Management The post-holder will be required to work within the Trust's management policies and procedures, both statutory and internal, accepting that the resources available to the Trust are finite and that all changes in clinical practice or workload, or developments requiring additional resources must have prior agreement with the Trust. He/ she will undertake the administrative duties associated with the care of his/ her patients, and the running of his/ her clinical service under the direction of the lead clinician and/or directorate chair.
