General Paediatric Trust Fellow

Scope of the role

The purpose of this post is to supervise the day-to-day clinical management and care of patients admitted to the Harris International Patient Centre by the various specialist units within the hospital. The Trust Fellow is expected to undertake daily ward rounds each morning along with the lead consultant and nursing team and hand over pertinent details, at the end of the day, to the Hospital at Night team.

Key working relationships

Internal:

Doctors, nurses, administrative teams

External:

Families, community services

Specific clinical roles and responsibilities

· Inpatient responsibility:

The Trust Fellow will be responsible for the General Paediatric International inpatient service based on Bumblebee, Butterfly and Hedgehog wards. The Trust Fellow will conduct a daily ward round to ensure that the inpatients are adequately assessed each day and that a management plan is made and executed. Specialty consultant ward rounds occur at regular intervals and the post holder will be available to attend these whenever possible.

The Trust fellow will be responsible for liaising with the other members of the team to ensure timely diagnostic investigations and treatment. They will liaise with the Clinical Site Practitioners over critically sick children and maintain a safe and efficient in-patient service. He/she will also need to take responsibility for checking that new and repeat admissions occur in a timely fashion and that discharge planning is initiated on admission.

The multidisciplinary team within the International Division will jointly, with the consultants who have admission rights, manage the care of all patients to an excellent standard in line with published best practice and GOS guidelines. A key aim of the Division is to manage the care of the patients effectively to ensure utilisation and throughput in the inpatient areas is optimised so as to balance the significant and growing demand we have, while ensuring bed availability. The Trust Doctor will be a key member of the team in facilitating the timely admission and discharge of patients in line with care programmes we are implementing within the Division.

· Outpatient and day care responsibility:

The Division has an outpatient and day care area, Caterpillar and Dragonfly, and the post holder will play a full part in supporting the efficient and safe functioning of these areas including providing medical support to the pre-admission clinics when required. The Trust Fellow will be expected to review patients attending Caterpillar and Dragonfly wards who present with acute problems related to their treatment or who come for routine day case review or diagnostic tests. There will also be a requirement to provide cover to the private outpatients department for un-booked attenders and unwell children during rostered hours.

Objectives

During the period of working within the International and Private Patients Division it is expected that the Fellow will develop their clinical skills. By the end of the placement the Fellow should be competent in certain clinical areas:

· To be able to clerk a patient with complex co-morbidities and formulate a clinical plan

· To clearly communicate in both verbal and written format with all members of the multi-disciplinary teams during an inpatients stay

· To clearly document discharge plans and the individuals given responsibility to achieve the discharge plan

· To recognise the deteriorating child and the appropriate escalation and management of such patients

· To develop effective communication with a cultural diverse patient and parent group

· To develop increased awareness of the needs of international families remote from their usual family support network and anticipate strategies to support such families

· To be committed to and contribute to the improvement work going in the Division

· To take part in educational programme of the Unit

· Participation in Clinical audit project / Clinical Improvement Project

· To achieve and maintain technical skills in cannulation, venepuncture, lumbar puncture and the safe transfer of patients.

· To manage post-operative patients, including pain management, fluid management and the assessment of evolving post-operative complications

· To become proficient in the range of central venous lines used within the Division and the merits of each

· To demonstrate effective team-working

The Rota

The Trust Fellows in IPP work a full shift rota providing cover between the hours of 08:00 to 21:00, Monday to Sunday. This rota is compliant with the New Deal and the European Working Time Directive. A normal working day is 08.00 – 16.00 Monday to Friday. There will usually be two day time doctors and one late shift doctor on Bumblebee ward Monday to Friday, one doctor on Hedgehog ward and one doctor each day on each ward at the weekends. There is prospective cover for both annual and study leave which must be requested at least 6 weeks in advance.

Out-of-hours commitment

There is no overnight work duty with this post. The post holder will be required to work one in four weekends. The post holder is also required to work one week of late shifts at a maximum frequency of every four weeks (12:00 to 21:00). In addition to the General Paediatric patients on Bumblebee, Butterfly and Hedgehog wards (a mixture of patients with complex medical/surgical needs under a number of specialities) the Fellow may be required to cover the Bone Marrow transplant patients and Haematology/ Oncology patients on Butterfly and Hedgehog when on a late shift or working the weekend. The late shift Trust Fellow is expected to hand over pertinent details, at the end of the day, to the Hospital at Night team.

The post holder will be remunerated according to their level of experience (ST 4-10); this post attracts a band 1A pay supplement.

Education and training

This post will afford the successful candidate with a unique range of experience in general and specialist paediatrics. Clinical education will be regarded as a priority. Each Trust Doctor will be linked and receive their educational supervision through the Consultant Paediatricians within the Division.

The post holder will be eligible to three hours protected teaching time per week. This may consist of attendance at speciality specific teaching ward rounds, clinics or the regular post-graduate teaching programme held within the Trust, for example.