Lewisham and Greenwich NHS Trust are a committed multi- professional team who provide much-valued hospital and community services to residents in South East London. The Trust has built a good reputation as a place to enjoy job satisfaction and develop professional skills and experiences. Our people value the opportunity to work in a supportive culture and, we ensure our team are well rewarded for their contribution. By joining us now, you can play a role in shaping our organisation that continues to put patient and client care first. Whatever the challenges ahead, we’re prepared to face them as one team.
University Hospital Lewisham (UHL) is looking to increase to 10 Physician Associates within the Division of Acute and Emergency Medicine. We have one vacancy, aiming to start in Feb/March 2019. The Division of Acute and Emergency Medicine is responsible for services in Acute General Medicine, Medicine for the Elderly, Therapies and Pharmacy.
Within the Division, UHL has 307 beds including a 46 bed Acute Medicine Unit (including up to 24 escalation beds) 24 bed Acute Frailty Unit, four General Medical/Specialty wards (comprising of the cardiology and Gastroenterology ward incorporating 5 Coronary Care beds, respiratory, endocrinology and metabolic medicine) and six Medicine for the Elderly wards (including two Stroke wards).
The 10 posts will be divided into two groups of five – one group for Acute/General Medicine, and one group for Care of the Elderly/Acute Frailty. Within each group, there will be four set ward areas which will be staffed 9-5 each working day by a PA. The fifth member of each group will be the “cover” PA, to fill in gaps in the service provision from annual leave. Post holders will rotate through each of these five positions every 10 weeks. After 1 year, the two groups will swap. Thus, each post holder will gain a huge background in all aspects of General and Elderly Medicine.
Written into the work schedule is one session every 2.5 weeks for participating in the acute medical take during weekdays from 4pm -8pm. We envisage that his will provide further experience in management of Medical patients to those post holders.
At UHL, an Acute Physician admits all cases between 8am and 2pm Monday to Friday. The acute physician will continuously review all patients admitted until 2pm. An on-call General/Acute physician then takes over to review patients admitted from 2pm to 8pm. The On-call remains on call from home until 8am the following morning. Another acute physician undertakes a post take ward round that commences at 8 am to review the patients admitted overnight.
There is also a frailty consultant from 8am to 8pm, who reviews all frailty admissions, and provides continuing care for those on the Frailty Unit. Communication between the Frailty and General teams is highly valued, with our target always being to have the right patient in the right place at the right time looked after by the right team. To this end, there will always be sensible dialogue between the two teams to make sure that they are supporting each other for a common goal. The average number of admissions at the present time is 30-35 per day, of which about two thirds are under the care of the acute physicians, and a third under frailty. There are obviously significant seasonal variations within this.
In addition to the in-patient service, there is also an Ambulatory Care Unit (ACU). The aim of this unit is to provide rapid assessment and management of those requiring secondary medical services, but who are ambulant and do not require an in-patient stay. At present, the ACU sees around 25 patients per day. This unit has been extremely successful in avoiding unnecessary admissions, providing for safe rapid discharge from the in-patient teams, and allowing for rapid assessment by medical specialty services. We are in the process of expanding this further, to incorporate a Frailty Assessment unit and daily TIA assessment service.
UHL has in-hospital specialist medical teams that will review patients on request. These include Respiratory, Cardiology, Endocrinology and Diabetes, Gastroenterology, Renal, Neurology, Haematology, Oncology and Stroke. There are referral pathways in place with local Tertiary referral units for all other Specialties.
Each of our downstream in-patient general medical wards does have a specialty interest:
Cherry Ward – Cardiology and Gastroenterology
Alder Ward – Diabetes and Endocrinology
Mulberry Ward – Respiratory
Laurel Ward – Metabolic Medicine and Haematology
In addition to the ward beds, each ward team (except Cherry) also has responsibility for any patients who have been placed on surgical wards for bed management purposes.
Each downstream ward team has a single Consultant responsible at any one time, aswell as 2 Registrars, 3 SHO level Drs and 2 FY1s allocated each rotation. In Elderly Care, there are two Acute (although not hyperacute) stroke wards, and four general downstream COE wards. There is a single Consultant responsible for each ward at any one time, aswell as 4 SpRs, 12 SHOs and 6 Fy1s across these wards.
Interview Date: To be confirmed
Start Date: February 2019
Please note that the as part of the application process for non-medical roles, you will need to complete a short values based pre-application question. Your responses to the question will impact on whether or not you are able to successfully continue with your application. Please have a look on our website to find out more information before you start the pre-application question. If you are unsuccessful with the pre-application question, it means that you are not in harmony with our values. We thank you for your interest in Lewisham and Greenwich NHS Trust.
We reserve the right to close the post before the stated closing date, please apply early. We do not contact applicants with the outcome of the shortlisting. If you have been shortlisted, you will receive an invite to an assessment day or interview.
This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service.