Hampshire Hospitals NHS Foundation Trust (Basingstoke)

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1 Hampshire Hospitals NHS Foundation Trust (Basingstoke) Individual (Job) Descriptions for Foundation Year 1 expect and learning opportunities Where the is Clinical Supervisor(s) for the Main duties of the F1 - General Medicine (Cardiology) Cardiology Consultant ward rounds every day to see high acuity patients. General house officer jobs such as liaising with relatives and multidisciplinary team members. The team are very good at teaching on the ward round and organising other teaching sessions if you are interested. Basingstoke and North Hampshire Hospital Dr Carl Brookes Dr Andrew Bishop Dr Michaela Scheuerman-Freestone Dr James Glover Ensure the ward round runs smoothly and the required information is available. Organise investigations, communicate with other members

2 of the MDT, and assess unwell patients. We have lots of medical students, both 3 rd and final years, so some time each day is spent teaching them and helping them see patients. Typical working pattern in this 2 FY1s, 1 FY2, 1 CT1/2, 2 registrars Consultant led CCU ward round every day, starting promptly at You are then often left to see the other patients independently or with the registrar Ward rounds Referrals Hampshire Hospitals NHS Foundation Trust It is important to note that this description is a typical example of your and expect and learning opportunities F1 Medicine General Infomation Medicine The medical wards are: AAU (Acute Assessment Unit next to A&E) C floor C4- surgical but with medical outliers (under Rheumatology team) E floor E1- Gastroenterology E2- Endocrinology Isolation ward- mixture E3- Respiratory E4- Acute Elderly Care F Floor F1- Stroke and Rehabilitation Medicine F2- Elderly Care Wessex ward- Haematology and GIM CCU on the 1st floor of Sherbourne Building. The Firs- Rehabilitation Unit (led by an SHO)

3 Where the is Clinical Supervisor(s) for the Main duties of the Typical working pattern in this Dr Andrea Norris Dr Phil Swales Daily job lists will be created on the rounds, and jobs allocated to each team member and prioritized. The rest of the day consists in ensuring each task is complete and outstanding tasks or results are fully followed through before the next consultant ward round. All handovers of bleeps should take place at the 9am or 9pm handover in AAU. This is important as it means that everyone can be made aware of sick people on the wards and also means you know the team that you will be working with for the shift. Week days FY1 (8:00am 9:30pm) Monday Thursday FY1 (Nights) (9pm 9am) Weekends FY1 ( AAU ) 9am-9:30pm FY1 (Wards) 9am-9:30pm Friday-Sunday FY1 (Nights) 9pm-9am. It is important to note that this description is a typical example of your and expect and learning opportunities F1 Respiratory Respiratory Daily job lists will be created on the rounds, and jobs allocated to each team member and prioritized. The rest of the day consists in ensuring each task is complete and outstanding tasks or results are fully followed through before the next consultant ward round.

4 Jobs may include, clerking elective admissions, perfoming practical procedures eg blood gases, discharge summaries, speaking to relatives, liaising with other teams, arranging investigations and checking blood tests and results. House officers are also in charge of creating the patient list before each ward round every morning. Where the is Clinical Supervisor(s) for the Main duties of the Typical working pattern in this Dr Kevin McKinlay Dr Salah Matti As above. The usual working day starts around The team usually consists of - 2 x FY1 2 x SHO (1 x CT1 and 1 x FY2) 2 x SpR 2 x consultants. It is important to note that this description is a typical example of your and expect and learning opportunities Gastroenterology Gastroenterology The gastroenterology inpatients are split into two teams. The upper GI team looks after patients with chronic liver disease, biliary pathology and pancreatic disease. The lower GI team look after inflammatory dowel disease and patients with complex nutritional needs. Patients with acute GI bleeding are

5 distributed between both teams. FY1 doctors will spend 2 months on each post, providing the opportunity to experience a variety of GI diseases and learn skills such as NG tube insertion and paracentesis. There are several weekly specialist MDTs which provide learning opportunities and an alternate weekly (sponsored) gastroenterology departmental meeting for discussion of difficult cases. FY1 doctors are expected to present clinical cases and journal papers at the regular BNHH grand round/journal club. Where the is Clinical Supervisor(s) for the Dr John Ramage Dr Corrine Brooks Dr Matthew Brown Dr Mike Reynolds Dr Rebecca Saich Main duties of the Both UGI and LGI teams undertake consultant ward rounds on Mondays and Thursdays. There is a multidisciplinary ward meeting at 0830 every Monday, Wednesday and Friday, including medical, nursing, therapist and adult social services to discuss safeguarding issues, complex needs and discharge planning. Standard working times are Monday to Friday Monday, Wednesday and Friday, and Tuesday and Thursday. However, you should expect to work beyond these hours on occasion to complete all your work. Attendance in endoscopy is available for those wishing to learn more about endoscopic procedures and therapies. Typical working pattern in this Monday to Friday , although you should expect to work beyond these hours regularly to complete all your work. nights or weekend.

6 . It is important to note that this description is a typical example of your and expect and learning opportunities Endocrinology Endocrinology The majority of your workload is diabetes but with some GIM. Team members - 1x Registrar, 1x SHO, 1x F1 Where the is Clinical Supervisor(s) for the Main duties of the This will allocated in first Day to day job involves ward work including documentation of ward rounds, prescribing medications and fluids, ordering tests and imaging, arranging other speciality involvement where required, reviewing tests and imaging. Also reviewing any sick patients and implementing appropriate treatment. On-call role includes acute admissions where you do any jobs required for newly admitted patients. There are some opportunities to clerk patients. Ward cover is also part of this being called to review patients on the wards, prescribing, actioning and reviewing tests ordered by the usual day team and implement appropriate action in light of the results. You also hold the crash bleep and will be called to any cardiac arrests. Typical working pattern in this 1:14 on-call : It is important to note that this description is a typical example of your and

7 opportunities Elderly Care Elderly Care Consultant led on Friday and Monday or Tuesday Dr Sam Arianayagam, Consultant Dr Zahid Hussain, Consultant 1 x SHO, 2 x FYI, 1 x SPR (+/-) Day Mon Tue Wed Thu Fri AM Lunch PM Dr Ari W/R + New pts Dr Hussain W/R Dr Hussain MDT Ward work Journal Club Grand Round Ward work Ward work F1 teaching Ward work Dr Hussain W/R Ward work Dr Ari W/R Elderly Care teaching Ward work Where the is Clinical Supervisor(s) for the Main duties of the Typical working pattern in this Dr Rebecca Rixon Dr Sam Arianayagam Dr Zahid Hussain Dr Lucy Sykes Daily multi-disciplinary meetings, ward rounds and ward jobs. Organise ward round; carry out ward jobs and trouble shoot medical issues during the day. Liaise with family and GP, complete discharge summaries. Keep up-to-date hospital notes. Liaise with the multi-disciplinary team for patient rehabilitation. MDT Tuesday morning 09:00 Medical teaching Tues + Thurs lunch time Foundation years teaching weds lunch It is important to note that this description is a typical example of your and Acute Elderly Care Elderly Care Team members: Dr Rixon, 1xSHO, 2x FY1

8 opportunities Day WR + Reviews Daily triage Monday Rixon WR Rixon WR Tuesday Rixon r/v of all Rixon WR sick patients and any new pts (morning only) Wednesday SpR WR Dr Rixon not in but contact via switch if issues Thursday Rixon WR, Rixon WR Friday Junior WR Rixon WR Where the is Clinical Supervisor(s) for the Main duties of the Dr Rebecca Rixon Dr Sam Arianayagam Dr Zahid Hussain Dr Lucy Sykes Generally the ward round follows the same pattern. On Rixon rounds it pays to try and get the jobs done on the way round (if numbers allow. The ward is sometimes split and you will often be split up to get through the patients. Key daily questions to ask the patients on ward round are eating and drinking, bowels, urine output and decisions about discharge if appropriate. There is a weekly meeting on Friday lunchtimes at 1pm in the F floor seminar room. You will also be expected to cross cover the other elderly care wards if they are short Typical working pattern in this As above It is important to note that this description is a typical example of your and expect and learning opportunities Stroke Stroke Team members: 2xSHO, 1xF1 Consultant WRs Monday & Friday. Junior full WR Wednesday. MDT Tuesdays

9 You will also find that you have patients transferred back from Wessex Neuro Unit in Southampton under your care. These patients often have really interesting neurology so it's a great chance to brush up on your examination Where the is Clinical Supervisor(s) for the Main duties of the Dr Elio Giallombardo Dr Lucy Sykes Dr Nigel Smyth All work cross sites Dr John Duffy You will predominately be the ward targeted at stroke rehab. It is important to note that this description is a typical example of your and expect and learning opportunities Trauma and Orthopaedics Trauma and Orthopaedics Orthopaedics, Pre-Assessment Clinic. You may have some paediatric patients, Trauma list templates and elective theatre lists, Adult Medicine. During your attachment to orthopaedics you are encouraged and expected to attend Consultant clinics and the Plaster Room where you will have the opportunity to learn plaster techniques Where the is Clinical Supervisor(s) for the Main duties of the and Typical working pattern in this You should attend theatres during your attachment and assist the anaesthetist and the surgeon This will allocated in first There are six FY1 s on T&O -two per Consultant Team. There is also an FY2 (attached to Team 1 There are roughly 2-3 Reg s per team. Trauma meeting starts at 8.30am Monday to Thursday and 8:00am on a Friday. After the trauma meeting you start your ward round. If you are post-take then you carry out a post-take ward round first with your Consultants + Regs. Your consultants and/or regs will grab you at

10 various times during the week to do ward rounds but otherwise you need to see the patients every day on your own. Throughout the day you may be bleeped by the nurses on the Pre-Assessment Clinic to check pre-op ECG s, listen to breath sounds/listen to heart murmurs that they may have heard during their assessment. The Fracture Clinic is run by the on-call team between 10h00-12h30 every day except Sundays. Weekday on call Arrive at around 8:00am to get handover from the night FY1 They will give you a handover about any new admissions and any sick patients and the bleep. You will then attend the trauma meeting in the seminar room. All the patients from the previous day/night will be discussed. The registrar will present each patient and then the Consultants decide together about whether surgery is appropriate and which type of operation is most suitable. By the end of the meeting you will usually have a rough idea what order the trauma list will be for that day. From 5pm onwards you will get bleeped about any jobs the day teams need to handover and the wards will start bleeping you about any jobs that need doing/ inpatients that need reviewing, so it is often a good idea to leave theatre around this time. At the end of your shift (9pm) it is best to bleep the surgical FY1 to hand over your bleep, as their shift times are different to yours. Weekend on call Friday on call works exactly the same as Monday to Thursday. On Friday afternoon the FY1 s from the day teams should have made a handover list of jobs for the weekend. This mostly consists of checking bloods and reviewing sick patients. On Saturday you start around 8.15am (unless otherwise specified by the Reg/Consultant) Sunday morning starts the same way as a

11 Saturday, but after the post take ward round the Reg and Consultant go off to do the trauma list in theatre. It is important to note that this description is a typical example of your and expect and learning opportunities Where the is Clinical Supervisor(s) for the Main duties of the Typical working pattern in this Surgery Surgery Ward rounds and administrative jobs focused on patient care, acute management and assessment of emergency admissions, care of postoperative elective inpatients. There are opportunities to go to theatre always welcome. WARD WORK Prepare for and attend the daily ward rounds conducted by the SpR s and Consultants [daily at 08:00 hrs (08:30 on Fridays after M & M meeting)] Clerking and continuing care of elective and emergency admissions to the ward Complete all routine ward work and gather the necessary results and reports before 17:00 hrs [do not leave any routine ward work to the on-call FY1, such as writing up fluid regimes, analgesia etc] Keep your SpR informed of developments with ward patients as soon as possible, particularly any acute problems. Always brief your team SpR and the on call FY1 before you leave the ward at 17:00 hrs WEEKDAY ON-CALL Day on-call starts at 08:00 and finishes at 16:30. WEEKEND ON-CALL The short day shift starts at 08:00 and finishes at 12:00.

12 WEEKDAY NIGHTS Night shifts begin at 20:00 and finish at the earliest at 08:00, following handover to the day team WEEKEND NIGHTS Begins at 20:00 and finish at 08:00 It is important to note that this description is a typical example of your and

13 opportunities Where the is Clinical Supervisor(s) for the Main duties of the Colorectal Colorectal 8am ward rounds. Emergency and elective admissions. Clerk in patients. Able to go to theatre and clinics when other F1 can cover. Booking procedures. Reviewing procedures. Reviewing and ordering bloods. Prescribe safely. Keeping accurate patient records. Communicating effectively with patients, family members and colleagues. Teaching medical students. This will allocated in first Ward Rounds with Consultants and SpR s Pre-op assessment for patients ECGs/listen to breathe sounds/heart sounds at the Pre-op Assessment Clinic Typical working pattern in this Ward round starts at 8am so you need to have your list ready before this time It is important to note that this description is a typical example of your and opportunities Where the is Clinical Supervisor(s) for the Main duties of the Typical working pattern in this VASCULAR Vascular Ward rounds and administrative jobs focused on patient care, acute management and assessment of emergency admissions, care of postoperative elective inpatients. There are opportunities to go to theatre always welcome. This will allocated in first Ward Rounds with Consultants and SpR s Care of elective vascular surgical admissions and vascular emergency admissions MDT vascular MDT meeting Thursdays 13:30 M&M three monthly Cross cover with Colorectal House officer The day starts with a ward round at 08:00. There is cross cover between colorectal and vascular and therefore the ward round will often include both types of patients if lead by the registrar.

14 On Thursday there is a Consultant lead ward round of all vascular patients at 08:00. Colorectal Consultant lead ward rounds will occure at different times. It is important to note that this description is a typical example of your and opportunities Where the is Clinical Supervisor(s) for the Main duties of the Typical working pattern in this PSEUDOMYXOMA The unit includes the National Specialised Commissioning Team (NSCT) Assessment and Treatment Centre for Pseudomyxoma Peritonei under the directorship of Mr Tom Cecil and Mr Brendan Moran. There is addition a large Peritoneal Surface Malignancy unit performing surgery for mesothelioma colorectal and ovarian carcinomatosis. The unit is also a nationally and internationally recognised centre of excellence for colorectal cancer running courses on rectal cancer and laparoscopic colorectal surgery. We are a Lapco training centre and Mr Brendan Moran is the National lead for the LOREC low rectal cancer programme running the LOREC national training courses. 1 x Clinical Fellow 1x SpR 1 x Trust Doctor 2 x FY1 This will allocated in first The F1 doctor is responsible with other staff for the ward care of patients and the maintenance of the patient s medical record. We take responsibility for problems arising on the ward. We are responsible for such other specific clinical duties as allocated by consultants including performing other duties in occasional emergencies and unforeseen circumstances. Involved in the general surgical on-call rota but no night duties The ward round starts at 8am On a Friday there is an audit meeting where. Each team takes it in turn to present interesting cases. Normal ward rounds start after the audit meeting and are consultant led on Friday and Wednesday There is a second ward round with one of the SpRs at the end of the day. The timing of this depends on their commitments during the day.

15 It is important to note that this description is a typical example of your and opportunities Where the is Clinical Supervisor(s) for the Main duties of the Typical working pattern in this BREAST/GENERAL SURGERY Ward rounds and administrative jobs focused on patient care, acute management and assessment of emergency admissions, care of postoperative elective inpatients. There are opportunities to go to theatre always welcome. Miss Anne Stebbing Mr Kevin Harris Please contact the trust for details on this , meet your registrar in the Junior doctor/registrar. They ll usually bleep you when they get in and will do a ward round. go on the ward round and do any jobs that need to be done. It is important to note that this description is a typical example of your and opportunities Where the is Clinical Supervisor(s) for the Main duties of the HEPATOBILIARY Ward rounds and administrative jobs focused on patient care, acute management and assessment of emergency admissions, care of postoperative elective inpatients. There are opportunities to go to theatre always welcome. Mr Merv Rees Miss Fenella Welsh Mr Ben Cresswell Post-op liver resection patients Clerking a patient for liver resection patients Follow ups M&M

16 Typical working pattern in this Monday Tuesday Morning 1. Ward round, 8am. 2. Theatre list, 3. Consultant ward round. 1. Ward round, 7.45/8am. 2. Clinic 3. Lunchtime Consultant ward round. Afternoon 1. Theatre list, 1. DTC list most weeks Wednesday Thursday Friday 1. Ward round, 8am. 2. Theatre list, 3. Lunchtime Consultant ward round. 1. Ward round, 8am 2. Lunchtime Consultant ward round. 1. M&M 7.30am 2. Ward round, 8.30am. 3. Theatre list, 1. Theatre list, Liver clerkings opportunities UROLOGY The work is mainly ward. It mainly involves a ward round followed by ward jobs e.g. blood taking, writing TTOs etc. You are a solo house-officer so are required to assess patients and problems as they arise on the ward. There is plenty opportunity for attending theatre, and practicing urological skills e.g. 3-way catheter insertion. Urology is a fairly busy but there plenty of learning and medical student teaching opportunity and the team are supportive and approachable. Where the is Clinical Supervisor(s) Mr Richard Hindley

17 for the Main duties of the Typical working pattern in this Mr Hugh Mostifid Mr Tim Nedas TURP Template biopsy TRUS/Combined biopsy TURBT HIFU Flexible ureterorenoscopy (FURS) or rigid URS or any laser to stone procedures PVP Any biopsy Monday: Prepare list (EPR - Urology and Urology Review) including any new urology patients from the weekend Usually no clinics or theatre lists (unless any emergencies for CEPOD list) Look through theatre list for the week and book any fluroscopy on ICE Tuesday: Urology MDT first thing WR usually will happen around 9.30 Outpatient clinics morning and afternoon Sometimes main theatres list in the afternoon (alternate weeks) Wednesday: List alternates between DTC and main theatres Thursday: Usually a main theatres list and a DTC list Friday: Surgical meeting then ward round DTC in the afternoon It is important to note that this description is a typical example of your and opportunities Where the is Psychiatry Psychiatry Please contact the trust for details on this Parklands Hospital

18 Clinical Supervisor(s) for the Main duties of the & Typical working pattern in this This will allocated in first Each morning check the doctor s book on each ward for any jobs. Jobs are shared between the team e.g. take bloods, review a patient s physical health, prescribe/review physical meds. Ward Rounds and CPA meetings - Tuesday mornings Thursday mornings at 10am. Prior to ward rounds it is important that the template has been initiated and the various members of the MDT insert their relevant information. CPA meetings are held Tuesday and Thursday afternoons. New Admission In new admission clerking Brief background, history, mental state, physical examination, medications (also write up prescription chart), bloods, MMSE, risk and a brief plan. ECG if warranted. Adult Psychiatry Each morning you should attend the handover meeting where a member of the nursing team, the discharge co-ordinator, psychologist, OT and, on occasion, the consultant will discuss all the patients on the ward It is important to note that this description is a typical example of your and Intensive Care opportunities Where the is Clinical Supervisor(s) for the Intensive Care See below This will allocated in first

19 Main duties of the & Typical working pattern in this Usually 1 FY1, 2 FY2, 1 CT1, 3 Clinical Fellows, 3 ACCPs Basingstoke has an 8 bed ITU managed by the ITU team, and a 6 bed HDU where patients are usually managed by their respective surgical/medical team however the ITU team may have an input in their care. Each ITU patient has an allocated nurse. After handover everyone is then allocated one or two patients depending on how busy the unit is and you will fully review your patients. ITU can initially seem a bit daunting for the foundation year doctor, with the sickest patients in the hospital being cared for on the unit. However, each consultant is strongly aware of foundation year doctors lack of experience in working in such an environment and as such you re not expected to have very much knowledge on the management of the ITU patient. ITU provides a great opportunity to practice skills that aren t normally encountered on the wards, such as arterial and central line insertion, airway management and intubation. It is also a great opportunity to develop the ability to clinically assess the unwell patient, and at least once a week there is a chance to go with the ITU bleep holder to assess ill patients on the ward. The rotation will also allow you to develop your knowledge on drugs frequently used in ITU, such as those used for cardiovascular support, common anaesthetic agents and methods of post operative pain relief. It is important to note that this description is a typical example of your and

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