The department works across both the Royal Shrewsbury and Princess Royal Hospitals with most of the diabetes and endocrine services and staff currently based at the Royal Shrewsbury Hospital in the purpose-built Hummingbird Centre.
Future reorganisation of the trust may alter bed bases, with plans being developed to have a hot and cold site. The role includes participation in the general medical on-call rota. In addition, there are discussions ongoing about providing a 7-day diabetes service with a separate rota.
Inpatient diabetes care will be a key emphasis of this post to strengthen the diabetes in reach service and optimise care of patients in diabetes across the hospital and thus enable reduction of length of stay. The candidate will also support ambulatory care to prevent admissions in patients with unstable diabetes. The consultant will be supported by the hospital Diabetes Specialist Nurses (DSN’s) in this work.
The work will also include developing robust protocols for management of acute diabetic emergencies, pre- and peri-operative management of diabetes. There are also active discussions in developing community-based outreach diabetes clinics to support primary care. The post will also support a subspecialty interest complementary to current interests of the department or input in the antenatal endocrine clinic and development of a diabetes/renal link service or young adults’ diabetic clinic.
The services are closely integrated with patients care through the local Diabetes UK branch as well as through the Pituitary Foundation. There are local patient support groups for those with pituitary disease, thyroid eye disease and those on insulin pumps (Severn Pumpers) through which the consultants take an active part in patient education and support. It is expected that the appointee will contribute to the existing groups and encourage development of further groups depending on clinical interest.
A formal job plan will be agreed between the successful candidate and their Clinical Director and consultant colleagues, on behalf of the Medical Director within 3 months of starting in post. A full-time job plan is based on a 10 PA working week. The job plan will be reviewed annually and is a prospective agreement that sets out the consultant's duties, responsibilities, and objectives for the coming year. It covers all aspects of a consultant’s professional practice including clinical work, teaching, research, education and managerial responsibilities. It will provide a clear schedule of commitments, both internal and external and will include personal objectives, detailing links to wider service improvements and trust strategic priorities.
For a full-time contract, the job plan will be divided on average per week (pro-rata for a part time post) as:
- 7.5 Programmed Activities (PAs) of Direct Clinical Care - includes clinical activity, clinically related activity and predictable and unpredictable emergency work.
- 2.5 Supporting Professional Activities (SPAs) - includes CPD, audit, teaching and research.
The allocation of PAs is reviewed and may be subject to adjustment when a further diary exercise is undertaken or if the service demands a review of the team job plan.
Any applicant who is unable, for personal reasons, to work full-time will be eligible to be considered for the post. If such a person is appointed, modification of the job content will be discussed on a personal basis with the Trust in consultation with other consultant colleagues.
The post holder will be expected to participate in the General Internal Medicine (GIM) on call on a 1 in 14 rota weekdays and weekends. When on call, the consultant will do an evening post take ward round from 17:00 to 20:30 and again next morning will do post take round from 08:00 to 10:00. There is a Tuesday off in lieu after a weekend on-call. There is a robust acute medical consultant team who will be working alongside the on-call consultant on the Acute Medical Unit (AMU). Admissions are unselected, but there is separate input in AMU both in and out of hours from the gastroenterologists, cardiologists, and stroke consultants (who have their own separate rota and do not participate in the GIM rota).
A separate 1 in 10 (weekdays and weekends) acute medicine consultant rota works alongside the GIM rota. The acute medicine rota is from 17:00 to 21:00 weekdays and 10:00 to 19:00 weekends. The appointee may choose to be on this rota instead of the GIM rota subject to agreement. 1.5 Direct Clinical Care depending on rota, 3% availability supplement if on overnight on call rota.