The Department

The Older Adult Medicine team is a multi-disciplinary team of committed clinicians, specialist nurses and allied health professionals who work collaboratively to deliver high-quality care to our patients on both sites. The current workforce consists of Consultants, Associate Specialists, Specialists and Allied Health Professionals.

Expand and Develop Older Adult Medicine

Older Adult Medicine has 2 ward bases: 20 beds at Shrewsbury (Ward 28) and at Telford there is a 38 bedded Unit split between 2 consultants (Ward 10). The post-holders will be primarily based at the Telford site, to work with the existing consultant team delivering high quality care to older inpatients, however the expectation to cross cover at Shrewsbury to help deliver the service will be required if needed. The post holders will also look after medical outliers on Ward 4  (6 per day) and see ward referrals from other specialities (average 1-2 per day).

There are close links to primary care and support from the discharge liaison teams to expediate patient discharge home or to other community facilities. There is an in-house mental health team (based on the RAID model) who support the units in caring for patients with delirium and dementia. The department is supported by junior doctors including Specialist Registrars, Internal Medicine Trainees, Foundation Doctors as well as Physicians Associates and ACP trainees. The post-holders will be expected to take on clinical supervision of a trainee once they are established in post.

The successful candidate will have a weekly clinic in the speciality of your choice, but ideally in an area that requires support and development. The clinic depends on the ratio of new patients to follow ups. On average a new patient review is a 30 minute time slot, with 15 minutes for each follow up in a session with time to dictate correspondence (average number of patients seen is 6).

Support Acute Frailty Services

There is a large ageing population in Shropshire and Telford and Wrekin which attend both acute hospital sites. The Trust and CCG are working together to address patients’ needs and develop a responsive service for older frail patients. The post-holder will be expected to be part of current services which deliver Comprehensive Geriatric Assessment in the Emergency Department and Acute Medical Unit. They will be expected to work closely with the teams in the ED and AMU to improve care for frail older patients. The post-holder will work with a team of therapists, ACPs, and the current training doctors in Elderly Care. They will be supported by therapies to deliver rapid assessment, treatment and as much as possible discharge to community services.

Developing the Virtual Ward

The Acute trust is working local partners to develop a virtual ward base in patient’s homes and care homes. Currently the Acute Frailty team has close links with community services and this will now be a formalised link for the consultant body to provide regular multidisciplinary meetings for selected patient groups.

Job Plan

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 Specialty Doctor's duties, responsibilities, and objectives for the coming year. It covers all aspects of a Specialty Doctor'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:

• 8.5 Programmed Activities (PAs) of Direct Clinical Care - includes clinical activity, clinically related activity and predictable and unpredictable emergency work.
• 1.5 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.