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NHS Hospitals
and Trusts in Medicine Speciality
Training Programmes of |
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The LNR Medicine Training Programmes involve training opportunities in a large number of NHS Trusts and Hospitals. Leicester, Northampton and Kettering and involved in a majority of training programmes including Core Medical Training. Other hospitals currently form a part of specific sub-speciality programmes:
University
Hospitals of Leicester NHS Trust
Other
Organisations and Trusts in Leicestershire
LOROS
– Leicestershire Hospice
Leicestershire
Community Hospitals
Other
Hospitals contributing to Sub-Speciality Training at ST3+
Peterborough
District Hospital
University Hospitals of Leicester NHS Trust
University Hospitals of Leicester NHS Trust Web Site
Clinical posts in University Hospitals of Leicester NHS Trust form a major part of many programmes. The Trust is based on three hospital sites, with Trust management headquarters currently based on the Leicester General Hospital site. Medicine and its specialities are found on all 3 hospitals sites, each of which also contribute to the care of acute emergency admissions in medicine.
A major PFI programme is under negotiation to upgrade clinical facillities on all three sites over the next decade – styled ‘Pathway Project’.
Leicester Royal Infirmary
Leicester Royal Infirmary is the oldest of the 3 hospitals – founded in 1771.
LRI is the site of the only Accident and Emergency Department in Leicestershire and hence has the busiest acute medicine workload.
It is host to a number of large departments providing training in Medicine and its sub-specialities including:
- A large Acute Medicine Unit – comprising 2 x 30 bed admissions wards and a 30 bed short-stay unit
- XX other Medical Wards which house post-acute emergency medical admissions and sub-speciality beds in Windsor and Balmoral Buildings
- A large Oncology Department and Wards in the Osborne Building
- Sub-speciality departments (in alphabetical order)
- Clinical Oncology
- The main Cancer Centre and Radiotherapy department in Leicestershire
- Clinical Pharmacology
- Based on the University of Leicester Academic Department of Clinical Pharmacology. Speciality interest in cardiovascular disease
- Coronary Care Unit
- A combined coronary care unit and ‘step-down’ beds to provide integrated care to patients with acute coronary syndromes
- Dermatology
- Leicestershire’s main Dermatology department – based in its own dedicated outpatient clinic area and including the Academic Department of Dermatology
- Diabetes & Endocrinology
- One of the largest clinical departments of Diabetes and Endocrinology in the country with a national and international reputation for clinical care and research. Department led by 6 consultants, including the Chair of Diabetes Medicine
- Gastroenterology
- Part of the Digestive Disease Centre, Leicester including the Academic Department of Gastroenterology. Department led by 6 consultants, including 2 with a special interest in Hepatology
- Genito-Urinary Medicine
- Based in Leicestershire’s main GU Medicine clinic
- Geriatrics
- Including ortho-geriatrics
- Haematology
- Clinical and laboratory department of Haematology – including the main Leicestershire Pathology laboratories
- Hypertension and Cardiovascular Medicine
- Internationally renounced Leicester Hypertension Clinic- which has made major contributions to clinical care and research in Hypertension
- Immunology
- Site of the main clinical and laboratory department of Immunology
- Infectious Diseases
- The Department of Infectious Diseases and Tropical Medicine, based on the Infectious Diseases Unit. The Department has an international reputation for research, specifically in influenza
- Medical Oncology
- Led by the Academic Department of Medical Oncology
Acute Medical Take at the Leicester Royal Infirmary is based on the Acute Medical Unit and is very busy (50-80 admissions per day). Currently two Consultants lead the take each day (based on the 2 AMU wards) and the unit follows a full 7-day working programme with consultants on-call for a 5-day week or 2-day weekend. The Consultant AMU ‘Core Team’ provide leadership and contribute a higher proportion of the week-day consultant presence on AMU, but a large number of other consultants and departments also contribute to the on-call rota.
Junior staffing of acute admissions is based on a full-shift system – but Acute Medicine Trainees at ST1, ST2 and ST3+ / SpR level provide a higher proportion of daytime weekday cover for admissions on AMU.
Overall, the current bed allocation in LRI is as follows:
Acute Medical 120
Rehabilitation & Medicine for the Elderly 96
Paediatric Medicine 90
Paediatric C.I.C.U. 8
Infectious Diseases 18
Dermatology 6
Rheumatology 15
Haematology 16
Bone Marrow Transplant 4
Radiotherapy 39
General Surgery (inc. Paediatric Surgery) 103
ENT 60
Oral Surgery 14
Orthopaedics 152
Ophthalmology 45
Plastic Surgery 40
Gynaecology 38
Accident and Emergency 6
Maternity Beds 100
Delivery Suites 18
Special Care Baby Cots 26
Hambleton Suite 3
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Day Ward (all specialities) 34
Ophthalmic Day Unit 15
Haematology Day Ward 20
Endoscopy Unit 10
Medical Admissions Unit 22
ITU/CCU 14
HDU 3
Central Operating Department 1
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There is a suite of 16 operating theatres with a 24 hour recovery area, and in addition there are 3 other outlying theatres.
The
Medical Physics and Physiological Measurement occupy two floors, with accommodation for Radio Isotopes, E.C.G. diagnostic reporting service, E.E.G., E.N.T. measurements and many special procedures.
The Robert Kilpatrick Clinical Sciences Building of the University of Leicester is situated on the Royal Infirmary site and provides offices, including the Postgraduate Dean's Office, and research laboratories for the greater part of the University Departments of Medicine, Surgery, Psychiatry, Obstetrics and Gynaecology, Paediatrics, Community Health, Pathology, Pharmacology and Therapeutics.
The
The Osborne Building opened in October 1997. It provides an integrated service including the Departments of Haematology and Oncology. New radiotherapy equipment has been installed and outpatient, inpatient and hostel facilities is available within the building. Regular meetings and lectures by invited speakers take place in the seminar suite within the Osborne Building.
Obstetric and all other women’s and neonatal services have been combined into the Women’s Hospital which opened in 1997. The centralisation of all these services is designed to improve the provision of women’s health in Leicestershire.
Leicester General Hospital
Leicester General Hospital was built in the 1900’s and its initial role was that of a poor law infirmary. Post war development has been rapid and this accelerated with the opening of the Medical School in Leicester in 1975.
LGH has an Emergency Medicine Unit and contributes to the Acute Medical take admitting patients referred directly by GPs and transferred from A&E at LRI
It is host to a number of large departments providing training in Medicine and its sub-specialities including:
- An Emergency Medicine Unit – comprising 2 x 30 bed admissions wards and a 30 bed short-stay unit
- XX other Medical Wards which house post-acute emergency medical admissions and sub-speciality beds
- Sub-speciality departments (in alphabetical order)
- Diabetes Centre
- A centre led by 3 consultants in Diabetes & Endocrinology, run as a single department with the LRI Department. It provides a comprehensive adult diabetes service servicing approximately half the population of Leicestershire.
- Gastroenterology
- Part of the Digestive Diseases Centre, Leicester with 4 consultant gastroenterologists – and with complimentary services from 5 colorectal and 2 hepatobiliary surgeons
- Geriatrics and Integrated Medicine
- Neurology
- The specialist Leicestershire Neurology service is now based on the LGH site with X consultant neurologist
- Rehabilitation Medicine
- Linked to the Young Disabled Unit
- Renal Medicine
- Large Regional Department of Renal Medicine with XX consultants and linked to a very active research programme and Academic Department of Renal Medicine
- Stroke Medicine
- The 3 site-based stroke units in UHL merged to a single clinical and research centre on this site in 2006
Overall, the hospital has approximately 801 beds within five clinical directorates. These include, Obstetrics and Gynaecology, including Neonatal Paediatrics; Integrated Medicine; Surgery including Orthopaedics, Urology and Renal Transplant Surgery; Anaesthesia, with ITU; and Nephrology which includes Renal Dialysis and Acute Nephrology.
The Leicester General Hospital houses the Professorial Unit for Psychiatry for the Elderly, Nephrology and General Practice and part of the Professorial Units of Medicine, Surgery, Anaesthesia, Obstetrics and Gynaecology along with the Supra-District Renal Dialysis Unit and the District Urological Service.
Leicester General Hospital has its own Sports and Social facilities squash and badminton courts. A multi-disciplinary Education Centre was opened in July 1994.
The hospital is committed to providing safe and effective care for patients. To ensure this, there is an agreed procedure for medical staff that enables them to report quickly and confidentially, concerns about the conduct, performance or health of medical colleagues (Chief Medical Officer, December 1996). All medical staff, practising in the hospital, should ensure that they are familiar with the procedure.
Glenfield General Hospital
Glenfield is the newest of the Leicester hospitals and opened in 198X. It is the main centre for Cardio-Respiratory Specialities in Leicestershire and since 2005 has operated a Cardio-Respiratory take which aims to admit a high proportion of emergency admissions with such problems
It is host to a number of large departments providing training in Medicine and its sub-specialities including:
- A Clinical Decisions Unit – comprising XX beds
- XX other Medical Wards which house post-acute emergency medical admissions and sub-speciality beds
- Sub-speciality departments (in alphabetical order)
- Cardiology
- A large Regional referral centre for Cardiology linked to the Academic Department of Cardiovascular Sciences
- Integrated Medicine
- Lipid Clinic
- The specialist Leicestershire Lipid clinic is run from this site, and linked to an outreach Diabetes clinic
- Respiratory Medicine
- A large specialist Respiratory Medicine unit with XX consultants including the Chair of Respiratory Medicine
Pursuit of excellence is an apt description of the cardiorespiratory department at Glenfield Hospital which has developed a national and international reputation for its clinical and research work.
The Professorial Respiratory Medicine Unit is one of the largest in the country with a large clinical and research workload. Acute inpatient work is delivered via three dedicated respiratory wards and the Clinical Decisions Unit (CDU) through which patients are admitted in a selective cardiorespiratory take with an average of 30-35 admissions each day. The unit has a full complement of consultant staff with subspecialist interests in COPD, non invasive ventilation, asthma, lung cancer, cystic fibrosis, bronchiectasis, tuberculosis, allergy, interstitial lung disease and intensive care medicine, many of whom are national opinion leaders. We have an excellent respiratory physiology laboratory, bronchoscopy and medical thoracoscopy service. The unit has a superb specialist nursing team supporting patients with lung cancer, TB, allergy, asthma, COPD, bronchiectasis and cystic fibrosis. The department has a prolific publication record and is one of the top 10 respiratory research units in Europe with multiple research projects occurring at any one time.
All trainees working in respiratory medicine will gain generic and specialist experience on the wards, CDU, attending outpatient clinics and would be expected to achieve their competencies in the specialty.
The Professorial Cardiology and Cardiovascular Unit at Glenfield has an excellent clinical and research reputation. The unit acts as a secondary and tertiary care centre for patients with cardiovascular problems in Leicestershire and the surrounding region. The large consultant team have specialist interests in coronary artery disease, interventional cardiology, electrophysiology, congenital heart disease, non invasive cardiac imaging including transoesophageal echocardiography and cardiac MRI.
It is a national leader in coronary artery angioplasty and stenting, pulmonary vein isolation techniques and is about to undertake percutaneous valve replacement. In patient care is delivered from 5 cardiology/cardiovascular wards and a 22 bedded CCU. The department has a 5 star basic and clinical science research programme and is one of the international leaders in cardiac stem cell research.
All trainees working in cardiology and cardiovascular medicine will gain generic and specialist experience on the wards, CCU, attending outpatient clinics and would be expected to achieve their competencies in the specialty.
Overall, the Glenfield Hospital has, year on year, increased the number of patients treated, introduced service developments and expanded the range of treatments available. We have also gained an excellent reputation for the quality of services we provide as recognised by the results in the Quality Health Patients’ Satisfaction Survey as well as achieving full accreditation by the Health Quality Service (formally known as the King’s Fund).
Glenfield Hospital provides a comprehensive range of clinical services. Many of these complement each other, enabling patients to obtain all the care they need within the hospital. The following medical services are provided: Anaesthetics & Critical Care, Breast Screening & Breast Surgery, Cardiology, Cardiac Surgery, General Surgery, Integrated Medicine, Orthodontics, Orthopaedic Surgery, Radiology, Restorative Dentistry, Respiratory Medicine and Thoracic Surgery.
Many of the Trust's Medical Specialties are now recognised as Centres of Excellence and Glenfield can boast the following:
- one of the largest and most technically advanced Cardiothoracic Units in the country currently performing around 1500 open heart cases per year on adults and children.
- recognition as the leading centre of only four in the
country performing neo-natal ECMO (extra-corporeal membrane oxygenation)
which has led to the designation as a supra Regional Centre, and the only
- recognition as a specialist centre for Orthodontics and Restorative Dentistry.
- one of the best equipped radiological departments in the country incorporating cardiac catheter rooms, gamma camera facilities, C.T. and MRI scanners.
- one of the country's largest Bone Banks, which is a co-ordinating centre for other Bone Banks facilitating the availability of donor bone for transplant purposes.
- Britains Leading Centre for Pulmonary Rehabilitation.
Glenfield currently has 5 professorial posts in Cardiology, Respiratory Medicine and Cardiac Surgery. Clinical research is undertaken by all the major medical specialties.
NHS Acute Healthcare in Leicester, Leicestershire and Rutland
In April 2000, the three acute hospitals in Leicester ( Glenfield, Leicester General and Leicester Royal Infirmary) came together to form University Hospitals of Leicester NHS Trust with the single aim of providing the residents of Leicester, Leicestershire and Rutland with more efficient and modern healthcare services.
Other Organisations and Trusts in Leicestershire
LOROS – Leicestershire Hospice
LOROS is a 31-bedded independent hospice in Leicester, offering a full range of specialist palliative care – it provides training opportunities in the Core Medical Training programme and sub-speciality training in Palliative Medicine
Leicestershire Community Hospitals
Leicestershire has a well established network of Community Hospitals, and outpatient training in General Medicine and a number of sub-specialities may include clinics in Community Hospitals in Coalville, Hinckley, Loughborough, Market Harborough and Melton Mowbray.
Northampton General Hospital
General Medicine
in Northampton
General Medicine
at
The directorate has recently changed to a ward based structure for the junior doctor teams led by 3/4 consultants. Each allocation includes duties as an admitting medical team joining the EAU team and there is a period of duty on the emergency assessment unit (EAU).
The EAU links into a short stay ward where the patients will remain under the care of the admitting team until discharge. Patients who clearly have specialty needs such as cardiology, respiratory and stroke will be admitted to the appropriate wards. All wards will continue the care for patients transferred from EAU through to discharge.
Each ward team will have 2-3 SpRs (ST3+), 3-4 SHOs and 2 FY1s. This allows CMT trainees to gain specialist experience off the ward with the security that the inpatient work is covered. Trainees on wards admitting predominantly GIM patients gain experience in a range of specialties as outlined in the specialty details listed.
Trainees choosing predominantly outpatient based specialties such as Dermatology, Rheumatology & Neurology will not have acute medicine duties during that period. This ensures that the outpatient experience is not disrupted. During this allocation the trainees will have out of hours duties covering more specialist areas within the hospital
There is a well established night team comprising an SpR or, a medical SHO (F2 ST1), a surgical SHO, and an F1 with support from a night nurse practitioner who takes all the calls and allocates the duties.
The night team is responsible for all admissions and for problems arising from inpatients. The team will work 3/4 nights at a time and the weekend between 2 blocks of nights will be spent as a cover team for the medical wards.
The haematology/Oncology ward and renal unit have a separate out of hours arrangements provided by trainees not on the acute medical rota.
Education
There are no regular clinical commitments on Wednesday afternoon, which is an academic afternoon. The afternoon starts with a clinical meeting (from 14.00 to 15.00) followed by a formal lecture for the next hour. There is then membership coaching at the level appropriate to the needs of the SHO from 16.00 to 17.30. Attendance is expected at this meeting and presentations from SHOs are an integral part of the clinical meeting.
In addition there are fortnightly meetings from 13.00 –14.00 on cardiology run by the consultants and Sprs.
There is a regular MRCP Part I Teaching course and clinical teaching directed towards the clinical part of Part II occurs after the formal part of the academic afternoon. There is a good pass rate for PACES with 7 consultants active PACES examiners and the examination is held regularly at NGH.
We have Medical students from the Leicester and Oxford Medical schools and the SHOs are expected to contribute to their education
Department of
Medicine
Consultant Staff
There are currently 18 general Physicians (full time equivalents) with an
interest who between them provide the acute general medical takes.
Dr David Sprigings Cardiology
Dr Helen Binns Cardiology
Dr Dominic Cox Cardiology
Dr Patrick Davey Cardiology
Dr Charles Fox (part time) Diabetes / Endocrinology
Dr Jonathen Rippin Diabetes / Endocrinology
Dr Anne Kilvert Diabetes / Endocrinology / AIDS
Dr Parul Shah Medicine for the Elderly
Dr Mel Blake (part time) Medicine for the Elderly
Dr Angela Kannan (part time) Medicine for the Elderly
Dr Roger Morgan Medicine for the Elderly
Dr Lyndsey Brawn (Clinical Director) Medicine for the Elderly
Dr Balakrishnar Manivannan (Mani) Medicine for the Elderly
Dr Andrew Jeffrey Respiratory Medicine / ITU
Dr Josephine Ojoo Respiratory Medicine
Dr Brian Richardson Respiratory Medicine
Dr Udi Shmueli Gastroenterology
Dr Paul Sherwood Gastroenterology
Dr Alan Ogilvie Gastroenterology
DR Igbal Khan Gastroenterolog
In addition there are other Consultants who are part of the Department of
Medicine and share junior medical staff but do not support the acute medical
take.
Dr Paul Davies Neurology
Dr Kannan Nithi Neurology
DrAnn Bissessar Neurophysiology
Dr James Taylor Rheumatology
Dr Meilien Ho (part time) Rheumatology
Dr Rachael jeffery Rheumatology
Dr John Mahood Dermatology
Dr Pick Woo Dermatology
Dr Christine Soon Dermatology
Dr Warren Pickering Renal Medicine
Dr Rob Preston Renal medicine (NGH and kettering)
Dr Eddie Tan Renal medicine
Junior Staff
There are twelve pre-registration (F1) house physicians, 28 senior house officers (F2, ST1& ST2) and 10 SpRs within the Department of Medicine with plans for significant
expansion in 2008.
THE HOSPITAL
All the acute beds within the district are based on the
A new Cardiac centre with a dedicated catheterization laboratory and a new Renal unit are due to open in 2008.
The acute and chronic psychiatric in-patient services are
based at St. Crispin's and
LEISURE
There is an active junior doctors mess with an active social programme and facilities include a junior doctors' dining room, lounge and medical staff bar. Single accommodation is provided above the post-graduate centre and also in the old part of the hospital. The standard of accommodation is good and there is an active programme of refurbishment to continually improve the standard of residences. A charge is levied (with appropriate reduction for the duty rota) for single accommodation. Married accommodation may be available and for those doctors not wishing to reside in hospital accommodation, an on-call room is provided.
There is an excellent recreation centre at the hospital with
an indoor heated swimming pool, gymnasium, squash and badminton courts,
floodlit tennis court, music room, bar and other leisure amenities.
THE TOWN
Communications from
Kettering General
Hospital
Kettering General
Hospital
Kettering General Hospital NHS Trust is a 590 bedded associate teaching hospital serving the north end of the county of Northamptonshire. It has a very wide catchment area encompassing a population of 330,000 and offers services in all of the acute medical specialties. The patient demographics comprise an interesting mixture of town and countryside in addition to its London commuters and consequently there are a wide and diverse range of clinical cases that present to the Hospital.
As part of the Leicestershire, Northamptonshire and Rutland Strategic Health Authority, Kettering has well-developed links with Leicester Medical School, receiving medical students, pre-registration house officers and rotational SpRs from both South Trent and Oxford.
Accommodation is generally available on site and there is an active Doctors Mess and social club within the hospital.
Kettering has very strong road and rail links in addition to its excellent leisure facilities which makes it a popular place to live and work. London is only 60 minutes away by train and there are three international airports within an hours drive.
Core Medical
Training at Kettering General Hospital
Kettering has been a popular choice for medical trainees for many years due to its friendly atmosphere and good track record with the MRCP exam, many former trainees returning to the Trust subsequently as senior trainees or Consultants.
We have used the introduction of MMC to design a Core Medical Training program that will provide trainees with a broad range of skills and experience to enable them to confidently progress to higher specialist training. The rotations thus contain a good mixture of the essential medical specialties with two of the rotations offering the further possibility of gaining valuable experience of Emergency medicine. These posts would be especially suited to trainees wanting to enter acute medicine which ties in well with the new Kettering training scheme in acute medicine starting in 2007.
Medical Trainees at Kettering operate within a ‘firm’ based structure which is exclusively ward based, each ward accepting its own specialty based patients and also general medical patients. Each firm has a full complement of senior and junior trainees according to the number of beds covered. Firms are only responsible for patients on their own wards with the exception of patients transferred to ITU.
For all firms, normal daily work will include attendance at Consultant ward rounds which occur on a daily basis on all wards and continuing care of all inpatients under the care of the firm. Additionally, trainees are encouraged to attend the outpatient department whenever possible. All firms participate in the on call rota.
The firms at present are as follows
Consultants
: Dr N Shaukat, Dr J
Cullen, Dr K Hogrefe, Dr S Nishtar
(Associate Specialist)
There are currently
13 juniors on this firm including 2 FY1 trainees.
Duties
include the day-to-day care of inpatients on the cardiology ward and coronary care
unit and attending the cardiology outpatient clinic. There is a ‘consultant of
the week’ system in place with regard to the Coronary Care unit and referrals
and there is a daily coronary care ward round with ample opportunity for
teaching. There is a busy permanent
pacing programme with over 200 device implants per year, on up to 3 lists per
week and a very active Cardiac Investigation department, including
echocardiography, 24 ambulatory monitoring stress testing. Dr's Cullen, Shaukat and Hogrefe are all fully
trained Interventionists and percutaneous coronary
intervention and angiography will be performed on site at Kettering from 2007.
.
Chest Medicine: Dr S F Hussain,
Dr A Sattar, Dr A Al-Aidi
There
are currently 11 trainees supporting this firm including 2 higher specialist
trainees, 2 FY1 and 1 FY2 trainees
Based
on the respiratory unit this firm offers a wide exposure to respiratory
medicine with excellent teaching opportunities. The unit is fully supported by
respiratory technicians and specialist nurses. There is extensive use of
community outreach teams to enable rapid but safe discharge of patients. The
recently opened NIV
beds offer a useful opportunity to gain experience in
non-invasive ventilation.
There
is a close liaison with the community TB team and weekly multidisciplinary lung
cancer meetings
Gastroenterology
Firm: Dr A P Chilton, Dr A Hussain, Dr A Steel
Currently
supported by 12 junior staff including 3 Higher Trainees, 2 FY1 and 1 FY2
trainees, this 44-bedded unit covers all aspects of gastroenterology and hepatology and includes GI bleed beds.
There is an excellent opportunity to gain hands on experience in the management of acute GI and hepatological emergencies as well as the ample exposure to ambulatory GI services. The aim of the unit is to provide a balance between service and professional development with the aim of grounding trainees in the delivery of evidence-based care. Core objectives will be set against which the trainee development will be measured. The trainee will provide care for patients in a multidisciplinary environment in which teamwork is essential. We aim to provide the tools for growth in the deliver of modern health care.
There
is a very busy endoscopy unit providing a range of
therapeutic and diagnostic work. There are weekly multidisciplinary meetings
and GI clinical meetings.
Care of the Elderly / Stroke Unit :
Dr I M Hubbard, Dr K Ayes, Dr Das
This firm is supported by 11 trainees including trainees in Renal Medicine and rheumatology. The Care of the Elderly and Stroke wards were newly opened in 2006 and offer different specialised areas of training, mainly in general medicine, geriatrics, movement disorders and stroke medicine. The placement offers additional opportunity to gain valuable experience in the rapid access neurovascular clinics, the rapid response stroke service and further training opportunities in the Parkinson’s clinics and falls.
Endocrinology and Diabetes: Dr G N Clifford, Dr K Rizvi
This firm contains 7 trainees including 1 higher specialist trainee, 1 FY1 and 1 FY2.
The unit offers specialist care to patients with predominantly diabetic or endocrine problems and also admits day-case patients for dynamic endocrine testing. Attendance at outpatients is encouraged and there are regular radiology and pathology meetings where interesting cases can be discussed.
Emergency
Medicine: Dr S McMorran, Dr A Dancocks,
Dr R Thamizhavell
The medical
staffing comprises three Consultants, 1 Associate Specialist, 8 Middle Grade doctors,
and 11 SHOs including 2 FY2 posts.
Based in close proximity to the Medical Assessment Unit, the A&E department offers excellent training in Emergency Care with a fully staffed and supported unit. The department has a five-bedded Resuscitation room, a separate Trauma room and its own Observation Unit. There is an established ENP service which assists in the assessment and management of patients presenting with minor injuries. The department is committed to teaching and offers a weekly protected teaching programme. Support for CT scanning is provided on a 24-hour basis by a supportive radiology department.
There are good
links with other departments and an integrated medicine/A&E quarterly
teaching programme.
On Call Medicine
The medical take at Kettering General Hospital is unselected and Consultant led with a very high turnover. Typically about 40% of patients referred to the medical take are assessed, investigated, treated and discharged within the confines of our Medical Assessment Unit without ever having to be admitted to an acute medical ward.
This efficiency has been developed through close liaison with the pathology and radiology departments who prioritise work from the Medical Assessment area.
GP admissions are
admitted directly to our newly built clinical decisions unit where the on-call
medical team is supported by our extremely competent and highly skilled nurse
practitioners. Senior help is available from the Consultant of the day and this results in a very high discharge rate. There is a very
close liaison between medicine and A&E and with the use of combined
documentation the junior medical staff are able to
avoid duplication of paperwork enabling them to devote more time to the
educational side of the job.
A Key feature of the on call team is that each tier of on call juniors has its own backup with the result help is always available and the rota is compliant with respect to breaks / rest periods.
The On Call Team consists of
Consultant (all normal commitments cancelled, based on MAU)
Middle grade cover ST3+
Clinical Fellow or ST2 (depending on experience)
Junior cover ST1 or ST2
FY2
FY1
A full shift system is in place with change over at the following times
DAY
SHIFT NIGHT SHIFT
ST3+ 09:00 to
21:30 21:00 to 09:30
Clinical Fellow /
ST2 09:00 to 21:30 21:00 to 09:30
ST1 09:00 to
21:00 20:30 to 09:30
FY2 10:00 to
21:00 20:30 to 09:30
FY1 08:00
to 20:30 17:00 to 22:00
The shift system allows for proper handovers and is fully compliant
with EWTD.
The normal duties of Core Medical Trainees when on call will be to attend consultant ward rounds, facilitate management of patients already admitted to the unit and assess patients referred to the medical take. On call trainees will also be a part of the cardiac arrest team.
Several consultant ward rounds are carried out on the assessment unit each day, the first major ward round starting at 8.00am with three further mini-rounds later in the afternoon at 12pm, 3pm and 5pm to see any further admissions and review selected patients. In between these times consultants are expected to be available to junior staff and GP’s for advice and to review any new admissions from time to time through the day. The on-call consultant is responsible for all the patients admitted on the medical assessment unit until they are transferred to another ward when they will then become the responsibility of the consultant covering that general medical ward. There is an average of about 35 medical admissions per day. This number may vary from between about 20 patients and as many as 60 admissions daily.
Similar ward rounds are carried out by the consultant on-call at weekends. During evenings and the rest of the weekends the consultant is on-call from home.
Education and Audit
Teaching
In house teaching is
delivered by the Medical Academic Half Day which takes place on a Friday
afternoon and is bleep free protected learning time. Attendance is obligatory
for all Consultants and junior staff excepting those who are on call. This
teaching session is consultant led and provides an excellent forum for firms to
present unusual cases as well as concentrating on key areas of the trainee
curriculum.
Additionally, there are a variety of meetings amongst the medical teams that are open to all trainees e.g, the weekly cardiology meeting, radiology meetings etc.
Audit
All trainees are expected to take part in regular audits and we have a rolling program of audit in place. This enables trainees to take on a ‘ready made’ audit and thus close the audit loop. Original ideas for audit will always be considered however and supported where appropriate.
Study Leave
The Trust fully supports
study leave as approved by the postgraduate dean.
The Prince William Education
Centre
The Education
Centre was opened in 1976 and recently enlarged at a cost of £3.4million. This
excellent facility now provides a further 3 seminar rooms and has a medical
skills room and 2 IT suites. There is a
large lecture theatre, a range of smaller seminar/tutorial rooms and an
extensive Post Graduate Library.
Other Hospitals contributing to Sub-Speciality Training at ST3+
Peterborough District Hospital
Peterborough Hospitals Web Site
Located within the city, the Trust provides hospital services to over 260,000 people in the Peterborough area and surrounding district.
The Trust occupies two sites within the
city;
The Trust was established in April 1993 and has continued to maintain and develop an excellent reputation, locally and nationally, for caring staff and quality services.
At the centre of these services is the seven storey tower block of the Peterborough District Hospital. The building houses a wide range of Medical, Surgical, Paediatric, Diagnostic and Rehabilitation services. The site also houses the Accident and emergency Department, CT scanner and Radiotherapy Unit. To the west of Peterborough District Hospital is the Maternity Unit.
Peterborough District Hospital has a bed complement of 567 and provides acute medical services with the exception of cardiothoracic surgery and neurosurgery for the Peterborough district. The Trust’s accident and emergency department is situated on site together with Homerton School of Health Studies and outpatient and pathology departments.
The hospital is 1 of 8 hospitals within the Anglia and Oxford Regional Health Authority designated as Postgraduate Medical Education Centres and provides an active programme of postgraduate education in a modern centre of site.
Regional specialities such as cardiothoracic surgery and neurosurgery are undertaken at Papworth and Addenbrooke’s Hospitals.
There are 6 main operating theatres, a 6 bed intensive care unit, hyperbaric oxygen unit, day ward theatre and facilities, accident and emergency theatre and a dental wing incorporating its own operating theatre. In addition there are 2 inpatient beds for the management of chronic intractable pain. There is a separate 77 bed maternity unit with 1 theatre.
Department
of Medicine staff
Consultants
· Dr C D Mistry (interest in nephrology)
· Dr S Acton (interest in nephrology)
· Dr I P F Mungall (interest in chest medicine)
· Dr C Hunter (interest in chest medicine)
· Dr M W Dronfield (interest in gastroenterology)
· Dr P Nair (interest in gastroenterology)
· Dr D B Rowlands (interest in cardiology)
· Dr J Porter (interest in cardiology)
Clinical Assistants - 1 session endoscopy
1 session diabetes
Staff Grade - 1 post
Specialist Registrars - 6 posts
- 3 linked to Leicester rotation
1 linked to Papworth
Derby Hospitals
South Derbyshire Acute Hospitals Web Site
The southern Derbyshire Acute Hospitals NHS Trust incorporates the Derbyshire Royal Infirmary and the Derby City General Hospital. We are a Department of Health rated three-star Acute Trust providing a wide range of general medical and surgical care in addition to accident and emergency services. We have a total of 1,147 beds across 44 wards and serve a population of over ½ million people throughout Southern Derbyshire.
The trust employs 5,500 staff, from doctors and nurses to housekeepers and porters, with an annual budget of around £300 million. This year our Trust will see and treat around 600,000 people as inpatients, outpatients, emergency patients and daycases.
The trust is currently working with other local health care organisations to radically reshape health services in Southern Derbyshire. This includes the proposal to develop the current Derby City Hospital site to become the main acute hospital in Derby, which will provide the very latest in modern healthcare. This will be the biggest single investment in health services in the history of Derby. The Derbyshire Royal Infirmary will become a major community health facility serving the City of Derby.
Pilgrim Hospital Boston
This is a modern Acute General Hospital with 617
beds covering the usual range of Acute Medical and Surgical specialties. There are 100 Adult Acute Medical beds; and a
further 70 Elderly Care rehabilitation beds.
There is further provision of rheumatology, haematology, oncology and
dermatology and there are 4 coronary care beds attached to the HDU/ICU.
Pilgrim Hospital has recently merged with Lincoln
and Louth NHS Trust and Grantham to form the United Lincolnshire Hospitals
Acute Trust covering a catchment area of
670,000. The catchment
population for Pilgrim Hospital is approximately 220,000.
There are excellent diagnostic services incluidng MRI, Spiral CT, isotope scanning, a full range of
cardiac exercise testing, echocardiography, ambulatorty
monitoring, tilt testing and access to other investigations.
United Lincolnshire Hospitals Web Site
Gratham District Hospital
Grantham & District Hospital is a member
of the United Lincolnshire Hospitals NHS Trust. It has approximately 190 beds
and has a 5 bedded CCU and 5 bedded HDU/ICU, covering a catchment
population of approximately 120,000.
Last updated: 22
January 2007