Consultant in Acute Internal Medicine & General Medicine

at  Guys and St Thomas NHS Foundation Trust

Guy’s & St Thomas’ NHS Foundation Trust
Acute & General Medicine Directorate
Consultant in Acute Internal Medicine & General Medicine
Full Time – 10 PAs
To provide high quality, innovative and cost-effective acute medical care for patients in the 56-bedded Acute Medical Admissions Ward (AAW) on the St Thomas’ site.
To provide a major contribution to the Same Day Emergency Care (SDEC), ambulatory and admission avoidance aspirations of the Trust.
To work with clinical colleagues in the ED, GIM, Medical Sub-Specialties and Community Services to deliver seamless medical care throughout the UEC pathways.
To participate in clinical and other service activities with the aim of ensuring high standards of patient care and delivery of the National Emergency Access Targets and the London Quality Standards of Care.
To contribute to the educational, management, development and governance needs of the clinical service as requested.
To establish, promote and contribute to the research base through working collaboratively to answer key questions about service design, delivery and development.
Workload follows RCP guidance for Acute Internal Medicine & General Medicine.
Guy’s and St Thomas’ NHS Foundation Trust (GSTT) is one of the largest and most successful hospital trusts in the country, including two of London’s oldest and best known teaching hospitals. The hospitals have a long history, dating back almost 900 years, and have been at the forefront of medical progress and innovation since they were founded. Our hospitals have built on these traditions and continue to have a strong national and international reputation for clinical excellence, teaching, research and innovation.
We are part of King’s Health Partners (KHP), a pioneering Academic Health Sciences Centre (AHSC) collaboration between one of the world’s leading research-led universities and three of London’s most successful NHS Foundation Trusts. See www.kingshealthpartners.org
We provide a full range of world class hospital services for our local communities, as well as a large number of specialist tertiary services for patients from further afield, including cancer, cardiovascular, cardiothoracic, infectious diseases, renal, women’s and children’s services. We have one of the largest Critical Care Units in the UK and one of the busiest Emergency Departments in London.
Our reputation for safe, high quality care is among the best in the UK and we strive to put patients at the heart of everything we do. We pride ourselves on ensuring the best possible patient experience, and are proud to have one of the lowest mortality rates in the NHS.
These are exciting times for Acute Medicine at Guy’s and St Thomas’ NHS Foundation Trust!
We are in the process of increasing and enhancing our Acute Medicine service at the Trust to optimise the workstreams provided both for the Same Day Emergency Care aspects of the role but we are also embarking on a reorganisation and restructuring of the whole Emergency Floor to ensure our processes and interactions between the Emergency Department, inpatient Medicine and other inpatient services are fit for the coming decades.
Since the Covid-19 pandemic, the role of SDEC has seen a large upsurge and the benefits of expedited, specialist yet holistic medical assessment has been proven, with improvements in bed-days, length of stay, patient satisfaction and healthcare associated morbidity. Wherever possible, we aim to ensure that excellent medical care is provided to patients as an outpatient and to do this, we are expanding our SDEC services.
We are currently in the process of a geographical move to allow medical SDEC to benefit from a larger footprint within the Emergency Floor and to allow a modernisation of our ways of working, accepting and assessing referrals and providing more streamlined and frictionless care.
We were one of the first providers in the country to provide a separation of SDEC workstreams to maximise efficiency and space, with an “admissions avoidance” and “facilitated discharge” separate stream. We are aiming to increase capacity for both of these streams to enhance reliability and robustness of the services. In the years ahead we envisage further improvements to the locations, ways of working and acceptance criteria to better serve our population and to reflect our changing work/life balances.
We are working with community providers including GP practices, the London Ambulance Service, NHS 111, the ICB and the local @Home service to standardise and expand pathways and routes of access for suitable patients and to increase the breadth of conditions we can see on a same-day or subacute basis. This includes a formalisation of virtual ward functions and the development of urgent and emergency automated follow up pathways (such as our in-development abnormal chest x-ray interval imaging pathway).
We have a reasonable conversion rate of SDEC attendance to medical admission, reflecting the acuity of the patient flow, and the Acute Medicine team contributes to the week-day running of the medical take by forming 2 in 5 of the Admission Ward medical team complement. This five team model is assisted by daily frailty and toxicology ward rounds as well as psychiatry in-reach where needed.
Expansion of the AIM service is vital to national healthcare strategic drivers aligned to the NHS Long Term Plan, and in supporting the Trust in delivering the NHSE SDEC Direct and Think SDEC campaigns, NHS SAMEDAY strategy and national SDEC benchmarking standards, with key collaborations across SEL

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