Locum Consultant in General Paediatrics

at  Alder Hey Childrens NHS Foundation Trust

PAEDIATRICS DIABETES AT ALDER HEY: The department has 10 WTE of general paediatricians, 4 of whom have diabetes as a specialist interest, providing a range of outpatient clinics and inpatient care. The diabetes team consultants (as a group) contribute to the general paediatric on call and Consultant of the week rota providing the equivalent of 1 WTE general paediatric consultant. In addition, the diabetes consultants deliver a diabetes consultant of the week and on call service. Diabetes The diabetes team is currently staffed by 1.6 WTE consultants, 0.6 WTE staff doctor, 10Diabetes nurses (8WTE), 3.5Diabetes Dietitians 1.5Clinical Psychologists,2 HCAs, 2.2band 4 Pathway coordinator (PCO) The clinical work (diabetes and general paediatrics) of the team is also supported by 1 diabetes SPIN trainee (ST4 and above) and 1GP trainee doctor.
The Alder Hey Diabetes Service looks after 500+ patients aged up to 18 years. Each consultant and nurse has their individual caseload, to maintain continuity of care. Our patients are mainly T1DM, some T2DM and other rarer forms of diabetes..The team accepts 40-50 newly diagnosed patients / year, and transfers a similar number to adult services via dedicated transition clinics, run jointly with the young adult diabetes teams from the Royal Liverpool University Hospitals and University Hospitals Aintree. The diabetes team regularly looks after secondary forms of diabetes, primarily from the Oncology and cystic fibrosis services.
The team also provides inpatient diabetes care for patients with diabetes admitted from other trusts to Alder Hey for surgical, dental and specialist medical care. More than 80% patients are on insulin pump, with almost all of these on Hybrid closed loop systems. All patients are offered CGM from diagnosis. There are 8 Multidisciplinary diabetes clinics and one dietetic clinic per week.
Patient related information is recorded on the Twinkle database, to which all team members have access. The Diabetes consultants provide a 1in 4 diabetes Consultant of the Week service and a 24 hour on call. There is also an emergency phone line manned 24 hours a day by the nursing members of the team. It is normally expected that patients and families will call the nursing emergency line and hospital medical queries will go to the Diabetes Consultants directly.
All newly diagnosed patients and other diabetes emergency admissions are accommodated as far as practicable on Ward 4C. All initial teaching and training required is started while on the ward, and completed with additional outpatient visits and home visits within the first 2-3 days after diagnosis.. There is a diabetes MDT meeting held every Thursday afternoon. All inpatients and relevant outpatients are discussed at this meeting.
A rolling agenda, covering Management, Service Development, Governance and Education is also addressed in the 2nd half of the meeting. General Paediatrics The department admits around 5000 children under its care annually and provides 15 general paediatric and 10 rapid access clinics each week. There are around 56,000 new attendances to Alder Hey emergency department annually, of which about 10% are admitted. Approximately 5% of emergency department attendances are direct referrals to the medical on call team by the primary care services.
Up to 25 paediatric patients[TW1] are admitted within each 24-hour period (may be more in winter) and currently the patients will have a lead consultant operating on a rolling 1:10 rota. The general paediatric department consists of 5 teams covering the 10-week rota cycle. Each team has 2-3 general paediatricians, associate specialists or staff grade doctors, and different grades of resident doctors. There is a senior staff meeting for general paediatrics on 1st and 3rd Monday of every month.
The general paediatric consultants also take part in the 1 in 10 consultant of the week (COW) duties during which all other elective work and outpatient clinics are cancelled. The diabetes team consultants together provide the equivalent of one General Paediatricians time to the out of hours on call and Consultant of the week (COW) rota. A new model of care is currently being piloted at the Trust predicated on the creation of a dedicated assessment area for acute paediatric patients (PAU). The new model means that patients will be referred onto Paediatrics sooner than our previous practice at Alder Hey, but this is in line with many other successful PAUs across the country.
Seriously ill children are resuscitated in the Emergency Department which has Emergency Paediatric Consultant presence until midnight. Children in the Paediatric Intensive Care Unit are managed by the Paediatric Intensivists until discharged to a ward under the care of the general paediatric consultant of the week. There is a neonatal surgical unit but no neonatal intensive care at Alder Hey. Childrens Community Nursing Team (CCNT) assists in early and safe discharge of children.
They support with administration of I.V antibiotics at home or providing general assessment and support following discharge. Child protection is the responsibility of all professionals working with children. In Alder Hey there is a team of clinicians based in the Rainbow Centre who have special expertise in this area and who provide out-of hours support service for child protection. Social services are now largely community based.
Applicant Requirements The applicant should be in possession of a CCT in Paediatrics or be within six months of achieving a CCT in Paediatrics and should have completed SPIN Module for Diabetes as per RCPCH guidelines. Accountability - The post holder will report through the Clinical Director for Acute Care Group to the Chief Executive with professional support from the Medical Director

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