Consultant in Anaesthesia and Intensive Care

Intensive care medicine and anaesthesia fall within the surgical care group specifically within the anaesthetic department at Darlington Memorial Hospital. Complementary anaesthetic sub-specialities include Chronic Pain, Acute Pain, Pre-assessment, Day Surgery and obstetrics. The care group director for Anaesthetics, Theatres and Intensive Care Medicine is Dr James Limb (trust wide). The lead clinician for the anaesthetic department at Darlington Memorial Hospital is Dr Jothika Thimappa and the lead clinician for the Intensive Care department is Dr Simone Carbert.

The successful applicant will primarily work at DMH but we do provide anaesthetic cover for elective surgical lists at the elective surgical hub based at Bishop Auckland Hospital. The anaesthetic department's culture is one of mutual respect with collective responsibility for the workload within the hospital. At DMH site, surgery is provided within 11 operating theatres covering Community Dental, ENT (Day case), General Surgery (including major colorectal surgery, breast surgery and bariatric surgery), Orthopaedic and Trauma Surgery, Obstetric and Gynaecological Surgery, Ophthalmology and Urology (Day case). The Plastic surgery team is based at University Hospital North Durham.

Regional Anaesthesia is well established and supported by a regional fellow post. Emergency lists are provided in routine hours for Orthopaedic trauma, General surgery and Gynaecology, as well as an out of hours emergency theatre. There is a Consultant-led pre-assessment service with weekly clinics including CPEX testing. Anaesthesia for CT scanning and MRI services is available. Monday to Thursday we have a PACU to provide Level 1 care of elective patients under the support of the surgical and anaesthetic teams.

There is an obstetric department located on the 6th floor that has its own theatre with dedicated elective lists in the main theatre suite. An anaesthetic nurse provides assistance for all theatre cases. The medical department consists of in-house acute internal medicine, cardiology (including a 4 bedded monitored CCU), respiratory (including 6 bedded ARU), haematology, endocrinology, gastroenterology and care of the elderly. Outpatient dermatology, rheumatology and psychiatry will provide virtual and face-to-face consultations. Palliative care provides face-to-face support with a team of consultant and specialist nurses.

DMH intensive care unit admits approximately 580 patients per year with a mix of emergency surgical and medical take. We have 11 funded bed spaces combining level 3 and level 2 care in a unit located near the theatre suite. The consultant rota provides a supportive and continuous approach to patient management. The unit is in the process of becoming fully electronic with its documentation. Consultant led RaCI plus nurse led IV, renal outreach and Acute Intervention Teams (critical care inreach) support our work. Weekend work is completed as part of the out of hours commitment with 12 hour shifts.

The majority of specialist support is provided via in-house referrals with otherwise good relations with our tertiary referral hospitals. Renal and neurology specialities based at James Cook University Hospital provide in-house reviews. Our consultant group forms a supportive team and recent appointments include a job share with James Cook Hospital and with Acute Internal Medicine. Trust wide collaboration between the intensive care units and specialist support within the trust occurs with regular Critical Care Delivery Group meetings involving the multidisciplinary team from both Durham and Darlington sites.

Trust wide ICM specific teaching programme is in place with availability of on-site simulation equipment. At the weekend, there are 3 dedicated consultants who separately cover critical care, emergency theatres and orthopaedic trauma lists. Consultants and Specialty Doctors are actively encouraged to support the weekly DMH teaching programme and attend our regular M&M and clinical governance sessions.

MAIN DUTIES AND RESPONSIBILITIES

The post holder will undertake clinical work in conjunction with their clinical colleagues (24 Consultants, 9 specialty/specialist doctors and an average of 13 trainees) and other professional staff in order to maintain and develop both the intensive care and anaesthetic service and be encouraged to develop specialist skills in accordance with the needs of the department and progress to hold departmental non-clinical roles. The post holder will have a continuing responsibility for the care of patients in his/her charge and will contribute to the proper functioning of the department of Anaesthesia and Intensive Care Medicine.

Furthermore, the post holder will be required to undertake administrative duties directly associated with the care of patients. The post holder will supervise junior medical staff and have responsibility to ensure continuing patient care at all times. For management purposes, the post holder will be accountable to the Lead Clinician for ensuring the effective and efficient use of resources allocated. The post holder will have scheduled activity with regular sessions, fixed continuity weeks and some flexible sessions. SPA activity will be timetabled within the weekly job plan but can be completed flexibly and diarised for review.

During some working weeks, flexibility in the ratio of DCC:SPA may be required although SPA time will always be paid back. As additional responsibilities are acquired, the number of SPAs may alter with remuneration agreed through the job planning process. The post holder must possess a UK driving license and be able to present for scheduled list start times as required by the Trust. The post holder will be expected to participate in teaching, research and clinical audit activities, which are considered to be an integral part of normal duties, will be encouraged. Research funding may be available following successful application to local committees.

The post holder will be encouraged and supported to develop services, courses and to undertake innovation. The post holder will be expected to deputise in the absence of colleagues. The post-holder will be expected to perform additional duties in emergency and unforeseen circumstances as are essential for continuity of patient care. The post holder will be responsible for the professional management and supervision of junior medical staff. The post holder will be expected to receive training and participate in educational and clinical supervision. The post holder will be expected to participate in clinical governance arrangements in line with national and local guidelines.

If you are involved in the care of a patient who subsequently initiates a claim against the Trust you will be expected to provide, free of charge, an opinion and statement of facts about the case.

PROPOSED TIMETABLE AND JOB PLAN

This is an indicative job plan, the final job plan/on-call arrangements will be agreed in partnership prior to appointment. Each session is 5.25 hours. Remuneration is 1.313 PAs per working session (which includes pre and post ward round care).