We are looking for an enthusiastic and motivated GP who enjoys working as part of a wide multidisciplinary team to deliver care as part of our Hospital at Home service across Wandsworth and Merton (CAHS). Hospital at home provides intensive hospital level care for acute conditions that would normally require an acute hospital bed, in a patient’s home for a short episode through multidisciplinary healthcare teams. As an experienced GP you will be working with clinical caseload managers, community nurses, therapists, social workers, pharmacists, and secondary care colleagues to provide quality clinical care.
Our Hospital at Home team aims to support patients with a full multidisciplinary approach, fast tracking patients from acute services into their home, enabling people to stay in their own homes for longer, avoid unnecessary A&E attendance and avoid unnecessary hospital admissions, linking into other health, social care and voluntary services in the community as required. The CAHS GP role provides clinical leadership to the multidisciplinary team and optimised medical management to patients on the caseload. You will be part of a team of five GPs providing this service.
This is an exciting post, with the opportunity to help develop the service further, make a real difference to patients, support community teams and a chance to develop both leadership and strategic skills. Part time and job share applications are welcomed.
Main duties of the job
Central London Community Healthcare NHS trust (CLCH) is responsible for the provision of community services for the adult population of Wandsworth and Merton. Wandsworth and Merton Community services are undergoing unique and innovative transformational change to develop fully integrated community services that can safely deliver healthcare in our patients own home. One such service development, building on previous community team experience and pilots, is the development of a Hospital@Home (H@H) service. This now covers the whole of Wandsworth and Merton and provides multidisciplinary team management of acute care to patients, a delivery of interventions previously only available in hospital. The service will comprise of GPs who will focus on the management of the acute and chronic conditions patients on their caseload, who will form part of the multidisciplinary team in Community Services Wandsworth and Merton as part of CLCH NHS trust.
Central London Community Healthcare (CLCH) is one of the largest community healthcare organisations in London and Hertfordshire, providing our services to diverse communities/boroughs in 11 London Boroughs – Barnet, Brent, Ealing, Hammersmith & Fulham, Harrow, Hounslow, Kensington and Chelsea, Merton, Richmond, Wandsworth, Westminster – and Hertfordshire.
09 February 2023
Hospital medical and dental staff
Doctor – other
£65,070 to £98,194 a year Per Annum
- To take and triage telephone referrals to the Hospital@Home team
- To implement clinical plans to support the earlier discharge of patients from hospital or to prevent an admission to hospital. You will have the ability to initiate or continue IV or IM antibiotics in the community. You will have access to point of care testing to support your decision making and the safe management of patients in the community. This will require the H@H GP to work with acutes trusts and primary care.
- To work effectively with the nurses, AHPs and pharmacists working within the hospital at home team.
- To liaise effectively and appropriately with the local GPs from whose practices the patients are being referred.
- To integrate effectively with the existing community services and look for creative ways of improving this integration wherever possible.
- To assist with ongoing monitoring and audit into the effectiveness of the community wards in reducing admissions, re-admissions within 28 days and reducing acute hospital length of stay.
- To deliver (where appropriate and with community nursing assistance) medical management, treatment and advice to patients on the H@H caseload.
- To arrange referrals where appropriate, i.e. onward referral to secondary care, community therapy services or Intermediate care.
- To ensure that clear, accurate contemporaneous records are made of all patient encounters within CLCH clinical system.
- To work with and provide clinical support to the associated nursing staff, pharmacists and AHPs for patients on the Community Services caseload.
- To utilise social services wherever necessary to assist with admission prevention.
- To assist with the improvement of the hospital at home clinical model and its associated systems which includes liaising with primary healthcare professionals (GPs, community matrons, district nurses, allied healthcare professionals and pharmacists as appropriate), hospital clinicians and Information Technology (IT) providers and to act on ones own initiative when required.
- To troubleshoot (and resolve with the assistance of Clinical and Management Leads where necessary) any problems in establishing the hospital at home model, for example, liaising with IT providers, GPs, and secondary care.
- To continually monitor the effectiveness of Community Healthcare services in Merton and Wandsworth operating systems, identifying areas for improvement and to assist with implementing system changes.
- To prioritise the workload as appropriate.
- To keep Clinical and Management Leads updated with progress at intervals deemed beneficial to the project.
- To have responsibility for the Health, Safety and Welfare of self and others and to comply at all times with the requirement of the Health and Safety Regulations.
- To ensure confidentiality at all times, only releasing confidential information obtained during the course of employment to those acting in an official capacity in accordance with the provisions of the Data Protection Act and its amendments.
- To work in accordance with the Trusts Equal Opportunities policy to eliminate unlawful discrimination in relation to employment and service delivery.
- To ensure skills are up-to-date and relevant to the role, to follow relevant Trust policies and professional codes and to maintain registration where this is a requirement of the role.
- To comply with St. Georges Healthcare No Smoking Policies.
- To undertake such duties as may be required from time to time as are consistent with the responsibilities of the grade and the needs of the service.
- To uphold the principles of good medical practice as stated in the GMC statement of duties of a doctor:
- Make the care of your patient your first concern
- Protect and promote the health of patients and the public
- Provide a good standard of practice and care
- Keep your professional knowledge and skills up to date
- Recognise and work within the limits of your competence
- Work with colleagues in the ways that best serve patients’ interests
- Treat patients as individuals and respect their dignity
- Treat patients politely and considerately
- Respect patients’ right to confidentiality
- Work in partnership with patients
- Listen to patients and respond to their concerns and preferences
- Give patients the information they want or need in a way they can understand
- Respect patients’ right to reach decisions with you about their treatment and care
- Support patients in caring for themselves to improve and maintain their health
- Be honest and open and act with integrity
- Act without delay if you have good reason to believe that you or a colleague may be putting patients at risk
- Never discriminate unfairly against patients or colleagues
- Never abuse your patients’ trust in you or the public’s trust in the profession.
Please refer to the attached Job Description for full list of responsibilities.
As an NHS Trust we strongly encourage and support vaccination uptake as this remains the best line of defence against COVID-19.
- Current GMC certificate
- Inclusion on a PCT performers list
- Vocational training certificate or equivalent
- Current resuscitation certificate
- Current Hep B immunity certificate
- MRCGP graduate
- Minimum of two years core GMS experience in General Practice/ Primary care home visiting
- Face to face consultations
- Experience in care of the elderly medicine and in A&E/Urgent care setting
Skills and Knowledge
- IT basic computer literacy
- Good telephone manner
- Clear speech
- Good record keeping
- Excellent communication skills
- Excellent interpersonal skills and ability to develop and sustain professional relationships
- The ability to work in a multidisciplinary team environment
- Flexible, caring and empathetic
- Professional approach
- Presentable appearance
- Ability to work under pressure, manage demanding workload
- Aware of needs of patients, relatives and carers
- Adhere to confidentiality requirements
- Reliable, punctual and committed to work
- Ability to cope with patients under extreme stress from both social and clinical circumstances.
- Ability to handle change and unexpected urgent requirements
- This role would suit a GP with at least 3 years of General Practice Surgery experience in managing acute illnesses and also experience in managing frailty in the community.
- The applicant would have broad knowledge of care of the elderly, frailty management, acute disease management (sepsis, LRTI, delirium etc…) also be proficient in management of chronic diseases such as heart failure, COPD, dementia, depression and anxiety as appropriate for current general practice. The applicant would have an interest in these areas with some knowledge of the range of support services available for care in the community post discharge from care, such as District Nursing, Specialist Nurse Services (Respiratory, Heart Failure, etc.), physiotherapy etc. The applicant would have an interest in maintaining patients supported in the community through full application of the bio psychosocial model. A particular interest and/or supplemental experience in geriatric medicine would be desirable.
- The GPs will be expected to lead sit-down ward rounds, including regular MDT meetings.
- Benefits to the Clinician – Development of expertise in elderly care medicine through clinical management supported by an MDT team including geriatricians. Satisfaction of managing complex bio psychosocial presentations with application of team resources. Satisfaction of working with a broad range of colleagues on a daily basis to provide excellent care.
- Benefits to the Patient – Management primarily by a clinician with general practice experience and perspective ensures a patient-centred and holistic approach, with the support of specialist input when required. This would result in the patient maintained in the community and supporting timely discharge from intermediate care back to their own home when possible, avoiding admissions to acute care, which can often be inappropriate and detrimental. This would also result in improved continuity of care through keeping the patient under community care.
- Benefits to the Health Economy – Improved outcomes for the patient Shortened bed stays Increased use of intermediate care as an alternative to acute admission
Applicants must have current UK professional registration. For further information please see NHS Careers website (opens in a new window).