Applications are invited for the position of Specialist Fellow in Air Ambulance and AdultCritical Care, for a 12 month period starting in August 2024 in partnership with Lincs & Notts Air Ambulance. 50% of the successful candidate’s time will be working with LNAA and the other 50% covering the critical care on-call rota at NUH. This post would best suit doctors wishing to develop their CV either before taking up a consultant post, or as an OOPE/ OOPP. Applicants must have at least 4 years’ post-foundation experience in acute specialties including anaesthesia (minimum 1 year), critical care (minimum 9 months) or emergency medicine. Please note this is an absolute minimum and preference will be given to those candidates with senior experience. Experience of working in the NHS or a comparable healthcare system is essential. Applicants will also have passed the Primary FRCA or equivalent level of postgraduate qualification (e.g. MRCEM). Full/ limited registration with the GMC is essential. Main duties of the job Clinical Responsibilities will include (not exhaustive): • Perform daily reviews on ICU patients and present findings on the MDT ward round • In conjunction with the consultant support the clinical decision making of junior medical and nursing staff as the senior member of the critical care team • Review critically unwell patients outside of critical care • Admit, stabilise and formulate an initial management plan for critically unwell adults · Competently initiate ventilation, use vasopressors, insert CVC and Arterial Lines and be able to transfer the critically unwell patient. • Providing care to patients attended by the Lincs and Notts Air Ambulance team • Initiate and maintain acute resuscitative care for an undifferentiated group of critically ill and injured medical and trauma patients. • Triage casualties, including multiple casualties, to the most appropriate receiving facility. • Respond by air and road to emergencies During your time in post you will also • Support the learning and development of other members of the critical care and anaesthesia team (inc undergraduates) • Participate in clinical governance and quality improvement. Working for our organisation LNAA is based at HEMS way RAF Waddington and provides prehospital critical care across Lincolnshire and Nottinghamshire. The service is dispatched to an average of 3 missions per day with a projected increase to 5 per day as 24/7 coverage is rolled out. A comprehensive induction and education programme is provided. NUH consists of the Queens Medical Centre Campus and the Nottingham City Hospital Campus. Adult Critical Care is based on both sites and caters for all medical and surgical specialties, admitting approximately 4500 patients per year. QMC houses the East Midlands Major Trauma Centre – the busiest major trauma centre in the UK. While this particular post is not recognised for training by the Postgraduate Dean, all of our critical care areas are recognised for training by the Faculty of Intensive Care Medicine as well as the Royal Colleges of Anaesthetists, Physicians, Surgeons, and Emergency Medicine. Detailed job description and main responsibilities The post is open to all applicants who meet the essential criteria as detailed in the person specification below. It is open to all doctors who hold Full/limited registration with the GMC and successfully completed foundation year 2 training, along with a further 4 years of acute specialty training (inclusive of one year of anaesthetics experience and 9 months of critical care), who wish to gain further experience in the management of critically unwell patients with a wide range of medical and surgical conditions with an equal amount of time spent in the pre-hospital setting. The post will offer successful candidates the opportunity to gain a wide range of experience in the pre-hospital setting allowing the opportunity to develop a unique set of additional skills which can rarely be acquired by most higher speciality training programmes. 50% of the post will be based with the LNAA and the remaining 50% will be based within NUH Critical Care on an alternating basis which may be 3 or 6 monthly. This post is whole time and is covered by the Medical and Dental Staff Terms and Conditions of Service. Doctors applying for this post from overseas should note that prior NHS experience is a prerequisite. The post is EWTD compliant and is will be paid at the MT04/MT05 scale plus additional payments for out of hours work. This post is not recognised for training by the Postgraduate Dean, the Faculty of Intensive Care Medicine or by the Royal College of Anaesthetists. All successful applicants are allocated clinical supervisors for critical care and HEMS who will support the individual to develop their clinical and non-clinical skills and offer advice on how to achieve any specific individual goals the fellow may wish to achieve. The NUH Clinical Supervisor will carry overall responsibility. We recommend that the appointee maintain a logbook of experience, complete appropriate assessments and participates in the wide range of non-clinical opportunities detailed below. Person Specification: Specialist Fellow in Air Ambulance and Adult Critical Care Essential for the post: • MB ChB or equivalent & GMC registration with licence to practise • Either Primary FRCA or equivalent e.g. Full MRCP or MCEM • Completion of Foundation training plus four years of post-Foundation training in acute specialties (Anaesthesia, Acute Medicine, Emergency Medicine or Intensive Care Medicine) • Twelve months’ anaesthetics and nine months’ critical care or emergency medicine with prior NHS experience. • Ability to stabilise the deteriorating patient including intubation and initiation of organ support • Evidence of continuous career development including evidence of attendance at meetings / conferences • Evidence of good written communication, successful team worker, sensitivity to needs of patients and colleagues • Punctuality, professional appearance and attitudes consistent with GMC guidelines. Values and behaviours aligned with NUH’s Desirable for the post: • Certificate of Completion of Training • FFICM, Final FRCA or FRCEM • ATLS or other trauma course • Completion of Stage 2 Critical Care or Anaesthesia Training • Experience of senior on-call roles in acute specialties in a UK hospital • Completion of audit cycle / Quality Improvement Project • Published research • Other evidence of academic achievement including additional qualifications, prizes • Competence in bronchoscopy, lung ultrasound, focused echocardiography • Attendance at meetings/ courses/ membership of professional bodies • Evidence of formal Human Factors training • Demonstrates non-medical interests/ activities The Speciality Critical care is part of the Clinical Support division. There are 3 distinct adult critical care areas managed by clinical support across both QMC and City campuses. We aim to rotate you through both campuses so that you are exposed to a wide range of pathologies and speciality experience. Queen’s Medical Centre Campus (QMC) On the Queen’s campus Critical Care is divided into a 29-bedded Intensive Care (level 3 beds), and a 20-bedded level 2 High Dependency Unit. At QMC critical care receives referrals from major trauma and the following surgical specialties: neurosurgery, spinal, emergency orthopaedics, hepatobiliary, vascular, lower GI, maxillofacial and ENT. It also receives referrals from acute medicine (including acute gastroenterology). Of note, NUH became the East Midlands Major Trauma Centre in April 2012 and is the busiest Major Trauma Centre in the UK. Nottingham City Hospital Campus The critical care unit at the City campus has 17 beds that are used flexibly to accommodate up to 9 level 3 patients, the remaining beds are for level 2 admissions. The major subspecialty interests at City are thoracic surgery, upper GI surgery, elective orthopaedics, urology, burns and plastics, renal medicine, infectious diseases, oncology, haematology and respiratory medicine. The City campus also houses the separate Trent Cardiac Unit with its own dedicated intensive care unit. There is a well-established critical care outreach team on both campuses. Across NUH CCOT provide support to all medical and surgical areas, seven days a week 08.00-22.00. Medical Staffing There are 75 Junior Staff in Critical Care There are 35 Critical Care Consultants at NUH with an extensive range of subspecialty clinical and nonclinical interests and roles. Non Clinical Opportunities Within NUH Fellows will have the opportunity to pursue their interest in a variety of clinical and non-clinical areas. This can include simulation, teaching, governance and quality improvement. Educational opportunities The departments offer extensive learning resources. There are several regular educational meetings each week including journal clubs, ITU rounds and morbidity meetings. There is a monthly protected teaching day for our Fellows which cover the clinical aspects of critical care in addition to optional teaching days which cover generic non-clinical topics (e.g. ethics, medical law, professionalism, interview skills). There are hospital and departmental libraries at both sites including IT facilities. FICE & FUSIC There is plenty of opportunity for fellows to gain their FICE and FUSIC accreditation. The department is supported by several FICE & FUSIC mentors as well as consultants with experience of TOE. Research opportunities Available by special arrangement. Critical Care has links with the Academic Departments of Anaesthesia and Surgery and participation in on-going research and audit programmes will be encouraged. Applications for training posts The department has an excellent reputation for successful recruitment into higher speciality training posts. Trainees are encouraged to develop their portfolio and identify and utilise opportunities to increase their success in subsequent recruitment. We are also fortunate to have a number of consultants who interview for example for National Anaesthesia Recruitment and therefore are in a position to support applicants during interview preparation. Study leave 20 days of study leave are allocated per annum, pro rata. Study leave should be split approximately evenly between time in adult critical care and prehospital. Attendance at courses and meetings is encouraged and can usually be accommodated with sufficient notice (minimum 6 weeks). Annual leave Annual Leave must be split evenly between the blocks in adult critical care and prehospital. Annual leave dates can nearly always be accommodated if there is sufficient notice given (6 weeks). Internal cover and Locums The current banding allocation of this post includes an allowance for internal cover to cover the normal leave allowance of colleagues. In exceptional circumstances and for short periods only, Clinical Fellows may be requested to provide additional cover, for example, to cover sickness. Locums may also be employed in this instanc Person specification Qualifications Essential criteria • MB ChB or equivalent. Full/limited GMC registration. • Either Primary FRCA or equivalent e.g. full MRCP/ MRCEM Desirable criteria • FFICM, Final FRCA or FRCEM Experience Essential criteria • Four years’ of post-Foundation training in acute specialties (acute specialties here defined as any of Anaesthesia (1 year min), Acute Medicine, Emergency Medicine, Intensive Care Medicine(9 months min)) • 12 months’ Anaesthetics & 9 months in Critical Care with prior NHS experience. Desirable criteria • ATLS or other trauma course • Experience of senior on-call roles in acute specialties • Completion of quality improvement cycle / audit Ability Essential criteria • Ability to stabilise the deteriorating patient including intubation and initiation of organ support Desirable criteria • Competence in bronchoscopy, lung ultrasound, focused echocardiography Interpersonal Skills Essential criteria • Evidence of good written communication, successful team-worker, sensitivity to needs of patients and colleagues Desirable criteria • Evidence of formal Human Factors training Professional Behaviour and Attitude Essential criteria • Punctuality, professional appearance and attitudes consistent with GMC guidelines Desirable criteria • Demonstrates non-medical interests / activities