Applications are invited for a Specialist Fellow in Adult Critical Care and Governance post starting in August 2024. This post would suit candidates with an established interest in governance who wish to further enhance their non-clinical experience/CV whilst gaining further skills and confidence in managing critically unwell patients in a tertiary referral centre. The successful candidate would be based in the Critical Care department but would have at least two days per week allocated to governance activities. We anticipate that a sustained interest in governance with a project demonstrating effective change will be desirable at Consultant interview The candidate will be supervised by dedicated consultants within Critical Care. Main duties of the job The successful candidate will participate in the general rota across both QMC and NCH campus critical care units to maximise the clinical experience you gain during this post. Clinical Responsibilities will include (not exhaustive) • Perform daily reviews on ICU patients and present findings on the MDT ward round • Review critically unwell patients outside of critical care • Admit, stabilise and formulate an initial management plan for critically unwell adults • After a period of training competently use vasopressors, insert CVC and Arterial Lines. During your time in post you will also • Dedicate at least 2 days per week to governance activities • Undertake a quality improvement project(s). • Engage in and deliver education to relevant staff groups. Working for our organisation Adult Critical Care at NUH is a highly supportive, friendly, cohesive, ambitious and energetic team led by a group of consultants devoted to delivering excellent care to our patients. We invest in every member of team, are positive about well-being and have an accommodating approach to the rota. There are an abundance of educational opportunities and on-site is the well regarded Trent Simulation Centre. Our juniors consistently secure their preferred training posts through competitive selection. Our 66 critical care beds are split between the Queen’s Medical Centre and Nottingham City Hospital, admitting in excess of 4500 patients per year. We accept patients from all of the major medical and surgical specialties and are a tertiary referral centre for many subspecialties. Of note we are a neurosurgical centre, burns centre and are one of the busiest major trauma centres in Europe. Among our staff are the National Lead for Organ Donation and the Vice Chair of NIHR’s Critical Care Group. 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 plus a further 2 years in the acute specialities (Acute Medicine, Anaesthesia, ICM or Emergency Medicine) who wish to gain further experience in the management of critically unwell patients with a wide range of medical and surgical conditions. This post uniquely offers the applicant an opportunity to strengthen the link between the governance team and wider Intensive Care team by leading quality improvement projects. The successful candidate would be based in the Critical Care department but would have two days per week allocated to critical care governance activities. Responsibilities could include attending the local governance meeting, organising the M&M, presenting cases, sharing learning, writing guidelines and preparing a governance report. You will learn about incident handling, supporting staff, being open/Duty of Candour, identifying themes, SJCR training and how to effect change. You will complete a large QI project based on a self-identified governance need. There may be opportunities to look at Serious Incidents, complaints, Coronial reports and higher level governance meetings. 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 and we would recommend applying for one of our Trust Grade posts in the first instance. The post is EWTD compliant The Salary for this post will be at MT04 or MT05 depending on experience with additional out of hours supplements. 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 a clinical supervisor 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. 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 Adult Critical Care and Governance Essential for the post: • MB ChB or equivalent & GMC registration with licence to practise • Successful completion of FY2 training • 2 Years of post-foundation experience in the acute specialities in an NHS setting. • Evidence of competence in clinical tasks • Evidence of continuous career development • 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: • Primary FRCA or equivalent higher qualification • ALS or equivalent accredited life support course • Six months’ experience in anaesthesia • Six months’ experience in internal medicine • Previous experience in critical care medicine • Completion of IAC • Completion of an audit cycle • Published Research • Evidence of academic achievement including additional qualifications, prizes • Competence in Bronchoscopy, Lung US and Focused Echocardiography • Attendance at meetings/ courses/ membership of professional bodies • Evidence of formal human factors training • Demonstrates non-medical interests/ activities 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 Junior Critical Care Fellows have the opportunity and paid time (15 Days of CPD) 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 trainees 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. Time for Continuing Professional Development CPD The CPD time in this post will be used for the governance component of the post. 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. 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 instance Person specification Qulaifications Essential criteria • MB ChB or equivalent. Full/limited GMC registration. • Successful completion of FY2 training in an NHS setting Desirable criteria • ALS or equivalent accredited life support course Experience Essential criteria • Two years of post-foundation training in acute specialities (Anaesthesia, Acute Medicine, Emergency Medicine or ICM) in an NHS hospital. Desirable criteria • 6 months experience of anaesthesia • 6 months of previous critical care experience • Other evidence of academic achievement including additional qualifications, prizes Ability Essential criteria • Evidence of competence in clinical tasks Desirable criteria • Competence in bronchoscopy, lung ultrasound, focused echocardiograph 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 • Evidence of continuous career development, including evidence of attendance at meetings/ courses Desirable criteria • Attendance at meetings/ courses/ membership of professional bodies