Individual Placement Description North Bristol NHS Trust

Severn Foundation School Individual Placement Description North Bristol NHS Trust

Placement F1 Acute Medicine (AAU) The department Acute Medicine The type of work to expect and Consultant and registrar led ward rounds, patient learning opportunities reviews, supervised procedures (lumbar puncture, paracentesis), new patient clerking when on call, high dependency patient management including BiPAP, discharge planning experience, handover. Where the placement is based AAU, gate 31, Brunel building, Southmead hospital. Clinical Supervisor(s) for the John Ho, Madhu Wickremaratchi, Sam Patel, placement Kiaran Flanagan, Ishita Dasgupta, Louise Powter, Nigel Lane. Main duties of the placement You will have responsibility for a block of patients (usually 16) on AAU – patient reviews, arranging investigations, discharge planning, handing over to other teams. Typical working pattern in this Normal day 8am – 4pm placement Employer Information You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people

The Southmead Hospital Bristol site also includes our outstanding maternity department and neonatal intensive care unit (NICU), the brand new Bristol Breast Care Centre, clinical research teams and Severn Pathology.

In addition the Trust is in the process of applying for Foundation Trust status.

It is important to note that this description is a typical example of your placement and may be subject to change.

Severn Foundation School Individual Placement Description North Bristol NHS Trust

Placement F1 Cardiology The department The department of cardiology has 6 Consultant Cardiologists. There is a catheter laboratory where diagnostic angiography, angioplasty and pacing procedures are carried out. We have a cardiac investigations unit for non-invasive tests such as echocardiography, ECG monitoring and exercise stress testing. The type of work to expect and All Foundation Doctors in hospital posts will learning opportunities generally be ward based during the ‘normal’ working day and expected to deliver the daily medical care of all the patients on their ward irrespective of specialty. Whilst on-call in the acute admissions unit, the F1 will be involved with the generic clerking of patients being admitted and the ongoing care of the patients in the unit.

The overall educational objectives of the F1 year are to provide the trainee with the knowledge, skills and attitudes to be able to  Take a history and examine a patient  Formulate a differential diagnosis  Prescribe safely  Keep an accurate and relevant medical record  Manage time and clinical priorities effectively  Communicate effectively with patients, relatives and colleagues  Use evidence, guidelines and audit to benefit patient care  Act in a professional manner at all times  Cope with ethical and legal issues which occur during the management of patients with general medical problems  Educate patients effectively  Become life-long learners and teachers. Where the placement is based Brunel building, Southmead Hospital, Bristol Clinical Supervisor(s) for the Dr Shahid Aziz, Dr Andrew Skyrme Jones, placement Dr Paul Walker, Dr Phil Boreham, Dr Ben Farrow and Dr Mark Papouchado. Main duties of the placement The F1 doctor is responsible with other staff for the ward care of patients and the maintenance of the patient’s medical record. They are expected to attend the structured teaching programmes provided by the department and grand rounds. Typical working pattern in this Mainly ward based from 9am-5pm, apart from placement on-call duties. Employer Information You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people

In addition the Trust is in the process of applying for Foundation Trust status.

It is important to note that this description is a typical example of your placement and may be subject to change.

Severn Foundation School Individual Placement Description North Bristol NHS Trust

Placement F1 Gastroenterology and General Internal Medicine The department The Dept of Gastroenterology comprises 6 Consultant Gastroenterologists who all do acute General Internal Medicine (GIM) on-call. There are interests in Inflammatory bowel disease, advanced nutrition, small bowel, obscure GI bleeding & hepatobiliary. All general gastroenterology and general internal medicine (except stroke) is represented. The department serves the local population of Bristol, South Gloucestershire and North Somerset. The type of work to expect and All F1 Doctors will be ward based during the learning opportunities ‘normal’ working day and expected to deliver the daily medical care of all the patients on their ward. Whilst on call for GIM the F1 will be involved with the generic clerking of patients being admitted, presentation to the on call consultant, initiation of their investigations & management and hand over to the next on call or ward based team.

On call requirements: 1 in 9 days and 1 in 18 nights. Employer Information You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people

In addition the Trust is in the process of applying for Foundation Trust status.

It is important to note that this description is a typical example of your placement and may be subject to change.

Severn Foundation School Individual Placement Description North Bristol NHS Trust

Placement F1 Care of the Elderly/General (Internal) Medicine The department The Department of Medicine for the Elderly in North Bristol Trust is largely based in specialty specific wards in the Brunel building at Southmead. All consultants work as General Physicians and Geriatricians, and each has an area of special expertise eg. Parkinson’s disease, bone health & orthogeriatrics, falls, respiratory disease, dementia, interface etc. The type of work to expect and All F1 Doctors in hospital posts will be ward learning opportunities based during the normal working day and expected to deliver the daily medical care of all the patients on their ward irrespective of specialty. Whilst on call the F1 will be involved with the either the clerking of undifferentiated medical patients being admitted, or during ward cover out of hours they will be responsible for the ongoing care of medical inpatients.

The overall educational objectives of the F1 year are to provide the trainee with the knowledge, skills and attitudes to be able to

 Take a history and examine a patient  Identify and synthesise problems  Perform IV cannulation and other appropriate procedures  Prescribe safely  Keep accurate and relevant medical records  Manage time and clinical priorities effectively  Communicate effectively with patients, relatives and colleagues  Supervise and provide support and guidance for F1 doctors  Use evidence, guidelines and audit to benefit patient care  Act in a professional manner at all times  Cope with ethical and legal issues which occur during the management of patients with general medical problems  Educate patients effectively  Become life-long learners and teachers.

In addition, trainees in the department will develop skills in:  The diagnosis and management of delirium in older people  The diagnosis and management of dementias  The recognition of non specific presentations of acute conditions in older people  The management of hospital acquired infections on older people, and the consequences of prolonged hospital stays  Assessment of capacity, deprivation of liberty safeguards, enduring power of attorney, and the Court of Protection.  Multidisciplinary team working  Early Discharge planning  Palliation for terminal illnesses in old age, and advanced care planning at the end of life. Where the placement is based Medical wards Southmead hospital, NBT Clinical Supervisor(s) for the Drs. R D Barber placement KA Neubauer JC Pounsford S Srivastava SK Wensley J Richards S McCracken K Rainey Main duties of the placement The F1 doctor will be responsible with other staff for the ward care of patients and the maintenance of the patient’s medical records, including drug charts and Discharge information. They will have opportunity to work with the consultants on Ward rounds at least twice weekly, and also take responsibility for problems arising in patients on the ward. They are expected to attend the structured teaching programmes provided by the department and the Directorate/ Academy/ learning centre. The doctor will be responsible for such other specific clinical duties as allocated by consultants including performing other duties in occasional emergencies and unforeseen circumstances. Typical working pattern in this Daily: 0900 Ward ‘Board’ round placement 09.30 – 17.00 Ward work/ rounds 1700 Handover Mon: am consultant Ward Round pm Ward work Tues: am ward work 1400-1600 MDM Wed: am ward work pm SpR Ward Round Thurs: am Consultant ward round pm Ward work Fri: am ward work pm weekend plans Sat: On call shifts as rostered Sun: On call shifts as rostered On call requirements: 48 hr EWTD compliant shift rota over 9 week cycle Employer Information You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people

In addition the Trust is in the process of applying for Foundation Trust status.

It is important to note that this description is a typical example of your placement and may be subject to change.

Severn Foundation School Individual Placement Description North Bristol NHS Trust

Placement F1 GI Surgery The department The Dept of general surgery comprises 19 consultant surgeons including 4 upper GI surgeons; the upper GI surgeons take in part in the acute general surgery on-call. There are interests in benign upper GI, gallstones surgery, anti-reflux surgery and bariatric surgery.

The department covers part of Bristol, North Somerset and South Gloucestershire with a catchment population of 500,000. The type of work to expect and F1 Doctors in hospital posts will generally be learning opportunities team based during the ‘normal’ working day and expected to deliver the daily medical care of all surgical patients irrespective of specialty. Whilst on-call the F1 will be involved with the generic clerking of patients being admitted and the ongoing care of the patients in the unit. The overall educational objectives of the F1 year are to provide the trainee with the knowledge, skills and attitudes to be able to  Take a history and examine a patient  Identify and synthesise problems  Prescribe safely  Keep an accurate and relevant medical record  Manage time and clinical priorities effectively  Communicate effectively with patients, relatives and colleagues  Use evidence, guidelines and audit to benefit patient care  Act in a professional manner at all times  Cope with ethical and legal issues which occur during the management of patients with general medical problems  Educate patients effectively  Become life-long learners and teachers. Where the placement is based Brunel building, Southmead Hospital, Bristol Clinical Supervisor(s) for the Mr C Armstrong, Miss S Norton, Mr C Wong, placement Mr J Hewes. Main duties of the placement The F1 doctor is responsible with other staff for the team care of patients and the maintenance of the patient’s medical record. They will have opportunity to work with the consultants in theatres and outpatients clinics, and also take responsibility for problems arising in surgical patients on the ward. They are expected to attend the teaching program provided by the department. The doctor will be responsible for such other specific clinical duties as allocated by consultants including performing other duties in occasional emergencies and unforeseen circumstances. Typical working pattern in this * placement Daily: 0800 Ward round *subject to change in new 1700/2030 Handover hospital building Wed: 0900 – 1230 Pre-Assessment clinic Wed: 1300 – 1700 Pre-Assessment clinic.

Sat: 0800 – 1700 1 in 17 Sun: 0800 – 1700 1 in 17

On call requirements: Full shift 1:8 nights and long days and 1:17 short day weekend. Employer Information You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people

In addition the Trust is in the process of applying for Foundation Trust status.

It is important to note that this description is a typical example of your placement and may be subject to change.

Severn Foundation School Individual Placement Description North Bristol NHS Trust

Placement F1 Colorectal Surgery The department The Dept of general surgery comprises 19 consultant surgeons including 6 Colorectal surgeons, All colorectal consultants take in part in the acute General surgery on-call. There are interests in benign and malignant colorectal diseases, colorectal laparoscopic surgery, inflammatory bowel disease and pelvic floor surgery.

Sat: 0800 – 1700 1 in 17 Sun: 0800 – 1700 1 in 17

In addition the Trust is in the process of applying for Foundation Trust status.

It is important to note that this description is a typical example of your placement and may be subject to change.

Severn Foundation School Individual Placement Description North Bristol NHS Trust

Placement F1 Vascular Surgery The department The Dept of general surgery comprises 19 consultant surgeons including 4 vascular surgeons, the vascular surgeons take in part in the acute city wide vascular surgery on-call also they contribute to the renal transplant on-call. There are interests in endovascular surgery, living kidney donor transplant, and vascular access surgery.

The department covers part of Bristol, North Somerset and South Gloucestershire with a catchment population of 700,000. The catchment area for renal transplantation is 2,000,000. The type of work to expect and F1 Doctors in hospital posts will generally be learning opportunities team based during the ‘normal’ working day and expected to deliver the daily medical care of all surgical patients irrespective of specialty. Whilst on-call the F1 will be involved with the generic clerking of surgery & urology patients being admitted and the ongoing care of the patients in the unit.

On call requirements: Full shift 1:6 twilight weekdays and long weekends Employer Information You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people

In addition the Trust is in the process of applying for Foundation Trust status.

It is important to note that this description is a typical example of your placement and may be subject to change.

Severn Foundation School Individual Placement Description North Bristol NHS Trust

Placement F1 General and Transplant Surgery The department The Dept of general surgery comprises 19 consultant surgeons including 3 general and transplant surgeons, the general and transplant surgeons take in part in the acute transplant surgery on-call with 3 vascular and transplant surgeons. There are interests in laparoscopic surgery, living kidney donor transplant, vascular access, endocrine and bariatric surgery.

The department covers part of Bristol, North Somerset and South Gloucestershire with a catchment population of 500,000. The catchment area for renal transplantation is 2,000,000 The type of work to expect and F1 Doctors in hospital posts will generally be learning opportunities team based during the ‘normal’ working day and expected to deliver the daily medical care of all surgical patients irrespective of specialty. Whilst on-call the F1 will be involved with the generic clerking of surgery & urology patients being admitted and the ongoing care of the patients in the unit.

On call requirements:

Full shift 1:6 twilight weekdays and long weekends Employer Information You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people

In addition the Trust is in the process of applying for Foundation Trust status.

It is important to note that this description is a typical example of your placement and may be subject to change.

Severn Foundation School Individual Placement Description North Bristol NHS Trust

Placement F1 Urology The department Urology The type of work to expect and Ward work, preoperative preparation, learning opportunities postoperative care, clinic consultations, attendance at operating lists. Ward-based and interactive teaching Where the placement is based Urology, Southmead Hospital Clinical Supervisor(s) for the Urology consultants placement Main duties of the placement Ward work, preoperative preparation, postoperative care, clinic consultations, attendance at operating lists. Typical working pattern in this Daily schedule, with night shifts within surgical placement directorate Employer Information You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people

In addition the Trust is in the process of applying for Foundation Trust status.

It is important to note that this description is a typical example of your placement and may be subject to change.

Severn Foundation School Individual Placement Description North Bristol NHS Trust

Placement F1 Intensive Care Medicine The department Intensive Care The type of work to expect and The Critical Care Unit based at Southmead learning opportunities Hospital consists of 48 beds allowing the individual to gain experience in managing a wide range of critically ill patients with particular emphasis on neuro-intensive care and trauma as well as general medical and surgical patients.

Learning opportunities include but are not limited to:

 The recognition and immediate treatment of critically ill/injured patients  The ongoing care of critically ill/injured patients through to discharge including wide experience of all aspects of intensive care, except post-cardiac surgery. This includes management of severe head injuries and other neurosurgical emergencies, major trauma patients, major surgical patients including burns and plastic surgical patients and medical patients  Practical procedures under direct supervision according to their own individual needs and proficiency.  Experience in advanced monitoring techniques, cardiovascular management, respiratory care including airway management and renal support. Where the placement is based Intensive Care Unit, Southmead Hospital Clinical Supervisor(s) for the Allocated on arrival, currently Dr Mark Dirnhuber placement Main duties of the placement Working as part of the Intensive Care multidisciplinary team the individual will be involved in all aspects of patient care and administration Typical working pattern in this As per F1 working pattern, Monday - Thursday placement Employer Information You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people

In addition the Trust is in the process of applying for Foundation Trust status.

It is important to note that this description is a typical example of your placement and may be subject to change.

Severn Foundation School Individual Placement Description North Bristol NHS Trust

Placement F1 Infectious Diseases & HIV The department There is 1 Consultant who works in Infectious diseases, including HIV & general medicine, and 2 consultants in immunology & HIV. Junior staff include 1 FY1 trainee, 1 CMT, and one SpR in GU medicine. We are responsible for the care of medical patients on the ward and the ID/ HIV unit, with 11 general medical patients The type of work to expect and As an F1 in ID/ HIV, you will be expected to learning opportunities deliver the daily medical care for the inpatients on the wards. Inpatient Care  You will often attend Consultant or Registrar ward rounds, although sometimes you will be expected to conduct your own ward round  Typically each day you will be responsible for the care of 10-22 inpatients.  ID & HIV medicine will give you the opportunity to manage a wide variety of infectious & tropical diseases, these are not rare, but you may not see more than one or 2 of the same condition in your 3 months with us.  Sometimes patients have complicated and prolonged admissions, which will require careful discharge documentation, and telephone communication with GP. You will get the opportunity to learn about the management of HIV, including issues of confidentiality, disclosure, testing, new diagnoses, and longterm complications. You will also learn the management of TB in the context of HIV and non-HIV infected patients. Clerking  You will have ample opportunity to assess and manage acutely unwell patients with a variety of conditions on take, and directly from clinic  You will be expected to present these patients to the on call Consultant on the post take ward round, the ID consultant, or the on call HIV consultant. For all kinds of work, senior review (SHO, registrar or consultant) is readily available and should be easily accessible. HIV senior advice is available out of hours by contacting the on-call consultant through switchboard. Where the placement is based Brunel building, Southmead Hospital Clinical Supervisor(s) for the Dr Bovill placement Main duties of the placement  To ensure the safe clinical management of each patient under your care (with senior support)  To carry out jobs from the ward round and liaise with other specialties as necessary  To ensure handover and discharge documentation is complete and accurate  To review patients when asked  To ensure that your documentation in the medical notes is thorough, accurate and legible Typical working pattern in this *Mon – Fri 09:00 to 17:00 placement On take for direct respiratory cardiology & *subject to change in new ID/HIV admissions on the F1 rota hospital building Employer Information You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people

In addition the Trust is in the process of applying for Foundation Trust status.

It is important to note that this description is a typical example of your placement and may be subject to change.

Severn Foundation School Individual Placement Description North Bristol Trust

Placement F1 Inpatient Psychiatry Later Life The department This post is based with Dr Hewitt, consultant old age psychiatrist, who is responsible for the inpatient care of mental ill elderly from the Bristol sector. Inpatient beds are shared with South Gloucestershire mental health services and are located at The Coppice unit, Callington Road Hospital Bristol: 20 organic (Laurel Ward) and 24 functional ( Aspen ward). The type of work to expect and The post will provide experience in the care of learning opportunities patients suffering from severe depression, bipolar disorder, psychosis and the behavioural and psychiatric symptoms of dementia. Where the placement is based South Gloucestershire Mental Health - The Coppice unit, Callington Road Hospital Bristol Clinical Supervisor(s) for the Dr Hewitt, Consultant old age psychiatrist placement Main duties of the placement The F1 will be responsible for clerking and reviewing these patients who almost universally will have complex physical co-morbidity. There will be opportunities to observe memory clinic assessments, assessments in the community and Electroconvulsive therapy. There is weekly teaching at Callington Road Hospital Journal Club, Lunch time presentations, psychotherapy and group discussions of issues.

These are a fantastic opportunity to get exposure to acute psychiatry in A+E and in the community. There is always consultant on-call cover available.

All staff at CRH are invited to participate in the psychiatric book and film clubs. Typical working pattern in this No on- call placement Employer information Your employer will be North Bristol NHS Foundation Trust, seconded to Avon and Wiltshire Partnership (AWP) Mental Health NHS Trust

It is important to note that this description is a typical example of your placement and may be subject to change.

Severn Foundation School Individual Placement Description North Bristol Trust

Placement F1 Neuropsychiatry The department This post is based with Dr Kate Seddon (or Dr Johanna Herrod) Consultant Neuropsychiatrist, working at the Neuropsychiatry Service at Southmead Hospital. The Neuropsychiatry Service is part of the Neurosciences Directorate. It has a multidisciplinary team with Nursing, Occupational Therapy, Neuropsychology, Physiotherapy, Cognitive Behavioural Therapy, Sleep Therapy, Epilepsy Nurses and Medical Staff (including Psychiatry Core and Advanced Trainees and Specialty Grade Doctor). The service provides community and inpatient assessment and treatment of Neuropsychiatric conditions. The inpatient unit has 10 beds and there are also two beds available in the main Southmead Hospital building for Video EEG monitoring (including full Sleep Recordings). The department also provides a Liaison Neuropsychiatry service to the Neurology and Neurosurgery wards at Southmead Hospital. The type of work to expect and This post offers training both in General learning opportunities Neuropsychiatry and in specialist topics relating to Neurology and Psychiatry. It will offer experience in the care of patients suffering from Somatoform Disorders, including Non Epileptic Attack Disorder, Sleep Disorders, Complex Pain, Neuropsychiatric Complications of Movement Disorders, sequelae of Brain Injury and difficult to diagnose conditions that lie between Neurology and Psychiatry. The post also provides experience in core psychiatric disorders such as depression, anxiety, psychosis and personality disorders.

The F1 doctor will be ward based during the ‘normal’ working day, providing first-line assessment of all inpatients for both physical and psychiatric disorders. There will be opportunities to take part in the Multidisciplinary Medically Unexplained Symptoms Assessment Clinic and Neuropsychiatry Liaison assessments with appropriate support and supervision. There will also be opportunities to observe other outpatient clinic assessments.

The F1 Doctor will be well supported with senior input to the ward throughout the week and weekly wards rounds. There will also be weekly individual consultant supervision.

There is weekly teaching at Southmead Hospital both at the Mental Health and Neurosciences (‘Grand Round’) Academic Programmes and monthly educational neuropsychiatry meetings. There are also opportunities to attend Multidisciplinary Sleep and Complex Pain Meetings. There will be opportunities to gain exposure to acute psychiatry on the ward and in Neuropsychiatry Liaison (all work will be appropriately supervised). There is always consultant on-call cover available.

The overall educational objectives are to provide the trainee with the knowledge, skills and attitudes to be able to:

Also on the Southmead site are other Psychiatry Advanced and Core Trainees, GPVTS and Foundation trainees on Psychiatry placements, and the post holder would be part of a supportive group of trainee doctors. The consultants are also experienced and enthusiastic trainers.

Developing Core Therapeutic Skills The Foundation Doctor will gain experience of working with patients who are frequently distressed, with complex mental health comorbidity, and who are often ambivalent about treatment and recovery. They will gain expertise and confidence in containing these difficult emotions as they occur in their patients. There will be support and supervision on building therapeutic relationships, along with the opportunity to attend the staff balint group. Where the placement is based The Neuropsychiatry Unit, Southmead Hospital, Bristol Clinical Supervisor(s) for the Dr Kate Seddon (or Dr Johanna Herrod), placement Consultant Neuropsychiatrist Main duties of the placement The F1 will be responsible for admitting, clerking, reviewing and facilitating the discharge of inpatients, some of whom will have complex physical co-morbidity. As previously mentioned there will also be other opportunities to have allocated sessions off the ward to participate in other clinical activities.

Assessment of Medically Ill Patients: Guidance for all Foundation Doctors on psychiatry placements. As a Foundation doctor, you may be called on to assess patients who are medically unwell in the in-patient unit. It is important to be aware that the unit does not have the facilities to support patients with serious physical health problems and you are not in a position working in these settings to facilitate urgent investigation, or initiate immediate and complex treatment such as IV support or catheterisation. In the event that a patient needs more immediate and complex physical assessment, it is advisable to discuss with a senior psychiatry colleague and it may be necessary to have these individuals seen by the appropriate medical team or in the A&E department. It would of course be helpful if a patient was referred, to discuss the case with the casualty or other medical team, while the transfer is being organised. This may require an ambulance, which the in-patient team would generally organise.

As a Foundation doctor working in psychiatry, you would not normally be expected to initiate complex physical treatments. If you are uncertain about appropriate physical care of an individual, you should always discuss this issue with a senior psychiatry colleague, who may be the local core/advanced trainee in your unit or your consultant or the consultant on-call. It may be useful to contact the specialist team in the main building for advice, but where a complex decision is being made this should always be shared with senior colleagues in the psychiatric team, who will be responsible for the treatment while the patient is in the unit. Note that discussion of the physical problems with a more senior psychiatric colleague is not generally to get expert medical advice (bearing in mind that as the psychiatric specialists become more senior their physical medicine skills tend to become out of date), but to bring the concerns to their attention so they can advise on the need to contact local acute medical/surgical teams and how best to do this. Typical working pattern in this Monday to Friday, 9am to 5pm. placement No on-call

Foundation training is on Tuesday pm at Southmead Hospital.

For the first F1 of the year there is an induction week prior to the starting date that consists of half the time at central induction at NBT and half the time shadowing the CT3/ Staff Grade/ F1 at the Neuropsychiatry inpatient unit. Employer information Your employer will be North Bristol NHS Foundation Trust, seconded to Avon and Wiltshire Partnership (AWP) Mental Health NHS Trust

It is important to note that this description is a typical example of your placement and may be subject to change.

Severn Foundation School Individual Placement Description North Bristol Trust

Placement F1 Inpatient Eating Disorders The department This post is based with Dr Hugh Herzig, Consultant Psychiatrist in Eating Disorder to the STEPs Specialist Eating Disorder Service in AWP Mental Health Trust. The service provides assessment, community and inpatient treatment for people with clinical eating disorders across Avon (pop 1M). This post will be based on the 10 bedded inpatient Eating Disorder Unit. The type of work to expect and The post will provide experience in the care of learning opportunities patients suffering from eating disorders

The Foundation doctor will be ward based during the working day, providing the first line medical cover to the 10 inpatients on the Eating Disorders Unit. There is also the opportunity to have sessions off the EDU ward, to participate in assessments of patients newly referred to the eating disorders service, and in clinical activities elsewhere in the mental health service at Southmead.

The overall educational objectives are to provide the trainee with the knowledge, skills and attitudes to be able to:

 Take a history and examine patients with particular emphasis on mental state examination and the physical risks of low body weight  Manage clinical problems independently and seek advice where appropriate  Prescribe safely psychotropic and physical health drugs, and be aware of their side effects particularly in medically frail and unstable patients  Keep accurate and relevant medical records  Manage time and clinical priorities effectively  Communicate effectively with patients, relatives and colleagues  Practice evidence based medicine and use local guidelines in place for the treatment of adults in the mental health setting  Act in a professional manner at all times  Consider the ethical and legal issues with particular reference to the Mental Health Act and Mental Capacity Act  Teach medical students formally and informally  Work in a multi-disciplinary setting as part of a multidisciplinary team, with particular emphasis on the care planning approach  Gain experience and confidence in risk management, and gain confidence in making decisions associated with risk in the psychiatric settings, and associated with low body weight and its medical complications Where the placement is based STEPs Service, Clifton Building, Southmead Hospital, Bristol Clinical Supervisor(s) for the Dr Hugh Herzig, Consultant Psychiatrist in placement Eating Disorders Main duties of the placement The Foundation doctor will be responsible for admitting, clerking, reviewing and facilitating the discharge of EDU inpatients, and liaising closely with senior doctors and the ward nursing team where there are physical health concerns

Medical Care The Foundation doctor will gain experience in managing a small number of inpatients, a few of whom are likely to be medically unstable at any one time, with the support of senior medical colleagues and an experienced multidisciplinary team

The patients can present with particular medical needs resulting from emaciation and longstanding poor nutrition. They are at risk of acute metabolic complications through starvation and as they start treatment (such as Re-feeding Syndrome), and require careful medical monitoring according to ward protocols

The post holder will advise and support the nursing team in the physical care of patients, and seek advice from experienced colleagues (nursing as well as medical) who are always readily contactable

Guidance: there is limited capacity to care for medically unstable patients in mental health wards. Nursing staff are rarely general nurse trained, certain procedures such as iv infusion cannot be safely managed, and very frequent medical investigation and monitoring cannot be provided.

It is not the duty of the foundation doctor to provide care when such needs arise, but rather to seek advice from senior colleagues and if necessary assist in organising medical assessment and treatment. Developing Core Therapeutic Skills The Foundation Doctor will gain experience of working with patients who are frequently very distressed, highly anxious, and nearly always ambivalent about treatment and recovery. Alongside experienced colleagues they will gain expertise and confidence in containing these difficult emotions as they occur in their patients. There will be support and supervision on building therapeutic relationships with this difficult “hard to reach” client group. These are core skills for any empathic clinician in whatever branch of medicine they enter.

Participation in mental health assessments and psychological treatments This post offers many possibilities to take part in psychiatric assessment, when patients are newly referred to the community service, and on admission to the EDU. The doctor will have opportunities to observe and participate in psychological work, include therapy groups taking place on the EDU. These therapies include motivational, supportive, psychodynamic and educational groups. The doctor is likely to have opportunities to observe and participate in medical liaison in the management of extremely ill non-compliant patients, and consider the ethical, capacity and MHA considerations that such situations bring.

Working with different teams and health professionals, and seeking advice and support The STEPs Eating Disorder Service and Inpatient Unit are located together, in the Clifton Building. Experienced staff in the team (including Consultant, Associate Specialist, senior nurses, Higher Trainee and CT3) are on site, and support and advice on clinical matters is readily available. Also on the Southmead site are Psychiatry Higher and Core Trainees, GPVTS and Foundation trainees on Psychiatry placements, and the post holder would be part of a supportive group of trainee doctors. Consultant and Associate Specialist are experienced and enthusiastic trainers. The Foundation doctor will be expected to attend weekly supervision meetings

Assessment of Medically Ill Patients: Guidance for Foundation trainees.

As a Foundation doctor, you may be called on to assess patients who are medically unfit either in the psychiatry in-patient units or possibly in the community. It is important to be aware that psychiatric hospitals do not have facilities to support patients with serious physical health problems and you are not in a position working in these settings to facilitate urgent investigation, or initiate immediate and complex treatment such as IV support, catheterisation. In many respects the support available may even be less than in a standard community setting as there is a lack of access to GP level medical advice. In the event that a patient needs more immediate and complex physical assessment, it is advisable to discuss with a senior psychiatry colleague and it is generally necessary to have these individuals seen in the nearest A&E department. It would of course be helpful if a patient was referred, to discuss the case with the casualty team, while the transfer is being organised. This would normally require an ambulance, which the in-patient team would generally organise.

As a Foundation doctor working in psychiatry, you would not normally be expected to initiate complex physical treatments. If you are uncertain about appropriate physical care of an individual, you should always discuss this issue with a senior psychiatry colleague, who may be the local core/advanced trainee in your unit or your consultant or the consultant on-call. It may be useful to contact the specialist team in the general hospital for advice, but where a complex decision is being made this should always be shared with senior colleagues in the psychiatric team, who will be responsible for the treatment while the patient is in a psychiatric hospital. Note that discussion of the physical problems with a more senior psychiatric colleague is not generally to get expert medical advice (bearing in mind that as the psychiatric specialists become more senior their physical medicine skills tend to become out of date), but to bring the concerns to their attention so they can advise on the need to contact local acute medical/surgical services and how best to do this. Typical working pattern in this Ward based, with sessions spent in assessment placement and outpatient clinics.

Monday to Friday, 9am to 5pm.

On call is 1:9 for weekends and evenings - the on call finishes at 9.15 pm and is non-residential. There is additionally a week of waking night shifts, 1:18 weeks – followed by daytime off-duty - based at Colston Fort with the Crisis Team, covering all Bristol inpatient units. The F2 is the junior trainee, supported by a more senior trainee (CT1-2), an advanced trainee on occasion, and a consultant.

The F1 will need their own transport to be able to travel between Callington Road, Blackberry Hill, Southmead and Colston Fort during nights shifts. There are pool cars available to use during nights shifts but the driver must have held a driving license for more than 1 year to be able to utilise these.

Foundation training is on Tuesday pm at Southmead Hospital. Employer information Your employer will be North Bristol NHS Foundation Trust, seconded to Avon and Wiltshire Partnership (AWP) Mental Health NHS Trust

It is important to note that this description is a typical example of your placement and may be subject to change.

Severn Foundation School Individual Placement Description North Bristol NHS Trust

Placement F1 Renal Medicine The department The department of renal medicine comprises 12 consultant nephrologists, all of whom participate in a specialist renal on call service. Renal medicine is a tertiary referral specialty. The department provides renal services to Bristol, South Gloucestershire, Bath and North East Somerset and Wiltshire. In addition it provides transplantation for Dorset, Gloucester and North Devon. The department provides a comprehensive renal replacement therapy programme to approx 1500 patients comprised of 600 patients on dialysis and 880 renal transplant recipients. The department performs about 100 adult transplants a year. The type of work to expect and All F1 doctors in renal medicine are ward based learning opportunities during the normal working day and provide the daily medical care of all patients in the renal unit under their Firm. There are two Firms of consultants providing inpatient care. There are learning opportunities on the twice weekly consultant lead ward rounds, the X-ray meeting, in house renal tutorials, biopsy meetings and in the course of the job as there is a high level of support provided by the renal registrars. F1s will be involved in the care of patients with acute kidney injury, chronic dialysis patients, newly transplanted patients and acutely unwell immunosuppressed patients. There are no out of hours or on call duties, but during the day they may clerk in new admissions if they wish to do so. Where the placement is based The Richard Bright Renal Unit, Brunel building Southmead Hospital, Bristol, BS10 5NB Clinical Supervisor(s) for the Dr Chris Dudley placement Professor Steven Harper Dr Charlie Tomson Dr Fergus Caskey Dr Rommel Ravanan Dr Karen Anderson Dr Alison Armitage Dr Helen Campbell Dr Uday Udayaraj Dr Simon Satchell Dr Andrew Salmon Main duties of the placement Together with the registrar for the respective inpatient firm and 3 F2/CMT1/CMT2 level doctors the F1 is responsible for the ward care of patients and the maintenance of the patient’s medical record. As the F1 does not do out of hours work they play an important role in maintaining daily continuity of care. The F1 is also very important to the discharge process and liaison with the patients GPs. They are expected to attend the in house renal tutorials and attend the F1 teaching programme. Typical working pattern in this Daily placement 8.30 - 9 am handover from the night team. 9am board round. 9.30 onwards ward round

Monday Consultant ward round,1-2pm x-ray meeting Tuesday 12-1 renal tutorial, 1-2 renal biopsy meeting. Wednesday 10 am vascular ward round with surgeons. 12 noon multidisciplinary team meeting. Thursday Consultant wards round. Friday 8.45-10 am Grand Round Employer Information You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people

In addition the Trust is in the process of applying for Foundation Trust status.

It is important to note that this description is a typical example of your placement and may be subject to change.

Severn Foundation School Individual Placement Description North Bristol NHS Trust

Placement F1 Respiratory Medicine The department North Bristol Lung Centre, Respiratory Medicine The type of work to expect and The assessment and day to day management of learning opportunities patients with acute respiratory disorders. This includes over 30 different kinds of respiratory disorders ranging from COPD, asthma, pneumonia, lung cancer, pleural disease and alveolitis, through to managing acute respiratory failure with non-invasive ventilation, assessment of blood gases, and management of patients in the palliative/terminal stages of chronic respiratory disease. Where the placement is based Brunel building, Southmead Hospital Clinical Supervisor(s) for the One of the seven respiratory consultants at placement North Bristol Lung Centre who will be allocated by the specialty training lead (currently Dr Andrew Medford). Main duties of the placement Clerking and day to day assessment of patient’s progress with up to date neatly written entries in the notes detailing the patient’s progress and future intended plans and investigations. Liaison with senior members of the team, specifically the specialist registrar and consultant, specialist physiotherapist, dietician, pharmacist, occupational therapist, senior nurses, and palliative care team. There will be daily ward rounds; twice a week from the consultant, once a week from the specialist registrar, and otherwise with more senior trainees. Typical working pattern in this Daily ward round to assess patient’s progress placement and keep the patient’s notes up to date with details of their progress and any important results and future plans. Employer Information You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people

In addition the Trust is in the process of applying for Foundation Trust status.

It is important to note that this description is a typical example of your placement and may be subject to change.

Severn Foundation School Individual Placement Description North Bristol NHS Trust

Placement F1 Short Stay Medicine The department Short Stay Medicine is closely allied to the Department of Acute Medicine which has 6 consultants. The type of work to expect and As the F1 in Short Stay Medicine, you will be learning opportunities expected to work with a CMT trainee to deliver the daily medical care. There will be times when the CMT trainee is on call, nights or leave. However other senior support should always be readily available, either from the Acute Medicine consultants and registrars (or from the admitting consultants’ teams.  Patients under Acute Medicine will have daily consultant ward rounds providing plenty of learning opportunities.  You will also have the opportunity to conduct ward rounds on your own with senior support available as necessary.  Much of your time will be spent liaising with other specialties, including radiology, to ensure that each patient’s care is managed smoothly.  Sometimes there is a rapid turnover of patients. There are ample opportunities therefore to develop skills in safe and efficient handover, particularly with regards to discharge documentation.  From time to time you will have the opportunity to assess and manage acutely unwell patients on the ward under appropriate supervision Where the placement is based Brunel building, Southmead Hospital, Bristol Clinical Supervisor(s) for the Drs Sam Patel/ John Ho/ Kiaran Flanagan/ placement Madhu Wickremaratchi/ Ishita Dasgupta & Louise Powter Main duties of the placement  To ensure the safe clinical management of each patient under your care (with senior support)  To carry out jobs from the ward round and liaise with other specialties (including radiology) as necessary  To ensure discharge documentation is complete and accurate  To review patients when asked to by nursing staff

 To ensure that your documentation in the medical notes is thorough, accurate and legible Typical working pattern in this Mon – Fri 09:00 to 17:00 placement Employer Information You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people

In addition the Trust is in the process of applying for Foundation Trust status.

Please note: posts are subject to change due to potential reconfiguration of services and departmental moves.

Severn Foundation School Individual Placement Description North Bristol NHS Trust

Placement F1 Acute Stroke Medicine The department Wards in the Brunel Building will have acute stroke beds.

Patients with a diagnosis of stroke (cerebral infarction, Haemorrhage or TIA are admitted to the wards directly from ED. If due to bed pressures patients are on a different ward they are still looked after by this team. All patients who have had thrombolysis will be admitted to the Hospital and after 24 hours transferred to the Neurology/Stroke wards if not admitted there directly. Supervised experience of seeing in patients in will be available

There will also be some other Neurology patients on the wards. These patients remain under the admitting Neurology / Medical consultant. The type of work to expect and Board rounds – Mon- Fri at 9.00- 9.15. Quick learning opportunities catch up of current issues and new (subject to change) admissions working closely with nursing and professions allied to medicine.

Opportunities for skills training such a lumbar puncture, iv, ia puncture. Management of stroke related complications Multi-Disciplinary Meeting (MDM) ~Every Week

The details of discussions are noted down on the yellow sheets in section 4 of the notes.

A representative from all teams tries to be present so that all aspects of each patients care can be discussed. Action plans, discharge planning and estimated discharge dates (EDD) are agreed for each patient. The MDM is chaired by the consultant, registrar or senior nurse depending on availability. All ward staff present help with documentation in the MDM to maintain speed and efficiency

Progress Meetings Patients with potentially complex discharge plans may require a progress meeting, so that the team can discuss with the patient, family and other carers the progress the patient has made so far, and set goals towards discharge planning. It is important to have the 1st meeting within 2 weeks of admission to hospital. You may be asked to give an overview of the patient’s medical condition and prognosis. Patients and their relatives may also approach you at separate times to discuss issues. The consultants are all happy to discuss with relatives if necessary, particularly for those who have a poorer prognosis - please organise this through the secretaries. Supervised training in generic skills e.g. Breaking bad news. Prescribing and drugs management. Care planning meetings Led by the social worker to plan placement/ packages of care. Discharges Patients TTAs need to be written and in pharmacy ideally in the morning but at very latest by 3pm on the day of (or prior to if appropriate) to discharge. Compliance aids (Dossett boxes etc) require at least 24 hours notice.

It is important to ensure that secondary prevention is addressed as an inpatient, and patients are medically ready for discharge (investigations done, warfarin etc) in line with the expected discharge date.

We do not provide routine follow up - only those with outstanding medical issues. All other patients should be directed to their GP. It is important that the discharge summary is explicit in any follow up requirements. Most Stroke inpatients will require therapy input (OT, PT, SLT etc) prior to discharge. Please check the notes for therapy discharge plans.

The Multi-Disciplinary Team (MDT) One of the key points to remember on the unit is that we function as a team. You may frequently find that the therapists who work closely with the patients are often the best source of information about progress etc and can help your management of the patient. Equally, they may come to you for advice as to the best way to manage a patient. It is especially important to remember that patients may not be fit for discharge just because all their medical problems have been addressed. The team comes to a consensus on issues such as these, which are discussed regularly at the multidisciplinary meeting (MDM).

Foundation doctors weekly teaching/training session. Neuro/Stroke X ray meeting weekly Wednesday. Stroke specific training (Friday 12.30 followed by stroke MDM. Where the placement is based Wards in Brunel Building, Southmead Hospital Clinical Supervisor(s) for the The Consultants in Neurology and Stroke are Dr placement Justin Pearson, Dr Rose Bosnell, & Dr James Stevens and Dr Phil Clatworthy. These Consultants are an essential part of the work in Stroke and Neurology at NBT and will continue to make a major contribution to the patient diagnosis, investigation, treatment, clinical care and clinical management of patients. They will also continue to be a major part of learning, teaching and medical experience of Foundation Trainees. Dr Ian Ormerod is C/S for Foundation Trainees Main duties of the placement Patient care Medical notes entries Arranging appropriate investigations Managing acute ischaemic stroke including role of thrombolysis Management if ICH Managing complications of acute stroke Stroke secondary prevention Care of the elderly issues On call duties Joint meetings Involvement in communication with patients, their families, other doctors, members of the health care team Typical working pattern in this Normal daytime ward cover 9am – 5pm placement Partial shift and general medical on call Employer Information You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people

In addition the Trust is in the process of applying for Foundation Trust status.

It is important to note that this description is a typical example of your placement and may be subject to change.

Severn Foundation School Individual Placement Description North Bristol NHS Trust

Placement F1 Trauma and Orthopaedics The department The Department of Orthopaedics and Trauma Surgery comprises 13 Consultants on the Acute Trauma on call rota (in team based working A-D = Mon –Thurs) and 2 additional Consultant Spinal Surgeons. The department provides the regional pelvic fracture and acetabular reconstruction service as well as complex tertiary referral spinal surgery. All adult and paediatric trauma pathologies are encountered and consultant sub-specialist interests also include shoulder & elbow, hip, knee and foot & ankle. There are consultant led fracture clinics & all day trauma operating lists 364 days per year as well as trauma day case lists 3 days per week and follow-up fracture clinics mon-thurs. The department works closely with our affiliated Ortho-Geriatricians and the Plastics Surgery and Neurosurgery departments. There is a well established trauma research team who are busy coordinating numerous research projects and overseeing audit activity. There is a trauma coordinator and specialist hip fracture and spinal surgery nurses. The type of work to expect and All F1 Doctors in hospital posts will generally be learning opportunities ward based during the ‘normal’ working day and expected to deliver the daily medical care of all the patients on their ward irrespective of specialty. Whilst in the T&O Surgery attachment the F1 will be involved with the generic clerking of patients being admitted and the ongoing care of the patients in the unit.

The overall educational objectives of the F1 year are to provide the trainee with the knowledge, skills and attitudes to be able to  Take a history and examine a patient  Identify and synthesise problems  Prescribe safely  Keep an accurate and relevant medical record  Manage time and clinical priorities effectively  Communicate effectively with patients, relatives and colleagues  Use evidence, guidelines and audit to benefit patient care  Act in a professional manner at all times  Cope with ethical and legal issues which occur during the management of patients with general medical problems  Educate patients effectively  Become life-long learners and teachers. Where the placement is based Brunel building, Southmead Hospital, Bristol Clinical Supervisor(s) for the Mr IN Packham; Mr JCJ Webb; Mr SJ Eastaugh- placement Waring; Mr TJ Chesser; Mr IW Nelson Main duties of the placement Each F1 doctor will be attached to a team (Trauma A-D or Spines) which comprises 3 or 4 consultants who attend on their trauma day and a specialist registrar and 1 or 2 SHO’s (Core Trainee, Clinical Fellow or F2) who are permanently in the department. They will be involved in the day-to-day ward care of patients and the contemporaneous medical note keeping during daily business ward rounds and weekly consultant ward rounds (especially post-take). They will join the Consultant Ortho-Geriatricians on their weekly ward-rounds and liaise with the specialist nurses as required. Whilst on call the F1 doctor will work closely with the SHO and SpR in assessing, admitting and managing acute cases presenting to the Emergency Department or Fracture Clinic. They will have the opportunity to shadow a consultant or registrar in new & follow up fracture clinics and they are strongly encouraged to attend either the main trauma list or day case list to assist a wide variety of cases and be taught some basic surgical skills such as suturing, metalwork removal, insertion of a screw or fixation of a fracture. Each F1 should arrange a session with the technicians in the Plaster Room and they will have the opportunity to partake in or undertake an Audit project the results of which they will present to the Department. They will be expected to present their team’s M&M data at the end of their 4 month attachment. They are expected to attend the structured teaching programme provided by the department and the Trust. The doctor will be responsible for such other specific clinical duties as allocated by consultants including performing other duties in occasional emergencies and unforeseen circumstances. Typical working pattern in this * placement Daily: 0800 daily trauma xray meeting *subject to change in the new 0900 ward round hospital building 1200/1700/2000 Handover On call 1 in 5 Mon: Am fracture clinic Pm ward work Tues: 1300-1400 F1 formal teaching Weds: Am ward work Pm main theatre Thurs: Am Day case theatre Pm ward work Fri: 0800-0900 weekly departmental teaching/clinical governance meeting 1000 Orthogeriatric ward round Employer Information You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people

In addition the Trust is in the process of applying for Foundation Trust status.

It is important to note that this description is a typical example of your placement and may be subject to change.

Severn Foundation School Individual Placement Description North Bristol NHS Trust

Placement F2 Anaesthetics/ITU The department Southmead Hospital, North Bristol NHS Trust The type of work to expect and Care of critically ill patients. Assessing and learning opportunities stabilising critically ill patients on the ward and managing their care on the intensive care unit. Where the placement is based Brunel Building, Southmead Hospital Clinical Supervisor(s) for the Dr Jasmeet Soar – Southmead placement Dr Ian Thomas – Frenchay Main duties of the placement The F2 is an integral member of the ICU team. They take an active role in the ward round, examining patients, completing the ICU paperwork and understanding the management plans for the day. They perform the ward work duties such as ordering investigations and ensuring the results are followed up and written in the notes. They carry the cardiac arrest bleep and attend cardiac arrests supported, whenever possible, by the anaesthetic registrar. They review critically ill patients on the ward and learn about appropriateness of admission to ICU, stabilisation and transportation of critically ill patients. They have the opportunity to gain experience in practical procedures such as insertion of invasive monitoring lines, vas caths and airway management, both on the ICU and in theatres. During their time on ICU they will learn about the principles of organ monitoring and organ support. They will attend daily microbiology rounds, weekly radiology meetings and weekly formal ICU teaching. Typical working pattern in this They work a full shift system under the close placement supervision of the ICU consultant. They will be expected to attend foundation teaching, ICU teaching and will be supervised by their Clinical Supervisor. Employer Information You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people

In addition the Trust is in the process of applying for Foundation Trust status.

It is important to note that this description is a typical example of your placement and may be subject to change.

Severn Foundation School Individual Placement Description North Bristol NHS Trust

Placement F2 Cardiology The department The department of cardiology has 6 Consultant Cardiologists. There is a catheter laboratory where diagnostic angiography, angioplasty and pacing procedures are carried out. We have a cardiac investigations unit for non-invasive tests such as echocardiography, ECG monitoring and exercise stress testing. The type of work to expect and All Foundation Doctors in hospital posts will learning opportunities generally be ward based during the ‘normal’ working day and expected to deliver the daily medical care of all the patients on their ward irrespective of specialty. Whilst on-call in the acute admissions unit, the F2 will be involved with the ongoing care of the patients in the unit.

The overall educational objectives of the F2 year are to provide the trainee with the knowledge, skills and attitudes to be able to  Take a history and examine a patient  Formulate a differential diagnosis  Prescribe safely  Keep an accurate and relevant medical record  Manage time and clinical priorities effectively  Communicate effectively with patients, relatives and colleagues  Use evidence, guidelines and audit to benefit patient care  Act in a professional manner at all times  Cope with ethical and legal issues which occur during the management of patients with general medical problems  Educate patients effectively  Become life-long learners and teachers. Where the placement is based Brunel building, Southmead Hospital, Bristol Clinical Supervisor(s) for the Dr Shahid Aziz, Dr Andrew Skyrme Jones, placement Dr Paul Walker, Dr Phil Boreham, Dr Ben Farrow and Dr Mark Papouchado. Main duties of the placement The F2 doctor is responsible with other staff for the ward care of patients and the maintenance of the patient’s medical record. They are expected to attend the structured teaching programmes provided by the department and grand rounds. Typical working pattern in this Mainly ward based from 9am-5pm, apart from placement on-call duties. Employer Information You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people

In addition the Trust is in the process of applying for Foundation Trust status.

It is important to note that this description is a typical example of your placement and may be subject to change.

Severn Foundation School Individual Placement Description North Bristol NHS Trust

Placement F2 Emergency Medicine The department Emergency Department The type of work to expect and Seeing undifferentiated emergency patients. learning opportunities Aiming to assess, stabilize and institute emergency treatment for these patients. Ability to see a wide variety of acute problems and insititute management plans under direct supervision of the shop floor consultant or registrar. Where the placement is based Brunel Emergency Department Clinical Supervisor(s) for the Dr Joydeep Grover placement Main duties of the placement Work on the shop floor seeing new patients, instituting a management plan, organizing investigations. Performing any practical procedures needed. Referring or discharging as appropriate. Typical working pattern in this Full Shift rota. Typical shifts are 08:00-18:00, placement 14:00-00:00, 22:00- 08:00 Employer Information You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people

In addition the Trust is in the process of applying for Foundation Trust status.

It is important to note that this description is a typical example of your placement and may be subject to change.

Severn Foundation School Individual Placement Description North Bristol NHS Trust

Placement F2 Elective, Trauma & Orthopaedics The department The Department of Orthopaedic Surgery comprises 30 Consultants the majority of whom are North Bristol NHS Trust based but also consultants based at the Bristol Royal Infirmary who have their elective operating lists and preoperative assessment clinics at the Avon Orthopaeic Centre. Consultant sub-specialist interests include young adult/ adolescent, hands, shoulder & elbow, spine, hip, knee and foot & ankle. There are consultant led pre-operative assessment clinics and all day operating lists in 5 operating theatres as well as elective orthopaedic outpatient clinics every day of the week. The department works closely with the affiliated physiotherapy & occupational therapy departments. There is a well established University research team (Bristol Implant Research Centre) who are busy coordinating numerous research projects and specialist nurses overseeing audit activity.

13 Consultants on the Acute Trauma on call rota (in team based working A-D = Mon –Thurs) and 2 additional Consultant Spinal Surgeons. The department provides the regional pelvic fracture and acetabular reconstruction service as well as complex tertiary referral spinal surgery. All adult and paediatric trauma pathologies are encountered and consultant sub-specialist interests also include shoulder & elbow, hip, knee and foot & ankle. There are consultant led fracture clinics & all day trauma operating lists 364 days per year as well as trauma day case lists 3 days per week and follow-up fracture clinics mon-thurs. The department works closely with our affiliated Ortho-Geriatricians and the Plastics Surgery and Neurosurgery departments. There is a well established trauma research team who are busy coordinating numerous research projects and overseeing audit activity. There is a trauma coordinator and specialist hip fracture and spinal surgery nurses. The type of work to expect and F2 Doctors in this department will generally be learning opportunities split between ward based work and introduction to outpatient clinic and operating theatre work during the ‘normal’ working day and expected to supervise F1’s and help deliver the daily medical care of the inpatients.

Whilst in the Orthopaedic Surgery attachment the F2 will be involved with the generic clerking of patients being admitted and the ongoing care of the patients in the unit.

The overall educational objectives of the F2 year are to provide the trainee with the knowledge, skills and attitudes to be able to  Take a history and examine a patient  Identify and synthesise problems  Prescribe safely  Keep an accurate and relevant medical record  Manage time and clinical priorities effectively  Communicate effectively with patients, relatives and colleagues  Use evidence, guidelines and audit to benefit patient care  Act in a professional manner at all times  Cope with ethical and legal issues which occur during the management of patients with general medical problems  Educate patients effectively  Become life-long learners and teachers Where the placement is based Brunel building, Southmead Hospital, Bristol Clinical Supervisor(s) for the Elective - Mr IN Packham, 2 BRI consultants placement TBC Trauma & Ortho - Mr JCJ Webb, Mr TJ Chesser & Mr M Katsimihas Main duties of the placement Elective - Each F2 doctor will be attached to 2 or 3 consultants who attend the AOC on their preop assessment and operating days. Each consultant has a registrar +/- fellow who are permanently in the department and may work for 1 or 2 consultants. The F2 will be involved in the day-to-day ward care of patients and the contemporaneous medical note keeping during daily business ward rounds and weekly consultant ward rounds. Whilst on call the F2 doctor will cover the wards and refer up to the on call registrar or liaise with medical colleagues as required. They will rotate through weeks of night shifts during which time they will be part of the Hospital at Night team. They will have the opportunity to shadow a consultant or registrar in new & follow up outpatient clinics and they are expected to attend the main operating list or day case list to assist a wide variety of cases and be taught some basic surgical skills such as carpal tunnel decompression, soft tissue handling, suturing and basic arthroscopic skills. Each F2 will rotate with their ‘SHO’ colleagues in covering the Nurse-led Pre-operative Assessment Clinic and Ward-based cover. When covering trauma & Orthopaedics each F2 doctor will be attached to a team (Trauma A-D or Spines) which comprises 3 or 4 consultants who attend on their trauma day and a specialist registrar, 1 or 2 SHO’s (Core Trainee, Clinical Fellow or F2) and an F1 who are permanently in the department. They will supervise the F1 doctors and liaise with the specialist nurses as required. Whilst on call the F2 doctor will work closely with SpR in assessing, admitting and managing acute cases presenting to the Emergency Department or Fracture Clinic. They will have the opportunity to shadow a consultant or registrar in new & follow up fracture clinics and they are strongly encouraged to attend either the main trauma list or day case list to assist a wide variety of cases and be taught some basic surgical skills such as suturing, metalwork removal, insertion of a screw or fixation of a fracture. Each F2 should arrange a session with the technicians in the Plaster Room.

Whether it be an elective or a trauma and orthopaeidc attachment, they will have the opportunity to partake in or undertake an Audit project the results of which they will present to the Department. They are expected to attend the structured teaching programme provided by the department and the Trust. The doctor will be responsible for such other specific clinical duties as allocated by consultants including performing other duties in occasional emergencies and unforeseen circumstances. Typical working pattern in this * placement Elective – *subject to change in new Daily: 0800 daily business ward round hospital building 1200/1700/2100 Handover On call 1 in 10 Mon: Am theatre Pm ward work/ outpt clinic Tues: Am Preop clinic Weds: All Day theatre Thurs: Am theatre Pm ward work Fri: 1230-1330 weekly departmental teaching 1415-1700 optional Regional Postgraduate training programme

Trauma & Ortho – Daily: 0800 daily trauma xray meeting 0900 ward round 1200/1700/2000 Handover On call 1 in 7 Mon: Am day case theatre Pm ward work Tues: Am ward work Pm fracture clinic Weds: Am day case theatre Thurs: Fri: 0800-0900 weekly departmental teaching/clinical governance meeting

There will also be formal F2 teaching to attend. Employer Information You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people

In addition the Trust is in the process of applying for Foundation Trust status.

It is important to note that this description is a typical example of your placement and may be subject to change.

Severn Foundation School Individual Placement Description North Bristol NHS Trust

Placement F2 Gastroenterology and General Internal Medicine The department The Dept of Gastroenterology comprises 6 Consultant Gastroenterologists who all do acute General Internal Medicine (GIM) on-call. There are interests in Inflammatory bowel disease, advanced nutrition, small bowel, obscure GI bleeding & hepatobiliary. All general gastroenterology and general internal medicine (except stroke) is represented. The department serves the local population of Bristol, South Gloucestershire and North Somerset. The type of work to expect and The F2 Doctor will be ward based during the learning opportunities ‘normal’ working day and expected to deliver the daily medical care of all the patients on their ward. Whilst on call for GIM the F2 will be involved with the generic clerking of patients being admitted, presentation to the on call consultant, initiation of their investigations & management and hand over to the next on call or ward based team. The overall educational objectives of the F2 year are to provide the trainee with the knowledge, skills and attitudes to be able to  Take a history and examine a patient  Identify and synthesise problems  Recognise & manage acutely ill patients  Contribute to the cardiac arrest team & get involved with DNAR decisions  Perform practical procedures including ascitic taps/drains  Prescribe safely  Keep an accurate and relevant medical record  Manage time and clinical priorities effectively  Communicate effectively with patients, relatives and colleagues  Use evidence, guidelines and audit to benefit patient care  Act in a professional manner at all times  Cope with ethical and legal issues which occur during the management of patients with general medical problems  Educate patients effectively  Become life-long learners and teachers. Where the placement is based Wards in Brunel building, Southmead Hospital, Bristol Clinical Supervisor(s) for the Dr Peter Marden, Dr Melanie Lockett, Dr Ana placement Terlevich. Main duties of the placement The F2 doctor is responsible with other staff for the ward care of patients and the maintenance of the patient’s medical record. They are expected to attend the teaching programmes provided by the Trust and department. The doctor will be responsible for such other specific clinical duties as allocated by consultants including performing other duties in occasional emergencies and unforeseen circumstances. Typical working pattern in this * placement Daily: Ward round *subject to change in new 1700 Handover hospital building Mon: 1315 Grand round Tues: 10.30 Ward MDM 1300 GI x-ray meeting Wed 1400 Gastro clinic Thurs: 1300 GIM journal club Fri: 0800 Departmental teaching 12.45 Gastro histol meeting/journal club 1300 F2 teaching programme

On call requirements: 1 in 7 days and 1 in 10.5 nights Employer Information You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people

In addition the Trust is in the process of applying for Foundation Trust status.

It is important to note that this description is a typical example of your placement and may be subject to change.

Severn Foundation School Individual Placement Description North Bristol NHS Trust

Placement F2 Care of the Elderly/General (Internal) Medicine The department The Department of Medicine for the Elderly in North Bristol Trust is largely based in specialty specific wards in the Brunel building at Southmead. All consultants work as General Physicians and Geriatricians, and each has an area of special expertise eg. Parkinson’s disease, bone health & orthogeriatrics, falls, respiratory disease, dementia, interface etc. The type of work to expect and All F2 Doctors in hospital posts will be ward learning opportunities based during the normal working day and expected to deliver the daily medical care of all the patients on their ward irrespective of specialty. Whilst in the AAU (on call block of shifts) the F2 will be involved with the clerking of undifferentiated medical patients being admitted. During ward cover out of hours they will be responsible for the ongoing care of medical inpatients.

The overall educational objectives of the F2 year are to provide the trainee with the knowledge, skills and attitudes to be able to

In addition, trainees in the department will develop skills in:  The diagnosis and management of delirium in older people  The diagnosis and management of dementias  The recognition of non specific presentations of acute conditions in older people  The management of hospital acquired infections on older people, and the consequences of prolonged hospital stays  Assessment of capacity, deprivation of liberty safeguards, enduring power of attorney, and the Court of Protection.  Multidisciplinary team working  Early Discharge planning  Palliation for terminal illnesses in old age, and advanced care planning at the end of life. Where the placement is based Medical wards Southmead hospital, NBT Clinical Supervisor(s) for the Drs. R D Barber placement KA Neubauer JC Pounsford S Srivastava SK Wensley J Richards S McCracken K Rainey Main duties of the placement The F2 doctor will be responsible with other staff for the ward care of patients and the maintenance of the patient’s medical records, including drug charts and Discharge information. They will have opportunity to work with the consultants on Ward rounds at least twice weekly, and also take responsibility for problems arising in patients on the ward. They are expected to attend the structured teaching programmes provided by the department and the Directorate/ Academy/ learning centre. The doctor will be responsible for such other specific clinical duties as allocated by consultants including performing other duties in occasional emergencies and unforeseen circumstances. Typical working pattern in this Daily: 0900 Ward ‘Board’ round placement 09.30 – 17.00 Ward work/ rounds 1700 Handover

Mon: am consultant Ward Round pm Ward work Tues: am ward work 1400-1600 MDM Wed: am ward work pm SpR Ward Round Thurs: am Consultant ward round pm Ward work Fri: am ward work pm weekend plans Sat: On call shifts as rostered Sun: On call shifts as rostered

On call requirements: 48 hr.EWTD compliant shift rota over 9 week cycle Employer Information You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people

In addition the Trust is in the process of applying for Foundation Trust status.

It is important to note that this description is a typical example of your placement and may be subject to change.

Severn Foundation School Individual Placement Description North Bristol NHS Trust

Placement F2 GI Surgery The department The Dept of general surgery comprises 19 consultant surgeons including 4 upper GI surgeons; the upper GI surgeons take in part in the acute general surgery on-call. There are interests in benign upper GI, gallstones surgery, anti-reflux surgery and bariatric surgery. The department covers part of Bristol, North Somerset and South Gloucestershire with a catchment population of 500,000. The type of work to expect and F2 Doctors in hospital posts will generally be learning opportunities team based during the ‘normal’ working day and expected to deliver the daily medical care of all surgical patients irrespective of specialty. Whilst on-call the F2 will be involved with the generic clerking of surgery & urology & orthopaedic patients being admitted and the ongoing care of the patients in the unit.

Mon: 0800 - 1700 theatre 1300– 1700 endoscopy Tues: 0830–1230 outpatient clinic 0830–1230 Day case theatres 0800 – 1700 theatre Wed: 0800 –1700 theatre Thurs: 0830–1230 endoscopy 0830–1230 outpatient clinic 0800 – 1700 theatre Fri: 0800 –1230 theatre Sat: 0800 – 2100 1 in 17 Sun: 0800 – 2100 1 in 17

On call requirements: Full shift 1:8 nights and long days and 1:17 short day. Employer Information You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people

In addition the Trust is in the process of applying for Foundation Trust status.

It is important to note that this description is a typical example of your placement and may be subject to change.

Severn Foundation School Individual Placement Description North Bristol NHS Trust

Placement F2 Colorectal Surgery The department The Dept of general surgery comprises 19 consultant surgeons including 6 Colorectal surgeons, All colorectal consultants take in part in the acute General surgery on-call. There are interests in benign and malignant colorectal diseases, colorectal laparoscopic surgery, inflammatory bowel disease and pelvic floor surgery. The department covers part of Bristol, North Somerset and South Gloucestershire with a catchment population of 500,000. The type of work to expect and F2 Doctors in hospital posts will generally be learning opportunities team based during the ‘normal’ working day and expected to deliver the daily medical care of all surgical patients irrespective of specialty. Whilst on-call the F2 will be involved with the generic clerking of surgery & urology & orthopaedic patients being admitted and the ongoing care of the patients in the unit.

The overall educational objectives of the F2 year are to provide the trainee with the knowledge, skills and attitudes to be able to  Take a history and examine a patient  Identify and synthesise problems  Prescribe safely  Keep an accurate and relevant medical record  Manage time and clinical priorities effectively  Communicate effectively with patients, relatives and colleagues  Use evidence, guidelines and audit to benefit patient care  Act in a professional manner at all times  Cope with ethical and legal issues which occur during the management of patients with general medical problems  Educate patients effectively  Become life-long learners and teachers Where the placement is based Brunel building, Southmead Hospital, Bristol Clinical Supervisor(s) for the Mr A Roe, Miss A Lyons, Miss A Pullyblank, Mr placement A Dixon, Miss C Burt, Miss K McCarthy. Main duties of the placement The F2 doctor is responsible with other staff for the team care of patients and the maintenance of the patient’s medical record. They will have opportunity to work with the consultants in theatres and outpatients clinics, and also take responsibility for problems arising in surgical patients on the ward. They are expected to attend the teaching program provided by the department. The doctor will be responsible for such other specific clinical duties as allocated by consultants including performing other duties in occasional emergencies and unforeseen circumstances. Typical working pattern in this * placement Daily: 0800 Ward round *subject to change in new 1700/2100 Handover hospital The colorectal team runs a weekly team palming meeting, this is to cover elective work in the unit and it includes: Mon: 0830 – 1230 Day case theatres 0830 – 1230 endoscopy 0800 - 1700 theatre 1330 – 1700 outpatient clinic Cossham Tues: 0800 - 1700 theatres 1330 – 1700 endoscopy Wed: 0800 - 1700 theatre 0800 – 1700 theatre 1:4 0830 – 1230 endoscopy 0830 – 1230 endoscopy 0830 – 1230 Day case 1330 – 1700 clinic Thurs: 0800 - 1700 theatre 0830 – 1230 endoscopy 0830 – 1230 day case 1330 -1700 outpatient clinic 1330 -1700 outpatient clinic 1330 -1700 endoscopy Fri: 0800 - 1700 theatres 0800 – 1230 outpatient clinic Sat: 0800 – 2100 1 in 17 Sun: 0800 – 2100 1 in 17

In addition the Trust is in the process of applying for Foundation Trust status.

It is important to note that this description is a typical example of your placement and may be subject to change.

Severn Foundation School Individual Placement Description North Bristol NHS Trust

Placement F2 Vascular Surgery The department The Dept of general surgery comprises 19 consultant surgeons including 4 vascular surgeons, the vascular surgeons take in part in the acute city wide vascular surgery on-call also they contribute to the renal transplant on-call. There are interests in endovascular surgery, living kidney donor transplant, and vascular access surgery. The department covers part of Bristol, North Somerset and South Gloucestershire with a catchment population of 700,000. The catchment area for renal transplantation is 2,000,000. The type of work to expect and F2 Doctors in hospital posts will generally be learning opportunities team based during the ‘normal’ working day and expected to deliver the daily medical care of all surgical patients irrespective of specialty. Whilst on-call the F2 will be involved with the generic clerking of surgery & urology & orthopaedic patients being admitted and the ongoing care of the patients in the unit.

The overall educational objectives of the F2 year are to provide the trainee with the knowledge, skills and attitudes to be able to  Take a history and examine a patient  Identify and synthesise problems  Prescribe safely  Keep an accurate and relevant medical record  Manage time and clinical priorities effectively  Communicate effectively with patients, relatives and colleagues  Use evidence, guidelines and audit to benefit patient care  Act in a professional manner at all times  Cope with ethical and legal issues which occur during the management of patients with general medical problems  Educate patients effectively  Become life-long learners and teachers. Where the placement is based Wards in Brunel building, Southmead Hospital, Bristol Clinical Supervisor(s) for the Mr D Mitchell, Mr A Baker, Mr W Neary and placement Mr A Weale. Main duties of the placement The F2 doctor is responsible with other staff for the team care of patients and the maintenance of the patient’s medical record. They will have opportunity to work with the consultants in theatres and outpatients clinics, and also take responsibility for problems arising in surgical patients on the ward. They are expected to attend the teaching program provided by the department. The doctor will be responsible for such other specific clinical duties as allocated by consultants including performing other duties in occasional emergencies and unforeseen circumstances. Typical working pattern in this * placement Daily: 0800 Ward round *subject to change in new 1700/2100 Handover hospital building The vascular team runs a weekly team palming meeting, this is to cover elective work in the unit and it includes: Mon: 0800 – 1700 theatre Tues: 0800 - 1700 theatre 1:2 0800 – 1230 day case theatre 1400 – 1700 outpatient clinic Wed: 0830 Xray meeting 0900 vascular ward round 0900 outpatient clinic 1330 – 1700 theatre Thurs: 0800 – 1700 theatre 0800 - 1330 days case theatre Fri: 0800 – 1700 theatre 1:2 Sat: 0900 – 2100 2:18 Sun: 0900 – 2100 2:18 On call requirements: Full shift 2:18 nights and long days Employer Information You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people

In addition the Trust is in the process of applying for Foundation Trust status.

It is important to note that this description is a typical example of your placement and may be subject to change.

Severn Foundation School Individual Placement Description North Bristol NHS Trust

Placement F2 General Practice The department Primary Care The type of work to expect and The GP is the first point of contact for most learning opportunities medical services. Most work is carried out during consultations in the surgery and some during home visits. GPs and their GP F2s provide a complete spectrum of care within the local community. You will need to deal with problems that often combine physical, psychological and social components. You will work in teams with other professions, helping patients to take responsibility for their own health. In your GP attachment, you will build on your knowledge of medical conditions, your ability to assess a problem, and your skills in deciding on the appropriate course of action. You will learn how and when to intervene, through treatment, prevention and education, to promote the health of your patients and families. The wide mix of General Practice is one of the major attractions. There can be huge variation in the needs of individual patients during a single surgery. Where the placement is based GP training practices in the Severn area. Clinical Supervisor(s) for the Each GP F2 will be in an approved teaching placement practice, where your supervisor will be an accredited GP Trainer or GP Clinical Supervisor. Main duties of the placement Your duties will include: - seeing patients in surgeries - responding to health problems presented by patients, including history-taking, investigation, diagnosis, and management - practicing preventative medicine - promoting health education - working closely with other health professionals - helping with repeat prescriptions and other administrative aspects of day-to-day patient care - helping the practice meet targets - managing resources as effectively as possible - maintaining confidentiality and impartiality - using basic IT skills and using the practice's clinical IT system - attending the practice's clinical meetings - you may also be asked to make domiciliary visits, if your GP Supervisor feels this is appropriate Typical working pattern in this Morning surgery: followed by discussion patients placement seen with Supervisor. Lunchtime: administrative work. Early afternoon: clinical meetings, domiciliary visits. Afternoon/early evening: surgery.

There will be a weekly tutorial lasting at least an hour.

This pattern varies from practice to practice. Practices may ask you to work the same pattern that most GPs do, with longer working days but time off in lieu.

On call requirements: While it may be in your contract to do on-call hospital work during your GP attachment, there will be no GP on-call requirements. Employer Information Your employer will be your acute Trust, not the GP practice.

Your employer will be North Bristol NHS Trust.

It is important to note that this description is a typical example of your placement and may be subject to change.

Severn Foundation School Individual Placement Description North Bristol NHS Trust

Placement F2 Neurology The department The Neuroscience department at NBT is a regional centre for neurology with inpatient and outpatient work. There are a number of aspects of specialist neurology in the department including neuro-inflammatory disease, multiple sclerosis, stroke, epilepsy, movement disorders, Parkinson’s disease, dementia and cognitive impairment, neuro-ophthalmology, motor neurone disease The type of work to expect and  Admission and care of patients on wards learning opportunities  Ward rounds  Attend outpatient clinics  Weekly Regional Neuroscience academic meetings.  Neuroradiology meetings.  Teaching programme for Trainees

When on call, neurology F2’s also cover the inpatient neurosurgery service.

The overall educational objectives of the F2 year are to:  Provide the trainee with the knowledge, skills and attitudes to be able to elicit a history and undertake a comprehensive examination of the neurology patient  Identify and synthesize neurosurgical and neurological problems  Prescribe safely  Keep an accurate, contemporaneous and relevant medical record  Manage time and clinical priorities effectively  Communicate effectively with patients, relatives and colleagues  Use evidence, guidelines and audit to benefit patient care  Act in a professional manner at all times  Educate patients effectively on general medical issues

F2 doctors will also have the opportunity to learn ward-based neurology procedures, including lumbar puncture and visual fields. They are extensively exposed to neuroradiology, and will have the opportunity to start to learn to interpret cranial and spinal CT and MR images. They are encouraged to undertake audits and participate in research. Where the placement is based Southmead Hospital (NBT) Neurology inpatients are mainly on Neurology wards in the new Brunel building Clinical Supervisor(s) for the The Consultant Neurologists at NBT are an placement essential part of the Neurology service. For the Foundation Trainees these Consultants will continue to be a major part of the Training, Education and the guidance in Medical treatment and Clinical Care of patients in Neurology at NBT.

Dr Ian Ormerod is usually the CS for Foundation Trainees. Main duties of the placement  To work with other members of the neurology medical team and other colleagues in Neuroscience Directorate  To carefully plan holiday and other leave and liaise with colleagues and Supervisors in advance. Obtain signed approval for leave significantly in advance.  To care for patients on the wards as appropriate and to liaise with other neurology staff if there are concerns or uncertainty about diagnosis, management, care and investigations.  There needs to be daily meetings with members of staff and daily handover of information and required work to be done by the team starting duty at night or in the day  Arranging investigations for patients as appropriate.  Obtaining consent from patients as appropriate for medical care, investigations and management.  Daytime and on-call duty Typical working pattern in this A full programme will be provided by your firm. placement You will also be notified of on-call duties in advance. Employer Information You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people

In addition the Trust is in the process of applying for Foundation Trust status.

It is important to note that this description is a typical example of your placement and may be subject to change.

Severn Foundation School Individual Placement Description North Bristol NHS Trust

When on call, neurology F2’s also cover the inpatient neurosurgery service.

In addition the Trust is in the process of applying for Foundation Trust status.

It is important to note that this description is a typical example of your placement and may be subject to change.

Severn Foundation School Individual Placement Description North Bristol NHS Trust

Placement F2 Neurosurgery The department The department of neurosurgery is a tertiary referral unit serving the counties of Gloucestershire, Somerset and Wiltshire in addition to the city of Bristol. It is one of the largest neurosurgical units in the country. Over 2600 emergency and elective neurosurgical procedures are performed each year. There are 13 consultant neurosurgeons and all the major neurosurgical sub-specialties are represented.

We currently have access two CT scanners, two angiogram suites and three MRI scanners, including a new 3 Tesla scanner.

Emergency referrals are dealt with by an ‘on call’ team consisting of a consultant neurosurgeon, a specialist registrar (who is the first line of contact) and a senior house officer grade doctor providing ward cover. The type of work to expect and The work is primarily ward-based, although there learning opportunities will be opportunities to attend theatre and outpatient clinics. Within a team structure led by consultants and registrars, F2 doctors will have the opportunity to deliver medical care to neurosurgical patients, pre- and post-operatively. Most of the work is defined in a structured daily morning ward round. Most elective patients are pre-clerked in the neurosurgical pre-admission clinics. Patients transferred to the unit on an emergency basis will require review and initial evaluation on admission, under the supervision of the on call registrar and consultant. When on call, neurosurgical F2’s also cover the in-patient neurology service. The overall educational objectives of the F2 year are to provide the trainee with the knowledge, skills and attitudes to be able to  Elicit a history and undertake a comprehensive examination of the neurosurgical patient  Identify and synthesize neurosurgical and neurological problems  Prescribe safely  Keep an accurate, contemporaneous and relevant medical record  Manage time and clinical priorities effectively  Communicate effectively with patients, relatives and colleagues  Use evidence, guidelines and audit to benefit patient care  Ensure the required discharge documentation has been prepared when patients are discharged home or transferred to other units  Act in a professional manner at all times  Educate patients effectively on general medical issues

F2 doctors will also have the opportunity to learn ward-based neurosurgical procedures, including lumbar puncture, management of external ventricular drains, access of ventricular access devices, and insertion of lumbar drains. They are extensively exposed to neuroradiology, and will have the opportunity to learn to interpret cranial and spinal CT and MR images. They are encouraged to attend theatre lists, undertake audits and participate in research. Where the placement is based Brunel building, Southmead Hospital, Bristol Clinical Supervisor(s) for the A consultant neurosurgeon will be allocated to placement act as the clinical supervisor for each of the F2 doctors. Main duties of the placement Together with the other junior doctors (ST1 and *subject to change in new ST2), higher specialist trainees and consultants, hospital building F2 doctors are responsible for the day to day care of patients on the wards. They attend the morning departmental hand over with the on call team at 08.00 and participate in the ward rounds on the high-dependency units and on the wards. They assist with the organization of haematological and radiological investigations, and the preparation of patients for theatre. They are involved in the care of the post-operative patient. F2 doctors are expected to attend the structured teaching sessions, covering aspects of neurosurgical and neurological care, held on *Tuesdays, between 1 and 2 pm. They should also attend and contribute to the department’s clinical governance meetings, held every two months. Typical working pattern in this * placement 08.00 Departmental handover meeting *subject to change in new 08.40 Team-based ward rounds hospital building 13.00 – 14.00 (Tuesday) teaching 11.00 – 12.30 (Wednesday) Regional neurosciences meeting 20.00 Evening handover

On call rota: Joint cover with neurology; 1 week of nights, 20.00 – 08.00, Monday to Thursday, approximately 1 in 10, followed by 1 week off; 1 weekend of nights, 20.00 – 08.00, Friday to Sunday, approximately 1 in 10, followed by Monday and Tuesday off; 1 weekend of days, 08.00 – 20.00, Saturday and Sunday, approximately 1 in 10; 1 weekend of days, 08.00 – 17.00, Saturday and Sunday, approximately 1 in 10. On call rota 17.00 – 20.00 during weekdays. Employer Information You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people

In addition the Trust is in the process of applying for Foundation Trust status.

It is important to note that this description is a typical example of your placement and may be subject to change.

Severn Foundation School Individual Placement Description North Bristol NHS Trust

Placement F2 Obstetrics and Gynaecology The department The department has 13 consultants. We are a busy teaching hospital with more than 6,000 deliveries a year. The type of work to expect and The position offers a broad range of experience learning opportunities in both obstetrics and gynaecology. The doctors will have the opportunity to develop their skills in the admission of emergency patients, practical skills and outpatient sessions. There is a strong emphasis on team working and communication within our department. Where the placement is based Department of Women’s Health, Southmead Hospital, Bristol. Clinical Supervisor(s) for the Mr Fraser Mcleod, Consultant Obstetrician and placement Gynaecologist Main duties of the placement Obstetrics – Antenatal clinics, reviewing admissions in the day assessment unit, participating in the oncall team for delivery suite. Reviewing postnatal patients. Gynaecology – on-call duties, reviewing referrals to our emergency clinic, outpatient sessions, assisting in theatre – gaining operating skills as appropriate Typical working pattern in this Our rota is EWTD compliant. It is a rolling rota placement with 14 juniors. We have 3 on-call for a long day each day including weekends and a split week of nights every 14 weeks. Employer Information You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people

In addition the Trust is in the process of applying for Foundation Trust status.

It is important to note that this description is a typical example of your placement and may be subject to change.

Severn Foundation School Individual Placement Description North Bristol NHS Trust

Placement F2 Inpatient Psychiatry Later Life The department Aspen Ward is a mixed sex unit and manages patients with Psychosis, Depression, Anxiety, Mania and any associated cognitive problems. Laurel Ward is also a mixed sex unit and manages patients with dementia including Alzheimer's Disease, Vascular Dementia, Lewy Body Disease, Frontotemporal Dementia, Normal Pressure Hydrocephalus and Primary Progressive Aphasia. The type of work to expect and There is regular teaching at Callington Road learning opportunities Hospital on a Wednesday morning including a Balint Group, Journal Club and Case Presentations. Foundation training is run at Frenchay Hospital on Thursday lunchtimes (subject to change). Where the placement is based Aspen and Laurel Wards at the Coppice, Callington Road Hospital, Brislington, Bristol. Clinical Supervisor(s) for the Dr West, Consultant old age psychiatrist placement Main duties of the placement Trainees will support the day to day administration of admissions and discharges of patients and coordinate all aspects of care including physical care while patients are on the wards. Trainees are well supported with Consultant or senior trainee ward rounds at least twice a week and weekly supervisions with Dr West. Opportunities to work in the ECT Clinic with Dr Hewitt and additional experiences within Old Age Psychiatry can be arranged depending on the interest of the individual trainee. Typical working pattern in this On-Call is based around a 1:9 rota and includes placement evening on-call (5-9pm) and weekend days: These on-calls can be provided remotely (i.e. from home). Doctors provide on-call cover for any issues on general adult and older adult inpatient wards at Callington Road Hospital and also clerk any out-of-hours admissions. Nights: usually one set of 7 night shifts from 9.15pm - 9am. These are waking nights based in Colston Fort, Bristol. F2s will be supported by a senior SHO, sharing ward cover and admissions for psychiatry units across Bristol. There is always consultant on-call cover available. Employer information Your employer will be North Bristol NHS Foundation Trust, seconded to Avon and Wiltshire Partnership (AWP) Mental Health NHS Trust

It is important to note that this description is a typical example of your placement and may be subject to change.

Severn Foundation School Individual Placement Description North Bristol Trust

Placement F2 Inpatient Mother and Baby Unit The department This post is based with Dr Kathryn Bundle, Consultant Perinatal Psychiatrist on the New Horizon Mother and Baby Unit (MBU) in AWP Mental Health Trust. The MBU is situated at Southmead Hospital. The service provides inpatient care for women with serious mental illness who require admission in the late stages of pregnancy, and for women and their babies where a psychiatric admission is required during the first postpartum year. The type of work to expect and The post will provide experience in the care of learning opportunities women with severe perinatal mental illness.

The F2 doctor will be ward based during the working day, providing the first line medical cover to the 4 inpatients on the MBU. It is anticipated that the F2 doctor will also work closely with the F1 doctor based on the Eating Disorders Unit (STEPS) at Southmead Hospital, to allow a greater variety of clinical experience.

The overall educational objectives of this post are to provide the trainee with the knowledge, skills and attitudes to be able to:

 Take a history and examine patients with particular emphasis on mental state examination  To gain confidence in physically examining and managing the physical health of pregnant and postpartum women (with support from maternity services) and the physical risks of low body weight (STEPS)  Manage clinical problems independently and seek advice where appropriate  Prescribe safely psychotropic and physical health drugs, and be aware of their side effects and potential risks particularly in pregnant or breastfeeding women, or severely undernourished patients (STEPS)  Keep accurate and relevant medical records  Manage time and clinical priorities effectively  Communicate effectively with patients, relatives and colleagues  Practice evidence based medicine and use local guidelines in place for the treatment of adults in the mental health setting  Act in a professional manner at all times  Consider the ethical and legal issues with particular reference to the Mental Health Act and Mental Capacity Act  Teach medical students formally and informally  Work in a multi-disciplinary setting as part of a multidisciplinary team, with particular emphasis on the care planning approach  Gain experience and confidence in risk management, with particular consideration of risk to the baby (MBU) and risk associated with low body weight and its medical complications (STEPS)  - The MBU also provides the opportunity to learn about the importance of the mother- infant relationship and gain confidence in managing common physical health problems in infants (with appropriate support) Where the placement is based New Horizon Mother and Baby Centre, Southmead Hospital, Bristol Clinical Supervisor(s) for the Dr Kathryn Bundle, Consultant Psychiatrist in placement Perinatal Psychiatry Main duties of the placement The F2 will be responsible for admitting, clerking, reviewing and facilitating the discharge of MBU inpatients. They will participate in the weekly ward round and management round. There may be opportunities for the doctor to join the staff grade or consultant in outpatient work, assessing women for pre-conception counseling or antenatal women with current or previous serious mental illness.

Participation in mental health assessments and psychological treatments This post offers many possibilities to take part in psychiatric assessment on admission to the MBU. The doctor will have opportunities to observe how mothers interact with their infants and the impact of maternal mental illness on this interaction.

Working with different teams and health professionals, and seeking advice and support There will be opportunities for working with midwives, obstetricians and health visitors and the MBU has nursery nurses on its staff. Opportunities to work with STEPs Eating Disorder Service and Inpatient Unit are currently being explored. Also on the Southmead site are Psychiatry Higher and Core Trainees, GPVTS and Foundation trainees on Psychiatry placements, and the post holder would be part of a supportive group of trainee doctors. Consultant and Staff Grade are experienced and enthusiastic trainers. The Foundation doctor will be expected to attend weekly supervision meetings.

Assessment of Medically Ill Patients: Guidance from Severn Deanery School of Psychiatry for all Foundation doctors working in psychiatry As a Foundation doctor, you may be called on to assess patients who are medically unfit either in the psychiatry in-patient units or possibly in the community. It is important to be aware that psychiatric hospitals do not have facilities to support patients with serious physical health problems and you are not in a position working in these settings to facilitate urgent investigation, or initiate immediate and complex treatment such as IV support, catheterisation. In many respects the support available may even be less than in a standard community setting as there is a lack of access to GP level medical advice. In the event that a patient needs more immediate and complex physical assessment, it is advisable to discuss with a senior psychiatry colleague and it is generally necessary to have these individuals seen in the nearest A&E department. It would of course be helpful if a patient was referred, to discuss the case with the casualty team, while the transfer is being organised. This would normally require an ambulance, which the in-patient team would generally organise.

As a Foundation doctor working in psychiatry, you would not normally be expected to initiate complex physical treatments. If you are uncertain about appropriate physical care of an individual, you should always discuss this issue with a senior psychiatry colleague, who may be the local core/advanced trainee in your unit or your consultant or the consultant on-call. It may be useful to contact the specialist team in the general hospital for advice, but where a complex decision is being made this should always be shared with senior colleagues in the psychiatric team, who will be responsible for the treatment while the patient is in a psychiatric hospital. Note that discussion of the physical problems with a more senior psychiatric colleague is not generally to get expert medical advice (bearing in mind that as the psychiatric specialists become more senior their physical medicine skills tend to become out of date), but to bring the concerns to their attention so they can advise on the need to contact local acute medical/surgical services and how best to do this. Medical Care of women and infants on the MBU Postpartum women can occasionally become seriously physically unwell and it is important to be able to recognise this and arrange for transfer to the general hospital where required. It has been identified through the Confidential Enquiry into Maternal Deaths process that some women die in the postpartum period because their physical illness is misattributed to mental disorder.

It is also important to recognise if an infant is acutely unwell and be able to seek advice from paediatric services / arrange transfer where appropriate. The nursing staff on the MBU are very experienced and will be able to advise the F2 in this. Typical working pattern in this Ward based, with sessions spent seeing placement outpatients (these women usually come to the Unit for their outpatient appointment).

Monday to Friday, 9am to 5pm.

Foundation training is on Tuesday pm at Southmead or Frenchay Hospital. Employer information Your employer will be North Bristol NHS Foundation Trust, seconded to Avon and Wiltshire Partnership (AWP) Mental Health NHS Trust

It is important to note that this description is a typical example of your placement and may be subject to change.

Severn Foundation School Individual Placement Description North Bristol Trust

Placement F2 Liaison Psychiatry of Later Life The department This post is based at Southmead Hospital, North Bristol NHS Trust with the Older People’s Mental Health Liaison Service and the postholder will work with Dr. Patel and his team. The type of work to expect and Liaison Psychiatry of Later Life is an ideal learning opportunities learning environment for the Foundation doctor, bridging learning from biomedical to bio- psychosocial care, whilst retaining links with allied medical specialties and colleagues within the acute hospital setting.

This post enables the Foundation doctor to gain skills, knowledge and attitudes needed to assess and manage common psychiatric presentations seen in non-psychiatric settings.

The Foundation Doctor will gain experience in the assessment informing diagnosis, treatment and management of existing or suspected new mental / neuropsychiatric disorder in older people admitted to the acute hospital (primarily dementia, delirium, depression and anxiety). Gain experience in the recognition and management of depression in the setting of a physical illness, of behavioral disturbance secondary to dementia in an acute setting and in prescribing safely and recognizing common drug interactions.

The postholder will also have the opportunity to assess older people admitted following an episode of self harm, older people with physical illness and associated complex psychological or emotional problems and those with physical symptoms of psychological origin and end of life issues. Additional experience can also be gained in the specialist opinion for complex capacity decision for patients with mental disorder.

The nature of the work involves frequently linking patients with community teams, primary care, non-statutory and social services for aftercare. Working across the interface of mental health and acute hospitals will encourage the foundation doctor in the development of excellent inter-personal and communication skills transferable and necessary in all branches of medicine.

Education as a key part of the role of a Hospital Mental Health Liaison service and the Foundation doctor will have the opportunity (with team members) to develop skills and experience in the delivery of educational packages/training to general hospital staff across a variety of medical specialties.

There is access on site to the library facilities in the Learning and Research Centre.

The F2 doctor will operate within Southmead Hospital during the ‘normal’ working day, providing first-line assessment of inpatients referred to the Liaison service. The overall educational objectives are to provide the trainee with the knowledge, skills and attitudes to be able to:

 Take a history and examine a patient with particular emphasis on mental state examination  Formulate a diagnosis and management plan  Manage clinical problems independently and seek advice where appropriate  Prescribe safely with particular emphasis on psychotropic drugs and their potential interactions in older people with concomitant physical health problems  Keep accurate and relevant medical records  Manage time and clinical priorities effectively  Communicate effectively with patients, relatives and colleagues  Practice evidence based medicine and use local guidelines in place for the treatment of older adults in the acute hospital setting  Act in a professional manner at all times  Cope with ethical and legal issues with particular reference to the Mental Health Act and Mental Capacity Act  Teach medical students formally and informally  Work in a multi-disciplinary setting with particular emphasis on the care planning approach  Gain experience of risk management and become confident in making decisions associated with risk in the acute hospital setting Where the placement is based Team Base is at Donal Early House, Southmead Hospital. Clinical duties will be within Southmead Hospital, North Bristol NHS Trust. Clinical Supervisor(s) for the Dr. Anish Patel, Consultant Liaison Psychiatrist placement in Older People. Main duties of the placement Your duties will include:

 To assess and manage those current hospital inpatients who are referred to the Later Life Liaison Psychiatry team.  To provide a timely response to referrals and efficient communication of assessments/ interventions to the relevant community teams/ referrer using either NBT or AWP Trust’s clinical IT systems.  In addition to seeing patients on wards (history-taking, investigation, diagnosis, and management), you will practice preventative medicine, promoting health education, and work closely with other health professionals.  To attend the weekly Multidisciplinary Acute Liaison team meeting  To participate in the audit activities of the department.  Attendance to weekly Academic Psychiatry meeting and monthly Foundation training.

Assessment of Medically Ill Patients: Guidance for all Foundation trainees placed in psychiatry.

As a Foundation doctor, you may be called on to assess patients who are medically unfit either in the psychiatry in-patient units or possibly in the community. It is important to be aware that psychiatric hospitals do not have facilities to support patients with serious physical health problems and you are not in a position working in these settings to facilitate urgent investigation, or initiate immediate and complex treatment such as IV support, catheterization. In many respects the support available may even be less than in a standard community setting as there is a lack of access to GP level medical advice. In the event that a patient needs more immediate and complex physical assessment, it is advisable to discuss with a senior psychiatry colleague and it is generally necessary to have these individuals seen in the nearest A&E department. It would of course be helpful if a patient was referred, to discuss the case with the casualty team, while the transfer is being organized. This would normally require an ambulance, which the in-patient team would generally organize.

As a Foundation doctor working in psychiatry, you would not normally be expected to initiate complex physical treatments. If you are uncertain about appropriate physical care of an individual, you should always discuss this issue with a senior psychiatry colleague, who may be the local core/advanced trainee in your unit or your consultant or the consultant on-call. It may be useful to contact the specialist team in the general hospital for advice, but where a complex decision is being made this should always be shared with senior colleagues in the psychiatric team, who will be responsible for the treatment while the patient is in a psychiatric hospital. Note that discussion of the physical problems with a more senior psychiatric colleague is not generally to get expert medical advice (bearing in mind that as the psychiatric specialists become more senior their physical medicine skills tend to become out of date), but to bring the concerns to their attention so they can advise on the need to contact local acute medical/surgical services and how best to do this. Typical working pattern in this Monday to Friday, 9am to 5pm. placement On call is 1:9 for weekends and evenings - the on call finishes at 9.15 pm and is non-residential. There is additionally a week of waking night shifts, 1:18 weeks – followed by daytime off-duty - based at Colston Fort with the Crisis Team, covering all Bristol inpatient units. The F2 is the junior trainee, supported by a more senior trainee (CT1-2), an advanced trainee on occasion, and a consultant.

The F2 will need their own transport to be able to travel between Callington Road, Blackberry Hill, Southmead and Colston Fort during nights shifts. There are pool cars available to use during nights shifts but the driver must have held a driving license for more than 1 year to be able to utilise these. Employer information Your employer will be North Bristol Trust, seconded to Avon and Wiltshire Partnership (AWP) Mental Health NHS Trust.

It is important to note that this description is a typical example of your placement and may be subject to change.

Severn Foundation School Individual Placement Description North Bristol NHS Trust

Placement F2 Renal Medicine The department The department of renal medicine comprises 12 consultant nephrologists, all of whom participate in a specialist renal on call service. Renal medicine is a tertiary referral specialty. The department provides renal services to Bristol, South Gloucestershire, Bath and North East Somerset and Wiltshire. In addition it provides transplantation for Dorset, Gloucester and North Devon. The department provides a comprehensive renal replacement therapy programme to approx 1500 patients comprised of 600 patients on dialysis and 880 renal transplant recipients. The department performs about 100 adult transplants a year. The type of work to expect and All F2 doctors in renal medicine are ward based learning opportunities during the normal working day and provide the daily medical care of all patients in the renal unit under their Firm. There are two Firms of consultants providing inpatient care. F2s will also spend long days on call for renal medicine from 8.30 am to 9pm, and blocks of nights for renal medicine shared with the registrars. There are learning opportunities on the twice weekly consultant lead ward rounds, the X-ray meeting, in house renal tutorials, biopsy meetings and in the course of the job as there is a high level of support provided by the renal registrars. F2s will be involved in the care of patients with acute kidney injury, chronic dialysis patients, newly transplanted patients and acutely unwell immunosupressed patients. Where the placement is based The Richard Bright Renal Unit, Brunel building, Southmead Hospital, Bristol, BS10 5NB Clinical Supervisor(s) for the Dr Chris Dudley placement Professor Steven Harper Dr Charlie Tomson Dr Fergus Caskey Dr Rommel Ravanan Dr Karen Anderson Dr Alison Armitage Dr Helen Campbell Dr Uday Udayaraj Dr Simon Satchell Dr Andrew Salmon Main duties of the placement Together with the registrar for the respective inpatient firm, the F1 and 2 other junior doctors, the F2 is responsible for the ward care of patients and the maintenance of the patients medical record. They are expected to attend the in house renal tutorials and attend the F2 teaching programme. When on call for renal they will clerk in new patients who will be reviewed by a registrar. Out of hours they will also care for unwell ward patients needing review. F2s will have the opportunity to admit patients for cadaveric and live donor kidney transplantation. Typical working pattern in this Daily placement 8.30 - 9 am handover from the night team. 9am board round. 9.30 onwards ward round

Monday Consultant ward round,1-2pm x-ray meeting Tuesday 12-1 renal tutorial, 1-2 renal biopsy meeting. Wednesday 10 am vascular ward round with surgeons. 12 noon multidisciplinary team meeting. Thursday consultant wards round. Friday 8.45-10 am Grand Round Saturday 8.30 – 9pm 1 in 6 Sunday 8.30-9pm - 1 in 6 Rota banded 2B Employer Information You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people

In addition the Trust is in the process of applying for Foundation Trust status.

It is important to note that this description is a typical example of your placement and may be subject to change.

Severn Foundation School Individual Placement Description North Bristol NHS Trust

Placement F2 Respiratory Medicine The department North Bristol Lung Centre, Respiratory Medicine The type of work to expect and The assessment and day to day management of learning opportunities patients with acute respiratory disorders. This includes over 30 different kinds of respiratory disorders ranging from COPD, asthma, pneumonia, lung cancer, pleural disease, and alveolitis, through to managing acute respiratory failure with non-invasive ventilation, assessment of blood gases, and management of patients in the palliative/terminal stages of chronic respiratory disease. Where the placement is based Brunel building, Southmead Hospital

Clinical Supervisor(s) for the One of the seven respiratory consultants at placement North Bristol Lung Centre who will be allocated by the specialty training lead (currently Dr Andrew Medford). Main duties of the placement Clerking and day to day assessment of patient’s progress with up to date neatly written entries in the notes detailing the patient’s progress and future intended plans and investigations. Liaison with senior members of the team, specifically the specialist registrar and consultant, specialist physiotherapist, dietitian, pharmacist, occupational therapist, senior nurses, and palliative care team. There will be daily ward rounds; twice a week from the consultant, once a week from the specialist registrar, and otherwise with more senior trainees. Typical working pattern in this Daily ward round to assess patient’s progress placement and keep the patient’s notes up to date with details of their progress and any important results and future plans. Employer Information You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people

The Brunel building is home to almost all of our specialist teams formerly based at Frenchay Hospital and in the old Southmead buildings. These include regional centres such as Neurosurgery, Renal (Kidney), Orthopaedics, Plastics and Adult Burns plus, the Emergency Department (A&E). The Southmead Hospital Bristol site also includes our outstanding maternity department and neonatal intensive care unit (NICU), the brand new Bristol Breast Care Centre, clinical research teams and Severn Pathology.

In addition the Trust is in the process of applying for Foundation Trust status.

It is important to note that this description is a typical example of your placement and may be subject to change.

Severn Foundation School Individual Placement Description North Bristol NHS Trust

Placement F2 Stroke Medicine The department Wards in the Brunel building will have acute stroke beds.

At present, patients with a diagnosis of stroke (cerebral infarction, Haemorrhage or TIA are admitted to the wards directly from ED. If due to bed pressures patients are on a different ward they are still looked after by this team. All patients who have had thrombolysis will be admitted to the Hospital and after 24 hours transferred to the Neurology/Stroke wards if not admitted there directly. Supervised experience of seeing in patients in will be available

There will also be some other Neurology patients on the wards. These patients remain under the admitting Neurology / Medical consultant. The type of work to expect and Board rounds – Mon- Fri at 9.00- 9.15. Quick learning opportunities catch up of current issues and new admissions working closely with nursing and professions allied to medicine.

Daily Consultant led Ward Rounds – There is a consultant led ward round every morning at 9.30 on the Wards & outliers to see all new admissions and Stroke inpatients. There are daily opportunities for case based discussion (CBD) and evaluation of skills. (mini-CX & DOPS). Opportunities for skills training such a lumbar puncture, iv, ia puncture. Management of stroke related complications

Multi-Disciplinary Meeting (MDM) ~Every Week The details of discussions are noted down on the yellow sheets in section 4 of the notes.

Most Stroke inpatients will require therapy input (OT, PT, SLT etc) prior to discharge. Please check the notes for therapy discharge plans.

Foundation doctors weekly teaching/training session. Neuro/Stroke X ray meeting weekly Wednesday. Stroke specific training (Friday 12.30 followed by stroke MDM. Where the placement is based Wards in Brunel building at Southmead Hospital Clinical Supervisor(s) for the The Consultants in Neurology and Stroke are Dr placement Justin Pearson, Dr Rose Bosnell, & Dr James Stevens and Dr Phil Clatworthy. These Consultants are an essential part of the work in Stroke and Neurology at NBTand will continue to make a major contribution to the patient diagnosis, investigation, treatment, clinical care and clinical management of patients. They will also continue to be a major part of learning, teaching and medical experience of Foundation Trainees. Dr Ian Ormerod is C/S for Foundation Trainees Main duties of the placement Patient care Medical notes entries Arranging appropriate investigations Managing acute ischaemic stroke including role of thrombolysis Management if ICH Managing complications of acute stroke Stroke secondary prevention Care of the elderly issues On call duties Joint meetings Involvement in communication with patients, their families, other doctors, members of the health care team Typical working pattern in this Normal daytime ward cover 9am – 5pm placement Partial shift and general medical on call Employer Information You will be working in the Brunel building, one of Europe’s leading hospitals and will be at the centre of the redeveloped Southmead Hospital Bristol site, serving a community of over 500,000 people

In addition the Trust is in the process of applying for Foundation Trust status.

It is important to note that this description is a typical example of your placement and may be subject to change.