During the 5 year rotation trainees will spend 1 year in the teaching hospitals (either Addenbrookes or Norwich) and 4 years usually rotation through 2 or 3 sites.   The rotations where possible take into account trainee needs both personally and clinically, and aim to retain a commutable distance.  The rotations generally form 2 hubs around Cambridge (Lister [Stevenage], Hinchingbrooke [Huntingdon], Peterborough, Broomfield, Basildon) and Norwich (Kings Lynn, James Paget [Gt Yarmouth], Ipswich), however we will work with our trainees to support their choices where possible.

 

Work is underway to update the page - to include details of Trusts acute medicine departments, the training programme and the specialties and specialist skills on offer

 

Addenbrookes Hospital, Cambridge

Acute Medicine Unit – Addenbrooke’s (Cambridge University) NHS Foundation Trust

Acute Care Hub (EAU4 and EAU5)

Situated above the emergency department, the two short-stay wards constitute our Acute Care Hub. These provide care for short-stay patients and during the initial acute phase of an admission. Patients are referred from the emergency department. Medical senior review is being carried out on these wards. Both wards have a dedicated consultant lead on a rotational basis. On EAU 4 the expected length of stay is <24 hours, on EAU5 < 72 hours. Excellent support is provided by allied professionals, as well as various clinical specialities. Daily multidisciplinary team meetings facilitate patient care and discharge planning. This is an excellent environment for trainees to gain the essential skills for the running of an Acute Medical Unit.

Outliers

A dedicated consultant led team looks after outlying patients under acute medicine. These are largely based on wards K3/CCU which are shared with cardiology. CCU acts like in most trust, as the medical high dependency unit. Trainees therefore get exposed to a wide range of acutely unwell patients and gain transferable skills in their management.

Emergency Department

Addenbrooke’s does not operate a conventional medical assessment unit. The medical take team is based in the emergency department where we work alongside emergency physicians. From there patients are discharged, referred to ambulatory or urgent outpatient pathways or admitted to relevant ward and specialty care. A significant proportion of the medical take is transferred to the Acute Care Hub run by acute medicine and geriatrics. A medical consultant is usually present in the emergency department between 9am and 10pm. During the 5pm and 10pm two medical consultants are on site. This helps provide senior input and guidance. The well supported environment provides an excellent learning opportunity for doctors in the transition period between CMT and higher medical training. It also allows more senior clinical decision makers to discuss complex clinical cases.

Ambulatory Care (EAU3) & Follow-up Clinics

Acute Medicine runs an Ambulatory Care Unit (EAU3). The unit is located above the emergency department and focuses on admission avoidance. A consultant is present between 9am and 5pm, a middle grade doctor between 12pm and 8pm. Pathways have been developed for the management of conditions such as suspected pulmonary embolism, cellulitis, syncope, atrial tachycardia, sub-acute diabetes, low risk upper gastro-intestinal bleeds, COPD, asthma, anaemia, ischaemic chest pain.

The Ambulatory Care Unit takes referrals from the Emergency Department and directly from GPs via a GP liaison service.  The unit is supported by dedicated nursing staff and direct access to a comprehensive range of investigative and diagnostic modalities. Ambulatory clinics are run jointly by a Consultant and trainee doctor, thereby offering excellent learning opportunities and gain all competencies needs for ambulatory care sign off on the JRCPTB curriculum

We also provide a Friday morning General Medical follow-up Clinic.

As a department we are lucky to have consultants with a wide variety of specialities who would be happy to help facilitate a particular interest and access to specialist clinics.

Lister Hospital, Stevenage

Acute Medicine

Situated next to the ED the acute medicine department consists of an Acute Medical Unit and a Short Stay Ward.   The ambulatory care unit is situated further along the corridor to allow ease of access for patients and their carers.

The AMU accepts patients via the Liaison team who are referred from the Emergency Department, General Practice, Community Specialists and Outpatient clinics for formal medical assessment, senior decision making and formal PTWRs.   Patients are then transferred to the appropriate ward aided by the senior site managers and service co-ordinators to ensure right place, right person, first time.   The maximum length of stay within the AMU areas is 24hours, with the Shirt Stay Unit accepting patients whose predicted length of stay is less than 72hours.

 

Ambulatory Care has been running since 2009 and sees patients directly from GPs, inreach to the Emergency Department, Early Supported Discharge patients from the wards and supports the management of patients in the community by means of the OPAT service and medical day unit (supporting procedures such as ascitic drains, LPs, pleural aspirations, blood transfusion and other infusions).  It has dedicated staff including a consultant and associate specialist (8am-5pm), 1 registrar (830am-8pm all GIM registrars rotate through the service to learn valuable skills in the OP management of patients), 1 GPVTS trainee (830am-5pm), 1 twilight CMT (12pm-8pm) and fully established nursing team, including EMTs and ERME certified nurses (8am-8pm).   Our acute medicine ANP also rotates through the ambulatory care.

We also provide a formal general medicine follow-up clinic on Monday afternoons supervised by an additional consultant

 

Specialties Offered

Within rotation at the Lister we offer rotations in ITU, Respiratory and Cardiology - fulfilling the 4 month requirements for the curriculum.

We have previously trained acute medicine registrars in bronchoscopy, echocardiography and hope to also establish Diabetes specialty skill within the next year.

 

 

Norfolk and Norwich

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James Paget Hospital (Great Yarmouth)

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Hinchingbrooke (Huntingdon)

 

Specialties:  Elderly Care, Respiratory

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Ipswich

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Peterborough

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Kings Lynn

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Basildon

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Broomfield

This page is awaiting editing

Friday, 8 March, 2019
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