Acute Medical Unit (AMU)
The Acute Medical Units encompass Same Day Emergency Care, Acute Assessment and Short Stay Wards. In the acute medical pathways, Consultants work closely with speciality physicians, providing care for acutely unwell medical patients referred directly from their GP’s care or from the A&E Department.
The case mix on the AMU is varied and interesting and presents excellent opportunities to develop clinical skills. They also will gain exposure to clinical procedures such as lumbar puncture, abdominal paracentesis and can also observe ultrasound guided pleural aspirations/chest drains etc. AMU is unique amongst the adult medical wards for having twice daily consultant ward rounds every day and excellent supervision. The AMU team is responsible for admission of all unselected acute medical patients.
There are also opportunities for the post holder to attend specialty ward rounds as there is daily in reach from cardiology, respiratory, gastroenterology, neurology, rheumatology and dermatology when needed. The post holder will have the opportunity to attend clinics and
participate in audits, AMU presentations, grand rounds and the monthly morbidity and mortality meetings.
The Post holder will also contribute to the admission clerking of admitted patients and have the opportunity to present cases on the consultant post take ward round. They will be responsible for the ongoing care of the patients on the AMU, contributing to the keeping of medical case-notes, ordering and interpreting investigations, writing electronic summaries and making referrals to other specialties.
Cardiology
The Cardiology department offers inpatient and outpatient treatment for patients with coronary heart disease, arrhythmias, heart failure and any other heart problems. We also work with GPs to provide some services in the community. Our consultants work at St George's Hospital, the Royal Brompton Hospital and St Peter's Hospital in Chertsey where they carry out invasive cardiac procedures. Four consultant cardiologists, who also treat
patients at leading teaching hospitals, lead the medical team of junior doctors and cardiac physiologists, clinical nurse specialists, specialist rehabilitation nurses and support staff.
Care of the Elderly
The care of the elderly departments at Epsom Hospital and St Helier Hospital sees all patients over the age of 75 for all medical conditions referred by GPs or other referring consultants. The aim is to see patients within four to six weeks of referral to our consultants, and a plan is usually discussed with the patient regarding their pathway. Once they are medically fit and the consultant is happy with the progress made, the patient is discharged back to the GP's care. There are three care of the elderly wards at St Helier Hospital looking after older and frail patients, a general medicine and a frailty ward at Epsom. If considered necessary, our patients will be admitted to these wards. They can also be admitted to these wards through A&E.
Orthogeriatrics
The Hip Fracture Unit at St Helier Hospital is a centre of excellence for the management of older patients with hip fractures. In the recent 2013 National Hip Fracture Database National Report St Helier was the highest achieving Trust in the country for the Department of Health’s best practice tariff for hip fractures. It is a busy unit with approximately 400 hip fractures per year. All patients are admitted under joint care of the orthopaedic and the orthogeriatric teams and remain under both teams for the duration of their admission. There is also very close working with the anaesthetic department, pain control teams, rheumatology, dietetics and therapy teams.
Frailty at Epsom
The Frailty team is currently based at Epsom General Hospital (EGH) and the wider Surrey Downs Health and Care service area. Frailty services have undergone significant changes in the last 6-months, with the development of an acute frailty service within EGH and greater integration with the community services.
The service includes presence within the Acute Medical Unit (AMU), where patients with Rockwood Clinical Frailty Scores 6+ are reviewed by the frailty team. The team manages the Mary Seacole Unit, with a dedicated pathway for patients with frailty on AMU/medical hub/ACU being transferred there in a timely manner. Frailty works with the @home services to provide input into Early Supported Discharges (ESD) from the wards and provide specialist opinions on admission avoidance Rapid Responses in the community or in the Emergency Department. The team works with Primary Care Networks to offer specialist frailty input at an earlier stage and provides specialist input (telephone/visits) for the community matrons and community hospitals in Dorking, Epsom and East Elmbridge.
Diabetes & Endocrinology
The Department provides Diabetes and Endocrine services on both the St Helier and Epsom sites. The Diabetes service has specialist centres on each site; in the Doreen Kouba Diabetes Centre at St Helier and the John Kilner Diabetic Unit at Epsom. As well as providing consulting rooms, each Centre has a Seminar Room, Dietitians’ Room, Podiatry Suite, and office accommodation. We provide a full range of clinical services in Diabetes and Endocrinology.
There is a weekly Diabetic Foot MDT clinic and ward round, a weekly multi-disciplinary Diabetes Pregnancy clinic and a multi-disciplinary Insulin Pump Therapy clinic. We have close links with the St Helier Renal Unit and there is a monthly Diabetes Renal clinic. Other specialist clinics include Paediatric Diabetes Transition clinics, Diabetes clinics for Young Adults, and Diabetes Psychology clinics. Our team of Diabetes Specialist Nurses provide clinics every day.
There are a number of endocrinology clinics which provide broad experience in pituitary, thyroid, parathyroid, adrenal and reproductive endocrinology. All endocrine investigations are carried out at our Medical Investigation Unit (MIU) and a full range of endocrine imaging techniques is available.
Gastroenterology
The Gastroenterology department is a well-established unit led by Consultants with junior support. The gastroenterology department deals with all aspects of general gastroenterology (digestive system) and hepatology (liver) in both inpatient and outpatient settings. Endoscopy is carried out at Epsom, St Helier and the Nelson hospitals, with more complex therapeutic endoscopies (ERCP, stents) centralised at St Helier Hospital. The department works closely with the gastrointestinal surgical department and specialist gastrointestinal radiologists within the Trust.
There are nurse specialists in endoscopy, viral hepatitis, inflammatory bowel disease and upper and lower gastrointestinal cancer.
Respiratory Medicine
The dynamic respiratory department medical team comprises consultants, ST3+ trainees and junior trainees at all levels. They are supported by clinical nurse specialists. There is opportunity to be part of the respiratory team to care for patients with all types of respiratory conditions and be part of the lung MDT team. There will be opportunities to do clinics in respiratory and to learn specialist skills such as pleural procedures and biopsies and attend bronchoscopy sessions.
Stroke Medicine
The stroke unit has two wards at the Epsom site and combines both acute and rehabilitation beds. Patients with acute strokes receive thrombolytic therapy on site as well as rehabilitation. There is a weekly TIA clinic and high-risk TIA patients are admitted. There are good links with the department of Vascular Surgery.
On Call duties
The post holder will be working with Consultant-led teams and will be responsible for the management of acute admissions supported by a Registrar. Dependent on the specialty and site that you bid for and are awarded you will be placed on the below rota. Please be aware that this is subject to change.
At night the hospital runs a Hospital at Night service and as such the post holder will be expected to work as part of that team.
