Senior CF Perioperative Geriatric Medicine & Geriatric Major Trauma

Ongoing development of perioperative geriatric medicine and trauma services is a strategic objective for the Trust. The post-holder will contribute actively to a modern model of shared medical and surgical care for all older patients admitted with major traumatic injuries.

Outpatient clinic opportunities will also exist to support development of skills in enhanced medical pre-assessment of older patients requiring elective colorectal, vascular, complex orthopaedic and urological surgery.

The post would suit trainees in Geriatric or Acute General Medicine seeking to broaden their perioperative medicine experience. Applications are also welcomed from candidates able to perform at senior clinical fellow grade who possess full MRCP(UK) or equivalent international qualifications.

The post holder will be supervised in every aspect of their role by substantive consultants working in Perioperative Geriatric Medicine. They will not routinely participate in unselected medical admissions during their fellowship unless specific training needs are required (subject to agreement).

The post-holder's timetable will be agreed at induction and job planning. Appointees will be rotationally based on 25a (Major Trauma), 25b (Femoral Fracture) or 6b (Neurosurgery). Each area will be supervised by substantive geriatric trauma consultants.

Example weekly schedule: trauma meetings, ward rounds and board rounds; perioperative medicine clinic and referrals; QI/research; admin and ward check‑in.

North Bristol NHS Trust is one of the largest NHS organisations in the Southwest of England. It is a progressive and ambitious teaching and research organisation, and a specialist regional centre for major trauma, neurosciences, plastics and burns, orthopaedics, urology and renal services. Our trust Board is committed to creating a strong, vibrant organisation that is at the forefront of healthcare delivery in the West of England.

Our acute services moved into the brand‑new £430 million state‑of‑the‑art Brunel Building in May 2014, enabling us to work together to create an environment for exceptional healthcare. This 800+ bed hospital at the Southmead site offers patients single rooms with ensuite facilities, greatly improving privacy and dignity and helping to control the spread of infections and, most importantly, enabling each patient to be treated as a person.

At the heart of what we do is a caring and compassionate workforce.

The supervising consultant will be Dr Andrea Joughin, or another substantive consultant working in perioperative geriatric medicine.

• Demographics and political landscape relevant to the older trauma and surgical patient
• National reports and policy drivers relevant to the older trauma and surgical patient
• Models and pathways of care for older trauma and surgical patients
• Risk assessment of perioperative morbidity and mortality (including use of tools) and investigations e.g. cardiopulmonary exercise testing
• Modification of risk including the use of organ specific national and international guidelines (e.g. European Society Cardiology)
• Use of inter‑disciplinary and cross‑specialty interventions to improve postoperative outcome (e.g. therapy delivered pre‑habilitation)
• Clinical assessment with appropriate use of investigations and tools to pre‑operatively risk assess for perioperative morbidity and mortality
• Communication of risk with health professionals and patients/relatives
• Timely medical optimisation of comorbidity and geriatric syndromes
• Appropriate allocation of postoperative resources (e.g. use of level 2 and 3 care)
• Decision making regarding rehabilitation, and timely and effective discharge pertinent to the surgical patient
• Liaison with patients, anaesthetists and surgeons to ensure shared decision making
• Application of ethical and biomedical approaches to ensure appropriate ceilings for escalation of care

The post would suit trainees in Geriatric or Acute/General Medicine seeking to broaden their perioperative medicine experience. Applications are also welcomed from candidates able to perform at senior…