Leadership Fellow in Ambulatory and Acute Medicine

The posts are aimed at (F2+ level doctors and can be performed Out of Programme or recognised as training (contingent on Deanery approval). Successful applicants will develop a job plan in conjunction with a senior Fellowship supervisor which will compose: 80% Clinical Work: to include Acute Medicine and Ambulatory experience across the John Radcliffe / Horton sites and subject to discussion with supervisor may involve activity in other acute and ambulatory medicine settings in the Trust. This will include short days, long days on call, some out of hours weekend work (which may include rarely nights on occasion). The clinical role allows flexibility in planning, an opportunity to work with a wide range of excellent consultants and gives clinical exposure at different levels in Acute Medicine. (The research fellowship - this would be 50%) 20% non-clinical work- include a combination of the below activities with a specific role in the following areas: Quality improvement, Education and training, Research and Leadership. Training in point of care ultrasound will be available and participation in this training is encouraged., OUH offers this role as an Out of Programme opportunity for advanced training that is complementary to existing specialist curricula. The successful trainee would leave their specialist training programme for the duration of the role (1 year minimum). The post is full time with additional scheduled hours of work (on call banding). Clinical 80% of 'basic' time will focus on delivering and leading clinical care that is 'ambulatory by default' at the John Radcliffe and Horton Hospital sites. This will be based in the both the Ambulatory assessment unit and the Emergency Medical unit. Input will focus on extending the reach and application of contemporary ambulatory care, will complement the current senior- and middle-grade input to ambulatory services. The ambulatory team will also spend time with the medical on call teams to help progress ambulatory medicine in other parts of the hospital. The 'additional hours' (beyond basic) commitment will focus on delivery of 'leadership in ambulatory care' support peak periods. Typically, urgent care pathways see sustained surges in demand from lunchtime until late evening; Chief Registrar leadership of early, rapid assessment, treatment and pathway determination during this period will be a vital component in delivering better patient outcomes and ensuring that every appropriate patient is 'home by midnight'. Service Transformation In aggregate, 20% of 'basic' time will be allocated to supporting service transformation towards an 'ambulatory by default' model: delivered in all assessment settings, 24-7, with exceptional patient-centred outcomes and inclusive use of innovative pathways that minimise use of traditional inpatient settings and optimise value. Delivering this will require close work with management teams, to initiate and develop projects including those identified by the Chief Registrars. All activities will embrace the Trust's vision of patient-centered service transformation and be aligned with the Future Hospital Commission's recommendations for ambulatory care: with greater vertical and horizontal integration of acute services transcending traditional hospital-community and intra-hospital barriers. Such activities will complement Trust service improvement initiatives and will have patient safety and the delivery of high-quality, better safe, compassionate care at their core. Service Transformation (Generic) The postholder will support existing and new projects led by Chief Registrar colleagues and the broader team. Example projects include: · The development and embedding of comprehensive ambulatory care pathways for o common and less common discrete 'medical' presentations o complex and/or frail patients, complementing existing services. o conditions with existing dedicated pathways but where further embedding, development or a complementary approach is needed to deliver best outcomes and resource use (e.g. DVT and TIA/minor stroke). · Evaluating care through the development and embedding of relevant patient-centred outcome measures, and useful measures of whole pathway resource use · Developing systems to support clinicians outside hospital (GPs, ambulance teams) to deliver effective care in the home. · Introduction and evaluation of pragmatic telemedicine systems · The AAU is embedded within the research and innovation infrastructure forming the Academic Health Sciences Centre (AHSC). Supervision and support are readily available to support projects that are aimed at improving clinical outcomes through changes in service models. The specialist fellows will participate alongside the Chief Registrars in the dissemination of quality and service improvement outcomes locally and with relevant national fora including the Ambulatory Emergency Care Network, the Acute Frailty Network and the Royal College of Physicians Future Hospital Commission. Opportunities for Specialist Interest Development The Trust and its partners offer multiple opportunities to incorporate the development of specialist interests into the programme of activity. Particular support and infrastructure are offered to candidates with an interest or qualifications in point of care ultrasound (POCUS), Echo, leadership and quality improvement projects (QIP). Teaching and Training The postholder will support teaching of medical students and training of trainee doctors and other clinicians within the Geratology and AGM departments. Reflecting contemporary service provision and teaching/training needs, programmes are increasingly innovative in nature.

Applications are invited for a Clinical Fellowship programme embedded within a well-established, innovative Departments of Ambulatory Care and Acute General Medicine. The applicant would be one of a team of 16 ambulatory and general medicine fellows working in a well-resourced unit lead by a team of 22 consultants and a large experienced multidisciplinary team. This is an exciting opportunity for an energetic, forward-thinking trainee who wishes to develop core clinical skills in a university teaching hospital and take full advantage of the links held with other Oxford institutions. The role would involve a mixture of banded clinical practise but also has one non-clinical day per week set aside where the candidate would be expected to gain experience in leadership, quality improvement, research, teaching and point of care ultrasound.,

• Full registration with GMC
• Be fit to practice
• Experienced in Acute medicine.
• Should be F2+ equivalent for Ambulatory Fellow
• Satisfactory progress throughout training, including ARCP outcomes
Desirable criteria
• Additional degree (intercalated, master's or doctorate)
Clinical SkillsEssential criteria
• Clinical competency in own medical specialty appropriate for their stage in training
• Appropriate knowledge base, and ability to apply sound clinical judgement to problems.
• Ability to prioritise clinical need.
• Ability to maximise safety and minimise risk.
• Ability to work without supervision where appropriate Demonstrable experience in ambulatory care
Desirable criteria
• Experience in management of frailty syndromes.
• Evidence of skills in management of acute medical emergencies (e.g. ALERT, IMPACT certification, ALS Instructor)
ResearchEssential criteria
• Understanding of research, including awareness of ethical issues
• Understanding of research methodology
• Knowledge of evidence-based practice
Desirable criteria
• Evidence of involvement in a formal research project
• Evidence of relevant academic achievements, including publications / presentations, Effective team working and leadership skills, supported by MSF or WBAs
• Self-awareness, with knowledge of personal strengths and weaknesses, impact and areas for development
• Interest in and knowledge of the importance of leadership and management for clinicians
Desirable criteria
• Effective leadership skills in and outside medicine (e.g. evidence of leading innovations or improvements)
• Understanding of NHS management and resources
• Understanding of the local and national context in which the trust operates, including economic and political influences, Understanding of clinical governance
• Active involvement in QIP/audit, research or other activity that focuses on patient safety and clinical improvement and innovation.
• Interest in / knowledge of the delivery of safe, effective healthcare services
Desirable criteria
• Evidence of completed audit/Quality improvement projects.
• Evidence of learning about the principles of change management
• Insight into issues facing UK healthcare services, Interest in and experience of teaching
• Evidence of excellent feedback on teaching
Desirable criteria
• Teaching diploma or degree
• Development of teaching programmes
• Participation in teaching courses, Clarity in written and spoken communication.
• Capacity to use logical/lateral thinking to solve problems/ make decisions, indicating an analytical/scientific approach and where appropriate, creativity in problem solving.
• Capacity to manage/prioritise time and information effectively.
• Ability to work effectively under pressure.
• Capacity to manage conflicting demands.
• Self-motivation, and resilience
• Initiative and ability to work autonomously.
• Can build effective teams and partnerships.
• Ability to work well in multidisciplinary teams
• Understands and values contributions of others
• Ability to show leadership, make decisions, organise and motivate other team members through, for example, quality improvement.
• Excellent computer literacy
Desirable criteria
• Leadership skills gained within the NHS or elsewhere
• Writing experience: - clinical and/or non-clinical topics - peer-reviewed publications and/or communication
• Evidence of achievements outside medicine
• Evidence of altruistic behaviour (e.g. voluntary work), You must have appropriate UK professional registration.
  
  The Oxford University Hospitals NHS Trust is one of the largest NHS teaching trusts in the country. It provides a wide range of general and specialist clinical services and is a base for medical education, training and research.
The Trust comprises of four hospitals - the John Radcliffe Hospital, Churchill Hospital and Nuffield Orthopaedic Centre in Headington and the Horton Hospital in Banbury. Our values, standards and behaviours define the quality of clinical care we offer and the professional relationships we make with our patients, colleagues and the wider community. We call this Delivering Compassionate Excellence and its focus is on our values of compassion, respect, learning, delivery, improvement and excellence. Many of our recruitment programmes use values-based interviewing to identify those who have the skills we seek, who share our values and who are able to deliver compassionate excellence from the outset. We know that this makes a significance difference to your job satisfaction and above all the outcomes and experience of our patients and their families., Oxford University Hospitals NHS Foundation Trust is one of the largest NHS teaching trusts in the country. It provides a wide range of general and specialist clinical services and is a base for medical education, training and research. The Trust comprises four hospitals - the John Radcliffe Hospital, Churchill Hospital and Nuffield Orthopaedic Centre in Headington and the Horton General Hospital in Banbury. Our values, standards and behaviours define the quality of clinical care we offer and the professional relationships we make with our patients, colleagues and the wider community. We call this Delivering Compassionate Excellence, and its focus is on our values of compassion, respect, learning, delivery, improvement and excellence. These values put patients at the heart of what we do and underpin the quality healthcare we would like for ourselves or a member of our family. Watch how we set out to deliver compassionate excellence via the OUH YouTube channel. In 2023 NHS England launched its first sexual safety charter, and our Trust proudly signed it. We pledge zero tolerance for inappropriate sexual behaviour and commit to the ten core principles Oxford University Hospitals promotes a safe, respectful hiring environment. If you want to make a difference with us, come and join our team. Together, we will uphold the highest standards of care and professionalism.