Job summary
Applications are invited from suitably qualified physicians for the post of Locum Consultant Physician in Geriatric Medicine, Maternity Cover for 12 months. The post will be based at Homerton University Hospital and the post-holder will have following core responsibilities:
To provide comprehensive inpatient care on the Elderly Care Unit, with approximately 14 inpatients per ward round
To assist the Trust in evaluating the efficacy - in clinical, operational and financial terms of the services.
Outpatient clinics are generally flexible to accommodate other clinical commitments, with profiles of between 2-3 new patients, and 3-5 follow-up patients.
The post is offered on a basis of 10 programmed activities for one year to cover maternity leave. Full secretarial support will be provided as well as suitably equipped office space with IT.
To achieve the departmental objectives the Trust is seeking a dynamic individual with highly developed leadership and communication skills and a commitment to multi-disciplinary and integrated working across specialty boundaries.
The Trust has the required arrangements in place, as laid down by the Royal College of Physicians, to ensure that all doctors have an annual appraisal with a trained appraiser and supports doctors going through the revalidation process.
Main duties of the job
The essential requirements of the post are:
To work collaboratively and pro-actively with all appropriate clinical colleagues within the Trust in developing and implementing an acceptable service model reflective of best practice
To share responsibility with colleagues for providing evidence-based standards of care for all inpatients and outpatients
To have continuing responsibility for the care of patients in his/her charge, including all administrative duties associated with patient care
To liaise effectively and on a timely basis with General Practitioners and all other external agencies
To maintain and promote team and multi-disciplinary working within all relevant services at all times
To lead and co-ordinate the dedicated multi-disciplinary team appointed to support the service models to achieve effective rehabilitation and effective discharge management
To deliver comprehensive ward rounds and weekly multi-disciplinary meetings to co- ordinate the delivery of high-quality patient care
To deliver multi-disciplinary outpatient clinics to provide specialist support
To participate in corporate and singular responsibility for the management of junior medical staff
There may also be an opportunity to work on the General Medical Consultant on-call rota.
About us
Homerton Healthcare NHS Foundation Trust (HH) is an acute hospital located in the east London Borough of Hackney. The current Chairman is Sir John Gieve (Mary Elford will take over from 31st March 2025), and the Chief Executive is Ms Basirat Sadiq.
The hospital building opened in 1986, with Homerton Hospital Trust established in 1994. We provide training for undergraduates from Barts and The London Medical School / Queen Mary's School of Medicine and Dentistry, and nursing and allied health professions training for students from City University and the University of East London.
Homerton became one of the first ten NHS Foundation trusts in the country in April 2004. This allows the Trust to secure certain freedoms to facilitate innovation in the way services are developed and provided. As well as our Trust Board, we also have a Council of Governors comprised of governors representing the local community.
In 2011 the Trust integrated with City & Hackney Community Health Services thereby providing it with an opportunity to develop new service models and pathways that cross traditional organisational boundaries.
Employing over 3000 people, the hospital has approximately 500 beds and manages a 50-bed nursing home, Mary Seacole Nursing Home, in Shoreditch, East London. In 2022, the Trust saw over 300,000 people in outpatient clinics, and over 126,000 people were treated in the Accident and Emergency department.
Job description
Job responsibilities
The comprehensive range of Geriatric services currently provided by HUH is as recommended by the National Service Framework for Older People and the British Geriatric Society. Multidisciplinary team working is strong with senior physiotherapists, occupational therapists and social workers dedicated to elderly services. There is close liaison and working with all departments and formally with orthopaedics, old age psychiatry, neurology & community teams.
Over recent years the Trust has undertaken an extensive programme of work to improve and better integrate its Elderly Care provision. These include:
Geriatrician at the Front Door
The Geriatrician at the Front Door operates through having the consultant geriatricians providing daily input into the Emergency Department (ED) and the Acute Care Unit (ACU) teams to identify patients as suitable either for rapid discharge or for direct admission to the Elderly Care Unit and providing a dynamic interface with a range of intermediate care services in the community. The intervention ensures optimisation of rapid and sustainable discharges and direct transfers to Geriatric inpatient beds from ACU with a view to reducing length of stay and re-admission rates. This service is in the process being reconfigured to a frailty same-day emergency care service (Frailty SDEC)
Virtual Frailty Ward
Approximate 26 patient capacity service for expediting discharge from local hospitals and avoiding acute hospital admission for selected frail older patients living in Hackney. This service is led by Consultant Geriatricians working with a team of nurses and therapists. The virtual frailty ward works in partnership with local GP's, Homerton elderly care and intermediate care services. local emergency departments and frailty SDEC service in Homerton and other local hospitals.
Elderly Care Unit
The inpatient care is delivered via two 28-bed bed Elderly Care units. The services strength is the interdisciplinary approach to assessment and treatment. The unit has benefitted from an increase in nursing and therapy staffing to enable the service to deliver the highest level of care. The units focus is to provide comprehensive geriatric assessment, acute treatment and inpatient rehabilitation to patients who have been rapidly assessed and identified at the Emergency Department, Acute Care Unit through the geriatrician at the front door initiative. Key features of the service are daily whiteboard MDT meetings and regular weekly MDM meetings, ward rounds and teaching sessions.
The increased throughput this approach generates is aimed at improving both the quality of care and experience of patients and ensuring a higher proportion of appropriate patients receive full and comprehensive Geriatric input.
Surgical Rehabilitation Team
In response to the NCEPOD report An Age-Old Problem which recommended regular geriatrician input into older patients admitted under surgeons the trust established a new Surgical Rehabilitation Team. The team consists of a consultant geriatrician and Band 8 Physiotherapist with additional physiotherapists, occupational therapists and one specialist nurses and was launched in March 2013. The service is innovative in that it takes the standard multidisciplinary model of hip fracture care and replicates it across all of surgery.
All Orthopaedic patients (elective and trauma) over the age of 65 years old are admitted under joint care of an orthopaedic surgeon and a geriatrician and are reviewed on twice weekly consultant geriatrician ward rounds and discussed in a weekly MDT.
In addition, the enhanced therapy service allows all patients to be offered a physiotherapy assessment on the day of their surgery with the aim of them getting out of bed within 24 hours.
Geriatricians also review patients over 65 years who have abdominal surgery as per NELA Audit standards and attend the Surgical Ward Whiteboard Meeting twice weekly to help with discharges and highlighting frail patients who would benefit from CGA.
Homerton also offer a preoperative MDT clinic to review high risk frail surgical patients to aid with optimisation and decision making.
All elderly surgical inpatients are offered a therapies assessment. The consultant geriatrician offers a single point of access for medical advice and review during the patients stay rather than relying on ad hoc involvement from the medical on-call team. Patients under the colorectal surgeons who often have complex post-operative stays are reviewed on joint surgical-geriatric ward rounds twice a week.
The team operates a weekly Pre-op comprehensive geriatric assessment clinic led by a Geriatrician and Physiotherapist to review elective patients who are flagged as having elderly medicine needs at conventional pre-assessment. The clinic has an open referral policy with any healthcare professional reviewing the patient in the pre-operative period being able to refer into the clinic directly.
For full details please refer to Job description.
Job description
Job responsibilities
The comprehensive range of Geriatric services currently provided by HUH is as recommended by the National Service Framework for Older People and the British Geriatric Society. Multidisciplinary team working is strong with senior physiotherapists, occupational therapists and social workers dedicated to elderly services. There is close liaison and working with all departments and formally with orthopaedics, old age psychiatry, neurology & community teams.
Over recent years the Trust has undertaken an extensive programme of work to improve and better integrate its Elderly Care provision. These include:
Geriatrician at the Front Door
The Geriatrician at the Front Door operates through having the consultant geriatricians providing daily input into the Emergency Department (ED) and the Acute Care Unit (ACU) teams to identify patients as suitable either for rapid discharge or for direct admission to the Elderly Care Unit and providing a dynamic interface with a range of intermediate care services in the community. The intervention ensures optimisation of rapid and sustainable discharges and direct transfers to Geriatric inpatient beds from ACU with a view to reducing length of stay and re-admission rates. This service is in the process being reconfigured to a frailty same-day emergency care service (Frailty SDEC)
Virtual Frailty Ward
Approximate 26 patient capacity service for expediting discharge from local hospitals and avoiding acute hospital admission for selected frail older patients living in Hackney. This service is led by Consultant Geriatricians working with a team of nurses and therapists. The virtual frailty ward works in partnership with local GP's, Homerton elderly care and intermediate care services. local emergency departments and frailty SDEC service in Homerton and other local hospitals.
Elderly Care Unit
The inpatient care is delivered via two 28-bed bed Elderly Care units. The services strength is the interdisciplinary approach to assessment and treatment. The unit has benefitted from an increase in nursing and therapy staffing to enable the service to deliver the highest level of care. The units focus is to provide comprehensive geriatric assessment, acute treatment and inpatient rehabilitation to patients who have been rapidly assessed and identified at the Emergency Department, Acute Care Unit through the geriatrician at the front door initiative. Key features of the service are daily whiteboard MDT meetings and regular weekly MDM meetings, ward rounds and teaching sessions.
The increased throughput this approach generates is aimed at improving both the quality of care and experience of patients and ensuring a higher proportion of appropriate patients receive full and comprehensive Geriatric input.
Surgical Rehabilitation Team
In response to the NCEPOD report An Age-Old Problem which recommended regular geriatrician input into older patients admitted under surgeons the trust established a new Surgical Rehabilitation Team. The team consists of a consultant geriatrician and Band 8 Physiotherapist with additional physiotherapists, occupational therapists and one specialist nurses and was launched in March 2013. The service is innovative in that it takes the standard multidisciplinary model of hip fracture care and replicates it across all of surgery.
All Orthopaedic patients (elective and trauma) over the age of 65 years old are admitted under joint care of an orthopaedic surgeon and a geriatrician and are reviewed on twice weekly consultant geriatrician ward rounds and discussed in a weekly MDT.
In addition, the enhanced therapy service allows all patients to be offered a physiotherapy assessment on the day of their surgery with the aim of them getting out of bed within 24 hours.
Geriatricians also review patients over 65 years who have abdominal surgery as per NELA Audit standards and attend the Surgical Ward Whiteboard Meeting twice weekly to help with discharges and highlighting frail patients who would benefit from CGA.
Homerton also offer a preoperative MDT clinic to review high risk frail surgical patients to aid with optimisation and decision making.
All elderly surgical inpatients are offered a therapies assessment. The consultant geriatrician offers a single point of access for medical advice and review during the patients stay rather than relying on ad hoc involvement from the medical on-call team. Patients under the colorectal surgeons who often have complex post-operative stays are reviewed on joint surgical-geriatric ward rounds twice a week.
The team operates a weekly Pre-op comprehensive geriatric assessment clinic led by a Geriatrician and Physiotherapist to review elective patients who are flagged as having elderly medicine needs at conventional pre-assessment. The clinic has an open referral policy with any healthcare professional reviewing the patient in the pre-operative period being able to refer into the clinic directly.
For full details please refer to Job description.
Person Specification
Qualifications& Higher qualifications
Essential
- Fully registered with GMC MRCP (or equivalent) On specialist register or within 6 months of Geriatric/General Medicine CCT at the time of interview Certificate of Eligibility for Specialist Registration (CESR)
Desirable
- Other higher degree or diploma (e.g. MD, PhD)
Clinical Skills and Relevant Experience
Essential
- Abilitytopracticeindependentlyin Geriatric and General Medicine. Ability to offer expert clinical opinion on a range geriatric medicine related problems. Ability to work as part of a multidisciplinary team. Excellent clinical skills
Leadership and professionalism
Essential
- Ability to take responsibility, lead, make decisions and respond appropriately to service need Evidence of cross craft working and interdisciplinary working which goes beyond usual team working
Desirable
- Familiar with current structure of the health service and conversant with recent initiatives and changes
Management skills
Essential
- Awarenessoftheoverallbusiness environment in which the hospital operates Understanding of the importance of good clinical coding Knowledgeofrelevantregulatory frameworks e.g. EWTD Understanding the principles of quality improvement.
Desirable
- Managementofteamor programme or project. Experience of using quality improvement methodology and managing change.
Teaching & training
Essential
- Experience of undergraduate and post- graduate teaching
Desirable
- Experience of educational supervision, teaching skills course/ qualification
Clinical Governance
Essential
- Evidence of contribution to effective audit and clinical risk management
Research
Essential
- Understanding of principles and application of clinical research
Desirable
- Relevant research experience Publication of peer reviewed papers
Communication skills
Essential
- Ability to communicate with clarity and intelligently in written and spoken English IT skills and computer literacy
Desirable
- Computer skills course/certificate
Patient focused skills
Essential
- Empathy, understanding, listening skills, patience, social skills appropriate to different types of client
Interpersonal skills
Essential
- Good interpersonal skills coupled with an ability to co- operate, persuade and negotiate within a senior clinical and management team
Personal attributes
Essential
- An awareness of own strengths and weaknesses coupled with an ability to deploy them effectively Professional attitude towards work, good record of attendance
Person Specification
Qualifications& Higher qualifications
Essential
- Fully registered with GMC MRCP (or equivalent) On specialist register or within 6 months of Geriatric/General Medicine CCT at the time of interview Certificate of Eligibility for Specialist Registration (CESR)
Desirable
- Other higher degree or diploma (e.g. MD, PhD)
Clinical Skills and Relevant Experience
Essential
- Abilitytopracticeindependentlyin Geriatric and General Medicine. Ability to offer expert clinical opinion on a range geriatric medicine related problems. Ability to work as part of a multidisciplinary team. Excellent clinical skills
Leadership and professionalism
Essential
- Ability to take responsibility, lead, make decisions and respond appropriately to service need Evidence of cross craft working and interdisciplinary working which goes beyond usual team working
Desirable
- Familiar with current structure of the health service and conversant with recent initiatives and changes
Management skills
Essential
- Awarenessoftheoverallbusiness environment in which the hospital operates Understanding of the importance of good clinical coding Knowledgeofrelevantregulatory frameworks e.g. EWTD Understanding the principles of quality improvement.
Desirable
- Managementofteamor programme or project. Experience of using quality improvement methodology and managing change.
Teaching & training
Essential
- Experience of undergraduate and post- graduate teaching
Desirable
- Experience of educational supervision, teaching skills course/ qualification
Clinical Governance
Essential
- Evidence of contribution to effective audit and clinical risk management
Research
Essential
- Understanding of principles and application of clinical research
Desirable
- Relevant research experience Publication of peer reviewed papers
Communication skills
Essential
- Ability to communicate with clarity and intelligently in written and spoken English IT skills and computer literacy
Desirable
- Computer skills course/certificate
Patient focused skills
Essential
- Empathy, understanding, listening skills, patience, social skills appropriate to different types of client
Interpersonal skills
Essential
- Good interpersonal skills coupled with an ability to co- operate, persuade and negotiate within a senior clinical and management team
Personal attributes
Essential
- An awareness of own strengths and weaknesses coupled with an ability to deploy them effectively Professional attitude towards work, good record of attendance
Disclosure and Barring Service Check
This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.
Applications from job seekers who require current Skilled worker sponsorship to work in the UK are welcome and will be considered alongside all other applications. For further information visit the UK Visas and Immigration website (Opens in a new tab).
From 6 April 2017, skilled worker applicants, applying for entry clearance into the UK, have had to present a criminal record certificate from each country they have resided continuously or cumulatively for 12 months or more in the past 10 years. Adult dependants (over 18 years old) are also subject to this requirement. Guidance can be found here Criminal records checks for overseas applicants (Opens in a new tab).
UK Registration
Applicants must have current UK professional registration. For further information please see
NHS Careers website (opens in a new window).
Additional information
Disclosure and Barring Service Check
This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.
Applications from job seekers who require current Skilled worker sponsorship to work in the UK are welcome and will be considered alongside all other applications. For further information visit the UK Visas and Immigration website (Opens in a new tab).
From 6 April 2017, skilled worker applicants, applying for entry clearance into the UK, have had to present a criminal record certificate from each country they have resided continuously or cumulatively for 12 months or more in the past 10 years. Adult dependants (over 18 years old) are also subject to this requirement. Guidance can be found here Criminal records checks for overseas applicants (Opens in a new tab).
UK Registration
Applicants must have current UK professional registration. For further information please see
NHS Careers website (opens in a new window).
