Job summary

This senior clinical fellow post at the Royal Brompton (RBH) and Harefield Hospitals (HH) is a rare and exciting opportunity to gain experience in complex non-HIV immune compromised patients, transplant infectious diseases, peri/myo and endocarditis, post-surgical infections, complex cardiac device-related infections including experience in mechanical circulatory support infection issues. There will also be opportunities to develop experience in infection prevention and control related to these patient groups.

These posts may also involve acquiring laboratory skills in Microbiology and Virology and applying these to a ward-based consult service on the Guy's, St. Thomas', Royal Brompton or Harefield site, or to looking after infectious diseases in-patients on the St. Thomas' site.

The post is suitable for clinicians experienced in Infectious Diseases / Microbiology / Virology (equivalent to ST3+ level), available to start asap.

The post involves opportunities to contribute to the wide-ranging clinical infection service run at Guy's, St Thomas', The Royal Brompton and Harefield Hospitals which compromises an inpatient ward, on site laboratories and specialist services focussing on delivering consults.

Main duties of the job

There are x2 senior infection fellow posts, rotating between RBH and HH under the supervision of the RBH Infection consultants.

Liaison with major clinical units

Serving the large cardiopulmonary departments, critical care and complex day unit teams within both hospitals.

Clinical consultation/microbiology & virology laboratory service

The clinical and diagnostic services are fully integrated. Most clinical work involves liaison with the diverse clinical specialities in the Trust. This may be via clinical consults comprising bedside assessment of referred patients or patients with significant microbiological or virological results, or telephone advice.

Multidisciplinary rounds in Paediatric ICU, adult ICU, cardiac/thoracic surgical, endocarditis (complex, tertiary referral) and transplant,in addition to other rounds the infection team will join when needed - congenital heart disease/cardiology, cystic fibrosis or inflammatory lung disease MDTs. There is also a ventricular assist device infection clinic weekly andregular fungal MDTs, antimicrobial stewardship meetings and infection control meetings.

The fellows work one to one with the infection consultantand also review referrals on the wards. This often includes pericarditis, myocarditis, endocarditis, cardiac and thoracic post-operative infections, transplant related infections in the immune compromised and returning travellers with febrile illness.

About us

Dr Nicholas Price is the Clinical Director and joint-Director of IPC (DIPC) and Ms Avey Bhatia, Chief Nurse, has Executive IPC responsibility. Dr William Newsholme (Infectious Diseases) and Dr Simon Goldenberg (Laboratories) are the medical Service Leads.

IPC staff are led by joint-DIPC, Dr Jon Otter, plus a dedicated ID pharmacy team. Every DoI consultant works in partnership with IPC colleagues.

The Royal Brompton and Harefield (RB&HH) hospitals, which make up the UK's largest postgraduate specialist heart and lung centre, were merged with Guy's and St Thomas' NHS foundation Trust (GSTT) in February are x4 ID/MMV or Microbiology consultants based at the RB and HH sites.

The Directorate also works closely with 7 Paediatric ID Consultants ( based at the Evelina London Children's Hospital on the St Thomas' site.

In addition, the DoI hosts one of the 4 national high-level infection units for High Consequence Infectious Diseases-airborne pathogens (HCID-a).

The DoI is fully integrated with, and provides clinical leadership to, the Microbiology and Virology laboratories, which are part of a 15-year Joint Venture (JV) between GSTT, Kings College Hospital and a private sector partner.

A defining characteristic of the service model we have striven to develop is seamless integration of these distinct but complementary clinical disciplines in order to deliver the highest-quality patient care.

Job description

Job responsibilities

1.Job Summary

This senior clinical fellow post at the Royal Brompton (RBH) and Harefield Hospitals (HH) is a rare and exciting opportunity to gain experience in complex non-HIV immune compromised patients, transplant infectious diseases, peri/myo and endocarditis, post-surgical infections, complex cardiac device-related infections including experience in mechanical circulatory support infection issues. There will also be opportunities to develop experience in infection prevention and control related to these patient groups.

These posts may also involve acquiring laboratory skills in Microbiology and Virology and applying these to a ward-based consult service on the Guys, St. Thomas, Royal Brompton or Harefield site, or to looking after infectious diseases in-patients on the St. Thomas site.

It may be possible to tailor the location in discussion with the service lead and local training faculty lead.

2. Liaison with major clinical units

Specimens are received from a wide range of departments including: Intensive Care Unit, HIV & Genitourinary Medicine, Renal Dialysis and Transplantation, Oncology, Haematology, Orthopaedics, Cardiothoracic Surgery, Haematology, cardiac and lung transplantation, specialist respiratory medicine (including cystic fibrosis), Evelina London Childrens Hospital (including the Neonatal Unit), Obstetrics, and Occupational Health. The Department also provides a comprehensive service for local Primary Care Trusts.

Any post holder based at RBH/HH sites will serve the large cardiopulmonary departments, critical care and complex day unit teams within both hospitals.

3. Direct clinical responsibilities

Clinical consultation/microbiology & virology laboratory service: The clinical and diagnostic services are fully integrated. Most clinical work involves liaison with the diverse clinical specialities in the Trust. This may be via clinical consults comprising bedside assessment of referred patients or patients with significant microbiological or virological results, or telephone advice.

At both RBH and HH there are multiple MDT rounds. All intensive care units are also ECMO retrieval units including the paediatric ICU. The clinical ID service is a consult service and there are 4 consultants covering the two sites.

RBH - Multidisciplinary rounds in Paediatric ICU, adult ICU, cardiac/thoracic surgical, endocarditis (complex, tertiary referral) that are routine weekly in addition to other rounds the infection team will join when needed - congenital heart disease/cardiology, cystic fibrosis or inflammatory lung disease MDTs.

HH - adult ICU, cardiac and thoracic surgical, endocarditis (complex, tertiary referral) and transplant ID MDTs routine weekly. There is also a ventricular assist device infection clinic weekly.

Across both sites there are regular fungal MDTs, antimicrobial stewardship meetings and infection control meetings.

The fellows work one to one with the infection consultantbut are also expected to review referrals on the wards. This often includes pericarditis, myocarditis, endocarditis, cardiac and thoracic post-operative infections, transplant related infections in the immune compromised and returning travellers with febrile illness.

4. Clinical service routineThe hours of work will be to Monday to Friday, plus any agreed on-call duties. Work outside these times may be required as necessary professional duties; nevertheless, the hours of work accord to the requirements of the New Deal on Doctors hours, the European Working Time Directive and the New Junior Doctors Contract. It is a condition of employment that the appointee be prepared to work at any site where work relating to the appointment is carried out.

The post holder may be required to undertake other duties in line with the grading of the post as may be required by the head of department. Staff should recognise that job descriptions reflect the core activities of a post at a particular time and that as the Institution and the individual develops there will inevitably be changes in the emphasis and duties of the post. The Trust expects that all staff will recognise this and adopt a flexible approach to work and be willing to participate in training. If changes to a job description become significant the job description should be reviewed formally by the Head of Department and the post holder. At all times staff must conduct themselves and carry out their duties in a manner which supports the Trusts equal opportunities policy and ensues that the working and learning environment provided within the Trust is free from bias or harassment.

The junior doctor accepts that he/she will also perform duties in occasional emergencies in unforeseen circumstances at the request of the appropriate Consultant, in consultation where practicable with his colleagues both junior and senior. It has been arranged between the Professions and the Department of Health that while they will perform such duties, the Secretary of State stresses that additional commitments arising out of this sub-section are exceptional; in particular, the junior should not be required to undertake work of this kind for long periods of time.

5. On-call

The postholder will be on the pay scale commensurate with their grade/experience. Rotations that involve the Guys or St Thomas sites would include an on-call commitment at a 1 in 9 frequency weekday nights (Monday-Friday) as first on call for Infection (Microbiology and Virology) advice to the Trust. If on-call, the postholder would also be expected to cover the High Consequence Infectious Diseases (HCID) service, if activated, and after appropriate training. This will include being contactable via mobile telephone. The StR on call will be covered at all times by a Consultant Virologist and Consultant Microbiologist from the department. The on-call commitment of this post will be timetabled with other junior medical staff in the Department to accord with the requirements of the New Deal and European Working Time Directive.

This can be discussed further to provide detail on the arrangements which will apply in varying circumstances, such as at Royal Brompton and Harefield sites.

6. Teaching responsibilities

The Departments provide training and teaching for a wide range of professional groups, including postgraduate doctors in training, medical students, nurses, allied health professionals and laboratory staff. On occasion the postholder will be expected to contribute to the teaching of medical students. Especially when they become more senior, they are encouraged to get more involved in postgraduate teaching and teaching of nursing staff and allied health professionals. Attendance at relevant teaching courses run by the Trust is encouraged.

7. Research possibilities

The post holder can be supported to develop R&D skills through participation in ongoing research projects. There are extensive research projects ongoing within the department and a well resource research infrastructure. The CIDR has particular interests in the pathogenesis and epidemiology of hospital-associated infection (especially C. difficile and MDR-Gram negative bacteria), S. aureus bacteraemia, and novel diagnostics, as well as an interest in Covid-19.

8. Clinical audit

There is an active clinical audit programme within theDepartment. The postholder is expected to lead audit projects through the 'audit cycle'. The Trust Clinical Audit Department provides advice and support in all aspects of clinical audit.

9. Management training

Experience should be gained, under supervision, in planning departmental policies and developing leadership qualities to implement them. Post-holders routinely take on responsibilities such as management of the on-call rota and organisation of the Tuesday morning educational Seminars. Once post-holders have achieved a certain seniority, they will be expected to attend meetings such as diagnostic service meetings, Infection Control meetings and senior staff meetings. Attendance at appropriate management meetings and training courses is encouraged towards the end of the training programme.

10. University links

Guys, Kings College & St Thomas School of Medicine (GKT) is a School of Kings College London. GKT is the largest free-standing medical and dental school in the UK with a projected annual intake of approximately 360 medical and 150 dental undergraduate and over 400 full time and part time postgraduate students. The GKT Department of Infectious Diseases comprises the Microbiology and Virology staff on the Guys, St Thomas and Denmark Hill campuses and their work is closely integrated with the GSTT Directorate of Infection. Members of the Departments of Infectious Diseases, Immunobiology, Rheumatology, Renal Medicine, Transplantation, the Neuroinflammation group and some members of the current Immunology Department at Denmark Hill, form the Division of Infection, Immunology and Inflammatory Diseases (DIIID).

Person Specification

Quallifications and training

Essential

MBBS or equivalent Full GMC Registration and hold a licence to practise Full MRCP (UK) or equivalent

Desirable

Higher degree ( MSc, PhD or MD)

Clinical Experience:

Essential

Experience of managing infections in a range of patient groups Experience of managing patients on an acute unselected medical take (ST1-2 level CMT or equivalent).

Desirable

Experience working in clinical Microbiology, Virology or Clinical Infectious Diseases departments FRCPath Part 1 or CICE examination

Knowledge and Skills:

Essential

Ability to work as an effective member of a multidisciplinary team Ability to prioritise clinical need Ability to work without direct supervision where appropriate Proven ability to conduct clinical audit

Desirable

Experience in clinical guideline development

Research

Essential

Understanding of the principles and applications of clinical research

Desirable

Evidence of original research

Teaching:

Essential

Experience of undergraduate and post graduate training

Management

Essential

Evidence of understanding of the role of clinical management

Other

Essential

Evidence of understanding of and adherence to the principles of Good Medical Practice set out by the General Medical Council