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RDGH Junior Doctor Network

Medical JD update 26/03/20

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Thursday, 26 March 2020

Medical JD update 26/03/20

Hi everyone. Firstly I wanted to say a massive thank you for the support you have been offering each other during this difficult time and offering me with the development of the COVID preparations. There is going to be a lot of change in the next few weeks, some of it will not work and some may add a bit of stress onto everyone whilst we find our feet. I apologise in advance, but ask that everyone keeps an eye on each other and we work together in the tidal wave to come.

Communication / Junior Doctor COVID

We are setting up a junior doctor COVID committee as there are lots of things to do and as we are all working clinically as well. We will be looking for junior doctor representatives at “FY1” and “SHO” levels across medicine, surgery and orthopaedics. We would also be looking to have a representative at “SpR” level from surgery and orthopaedics.

Will Sapwell will be working with me leading and coordinating the committee, and representing the junior teams at senior management level. If there are things that you have concerns about or solutions you want to share let us know via EMAIL:

Matt Gittus will lead the communications from the committee. We are aiming to have a web-area with access to key documents, national and local policies as well as training materials and videos. We will also be keeping a blog up-to-date with what’s going on within the Trust.

Suneil Raju will lead the work supporting the health and wellbeing of junior doctor team. We will update with all his hard work soon

We are looking for any SpR that would be keen to lead support with education and training issues during this time, and ask for any volunteers to come forward.

We are looking for any SpR that would be keen to lead support with medical staffing and rotas. Again any volunteers to come forward.

Rota & Staffing

At present, the rota will be escalated according to staff sickness and the cover across the hospital. Whilst this has not been finalised there have been some ideas and below is the lead suggestion.

Escalation   Status

SpR

SHO

FY1

Green

Rota   as it stands

Rota   as it stands

Rota   as it stands

Amber

2 x SpRs during the day (M-F)

1st oncall – 8am til 8pm

2nd   oncall – 12pm til 8pm

 

2 x SpRs during the day (Sat & Sun   where possible – these will be put out as locum shifts and asked as   voluntary)

1st oncall – 8am til 8pm

2nd oncall – 12pm til 8pm

 

SpRs to try and cover

Continue with current rota

 

Oncall teams would work as normal –   “team a”.

Members from the SHO medical team that   are not oncall at a certain part of their rota will be on standby “team b”.

 

If a member “team a” is unable to work   then a member of “team b” would step in a cover for that oncall period.  They would be paid at standard locum rates)

 

There would be cross covering across   SHO and FY1 rota.

Red

Amber rota should be maintained where   possible. However there will be multiple cross-covering and this will need to   be logged and supported by individuals and the Staffing SpR.

 

There will be a point in the future where junior doctors will be moving around the wards and not working as part of their current clinical teams. It may well be that junior team will be allocated to clinical teams on a daily basis at handover.

Health & Wellbeing

There are numerous efforts happening at a Trust level including access to talking / counselling therapies and debriefing. We will have more information about this soon. In the meanwhile there is free access for NHS staff to unmind at http://nhs.unmind.com/signup

The trust are to provide free meals to staff from the Rooftop Restaurant within the next week for the foreseeable. Will have more information about this as soon as it is available.

Car parking will also be free to staff from very early April for a period of 6 months. Again more information will be given about this soon as it becomes available.

Training & Education

As you all are aware, there is much change going on with ARCP, career progression, portfolio and training. We will support you where you will need it, but would be mindful to contact your Training Programme Director if you have any questions or concerns in the first instance.

Palliative care are providing some training for medical staff given the likelihood of increasing the amount of palliative care we will be providing to patients who are unwell and frail. The sessions are:

  • Friday 27th 1pm &  2pm Wentworth 12 people
  • Monday 30th 10am & 11am Ravenfield 16 people
  • Tuesday 31st 1pm &  2pm Wentworth 12 people
  • Wednesday 1st 10am & 11am Ravenfield 16 people
  • Thursday 2nd 12pm & 1pm Ravenfield 16 people
  • Friday 3rd 10am & 11am   Ravenfield 16 people

The SpRs are going to work to try and provide some training for junior staff. Suggestions include:

  1. COVID-19 assessment and management
  2. PPE Donning and Doffing
  3. US guided venous access
  4. Lumbar puncture procedure training
  5. NIV and basics to critical care
  6. Cardiac arrest calls for confirmed or suspected COVID-19 patients

If you feel there are any other areas you’d like support, feel free to let the team know.

Clinical Pathways

As the clinical operation of the Trust will affect the how we will treat patients, this will be subject to significant change.

Please see the documents source on the NHS Networks Website to links about the clinical assessment and management of COVID-19. It is important to assess comorbid state and state of frailty. There is a NICE guideline that outlines this approach.

We are looking at streamlining the clinical clerking sheet and a pilot document will be available next week.

 

Clinical Operations

The hospital will be divided into clean areas and dirty areas. There will be many concerns about staffing these areas and how the changes will affect where junior staff are working.

Briefly:

  • ED will remain as it is for the moment.
  • ASU will close
  • AMU bed-base will extend into old SDEC (now the “Covid-19 ward”) and into the current SDEC base. It will become a “dirty” area and will be a combined assessment unit between medicine and surgery. “Covid-19 ward” will extend into ASU.
  • B5 will become a clean combined assessment unit.
  • A1 and A2 will become clean outlier wards that medical teams will do safari wards rounds over their listed patients
  • A3/A4/A5 will become dirty wards and will open dirty bays across the floor as more patients need to be cohorted. Clinical consultant staff will be shuffled around so that there is fair cover.
  • Sitwell, Keppel wards at present will remain clean but could be flexed
  • Fitzwilliam & Stroke wards will be mixed dirty and clean and further advice about this will be released when available.

There is a meeting occurring with the consultant body about how they are prepared and going to adapt their working. More information will be available after this.

Environment and Equipment

The senior management team would be keen to know about what further things we can do with on the wards.

 

Dr Rob Parker