Job overview

We are looking for enthusiastic trainees from Geriatric Medicine, Acute Internal Medicine, Anaesthesia or other medical specialties to apply for this one-year peri-operative fellowship.

Oxford University Hospitals NHS Foundation Trust (OUH) has an established perioperative medicine service in the acute surgical emergency unit (SEU) and hip fractures. Over the last five years our services have expanded to provide consultant-led medical perioperative care to the major trauma, elective orthopaedic and the vascular services. We also form a part of the TAVI MDT. We particularly focus on older patients having emergency surgery, and patients with complex co-morbidities.  The perioperative consultants (who are from an acute medicine, HDU, renal and geriatric medicine background) are supported by medical residents (CMT, FY 1& 2 or GPVTS).

Main duties of the job

Surgical services

OUH has developed perioperative medicine services into emergency surgery, which is distinct from a number of other perioperative medicine services, which focus on elective work. Having run successful pilot programs we plan to expand our perioperative services into elective surgery over the next five years starting with our expansion to the elective orthopaedic group of patients later this year.

SEU

As well as accepting referrals locally, the SEU provides a tertiary referral service for acute and complex hepatobiliary cases, which may be transferred in from neighbouring counties.

Trauma

The John Radcliffe is a one of five Major Trauma Centres in the South of England, accepting patients with severe injuries from Oxfordshire and all neighbouring counties, serving a population of over 3-million. The trauma unit also provides care to over 500 hip fractures a year.

Vascular

The John Radcliffe Hospital is the hub for the regional vascular service, accepting referrals locally as well as from neighbouring counties. Procedures undertaken include all forms of vascular surgery including endovascular aneurysm repair.

Working for our organisation

Oxford University Hospitals NHS Foundation Trust is one of the largest NHS teaching and acute trusts, and is a world renowned centre of clinical excellence. Many surgical services are multisite, with the bulk of the emergency work being undertaken at the John Radcliffe Hospital, and with predominantly elective surgical services at the Churchill Hospital and the Nuffield Orthopaedic Centre; a small-moderate volume of work is undertaken at the Horton General Hospital in Banbury.

The perioperative physicians have become an essential part of the surgical department working collaboratively with the surgeons, anaesthetists and the multidisciplinary team. We provide acute medical and post-operative care, optimise patients for surgery and co-ordinate discharge planning for complex patients. We also provide teaching on perioperative medicine for surgical junior doctors, attend all surgical governance meetings including morbidity and mortality meetings and contribute to high-risk decision making. This year our team including our perioperative medicine fellows have run a number of quality improvement and service development projects in surgery around themes including patient blood management, post-operative cognitive dysfunction and delirium, consent and antiocoagulation management. This approach has shown a positive impact with respect to improvement of quality, patient safety and a reduction in length of stay and morbidity.