Consultant physicians working with patients - Royal College of ...
Consultant physicians working with patients - Royal College of ...
Consultant physicians working with patients - Royal College of ...
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<strong>Consultant</strong> <strong>physicians</strong> <strong>working</strong> <strong>with</strong> <strong>patients</strong>have a daily visit from a consultant; in most hospitalsthis will involve more than one physician.Because many consultant <strong>physicians</strong> are already<strong>working</strong> longer hours than their contract stipulates, therecommendation means that, instead <strong>of</strong> increasing theamount <strong>of</strong> hours worked overall, job plans will need tochange to reflect the different <strong>working</strong> patterns andmust include arrangements to ensure adequate rest. Thestatement builds on previous RCP surveys, audits andreports on acute medicine, which have led toimprovements in the way acutely ill <strong>patients</strong> arecared for.Additional areas <strong>of</strong> work undertaken by <strong>physicians</strong> topromote personal and pr<strong>of</strong>essional excellence arecategorised as SPAs. Such activities include teaching,research, audit, self-development, management,quality improvement and wider contribution to theNHS. This work done in SPAs has expanded in natureand complexity. One example is the new arrangementfor the education and training <strong>of</strong> junior doctors,which requires that consultants who have juniorstaff should set aside about one hour each week tosupervise, educate and train each junior doctor.In a large team that is the equivalent <strong>of</strong> one halfday a week.In a standard <strong>working</strong> week <strong>of</strong> 10 sessions usually 7.5 <strong>of</strong>them will be devoted to clinical care and 2.5 to SPAs.Not all consultants will have 2.5 SPAs. Others <strong>with</strong>substantial educational, managerial qualityimprovement or research activities will have more.Many roles held at regional or national level shouldattract additional SPAs; this happens in some trusts, butnot others and is a contentious issue that is currentlyunder discussion nationally. <strong>Consultant</strong>s are stronglyencouraged to ensure that SPAs are recognised and paidforappropriately,butalsotorecognisethat2.5SPAsarenot a right and have to be justified.Excellence over and above just fulfilling contractualobligations to a satisfactory standard can be rewardedby the Clinical Excellence Awards scheme. 21Discretionary points can be allocated by local trustmanagement. Bronze, silver, gold and platinum awardscan be allocated by a national process, to rewardexcellence in service delivery, quality improvement,teaching, research or management. About 30% <strong>of</strong> allconsultants are in receipt <strong>of</strong> some sort <strong>of</strong> award, eitherlocal or national. The number <strong>of</strong> <strong>physicians</strong> who receivenational awards is proportionally higher than in othermedical disciplines. The scheme is under review andmay be changed after a period <strong>of</strong> consultation. The RCPhas submitted its view that the scheme does rewardexcellence and encourages the delivery <strong>of</strong> high-qualitycare and excellence in teaching, research, managementand clinical care.The changing role <strong>of</strong> the consultantover timeThe role <strong>of</strong> the modern consultant is expected todevelop and change during a pr<strong>of</strong>essional lifetime.<strong>Consultant</strong>s usually have three phases to theirpr<strong>of</strong>essional lives:1 establishment <strong>of</strong> clinical practice and vigorousinvolvement in it2 new responsibilities and roles <strong>with</strong>in their ownhospital3 leadership roles at local, regional and national level,for some.As part <strong>of</strong> this wider development some clinicians takemajor roles in clinical service development, qualityimprovement, management, research or education.These roles may be at local, regional or national level.Although not always <strong>of</strong> direct and immediate value tothe employing trust, they are important for the widerservice and add greatly to national strategic directionand support the drive for excellence.Additional duties that may be undertaken include: work on advisory panels for employment <strong>of</strong> otherconsultants lead for undergraduate education royal college tutor clinical tutor director <strong>of</strong> postgraduate medical education manager or director <strong>of</strong> service leadership <strong>of</strong> quality improvement processes clinical audit lead/governance lead.Within the health economy, activities can include: sessional commitments to primary careorganisations or regional bodies educational leads for undergraduate andpostgraduate education <strong>with</strong>in the deanery RCP regional advisers (RAs).8 C○ <strong>Royal</strong> <strong>College</strong> <strong>of</strong> Physicians 2013
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