Consultant physicians working with patients - Royal College of ...

Consultant physicians working with patientsNHS or the independent sector. Infectious diseasesphysicians are prominent in the development ofantibiotic policies, not only for the hospital but alsothose that are used in primary care. They help toeducateGPsintheappropriateuseofantibioticsinthecommunity, the interpretation of laboratory tests andthe prevention and management of healthcareassociatedinfections.Specialist activity beyond local servicesInfectious diseases physicians have taken on the burdenof providing clinical expertise and cover in the event ofbioterrorism. Each region has an infectious diseasesphysician named as the smallpox diagnostic expert(SDE), who has been vaccinated and trained in therecognition of this disease and its management in theevent of a new case emerging. These physicians are alsoinvolved in the planning for other outbreaks, includingpandemic influenza, in conjunction with the HealthProtection Agency (HPA) and public health physicians.Infectious diseases physicians play an active role innational bodies. As well as working at the Royal Collegeof Physicians (RCP), they serve on national committeessuch as the Joint Committee on Vaccinations andImmunisations (JCVI), the Expert Advisory Group onAIDS (EAGA), the Advisory Committee onAntimicrobial Resistance and Healthcare AssociatedInfection (ARHAI) and the National Expert Panel onNew and Emerging Infections (NEPNEI). Many havehelped with the development and running of theNational Travel Health Network and Centre which nowprovides excellent advice about travel medicine to thepublic as well as to health professionals.5 Delivering a high-quality serviceCharacteristics of a high-quality serviceCharacteristics of a high-quality service include: inpatient facilities and expertise 24 hours a daythroughout the year isolation rooms, including those with negativepressure ventilation same day access to outpatients for acute infectionsand travellers open access to those with HIV infection open access to those with accidental blood-bornevirus exposure clinical management that takes a holistic approach regular clinical liaison with themicrobiology/virology laboratory lead on the trust’s antimicrobial policy active promotion of appropriate antimicrobial usagein the hospital lead on the trust’s infection control policies and withthe team active promotion of best practice of infection control promoting safe intravenous antibiotic usage outsidethe hospital meeting recognised standards in clinical care meeting NHS targets for inpatient and outpatientwork.Maintaining and improving the quality of careLeadership role and service developmentInfectious diseases physicians often take leadership rolesin the hospital, in addition to having clinical leads intheir specialty. Many will serve on or chair antibioticcommittees or infection control committees in theirtrusts. They will frequently have leadership roles in theirregions for infection-related policies and links withprimary care trusts (PCTs) and with the HPA.Infectious diseases physicians have taken the lead indeveloping OPAT to facilitate patient discharge, whileproviding appropriate antibiotic therapy for seriousinfections. In addition, by supporting the developmentof standards for managing HIV and TB, they arecontributing to improvements in the service.Education and trainingMost infectious diseases physicians are involved inteaching medical students, both preclinical and clinical.In addition, because many have academic positions,there is wider teaching, both regionally and nationally.However, some of the new medical schools do not haveinfectious diseases physicians so not all students andtrainees get exposed to such teaching, which is a gap intheir training. Most infectious diseases physicians willact as trainers for junior medical staff. Some centreshave appointed new academic clinical fellows under theWalport scheme to continue to nurture academicmedicine and, particularly, academic infectiousdiseases. The physicians also teach other trainees,including nurses and ancillary workers. Infectiousdiseases physicians, as in other specialties, have beeninvolved in training foundation doctors and inacademic training schemes. In addition, recognising theneed to encourage trainees to learn about internationalhealth, our specialty is keen to allow trainees to spendtime abroad and to encourage trainees from developingcountries to be involved in research and to get someexperience in the UK.148 C○ Royal College of Physicians 2013