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

2 Specialties Respiratory medicineTable 2 Consultant work programme/specimen job planActivityDirect clinical careWorkloadProgrammed activities(PAs)Outpatient clinics 3Ward rounds20–25 patients maximum (half that number ifinvolving complex or high-care patients, such asITU step-down cases)2MDT meetings (eg lung cancer) 0.5Routine bronchoscopy, transbronchial lung biopsyand pleural proceduresBronchoscopy (6 per session) 1Specialist investigative/therapeutic procedures Lung or pleural biopsies (3 per session) 0–1Clinical lead activityWorkload examples are given in the text.Depending on the activity, some of this workmay fall under supporting professional activities(see below)0–1Clinically related administration 1–2Specialist on-call and/or general medicalon-call/post-take ward roundsTotal number of direct clinical care PAsSupporting professional activities (SPAs)Work to maintain and improve the quality ofhealthcareOther NHS responsibilitiesExternal dutiesMost respiratory physicians also undertakeacute and general medicineEducation and training, appraisal, departmentalmanagement and service development, auditand clinical governance, CPD and revalidation,researchFor example, medical director, clinical director,lead consultant in specialty, clinical tutorFor example, work for deaneries, royal colleges,specialist societies, Department of Health orother government bodies0.5–1.57.5 on average2.5 on averageLocal agreement withtrustLocal agreement withtrustCPD = continuing professional development; DH = Department of Health; ITU = intensive treatment unit; MDT = multidisciplinary team meeting.10 Key points for commissionersCommissioning is considered to be the process ofassessing the health needs of a population, and thenplanning, securing and monitoring the best possiblerange and quality of health services and healthimprovement services given the resources available. 111 High-quality respiratory commissioning enablesthedeliveryoftherightcareattherighttimeandin the right location for each individual patientwith respiratory illness by a competent workforcethat intervenes with knowledge and understandingof the patient’s place on a local pathway ofcare.2 High-quality respiratory commissioning isinformed by accurate local information on theburden of respiratory disease and the impact onexisting services across the whole system ofrespiratory care.3 It is necessary to have a common understanding ofexisting local respiratory pathways and services andtheir interdependence, as well as accurateinformation on local respiratory outcomes,including distinguishing variation fromunwarranted variation.4 High-quality respiratory commissioning supportsthe development and implementation of‘currencies’ that encourage right care, eg carebundle tariffs and personalised care tariffs.C○ Royal College of Physicians 2013 233