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ForewordThe revised fifth edition of Consultant physicians working with patients is more relevant than ever, as it coincideswith the major change in commissioning arrangements in England. I hope that the information containedhere on service organisation and standards, workload, job plans and the role of the Royal College of Physiciansin supporting these activities will also be of particular value to clinical commissioning groups as they take uptheir new role.To support the commissioning process, the RCP has developed a clinical commissioning hub on its website,containing all the elements of its work that can contribute to commissioning decisions – clinical guidelines,audit results, quality improvement programmes, and information relating to all 30 medical specialties coveredby the RCP. Each specialty chapter of this book contains major recommendations specifically forcommissioners. Further information on the role of the Royal College of Physicians and the clinicalcommissioning hub can be found on our website (www.rcplondon.ac.uk). This information is also relevant tothe planning processes in the devolved nations.Consultant physicians working with patients will also help individual physicians and clinical teams demonstratehow the structures and resources described here will result in high-quality patient care, which is vital at a timewhen the NHS faces major financial constraints. We underline the importance of multidisciplinary teamworking, not just within the hospital, but stretching out across primary, community and social care, to supportintegrated care for patients and bring care ‘closer to home’.I am enormously grateful to all those who have contributed, and in particular to our clinical vice-presidentDr Linda Patterson OBE, and to Urooj Akhtar, who has quietly and efficiently put it all together.June 2013Sir Richard ThompsonPresident, Royal College of PhysiciansC○ Royal College of Physicians 2013v
AbbreviationsA&EAACsAMUsARCPCCGsCCSTCCTCEEUCESRCMOCMTCPDCQCDFIDDGHDHDOPSEWTDGIMGMCGPwSIGSFHDUHESHIUHPAHWDUICUsIOGJRCPTBaccident and emergencyAdvisory Appointment Committeesacute medicine unitsAnnual Review of CompetenceProgressionclinical commissioning groupsCertificate of Completion of SpecialistTrainingCertificate of Completion of TrainingClinical Effectiveness and EvaluationUnitCertificates of Eligibility for SpecialistRegistrationchief medical officerCore Medical Trainingcontinuing professional developmentCare Quality CommissionDepartment for InternationalDevelopmentdistrict general hospitalDepartment of Healthdirectly observed procedural skillsEuropean Working Time Directivegeneral internal medicineGeneral Medical Councilgeneral practitioner with a specialinterestGold Standards Frameworkhigh dependency unitHospital Episode StatisticsHealth Informatics UnitHealth Protection AgencyHealth and Work Development Unitintensive care unitsImproving Outcomes GuidanceJoint Royal College of PhysiciansTraining BoardKBALATMAUMDTMINAPmini-CEXMMCMRCMTASNCGCNHDsNHSNICENSFsNTNOoHMTPAsPACESPbRPCNPGDsPIUPMETBPwSIsRITASACSASSPAsStRWHOWTEknowledge-based assessmentlocum appointment for trainingmedical admissions unitmultidisciplinary teamMyocardial Infarction Audit Projectmini clinical evaluation exerciseModernising Medical CareersMedical Research CouncilMedical Training Application ServiceNational Clinical Guideline Centrenotional half daysNational Health ServiceNational Institute for Health and CareExcellenceNational Service Frameworksnational training numbersOut-of-Hours Medical Teamprogrammed activitiesPractical Assessment of ClinicalExamination SkillsPayment by ResultsPatient and Carer Networkpatient group directionsPatient Involvement UnitPostgraduate Medical Education andTraining Boardpractitioners with a special interestRecord of In-Training Assessmentspecialist advisory committeestaff and associate specialistssupporting professional activitiesspecialty registrarWorld Health Organizationwhole-time equivalentNote: this edition uses the terminology specialty registrar (StR) to update the term specialist registrar (SpR).vi C○ Royal College of Physicians 2013
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