FOUNDATION YEAR 2
EMERGENCY DEPARTMENT
Milton Keynes Hospital NHS Foundation Trust
Standing Way
Eaglestone
Milton Keynes
MK6 5LD
Medical Staffing:  01908 243685
Generic Consultant JD –Approval 23 Feb 07
MILTON KEYNES HOSPITAL NHS FOUNDATION TRUST
FOUNDATION YEAR 2 – EMERGENCY DEPARTMENT
JOB DESCRIPTION AND OUTLINE JOB PLAN
1.
THE POST
1.1
Title:
Foundation Year 2, Emergency Department
1.2
Employing Organisation:
Milton Keynes Hospital NHS Foundation Trust
1.3
Accountable to:
The appointee will be accountable to the Consultants and Clinical Director for the Emergency
Department.
2.
THE DEPARTMENT
The Emergency Department is a purpose-built modern unit commissioned in 1984. The department underwent a major
refurbishment in 2005.
The accommodation and facilities are constantly upgraded to deal efficiently with 24 hour a day with major and minor
Medical, Surgical, Trauma & Orthopaedic, Paediatric, Obstetric & Gynaecology, and Psychiatric emergencies. The
department currently sees 69,000 new patients per year. Approximately 30% of these are children. It is the only
Emergency Department for the Milton Keynes district and currently serves a population of 200,000. It is also a designated
major incident centre, and organises regular exercises in this regard.
Daily follow-up clinics are conducted in the department by the Emergency Department Consultants for the continuing
treatment of minor conditions. These clinics are called Minor Trauma and Review clinics (MTRC). In addition, Soft Tissue
Injury Clinic, Hand Trauma Clinic and Burns Clinic are held once a week.
The department organises a one day induction for new F2/ST1-2 doctors. The day includes hands-on workshops on
resuscitation, suturing, x-ray interpretation, use of the computer, etc plus talks on nurse liaison, management of common
emergencies, etc.
There is a very close liaison with the South Central Ambulance Service. Paramedics and Emergency Care Practitioners
(ECPs) receive training within the department. There is a dedicated phone line for advance warning (red phone).
Staffing
The Consultants in post and their special interests:
Mr P Thomas (Clinical Director)
Mr R Ajuwon
Mr R Simpson
Mr I Ezeilo
The consultants are supported by:
3 Staff Grades
3 Specialist Registrars
Education
Major Incident Planning
Foundation Training Programme Director
Clinical Governance
8 Senior SHOs, including 4 Foundation Year 2, 3 GPVTS and 1 ACCS
1 Senior Clinical Fellow
2 Trust Grade doctors
1 Senior Medical Officer
Clinical Assistant sessions
3.
DUTIES AND RESPONSIBILITIES
The Foundation Year 2 posts in Accident and Emergency are for a duration of 4 months.
The department is open 24 hours a day and the workload is not always predictable.
There is always senior medical cover (until at least 01.00) and nursing colleagues present. Teamwork is essential in the
department.
Your duties include initial diagnosis, resuscitation and overall clinical management of all patients arriving at A&E.
Appropriate follow-up, admission, transfer or discharge to GP care is an important part of the work along with the liaison
with colleagues in the community i.e. GPs, Health Visitors, and District Nurses, for the proper continuity of care.
Second opinion for admission or further management along with on the spot teaching is available from the on-call firms
from various specialties within the hospital. Most of the residents live on site.
Clinical audit is well established in A&E and you will be expected to take an active role in the process, and will be
supported to present a project. The Clinical Audit department is very happy to provide relevant support.
You will also be encouraged to take part in departmental research activities along with career Registrars and other senior
medical staff.
The hours worked each week will vary. The band for this post is Band 1A which includes prospective cover for colleagues
on annual leave. A 12 week rota is in place which allows 2 days off each week. One of the weeks is allocated for leave
cover. In order to make efficient use of this facility, only one person can be away on leave at one time. All leave
entitlement must be taken by doctors during their stay on a first come first served basis. The leave cannot be paid at the
end of the post or transferred to another post in the Trust.
All the posts have educational approval from the Oxford Deanery.
There is an initial two day departmental induction for the purpose of orientation. This includes hands on workshops on
resuscitation, suturing, X-ray interpretation, use of computer, talks on nurse liaison and management of common
emergencies.
4.
FACILITIES
a. The reception area is staffed 24 hours a day by two receptionists. The Emergency Department records are
computerised, and the computers work on an integrated system. The Emergency Department card is designed
so that clinical staff can select the pre-printed options. These clinical details as well as a brief free text are fed
into the computer system by the reception staff. The data is stored for audit and research purposes as well as
for sending letters to colleagues in the community, i.e. GPs (in all cases) and Health Visitors for patients under
15 and over 65 years of age.
b. Waiting area: there are separate children and adult waiting areas, which are suitably equipped with TV/video and
toys in the children’s area. The ambulance patients are brought in through a separate entrance. The initial
assessment desk at present is in the adult waiting area, where the nurse ‘meets and greets’ the patient and
allocates treatment priorities for walking wounded patients.
c. There are nine multipurpose major examination and treatment cubicles, of which one is adapted and equipped
for the care of children and one for Obstetric and Gynae patients. The nurses’ station, nurses’ office and doctors’
office with computer terminals are also located in this area.
d. There is a 7-bedded observation unit equipped with piped oxygen and suction is available for appropriate
patients.
e. There is a newly built paediatric area with separate trolley and treatment areas.
f.
There is a fully equipped Resuscitation Room with 5 bays, one of which is equipped primarily to resuscitate
children.
g. There is a Departmental seminar room with audio-visual teaching aids. Boards and computer terminals are also
located in this area.
h. There is a well furbished distressed relative room with TV, fridge and other amenities. There is also a purposebuilt body viewing area and quiet area.
i.
There is a plaster room, and this service is provided by trained nursing and auxiliary staff.
j.
The minor operating theatre is well equipped to deal with repair of complicated wounds, reduction of fractures
and dislocations, exploration of wounds or incision and drainage abscesses, or any other operation procedure.
k. There are three examination and treatment bays for the walking wounded, and like all clinical areas have piped
gases and suction. Another doctors’ office and an ENP room are located in this areas. There is also a newly
built triage room.
l.
The Eye/ENT and dental room is equipped with slit lamp, magnifying lamp and various other diagnostic tools.
There is an eye review clinic held Monday to Friday at 9.30am.
m. There is a review clinic held Monday to Thursday including a hand clinic. An experienced Hand Therapist assists
in the Hand Trauma Clinic. Trainees are welcome to attend.
n. There is office accommodation for doctors, nurses and secretaries.
o. There is a staff common room equipped with TV, microwave and other amenities, which is shared by all staff
within the department.
p. A helipad is available across the car park and is near to the department.
q. A dedicated car park bay for disabled drivers and short stay wait of 30 minutes is reserved for free use by A&E
patients outside the department. The rest of the public car parks operate a pay and display system.
r.
There is an Emergency Department x-ray unit near the Fracture Clinic and walking wounded areas, which
operates digital computerised radiology (DCR). There are 24-hour CT scan facilities available from a wellequipped Radiology Department. The scan can be transmitted to the Regional Neurosurgical Unit which is at
Oxford.
s. There is a very close liaison with the local Ambulance Service. Advance Paramedics are trained within the
department and joint audit of their work takes place regularly. There is a dedicated phone line for advance
warning.
t.
Ophthalmic, Plastic and Burns in-patient facilities are provided at the neighbouring Stoke Mandeville Hospital in
Aylesbury. Facio Maxillary in-patient facilities are provided at Bedford Hospital.
u. ITU and Phase I Operating Theatres are situated directly above the department and are easily accessible.
v. There is a sub-pharmacy within the department which houses most of the commonly used drugs for after-hours
dispensing. A very prompt service from a fully trained Pharmacist is available during normal working hours and a
Pharmacist is on-call if necessary.
w. Community liaison with Paediatric and Geriatric Health Visitors exists. The liaison Health Visitor and District
Nurse visit the department on a daily basis accepting referrals and relaying information to Health Visitors, school
nurses, community Paediatric sectors for children 0-16 years and another community liaison for patients aged 65
years and over exists. Social Services liaise with us regarding children on the child protection register regularly.
Community Psychiatric service is available in the evening.
5.
SUPPORT SERVICES
X-Ray
There is a modern Imaging Department with 10 Consultant Radiologists. The department provides plain x-rays, image
intensification, ultrasound, CT and MRI scanning. The department has its own x-ray facility exclusively for A&E patients
which operates approximately 16 hours a day. Outside these hours the main hospital x-ray department is used.
6.
6.
TEACHING, TRAINING, RESEARCH AND CLINICAL AUDIT
Education, Training and Research
There is an active Post Graduate Education Centre which houses a Library and Information Services facility. Library and
Information Services provide access to printed and electronic journals , books and research support. It also provides
related training and support to clinical teams. The Associate Medical Director (Medical Education), Mr Peter Thomas, is
responsible for ensuring excellence of medical education within the Trust. There is an active Speciality Tutors Committee
that meets regularly.
Teaching for the F2 doctors is shared with A&E VTS doctors and the ACCS trainee (all working at ”first tier” level).
Teaching is conducted weekly in the A&E seminar room on a Thursday afternoon for 2 hours. This is protected teaching
time.
Middle grade staff are normally present in the department until 1am for seeing patients, supervision of trainees and on the
spot teaching. A senior doctor is always on-call along with a Consultant.
A departmental handbook is sent to all new doctors with their appointment letter which contains helpful hints of how the
department is organised and run.
The Resuscitation training department organises a variety of courses including BLS, ALS, EPLS, and ALERT. FY2s and
middle grade doctors are encouraged to attend.
Regular job appraisal to facilitate trainees to achieve what they want is in practice and a jointly produced skill list is
available to select the special skills training you may wish to select.
Research is encouraged within the department and Foundation Year 2 and other trainees and trained staff will be
welcome to join the Consultants and Career Registrars for any ongoing research projects or initiate their own projects.
Opportunities are available for trainees to visit other specialities.
Clinical Audit with peer review is practised at least once a month and any feedback after x-ray audit, etc, is channelled
through as soon as possible. Various learning methods are introduced including publication of ‘lesson of the week’.
Audit/Governance
The Healthcare Governance Support Unit has good resources and provides regular support. There are nine dedicated
audit half days per year held in the Post Graduate Centre.