Duties of Middle-Grade Doctor (FY2/IMT/GPST)

Fixed time activity

Time: 9amLocation: Langlands - Ward 51 dayroom. GGH - Level 8 Day Hospital. NV ACH - Base ward (handover from nurses)

Activity: Attend handover from night-shift team

Time: 9.10am (approx.)Location: Base Ward

Activity: Identify lead nurse and carry out board round to prioritise workload. This should be a brief meeting to identify:

• Unwell patients
• Upcoming discharges – ensure IDLs completed in advance and ensure any outstanding tasks are prioritised
• New patients for review

Time: 3pm (approx.)Location: Base Ward

Activity: Board Round with Lead nurse to update on any changes to treatment / discharge plans

Time: 4.45pmLocation: Ward 51 dayroom, GGH - 5A Seminar Room, door code 1835A, NV ACH - Ward 1 doctors room

Activity: Handover to evening on-call team

1. Attend morning and evening handover meetings promptly
2. Provide a handover for any patients on your ward who require review by the on-call team. On weekdays provide a verbal handover at the handover meeting. For weekend reviews request on Trackcare.
3. Participate in Board Rounds (see below structure) and work collaboratively with the MDT to prioritise and plan patient care

1. Log in to a mobile laptop and bring this on the ward round
2. Provide an update on any new results / developments since last review
3. Present any new patients you have seen
4. Complete ward round tasks as you go (e.g. blood/imaging requests) and keep a list any tasks which need to be completed after the ward round

1. Review all new admissions.
2. Summarise active issues (bullet points). You do not need to re-write the admission history.
3. Ensure E-medicines Reconciliation has been done and review medicines kardex.
4. Check if the patient has a community anticipatory care plan (this can be found in the key information summary tab on ECS)
5. Check nursing observations / NEWS score and document plan if abnormal.
6. Check for new results and ensure any outstanding investigations or tasks have been requested.
7. Assess and document the patient’s capacity to consent to treatment. If incapable complete AWI documentation.
8. If you think a patient needs early senior review, or is fit for discharge, or can move to an off-site rehabilitation ward please highlight this to any member of the ward consultant team (do not wait for the next named consultant ward round).

1. Attend daily board round with lead nurse.
2. Complete independent ward rounds between consultant rounds. It is appreciated that depending on staffing it is not always feasible to review all patients. In this case you should prioritise unwell patients, new patients and upcoming discharges.
3. Update nursing and AHP colleagues on any changes to treatment plans.
4. Complete any tasks or reviews requested by the nurses or AHPs (or delegate to an appropriate member of the team)
5. If senior advice is required between ward rounds contact the registrar or consultant for the ward. If not available or it is out of hours contact the on-call registrar (Page 14974) or consultant (via switchboard)
6. Respond rapidly to any request to review a deteriorating patient.
7. Consider the treatment escalation plan (TEP) as part of your review and complete a TEP form if not already in place. If in doubt consult the registrar or consultant.

1. It is the responsibility to the requesting doctor to ensure that results are reviewed and signed off (or that this is delegated to an appropriate individual with clear handover)
2. All standard blood results should be checked on the day of request. A List should be kept of any other results which take longer than one day to process.
3. Trackcare should be checked daily to sign off all new laboratory and radiology results for your ward (see ’signing off laboratory and radiology results in Trackcare’ SOP)
4. The doctor completing the IDL should check and sign off any outstanding results on Trackcare.

1. Listen to patients, take account of their views, and respond honestly to their questions. Provide updates and information on results in an understandable way.
2. Help to communicate with relatives and carers to update on treatment and discharge plans (always ask for patient’s consent if they have capacity)
3. Document all communication clearly in the medical notes and communicate regularly with the ward MDT to update on any information you have gathered
4. Communicate and work collaboratively with the ward MDT to plan patient care

1. Certify death and document time of death in the medical notes.
2. The medical certificate of cause of death (MCCD) should be completed by a doctor involved in the patients care. The on-call doctor does not need to complete the MCCD if death occurs out of hours, this should be handed over the usual team.
3. The cause of death should always be discussed with a registrar or consultant before completing the MCCD.
4. If a case needs to be referred to the procurator fiscal do not issue the MCCD unless you are advised to following consultation with the PF.
5. Ensure a photocopy is filed in the medical notes before issuing the MCCD.
6. Complete a short IDL to notify the GP of the cause of death.

1. Provide supervision and support for junior medical colleagues
2. Provide leadership for organisation of ward duties and medical care, help FY1 to prioritise workload and provide assistance when required
3. Ensure it is clear who is responsible for any outstanding tasks and communicate with the team at the end of the day to make sure all required tasks have been completed or handed over
4. If you have concerns about the performance of a member of the ward team you should escalate this to the consultant and senior charge nurse (SCN).