North West London Hospitals

North West London Hospitals

JOB DESCRIPTION

TITLE:Physician’s Assistant (Anaesthesia)

Band:8A

MINIMUMQualified Physician Assistant – Anaesthesia

QUALIFICATIONS:Advanced Life Support Provider

Postgraduate Diploma

Affiliate membership of Royal College of anaesthetists

ACCOUNTABLE TO: Consultant Anaesthetist

ACOUNTABLE FOR: Assisted delivery of anaesthetic services to patients

PROFESSIONAL Lead Clinician - Anaesthesia

ACCOUNTABILITY

RESPONSIBLE TO: Clinical Director Critical Care

Divisional General Manager, Critical Care

The Trust

The North West London Hospitals NHS Trustcomprises Northwick Park & St. Mark’s Hospitals (Harrow site), and Central Middlesex Hospital (Brent site). It is one of the biggest and busiest Trusts in the Country.

Operative work across the Trust includes acute and elective general surgery, tertiary referral colorectal, major head and neck, and a full range of other specialities. Facilities include an extensive inpatient theatre complex at Northwick Park/St. Mark’s supported by a full elective surgical floor comprising an advanced theatre admission unit, overnight intensive recovery, and elective surgical HDU; and a new build hospital at Central Middlesex incorporating main theatres and a busy, state-of-the-art ambulatory care and diagnostic (ACAD) unit.

Anaesthesia is also provided in other clinical areas including endoscopy and radiologically-guided surgery.

This adds up to a dynamic and developing clinical environment and a good basis for practitioner role redevelopment.

The Department

The anaesthetic department benefits at both sites from access to a wide and interesting casemix, including advanced airways, complex surgery, and anaesthesia in patients with high co-morbidity and anaesthetic risk. The combined anaesthetic department has a strong record of anaesthesia training at both sites, providing a stimulating and friendly work environment.

The departmental strategy is to develop as a major training base within the Imperial (NW London) School of Anaesthesia for medical anaesthetists, with an aspiration to build a new and equally high-profile place within the PA(A) sphere as the profession approaches HPC accreditation.

The PA(A) programme, and the medical anaesthetic training programme, are seen as complementary and mutually beneficial.

PA(A) Programme Strategy

The Trust currently has no PA(A)s. These new posts are created with the explicit intention of launching a dynamic, permanent, and expandingprogramme.

As this is a new service, the initial role (phase 1) will be for fully trained staff, working with a supervising consultant anaesthetist, within their existing qualifications and within the terms of the RCoA Statement on PAA Supervision and Limitation of Scope of Practice (August 2010 revision).

Competencies at this stage will be as per Section Four of the Anaesthesia Practitioner Curriculum Framework (DH 2005), and it is expected that these will have been covered by the postholder’s formal training and qualification as a PA(A).

The intent (phase 2) is to develop and extend these roles over time with full use of appropriate protocols and local authorisation, in line with para. 12 of the RCoA statement. Postholders will additionally be supported to undertake the Prescribing Course through timetabled allowance and funding.Postholders will work with a nominated lead clinician to develop extended role working.

There is a longer term aspiration (phase 3) to develop as a training hub for PA(A)s, consistent with the Trust’s current position as a major training base for medical anaesthetists.

The anaesthetic department is in contact with colleagues at University Hospital Birmingham and University College London Hospitals, and with the Director of Professional Standards at the Royal College of Anaesthesia. The strategic intent is to develop the PA(A) role to its full potential and in line with national best practice, actively learning from peer units.

Role

In the first instance the post holder will provide anaesthetic services to the full extent of the RCoA (Aug 2010) statement and AP Curriculum Framework (2005). This will includeinduction and emergence from anaesthesia under consultant supervision, and assistance with anaesthesia, monitoring and maintenance of patient condition.

The postholder will work under the supervision and direction of a consultant anaesthetist to undertake pre-operative assessment, prepare, equip and maintain a safe environment for anaesthesia, and administer drugs for anaesthetic induction and maintenance,intra-operative fluids, post-operative analgesia and anti-emetics.

PA(A) postholders will not be expected to undertake anaesthetic assistant (anaesthetic nursing or ODP) duties. In line with national recommendations, an anaesthetic assistant will be present at all times to support the PA(A) and medical anaesthetist.

DUTIES

  • To work competently and within the core training curriculum in the role of Physician’s Assistant in Anaesthesia, under appropriate supervision.
  • To work in accordance with professional anaesthetic standards and competencies, in assessing patients, planning anaesthetic provision in a prescribed framework, monitoring and maintaining anaesthesia in normal situations.
  • To take every measure to keep patients free from harm, pain, or distress, and to enable treatment of their illness, while respecting patient consent and confidentiality.

RESPONSIBILITIES AND COMMUNICATION

  • To work responsibly and professionally as a member of the anaesthetic team, with the highest emphasis on patient safety.
  • To communicatecomplex condition-related information to patients and relatives in a manner that demonstrates empathy and reassurance.
  • To establish a good working relationship within the wider hospital, offer support when required.
  • To promote and contribute to the development of the new ways of working in anaesthesia within the Trust and other organisations by taking part in presentations and conferences.
  • To understand infection control and child protection issues and undergo appropriate training as necessary.

PLANNING AND ORGANISATIONAL SKILLS

  • To plan anaesthetic provision within a prescribed framework.
  • To administer drugs as individually prescribed and (where applicable) by patient group directives
  • To initiate and manage fluid and blood therapy within the plan of care.
  • To attend relevant meetings as appropriate.

ANALYTICAL AND JUDGMENTAL SKILLS

  • To assess and interpret acute patient conditions, and to take appropriate action, recognising and managing emergency situations.
  • To perform/participate in the pre-operative assessment of patient under the supervision of the anaesthetist.
  • To implement anaesthesia care plan under the supervision of the Consultant anaesthetist.
  • To administer and/or participate in the planned administration of general and regional anaesthesia for a variety of surgical and medically related procedures, within the bounds of existing qualifications or (when applicable) properly implemented extended roles.
  • To interpret and utilise data obtained from invasive and non invasive monitoring equipment.

PHYSICAL SKILLS

  • High levels of dexterity and accuracy required for current and anticipated role.
  • Ability to learn new skills. As the role develops, it is anticipated that further training will be given to provide competencies in extended roles, with appropriate policies and documentation.
  • Ability to position or supervise positioning of patients to assure optimal physiological function and patient safety.

RESPONSIBILITY FOR PATIENT CARE

  • Assesses, develops and implements anaesthetic programmes within prescribed framework, provides advice to the surgeon on anaesthetic care of the patient
  • To evaluate and/or collect patient information from the patients history, physical examination, laboratory radiographic and other diagnostic date and identify relevant problems.
  • To identify and take appropriate action in the immediate post-operative period in relation to common post-operative problems, keeping seniors informed.

RESPONSIBILITY FOR SERVICE/POLICY DEVELOPMENT

  • To assist in the development of protocols and patient group directives within the anaesthetic team.
  • Comment on policies and contributes to change.
  • Adheres to Trust policies and relevant codes of practice.

RESPONSIBILITY FOR FINANCIAL AND PHYSICAL RESOURCES

  • Responsible for safe use and setting up of anaesthetic equipment.
  • To monitor and maintain a safe, clean and therapeutic environment for staff patients and visitors, initiating appropriate action to achieve this.
  • To use resources appropriately to ensure high quality and cost effective service.
  • To communicate shortages or faulty equipment.

RESPONSIBILITY FOR HUMAN RESOURCES

  • Participate in the education of patients and their carers.
  • Participate in the teaching, supervision and assessment of other team members.
  • Clinically supervises Trainee Physician Assistants (Anaesthesia).

RESPONSIBILITY FOR INFORMATION RESOURCES

  • Updates patient records.
  • Responsible for timely, accurate and complete records both manual and electronic (eg PICS and PACS) ensuring safety and confidentiality of information with statutory requirements.

RESPONSIBILITY FOR RESEARCH AND DEVELOPMENT

  • Regularly participates in the critical review of audit, complaints, complements and clinical/non clinical incidents as outlined in directorate protocols with a view to improving patient care as part of the wider anaesthetic team.
  • To assist the anaesthetic department in research and audit projects, including the collection and analysis of data if required.
  • Leading in clinical audit within an area of anaesthetic practice if appropriate

FREEDOM TO ACT

  • Work with supervision of a senior medically qualified Anaesthetist
  • Accountable for own Professional actions. Works in accordance within professional anaesthetic standards and competencies
  • Specialist in monitoring and maintaining anaesthesia in normal situations
  • Promote and contribute to the development of new ways of working in anaesthesia
  • Responsible for maintaining own personal development in accordance with relevant standards in anaesthesia
  • To ensure own actions support equality, diversity and rights

PHYSICAL EFFORT

  • Works in restricted position in operating theatres
  • Manoeuvres patients from table to bed, bed to table assist in the positioning of patients as required for surgical procedures

MENTAL EFFORT

  • Concentration on patient anaesthesia for lengthy periods
  • Assessment of patient responses for readiness to move to next level of care in relation to common post operative complications

EMOTIONAL EFFORT

  • Identify and take appropriate action in immediate post operative period in relation to common post operative problems
  • Ensure safe checking of equipment reporting and taking appropriate action where defects are identified to prevent clinical incidents affecting patients
  • To take the lead or act as a resource person in cardiopulmonary resuscitation, respiratory care and for other acute needs

WORKING CONDITIONS

  • Exposure to body fluids and open wounds

General Notes

Although this is a list of the key responsibilities of the post it is expected that the post holder and manager will develop and define the detail of the work to be undertaken. Any changes to the key responsibilities will be the subject of consultation with the postholder.

All employees must adhere to and perpetuate Trust policies and procedures relating to:

  • Health and Safety
  • No Smoking at Work
  • Equal Opportunities in Employment, including responsibilities under the Disability Discrimination Act

Your attention is drawn to the confidential nature of information collected within the NHS. The authorised use or disclosure of patient or other personal information is a dismissible offence and in the case of computerised information could result in a prosecution for an offence or action for civil damages under the Data Protection Act.

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