An exciting opportunity for GPs to work in GSTT @home Service. 

Are you looking for a new role that is challenging, exciting, innovative and involves working as part of a wider multi-disciplinary team? 
 
Seldoc are looking for GPs to work within the GSTT @home service using their in depth experience and skills to provide excellent care to patients in their usual place of residence. 
We have a variety of weekday and weekend daytime shifts at excellent rates of pay. 
 
Please read on to learn about the service and the role. 
 
 
@home provides acute clinical care at home that would otherwise be carried out in hospital. Interventions are delivered in the usual place of residence in order to provide the best possible patient experience and outcome, and enable the patient to benefit from holistic integrated care. 
The concept of providing healthcare @home means that instead of patients being admitted to hospital, our multi-disciplinary team works collaboratively with GPs, hospital staff and other organisations to deliver safe, quality healthcare within the patient’s own home. 
 
The service has three main aims: 
 
Accepting referrals from GPs, LAS, and other Community clinicians for those people who are at risk of hospital admission, and providing care at home which prevents their condition getting worse. 
Allowing people to be given a high level of care in their own homes instead of being admitted unnecessarily to hospital. 
Allowing for advanced discharge from hospital, so patients can recuperate in the comfort of their home while receiving high quality care. 
 
The @home service is currently operational within Lambeth and Southwark and works in collaboration with Guy’s and St Thomas’ and Kings College Hospitals. 
 
The @home team includes: 
 
@home Acute Geriatricians 
@home GP - provides clinical support and liaises with patient’s own GP 
@home Matron - leads the team and patients’ clinical care 
@home Team of predominantly senior nurses 
@home Physiotherapist, OT and Pharmacists 
@home Administrators co-ordinate the general running of the ward and information between the patient and team. 
@home Social worker for Lambeth and Southwark 
 
Referral Sources 
 
Guy’s and St. Thomas 
Kings’ College Hospital 
Other acute hospitals 
GPs 
London Ambulance Service 
Other community clinicians (such as community nursing) 
Specialist Palliative Care 
 
Possible patient conditions include: 
 
Cellulitis 
COPD 
Dehydration 
Diabetes 
Gastroenteritis 
Heart Failure 
Infected Foot Ulcers 
Post-Surgery 
Pyelonephritis 
UTI/CAUTI 
Viral Illness 
Hyperemesis 
Diarrhoea & Vomiting 
Post falls 
General decline requiring geriatric assessment 
End of Life care with reversible clinical condition 
 
Services offered by @home include: 
 
IV Therapy 
Blood monitoring and Anticoagulation Therapy 
Cannulation, Cannula Care inc. PICC & Hickman Lines 
Complex wound management 
Respiratory Care 
Observation and Vital Sign Monitoring 
 
 

Roles and responsibilities of GPs in the @Home? 

Monday to Friday there are 3 supporting GPs for the @home service, and Saturday and Sunday there are 2 GPs. 
 
One GP is allocated to see all new LAS referrals and the remaining 2 GPs support the matrons with the current caseloads of patients and see the high acuity patients. There are up to 70 patients on the caseload throughout Southwark and Lambeth and all GPs will be expected to see an average of 4-6 patients per day depending on the needs of the service, and directed by the matrons. 
 
GPs visit patients either on their own (with a SELDOC driver) or with another @home clinician to perform the following:An exciting opportunity for GPs to work in GSTT @home Service 
An initial assessment 
A review of patients due to a change or deterioration in condition that warrants a GP review rather than a direct admission to acute hospital 
Before visiting the GP will receive a handover from the matron with regards to presenting complaint and where available a summary of past medical history from either the patient’s own GP or KPH online records 
Equipment will be provided to carry out a full assessment including taking bloods and administering IV therapy when required. 
During the shift the G{ will also be expected to do a virtual ward round of the patients on the caseloads in order to review treatments plans, blood tests and planning discharge 
 
Responsibilities include: 
Attending handover at 8am. This is a chance to hear an update for each of the patients from the day before. 
Reviewing all blood tests and acting on any abnormal tests 
Ensure all patients have a plan and an estimated date of discharge 
Work with the multidisciplinary team reviewing medications and addressing any therapy and social needs 
Arrange any investigations required e.g. X-rays, ECHO’s, ultrasound scans. 
Arrange any follow up required 
Assessing acutely unwell patients and to liaise with hospital physicians where required 
Initiate treatment/prescribe as to when is necessary at the point of contact with the patient. 
Writing discharge summaries on the EPR system and liaise with the patient’s own GP by phone if there is a change in treatment, update on developments or change in management, or to gain further information. 
The GP will receive training on discharge summaries if regularly working in the service 
 
The @home service manages acutely unwell patients in the community. GPs are required to have the following skills: 
Cannulation 
Administering IV /SC fluids 
Administrating IV antibiotics 
Venepuncture 
Male/Female Catheterisation 
ECG taking and interpretation 
Vital signs observation and familiar with the NEWS scoring 
Bladder scanning [desirable not essential] 
Basic wound management (more complex managed by community nursing team) 
 
GPs will be supported by the wider team in refreshing and renewing skills. Once approved, GPs will undertake a shadow shift and induction training. 
It would be desirable for GPs to have a good understanding or background in the management of heart failure, COPD, and managing common geriatric issues, and will be fully supported by the nurses and other doctors. 
 
To find out more, please contact Dr Amina Albeyatti, Medical Director at SELDOC at: amina.albeyatti@nhs.net or complete the below form to apply. 
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