MoE at WGH

Welcome to Medicine for the Elderly at the Western General Hospital.

We hope you enjoy your time working and learning with us. This page gives an overview of the department and what you need to know when working here.

 
 

Introduction

Each area is covered in more detail in the handbooks for the department and day hospital. This will be also covered in more detail during the induction sessions where there will be an opportunity to ask questions. There’s also the details to contact with any specific questions before starting, but please also speak to your Educational Supervisor about your training needs and what you want to get out of you attachment with us.

You will find useful links including for induction documents on the MoE page on the intranet.

Finally, please share any feedback you have with us. Your opinions are very helpful in guiding us to make changes and improvements in training. We hope you enjoy your time in the department. We are here to help in any way we can.

 
 

Department contacts

The main contact for any enquires should be Jack Hellberg, medical secretary. Contact details are in our unit handbook below.

The rota coordinators are Dr Andrew Pearson and Dr Rebecca Woodfield. There is also the generic email address for geriatric medicine in the north of Edinburgh that we ask any emails concerning rotas and shift cover are copied to:

Supervising consultants

Several consultants in the department have responsibilities for different trainees. These are:

  • Dr Liz Keane – Clinical Director for MOE and Stroke services

  • Dr Andrew Pearson and Dr Rebecca Woodfield – rota coordinators

  • Dr Rowan Harrison – training contact for foundation year doctors

  • Dr Kathryn Anderson & Dr Liz Keane – training contacts for GPSTs

  • Dr Conor Maguire – training contact for IMTs

  • Dr Gordon Duncan and Dr Helen Jones – training contacts for SpRs

  • Dr Jo Cowell – Clinical Lead for ARC Day Hospital

 

Our department

Medicine for the Elderly / Stroke Unit at the Western General Hospital provides inpatient and outpatient services for the elderly population of North Edinburgh. We have 194 medicine of the elderly inpatient beds and they are split between the Royal Victoria Building and the Anne Ferguson building.

We look after a mix of acute and rehabilitation patients in all of our wards, with wards dedicated to acute stroke services and orthogeriatric rehabilitation. Our Mobile MoE Team (MMOET) also covers MoE patients on other wards across the hospital, and we run liaison services supporting many other departments, including surgery (POPs) and front door frailty post-take rounds in the Medical Assessment Unit.

We run various medical outpatient clinics and two Medical Day Hospitals – one on site in the WGH’s Assessment and Rehabilitation Centre (ARC), and another at Leith Community Treatment Centre in the Older People’s Rehabilitation & Assessment Unit (OPRA).

Working here

When working here you will be based in wards for 4 to 8 week blocks. Everyone will have exposure to more than one clinical setting (including the ARC day hospital, stroke unit, or the assessment and rehabilitation ward).

GP Trainees all spend one block in the ARC day hospital.

We also provide an FY2 position in community services.

Clinical Fellows will usually be based in one main clinical area for 3 to 4 months and will have links with other clinical services e.g. Parkinson’s, Front door frailty round, POPs service.

Registrars will usually be based in one main ward area for 12 weeks. They will have links with other clinical services, for example Parkinson’s, Front door frailty round, POPs service, or a general OPD. The specific attachments can varied to match a trainee’s needs and you should aim to contact your educational supervisor ahead of a placement to help coordinate this.

 

Teaching and training

There is a strong programme of weekly meetings for staff of all grades. This includes a multidisciplinary department meeting on Thursdays.

Monday9am weekend handoverVia Teams
TuesdayFY2 Teaching (weekly sessions)Via Teams
WednesdayGrand rounds 12:30pm to 1:30pmVia Teams - link in weekly email or med.scot.nhs.uk website
Thursday12:30pm to 1:30pm MoE departmental meeting
FY1 Teaching (weekly)
RVB Seminar Room
Friday12:45pm FY Case Presentation TeachingRVB Seminar Room
1:30pm X-ray meetingRVB Seminar Room
 

We regularly have Year 4 Students attached to each ward, as well as occasional Elective Students and final year assistantship students. In addition to a Formal Teaching Programme, we try and involve the students in the Ward Team as much as possible. Students are required to have a number of sign offs completed by medical staff and it's your contribution to this is appreciated. The clinical fellows and more senior trainees in the department may be allocated to supervise some students.

Middle-Grade staff will be involved in teaching sessions and the students always appreciate ward-based teaching from any doctor. Please make them feel welcome.

 
 

Quality Improvement activity

There is an active audit and quality improvement programme in MoE/Stroke. Dr Keir and Dr Pearson co-ordinate this and we are very keen all junior staff are involved. We have a rolling programme of audits which keep us on our toes so please arrange to meet with her early to discuss your project or suggest something new for us to consider.

Our standard is to deliver the best possible care for older people. We review our performance regularly, in our Morbidity and Mortality Meetings. The aim of these is to look at any problems that may have arisen, share learning and find ways to improve. Many of our doctors have been rewarded with poster presentations for their quality work whilst here and our department prides itself on our track record and culture of quality improvement and safety.

Further information about Quality Improvement can be found on the Lothian QI site.

 
 

Leave arrangements

The rotas are co-ordinated by Dr Pearson, Dr Woodfield, and Jack Hellberg in our admin team. Any queries, please speak to Jack.

Any proposed ‘swaps’ must be approved and noted by the secretary, and Dr Keane or Dr Woodfield.

The Registrars’ Ward/Clinic Attachments are co-ordinated by Dr Duncan and will vary according to training and service needs.

Study leave

To request study leave, please firstly complete the appropriate “Application for Study Leave” form and forward to geriatricmed.north@nhslothian.scot.nhs.uk for all grades.

We always do our best to allow appropriate study leave but we must ensure the service is not compromised so sometimes it is not possible. If you are unsure, it would be best to discuss first with Kim Napier to check that the proposed leave is appropriate.

Once your leave has been approved by the department you can submit your study leave application online through TURAS for TPD approval.

Annual leave

10 days of leave is fixed in the rota. This is unfortunate – but we are restricted by the combination of New Deal Rules, need to provide continuity for training and ensuring a robust service for our patients. Any queries should be directed to Kim Napier initially.

Every FY1/FY2/ST is entitled to 25 Annual Leave days in one calendar year. There are also 10 Public Holidays in a calendar year. For doctors on training rotations this total of 35 days leave is spread equally across the year split between all your posts.

  • Doctors spending 4 months at the Department are therefore entitled to 12 days leave

  • Doctors spending 6 months at the Department are therefore entitled to 18 days leave

  • These leave days will be a mix of annual leave days (fixed in rota) and Public holidays that you are rostered ‘off’

  • In exceptional circumstances we can consider a request to have a day off outside rostered holiday time (e.g. for a family wedding). If the doctor is not due an ‘in-lieu’ day, they may be asked to swap one of their rostered Annual Leave/PH days for the day they wish to take off

The Middle-Graders co-ordinate their own holidays which need to be signed off by Dr Gordon Duncan, with typically one SpR being allowed leave at any one time. Please see the attached Annual Leave Form for SpRs above.

Sick leave

Arrangements for sick leave will be discussed in departmental induction.

If you are off sick please contact Jack Hellberg or another secretary (contact details in the handbook), email Jack and geriatricmed.north@nhslothian.scot.nhs.uk as early as possible. Ideally, also copy in Dr Pearson and Dr Woodfield.

At the weekend, also speak to the consultant on call through switchboard, or if this is not possible contact the RESOURCE NURSE (through switchboard) and ask that the message is passed on.

Let them know which ward you are based in and if you are due to be On-Call that day or the next.

Thereafter, please contact us by 2pm each afternoon to inform us as to whether you will be off the next day (Either phone/email Kim Napier or the MoE Resourse Nurse).

The remaining doctors will be required to provide emergency cross-cover in the event of sickness so please make yourself familiar with the “Urgent On-Call Shift Cover Process” detailed in Appendix 2 of the MoE Induction Manual.

If sick leave is significantly prolonged a doctor’s letter should be provided and we will try to provide locum cover.

On your return to work you will meet with your Clinical Supervisor who will then complete a return to work form during the meeting.

 
 

MoE on-call activity

From Monday to Thursday there are 2 doctors coving the RVB and ARB buildings plus ward 75 (GI), working shifts 8:45am to 9:15pm. On Friday there is an additional Middle grade doctor on until 8pm.

At weekends, the cover is provided by 3 doctors (a mix of FY1 and FY2/ST) working various shifts plus a middle-grade doctor working until 8pm. An FY2 from a local GP Practice will also cover some weekend shifts.

Additionally, all FY2/ST’s in medical specialties participate in the Evening cover of the Medical Assessment Unit front door as part of the acute medical team. Look out for when your evening on-call shifts are in ARAU – these are shaded in on the rota and almost always during your 4 week block. Non-shaded on call means you are covering the RVB/ARB wards.

 
 

Hospital at Night

FY2/CMT/GPST doctors do 2 blocks with the HAN team during this post. Information about the duties in HAN will be provided at Hospital Induction.