Cheltenham and Gloucester lie at the head of the Severn Estuary, midway between London and South Wales. Gloucester is an old Roman fortification and a historic cathedral city. Cheltenham is a large Regency town renowned for its music, literary and cricket festivals and for the ‘Cheltenham Gold Cup’.
Gloucestershire Hospitals Emergency Departments
Gloucester Hospitals NHS Foundation Trust provides acute services for the population of Gloucestershire.
Emergency Care is delivered through both hospitals. Gloucestershire Royal Hospital serves the west of the county and Cheltenham General serves the east. Both are busy District General Hospitals.
In 2013 Cheltenham General Hospital Emergency Department closed overnight, this allowed us to concentrate all our ED medical staff in one place and provide senior cover 24/7. Cheltenham still run an ENP led Minor Injury Unit / Urgent care center overnight.
Working in GHNHSFT presents unique challenges as we have two sites separated by a ‘6 mile corridor’. This list shows you where all the specialities are based:
In ED we like to think of ourselves as one big family. We have team members from physio, nursing, occupational therapy, management, admin and many other disciplines all working together as a team. As clinicians you are going part of that team and work together with our colleagues to do the best we can for our patients. In total our ED family has nearly 300 members and every year we see over 120,000 patients, making us the busiest Department in the Severn Deanery.
We have 20 consultants who work as part of the team and don’t have any clinics of surgeries to pop off to. We have consultants on the shop floor seeing patients from 0800-midnight 7 days per week in GRH and 0800-2200 weekdays at CGH, 0900-1800 at weekends.
We take education very seriously in the Emergency Department. Here are some of the things we do.
- Educational / Clinical Supervisor
You will have a named clinical supervisor in ED. They are your first port of call for any educational or other needs.
- 1 to 1’s
Emergency medicine is a great place to get all those difficult WBPA’s signed off. Consultants are very happy to complete them but it can be quite busy to complete them at the time. In response to trainee feedback every month all trainees get an hour assigned with an ED consultant. You can use this time to go over whatever you like. Often trainees try to get 1 or 2 CBD’s completed. You could try to do a mini-CEX or just talk through some cases which have been nagging you. You can even ask for some tailored teaching on an area you are concerned about (maybe slit lamp examination and the red eye…).
Unless you are on night shifts we expect you to attend every teaching session. We have staffed the rota with cover to enable you to do this. Whilst the F1’s, F2’s and GP trainees attend their own teaching sessions the ACCS trainees attend the ED middle grade teaching which is held on a Wednesday or a Friday.
- Simulation teaching
We run regular simulation sessions as part of the middle grade teaching programme. In addition there are monthly in-situ simulation sessions run in both ED Resus Rooms. This is a great learning opportunity for the whole ED team with a particular focus on non-technical skills and human factors.
- Shop floor learning
You are constantly seeing new presentations and making plans, every day really is a learning day! A high level of senior presence on the shop floor means you’re encouraged to discuss presentations, get feedback and recommendations and act on it. This is probably the best form of supported learning.
- Handover teaching
Every weekday we have a sit down handover at 1pm. We’ll go over the patients then have 10-15 minutes to talk about a teaching topic. It could be a case in the department, an interesting x-ray, how to examine a joint, a patient safety update etc. This is a great forum for asking questions about management and disseminating messages.
The EMCAGE website (www.emcage.net) is our education internet site. The site hosts our bespoke ED eInduction but that’s only the beginning. We’ve plenty more learning topics and links to other resources such as joint exam, x-ray interpretation, abdominal pain, wound care, slit lamp use etc. We’ve tried to link to good online resources.
- Theme of the Fortnight
Every fortnight one of our ACCS trainees does a poster presentation. These get posted on the boards, presented and some of them get turned into blogs. We encourage everyone to sign up to the blog (via EMCAGE) so you get a notification when a new post is put up.
- Departmental Guidelines
These are on the intranet and you’ll find guidelines for a huge number of conditions. Have a look when you get started as they are invaluable. They can be found through our Patient First IT system.
And more. The list goes on. Suffice to say we take education seriously and really want you to have a good learning experience whilst in ED. Lessons you learn here are invaluable for your later career in whichever speciality you choose.