14 Mar 2018

Full-Time Unaccredited Trainee

NSW Health Service – The Entrance, New South Wales, Australia

Job Description

NSW Health Service require a “Unaccredited Trainee” in Central Coast NSW:

Unaccredited Trainee

Position Number

Employment Status
Full Time – Exempt

Applications Close

Local Health District
Central Coast Local Health District

Gosford Hospital

General Medicine

Sub Specialty

Public Hospital Medical Officers (State) Award

Resident Medical Officer

Current Rotations/Networks (which may change from time to time)
You may be required to work at the different facilities and locations with the NSW public health system as part of Central Coast Local Health District which includes Gosford, Wyong, Woy Woy and Long Jetty Hospitals.

Main Purpose of Position
An exciting opportunity exists for a trainee to work with the adult Hospital In The Home service (HITH) based in Wyong and Gosford hospitals, CCLHD. HITH provides care in the community for patients who would otherwise be admitted to an acute hospital bed. The service is designed to give patients the choice of care at home rather than as an inpatient, as well as to reduce the length of hospital stay and avoid unnecessary admissions. The service operates a general medical model of care and the HITH patients are admitted to a virtual bed under the care of the HITH staff specialists on call while providing a multidisciplinary team approach incorporating health promotion and health education for both patient and carer. HITH provides an acute treatment service for patients with conditions such as pneumonia, cellulitis, wound infections, osteomyelitis and supervised anticoagulation of patients with VTE in addition to a supported discharge service, a multidisciplinary out-patient facility and management of chronic and complex medical conditions during their HITH episode of care. A patient-centred, evidence-based clinical approach is fostered within the service. A patient-centred, evidence-based clinical approach is fostered within the service. This position is offered as unaccredited trainee position until beginning of February 2019 .
Duties include Clinical assessment and management of patients referred to the Service by specialists, GPs, ED MO. This will include ward consults, ED consults, Home Visits and visits to Residential Aged Care Facilities. Liaison with local General Practitioners and other specialist and services is a major part of daily activities and the patient handover is a vital part of the continuum of care. The service is well supported by experienced HITH nurses who co-ordinate the referrals and provide care for the patients outside the hospital during their HITH episode of care by delivering their treatment in the community- e.g. iv antibiotics. The service has access to community health allied health clinicians if necessary. Expectations of the trainee include participation in a quality assurance improvement projects, participation in current research and multidisciplinary teaching sessions. The trainee will also have the opportunity to be exposed to general medicine, geriatric medicine, rehabilitation, and optional attendance at Outpatient Clinics other than the HITH medical clinics.

The Unaccredited Trainee is responsible for co-ordinating and documenting the admission, management and discharge planning of patients within the unit; the day-to-day assessment and management of the patients, maintaining high levels of communication with patients and family regarding the nature of their condition and its treatment; communicating and co-ordinating care with the team; arranging consultation with other staff when appropriate; and arranging discharge and liaising with local medical officers
and other community based care modalities in order to ensure the provision of optimal patient care within CCLHD.

Each patient that is admitted into hospital will transition through five stages of care coordination:

  • Pre Admissions/Admission
  • Multidisciplinary Team Review
  • Estimated Date of Discharge (EDD)
  • Referrals and Liaison for patient transfer of care
  • Transfer of care out the hospital

It is the responsibility of the position holder that in order for best care and practice for the patient, that discharge documentation, referrals and medication must be completed prior to the transfer of the patient.

Mandatory Courses:
Compliance and currency certificates must be submitted to Central Coast Local Health District Medical Workforce and Education Unit prior to commencement of the position:

Bloodsafe: eLearning module/s
Detect: – Between the Flags e-learning module and face to face BLS and/or ALS

Employment is subject to you having current immunity status that complies with the Occupational Assessment, Screening and Vaccination Against Specified Infectious Diseases PD2011_005.

Appointment and ongoing employment will be subject to continued compliance of all NSW Health Policy Directives.

Mandatory Clinical Handover:
Clinical handover involves the transfer of information, accountability and responsibility for a patient or group of patients. Clinical handover happens within and between Medical, Surgical, Emergency, Paediatric and Critical Care teams to ensure that we are following the ISBAR protocol, National Australian Standards and providing the best care
and safety to all of our patients. Night to morning handover is conducted at 0800 hrs sharp at Wyong and Gosford Hospitals each day. Evening to night handover is conducted at 2200 hrs sharp at Wyong and Gosford Hospitals each day.

To provide effective medical services and training exposure for the Unaccredited Trainee to patients under supervision in a complex clinical environment in both Medical and Surgical inpatients and outpatient areas in the public health organisation.

Responsibilities include:

  • Coordinating and documenting the admission, management and discharge planning of patients seen in or admitted to his/her Unit within the public health organisation.
  • The day-to-day assessment and management of the patients in his/her Unit, communicating with them and their family the nature of their condition and its treatment.
  • Communicating and coordinating care with their team, arranging consultation with other staff when appropriate, then arranging discharge and liaising with local medical officers and other community based care modalities.
  • All decisions concerning the patient(s) in consultation with their immediate supervisor.
  • Participation in the afterhours and relief roster

Position Requirements
CCLHD has a strong commitment to vocational training and career support; term allocation is based on submitted preferences, operational requirements, training needs and future aspirations of the Trainees. Good general experience is provided in all CCLHD hospitals. The position is full-time, Monday to Friday and you may be required to participate with rostered ward overtime and on-call. All overtime shifts are evenly distributed amongst the Unaccredited Trainees.

1. Qualifications

  • MBBS or equivalent.
  • Australian & New Zealand Graduates or Competent Authority; completion of two postgraduate years.
  • For Standard Pathway candidates; two post graduate years or more working as a medical officer in a hospital within the last 5 years.
  • Currently registered or eligible for registration with AHPRA

2. Clinical Competency is expected in the following as a minimum:

  • Venipunctures
  • Veni/Arterial Puncture for sampling
  • Venous cannulation
  • ABG Analysis
  • Insertion of Nasogastric tube
  • CPR
  • Suturing skills / Removal of foreign bodies
  • Catheterisation
  • Plastering techniques
  • Lumbar Puncture
  • Slit lamp examination
  • Reading of X-rays
  • Recognition and initial management of acute illness eg. DETECT Principles
  • Interpretation of basic results o main features of ECGs

o Electrolyte Patterns
o Liver function tests
o Cerebrospinal fluid results
o Blood smear reports, coagulation, iron studies
o Radiological reports

  • Can apply the principles of blood transfusion/use of blood products
  • Can demonstrate an understanding of:

o Principles of antibiotic usage, medication risks and prescribe and administer drugs appropriately
o Principles of safe oxygen therapy
o Hazards of drug treatment in the elderly
o Pain management
o Principles of preventive geriatrics and geriatric rehabilitation

3. Research Teaching & Education:

  • Contribute to teaching activities in the supervision of Medical Students and Interns, unless AHPRA conditions apply.
  • Undertake relevant research under the supervision of Term Supervisors
  • Provide evidence of continued professional development and commitment to self-education
  • Must attend education as organized by the hospital/LHD

4. Orientation
Orientation: Hospital orientation takes place on upon commencement. Attendance is compulsory for all SRMOs/Trainees Medical Skills

Unaccredited Trainees HITHs will be required to undertake the core mandatory orientation to:

  • Gain an understanding of the organisational values, goals and ethics.
  • Gain knowledge and develop skills to work in a manner which promotes their own health, safety and security at work, including information relating to infection control and needle-stick injury.
  • Gain an understanding of child protection legislation policies and responsibilities associated with notifying and reporting issues about child protection.
  • Given guidance on ways to perform their job in an efficient and effective manner; and the code of conduct and ethics, including the behaviours and standards expected by the Public Health Organisation.
  • Understand the principles of waste management and the local processes in place which are designed to reduce waste.
  • Gain an understanding of the administrative procedures relating to the performance of their work.
  • Develop an understanding of the legislative and industrial context in which they work.
  • Gain information on the Health Service Employee Assistance Program (EAP).
  • Gain education and training in the minimisation and management of aggression, Occupational Health and Safety, Fire Safety and quality improvement processes.

5. Supervision
Supervision by the HITH Staff Specialist. The Unaccredited Trainee HITH will provide direct supervision of prevocational trainees.

Supervision of prevocational trainees by the Unaccredited Trainee HITH after hours: The Unaccredited Trainee HITHs will provide direct supervision of prevocational trainees performing after hours duties.

6.Other responsibilities

In addition to the Values & Behaviours Charter, the Medical Officer is expected to comply with legislative, policy/protocol requirements as they relate to:

  • Produce appropriate discharge summaries
  • A professional attitude and flexibility in work role
  • The supervision requirements as set out by the AHPRA;
  • The public health organisation’s Performance Management Policy;
  • Occupational, health and safety requirements as an employee;
  • The NSW Health Code of Conduct.
  • Must know the principles of Open Disclosure & Time Out – Correct Side/Site Policy Directive
  • Compliance with all applicable public health organisation and hospital policies and protocols, and with applicable Policy Directives and Guidelines issued by the Department of Health, as amended and as in force from time to time, including the NSW Health Code of Conduct
  • Ensuring that all services provided to patients are consistent with any instructions issued by your supervisor or Department Director or any conditions imposed by the Medical Board of Australia;
  • Maintenance of adequate hospital clinical records, including completion, within a reasonable time period following the patient’s discharge, of patient discharge letters;
  • Observance of general conditions of clinical practice applicable at the Public Health Organisation where you will be working from time to time;
  • Demonstrating at all times courteous and professional behaviour towards patients, their relatives and other staff.

Local Background & Environment
The NSW Central Coast is positioned between Sydney and Newcastle, with a population that is expected to grow from the current approximate 300,000 to 450,000 before 2030. The Central Coast is a popular destination for holiday makers and retirees, but is also a growing centre for day commuters into Sydney, Newcastle and the Hunter Valley.
Central Coast Local Health District (CCLHD) provides over 700 beds across its network facilities comprising Gosford Hospital, Wyong Hospital, Long Jetty Continuing Care Unit, Woy Woy Hospital and various Community Health Centres and Services. CCLHD has strong connections with Royal North Shore Hospital and is affiliated with the University of Newcastle.
Wyong Hospital is an acute major metropolitan hospital providing inpatient, outpatient and emergency services to residents in the northern part of the NSW Central Coast. Wyong Hospital has approx 300 inpatient beds and provides a range of medical and surgical services, and rehabilitation. Specialty services include Drug and Alcohol, Renal, Coronary Care, Stroke, Mental Health and Cancer services. It is anticipated that Wyong Hospital will further develop its role as a district general hospital for a growing population with well established patient transport and referral links with Gosford Hospital for patients with a need for more complex or intensive clinical services.
Gosford Hospital is part of Central Coast Local Health District and the central point of administration for the Central Coast community. Gosford Hospital is the principal referral hospital and a trauma centre for the Central Coast, with approximately 500 inpatient beds and 24-hour access to its Emergency Department and Operating Theatres. Inpatient services include Coronary and Intensive Care, HITH, Neurology, Renal, Geriatrics, General Surgery, Obstetrics, Mental Health, Paediatric and Emergency services.
Outpatient and community services include Allied Health, Dental, Podiatry, Nursing, Child and Adolescent and Family Health, Drug and Alcohol, and Cardiac Rehabilitation.

Key Internal and External Relationships
The Unaccredited Trainee HITH is a key person who works closely with all members of staff and Relationships must work as part of, and contribute to a multi-disciplinary team; deal with matters of an urgent or sensitive nature; must have the ability to exercise discretion, sensitivity and maintain confidentiality; work co- operatively within a team environment and actively contributes to team activities. The position holder needs to display sound communication skills to deal effectively with administrative and medical staff.

Key Internal Relationships

  • Clinical streams
  • Multidisciplinary teams
  • Consumers/Carers
  • Other Clinical Divisions
  • Hospital Administration

Key External Relationships

  • Consumer/Carers
  • GP’s
  • Community
  • Police, Ambulance

Supervision Arrangements
Supervision of the Unaccredited Trainee HITH in normal hours of work:

  • Will receive supervision and support from the Trainees more senior and the Consultant within the department they are rotating through. As such daily supervision is available at any time.
  • Will benefit from the additional supervision of the Director of Training (Medical Skills Program) and the Director of Prevocational Training and Development within the hospital.
  • Additional supervision is available by the department the Medical Officer is rotating through by telephone.

Supervision of the Trainee HITH after hours:

  • Immediate supervision by the Trainee (Including Advanced Trainee, Basic Trainee) on duty;
  • The unaccredited Trainee HITH will be responsible for other Resident Medical Officers working after hours.
  • Will be able to call the Consultant on call to for support and supervision after hours.

Challenges/Problem Solving
Balancing mandated training and education requirements with service provision, within the limitations of a busy public health service.

  • Maintaining a professional role and responsibility for patient care, in close liaison with supervising consultants.
  • Working collaboratively with other staff in a multi-disciplinary team.
  • Maximising the efficient utilisation of the physical resources of the Health District.
  • Being flexible with the work required in a range of specialties and locations.
  • Maximising the efficient use of the physical resources of the Health District
  • Responsibility for supervision and teaching of more junior medical staff (i.e. junior medical officers and Basic Trainees) attached to the medical team.

Decision Making
The Unaccredited Trainee HITH will have a moderate level of clinical independence. All patient related decisions which are clinically, organisationally or socially significant should be discussed with the consultant.

This will require close and effective liaison with consultants will allow the Unaccredited Trainee HITH to demonstrate their level of ability and understanding of patient care and enable you to expand your areas of responsibility.

The position holder needs to display sound communication skills to deal effectively with administrative and medical staff. The Medical Officer is a key person who works closely with all members of staff and must:

  • Work as part of, and contribute to a multi-disciplinary team.
  • Deal with matters of an urgent or sensitive nature.
  • Must have the ability to exercise discretion, sensitivity and maintain confidentiality.
  • Works co-operatively within a team environment and actively contributes to team activities including pro- actively participates in team meetings and decision making processes.

Performance Monitoring
Unaccredited Trainee HITH will be allocated a Term Supervisor at the beginning of the term.
Assessment forms to be completed by Term Supervisor or delegate. The completed forms are to be given to
the DPET Assistant or ED Secretary. Emergency Department have a requirement for 3 assessments per
term. At the end of the term your nominated Supervisor will review assessment forms before completing your
end of term assessment.

The Medical Officer is responsible for:

  • Participating in ongoing review of their clinical practice as per conditional registration guidelines;
  • Participating in continuing medical education and professional development as covered by the supervision

arrangements stipulated by the AHPRA; and

  • Maintaining his/her professional competence.

The Unaccredited Trainee HITH is required to maintain a continuing level of satisfactory

  • Supervision reporting to AHPRA as per conditional registration guidelines by the Director of Prevocational

Education & Training.

  • End of term reports with the Director of Prevocational Education & Training.
  • Participation in continuing medical education and professional development.

If performance is judged to be below the level of requirement of Position Description a standard process
applies PD2013_034 Managing for Performance

Additional Information

Responsibilities of the role include the provision of early clinical decision making as welll as the immeidiate documentation and implementation of a management plan which achieves patient outcomes with the most efficient use of resources.

Additional Documents

no addditional documents have been provided


Organisation Chart

2018 – Unaccredited Trainee – HITH – Organisational Chart.docx

Job Demands Checklist
Click Here to View

Selection Criteria
1: MBBS or equivalent, currently registered or eligible for registration with the Medical Board of Australia

2: Australian & New Zealand Graduates or Competent Authority;completion of two postgraduate years. Standard Pathway candidates; completion of two post graduate years or more, working as a medical officer in a hospital within the last three years.

3: Demonstrated ability of the required level of clinical skills including courses such as or similar to DETECT (management of the deteriorating patient course).

4: A professional attitude and flexibility in work role with a preparedness and ability to participate in after- hours overtime and on-call rosters and the required rotations both between services and geographical location to deliver patient care.

5: Demonstrated good organisational, time management skills and commitment to Continued Professional Development, quality improvement, patient safety and risk management.Demonstrated excellent communication skills (verbal and written), and computer skills and the ability to work as part of a team.

6: Demonstrated ability to work within a supervised complex clinical environment utilising excellent clinical skills (at the required level of competency) and judgment and expertise.

7: Unrestricted NSW Drivers Licence (P2 Licence acceptable)

8: Demonstrated commitment to Caring for the Coast vision, goals and strategies, with demonstrated behaviours which align with the NSW Health CORE values and CCLHD Values and behaviours charter.

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