Working hours: Monday- Friday 9am- 5pm
The clinical fellow will split their time between clinical service and research.
The fellow will support the clinical activity of the CNMD- The Centre for Neuromuscular Disease. This primarily involves the NMCCC- Neuromuscular Complex Care Centre and outpatient clinics. The fellow will see neuromuscular disease patients under supervision of the relevant consultants. He/she will also support day care and inpatient admissions and attend weekly MDT meetings. There will be opportunities to attend transition clinics at GOSH and at NHNN. This post will provide opportunity to obtain broad clinical exposure to patients with these rare diseases and to gain experience in their management.
The research element of the post will focus on analysing the impact of the NMCCC. Two 30-month multi-regional audits of all unplanned admissions of neuromuscular patients showed significant improvements after the NMCCC opened. Preventable admissions were reduced in total by 41% and those related to the NMD by 48%. Readmission rates were halved (51% reduction) and deaths reduced 12-fold (93% reduction). The particular impact of specialist care was shown by comparing the re-audit’s patients under a specialist NMD service to those who were not: median length of stay eight days versus 15 and ITU admission rate of 14.1% versus 23.1%. Finally, the NMCCC has been estimated to save £2069 versus standard care, and £10569 for each seven day unplanned admission it prevents.
We seek to evaluate the effectiveness of the NMCCC model of care and to use the patient group there to answer several questions. In particular, we seek information on the clinical and economic effectiveness of the NMCCC and how to identify those patients most at clinical risk. Research questions being addressed:
- Identifying the most vulnerable patients to emergency admission and/or clinical deterioration – the most disabled, or those on threshold of disability?
- Quantifying the impact of both NMD and NMCCC care on quality of life
- Quantifying the cost-effectiveness of the NMCCC model of care (summed NMCCC medical activity versus standard outpatient care, cost of other admissions to hospital).
- Assessment of which respiratory outcome measure is most useful in identifying patients at risk of requiring initiation of cough assist /non-invasive ventilation / chest infection /
- Assessing the impact of patient’s emergency plan
Bank Partners is an employment agency/employment business (as defined by the Conduct of Employment Agencies and Employment Businesses Regulations 2003) and is acting on behalf of its client in relation to this vacancy.