Leicester Royal Infirmary, part of the University Hospitals of Leicester

• Medical specialties served include: GIM, acute medicine, elderly care, neurology, stroke, gastroenterology, hepatology, a tertiary haematology (including bone marrow transplant, TTP, CAR-T therapy), oncology, rheumatology, dermatology. We have a particularly high proportion of haem-oncology, hepatology and general medical patients.
• Surgical specialties served include: upper and lower GI (including large elective tertiary cancer resections and a high proportion of emergencies), ENT (including head and neck), max fax, plastics, trauma, tertiary high-risk obstetrics, gynaecology, ophthalmics, and interventional radiology.
• We have one of the busiest EDs in the country and a high proportion of our workload is directly from there.
• There is no split site working at this site

• We are regularly involved in NIHR projects and have a busy and active research team of consultant and nurses.  We also regularly have participants in the NIHR Associate PI scheme.  Currently, we are involved in MOSAICC, ABBRUPT and T4P.
• In collaboration with the University of Leicester, original translational research is being conducted. 

• Consultants work a rota with weeks on and off the unit. There are two consultants doing ward rounds, making clinical decisions on the unit and communicating with families and other specialties. There will also be one consultant dealing with referrals, beds and generally being supportive who is present at evening handover and then on call from home overnight.
• Resident doctors are split into four rotas: two senior, airway-trained doctors are present (may be an intensive care or anaesthetic trainee, plus a fellow or specialty doctor); a more junior trainee (who may be anaesthesia CT, ACCS, medical SpR or ED SpR) and a complementary FY/IMT tier. All rotas do full shift patterns to facilitate a broad range of experience and to provide safe patient care. In addition, there is an anaesthetic senior registrar for support if needed.  We do not have any ACCPs on our unit.
• We have a large, diverse and experienced cohort of nurses specialised in intensive care nursing, with ongoing training on the unit.  We have close relationships with our Deteriorating Adult Response Team (critical care outreach) who are often previous ICU nurses.  We also have advanced critical care pharmacists, specialised physiotherapists, occupational therapists, critical care dieticians and psychologists. These work on acute care, but also have a focus on rehabilitation and we have an ICU garden to which we can take patients as they start to improve, and a useful ICU follow up clinic.

• Training in point of care ultrasound - FUSIC Heart and Lung 
• Opportunity to attend theatre for airway experience
• Exposure to paediatric emergencies 
• Interhospital transfers
• Acting up as an ICM Consultant (for Stage 3 trainees) yes, to lead ward rounds, lead referral deicions making and beds etc during the day, and as non-resident on call shifts with a consultant as back up overnight

Other:

Daily formal teaching ward rounds. 

Daily MDT for patients within and without the unit involving nursing staff, physiotherapists, occupational therapists, dieticians, pharmacists and microbiologists. 

Vast exposure to a wide array of patients and presentations. 

Ward/ED reviews of referred patients with consultant support. 

Able to gain experience in communicating with families, end of life care and organ donation. 

Many opportunities for invasive procedures including but not exclusively vascular access, bronchoscopy, tracheostomy and chest drains. 

Support to conduct audit and quality improvement projects. 

Support to be actively involved in the M&M process. 

Support to complete training portfolios, whatever a trainee’s requirements. 

Support to get involved in national and local research projects if interested, with regular use of the NIHR Associate PI scheme.

• Monthly consultant meeting to which senior trainees are invited
• Quarterly multi-disciplinary M&M meetings to discuss deaths and incidents on ICU, often linked with another specialty (surgical, ED)
• Quarterly departmental QI meetings