Users and Hierarchies

This page explains how medical and surgical teams that will use the application are structured in NHS hospitals and the relationships between the daytime teams and the night/weekend/bank holiday teams.

Seniority

Every doctor is graded by seniority as follows - starting from the most junior. They rise by a grade after each year of practice.

• Foundation Year 1: junior - not yet having full registration with the General Medical Council (GMC)
• Foundation Year 2: has full GMC registration but still in a protected training stage
• Speciality trainee 1 - 2: finished protected training stage, beginning general specialization (in surgery, medicine, general practice, etc)
• Speciality trainee 3 - 8: where subspecialisation necessary e.g. cardiology in medicine, thoracic specialization in surgery. Usually most senior resident doctor on-call over night or weekend

Consultants are at the top of each teams, as the attending doctor to each patient i.e. the person that has overall responsibility for decision-making.. They are allocated to patients in ways that are specific to each hospital (e.g. by ward, by patient category etc) and therefore may have several groups of juniors reporting to them at various times, though most will have a dedicated team of junior doctors.

Teams

Every team in the hospital has the same basic structure. This applies to both Medical and Surgical teams.

• 1 or 2 Foundation Year 1's
• 1 or 2 Foundation Year 2's
• 1 or 2 Speciality Trainee 1 or 2's
• 1 or 2 Speciality Trainee 3+'s

Thus, the team is able to handle a broad range of patients' disorders while also supporting training and development.

Shift Pattern

During the day, the hospital is fully staffed with doctors. Each team covers one or more wards (e.g. medical teams) or theatres and wards (e.g. surgical teams). Many teams will also cover outpatient clinics and procedure lists.

At the end of the shift, the respective day teams handover to one rota’d team that cover the night shift for the whole hospital for their particular specialty e.g. medicine, surgery, psychiatry. Similarly, these teams cover the whole hospital on weekends and bank holidays.