Workforce and job planning

Physician workforce

The number of infectious diseases and tropical medicine physicians recorded in the 2018–19 census of consultants and higher specialty trainees in the UK is:

Role

Total

Proportion working less than full time (LTFT)

Consultant

273

18%

Higher specialty trainee

353

12%*

*HST LTFT percentages are calculated from JRCPTB data to give overall figures which may differ from those in the census

These figures relate to physicians who work substantively for the NHS. 

Regional variation

There is significant regional variation for this specialty: the South West has no established infectious diseases unit, while London and Scotland have better than average provision.


Job planning

The job plan below is an example included as guidance and not intended to be prescriptive. Activities will vary according to population served, demographics and location. For further information, see the BMA/NHS Employers guidance from 2011.

Sample job plan for infectious diseases and tropical medicine physicians

Ward rounds

On average, consultants undertake two to three specialty-based ward rounds per week (2 PAs). Daily ward visits have become necessary to ensure that patients are reviewed daily by consultants and to facilitate timely review and discharge from hospital. This involves each consultant in an additional 0.5–1.0 PA per week. Each consultant team should have no more than 20 inpatients under their care at any one time, including when cross-cover is needed for leave

Inpatient infection referrals

Referral work involves an additional 0.5–2 PAs per consultant. This may include attendance at other MDTs (eg haematology, bone infection), and other specialty ward rounds eg intensive care. Increasingly, patients with a confirmed bloodstream infection are seen without formal referral during infection consultation rounds 

Antimicrobial stewardship activity

Infection consultants have an important role to play in antimicrobial stewardship activities. This can include stewardship rounds in particular clinical areas, often combined with seeing infection referrals, as well as developing antibiotic guidelines. Infection control activity/reviews may also occur during these sessions

General infection outpatients

A general infection clinic should on average see 2–3 new referrals (30 mins per appointment) and 5–9 follow-up patients (15 mins per appointment), together with the associated admin time. When senior trainees are present then they should see approximately half the numbers described for consultants, while junior trainees should not be included in clinic allocation

Inpatient MDTs

Infection inpatient MDT generally requires 1–2 hours of consultant time per week, together with a 1-hour radiology meeting (0.75 PAs)

OPAT (Outpatient Parenteral Antibiotic Therapy) work

Ad hoc OPAT patient reviews together with the weekly OPAT MDT (with nursing, pharmacy and microbiology colleagues) require 1–2 PAs per week

Hepatitis clinics

1–2 clinics per week, together with monthly MDT involving hepatology/gastroenterology, pathology and virology, together with the specialist nursing team

HIV clinics

Most infectious diseases physicians undertaking HIV outpatient care will have 1–2 clinics per week, together with an MDT involving specialist nurses, pharmacy, genitourinary medicine and virology colleagues

Tuberculosis (TB) clinics

1–2 clinics per week , together with a TB MDT requiring the presence of respiratory and infectious disease specialists, a radiologist, a microbiologist, consultant in health protection and a paediatrician

Other specialist clinics/referrals

Variable depending on type (eg travel, bone infection, chronic fatigue), comparable time requirement to general infection clinics

On-call commitment

On-call commitment is variable dependent on local consultant numbers and registrar/middle grade availability. For a dedicated infectious diseases on-call service available 24 hours a day, 7 days a week to admit patients at least 5 whole-time equivalent (WTE) consultants are required. In larger units there may be subspecialty on calls (eg HIV separate from other infection work), and this may also be the case with inpatient work with different infection teams covering differing areas.

General internal medicine (GIM)

The GIM commitment will vary between units and consultants as some will be jointly trained with medical microbiology and may be on call for that specialty.

Additional activities

Attendance at sporadic outbreak meetings and regional/national groups for various infection-related planning.

30/06/2017