HULL AND EAST YORKSHIRE HOSPITALS NHS TRUST
JOB DESCRIPTION
APPOINTMENT OF TRUST DOCTOR (ST3+ LEVEL) – NEUROLOGY
Up to One Year Fixed Term
1 INTRODUCTION
1.1 The Hull and East Yorkshire Hospitals NHS Trust has an annual budget of circa £481 million, employs over 8,000 staff and serves an extended population of 1.2 million.
1.2 Hull York Medical School
1.2.1 The first students of the joint Undergraduate Medical School of the Universities of Hull and York (HYMS) graduated in 2008. Students follow a five year curriculum which makes strong use of problem based learning techniques. For the first two years the students are split into two equal sized cohorts, one of which is based at The University of Hull and one at The University of York. The two cohorts follow the same curriculum and some teaching is delivered synchronously to both. At the end of the second year students undertake their clinical attachments across the wider NHS patch which incorporates North Yorkshire, East Yorkshire and South Humber. In the three ‘clinical’ years approximately 50% of the teaching is hospital based and 50% community based.
Professor Trevor Sheldon is the interim Dean of the School.
1.2.2 The Postgraduate Medical School was part of the Faculty of Health until August 2002, when following reorganisation it became a ‘stand alone’ school known as the Postgraduate Medical Institute. The Director of the
Postgraduate Medical Institute is Professor N D Stafford.
1.3 Chairs in Reproductive Medicine, Surgery, Psychiatry, Primary Care Medicine, Radiology, Respiratory Medicine, Vascular Surgery, Head and Neck Surgery,
Oncology and Cardiology have been appointed.
2. MEDICAL NEUROSCIENCES
1.1 Neurology is a part of the Neurosciences group that lies within the Specialties subunit within the Medicine Health Group. Neurosciences include Neurology, Stroke and Neurophysiology.
1.2 The Department provides neurological services to East Yorkshire, Hull, Grimsby, Scunthorpe and North Lincolnshire (a combined population of approximately one million). The Neurology Services in Grimsby and North Lincolnshire are currently run by Dr Jayam Lazarus, a locum consultant Neurologist. There is one vacant post in Grimsby. Hull acts as the ‘Referral Centre’ for North and North East Lincolnshire providing secondary and tertiary services and after hour neurology supervision.
1.3 This is a locum post for up to one year. The successful candidates will join Dr Alec Ming, Dr Fayyaz Ahmed, Dr Jayati Tarafder, Dr James Harley, Dr Modar Khalil and Dr Rubesh Gooriah, Consultant Neurologists and Dr Nandakumar (Locum Consultant). There are also 2 specialty doctors in post, 5 Neurology Registrars and one research fellow. Dr J Harley is the Clinical Lead for Neurology.
1.4 Neurology in-patient services are based at the Hull Royal Infirmary. There is a 26 bed unit shared by Neurology and Stroke rehabilitation. Out-patient sessions are mainly held at the Hull Royal Infirmary, although there are established clinics at Castle Hill Hospital and Beverley Community Hospital and outreach clinics based in primary care at Marfleet and Sutton practices, all within 12 miles of the main centre.
1.5 There is a fully established Level 1 Stroke Unit (including a hyper-acute section) with 24 beds (on the same floor as the Neurology/Stroke Rehabilitation Ward). The Stroke Services are provided by 5 Stroke Physicians in normal working hours. Within the team, there are 5 Stroke co-ordinators (specialist nurses) who work from 08.00 to 24.00 each day. Since 2010 the Stroke Physicians have provided a 24/7 acute Thrombolysis Service with the assistance of the stroke co-ordinators. All of the neurologists contribute to the afterhours and weekend neurology on-call.
Thrombolysis and Stroke Service.
1.6 The interests of the current team include epilepsy, headaches, movement disorders, Motor Neurone disease, Multiple Sclerosis and use of Botulinum toxin.
2. THE POST
2.1 This post of Trust Doctor is for a period up to one year
2.2 The successful candidate will join the medical and nursing team in supporting neurology clinics and ward rounds. S/he will work with Consultant Neurologists to see patients in an outpatient setting as well as ensuring consistency of care to inpatients on the ward.
2.3 The successful candidate will follow a timetable of sessions with supporting Consultants to include general outpatient consultations. The post holder will also take part in formal ward rounds.
2.4 There will be a fixed admin session for the post and you will be expected to participate in CPD.
2.2 Workload
2.2.1 In the last 12 months the the Neurological Service has delivered a total of 13,078 an annual workload of:
In-patients – 1,666 (Elective, Non-elective and day case episodes)
New Outpatients – 4,473; FU Outpatients 8,605
2.2.2 Urgent referrals are seen in most clinics. Ward referrals from other Consultants are seen on request and there is a dedicated Neurology opinion services to the Acute Assessment Unit which is provided daily and on weekends and bank holidays.
2.2.3 Consultant Neurologists rotate their inpatient work, either to attend to the patients in the Neurology ward, outlying patients in other wards or covering referrals in the Acute Assessment Unit. In any setting there will be 1.5 sessions a week dedicated to the ward round or seeing referrals.
2.2.4 The Neurology Team contribute to the supervision of 4 Specialist Registrars and 2 Specialty Doctors. They also provide regular supervision to our extensive team of Specialist Nurses.
2.2.5 Some of the Neurologists and Stroke Physicians are Honorary Clinical Tutors at Hull York Medical School.
2.2.6 The Neurologists all contribute to the on call service after hours 1 week in 6 (prospective) for Neurology
2.3 Current Staffing
Medical:
7 Neurology Consultants
3 Stroke Consultants
1 Locum Consultant Neurophysiologist
5 Specialist Registrars in Neurology
5 Core Medical Trainees (including 2.0 in Stroke)
2 Specialty Doctor
1 Research Fellow
Other:
3 Epilepsy Nurses
4 Parkinson’s Nurses
3 Multiple Sclerosis Nurses
1 MND Nurse
5 Stroke Co-ordinators
1 Headache Specialist Nurse with a second post under recruitment
1 Neuromuscular disease co-ordinator
Huntington’s Disease Support Team
3. PROPOSED TIMETABLE
3.1 The timetable will be formalised by Dr Harley, Clinical Lead.
3.2 Audit/Teaching
3.2.1 There is a 1:6 on-call commitment with this post. Audit is well supported by the department. The LAS will be involved in audit activities undertaken within the Neurology Department and play an active role in the evaluation of new treatment modalities introduced. 3.3 So far as is consistent with regular duties, the post holder undertakes to deputise from time to time for absent colleagues.
3.4 The post holder undertakes, exceptionally, to be available for such irregular commitments outside normally rostered duties as are essential for continuity of patient care and, therefore, may be required, in exceptional circumstances, to perform additional duties.
3.7 The post holder will be subject to review to assess progress (including the relevant professional development activities undertaken). A Consultant Neurologist has been allocated to supervise the post holder and also have responsibility for education and career developments. Study leave will be in accordance with the terms and conditions for medical staff.
3.8 Access to office facilities, secretarial support and IT facilities will be available.
6 THE HOSPITALS
6.1 The Trust comprises of three main hospital sites and operates Outpatient Clinics from various peripheral sites.
6.2 Hull Royal Infirmary (752 beds)
6.2.1 This hospital is the major Acute hospital in East Yorkshire and serves a population in excess of 600,000. It has the only Accident and Emergency department and the following specialities:-
Dermatology Neurosurgery
Clinical Haematology Neurophysiology
Diabetes/Endocrinology Ophthalmology
ENT & Head & Neck Surgery Oral Surgery & Orthodontics
General Medicine Orthopaedics
General Surgery & Vascular Surgery Paediatric Medicine
Gastroenterology Paediatric Surgery
Medicine for the Elderly Plastic Surgery
Neurology Renal Medicine
Obstetrics and Gynaecology Rheumatology
6.3 Acute Admissions Unit - The Acute Admissions Unit is situated adjacent to the A & E Department. The Unit has promoted greater integration of the General Medical teams with the Department of Medicine for the Elderly, allowing medical and nursing staff to cope better with the growing pressures on emergency admissions. Close working relationships are established between the Admissions Unit and the A & E Department.
6.4 A ten bedded Intensive Care Unit and a ten bedded High Dependency Unit is in close proximity to the 9 main Operating Theatre complex. This hospital has a separate eurosurgical Intensive Care and Neurosurgical High Dependency Unit and a Cardiac Monitoring Unit.
6.6.5 Women’s and Children’s Hospital - This new development opened in March, 2003 and provides maternity wards and clinics, an antenatal day unit, a delivery suite, a neonatal unit with special and intensive care, theatres, an early pregnancy assessment unit, 25 gynaecology beds, a gynaecology day surgery unit, gynaecology day care and outpatients' department, a sub-fertility unit, an ultrasound department, and a children's outpatient department.
6.6 Eye Hospital – A new eye hospital was completed in October, 2002, and provides three operating theatres, a pre-assessment suite, a twelve bed inpatient ward, administrative space and a seminar room.
6.7 Phase two will provide sufficient space to allow a planned for expansion of Consultant numbers and also for paediatric and adult outpatient clinics, along with supporting facilities such as orthoptics.
6.8 Castle Hill Hospital (507 beds)
6.8.1 The hospital is one of the two major hospitals on North Humberside.
Clinical Services currently on site include:
Birth Centre
Cardiology
Cardio-Thoracic Surgery
Gastroenterology
General Medicine
General Surgery
Genito Urinary Medicine
Infectious Diseases
Medicine for the Elderly
North Humberside Breast
Screening Service
Orthopaedics
Plastic Surgery
Rehabilitation
Rheumatology
Thoracic Medicine
Urology Service
6.9 As part of the ongoing ICU/HDU development, a new building will help provide an additional 7 beds to the existing 9 bedded Intensive Care Unit.
6.10 The Academic Surgical Unit, headed by Professor John Monson and the Academic Medical Unit led by Professor Alyn Morice are based at this hospital. 6.11 Beverley Community Hospital - Outpatients and minor injuries only.
7 PERFORMANCE RATING
7.1 The Trust was rated as FAIR for its ‘Quality of Services’ and WEAK for ‘Use of Resources’ in the Healthcare Commission’s Annual Performance Review.
7.2 Since the start of this financial year the Trust has made significant changes to its financial management process and has returned to financial balance.
7.3 The Trust achieved 38 of the 44 standards in its self-assessment and has already addressed a number of the areas where it felt performance needed to be improved.
8 FUTURE DEVELOPMENTS AND SERVICE IMPROVEMENTS
8.1 The Trust has announced a £45m investment in Cardiac Facilities at Castle Hill Hospital. The centre, due to be completed in 2008, will significantly increase capacity at the Trust and contribute towards meeting government targets, principally for revascularisation and waiting times. Work has now begun on site.
8.2 Work is also continuing at pace towards a £65m Oncology and Haematology development at Castle Hill Hospital. The building is due for completion mid-February, 2008 with the facility becoming fully operational by May, 2008.
9 EAST RIDING MEDICAL EDUCATION CENTRE
9.1 Medical Education at Hull and East Yorkshire Hospitals NHS Trust compromises of the Medical Education Centre (MEC), Hull Institute of Learning and Simulation (HILS) and the Clinical Skills Facility. The department is accessed by all health care professionals and offers a broad range of clinical training and support.
These facilities are easily accessible for both internal staff and external visitors due to their ideal location at one of the Trusts main hospital sites. The facilities have been built with the delivery of training in mind, they each house seminar rooms and lecture theatres which are fully equipped with up to date Audio Visual Presentation equipment. The Clinical Skills Facility is also able to offer practical skills rooms including ward areas, operating theatre and simulation suites. Each room has been built with a high level of flexibility and all can be customised to the user’s needs. MEC has a newly refurbished Lecture Theatre which has a capacity for 200 people. Both facilities have the capability to provide video conferences and each have cyber spaces available for use.
There is an extensive Resource Centre with a sister facility at Castle Hill Hospital. The Resource Centres have holdings of over 10,000 texts and receive 72 journals on weekly or monthly receipt, together with some Video and DVD items. Access is available to the numerous online resources available from the Resource Centres’ The Resource Centres have 24/7 access via a swipe card system. The centre incorporates the largest Postgraduate medical educational facility in the Yorkshire Region and supplies support services, in addition to its central teaching and academic roles.
8.2 The associated department at Castle Hill Hospital includes a 70 seat lecture theatre with modern audio-visual equipment.
8.3 Dr Makani Purva is the Director of Postgraduate Education for East Yorkshire and is responsible for the education of medical staff and the running of the Medical Education Centre. Dr Purva is also simulation lead for the Hull Institute of Learning and Simulation. Dr Tun Aung is the Deputy Director for the Medical Education Centre. The Centre has a comprehensive Postgraduate tuition programme in which the successful candidate will be encouraged to take part.
9. APPRAISAL/CONTINUOUS PROFESSIONAL DEVELOPMENT
9.1 The Trust is committed to supporting the requirements for continuing education and professional development is laid down by the Royal Colleges. A personal development review will be undertaken by the Clinical Area Lead annually and objectives agreed. Appraisal is carried out according to GMC guidance in preparation for revalidation.
10 OTHER MEDICAL INFORMATION
10.1 Local professional bodies include the Joint Hospitals Medical Staff Committee whose membership comprises of all consultant staff and top-grade scientists; the Hull Medical Society and a branch of the British Medical Association.
11 RESEARCH AND DEVELOPMENT
11.1 There is a Research and Development Facilitator who promotes and facilitates NHS research in the area.
11.2 The Service has an admirable record of research publications and international presentations. …. academic staff have attained MD degrees in the last year.
12 RELATIONSHIPS BETWEEN CONSULTANTS, CHIEF EXECUTIVES AND TRUSTS
12.1 The management of hospitals and other health care facilities is the responsibility of Trust Boards discharged through their Chief Executives, who have authority to decide policy commensurate with their responsibility.
Consultants have a primary role to provide clinical services to patients referred to them.
12.2 The Consultants have a responsibility to the Chief Executive and a commensurate authority in respect of the reasonable and effective use of such resources and staff as they use and influence. The successful candidate will be expected to operate within the agreed speciality budget and workload target. There is in addition a collective responsibility falling on all Consultants to consult with their colleagues and, hence, to co-ordinate their individual commitments in order to ensure that the particular clinical services with which they are involved operate effectively.
12.3 Each consultant has a specific responsibility to the appropriate Service Management for the use of the resources. Specialist Medicine is managed within the Medicine Health Group.
13 ADDITIONAL INFORMATION
13.1 Hull is one of the country's main ports with the advantage of closeness to the rest of the European Community.
13.2 There is an increasing number of direct inter-city trains to London and regular services to other major centres. The M62 motorway provides fast communications within Yorkshire and links up directly with the A1 and M1 North/South motor routes. Humberside Airport provides a reliable service to several European cities. There is easy access to nearby pleasant countryside, dales, moors and first class coastal resorts. The City of York, with its Minster and many other attractions, including the Jorvik Centre, can easily be visited in a day.
13.3 East Yorkshire has forty miles of spectacular coastline from Spurn Point in the south to Filey Brigg in the north. Spurn Point has the only full-time lifeboat crew in the country and is a bird watchers' paradise. Nearby is Hornsea Mere, a huge freshwater lake and RSPB reserve. Hornsea also has a famous local pottery and an award winning Museum of Village Life.
13.4 Both the City of Hull and the nearby market town of Beverley are ancient Boroughs of considerable interest. Hull was very much rebuilt after heavy bombing in World War II and is, therefore, a modern as well as an historic City. There is an attractive Yacht Marina and an international ice rink and there is a good choice of theatre and concert programmes, at both the New Theatre and Spring Street Theatre within the city centre.
13.5 Beverley has a beautiful medieval Minster, fine Georgian and other period houses and cobbled market square. The restored Dominican Friary, dating from the 14th Century, and nearby racecourse are notable attractions.
13.6 The Humber Bridge links the North and South Banks of the Humber, which have a combined population of some 900,000 people.
13.7 There are good education facilities, both private and state, for school age children and, in addition to the University of Hull, there is a second university, the Lincolnshire and Humberside University, based in the area.
13.8 Several new projects have been completed/are underway in the City, to ensure that Hull is recognised as one of the UK's Top 10 cities by 2010. These include the Deep, (a Marine Science and Visitor Centre), a £43 million Stadium and the redevelopment of the Ferensway shopping area and Transport system.
13.9 Housing locally is generally cheaper than in most other parts of the country. There are many villages with good housing/facilities surrounding Hull and within the required travelling time.
14 RESIDENCE
14.1 The post holder must live within 30 minutes travelling time of base hospital.
15 CONDITIONS OF SERVICE
15.1 Any Consultant who is unable, for personal reasons, to work full time will still be eligible to be considered for the post. If such a person is appointed, modification of the job description will be discussed on a personal basis following consultation with colleagues and the Chief Executive. 15.2 Appointment under the Department of Health Flexible Careers Scheme will be in accordance with the provisions of that scheme and the associated guidelines for Trusts (08/05/02).
15.3 It is a legal requirement for all doctors to be on the Specialist Register before they can take up a Consultant appointment.
16 TRUST SAFETY POLICIES AND PROCEDURES
16.1 You are responsible for your own health and safety and must co-operate with management to achieve safer work processes and work places, particularly where it can impact on others.
16.2 You are to ensure suitable and sufficient equipment is provided and the adherence to Trust safety policies, to sustain the health and safety of staff, patients and visitors, to areas within your remit.
16.3 You are required to review all risk assessments periodically and particularly when staffing and/or equipment changes, monitoring the effectiveness of any control measures implemented.
16.4 You are to ensure suitable and sufficient equipment is provided to sustain the health and safety of staff, patients and visitors to areas within your remit.
16.5 In addition to the Trust’s overall responsibilities under the Health Act Code of Practice for the Prevention of HCAI 2006 for your safety, you have a personal responsibility to ensure that your work adheres to this Code in the delivery of safe patient care within the organisation.
17 EQUAL OPPORTUNITIES
17.1 The Trust is an equal opportunities employer with family friendly working practices available.
18 ACHIEVING A BALANCE
18.1 The Strategic Health Authority is committed to this nationally agreed initiative and will, in accordance with "Plan for Action" be reviewing and adjusting the numbers and disposition of hospital doctors. This will involve an increase in Consultant staff and a reduction in some of the training grade staff. The numbers and grades of junior staff currently supporting this post are, therefore, not guaranteed and may be changed as the plan develops.