Information Pack
and
Job Description
for
Consultant in Medicine for Older People
(Frailty)
MEDICINE AND EMERGENCY CARE
(MEC) 2021
Some facts about us:
Our Foundation Training Programme has been the highest rated in the North West Region
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INTRODUCTION
This is a full time substantive post and supports our ongoing comprehensive reconfiguration of services for unscheduled care which involves further development of our “front door multidisciplinary frailty service”. The successful applicant will share the responsibility for an MfOP ward. They will also support the frail elderly patients on the Older Person’s Rapid Assessment (OPRA) Unit, Older Person’s Units (OPU) and outpatient clinics. We would welcome subspecialty interests in Parkinson’s disease, Community Care of the Elderly, Acute Frailty, Dementia, Ortho-Geriatrics, Surgical Liaison or Stroke Medicine.
Other sub specialty interests will be also be considered and the department will look at options of providing specialty cover through a departmental job plan if a strong candidate has an interest in other areas which fits into the elderly medicine strategic vision for the Trust.
The successful candidate must hold or be within 6 months of being eligible for specialist registration in General (Internal) Medicine and Geriatric Medicine.
The OPRA Unit has 9 assessment areas and two 19 bedded Older Person’s Units. This forms our new Frailty Unit with consultant board rounds throughout the day and full MDT input. There are no long-stay beds.
In addition there is an Acute Stroke Unit and a Stroke Rehabilitation unit at the Trust. This is run by 4 stroke consultants and 2 stroke consultant nurses with close links with the regional interventional neuroradiology team.
The successful candidate must hold or be within 6 months of being eligible for specialist registration in General (Internal) Medicine and Care of the Elderly Medicine.
EAST LANCASHIRE HOSPITALS NHS TRUST
3 East Lancashire Hospitals NHS Trust is a large, integrated healthcare organisation. With over 7800 staff and 1041 in-patient beds, we are a large provider of Acute District General and Specialised Hospital services, as well as Community Services and Children’s Mental Health services.
Our two main hospital sites, The Royal Blackburn Teaching Hospital and Burnley General Teaching Hospital have been rated “GOOD with Outstanding in some services” in February 2019 by the Care Quality Commission. Our Board is professional, ambitious and capable.
The Emergency Department (ED) at Blackburn is the only ED for East Lancashire; it has a Trauma Unit and is part of the Lancashire Trauma network with the Trauma Centre at the Royal Preston Hospital. The ED is supported by Urgent Care Centres at Blackburn and Burnley and a Minor Injuries Unit at Accrington.
Burnley is the site for the East Lancashire Women and New-born Centre with an in-patient obstetric unit. There is a midwife led birthing unit off the Hospital site in Blackburn.
Royal Blackburn Hospital is designated as one of the Lancashire Vascular Centres and the Trust has close links with a number of Tertiary Centres in Lancashire, Manchester and Liverpool.
East Lancashire Hospitals NHS Trust provides a caring service to a population of 550,000 in the Pennine Lancashire area. Services are provided from our two main sites, the Royal Blackburn Teaching Hospital and Burnley General Teaching Hospital and from our community rehabilitation wards at Pendle Community Hospital, Accrington Victoria Hospital and Clitheroe Community Hospital.
Our current five-year clinical strategy ‘Fit for the Future’ provides a robust clinical platform to ensure we deliver safe, personal effective services in the community and in our hospitals.
We treat almost 700,000 patients every year in our hospitals and community settings, using state-of-the-art equipment and facilities. We provide a full range of acute hospital and adult community services and we are a specialist centre for hepatobiliary, head and neck and urological cancer services, robotic assisted surgery, specialist cardiology services and we are also a network provider of Level 3 Neonatal Intensive Care. We are a nationally accredited Centre for Endometriosis and Uro-Gynaecology Surgery.
Our Blackburn site is the centre for all acute services in East Lancashire other than Obstetrics and Gynaecology. The Emergency Department at Blackburn is the only ED for East Lancashire and is a Trauma Unit in the Lancashire Trauma Network working closely with the Trauma Centre at the Royal Preston Hospital. The ED is supported by Urgent Care
4 Centres at Blackburn and Burnley and a Minor Injuries Unit at Accrington. We have day and night Air Ambulance helicopter landing facilities.
Burnley General Teaching Hospital is the site for the East Lancashire Women’s and New-born Centre and is the largest in-patient consultant led obstetric unit in the North West. There is also a midwife-led birthing unit off the Hospital site in Blackburn.
The Trust also has close links with a number of Tertiary Centres in Manchester and Liverpool for both adult and children’s services.
ROYAL BLACKBURN TEACHING HOSPITAL
The hospital is situated just off Junction 5 of the M65. It is our main hospital site receiving most emergency patients. Other than for obstetric emergencies, all blue light ambulances attend this site.
Services at the Royal Blackburn Teaching Hospital site include:
A busy Emergency department, with co-located Urgent Care Centre and ambulatory care facility
ITU, HDU and POCU
Older Person’s Rapid Assessment (OPRA) Unit with 2 Older Person’s Units (OPU) Medicine for Older People (MfOP)acute inpatient care wards Acute Stroke recovery unit
Acute Medical beds, Acute Medical Units and fast flow wards. Cardiac unit with 2 Cath labs Acute Surgical Services (general surgery, vascular surgery, urology, T&O, ENT, Maxillofacial and Surgical Triage Unit)
Radiology including MRI, CT seven days per week, as well as isotope scanning
Endoscopy Unit providing a 24/7 Upper GI bleed endoscopy service Centralised Paediatric service
Learning & Development
Centre Research Centre
We are also building a primary care access centre at our ED front door as part of our redesign programme.
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BURNLEY GENERAL HOSPITAL
Services at this site include:
Womens and New-born Centre including 5 Operating Theatres, Consultant led maternity unit, Midwife led Birthing Centre, Level 3 Neonatal Intensive Care Unit Urgent Care Centre: This is a new purpose built centre including a children’s assessment and observation area
Elective Orthopaedic Centre (28 beds and 5 operating
theatres) Day Case Unit with 2 theatres and procedure room
Endoscopy Unit
Paediatric Day Surgery Unit
Radiology services
Ophthalmology Unit with 2
theatres Outpatient departments
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TRUST VISIONS AND VALUES
Our vision is ‘To be widely recognised for delivering safe, personal and effective care’ for our population of 550,000 across East Lancashire. Quality and safety are at the heart of everything we do and we are committed to providing harm free care. Our fabulous, highly trained staff are key to our growing reputation as a great place to receive treatment, as well as a great place to work. All employees are expected to strive to act in accordance with these values.
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TEACHING AND RESEARCH and INNOVATION
Across all our sites we pride ourselves on our teaching and for providing a great experience for trainee doctors. We have received excellent feedback from medical students, foundation year doctors and specialty trainees. The Trust is linked to the medical school at UCLAN and Lancaster University for the teaching of medical and students are frequently attached to the department for various modules.
There is an active Post-graduate Medical Centre on both sites and the Director of Medical Education is Miss S Gawne.
Since 2016, we have entered into a strategic alliance with University of Central Lancashire, a fast-growing medical school, as their main provider of clinical placements and teaching. Our medical student intake is increasing year on year, with students from several medical schools, both locally and internationally.
We have a thriving community of research in the Trust and we contribute to a wide range of national and international studies, with a high number of patients entering clinical trials.
LOCAL AREA/POPULATION
The Trust’s catchment area is co-terminus with the local districts of Blackburn with Darwen, Hyndburn, Ribble Valley, Burnley, Pendle and Rossendale. Together, these localities represent the area known as “Pennine Lancashire”. Each of the locality districts contains substantial rural areas including parts of the West Pennine Moors, the Ribble Valley, the Forest of Bowland, Gisburn Forest and Pendle Hill; some of the most outstandingly beautiful
8 countryside in Northern England. The local town of Whalley has been voted one of the top 50 places to live in the UK
The district is well served by road and rail and is within reach of the Universities of Manchester, Lancaster, Liverpool and Leeds, including UCLAN with which ELHT has forged strong links. There may be opportunities for Honorary Senior Lectureships at UCLAN. As well as being close to many urban centres, Blackburn and Burnley are also within easy distance of the Lancashire Coast, the Lake District and the Yorkshire Dales.
The district itself is well provided with leisure activities, for both spectators and participants. There are well developed parks, sports grounds and sports centres in the urban community. There are excellent schools in the locality, both state and fee paying. The housing in the area is both to a high standard and is reasonably priced. The local population looks to the district’s health services for most of their health needs.
In comparison with England and Wales as a whole, the Trust has a higher proportion of the population between the ages of 0-14 and a lower proportion of the population between the ages of 15-64. This trend is set to increase with projected increases of about 5% in the population between 0-14.
Townley Hall, Burnley
JOB SUMMARY
THE POST
9 This is a 10.00 programmed activity (PA) post, with 7.5 PA set aside for Direct Clinical Care (DCC); and 2.5 PA for Supporting Professional Activities (SPA). SPA is important for consultant job satisfaction and includes continuing professional development (in addition to study leave) mandatory training, job planning and preparation for appraisal. This post will contribute to the general medical on-call rota which is a 1:21 (3% supplement to pay) for overnight cover and 1:6 for weekend cover.
Responsibilities:
1. To take a shared role in the development of the geriatric medicine service, in conjunction with the management team and consultant colleagues in the department of Medicine for Older People.
2. To develop and support sub-acute rehabilitation for geriatric patients in community hospitals and community settings.
3. To provide an outpatient service in various locations
4. To provide continued clinical responsibility for the patients under his/her care in conjunction with colleagues in medicine for older people.
5. To take part in agreed provision of cover for consultant colleagues during leave.
6. To develop and promote services that minimise hospital stay and maximise opportunities for recovery and independent living.
7. To participate in medical audit and clinical governance.
8. To provide professional supervision, direction and training to junior medical staff.
9. To participate in postgraduate teaching
10. To attend meetings of the Directorate of Medicine for Older People, Rehabilitation and Stroke.
11. To be part of the MDT on Older Person’s Rapid Assessment (OPRA) Unit with 2 Older Person’s Units
It is the responsibility of the appointee to ensure that they maintain their knowledge and skills to the appropriate level laid down for their specialities by the relevant professional bodies (e.g. Royal College, Speciality societies). The trust for its part supports CPD in principle and is committed to providing the necessary time and financial support for such activities, subject to agreed local policies.
This post also carries a commitment to support the management of acute illness in older people with on call commitment for GIM, and care of a minimum of 20 acute older/general medical inpatients.
There is a degree of flexibility within the role and candidates will be supported in specialist interest within geriatrics where this compliments current service availability and service need.
10 THE DEPARTMENT
This is an exciting time in Medicine for Older People. In recent years there has been a national push to ensure that the NHS is “Fit for Frailty” and, in the Northwest, East Lancashire Hospitals Trust is leading the charge. We have also improved Stroke Services and this is reflected in the achievement of a level A in the Sentinel Stroke National Audit Programme for the last 10 reporting periods. This has been due to an MDT approach working with all our colleagues involved in patients’ stroke journey.
We were selected as one of the first sites for the Royal College of Physicians “Future Hospitals” project and a lot of changes have been made to our service provision for older people as a result.
These changes include providing “front door” frailty assessment and review in the Emergency Department, enhancing community geriatrics support and care in our community hospitals and creating an Older Persons’ Rapid Assessment Unit to ensure safe, personal and effective care for the frail older people that present acutely. All of these align with our Trust’s Improvement Priorities.
You will be joining a dedicated and passionate multidisciplinary team who are committed to making our Frailty Pathway a reference point of excellence in the Northwest and indeed in the country
Medicine for Older People services are throughout all 4 sites of the Trust with the acute stroke unit and four acute MfOP wards on the Blackburn site and step down and rehabilitation wards on all other 3 sites. The directorate is currently in the process of developing and strengthening its stroke pathway and frailty pathway, ensuring patients are provided with the correct standard of care in the right environment. The directorate also provides Ortho-Geriatric support for the fractured neck of femur pathway.
The directorate provides a comprehensive service for older patients both in hospital and in the surrounding community and comprises of integrated acute services, with designated elderly out-patient and in-patient rehabilitation services.
The department currently has the following consultant medical staff:
11 Dr N Roberts Geriatrician, Stroke Physician, Clinical Director
Dr N Goorah Geriatrician, Stroke Physician
Dr R Hyatt Orthogeriatrician, General Physician
Dr A Singh Geriatrician, Stroke Physician
Dr H Siddiq Locum
Dr A Bhayo Locum
Dr A Pramanik Consultant Orthogeriatrician
Dr M McCarthy GP With Special Interest
Dr F Shah GP With Special Interest
Prof I Singh Locum Consultant Geriatrician
Dr M Greenhalgh NHS Locum Consultant Geriatrician
Dr H Ringrose Consultant in Neurorehabilitation
C Curley Stroke Nurse consultant
S Philip Stroke Nurse consultant
The department has support from medical trainees/non consultant career grade doctor as follows:
St3+ 6 posts
Specialty Doctors 4 posts
Senior clinical fellow 3 posts
CMT 3 posts
Junior clinical fellow 9 posts
FY2 3 posts
FY1 7 posts
Trainees are largely ward based and the new appointee will receive pro-rata support from the department’s medical trainees. There will also be support from specialist nurse in stroke and the two trainee advanced nurse practitioner posts.
A mentor from another department will be provided for the first year in post.
12 The directorate provides care from the ED (frailty pathway and development of the use of CGA), through the 7 acute MfOP wards on the Royal Blackburn Hospital site (4 elderly medicine and 1 acute stroke unit), through to the 5 wards/ departments on the other 3 sites which specialise in rehabilitation and step-down care.
Outpatient clinics including, Frailty rapid assessment, TIA and elderly medicine clinics are also provided.
Trust Workload:
The medical division admits an average of 100 patients per day. Most go to the AMU. If patients need admission after 48 hours they are moved to one of the medical wards. The Department of Medicine for Older people has 4 medical wards.
Personal workload:
One outpatient clinic per week – 3 new and 5 review patients
Five ward rounds per week on OPRA/OPU of which 3 to 6 will be new patients to the ward.
Consideration of time in lieu in place of pay for weekend working will be given
TERMS AND CONDITIONS OF SERVICE
This post is subject to the New Consultant Contract 2003.
The appointee will be required to live within an appropriate distance from the Trust to ensure all elements of the role can be undertaken. The Trust will reimburse certain expenses relating to removal and relocation when required; the expenses refunded shall reflect the actual costs involved but will not exceed £8,000.
A satisfactory medical examination is a condition of employment for Medical and Dental staff in the NHS.
Candidates are requested to note that any person recommended for appointment in connection with this post will be referred to the DBS (Disclosure & Barring System) for their clearance.
Please note: In line with other NHS organisations in the North West Region, the Trust is now passing the charge for undertaking a DBS check on to candidates in the event they are successfully appointed into the post for which they have applied.
13 Candidates can choose whether to pay this over 1-3 months as a deduction from the monthly salary. By applying for this vacancy you are agreeing to this undertaking in the event you are successfully appointed.
TEACHING
We have a very active learning and development centre and we teach an increasing number of medical students and all grades of medical trainees. We actively encourage all relevant consultant staff to undertake teaching and educational supervision roles, following the appropriate training. Teaching is a fundamental part of our continuing improvement culture. We rate amongst the highest in the North West in the evaluation of our teaching programmes
The post holder will be expected to keep up to date with developments within medical education and his/her own specialty by attending appropriate conferences and study courses.
RESEARCH
There are ample opportunities and facilities for research, which is supported locally through the Research and Development Committee. There is also active support from the Universities of Lancaster, Central Lancashire and Manchester, with which there are collaborative projects.
CONTINUING CARE
The appointee will be responsible for the continuing care of patients in his/her charge and for the proper functioning of his/her department.
SECRETARIAL SUPPORT
Secretarial support will be available for this post.
OFFICE ACCOMMODATION
Office accommodation will be provided for the appointee.
MANAGEMENT RESPONSIBILITY
All Consultants are required to attend the monthly departmental and Directorate Meetings. Post holders will be expected to share in administrative duties allocated by mutual agreement within the Directorate.
STANDARDS OF CONDUCT
14 The post holder will conduct duties with regard to the Trust’s Vision and Values detailed in pages 3 and 4 of this Job Description.
GOVERNANCE i) CONTINUING PROFESSIONAL DEVELOPMENT
The appointee is expected to undertake CPD activities, in accordance with the relevant College’s and Trust’s requirements. There is a funded study leave allocation of 30 days/3 year cycle. The funding for this is as per the trust guidelines. ii) APPRAISAL & REVALIDATION
The post holder, in common with all posts in the Trust, will participate in the Trust’s appraisal process. The Trust has the required arrangements in place, as laid down by the General Medical Council, to ensure that all doctors have an annual appraisal with a trained appraiser and supports doctors going through the revalidation process. iii) SAFE AND EFFECTIVE CARE FOR PATIENTS
The Trust is committed to providing safe and effective care for patients. To ensure this there is an agreed procedure for Medical staff that enables them to report quickly and confidentially, concerns about the conduct, performance or health of medical colleagues (Chief Medical Officer 1996).
All Medical staff practising in the Trust should ensure that they are familiar with the procedure and should apply it. iv) RISK MANAGEMENT
It is a standard element of the role and responsibility of all staff of the Trust that they fulfil a pro-active role towards the management of risk in all of their actions. This entails the risk assessment of all situations, the taking of appropriate actions and reporting of all incidents, near misses and hazards. v) TRUST POLICIES AND PROCEDURES
All staff should ensure that personal action and conduct comply with Trust Policies and Procedures, e.g. Infection Control, Health and Safety, Fire Procedures, No Smoking Policy, Equal Opportunities, Confidentiality, etc.
RECORDS MANAGEMENT/DATA PROTECTION ACT
As an employee of the Trust, you have a legal responsibility for all records, including patient health, financial, personal and administrative, that you gather or use as part of your work
15 within the Trust. The records may be paper, electronic, microfiche, audio, video tapes, x-ray images etc. You must consult your Manager if you have any doubt as to the correct management of the records with which you work.
HEALTH AND SAFETY REQUIREMENTS
All employees of the Trust have a statutory duty of care for their own personal safety and that of others who may be affected by their acts or omissions. Employees are required to co-operate with Management to enable the Trust to meet its own legal duties and to report any circumstances that may compromise the health, safety and welfare of those affected by the Trust undertakings.
CONFIDENTIALITY AND INFORMATION SECURITY
As a Trust employee you are required to uphold the confidentiality of all records held by the Trust, whether patient records or Trust information. This duty lasts indefinitely and will continue if you are no longer employed by the Trust.
All the information which identified individuals in whatever form, paper, picture, electronic data, images or voice, is covered by the Data Protection Act 1988 and should be managed in accordance with this legislation.
EQUAL OPPORTUNITIES
The Trust provides a range of services and employment opportunities for a diverse population. As a Trust employee you are required to treat all patients, customers, visitors and work colleagues with dignity and respect irrespective of their background.
Safeguarding
All employees have a responsibility for safeguarding and promoting the welfare of children and vulnerable adults. Our induction programme covers essential requirements and further guidance can be sought from your Line Manager.
The purpose of this document is to act as a guide to the duties which may be required. It is not an exhaustive list and other duties may be required in accordance with the grade of the post and the competence of the post holder. The Job Description, from time to time, may be subject to review and change following consultation with the post holder.
For further information, please contact:
Dr Nick Roberts 16 Clinical Director- Medicine for Older People [email protected] Tel: 01254 732566
Mrs Catherine Taurozzi Directorate Manager for Medicine for Older People [email protected]
PERSON SPECIFICATION CONSULTANT IN MEDICINE FOR OLDER PEOPLE
DESIRABLE FOR THE ESSENTIAL FOR THE POST POST
17 DESIRABLE FOR THE ESSENTIAL FOR THE POST POST
ATTAINMENTS
Educational Qualifications Full registration with General Medical Council A higher degree such as Professional/Occupational MD, MSc, PhD or Qualifications Inclusion on the Specialist Register or equivalent. due admission to register within six months
MRCP or equivalent.
CCT or within 6 months of CCT
Or CESR or European Community Rights.
TRAINING Experience in teaching under- graduates, post-graduates, nurses and professions allied to medicine
Experience of clinical audit and understanding of the process
CONTINUING Clear commitment to lifelong learning Membership of PROFESSIONAL appropriate post DEVELOPMENT Experience of evidence based graduate societies. medicine IT skills Ability to keep up to date in the speciality.
CIRCUMSTANCES
Able to travel to meet the requirements of the post
Satisfactory medical clearance from the Trust’s Occupational Health Physician
Free from disabilities or illness that would prevent clinical management of patients.
Immunised against Hepatitis B
Sample JOB PLAN - CONSULTANT GERIATRICIAN
18 East Lancashire Hospitals NHS Trust Job Plan Date: Name: Category Start Finish Location Work DC SPA Add Ext Total 08:30 12:30 MfOP ward/ Post Take 1 OPRA/OPU Ward round - RBH Monday 12.30 15.30 RBH Clinical 0.75 Admin 1 08:30 12:30 MfOP ward/ Post Take 1 OPRA/OPU Ward round Tuesday - RBH 13:00 15:00 RBH Education 0.5 1.5
12.00 16:00 Directorate 1 meetings/ Wednesday admin 16.00 18.30 MfOP ward/ Post Take 0.75 OPRA/OPU Ward round 1.75 - RBH 08:30 12:30 MfOP ward/ Post Take 1 OPRA/OPU Ward round - RBH Thursday 13:00 17:00 OPD Out patients 1
2 08:30 12:30 MfOP ward/ Post Take 1 OPRA/OPU Ward round Friday - RBH 13:00 17:00 SPA 1 2 08:00- 14:00 OPRA/OPU Post Take 0.5 Saturday - RBH Ward round (1 in 6) 0.5 08:00- 14:00 OPRA/OPU Post Take 0.5 Sunday - RBH Ward round (1 in 6) 0.5 Additional agreed activity Predictable emergency on- call work
Unpredictable 0 emergency on- 0 call work Total PA’s 7.5 2.5 0 0 10.00 MfOP = Medicine for Older People OPRA = Older Peoples Rapid Assessment
OPU = Older Peoples Unit RBH = Royal Blackburn Hospital
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