LOCUM CONSULTANT JOB DESCRIPTION

Locum Consultant in Intensive Care Medicine at Royal JOB TITLE: Free (RFH) site

DIVISION: Surgery and Associated Services

SPECIALTY: Intensive Care

NAME OF LINE MANAGER: Dr K Dhadwal

NAME OF RESPONSIBLE OFFICER Dr Jane Hawdon FOR REVALIDATION:

NUMBER OF PROGRAMMED 10 PA ACTIVITIES PER WEEK:

LOCATION: Royal Free NHS Foundation Trust

Directly: Junior Medical staff

MANAGES: Indirectly: 250 Nursing staff

JOB SUMMARY:

Royal Free London NHS Foundation Trust is a large teaching hospital employing over 10,000 staff. The Trust is recognised internationally for its work and is a key partner in one of London’s foremost Academic Health Science Centres, UCL Partners. UCL Partners is one of only 8 Department of Health designated AHSCs in England that combines excellence in research, health education and patient care. Construction is currently underway to build The Pears Building on the grounds of the Royal Free Hospital and is due for completion in Autumn 2020. This will be home to the UCL Institute of Immunity and Transplantation (IIT), a world-class facility for developing revolutionary treatments and therapies for patients.

The Royal Free Hospital is one of two principal Contact HCID Treatment Centres and one of five interim Airborne HCID Treatment Centres in England. It was at the forefront of the COVID outbreak and in response to the demand in critical care expanded from a 42 bed ICU to 70 beds, with plans to expand further to over 100 beds if required during a surge. Planning is ongoing for long term ICU requirements after the COVID-19 demand has ceased.

During the outbreak the hospital was also part of the award-winning BBC Two documentary “Hospital – Fighting COVID-19”, which showcased the response of our staff from day one of lockdown. The BBC has commissioned a sixth series of the documentary to be filmed across the Royal Free London Hospital following the impact of COVID-19.

This is an exciting opportunity for excellent individuals to join our critical care team and to become involved in the development of long-term expansion, introduce new services, develop research and your own interests in support of the growth of the department.

The Intensive Care Unit (ICU) at the Royal Free Hospital (RFH) site currently occupies all the clinical areas on the 4th floor of the main hospital building. The main unit was opened in 2 phases in October 2012 and September 2013 and compromises of 34 beds. An eight bed 3rd floor Surgical High Dependency Unit was opened in 2019 and further expansion is underway to give a total of 20 beds. This is to allow an increase in capacity and also allow development of peri-operative medicine research and pathways.

The units are fully equipped to provide critical care services at all defined levels to the highest standards. With the exception of extra-corporeal membrane oxygenation, all modern treatment modalities are catered for.

The special interests of the service include a major commitment to liver and renal transplantation, Hepatobiliary surgery and complex vascular surgery. All other tertiary services, with the exception of cardiothoracic and neurosurgery are also catered for. Each year more than 1750 patients are cared for in our ITU.

The critical care department supports a wide range of tertiary surgical and medical services including a commissioned national pulmonary hypertension centre, regional heart attack centre and a national amyloid centre. The department has a Reader and research nurses and is actively involved in a variety of major national research projects.

Staffing consists of 20 Intensive Care Consultants and 44 critical care trainees. The Royal Free Hospital ICU is recognised for ICM training and attracts trainees from a number of rotational speciality training posts.

The Royal Free Hospital has a successful and progressive critical care outreach service led by a nurse consultant and providing a 24 hour service.

Recent Organisation Changes

Royal Free Hospital took over Barnet and Chase Farm in 2015. This has resulted in service reconfiguration. The Royal Free site has become the complex surgical site, whilst Chase Farm has been rebuilt as an award winning elective surgery hospital.

Direct Clinical Care Arrangements

The current job-plan is annualised over a 42week rota. PA’s involving other departments can be negotiated on an individual basis.

The nature of critical care services requires that senior medical staff work a flexible pattern. At present the consultant staffing model provides for 4 consultants physically present during the weekdays and 3 at weekends, each with responsibility for one wing. With the increase in patients, and the opening of HDU, it is likely that we will need to staff 3 consultants at weekends soon. The On-call consultant takes all referrals and is in overall charge of critical care beds and the critical care outreach service for a 24 hour period.

The rota is highly flexible and is planned according to leave and other requirements of the post holders. Internal cover for leave in critical care will be provided by the critical care consultants. For the above reasons a fixed timetable 2 cannot be published. The current on call commitment is 1 in 20 during the week and approximately 1 in 7 weekends.

On this basis the post will carry 10 PAs per week. Supporting professional activity is negotiable. The DCC PAs vary significantly on a week-by-week basis. The exact timetabling varies from week to week according to the commitments of the consultant team. Examples can be seen in consultation with the Clinical Lead or the Clinical Director of the Intensive Care Service.

The timing and location of the fixed sessions must be agreed between the successful candidates and the current critical care team

Supporting Professional Activity (SPA)

The post attracts 1PA for continuous professional Further SPA’s are available and can be negotiated depending on the need of the individual and the department. Consultants are encouraged to develop areas of interest to assist in the management of the department.

Teaching/Audit

There is a weekly teaching session in ITU every Thursday and Friday afternoon. There is X-ray teaching on Tuesday mornings. Critical care consultants are expected to take an active part in leading these teaching activities. There is a general medical grand round held weekly to which the critical care service is expected to contribute. Physicians hold a daily morning report for trainees and a wide variety of specialist meetings are organised by the various departments within medicine. In addition there is a weekly anaesthetic departmental meeting at 07.30 on Friday mornings. Consultants in critical care are encouraged to attend these meetings and will be expected to contribute to both formal and informal teaching sessions and to take part in medical audit. The post holder will have a contractual obligation to meet CME / CPD and Clinical Governance guidelines and will be required to undergo annual appraisal in accordance with national guidelines.

Research and Development

Research and development is a major component of the Royal Free NHS Trust strategy and reflects the Trust's desire to maintain its position as one of the top ten Trusts for R&D income in the UK. The Trust's R&D allocation is £11.5 million and is rated 3rd highest in the country for its support for Science. There are 20 research programmes all of which the department of Health rated as "strong". In addition to this the Trust was held up as an exemplar for R&D. Our research programmes have collaborations nationally and internationally.

The Trust is in the fortunate position of being co-located with the Medical School and their research agenda is closely integrated. There are extensive facilities for both clinical and basic science research. In addition, each year the special Trustees invite applications for clinical research fellowships to enable consultant staff to conduct research towards a higher degree.

Consultants are expected to participate in research according to their skills and specialty. Publications and a quality assessment exercise are produced annually. All research undertaken is bound by the research governance framework which is in turn managed by controls assurance as a means of improving quality and being accountable in R&D.

The Anaesthetic Department

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Critical Care Services work closely with the Anaesthetic Department and is now part of the same department with one Clinical Director. The departments sit within the Surgery and Associated Services division. The Royal Free Hospital has 16 main operating theatres, 3 day case theatres and 2 obstetric theatres. The Department is involved in providing anaesthesia for all major specialities including interventional radiology, vascular, hepatobiliary, orthopaedic, urological, ophthalmic, colorectal, upper gastrointestinal, plastic surgery and liver and kidney transplantation. The Department also runs a chronic and acute pain service. The Department actively encourages clinical research and has strong links with the Academic Department of Surgery. The labour ward delivers in excess of 3000 parturients annually. The anaesthetic department at the Royal Free Hospital is one of two major teaching hospital departments within the Royal Free and University College Hospitals School of Anaesthesia. The school operates training rotations for 60 SHO’s and 110 Specialist Registrars.

Applicants are invited to visit the department and discuss the job with the Clinical Director in Intensive Care.

Candidates should in the first instance contact Dr Kay Dhadwal (Clinical Lead) or Dr Duncan Jackson (Clinical Director) on 0207 794 0500, extension 24517, or email [email protected]

Royal Free London NHS Foundation Trust World Class Values

The post holder will offer World Class Care to service users, staff, colleagues, clients and patients alike so that everyone at the Royal Free can feel:

all of the time Confident because we are clearly and cared for that they are always in safe hands

About us

The Royal Free began as a pioneering organisation and continues to play a leading role among UK hospital trusts. Established in 1828 by William Marsden, a newly qualified surgeon shocked that he could not find treatment for a penniless young woman, we were the first to provide care free of charge and the only London th hospital to stay open during the 19 -century cholera epidemics.

In the 21st century, we continue to lead improvements in healthcare, from targeted cancer therapies to new kinds of surgery. We offer an exceptionally wide range of local and specialist services, including cancer, plastic and neurosurgery, blood disorders and infectious diseases and are proud to have some of the best clinical outcomes in the country. A regional centre for kidney and liver diseases and a major transplantation centre, we see around 700,000 patients a year from all over the world.

We are a campus of UCL Medical School and conduct important medical research. We also train doctors, nurses, midwives and many other clinical and non-clinical professionals. We helped to set up the academic health science centre, UCLPartners.

We were Dr Foster's 'large trust of the year' for 2010 and were particularly praised for our patient safety and infection control record. We are ranked among the best English trusts for mortality rates - our rate is 25 per cent below that expected. Our infections rates are some of the lowest in London teaching hospitals.

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On 1 April 2012 we were authorised as a foundation trust by the regulator Monitor and are now knows as the Royal Free London NHS Foundation Trust. We plan to use the greater freedoms this brings us to provide the best possible services for our patients and local community.

Our mission is to be in the top 10 per cent of English hospitals for clinical quality, customer satisfaction, staff satisfaction and financial performance. We want to give patients the best possible care in a safe, clean and welcoming environment.

Our commitment is to offer world class care so everyone at the Royal Free can feel welcomed all the time, respected and cared for, confident because we are communicating clearly and reassured that patients are in safe hands.

The Royal Free London a trust-wide ‘vision 2020’ transformational programme is underway to improve the quality of care we deliver whilst making significant efficiency savings. A number of improvement programmes form part of the overall programme: patient flow and discharge, out-patients and pathways, surgical improvement, pathology, radiology, pharmacy, endoscopy, therapies, workforce, non-clinical support, procurement and the redevelopment. Each of these improvement programmes focuses on a particular aspect of patient care.

Organisation

Patient services are managed by four clinical divisions, each led by a clinically qualified divisional director, who is supported by a team of clinical directors, a director of operations and a nurse director. The divisions are:

o Surgery and associated services

o Medicine and urgent care

o Transplantation and specialist services

o Women, children and imaging

There is a separate private practice department. Consultants undertaking private patient work are encouraged to use the trust's facilities.

The University College London Medical School

University College London is the largest of over 50 colleges and institutes which make up the federal and is consistently rated as one of the U.K.’s premier academic institutions. The University College Medical School is a general medical school in the Faculty of Medicine of the University of London, formed on 1 August 1998 by the merger of the Royal Free Hospital School of Medicine and University College School of Medicine. A joint Department of Medicine, with around 400 staff, has existed between the two Schools since January 1994. The Department encompasses a broad range of basic and clinical research programmes and undertakes teaching of undergraduates and postgraduates.

Research

Research and development is a major component of the Royal Free London NHS Foundation Trust strategy and reflects the Trust’s desire to maintain its position as one of the top ten trusts for R&D income in the UK. The research efforts of the Trust and Medical School are closely integrated and there are extensive facilities for both clinical and basis science research. Consultant staff are expected to participate in research according to their skills and speciality. An audit system for 5 quality in R&D was introduced during 1998 and reflects an individual’s commitment to this area. Applicants should prepare an outline of the research they would wish to undertake if appointed.

STAFFING IN (critical care)

The consultant medical staffing in the department comprises the following:

Name RFL Sessions Clinical Interest/s

Dr Kulwant Dhadwal WT Clinical Lead for ICU Dr Amit Adlakha WT Locum Respiratory Dr Banwari Agarwal WT Divisional Appraiser Lead Dr Tamara Banerjee WT Locum Global Health Dr Nicholas Barnett WT USS & ECHO Dr Jim Buckley WT M&M Lead, PARRT Lead, Ed Lead Dr Sarah Bigham WT Regional Advisor for ICM Dr Mark Carrington WT Risk Lead Dr Mark De Neef WT ICNARC Lead, Research lead Dr Nas Ekbal WT Renal Lead, Deputy College Tutor Dr Jenny Price WT College Tutor Dr Nikul Patel WT Locum ED Lead Dr Prashanth Nandhabalan WT ECHO Dr Daniel Martin WT Reader, Research, HLIU Lead Dr Deidre Morley WT Locum Infectious Diseases Dr Yadhu Rajalingam LTFT MTI Lead Dr Mike Spiro WT Liver Transplant Dr Naz Unni WT Locum ECHO Dr Agnieszka Walecka LTFT Audit Lead, Deputy College tutor Dr Stephen Ward WT Pharmacy Lead

Junior Medical Staff

The junior doctor medical staff consists of 44 trainees and allocated from a number of national training posts including Intensive Care Medicine, Anaesthesia, Respiratory and Internal medicine as well as ED ACCS and FY2 rotations.

Nursing Staff

2 Matrons 2 Band 7 (Clinical Practice Educator) 16 Band 7 10 Band 6.5 26 Band 6 100 Band 5

There has been a large successful recruitment drive over the past year. The ICU Nursing dept runs its own ICU course and will soon be introducing a HDU nursing course.

The Royal Free London is also a training site for Advanced Critical Care Nurse practitioners (ACCNP).

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THE DEPARTMENT

See Job Summary

NATURE OF EMPLOYMENT AND HOURS OF WORK

This is a full time NHS appointment attracting 10 PAs, plus an availability allowance for the on-call rota. Any candidate who is unable for personal reasons to work full-time will be eligible to be considered for the post; appropriate modification of the job content should, however, be discussed and agreed with the Divisional Director in consultation with the Clinical Director and Consultant colleagues prior to accepting any appointment that might be offered.

MAIN DUTIES AND RESPONSIBILITIES OF THE POST

See Job Summary

ADMINISTRATIVE SUPPORT

Full time PA for consultant body

INDICATIVE JOB PLAN AND TIMETABLE

Owing to the flexible nature of the duties a fixed time table is not available. The job is annualized over a 42 week period. The post holder is required to attend biweekly consultant meetings, M&M, departmental and audit meetings. The intensity of on call is 1 in 19.

GENERAL RESPONSIBILITIES

Infection Control Infection control is everyone’s responsibility. All staff, both clinical and non clinical, are required to adhere to the Trust’s Infection Prevention and Control policies and procedures and the Health Act (2006) Code of Practice for the prevention and control healthcare associated infections and make every effort to maintain high standards of infection control at all times thereby reducing the risk of Healthcare Associated infections.

It is the duty of every member of staff to take personal responsibility for the prevention and control of infection, as laid down in the Trust’s policies and procedures which reflect the statutory requirements of the Hygiene Code.

 To work in close collaboration with the Infection Control Team.

 To ensure that monitoring of clinical practice is undertaken at the agreed frequency.

 To ensure that the ward environments are cleaned and maintained to the highest standards; ensuring that shortfalls are rectified, or escalate as necessary.

 To ensure that all relevant monitoring data and issues are provided to the Directorate’s Governance structures.

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 To ensure that all staff are released to attend infection control-related educational sessions and staff with specialist roles, e.g. link practitioners, are released to undertake their duties.

Health and Safety at Work The post holder is required to:

 Take reasonable care for the health and safety of himself / herself and other persons who may be affected by their actions or omissions at work.  Co-operate with the employer in ensuring that all statutory and other requirements are complied with.

Confidentiality & Data Protection The post holder has a responsibility to comply with the Data Protection Act 1998 and maintain confidentiality of staff, patients and Trust business. If you are required to process information, you should do so in a fair and lawful way, ensuring accuracy is maintained. You should hold information only for the specific registered purpose and not use or disclose it in any way incompatible with such a purpose.

You should disclose information only to authorised persons or organisations as instructed. Breaches of confidentiality in relation to information will result in disciplinary action, which may include dismissal. Employees are expected to comply with all Trust policies and procedures and to work in accordance of the Data Protection Act 1998. For those posts where there is management or supervision of other staff it is the responsibility of the employee to ensure that the staff receives appropriate training (e.g. HISS induction, organising refresher sessions for staff when necessary.)

Conflict of Interest The Trust is responsible for ensuring that the services for patients in its care meet the highest standards. Equally, it is responsible for ensuring that staff do not abuse their official position, to gain or benefit themselves, their family or friends.

Equality and Diversity

The Trust values equality and diversity in employment and in the services we provide. It is committed to promoting equality and diversity in employment and will keep under review our policies and procedures to ensure that the job related needs of all staff working in the Trust are recognised.

The Trust aims to ensure that all job applicants, employees or clients are treated fairly and valued equally regardless of sex, marital status, domestic circumstances, age, race, colour, disablement, ethnic or national origin, social background or employment status, sexual orientation, religion, beliefs, HIV status, gender reassignment, political affiliation or trade union membership. Selection for training and development and promotion will be on the basis of the individual’s ability to meet the requirements for the job.

All staff are responsible for ensuring that the Trust’s policies, procedures and obligation in respect of promoting equality and diversity are adhered to in relation to both staff and services.

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Vulnerable Groups

To carry out responsibilities in such a way as to minimise risk of harm to children, young people and vulnerable adults and to promote their welfare in accordance with the Children Act 2004, Working Together to Safeguard Children (2006) and No Secrets guidance (DH 2000). To demonstrate an understanding of and adhere to the trust’s child protection policies.

No Smoking

The Trust implemented a No Smoking Policy, which applies to all staff. Staff contravening this policy will be subject to disciplinary procedures.

Standards of dress

All staff are expected to abide by the Trust’s guidance on standards of dress.

This job description outlines the current main responsibilities of the post. However the duties of the post may change and develop over time and may therefore be amended in consultation with the post holder

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