Job Details Reporting Arrangements

Job Details

Job Title: Locum Consultant in General Surgery/Colorectal Surgery x 12 months Hours of Work: Full Time Band or Grade: Consultant Department: General Surgery and Colorectal Division: Surgery Base: Royal Albert Edward Infirmary

Reporting Arrangements

Managerially Accountable to: Clinical Director

Professionally Accountable to: Medical Director / Divisional Director

Responsible for: Doctors in Training

Job Purpose Wrightington, Wigan and Leigh NHS Foundation Trust is engaged in the ongoing transformation of clinical services in Greater Manchester under the Healthier Together Programme being part of the North-West sector in partnership with Royal Bolton NHS Foundation Trust and Salford Royal NHS Foundation Trust.

An essential part of this programme is the formation of a single general surgery service delivering the high risk emergency surgery at a hub site (Salford Royal) while maintaining low risk emergency and elective surgery on all sites.

This is a locum posts for 12 months and it is for service delivery to cover for a post fell vacant due to retirement from the NHS of the previous post holders.

The appointments are currently for Wrightington, Wigan and Leigh NHS Foundation Trust with clear commitment from the successful appointees to become part of the North-West Sector General Surgery single service at completion of service reconfiguration in the future. This will include participation in the on-call rota for emergency surgery at hub site and working across two sites.

Site working

Royal Albert Edward Infirmary RAEI has 470 in-patient beds. In-patient facilities include all the acute beds for General Medicine, Paediatrics, General Surgery, ENT, Urology, Orthopaedics, Ophthalmology and Oral Surgery.

Both General Medicine and General Surgery have established emergency assessment units and a shared endoscopy suite. There is a surgical review clinic within the surgical assessment unit along with a well-established daily hot clinic. There is also a surgical assessment lounge where elective patients are admitted and discharged.

The Trust has invested in a state of the art integrated laparoscopic theatre which supports the delivery of laparoscopic colorectal service, laparoscopic general surgery sessions and gynaecology sessions. There are additional modern laparoscopic facilities for emergency theatre, elective general theatres at RAEI and Leigh General Infirmary.

Leigh Infirmary This is situated about 8 miles east of Wigan.

This has 3 operating theatres for day case surgery and a treatment room for minor operations. The theatre suite is modern and well equipped. There is a patient recovery area and a small patient reception area. These theatres provide for day case surgery only. Specialties covered are Gynaecology, Orthopaedics, Urology, General Surgery, Plastics, Dental Surgery, and Chronic Pain.

Thomas Linacre Centre The Thomas Linacre Centre is the main Outpatients Department, located in Wigan town centre, approximately less than a mile from Wigan Infirmary. Outpatient clinics are also undertaken at Leigh Infirmary.

Organisation Chart

Clinical Director

Consultants

Specialty/ SPR Foundation Doctors Doctors

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Duties and Responsibilities .

Key results from the job holder and Planning and Organisational Duties

The appointee will be required to provide a general surgical elective and emergency surgery service to support the Trust’s surgical workload wherever it is located (including an on call element). The appointee will be responsible for:

 Providing specialist advice to patients regarding their illness  Providing clinical care to patients referred to them  Working with colleagues to provide effective clinical leadership for all staff in the service  Contributing to and participating in the development of the day case and ambulatory surgery  Developing and enhancing the emergency surgical service  Undertake acute on call during the day and out of hours

The primary role of this locum posts is delivery of the elective and emergency general & colorectal surgery service and on-call duties including assessment of all general surgery emergency referrals, Consultant delivered NCEPOD general surgery list, supervision or delivery as necessary of the hot clinics.

The applicants are expected to contribute to the delivery of the acute cholecystectomy service dealing with patients with acute gallstone cholecystitis disease in accordance with best national practice and are required to demonstrate ability to perform emergency cholecystectomy (hot gallbladder).

The Trust will strongly support development of an elective specialty interest in day case surgery, laparoscopic cholecystectomy (including development of a common bile duct exploration service by suitably trained applicants), day case coloproctology. Access to endoscopy list for suitably qualified applicants (as per JAG criteria) is supported and encouraged but it is not an essential requirement. .

The post holder is required to deliver emergency surgery service at RAEI site and elective sessions (operating theatre sessions, outpatient clinics and endoscopy sessions) at RAEI Wigan/Leigh Infirmary and Thomas Linacre Centre.

Specialist support is available as advice, joint operating or transfer of care to the colorectal team for colorectal emergencies of complexity beyond the expertise of a general surgeon.

There is no vascular service in the Trust and patients requiring vascular interventions are referred to the vascular regional service.

There is expectation that the applicant is competent in clinical assessment of abdominal pain in children over age of 5 in collaboration with the paediatric team. Complex cases are referred to the specialist children hospital in Manchester.

Specialist Radiology support for is available on the RAEI site. This includes two CT scanners, MRI and ultrasound. Interventional Radiology is limited and some patients may require transfer to tertiary specialist centres. There is a well establish 24 hour emergency CT scan service available for general surgical admissions.

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The Departments of General Surgery works closely with the department of Gastroenterology and an established upper GI bleeding rota and ERCP service.

Local Upper GI and HPB MDT run weekly in cooperation with the specialists from the tertiary referral centres.

General The post-holder will assume a continuing responsibility for the care of patients in his/her charge and the proper functioning of his/her department. The post-holder will have full secretarial support and a dedicated office space with IT facilities.

Communications and Key Working Relationships

Mr Imran Alam, who is the Clinical Director, leads the department. The General Surgery & Urology Directorate forms part of the Surgical Division, which is led by the Divisional Medical Director, Dr Andrew Twist, Consultant Anaesthetist. All the clinical directorates are under the leadership of the Medical Director, Dr Sanjay Arya, Consultant Cardiologist.

The General Surgery & Urology Directorate is largely autonomous with its own business plan and has regular meetings with the other specialties within the Surgical Division to co-ordinate services. The directorate also has a seat on the Clinical Advisory Board where representatives of all specialties meet monthly to discuss clinical policies for the whole Trust.

The Trust Board runs the Trust. The Chief Executive is Mr. S Nicholls, The Chairman of the Trust is Mr R Armstrong

3. KEY RELATIONSHIPS (General Surgery)

Consultant General Surgeons Mr I Alam (Clinical Director) – Consultant General & Benign Upper GI Surgeon Ms N Mackenzie – Consultant General & Colorectal Surgeon Mr M Paraoan- Consultant General & Colorectal Surgeon Mr M Fani Consultant Emergency General Surgeon Mr P Ichim- Consultant Emergency &General Surgeon Mr R Nath – Locum Emergency/General

Other Staff: 1 Associate Specialist 3 Specialist Registrar’s 5 Staff Grades 6 FY2’s and ST1/2’s 5 MCh Fellow 9 FY1’s

The configuration of the surgical teams maximises middle grade support for both theatre sessions on the RAEI site and clinics. A middle grade will be available to support, subject to on call commitments and leave and there is a shared core trainee or FY2 and FY1 support for these posts.

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Responsibility for Finance

Compliance with Standing Financial Instructions (SFIs) – The SFI’s identify the financial responsibilities which apply to everyone working for the Foundation Trust and its constituent organisations including trading units. Failure to comply with Standing Financial Instructions can in certain circumstances be regarded as a disciplinary matter that could result in dismissal. Compliance with the SFIs is monitored by the Finance Department and post holders are therefore required to understand their responsibilities outlined within this document and ensure compliance with its instructions.

Responsibility for Human Resources

Adhere to Trust policies and maintenance of the professional Code of Conduct.

Contractual Commitment The post holder will have continuing responsibility for the care of patients in his or her charge and for the proper functioning of the service, and will undertake the administrative duties associated with the care of patients and the running of the clinical department. If the post holder does not take undertake their contractual obligations then this will be seen as a breach of contract, and as such may be actioned under Trust policies and procedures.

Code of Conduct Professional staff who have a national Code of Conduct are expected to adhere to that Code and failure to do so could result in disciplinary action being taken.

Diversity The Trust has a Diversity Policy and aims at positive measures to eliminate discrimination and promote a diverse and inclusive culture. As a minimum you should ensure that your own actions support diversity and equality by complying with Trust Policies, accepting differences and treating all with dignity and respect.

Responsibility for Health & Safety Compliance with the Health & Safety at Work Act 1974 – the post holder is required to fulfil a proactive 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, and a statutory duty of care for their own personal safety and that of others who may be affected by their acts or omissions.

Infection control You are accountable for the effective deployment of activities that ensure that your department/ward/clinical team is reducing hospital acquired infection. You will ensure that you and your staff comply with the Trust’s policies on infection, prevention and control. You will ensure that you and your staff receive the training required to maintain competence to execute the Trusts policies on infection, prevention and control. You have a responsibility to bring deficiencies in the deployment of such policies to the attention of your line manager.

Risk Management A comprehensive risk management strategy is in place with a successful serious incident reporting system in operation. The Trust has an electronic adverse event reporting system. All employees are required to work within the system. Departmental risk profiling has been introduced and is linked to the Trust’s Risk Management Department.

Clinical Governance Clinical governance requires that all clinical staff adopt personal responsibility for not only knowing

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what constitutes best practice in their field, but also defining policies that translate knowledge into practice within their own service and for systematically measuring performance and outcomes when changes in practice are implemented.

Responsibility for Teaching

The appointee will be expected to participate in the teaching of undergraduate staff and the professional development of junior medical staff working in the department.

Audit meetings are held monthly during working hours and shared audit with colleagues from other disciplines are held regularly.

The Trust supports the College guidelines on CME and is committed to providing time & funding for this.

Work Circumstances & on-call

A hospital consultant has continuing clinical responsibility for any patient admitted under his or her care. A consultant and the chief executive responsible for the management of the consultant’s contract shall agree a job plan.

The job plan will identify the average time per week required to perform the duties of the post, based upon 10 programmed activities per week.

For consultants on part-time contracts, including honorary contracts, duties will be negotiated to ensure fairness. If this part-time role is the consultant’s only work then a reasonable allowance will be made for supporting professional activities. The flexible and special interest sessions will be average over 12 months and it is expected that a total of 21 additional sessions each, which could be theatre, outpatients, Consultant of the day, endoscopy etc. as appropriate and required by the trust and agreed between the Clinical Director and Surgical Management Team. There is a possibility of offering an additional PA based on contracted activity and expertise of the applicant (such as endoscopy skills).

Where a consultant has private practice commitments the timing, location and nature of these will need to be declared to the Trust.

The number, nature and location of programmed activities may be varied with the agreement of the consultant and the chief executive, (who may delegate this function to the appropriate clinical director) taking account of the job plans of the other consultants, the resources available at certain time and the service delivery needs of the department.

There is an expectation that the consultant will fulfil all job plan commitments, emergency situations will take precedent over this and the Clinical Director may agree some deviation from the job plan, provided it fits the needs of the service.

The successful candidates will participate in an on call rota which averages a 1 in 8 commitments (week-end and out of hours) and one COTD session weekly when there are no elective clinical sessions scheduled. This is category A on call and at 1 in 8 gives a 5% uplift to basic salary. The out of hours on-call commitment currently agreed for this position has been estimated as 1 PA.

A full timetable will be agreed with the appointees within 3 months of starting.

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A indicative table of activities and related Pas is shown below:

Activity PAs

Theatre Sessions 2

Outpatient Clinic 2

Ward Rounds 1

Administration 1

SPAs (including audit) 1.5

Consultant of the day 2.5

Flexible 0.5

Review of the Job Plan The job description contains an indicative job plan and this may change based on the service needs and re-allocation of resources.

The job plan sets out your main duties and responsibilities, service responsibilities and objectives. You and your Clinical Manager / Lead are required to review the job plan annually in line with the provisions in Schedule 3 of the Terms and Conditions of the new Consultant Contract (England) 2003. You will ensure that that you participate in job plan reviews and that it contributes to the efficient and effective

Clinical Governance The post-holder will participate in clinical governance activities, including clinical audit, clinical effectiveness, risk management, quality improvement activities as required by the Trust, and external accrediting bodies.

Personal and professional development The post holder will be required to keep himself/herself fully up-to-date with their relevant area of practice and be able to demonstrate this to the satisfaction of the Trust.

Personal or study leave will be granted at the discretion of the Trust in line with the prevailing Terms and Conditions of Service, to support appropriate study, postgraduate training activities, relevant CME courses and other appropriate personal development needs. The post holder is required by the trust to participate in annual appraisal.

Supporting professional activities The SPA allowance is for core activities leading to revalidation (i.e. CPD and audit). Any additional activities which fall into the SPA category will be remunerated separately. These activities will be reviewed at 3 months and at the formal 12 month job plan review. For applicants already in a Consultant position, consideration will be given to an increased SPA allowance from appointment, reflecting additional roles. use of NHS resources.

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This appointment is subject to the terms and conditions of the New Consultant Contract.

Appraisal will be carried out with the Clinical Director as outlined in the consultant contract on a yearly basis. Standard Duties & Responsibilities The Trust operates a No Smoking Policy.

All Wrightington Wigan and Leigh NHS Foundation Trust staff employed within Clinical Environments and have contact with children, vulnerable adults; service users and their families must familiarise themselves, be aware of their responsibilities and adhere to Local Safeguarding Children’s Board, Local Safeguarding Adult Board and WWL Procedures for Safeguarding and Protecting Children which are available on the Trust Policy Library.

In accordance with Part 7 of the Immigration Act 2016, employees who are required to interact regularly with the public, both face to face, and by telephone, are required to be able to speak English to an appropriate standard relevant to their role, i.e. with confidence and accuracy, using correct sentence structures and vocabulary, and without hesitation.

Compliance with the Data Protection Act 1998 and Information Governance – the postholder is not entitled to use for their own benefit or gain, or to divulge to any persons, firm or other organisation whatsoever, any confidential information belonging to the Trust or relating to the Trust’s affairs or dealings which may come to their knowledge during employment.

Compliance with the Health & Social Care Act 2008 – Code of Practice on the Prevention and Control of Infections and related guidance – the post holder is required to fulfil a proactive role towards the reduction and management of healthcare related infection in all of their actions. This entails compliance with Trust Infection Prevention and Control policy and related Standard Operating Procedure (SOP’s); along with risk assessment of all situations; as staff have a statutory duty of care for their own personal safety and that of others who may be affected by their acts or omissions. Staff must be fully compliant with Trust Infection prevention and Control eLearning policy.

All applicants to any post within the Trust are required to declare any involvement either directly or indirectly with any firm, company, relevant person or organisation which has any interest with the Trust, the services provided by the Trust or any element of patient care. Failure to do so may result in an employment application being rejected, or if it is discovered after appointment the omission of such information could lead to dismissal. This includes any form of private practice relating to medical care.

Compliance with Trust Policies and Procedures including the Code of Conduct.

Responsibility for all records (including patient health, financial, personal and administrative) that they gather or use as part of their work within the trust. The records may be paper, electronic, microfiche, audio or videotapes, x-ray images.

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Any other duties appropriate to the grade. The range of duties and responsibilities outlined above are indicative only and are intended to give a broad flavour of the range and type of duties that will be allocated. They are subject to modification in the light of changing service demands and the development requirements of the postholder.

This document is also available in audio, large print, Braille and other languages upon request. For more information call 01942 773106.

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