Consultant Rheumatologist

JOB DESCRIPTION

May 2020

CONSULTANT RHEUMATOLOGIST

JOB DESCRIPTION

THE POST

This is a full time (10 PA), Consultant Rheumatologist appointment for the United Hospitals NHS Trust. There is a new post due to expansion of services and to cater to the demand and also another existing post available.

The department will comprise 6 consultants (including this post), 4 specialist nurses and a specialist registrar. A post will be based at Lincoln County Hospital with clinical commitments at Pilgrim Hospital, Boston the other will be also based at Lincoln County Hospital with clinical commitments at & District Hospital. Whilst developing a special interest is not a requirement of the post, this will be encouraged should the successful applicant request this.

Any applicant who is unable for personal reasons to work full time will be eligible to be considered for the post. If such a person is appointed, modification of the content will be discussed on a personal basis with the Trust in consultation with consultant colleagues.

GENERAL INFORMATION

Lincolnshire is scenically and geographically varied. It includes the Lincoln escarpment on which the beautiful medieval Cathedral stands, the Wolds, a designated area of outstanding natural beauty, the extensive beaches of the coastal strip, and the vast farmlands in the south of the county.

Lincoln is a developing city with a recently established and successful University with which the Trust has developed strong research and teaching links. The city is known for the historic Cathedral and Lincoln Castle as well as the many social and leisure facilities available within this expanding city.

Grantham is an historic market town with many attractions, including plentiful shops, restaurants and leisure facilities and is only just over an hour from by train.

South Lincolnshire has retained the grammar school system, and has a reputation for providing excellent state school education. In addition, the cost of housing compares very favourably with many areas of the country.

Boston is an attractive market town in South Lincolnshire with a growing population. It has a flourishing port on the River Witham dating back to the thirteenth century. Most of the town’s industry is linked to agriculture or the port.

THE HOSPITALS

The United Lincolnshire Hospitals NHS Trust brought together Lincoln and Louth NHS Trust, Pilgrim Health NHS Trust and Grantham and District Hospital NHS Trust. It is responsible for a comprehensive range of health services to a local population of some 770,000 people.

Page 2 of 10 Many local general practitioners are known personally to the consultant staff and are met at postgraduate meetings and elsewhere.

COUNTY HOSPITAL, LINCOLN

County Hospital is situated close to the city centre of Lincoln. It is a newly developed large and modern complex that caters for most of the major specialties and has 557 beds. There are 172 are general medical and care of the elderly beds including coronary care and renal beds. There is a 51 bedded Medical Emergency Admissions Unit (MEAU) comprising 26 assessment beds and a 25 bedded ward. There is a separate 18 bedded Surgical Assessment Unit. There is a large, well-staffed Accident and Emergency Department. There are at present 108 general surgical beds, a 20 bed critical care unit (level 2 and level 3), a 10 theatre suite and 3 orthopaedic wards. There is an Ophthalmic Unit, Adult Day Care Unit, an ENT department and a purpose built, fully equipped department of Clinical Oncology.

The large X-Ray Department is situated close to the Outpatients and has sophisticated x-ray facilities with new CT and MRI scanners. There is also a fully developed Medical Physics Unit. There is a modern and well organised Outpatient Department which is at present used by all the surgeons and physicians.

The maternity service is housed in a separate wing and has 49 ante and post natal beds, 14 delivery beds and 24 special care infant cots. The maternity wing also houses the gynaecological wards with 34 beds and 2 operating theatres, plus a 12 bed day case unit.

Pathology and Microbiology Services are provided by Path Lincs.

PILGRIM HOSPITAL, BOSTON

Pilgrim Hospital is situated on the outskirts of Boston. It is a modern District General Hospital. It has 414 beds. If offers a full range of clinical and laboratory services for Boston and the surrounding area. It has close links with community hospitals in and Spalding.

The hospital has an Accident and Emergency Department, a Medical Admissions Unit, a combined ITU/HDU/CCU with 12 beds and beds for all the major specialties. The Radiology Department has both spiral CT and MR scanners. There is also a fully developed Medical Physics Unit.

GRANTHAM AND DISTRICT HOSPITAL

Grantham and District Hospital is a small district general hospital with 194 beds, there is an Accident and Emergency Department together with elective surgery and outpatient clinics in most specialties. Rheumatology outpatients are provided weekly at Grantham. The Hospital works closely with other sites within the Trust as well as links with Newark Hospital and teaching centres in Nottingham and Leicester. Primarily it serves the people of Grantham, and Newark with a total catchment population of around 120,000. The Newark part of the service is within Sherwood Forest Hospitals NHS Trust with significant cross-boundary flow.

Grantham provides Integrated Medicine, General Surgery, and Orthopaedics, Anaesthetics and Accident and Emergency services. There is an ambulatory Paediatric service and

Page 3 of 10 Midwife Managed Maternity Unit. There is a fully equipped X-Ray Department with a modern CT scanner as well as a Pathology Department providing all pathological services on site. There is a Medical Physics Department which does all cardio-respiratory work as well as gamma camera work.

LOUTH COUNTY HOSPITAL

Louth County Hospital has approximately 72 beds consisting of Integrated Medicine, Surgical and Orthopaedic Wards. There are direct acute admissions only to the Medical Wards. The hospital has a High Dependency/Coronary Care Unit and a ward caring for severely mentally infirm patients. The hospital also has an Accident and Emergency Department, Endoscopy, Day Hospital and a very busy Outpatient Department supported by X-Ray, Physiotherapy and Occupational Therapy Departments. There is an on-site education centre with lecture theatre, library and internet access.

JOHN COUPLAND HOSPITAL, GAINSBOROUGH

The John Coupland Hospital is in Gainsborough, approximately 18 miles from Lincoln. Scotter Ward is rehabilitation/care of the older person ward. The hospital has an operating theatre, Outpatients Department and a Nurse Led Minor Injuries Unit.

JOHNSON HOSPITAL, SPALDING

This is a community hospital situated in the market town of Spalding, some 16 miles from Boston. There is an X-Ray Unit, Physiotherapy and Occupational Therapy Services, an active Outpatients Department and a Minor Injuries Unit.

WELLAND HOSPITAL, SPALDING

This hospital has 28 inpatient beds used flexibly between an Elderly Care Physician and local General Practitioners. It has active Physiotherapy and Occupational Therapy Services and a small Outpatient Suite.

SKEGNESS HOSPITAL

This community hospital has 15 GP beds and 15 beds managed by an Elderly Care Physician. There are Physiotherapy and Occupational Therapy Services on site and a busy Outpatients Department. The Accident and Emergency Department is supported by Associate Specialists 24 hours a day and is a very busy department, especially in the summer months.

DIRECTORATE AND DEPARTMENT INFORMATION

The Rheumatology Service is part of the Speciality Medicine Business Unit and is managed by a Clinical Director, Head of Service for Rheumatology pan-Trust and business unit managers which include Business, Service, and Support Managers.

Page 4 of 10 The Rheumatology Department occupies a dedicated two storey building and is set aside from the main hospital building, adjacent to the Physiotherapy and Occupational Therapy Departments. The department was fortunate to receive a generous charitable fund donation, which has enabled the expansion and improvement of both clinical and non-clinical areas providing very pleasant facilities in which to work.

The Rheumatology Department has its own dedicated ultrasound machines for diagnosis and guided injections. There is also a newly purchased state of the art video-capillaroscopy available. The team provides a county-wide service to Lincolnshire and provide outpatient clinics at Lincoln County, Pilgrim Hospital Boston, Grantham Hospital and Skegness Community Hospital. The Department has access to CT, MRI and Electromyography and has dedicated Occupational Therapy and Physiotherapy Support. The team has forged close links with both the Renal (Lincoln County) and Orthopaedic Departments and has excellent Haematology support.

The Rheumatology activity levels for 2019/20 were 3324 new outpatients and 1035 follow up patients which includes nurse led clinics with Day case activity of 1832. Because all activity daycase activity is carried out at the Lincoln site, there is always a consultant presence in the department to support the nursing teams who deliver the day case activity.

The unit has approximately 900 patients on biologic treatments.

Rheumatology is an outpatient service and consultants are on a rota to review ward referrals. Acute medical admission is seen in the Emergency Assessment Unit (EAU) under the care of the Acute Physician.

The Rheumatology Department comprises:

There are 5wte Consultant posts each having a special interest in the following areas of Rheumatology and the new appointments will be encouraged to pursue an appropriate special interest.

• Osteoporosis • Raynaud’s disease and nailfold video-capillaroscopy • Connective tissue diseases • Eye diseases • Ankylosing spondylitis • Paediatric rheumatology

The Consultants are:

Dr Batsi Chikura – Consultant and Department Lead Dr Tim Tait – Consultant Dr Shaza Obaid – Consultant Dr Al-Shami – Locum Consultant Vacancy (This Post) - Consultant

The team is supported by 1wte Registrar post who works between the acute medical rota and the Rheumatology Department. There are no other junior doctors in Rheumatology.

There is an experienced nursing team which includes:

4 Clinical Nurse Specialists 2 Infusion Nurses Page 5 of 10 1 Biologics Nurse 1 Service Co-ordinator

Support is also provided by 1.0WTE Occupational Therapist and 1.0WTE Physiotherapist with a special interest in Rheumatology.

Secretarial support is provided by a Specialty Co-ordinator and admin workforces are located on the Lincoln County, Boston Pilgrim, Grantham and District, Johnson Hospital, Spalding and Skegness Community Hospital sites.

DUTIES AND RESPONSIBILITIES

The appointee will be expected, in conjunction with his / her colleagues, to provide a comprehensive, county-wide Rheumatology service to the population of Lincolnshire.

In addition, he / she will be required to:

• Have continuing responsibility for patients in his / her care and for the proper functioning of the department • Developing a sub-specialty interest will be encouraged and welcomed by the Team • Provide on a reciprocal basis, emergency cover for colleagues during periods of absence • Carry out teaching duties as required and take an active part in the Undergraduate and Postgraduate Medical Education programme and in the teaching of junior medical staff from other specialties. • Be involved in the education of nursing staff, general practitioners and other clinical professions • Regularly attend departmental team meetings • Take part in team, department, regional and national audits • Be involved in research where appropriate • Participate proactively in the development and management of the Rheumatology service in line with the Trust’s Business Plan. • Undertake domiciliary visits where agreed, and appropriate. Rarely, if ever, needed in last few years • Undertake such other duties as may be identified to meet the needs of the service. • This post does not include on call responsibilities. • Be very much involved with developing the “New NHS”, we are currently trialling video consultancy and looking to take this forward developing it for the benefit of our Patients and Trust

AUDIT

The Unit takes an active role in national and local audit. The Trust is a part of the Comprehensive Research network and research facilities are available and the Unit publishes regularly. The team regularly meets on a Wednesday for audit, clinical governance, journal club and x-ray meetings.

THE FUTURE

The department was very fortunate to have been given a legacy of £500,000 in order to develop the Rheumatology service in Lincolnshire.

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JOB PLAN, APPRAISAL AND MENTORSHIP

There will be an annual appraisal and job review conducted by the Clinical Director or the Lead Clinician. The appointee is responsible for their own Continuous Professional Development and have a commitment to Revalidation, which is supported by the Trust.

This post is based on a 10 PA consultant contract which comprises 8.5 Direct Clinical Activities and 1.5 Supporting Activities including teaching in clinic. Mentorship will be provided for newly appointed Consultants. The trust actively supports newly appointed consultants to take part in the RCP Mentorship scheme. Proposed job plan: PA Day Site Time Activity DCC/SPA allocation 0830- AM 1230 OP clinic DCC DCC 1 Monday Boston Lunch 1300- PM 1700 Admin DCC 1 0800- 0830 Travel DCC 0.125 AM 0830- New patients’ clinic 1230 DCC DCC 1 Tuesday Spalding Lunch 1300- 1730 Admin DCC 1 PM 1730- 1800 Travel DCC 0.125 0745- 0830 Travel DCC 0.0625 AM 0830- 1300 OP clinic DCC 1 Lunch Wednesday Lincoln Clinical 1330- Governance/Audit/ 1530 PM Appraisal/Trust Meetings/SPA SPA 0.5 1530- 1615 Travel DCC 0.0625 0830- AM 1230 OPD Clinic DCC 1 Thursday Boston Lunch 1300- PM 1700 CPD SPA 1 0830- AM 1230 OPD Clinic DCC 1 Friday Boston Lunch 1300- PM 1730 Admin/Ward referrals DCC 1.125 Total DCC 8.5 SPA 1.5 Total 10 Page 7 of 10

Clinics will have a selection of News and Follow ups consisting on average 10 patients 2 new and 8 follow ups. Ward referrals are covered by the team and will on average receive 1- 2 a day.

Extra PA’s are available through Job Planning and negotiation for Educational and Clinical Supervision of junior doctors and additional roles and responsibilities.

The appointee is responsible for their own workload and deadlines, keeping their administration up to date within the required timelines and on occasion may need to take the lead in the absence of another senior.

Time off in lieu will be considered for weekend and out of hours working, however this is unlikely within Rheumatology.

TEACHING AND EDUCATION

The new appointee may be expected to support undergraduate and post-graduate teaching. The Trust supports the requirements for continuing medical education as laid down by the Royal College of Physicians and is committed to providing time and financial support for these activities. Teaching of undergraduates at Lincoln is on Friday morning, should the appointee be involved in any of the teaching then extra Pa will be allocated for this.

MAIN CONDITIONS OF EMPLOYMENT

The terms and conditions of employment will be determined by the United Lincolnshire Hospitals NHS Trust terms and conditions of employment. These are generally in line with the relevant provisions of the Terms and Conditions of Service of Hospital Medical and Dental Staff ( and Wales) and General Whitley Council Terms and Conditions of Service, as amended from time to time. Copies of these can be seen in the Personnel Department.

In determining salary for the post, the Trust will pay no less favourable rates than those paid to NHS Consultant Medical and Dental Staff. If, in the future, the Trust establishes alternative negotiating arrangements you will be notified of those arrangements, and thereafter any agreements thus reached will form part of your Contract of Employment.

The post holder shall have medical clearance arranged by the Trust before taking up employment.

RESIDENCE

The person appointed will be required to maintain his/her private residence in contact with the public telephone service and reside within reasonable access bearing in mind the duties of the post. Travelling time, as a sessional commitment, will depend on residence.

RELOCATION EXPENSES

Relocation expenses will be payable to the successful candidate in accordance with the Trust policy on relocation and are subject to Trust policy.

Page 8 of 10 OFFICE ACCOMMODATION

Office accommodation will be available with a consultant secretarial support on both sites. There is a desk top computer with IT support.

HEALTH AND SAFETY

The United Lincolnshire Hospitals NHS Trust recognises its duties under the Health and Safety at Work Act 1974 to ensure, as far as is reasonably practicable, the health, safety and welfare at work of all its employees. In addition, the business of the Trust shall be conducted so as to ensure those patients, their relatives, contractors, voluntary workers, visitors and members of the public having access to the Trust premises and facilities are not exposed to risk to their health and safety.

All Medical and Dental staff under contract to the United Lincolnshire Hospitals NHS Trust will be expected to comply with the Trust Health and Safety Policies.

FURTHER INFORMATION

For informal inquiries and visits to the Trust prospective candidates are actively encouraged to contact:

Dr Batsi Chikura, Consultant Rheumatologist and Head of Service for Rheumatology on Tel 01522 573036 or e-mail [email protected]

Page 9 of 10 Person specifications: Consultant Rheumatologist

REQUIREMENT ESSENTIAL DESIRABLE Assessment

Qualifications MRCP or equivalent. An appropriate CV higher degree, e.g. CCT or within 6 months of achieving it. an MSc/MD/PhD or equivalent Full GMC Registration.

Entry on the General Medical Council (GMC) Register via one of the following: a) Certificate of Completion of Training (CCT) (the proposed CCT date must be within 6 months of the date of the interview) b) Certificate of Eligibility for Specialist Registration (CESR) c) European Community Rights

Clinical Evidence of good clinical skills and CV Experience ability to manage rheumatological Interview problems of varying complexity.

Evidence of ability to supervise trainees.

Evidence of ability to work independently.

Academic Demonstrates an understanding of the Publications in peer CV principles of research and review of reviewed journals Interview literature and evidence based practise. Management Evidence of understanding management Attendance at CV skills issues. management training Interview course. Evidence of understanding and involvement in audit.

Understanding of clinical governance.

Organisational skills and time management skills.

IT skills.

Teaching Skills Evidence of ability to deliver effective Attendance at CV teaching and training to trainees. medical teaching Interview course

Communication Good communication skills. CV and Interview Interpersonal Good interpersonal skills. skills Evidence of good team working and team management.

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