General Information

JOB TITLE: Clinical Fellow in Neurosurgery

GRADE: Clinical Fellow – Specialist Registrar Level (ST4-8)

HOURS: 40 with on-call commitment

RESPONSIBLE TO: Training and Clinical Leads, Neurosurgery

ACCOUNTABLE TO: Training and Clinical Leads, Neurosurgery

TENURE: 6 months

Background

King’s College Hospital NHS Foundation Trust

King’s College Hospital NHS Foundation Trust is one of the largest and busiest teaching hospitals in , with a well-established national and international reputation for clinical excellence, innovation and achievement. King’s has built its reputation as a world class hospital, with roots that lie firmly in the heart of our community. The hospital is principally located on a single site, with approximately 900 beds, but has a number of important outlying satellite services in other locations. It works in close collaboration with other health providers in South East London, to ensure the sustainability and excellence of services across the area. In recent years, there has been substantial investment in both the facilities and resources of the hospital, which has transformed the quality of care that it now delivers.

Established in 1840, the original hospital – a former workhouse – was based on Portugal Street, , close to Lincoln’s Inn Fields. It was first used as a training facility for students at King’s College London, but quickly developed into a major hospital for the area. Over the next 60 years it became respected for both its medicine and teaching, and remains so to this day. King’s moved to its current site in in 1913 with around 300 beds at that time. It played major roles in both World Wars. King’s joined the NHS in 1948.

We became a Foundation Trust in 2006 because we believed our hospital and the services we provide could be improved with greater involvement from our patients, staff, local communities and organisations. It allows us to be more responsive to the needs and wishes of those we serve. We are firmly part of the NHS but are free from central government control, manage our own budget and shape our services to meet the needs of the communities we serve. Our Council of Governors represents the views of our patients, staff, local people and organisations. Working together means we can improve care and services to benefit the lives of people who live locally and further afield.

2013 was a momentous and historic year for King’s. We celebrated our centenary serving the community from our Camberwell site and, on 1st October, we acquired the Princess Royal University Hospital and Hospital from South London Healthcare Trust as well as additional services at Beacon, Sevenoaks Hospital and Queen Mary’s Hospital (Sidcup). Our enlarged Trust is located on multiple sites serving the economically diverse boroughs of , , , and . As a major employer with over 10,000 members of staff, we play an important part in helping reduce local, social and health, inequalities. Many of our services are highly specialised such as Liver, Foetal Medicine, Trauma and Neurosurgery and are delivered on a national / regional basis with people coming to us from throughout the UK and beyond.

The enlarged Trust has an annual income of over £800m, the majority of which is derived from Clinical Commissioning Groups. However, education and research are also important sources of income, currently contributing around 8% of the total. The Trust is embarking on a strategy to achieve greater diversification of its income, with growth anticipated in tertiary referrals, research and commercial services activities. There is also a developing fund raising partnership with the King’s College Hospital Charity.

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King’s College Hospital NHS Foundation Trust has a very positive culture, built on the core staff and service values of: • Understanding you • Inspiring confidence in our care • Working together • Always aiming higher • Making a difference in our community

King’s College Hospital offers a family-friendly working approach for all staff to ensure a good work-life balance. It is an environment where family life is promoted and this will be a feature of your annual appraisal. The Trust provides childcare advice and nursery facilities in conjunction with a supportive mentoring and career-planning programme. Applications for job sharing are welcome.

King’s College Hospital has also recently strengthened its research and development infrastructure in order better to support clinical researchers across the organisation. Translating the results of research from bench to patient bedside is now quicker and easier thanks to the formation (with King’s College London University, Guy’s and St Thomas’ and South London and Maudsley NHS Foundation Trusts) of King’s Health Partners, an Academic Health Sciences Centre.

Further information about King’s can be found on its website, www.kch.nhs.uk.

King’s Health Partners Academic Health Sciences Centre (AHSC)

King’s Health Partners Academic Health Sciences Centre (AHSC) is a pioneering collaboration between King’s College London, Guy’s and St Thomas’ NHS Foundation Trust, King’s College Hospital NHS Foundation Trust and South London and Maudsley NHS Foundation Trust.

This unique combination brings together one of the world’s leading research-led universities and three of London’s most successful NHS Foundation Trusts.

The driving purpose behind King’s Health Partners is to continually seek and bring about swifter and more effective improvements in health and well-being for patients and people everywhere, by combining the best of basic and translational research, clinical excellence and world-class teaching to deliver ground-breaking advances in physical and mental healthcare.

King’s Health Partners (KHP) is one of only five Academic Health Science Centres in the UK accredited by the Department of Health. This followed a selection process carried out by a panel of internationally renowned clinicians and researchers.

Further information on KHP can be found on its website www.kingshealthpartners.org

Neurosciences

In July 1995, the Regional Neurosciences Unit from the Brook General Hospital and the Neurosurgical Unit of the Maudsley Hospital merged to form the King’s Neurosciences Centre. The population served is over 4.5 million and includes the population of the County of as well as the Lambeth, Southwark & Lewisham (LSL), Bromley and Bexley & Health Authorities’ populations.

The centre includes the departments of Neurosurgery, Neurology, Neuroradiology, Neurophysiology, Clinical Neuropsychology, Neuro Rehabilitation and Neuropathology. The constituent departments lie in close proximity to each other on either side of Denmark Hill, some in King’s College NHS Foundation Trust, some in Mapother House on the Maudsley Hospital Site and some in the Institute of Psychiatry. The Institute of Psychiatry is a post-graduate institute of the University of London.

On average there are around 100 neurosurgical in-patients at any one time. There are 12 dedicated neurosurgical HDU beds. Ventilated neurosurgical beds are available in the general ITU. A 10-bed dedicated paediatric 2

neurosurgical ward (Lion Ward) is situated within the Variety Club Children’s Hospital at King’s. Ventilated and non- ventilated neurosurgical beds are available in the PICU and our Neonatal Unit. Outpatient clinics are conducted in the Outpatient Department in The Golden Jubilee Wing. Paediatric Clinics are held in the Variety Children’s Club Hospital.

Housed within the Neurosurgical Unit is a 5-bed adult telemetry unit, which is used by Neurosurgery, Neurology and Neuropsychiatry. There is also a dedicated paediatric telemetry bed. In addition, there are 15 beds for adult Neuro Rehabilitation and 2 for paediatric.

There are 4 fully equipped dedicated neurosurgical operating theatres, with separate neurosurgical theatre staff and neuroanaesthetic teams for elective work and emergency cover. The theatres are adjacent to ITU and Neuroimaging.

The Neurosciences Care Group has major Service Level Agreements contracts with Local Health Authorities and other Health Authorities in the South East of . Since the transfer of the service in July 1995, the workload through the unit has steadily grown. The current work-load of the unit is around 3,000 cases a year including adult and paediatric, emergency and elective cases.

A significant proportion of the department’s work, both with adults and children, is highly specialised and attracts referrals from across the country.

The Neurosurgical Unit

There are 19 Consultant Neurosurgeons and Associate Specialist with a variety of interests who provide both the general neurosurgical service as well as their special interests:

1. Prof Keyoumars Ashkan: Functional neurosurgery and neuro-oncology

2. Mr Sinan Barazi: Skull base and spinal surgery

3. Mr Sanjeev Bassi: Paediatric neurosurgery

4. Mr David Bell: Spinal neurosurgery

5. Mr Ranjeev Bhangoo: Neuro-oncology (Clinical Director)

6. Mr Peter Bullock: Pituatary surgery

7. Mr Chris Chandler (Part time): Paediatric neurosurgery, neuro-oncology

8. Mr Richard Gullan (Part time): Neuro-oncology and complex spinal surgery

9. Mr Irfan Malik: Spinal neurosurgery and epilepsy surgery

10. Mr Richard Selway: Functional and epilepsy surgery

11. Mr Nick Thomas: Skull base and spinal surgery

12. Mr Christos Tolias: Vascular neurosurgery

13. Mr Daniel Walsh: Vascular neurosurgery

14. Mr Bassel Zebian: Paediatric neurosurgery

15. Mrs Eleni Maratos (Locum): Skull base and spinal surgery

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16. Mr Francesco Vergani: Neuro-oncology

17. Mr Gordon Grahovac: Spinal neurosurgery

18. Mrs Cristina Bleil (Locum): Paediatric Neurosurgery

19. Mr Ahilan Kailaya-Vasan: Vascular Neurosurgery

20. Mr PD Kulkarni (Associate Specialist): Spinal Neurosurgery

There are currently 6 neurosurgical fellowships offered at King’s: Functional, vascular, neuro-oncology, skull base, spinal and paediatric. The fellows are all senior trainees at the end of their training or having completed it with FRCS (Neuro.Surg) or equivalent. As well as their in-depth involvement and training in their subspecialty of interest they provide a 1 in 6 senior (tier 2) cover for the registrars on call out of hours.

There are 15 registrars / registrar-equivalent neurosurgeons. King’s is one of three neurosurgical units providing training on the London South Thames rotation. The registrars all participate in a 1 in 14 rota (tier 1) covering the on-call service in and out of hours. They rotate every 6 months between different subspecialties at King’s.

The unit also has 15 SHOs (a number of those are junior trainees on their neurosurgical rotation), 3 Physician’s Assistants and a number of Clinical Nurse Specialists covering vascular, neuro-oncology, skull base, functional, spinal and paediatric neurosurgery.

The department believes strongly in the multi-disciplinary approach. There is a wide range of expertise within the department, which is further improved by cross-referral and sub-specialisation.

There is a well-established formal teaching programme which is aimed at covering the FRCS (Neuro.Surg) syllabus. Attendance is compulsory to all but the 6 senior fellows. In addition, there are monthly journal clubs with the aim of covering landmark and/or recent papers in each of the subspecialties. We also hold regular teaching meetings at the Royal Society of Medicine and have close ties with the department of anatomy at King’s College London.

The department has an active research programme and involvement is encouraged.

There is funding for study leave by application through the appropriate channels. There are excellent library facilities available. There is a good medical library in KCHMDS with CD Rom search facility. The library in the Institute of Psychiatry contains most of the common Neurosciences journals.

Introduction to the post

This post is suitable for a trainee who has full registration with the General Medical Council and has completed the MRCS examination or its equivalent. Previous experience of neurosurgery at least at ST2/3 level is required.

Although these appointments are not accredited for training the appointees will be expected to participate fully in the educational and training programmes. Appointees will have a named educational supervisor and clinical supervisor. Annual leave and study leave is commensurate with other post-foundation doctors. The experience and opportunities offered would be excellent experience for applicants planning a career in neurosurgery. The successful candidate will be expected to participate in the teaching of more junior colleagues and students.

This post is intended to allow a neurosurgical trainee to obtain experience in all aspects of neurosurgery within a busy regional neurosurgical unit where all areas of subspecialist interest are represented.

The candidate will play a full part in the provision of neurosurgical services at middle grade level. This will include participation in the tier-one registrar on-call rota directly supervised by a post-CCT Specialist Fellow and Consultant. 4

Job Description or Job Summary

Duties

The duties will comprise assistance with and responsibility for the care of patients on the wards, assistance in the operating theatre, attendance at appropriate clinics and MDTs and review of appropriate literature and clinical data. Excellent neurosurgical clinical and operative experience can be obtained with senior supervision and feedback provided. The timetable for these activities is dependent upon which consultant the post holder will be working for, as is the list of possible research topics.

In addition, you will take part in the 1 in 14 tier-one on-call rota with the responsibility of taking emergency referrals and triaging appropriately as well as providing emergency neurosurgical care under supervision.

The post may involve travel to other hospitals.

General

The post holder has duties: of care for their own health, safety and well-being and that of work colleagues, visitors and patients within the hospital, in addition to any specific risk management or clinical governance accountabilities associated with this post. to observe the rules, policies, procedures and standards of King’s College Hospital NHS Foundation Trust together with all relevant statutory and professional obligations. to observe and maintain strict confidentiality of personal information relating to patients and staff. to be responsible, with management support, for their own personal development and to actively contribute to the development of colleagues.

This job description is intended as a guide to the general scope of duties and is not intended to be definitive or restrictive. It is expected that some of the duties will change over time and this description will be subject to review in consultation with the post holder.

All employees must hold an 'nhs.net' email account which will be the Trust's formal route for email communication. You are therefore required to check this regularly and to deal with such communication promptly.

Infection Control Statement

The post holder has an important responsibility for and contribution to make to infection control and must be familiar with the infection control and hygiene requirements of this role.

These requirements are set out in the National Code of Practice on Infection Control and in local policies and procedures which will be made clear during your induction and subsequent refresher training. These standards must be strictly complied with at all times.

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PERSON SPECIFICATION

Clinical Fellow

ESSENTIAL DESIRABLE

Education/Qualifications • Full registration with the GMC • PhD, MD

• MBBS (or equivalent) • Other degrees/qualifications

• MRCS/AFRCS/FRCS or equivalent postgraduate surgical qualification • 6 months neurosurgical experience at ST2/3 level Previous experience • Experience of NHS clinical • ALS and ATLS (or equivalents) culture and evidence based within 2 years

practice • Research experience,

presentations, publications

Skills/Knowledge/Ability • Knowledge and experience of • Understanding of NHS, clinical Neurosurgical emergencies. governance & resource • Competent to work without constraints; direct supervision where management/financial appropriate awareness experience of • Clear, logical thinking showing committee work an analytical/scientific approach • Information technology skills • Ability to prioritise clinical need • Academic prizes and honours • Ability to organise oneself & • Demonstrates breadth of own work experience and awareness in and outside specialty/medicine • Evidence of participation and active involvement in an audit • Demonstrate use of evidence- project informed practice • Experience and ability to work in • Shows initiative / drive / multi-professional teams enthusiasm (self-starter, motivated, shows curiosity, • Appropriate level of clinical initiative) knowledge • Enthusiasm for teaching; • Shows knowledge of evidence- exposure to different informed practice groups/teaching methods • Shows awareness of own limitations • Understanding of clinical risk management • The ability to communicate with clarity in written and spoken English; ability to build rapport, listen, persuade, negotiate the ability to produce legible notes • The ability to take responsibility, show leadership, make decisions, exert appropriate authority

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• Empathise with patients and work co-operatively with others • Uses a non-judgemental approach to patients and colleagues • Able to change and adapt, respond to rapidly changing circumstances • Able to operate under pressure, cope with setbacks, self-aware • Is well prepared, shows self- discipline/commitment, is punctual and meets deadlines • Displays honesty, integrity, aware of ethical dilemmas, respects confidentiality • Evidence of teaching experience; involvement in organised teaching

Physical Requirements • Meets professional health requirements • Is up to date and fit to practise safely

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