Royal Manchester Children’s Hospital with Managed Clinical Services
JOB DESCRIPTION
CONSULTANT PAEDIATRIC EMERGENCY MEDICINE
Manchester University NHS Trust
Manchester University NHS Foundation Trust (MFT) is one of the largest acute Trusts in the UK, employing over 20,000 staff. We are responsible for running a family of nine hospitals across six separate sites, providing a wide range of services from comprehensive local general hospital care through to highly specialised regional and national services. We are the main provider of hospital care to approximately 750,000 people in Manchester and Trafford and the single biggest provider of specialised services in the North West of England. We are also the lead provider for a significant number of specialised services including Breast Care, Vascular, Cardiac, Respiratory, Urology Cancer, Paediatrics, Women’s Services, Ophthalmology and Genomic Medicine.
Our vision is to improve the health and quality of life of our diverse population by building an organisation that: Excels in quality, safety, patient experience, research, innovation and teaching. Attracts, develops and retains great people. Is recognised internationally as a leading healthcare provider.
MFT is a key partner in Manchester Local Care Organisation (MLCO) (https://www.manchesterlco.org/) which provides integrated out-of-hospital care in Manchester. This includes community nursing, community therapy services, intermediate care and enablement, some community-facing general hospital services and adult social care services. Around 1,500 MFT NHS community staff are deployed to MLCO. Beyond Greater Manchester, we also have significant responsibilities for providing specialist services commissioned by the NHS England Specialised Commissioning Team.
Our Hospitals
Manchester Royal Infirmary Wythenshawe Hospital Royal Royal Manchester Children’s Hospital Manchester Royal Eye Hospital Saint Mary’s Hospital University Dental Hospital of Manchester Withington Community Hospital Trafford General Hospital Altrincham Hospital
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The Royal Manchester Children’s Hospital
Royal Manchester Children's Hospital can trace its foundations back to 1829. Until relatively recently our services were provided in three different hospitals across the city: Saint Mary’s, Pendlebury & Booth Hall. In 2009 we merged together and moved into our brand new, state of the art hospital, alongside the other Manchester University Hospitals on Oxford Road.
We are the largest and busiest children’s hospital in the UK with 371 paediatric beds. A further 60 neonatal cots also operate, within the same building, in the tertiary neonatal unit of Saint Mary’s Hospital. This enables the staff of our two hospitals to deliver completely joined up services for families, from prenatal care through birth and beyond. Our specialised (tertiary), and highly specialist (quaternary), services provide care for children and young people across the North West, across the UK and internationally. We also provide general paediatric care for children and young people living in Greater Manchester. We are fortunate to share a campus with our Trusts specialist adult hospitals and are also adjacent to the University of Manchester. This enables our teams to collaborate closely with the many international experts working across the site, to deliver both excellent healthcare and a vibrant, world class research programme.
We are very proud of our staff; they demonstrate a consideration for others at all times and share a strong ethos of providing family centred, compassionate care, with a constant focus on the dignity of the children and young people that we care for.
The Paediatric Emergency Department
There is a purpose built dedicated Paediatric Emergency Department. This provides the portal of entry for ED patients and all non-elective referrals to the secondary and tertiary services, seeing approximately 50,000 new patients per year. Royal Manchester Children’s Hospital is an accredited Major Trauma Centre for Children working as part of the North West Children’s Major Trauma Network.
The Posts
We have expanded our team of Paediatric Emergency Medicine Consultants at Royal Manchester Children’s Hospital with 2 new posts in 2019 and 2020 and are now looking to appoint additional consultants as colleagues have moved into other roles within the organisation. We are keen to attract dynamic and high calibre dedicated specialist Paediatric Emergency Medicine consultants from either an Emergency Medicine or Paediatric background as we believe that both training routes provide complementary expertise.
Currently there are 2 consultant shifts each weekday 0800-1600 and 1500-2300 with the late shift consultant on call overnight. Weekends have 3 consultant PAs worked flexibly plus on call. As the consultant numbers expand, the rota will evolve with the aim that when fully recruited there will be a shift pattern of: Weekdays 0800-1700 1000-1900 1600-2400 plus on call 2 #OurFamilyCaringforYours
Weekends 0800-1700 1600-2400 plus on call
Main Responsibilities
To provide clinical leadership and expertise in the delivery of high quality family focussed care to all children and young people presenting to the Paediatric Emergency Department, including leadership of the Paediatric Trauma Team and Resuscitation Team.
General Responsibilities
Work with colleagues to provide a Consultant-led and Consultant delivered service with the highest standard of care. Work with the multi-professional team to develop care pathways and clinical guidelines. Collaborate and promote close working links with colleagues, other specialities and primary care. Offer educational, clinical support and leadership to junior medical colleagues, nursing colleagues and other members of the multi-disciplinary team. Provide a role model of professional leadership, which underpins the corporate values and behaviours agreed by the organisation, ensuring these are understood and demonstrated by the medical workforce within your area and take remedial action where poor behaviour are demonstrated. Ensure that junior doctors training confirms to College requirements. Participate in the appraisal of medical staff within the department in line with the Trust’s agreed policy.
Clinical Responsibilities
Clinical and administrative responsibility for the safe and effective functioning of the Paediatric Emergency Department and Children’s Clinical Decision Unit. Organising admissions through the Emergency Department, or discharging from the Emergency Department directly. To develop joint protocols for the management of emergency admissions with the nursing team and clinical colleagues. Develop standards, procedures and robust systems in the Paediatric Emergency Department to ensure safe, high quality and efficient patient care from the point of entry into the Paediatric Emergency Department until admission or discharge. Clinical and Educational Supervision and teaching of junior medical staff, Advanced Clinical Practitioners and the wider multidisciplinary team.
The post-holder will be expected to take an appropriate share in the management and administrative workload of the Department. Consultant engagement in planning and developing the service is valued.
The department actively encourages the development of specialist interests within Paediatric Emergency Medicine
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Staffing of the Department
The post holders will join the Team, which currently consists of 4 Paediatric Emergency Medicine consultants employed by RMCH and a number of Emergency Medicine consultants who work across both the Adult Emergency Department at Manchester Royal Infirmary and the Paediatric Emergency Department at Royal Manchester Children’s Hospital. There is a separate duty consultant and on call rota for each department. The current staffing model works out at 5.75 WTE consultants for the Paediatric Emergency Department.
Dr Rachel Jenner (Clinical Lead Paediatric Emergency Department) Mr Lorcan Duane Dr Nicola Wilson Dr Gabrielle Magnall (commencing September 2020)
Dr Rosemary Morton Prof Simon Carley Prof Kevin Mackway-Jones Prof Rick Body Dr Janos Baombe Dr Alastair Rennie Dr Alistair Hayes Dr Craig Ferguson Dr Dhurga Gnanasegram Dr Alan Grayson Dr Joey Godfrey Dr Katie Cole Dr Kirstin Ballantyne Dr Omar Amin Dr Peter Hulme Dr Nandini Sen Dr Sivanthi Sivanaradajah Dr Sarah Leech
The department has 8 ST3 Paediatric Emergency Medicine posts (all Emergency Medicine trainees in the Manchester region rotate through PED RMCH during their ST3 year) and 2 subspecialty ST7 equivalent Paediatric Emergency Medicine trainees from Emergency Medicine. In addition there are 2 GRID training posts in Paediatric Emergency Medicine posts for Paediatric Trainees.
Junior doctor staffing is from a mixture of F2 doctors, clinical fellows and GP trainees with some working exclusively in PED, others rotating between adult and paediatric ED or between PED and ward based general paediatrics.
We have regular sessional GPs seeing primary care patients within PED and are committed to the development of Advanced Clinical Practice with currently 2 trainee Advanced Clinical Practitioners. 4 #OurFamilyCaringforYours
The non-medical staffing establishment of is currently as follows:
Matron Sue Rothwell oversees the Paediatric Emergency Department from a nursing perspective supported by a ward manager, practice educator and team of band 7 nurses. Nursing numbers for each shift are as below.
Early Late Twilight Night Mon 7 + 2 9 + 2 2 7 + 2 Tues 7 + 2 9 + 2 2 7+ 2 Wed 7 + 2 9 + 2 2 7+ 2 Thurs 7 + 2 9 + 2 2 7+ 2 Fri 7 + 2 9 + 2 2 7+ 2 Sat 7 + 2 9 + 2 2 7+ 2 Sun 7 + 2 9 + 2 2 7+ 2
Senior managerial support is from Jill Scotson Unit Director for Paediatric Medicine and Operational Manager Emily Broughton.
Facilities within the Department
The Paediatric Emergency Department at RMCH is a purpose built type 1 consultant led 24 hour ED for children and young people up to the age of 16, or older if still in the process of transitioning to adult services. It has full resuscitation and stabilisation facilities and is a designated Major Trauma Centre for children, receiving seriously injured children from across the region as part of the North West Children’s Major Trauma Network. There are up to 50 Paediatric Major Trauma Calls per month with a PED consultant expected to act as Trauma Team Leader or directly supervise a senior trainee in this role.
PED acts as a single point of access for non-elective paediatric admissions, including GP referrals for secondary and tertiary paediatric specialties. Walk in patients with minor and moderate illness and injury are also seen within PED.
The department has strong links with the local community, primary care and the inpatient teams and services at RMCH with integrated clinical pathways for both ambulatory patients and those requiring hospital admission. There are consultant delivered follow up clinics within PED for injuries and paediatric medical problems.
There is a 3 bedded fully equipped resuscitation room, adjacent assessment area with cubicles and consulting rooms for children and young people and an 8 bedded Children’s Clinical Decision Unit within PED allowing multidisciplinary short stay admission and observation to prevent unnecessary hospital admissions. Plans are in progress to double the physical space of the department and create additional facilities such as a dedicated area for assessing children with acute mental health problems (estimated completion 2023).
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There is a strong team ethos within PED with all members of staff committed to providing high quality family centred care to all our patients. “Nobody wants to bring their child to an Emergency Department. The families we meet are having a bad day. Our aim is to make their bad day better”
There is a PED consultant present in the department from 0800 until at least 2300 and available 24/7 on call for major trauma calls and any other emergencies.
We have strong working links with other specialties within the hospital.
Overall Specific Requirements of the Post
The appointee should possess a Certificate of Completion of Training (CCT) or Certificate of Equivalence Of Specialist Registration (CESR) in either Emergency Medicine or Paediatrics and be on the Specialist Register with documented subspecialty training in Paediatric Emergency Medicine or be eligible to receive this within 6 months of interview. The appointee should have a proven track record in postgraduate education and have demonstrated expertise within a specialist area (complementary to the existing interests within the department) or be willing to develop such an interest.
The Clinical Service Unit
Managerially, the Paediatric Emergency Department (PED) sits within the Clinical Service Unit Medicine 1. This includes PED, general paediatrics, paediatric diabetes and endocrinology, ward 75 and Paediatric Outpatients Department.
Clinical Lead Dr Maggie Steggall Unit Director Jill Scotson Matrons Sue Rothwell PED Kathryn Stanton Ward 75 and OPD
There is a close working relationship between PED at RMCH and the Paediatric ED at Wythenshawe Hospital and North Manchester General Hospital and Urgent Care Centre at Trafford Hospital and with the adult ED at Manchester Royal Infirmary.
Division of Work, Job Plan and Appraisal
Annual appraisal of consultants is carried out within the Clinical Service Unit. It is expected that the appraisal for the posts would be undertaken by one of the senior departmental Consultants.
Appraisal familiarisation courses are provided within the Trust. The appraisal discussion is confidential. The Trust has adopted an on-line electronic based appraisal process.
In the event of inability to agree a job plan either at appointment or upon annual review, or in the event of issues arising from the appraisal process, negotiation will be with the departmental Clinical Lead, Clinical Service Unit Lead and Medical Director of the Hospital or Group as required. 6 #OurFamilyCaringforYours
One of the Associate Medical Directors (currently Professor Daniel Keenan) is responsible to the Medical Director and Responsible Officer (currently Miss Toli Onon) for facilitating revalidation of Trust Medical Consultant staff. Individual Consultants are responsible for ensuring that they have annual appraisals and that they undertake multisource (360 degree) feedback every 5 years in preparation for revalidation. Currently 360 feedback is facilitated by a GMC approved system hosted online. The Responsible Officer makes recommendation for revalidation of individual Consultants on the basis of appropriate completion of annual appraisals and review of multisource feedback.
Accommodation and Administrative Support
The appointee will be provided with desk space in a shared office.
Research
The Trust undertakes research in a diverse range of clinical areas and regularly recruits patients into clinical trials. We believe that clinical research is most successfully translated into improved care for patients through the combined efforts of patients, clinicians, scientists, industry and other partners.
We are dedicated to improving health and well-being for our diverse population. Research and innovation are central to our vision to be recognised internationally as a leading centre for healthcare provision.
Patients
Some 2.6 million people live in Greater Manchester, with demographics representative of all major developed world disease areas, ethnic groups and areas of considerable deprivation. Over one million patients per year are cared for across our eight hospitals and community services.
Location
Greater Manchester is in the top three UK regions for attracting industry studies, and is home to a large, diverse and stable patient population. Manchester Royal Infirmary is located at the heart of the largest clinical-academic campus in Europe.
Connections
We are intrinsically connected with The University of Manchester – through colocation, and our joint biomedical research strategy, appointments, and medical training programme. With the University of Manchester we are one of seven partners in the Manchester Academic Health Science Centre (MAHSC), the only AHSC outside of Southern England; designated by the Department of Health, this is a quality stamp for the research we conduct. We host the National Institute for Health Research (NIHR) Clinical Research Network: Greater Manchester, and work closely with the Greater Manchester Academic Health Science Network and the Northern Health Science Alliance.
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Quality of research
We are home to the NIHR/Wellcome Trust Manchester Clinical Research Facility (adults and children’s), the NIHR Manchester Musculoskeletal Biomedical Research Unit and one of the NHS England 100K Genome Centres.
Infrastructure
We empower our staff to identify and assess unmet needs, and support them in working with industry and other partners to craft co-developed diagnostics, treatments and devices. Principal investigators work as part of a cross-functional team (divisional research managers, research nurses/midwives/coordinators, research office administrators, quality manager, innovation management service [TRUSTECH], etc.) dedicated to driving research and innovation.
Performance
We are continuously looking for ways in which we can improve delivery of our research studies. Over the past three years, we have significantly reduced the average time for study approval and first patient recruited (NIHR targets). Research and Innovation Division reports directly to the Board providing timely decision making, as well as strategic oversight and assurance to the Trust Board in relation to the management and governance of all research activities within the Trust and in our collaborations and partnerships.
Our world-leading research facilities, and the provision of internal pump-priming grants, provide a first- class environment for translational research in a hospital setting.
The Directorate, Trust and University have superb facilities for undertaking research and contributions to research will be actively encouraged. Areas of research interest should be discussed with the Head of Service and will normally be expected to relate to the clinical interests of the Departments and Trust. Research activity must be adequately funded by appropriate grant income secured by the appointee. Excellent opportunities exist to work in collaboration with colleagues of all disciplines including those based at the University of Manchester.
Clinical Audit
Clinical Audit is mandatory within the Trust and the appointee will be expected to attend and participate in the audit programme within the Department. Mr Lorcan Duane is the current Clinical Audit Lead for the Paediatric Emergency Department.
Consultant Development Programme
Individuals taking up their first consultant post are now offered a place on the Leadership and Management Development Programme. This is a recent initiative designed to engage newly appointed consultants in the development of their leadership capability. The programme utilises 0.5 SPA and includes a series of talks and group based activities with an individual service improvement project. The
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Trust also offers a Leadership for Excellence programme for clinical leads or medical managers to further develop their leadership skills.
In addition to the Trust programme, a one-to-one mentoring scheme outwith appraisal processes to provide additional support for new appointees can be arranged, if this is appropriate.
Continuing Professional development
The Trust supports the requirements for Continuing Professional Development according to the standards laid down by the Royal College of Emergency Medicine and Royal College of Paediatrics and Child Health.
The Trust is committed to providing both the time and financial support for these activities. We are unable to reimburse staff for the cost of joining professional societies.
Responsibility for Professional Supervision and Management of Junior Medical Staff
The appointee will have responsibility for the supervision and training of junior medical staff and will be expected to attain and maintain the GMC domains for clinical (and preferably educational) supervision of trainees.
Colleague Cover
A system of internal cover operates within the Clinical Service Unit for annual, study and sick leave. This current practice works effectively and equitably.
Experience Required
The appointee should possess a Certificate of Completion of Training (CCT) or Certificate of Equivalence Of Specialist Registration (CESR) in either Emergency Medicine or Paediatrics and be on the Specialist Register with subspecialty training in Paediatric Emergency Medicine or be eligible to receive this within 6 months of interview. The appointee should have a proven track record in postgraduate education and have demonstrated expertise within a specialist area (complementary to the existing interests within the department) or be willing to develop such an interest.
Undergraduate Teaching
The Trust is one of the major teaching centres for the University of Manchester. Involvement with undergraduate teaching is a core commitment for the department’s medical staff and the appointees should be aware of the methods employed for teaching medical, dental and other students.
Library Facilities
There are extensive library facilities within Central Manchester site, easy access to the internet, the Trust intranet and medical databases. The Directorate currently subscribes to a number of on-line journals and these will be available to the appointees. In addition the University library is within five minutes walk of the Trust.
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Information Technology
You are encouraged to pro-actively seek to work with the Trust’s Information Technology resources and to exploit the full benefits of Information Technology in delivering improved patient care.
Maintaining Medical Excellence
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, December 1996). All medical staff practising in the Trust should ensure that they are familiar with the procedure and apply it.
Clinical Governance & Risk Management
The Trust has a Clinical Governance Strategy. All consultant medical staff are required to adhere to the principles and practices contained therein.
General Requirements and Conditions of Service a) Appropriate training and experience with an interest in teaching are essential. b) The Trust supports CPD according to College guidelines and the post holder will be expected to fulfil College requirements for CPD with both time and financial support from the Trust. c) Candidates should have an understanding of NHS management responsibilities of Consultants and be able to demonstrate how they perceive the management role in this post. d) The person appointed to this post will be responsible for providing a service within the resources allocated by Manchester University NHS Foundation Trust. e) The post holder will only develop those services which Purchasers can fund and which have been discussed and agreed with the Executive Committee. f) The appointee will carry out the duties of the post within the policies agreed by the Trust, e.g. Health and Safety at Work, Control of Infection, Training of Junior Staff, Continuous Quality Improvements Programme etc. g) The appointment will be subject to satisfactory checks with both the Disclosure and Barring Service and the Trust’s Employee Health & Well Being Service. h) The appointee will be required to live within 10 road miles of Manchester University Hopitals 10 #OurFamilyCaringforYours
NHS Trust Oxford Road Campus or at a greater distance subject to the Trust’s agreement.
Terms and Conditions of Service
The appointee will be required to maintain General Medical Council (GMC) full and specialist registration with a licence to practise and revalidation, and should follow the GMC’s Code of Good Medical Practice. The appointment will be covered by the National Health Services Terms and Conditions of Service for Hospital, Medical and Dental Staff (England and Wales) and the General Whitley Council Conditions of Service.
Visiting Arrangements
Potential applicants are strongly encouraged to discuss these posts by contacting one or more of the people listed below, depending on areas of specialist interest.
Dr Rachel Jenner : Clinical Lead for Paediatric Emergency Department [email protected] Tel 0161 7019124
Dr Maggie Steggall : Clinical Lead for Medicine 1 CSU [email protected]
Mrs Jill Scotson General Manager, Medicine 1 and 2 CSU [email protected] Tel 0161 7015559
Dr Jane Valente : Medical Director Royal Manchester Childrens Hospital PA Hazel Spain [email protected] Tel 0161 7011056
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Job Content
Precise job plans will vary according to clinical commitments and specialisations, e.g. whether RCEM or RCPCH background. Specialities covered will depend on individual interests. These will be agreed at appointment.
Example job plan:
Day Time Location Work Code PAs 0800-1600 PED Clinical Shopfloor C1 2 Monday
Tuesday 0800-1200 PED Clinical Admin C11 1 1200-1600 Flexible SPA inc audit and CPD 1
Clinical Shopfloor then Wednesday 15.00-23.00 PED C1 2.33 on call
Thursday Day off Friday 08.30-10.30 Flexible SPA 0.5 10.30-12.00 Consultant meeting 0.375 1.0 Educational Supervision (0.5 in 1200-16.00 PED (2 trainees in first year first rising to 4 trainees) year) Either 0800-1700 1 in 8 PED cover (either Saturday PED C1 0.375 Or 1600- day or evening shifts) 2400 Either 0800-1700 Sunday PED C1 0.375 Or 1600- 2400 Additional agreed activity to Participation in new Consultant Programme (instead 0.5 be worked of supervising 2 trainees in first year) flexibly Predictable Direct emergency on- 0.5 clinical care call work Unpredictable On-site, at Direct emergency on- Variable home on the 0.5 clinical care call work telephone 12 #OurFamilyCaringforYours
and travelling to and from site TOTAL PA’s 10
Programmed Activity Number Direct clinical care (including unpredictable on-call) 7.5 Supporting professional activities 2.5 TOTAL PROGRAMMED ACTIVITIES 10
PERSON SPECIFICATION – CONSULTANT Paediatric Emergency Medicine
13 #OurFamilyCaringforYours Please state whether or not Essential / Method of Requirements you meet the criteria, Desirable Assessment providing brief details Qualifications and Training MB ChB or equivalent Essential CV Full and specialist registration (and a licence to practise) with the General CV and Medical Council (GMC) (or be eligible Essential Certificates for registration within six months of interview) Applicants who are UK trained must also be a holder of a Certificate of Completion of Training (CCT) in either Emergency Medicine or Paediatrics with a subspecialty registration in CV and Paediatric Emergency Medicine, or be Essential Certificates within six months of award of CCT by date of interview. Applicants who are non-UK trained will be required to show evidence of equivalence to the UK CCT. FRCEM or MRCPCH or equivalent Essential CV MD, PhD or other higher degree Desirable CV Teaching and Audit Teaching of medical students Desirable CV and Interview Experience of Audit Essential CV and Interview Teaching of junior medical staff Essential CV and Interview Experience of supervision of ST1 level trainees including workplace-based Desirable CV and Interview assessment and MSF Trained Clinical Supervisor Essential CV and Interview Trained Educational Supervisor Desirable CV and Interview Academic Achievements and Research Publications in recognised Clinical Desirable CV and Interview Journals Specialist interest in areas complementary to other consultants in Desirable CV and Interview the departments Research projects relating to the Desirable CV and Interview specialist area Interpersonal / Professional Skills Interview, Organisational skills Essential References and Presentation Interview, Communication skills Essential References and Presentation Interview, Leadership skills Essential References and Presentation Involvement in service development Desirable CV and Interview 14 and/or#OurFamilyCaringforYours quality improvement processes Completed by Candidate’s Name:
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