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  3. 3. CARDIFF AND VALE NHS TRUST JOB DESCRIPTION LOCUM CONSULTANT PAEDIATRIC GASTROENTEROLOGIST1. THE JOB ITSELF Title: Locum Consultant Paediatric Gastroenterologist Base Hospital: University Hospital of Wales The post holder should be fully (CSAC) accredited in paediatric gastroenterology as well as general paediatrics and will be expected to work as part of the existing Welsh Clinical Network in paediatric gastroenterology, hepatology and nutrition which already exists in South and Mid Wales. Although based at the University Hospital of Wales, the post holder will help to provide a service for South and Mid Wales and undertake a number of outreach clinics in other hospitals. The current provision of paediatric facilities in Cardiff is split between the University Hospital of Wales and Llandough Hospital. The hospitals are 7 miles apart, the UHW being the larger hospital and the base for a wide range of specialist services. Llandough Hospital provides a limited range of specialist services and delivers DGH services to the population of the west of Cardiff and the Vale of Glamorgan. The Paediatric Medical Unit beds are currently located at UHW and Llandough Hospital. This will change with the completion of the Children’s Hospital for Wales, Phase 1 (Spring 2005) which centralises all paediatric medical beds onto one site in new purpose built accommodation. The current Paediatric Medical Unit beds located at UHW are as follows:- 35 medical beds Children’s Assessment Unit (6 beds) The Paediatric Surgical Unit / Critical Care Services at UHW are as follows:- 43 surgical beds Paediatric Intensive Care Unit (8 beds) High Dependency Unit (6 beds) Children’s Assessment Unit (6 beds) The Paediatric Medical Unit beds located at Llandough Hospital are as follows:- 20 medical beds 1 ward x 24 oncology beds (includes day case workload) Facilities are also provided on a separate unit at UHW for in-patient care of adolescents from a wide range of specialties. 3
  4. 4. Children’s outpatients mainly take place on the UHW site in dedicated facilities, but thereremain a limited number of specialties where paediatric clinics are run in adult outpatientpremises.The construction of a new Children’s Hospital for Wales is underway to improvepaediatric care in relation to both the secondary and tertiary services.A Children’s Hospital for Wales, Phase 1 is being constructed on the UHW site and theTertiary Service base for Paediatric Gastroenterology will be located within the hospital.Construction of Phase 1, which encompasses medical specialities is scheduled to becompleted in spring 2005.It is anticipated that there will be 3 phases of development in the Children’s Hospital.Phase 1 will address the following:At UHW:Common core features of the Children’s Hospital to include a MainEntrance/Reception/dedicated access.Two medical wards including improved bedside parent accommodationA Paediatric Oncology Unit, including a ward, day treatment unit, outpatients anddedicated parents accommodation.At Llandough Hospital:A Children’s Assessment UnitAdditional Paediatric Outpatient accommodationThe planning of Phase 2 is currently ongoing and this second Phase will includededicated Paediatric Theatres, extended HDU and Assessment Unit, associateddiagnostic and treatment facilities, 2 surgical wards and a Children’s Outpatient Suite.The tertiary service for paediatric gastroenterology, hepatology and nutrition alreadyworks closely with the Departments of Adult Gastroenterology, Paediatric Surgery,Paediatric Radiology and Pathology and this will continue with the provision of the newChildren’s Hospital.Other Hospitals at which duties are performed:In addition to in-patient and outpatient work based at UHW and Llandough, clinics will bedelivered to the pattern determined by the Managed Clinical Network (MCN) for PaediatricGastroenterology. The Regional Service is provided at present by Dr H R Jenkins, basedin Cardiff (0.8 WTE) and Dr Mike Cosgrove (0.5 WTE) and Dr Peter J Dale (0.5 WTE)based respectively in Swansea and Newport. A number of outreach clinics are alreadyoperational and the post holder will be involved in discussion regarding the split of existingestablished clinics as well as establishing and running new outreach clinics. 4
  5. 5. 1.1 Names of Senior and Consultant members of the Department of Paediatric Gastroenterology, Hepatology and Nutrition Dr H R Jenkins Consultant Paediatric Gastroenterologist (0.8 WTE) Dr P J Dale Consultant Paediatrician with a special interest in gastroenterology (based in Gwent Healthcare NHS Trust – 2 sessions per week in Cardiff) Dr D P Tuthill Consultant Paediatrician with a special interest in nutrition (1 session per week & co-ordinator of the Paediatric Nutrition Support Team) Mrs K Bryant-Davies Paediatric Gastroenterology / Nutrition Nurse Specialist (1 WTE)1.2 Other Medical Staff in the Department Paediatric Gastroenterology sits within the Directorate of Child Health at Cardiff and Vale NHS Trust. The Directorate is the base for a range of All Wales Tertiary Paediatric services with which several joint clinics are undertaken, as well as providing District General Hospital services to the resident population. All Wales Paediatric Tertiary Services / Consultant medical staff based at Cardiff and Vale NHS Trust include: Dr H Jenkins Consultant Paediatric Gastroenterologist Mr S Huddart Consultant Paediatric Surgeon Mr K Hutton Consultant Paediatric Surgeon Mr R Surana Consultant Paediatric Surgeon Dr C Powell Consultant Paediatrician Prof J Sibert Consultant Paediatrician Prof D Davies Consultant Paediatrician Dr G Shortland Consultant Paediatrician Dr M Alfaham Consultant Paediatrician Dr D Tuthill Consultant Paediatrician Dr H Williams Consultant Paediatrician Dr M Jenney Consultant Paediatric Oncologist Dr H Traunecker Consultant Paediatric Oncologist Dr R Hain Consultant Paediatric Oncologist / Palliative Care Dr M Drayton Consultant Neonatologist Dr P Cartlidge Consultant Neonatologist Dr C Doherty Consultant Neonatologist Dr I Doull Consultant Paediatric Respiratory / Cystic Fibrosis Dr J Gregory Reader / Consultant Paediatric Endocrinologist Dr K Verrier-Jones Reader in Paediatric Nephrology Dr G Smith Consultant Paediatric Nephrologist Dr B O’Hare Consultant Paediatric Nephrologist (Locum) Dr J van der Voort Consultant Paediatric Nephrologist (Locum) Dr F Gibbon Consultant Paediatric Neurologist Dr D Wilson Consultant Paediatric Cardiologist Dr O Uzun Consultant Paediatric Cardiologist Dr O Onuzo Consultant Paediatric Cardiologist Mr R Hatfield Consultant Neurosurgeon Dr S Morris Consultant Paediatric Radiologist Dr S Harrison Consultant Paediatric Radiologist 5
  6. 6. The Paediatric Gastroenterology service is supported by a full-time Specialist Registrar and at times a variable number of other part-time Specialist Registrars.1.3 Other Relevant Staff Paediatric Gastroenterology / Nutrition Nurse Specialist The post holder (1.0 WTE) is a pivotal member of the Paediatric Nutritional Support Team for Cardiff and also is involved in the clinical care of children with chronic g-i disease e.g. inflammatory bowel disease. The business case for a second full-time specialist nurse is being submitted. The post provides a central focus for the provision of nutrition support e.g. children with gastromies and liaison between hospital care and the community as well as the different paediatric hospital specialties including surgery and neonatology. Multi-disciplinary team There is excellent input to the service from paediatric dietitians, clinical psychologists, speech and language therapists and developing links with the newly formed children’s community nursing team. Links with other Tertiary Centres and Joint SpR Training The Paediatric Gastroenterology groups in Cardiff, Bristol and Birmingham have joined forces to provide a joint training centre for applicants to the National Grid for training in tertiary Paediatric Gastroenterology (3 year rotation). In addition, there are regular clinical and research meetings between the Welsh Paediatric Gastroenterology Service for Wales and the South West of England with meetings alternating between South Wales and Bristol.1.4 Secretarial Support and Accommodation Funding has been identified for 1 WTE Medical Secretary and office accommodation for the post holder and secretary on the UHW site. Full access is available to the Trust management and patient information systems with internet/intranet access. Medical secretarial work associated with outreach clinics are the responsibility of the host Trust.2. WORK OF THE DEPARTMENT2.1 The Paediatric Gastroenterology service at Cardiff and Vale NHS Trust provides the focus for the specialised medical service for the children of South and Mid Wales. The clinical workload has increased over a 10 year period with approximately 250 new patients and 1,200 follow-up outpatients and 100 in-patients per annum. The service (already run as an informal network between Cardiff, Newport and Swansea) seeks to support South and Mid Wales through joint and outreach clinics for children with gastroenterology disorders. There are currently 128 clinics in UHW / Llandough and 36 outreach clinics held in different locations (including Haverfordwest, Aberystwyth, Carmarthen, Bridgend, Aberdare / Merthyr). 6
  7. 7. The Paediatric Gastroenterology service also plays a crucial role in the provision of thewhole Paediatric Tertiary Service with several other specialties dependent on input fromGastroenterology e.g. surgery, neurology, neonatology, endocrinology and intensive care.It is recognised that Paediatric Gastroenterology, Hepatology and Nutrition is vital to thefunctioning of the whole Tertiary Paediatric Service.There is an endoscopy service with weekly dedicated paediatric sessions – 200-250procedures performed per year.There are many joint clinics held with other departments within Cardiff and with supra-regional services for the UK.Local Joint clinicsSurgeryEndocrineFeedingTransition (with adult gastroenterologist)ConstipationCoeliacImmunologySupra-RegionalØ Liver (x 6 per year with Birmingham and King’s College Hospital Liver Units)Ø Constipation (x 4 per year with Dr Graham Clayden, Guy’s & St Thomas’ Hospital, London)A Review undertaken by the Specialist Health Service Commission for Wales (SHSCW)in 2002 recognised the urgent requirement to appoint a second Consultant to thePaediatric Gastroenterology service together with associated specialist nursing andtherapy staff. The strengthening of this service is integral to SHSCW’s proposedstrategy for the major configuration of Children’s Tertiary Services and will form anessential element of the care to be provided within the new Children’s Hospital for Wales.As a result of the SHSCW’s report, ‘A Special Service – The Future of SpecialisedHealthcare for the Children of Wales’, the Welsh Assembly Government (WAG) hasfunded the post of Consultant Paediatric Gastroenterologist and associated supportedcosts. The new Consultant post will enable the Paediatric Gastroenterology Service todevelop strategically through the Managed Clinical Network (MCN) model to undertakeadditional outreach clinics and to provide more gastroenterology input at UHW.The post holder will be integrated into the General Paediatric rota for clinical serviceweeks with a 1 in 12 commitment and the general paediatric on-call rota at UHW, alsoapproximately 1 in 12.The post holder will be involved in an informal arrangement for providing specialistpaediatric gastroenterology advice to DGH colleagues. This advice will be, in the main,through telephone contact. 7
  8. 8. 2.2 Administrative Responsibilities / Budget Details2.2.1 You will be responsible for undertaking the administrative duties associated with the care of patients and the administration of the department.2.2.2 You will be required to comply with the appropriate Health and Safety Policies as may be in force.2.3.3 Travel as necessary between hospitals/clinics will be required but a planned and cost effective approach will be expected.2.3.4 The successful candidate will become a member of the Paediatric Directorate and will be encouraged to attend divisional meetings.3. MAIN DUTIES AND RESPONSIBILITIES3.1 Clinical3.1.1 You will provide with consultant colleagues (as appropriate) a service in the speciality to the hospitals so designated, with responsibility for the prevention, diagnosis and treatment of illness.3.1.2 You will have continuing responsibility for the care of patients in your charge in liaison with consultant colleagues and for the proper functioning of the department in line with the Operational Policy and Strategic Plan (as amended from time to time).3.1.3 You will be responsible for the professional supervision and management of junior medical staff. If appropriate the post holder will be named in the contracts of junior staff as the person responsible for overseeing their training and as an initial source of advice to such doctors regarding their careers.3.1.4 You will be required to participate in continuing medical education in ways which are acceptable to the Chief Executive.3.1.5 You will be required to participate in and contribute to Clinical Audit in line with the Trust’s policy on the implementation of Clinical governance.3.1.6 Domiciliary consultations - as appropriate to Bro Taf residents in accordance with the Trust Policy.3.1.7 The post holder will participate in the General Paediatric on-call rota as specified previously but, with the full development of the managed clinical network in the future, there may be the development of sub-specialty (paediatric gastroenterology) ‘on-call’ with other colleagues in South Wales.3.1.8 You will be required to cover for consultant colleagues periods of leave.3.1.9 Any other duties with other agencies that have been agreed with the employing Trust (e.g. Prison Service). 8
  9. 9. 3.2 Teaching3.2.1 You will be responsible for carrying out teaching, examination and accreditation duties as required and for contributing to and participating in postgraduate and continuing medical education activity and audit activities, locally and nationally.3.2.2 All consultants teach and train at all levels of undergraduate and postgraduate education. There is a very active postgraduate training department, which organises medical and dental education led by the Dean of Postgraduate Medical and Dental Education, at the University of Wales College of Medicine. There is a well stocked medical library on site.3.3 Research3.3.1 The successful candidate will be encouraged to participate fully in current research projects and to initiate projects of his/her own. These activities will have the full support of the Head of the Academic Department of Child Health (Prof. J Sibert) and within the Department of Child Health.3.4 Management3.4.1 You will be required to co-operate with local management in the efficient running of services and an expectation to share with consultant colleagues in the medical contribution to management. In addition it should be noted that a system of Clinical Directorship is in operation and close liaison with appropriate colleagues will be required.3.4.2 You will be required to work within the financial and other restraints decided upon by the Trust. Additional expenses of any kind will not be committed without the approval of the appropriate manager/budget holder.3.4.3 Subject to the Terms and Conditions of Service you will be expected to observe policies and procedures of the Trust, drawn up in consultation with the profession where they involve clinical matters.3.4.4 You will be expected to pursue local and national employment and personnel policies and procedures in the management of employees of the Trust.3.4.5 You will be required to ensure that arrangements are in place for adequate medical staff to be available in relation to the treatment and care of patients.3.4.6 You will be expected to participate in the Trust’s policies and procedures relating to annual performance review and appraisal.4. PROVISIONAL WORK PROGRAMME (as required under paragraph 30A of the Terms and Conditions of Service) 9
  10. 10. 4.1 WEEKLY TIMETABLE OF FIXED COMMITMENTS (i.e. regular scheduled NHS activities in accordance with paragraph 30B of the Terms and Conditions of Service). The duties described here are provisional and will be the subject of annual review and will form a composite part of the JOB PLAN which will be agreed between the post holder and the Chief Executive or a nominated deputy. Hospital/Location Type of Work Monday AM) University Hospital of Wales Outpatient clinic* PM) University Hospital of Wales Ward round* Tuesday AM) University Hospital of Wales Administration PM) University Hospital of Wales CPD / Clinical Governance Wednesday AM) University Hospital of Wales Nutrition / Feeding clinic including multidisciplinary team assessment* PM) University Hospital of Wales Teaching / Research Thursday AM) University Hospital of Wales Ward round* PM) UHW / Outreach clinic Outpatient clinic* Friday AM) Outreach clinic Endoscopy session (alternate weeks)* PM) Outreach clinic / UHW Outreach clinic (alternate weeks)* Weekend On call as described in Para 3.1.7Note: * Fixed sessions In addition to these fixed sessions, it is expected that the post holder will devote the equivalent of one session per week to undergraduate clinical teaching. 10
  11. 11. 4.2 AVERAGE NUMBER OF HOURS SPENT EACH WEEK ON NHS DUTIES (This table, in terms of duty hours, does not need completion at this time, other than on call duties, but will form part of the Job Plan in future years). Type of Duty Average Number of Hours (weekly) Outpatients 14 (+ additional travelling time for outreach clinics) Ward Work 8 Theatre or Special Procedures 2 Teaching/Training/Examining 4 Research 4 Medical Audit 2 Management 2 Committees (local and national) 2 Administration 4 Other - On-call 1 in 12 Travelling Time (part-time only) NOTE: Completion of this table does not give rise to a contractual duty to work beyond the actual contractual commitment.5. REVIEW OF THIS JOB DESCRIPTION IN RELATION TO JOB PLANS This job description will form a composite part of a Job Plan which will be subject to annual review by you and the Chief Executive or his nominated deputy. For this purpose you and the appropriate manager should have a copy of this job description and an up-to-date work programme (i.e. not provisional, together with a completed paragraph 4.2) and relevant statistical information (preferably over a 12 month period) together with notes provided by either side of any new or proposed service or other developments. Local procedures must be followed if it is not possible to agree a job plan, either initially or at an annual review. These procedures culminate in an appeal to the employing Trust. 11
  12. 12. 6. MAIN CONDITIONS OF SERVICE6.1 This post is covered by the National Health Service Terms and Conditions of Service for Hospital Medical and Dental Staff (England and Wales) and the General Whitley Council Conditions of Service as amended in negotiation with the Trust Medical and Dental Staff Negotiating Committee. Details of these may be obtained from the Medical/Dental Personnel Department.6.2 The post is pensionable unless the appointee opts out of the scheme or is ineligible to join. Remuneration will be subject to deduction of pension contributions in accordance with the Department of Health regulations.6.3 The post holder will be managerially accountable to the Clinical Director and professionally accountable to the Medical Director.6.4 Candidates 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 job content will be discussed on a personal basis, in consultation with consultant colleagues and the Medical Director.6.5 The salary applicable is on the locum consultant pay scale and will be specified in the contract. (See also paras 6.10 and 6.14).6.6 The locum consultant appointed will be required to live within 10 miles by road of their base hospital unless specific approval for a greater distance is given by the Trust.6.7 The locum consultant will be required to maintain his/her private residence in contact with the public telephone service. Assistance can be given with the cost of installation and rental charges.6.8 You will be required to ensure that any private practice you undertake will in no way diminish the level of service that may be expected of you by the Trust in carrying out your main duties and responsibilities.6.9 You must provide us with evidence which is acceptable to the Occupational Health Department, that you are not a carrier of Hepatitis B. This would normally be a pathology report from a laboratory in the UK or alternatively a report from another NHS Occupational Health Department within the UK. It will not be possible to confirm this appointment unless this condition is met. Before starting work you may therefore need to attend the Occupational Health Department for assessment. If this is not possible, then you must attend on the day you start work.6.10 The Trust will require the successful candidate to have and maintain full registration with the General Medical Council.6.11 As you will only be indemnified for duties undertaken on behalf of the Cardiff and Vale NHS Trust, you are strongly advised to ensure that you have appropriate Professional Defence Organisation Cover for duties outside the scope of the Trust, and for private activity within the Trust.6.12 The Locum Consultant appointed should preferably possess an appropriate certificate of Specialist Training. 12
  13. 13. 6.13 So far as is practicable the consultant appointed will be expected to provide cover for annual and study leave of consultant colleagues.6.14 The Ionising Radiation (Medical Exposure) Regulations 2000 The Ionising Radiation (Medical Exposure) Regulations 2000 impose a legal responsibility on Trusts for all staff who refer patients for medical radiation exposures such as diagnostic x-rays to supply sufficient data to enable those considering the request to decide whether the procedure is justified.6.15 Disclosure of Criminal Background of Those with Access to Patients It is the policy of the Trust that in accordance with the appropriate legislation, pre- employment Disclosure Checks are undertaken on all newly appointed Doctors and Dentists. The Criminal Records Bureau is authorised to disclose in confidence to the Trust details of any criminal record including unspent and spent convictions, cautions, reprimands and final warnings. Applicants being considered for this post must provide this information on the application form before they can be considered. Any information disclosed will be treated in the strictest confidence and all circumstances will be taken into account before any decision is reached. The successful applicant will be required to complete a CRB Disclosure Check application form and to provide the appropriate documentation. Applicants should be aware that a refusal to comply with this procedure may prevent further consideration for the post.7. GENERAL INFORMATION FOR APPLICANTS7.1 Applicants who are related to any member or senior office holder of the Cardiff and Vale NHS Trust should clearly indicate in their application the name of the member or officer to whom related, and indicate the nature of the relationship. A candidate deliberately concealing such a relationship would be disqualified.7.2 Candidates are asked to note that canvassing of any member of the Advisory Appointments Committee or the Employing Trust will disqualify them. This should, however, not deter candidates from approaching any person for further information about the post.7.3 Any offer of appointment will be subject to the receipt of three satisfactory references.7.4 The nature of the work of this post is exempt from the provisions of Section 4 (2) of the Rehabilitation of the Offenders Act 1974 (Exemption Order 1975). Applicants are, therefore, not entitled to withhold information about convictions under the Act and, in the event of employment, any failure to disclose such convictions could result in dismissal or disciplinary action by the Trust. Any information given will be completely confidential and will be considered only in relation to an application for positions to which the Order applies.7.5 Travelling expenses will be reimbursed for only one pre-interview visit, and only then to those candidates selected for interview. Shortlisted candidates who visit the District on a 13
  14. 14. second occasion, say on the evening prior to interview, or at the specific request of management, will be granted travel and appropriate subsistence expenses on that occasion also. In the case of candidates travelling from abroad, travelling expenses are payable only from the point of entry to the United Kingdom.8. DATE WHEN POST VACANT New post available immediately.9. DETAILS FOR VISITING Candidates who may wish to see the Department involved or discuss the post are invited to contact:- Dr Huw R Jenkins Dr Graham Shortland Consultant Paediatric Gastroenterologist Clinical Director & Consultant Paediatrician Department of Child Health Department of Child Health University Hospital of Wales University Hospital of Wales Heath Park Heath Park Cardiff Cardiff CF14 4XW CF14 4XW ( (029) 2074 4558 ( (029) 2074 3275 Shortlisted applicants are welcome to contact: Mr Daniel Phillips General Manager, Women, Children’s and Community Service Group Management Corridor Llandough Hospital Penarth CF64 2XX ( (029) 2071 6874CON136-LOC PAED GASTRO CARDIFF AND VALE NHS TRUST 14
  15. 15. PERSON SPECIFICATION FORM FOR LOCUM CONSULTANT PAEDIATRIC GASTROENTEROLOGIST REQUIREMENTS ESSENTIAL DESIRABLE Ø Full GMC Registration Ø Higher Degree (e.g. Ø MRCP / MRCPCH or equivalent Ph.D., M.D.)QUALIFICATIONS Ø On Specialist Register for Paediatrics (Paediatric Gastroenterology) or equivalent / Specialist Registrar with CCST due within 3 months of interview date Ø Investigation and management of Ø Adult Gastroenterology tertiary paediatric gastroenterology and joint clinicsEXPERIENCE disorders Ø Commitment to team approach and Ø Computing skills multi-disciplinary workingABILITY Ø Counselling and communication skills Ø Evidence of participation in clinical audit and understanding role of auditAUDIT in improving medical practice. Understanding of clinical risk management and clinical governance Ø Active research interests Ø Evidence of initiating, progressing andRESEARCH concluding research projects leading to publication and further degrees Ø Commitment to participating in and Ø Evidence of understanding of the management management trainingMANAGEMENT process Ø Evidence of teaching medical Ø Organisation of students and junior doctors (undergraduate and/orTEACHING postgraduate) teaching programmes Ø Evidence of ability to work both in aPERSONAL QUALITIES team and alone. Ø Flexible approach Ø Satisfactory Immigration StatusOTHER Ø Satisfactory Health ClearanceREQUIREMENTS Ø Satisfactory Disclosure Check 15