Consultant Gastrenterologist
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  • 1. Appendix 2 APPROVAL OF CONSULTANT APPOINTMENTS CRG/BOARD AND PCT APPROVAL REFERENCE NUMBER CARP 005.1This proforma should be accompanied by the 2nd stage Business Case proposal. LEEDS TEACHING HOSPITALS NHS TRUST TITLE OF THE POST : CONSULTANT GASTROENTEROLOGISTPROPOSAL FOR: Replacement Post: New Post: Other: Part replacement at 7(tick) PA’s and part new at 3 PA’s (please detail in text)FULL TIME/PART TIME Base Hospital:(please detail number of Programmed Activities) LGI / Wharfedale10 PA’s Full TimeSECTION 1 : REQUIREMENT FOR THE POST :a) Why is the appointment needed and how does the post fit with the agreed PCT/Trust plans for service provision? (Please give any contact in PCTs with whom the post has already been discussed). This is a replacement for a part-time consultant post with vacant GP slots equating to a full time post. 7 sessions replacement with 3 sessions new. This appointment is needed to:i) Increase Consultant numbers towards a level supported by the British Society of Gastroenterologyii) Support the delivery of a centralised Colorectal service on the LGI siteiii) Contribute to service delivery adversely affected by Working Time Directive which has seen a 30% reduction in Outpatient capacity since introductionb) Is the proposed new post documented in the CMT’s YES: NO: Business Plan and covered :  i) in the Leeds LDP? ii) by National policy documents?  iii) by Network funding?  iv) other (e.g. New Oncology Wing FBC)
  • 2. SECTION 2. JOB PLANa) Please indicate the job plan programmed activities (normally 7.5 Direct Clinical Care and 2.5 for Supporting Professional Activities). - How many for Direct Clinical Care? 7.5 - How many for Emergency work arising from on call rotas? - How many for supporting professional activities? 2.5 - How many for additional responsibilities?b) If there is any variation to the 7.5/2.5 split, please give reasons why. N/Ac) Are additional Programmed Activities above 10 PA’s to be offered and, if so, please give reasons why, and state for how long (up to two maximum). N/A – Strategic plans within the specialty around the Consultant base make it unlikely that there will be a need to increase this job plan above 10 PA’s.d) Please outline the objectives of the post. - To support the gastroenterology service at Leeds General Infirmary - To develop the specialist GI colorectal service for both local and regional referrals - To help develop colonoscopic services and training in Leeds - To improve the quality of care and increase the scope for innovation - To facilitate and develop research interests in colorectal disease in Leeds - To contribute to undergraduate and postgraduate educatione) Does this post impact on other job plans in the specialty, e.g. reduction in additional programmed activities for other job plans? NO – The job plan formed part of the generic discussions around the Gastro service prior to the new Consultant contract negotiation. Please provide current and proposed specialty job plan summary.CURRENT JOB PLAN SUMMARY
  • 3. DAY AM PM Monday MDT Meeting Endoscopy (LGI) Tuesday Ward Round Admin Wednesday IBD Clinic (LGI X Ray) CME Thursday Admin Clinic (LGI) Friday Ward Round Endoscopy (WGH)PROPOSED JOB PLAN SUMMARY DAY AM PA PM PA Monday MDT Meeting 0.5 D Endoscopy (LGI) 1D Tuesday Ward Round 0.75 D Admin / Research 1S Wednesday IBD Clinic 1D CME 1S LGI X Ray 0.25D Thursday Endoscopy 1:4 0.25D Clinic (LGI) 1D (WGH) 0.5S Admin Friday Ward Round 0.75D Endoscopy (WGH) 1D Histopathology 0.25D Programmed Activity 6.75 + 0.75 on call Total 7.5 Direct 2.5 Supportingf) Does this appointment change the frequency of others on the rota NO (i.e. is there a reduction in the availability supplement?). This post is being covered by a locum Consultant at present who is part of the on-call rota. The rota will be adversely impacted in the event of the post not being substantively supported by reducing the frequency of the on call commitment to the team from 1:4 to 1:3. This will need to be supported by increasing the remaining Consultant job plans above 10PA’s.g) What sub-specialty interest is planned and why? Colorectal GI medicine. This will support the centralised colorectal service on the LGI site as part of the Trust Acute Services Reconfiguration.h) Is this subspecialty interest a new one? YES: NO: i) Does it follow the interest of the previous encumbent? YES: NO: SECTION 3. LOCATION AND KEY LINKS (internal and external)a) Will the postholder work entirely within this Trust? YES: NO: (please give details) 
  • 4. See job planb) If Clinical Academic post – is there University N/A agreement? Give details of University element of the job plan.c) Key clinical dependencies (include clinical support services and other specialties) In patient and Out patient Gastroenterology The majority replacement element of the business case supports the utilisation of beds and outpatient sessions used by the previous post holder(s). There is no identified increase in the numbers of beds / outpatient sessions and supportive infrastructure required to support this case. Endoscopy The 2.25 Endoscopy sessions form the major part of the ‘new’ element of the business case. The Endoscopy session in themselves are not ‘new’ as this activity has been carried out as part of the SpR rota. With the advent of the new rota configuration and the clinical move towards a Consultant led service this post is utilising sessions which would be unused. GI Physiology The locum in post has shown no increase in the requirement for GI Physiology services. This is not anticipated to alter once the post is made substantive. Histopathology There has been no significant increase in the demand for histopathology services based on the full time locum post. This is not anticipated to alter once the post is made substantive. Radiology There has been no increase in the demand for radiological investigations based on the full time locum post. This is not anticipated to alter once the post is made substantive. Dieticians The level of dietician support required has not altered since the full time locum has been in post. This is not anticipated to alter once the post is made substantive.
  • 5. SECTION 4 ACTIVITY – Planned outcome in terms of activity and quality (where applicable).a) IP FCEs DC FCEs 1st OPs 729Agreed baseline activity 2561 4583Acute activity 02/03 outturn – 4404 FCE’sEstimated change of activity for the appointeeAcute FCE’s 551 Elective FYE 91 320 573Total revised activity for the Specialty (NB describethe acute/elective split below)Acute FCE’s 495590% acute / 10% elective 729 2561 4583 Elective FYEb) If no additional activity, please state why not.The baseline activity is based on the 02/03 outturn. The individual activity is contributing to theoverall activity for the specialty in line with the levels achieved during this period by the substantiveConsultant base.c) Impact on contract income (to include assessment of any displaced activity)NoneSECTION 5. RESOURCESa) Post: Consultant Gastroenterologist Estimated Start Date Locum: Locum currently in post Estimated Start Date Substantive: Nov/Dec 2004 In Year Full Year WTE Recurrent Non Recurrent WTE Recurrent £000’s £000’s £000’sPay Direct StaffingMedical - Minimum Salary (WTE) 1.0 £94,417 1.00 £94,417 - Programmed Activities N/A N/A - Availability Supplement £2,833 £2,833 (3% of basic) - Premium Rate hours N/A N/A - CEA (current) 1 2,252 5,4041 Insert details of average funds to cover an appointee who comes with existing award.
  • 6. Consultant (inc Locum Cover)Junior – specifyNursingWardOther – specifySecretarialOther – adminOther – specifyPay Support StaffingTheatresAnaesthetistsOther – specifyOutpatients – specifyTherapies – specifyPathology – specifyRadiology – specifyPharmacy – specifyFacilities – specifyOther – specifyTOTAL PAY COSTS 1.0 £99,502 1.0 £102,654Non PayRemoval expenses £15,000Advertising £1,000Training/TravelDrugsWard consumablesOther consumablesLease/MaintenanceTheatres – specifyOutpatients – specifyTherapies – specifyPathology – specifyRadiology – specifyPharmacy – specifyFacilities – specifyOther – specify PC & Printer £1,500TOTAL NON PAY COSTS £17,500CAPITAL CHARGESTOTAL REVENUE EXPENDITURE 1.0 £99,502 £17,500 1.0 £102,654CMT IncomeProvider – providerPrivate patientsResearchService Agreement IncomeExisting funding from vacancies & PCT’s (1.00) £(97,369) (1.00) £(97,369)TOTAL CMT INCOME (1.00) £(97,369) (1.00) £(97,369)NET REVENUE IMPLICATIONSIMPACT ON CONTRACT INCOME NIL NILCapital Resource RequirementEquipment – specifyFacilities – specifyOther – specifyTOTAL CAPITAL IMPLICATIONS NIL NIL
  • 7. b) Define the funding source/sources.Current funding sources are Recurrent funding allocated by PCT’s following Leeds Endoscopy Review £29,258 Recurrent funding relating to leaver KJA Miloswekski (Leaving Date 30th £44,786 April 2004) Recurrent funding transferred from General Medicine (601070) £23,325 TOTAL £97,369All financial elements collated into 601055 Consultant Pay Expenditure and fund Consultant post inentirety.Secretarial support for this post will be through the existing Secretarial base at the LGI.The additional funding identified for the appointment of a successful applicant with an existing awardwould be funded by the management of the current budget should this occur.c) Please demonstrate the impact of this case on the CMT recurrent financial position.Costs of the Consultant post will not adversely affect the CMT recurrent financial position as theseven replacement PA’s are already recurrently funded within the CMT and are presently supportinga full time locum post. Recurrent funding is available to cover the additional three PA’s through theLeeds Endoscopy Review monies.
  • 8. SECTION 6. ACCOMMODATIONa) Please identify where the accommodation required is to be sited : i) Office for the Consultant and Secretary LGI – Room 2.02, B Floor, Clarendon Wing (Already utilised by locum) ii) Office for other staff to be appointed as a result of the post; N/A iii) Clinical (e.g. O/P sessions, theatre sessions, beds, critical care beds, etc). 2 - Outpatient sessions at Leeds General Infirmary 1 - Endoscopy session at Leeds General Infirmary 1.25 – Endoscopy sessions at Wharfedale Bed availability on Ward 53 at LGI As the Consultant base manage their beds collaboratively on Ward 53 with a rotational ‘take’ system there is no requirement to increase the bed base in line with this appointment.Please note: If new accommodation/sessions are required, this must have been resolvedbefore the Business Case is approved.SECTION 7. TIMETABLEa) Please indicate the proposed timetable for recruitment, if approved. TMG Approval - October 2004 Trust Board Approval - October 2004 (if required) Advert - October / Nov 2004 Interview - Nov / Dec 2004 In Post - Dec / Jan 2004 Locum Potential (Date) - Currently in postb) Please name the individual responsible for the monitoring and the date for review.Dr Mark Denyer – Clinical Director Gastro MedicineResponsibility of Clinical Director and Business Manager – Review at 12 month annual appraisal andjob plan review.
  • 9. THIS FORM MUST BE COMPLETED TO ENSURE OWNERSHIP BY ALL AFFECTED CMTs(INCLUDING ALL CLINICAL AND NON CLINICAL SUPPORT CMTs) OF THE RESOURCEIMPLICATIONS IDENTIFIED IN THE BUSINESS CASE (ALL NAMES BE ADDED WITHINSEVEN DAYS OF CIRCULATION)C.M.T./CORPORTATE SUPPORTED COMMENTS SIGNEDFUNCTIONS Yes/No Managed within theIn/Out Patient Yes CMT – authorised byGastroenterology Robert McEwanEndoscopy Managed within the Yes CMT – authorised by Robert McEwanGI Physiology Managed within the Yes CMT – authorised by Robert McEwanHistopathology Yes Hard copy signed ByRadiology Yes Len WrightDieticians YesCHECKED BYSigned: Hard copy signed by Robert McEwan Head of CMTSigned: Hard copy signed by Annette Naylor Assistant Director of FinanceHR SIGN OFF FOR CONTRACT/SALARY IMPLICATIONSSigned : …………………………………………………………………………….. Date ………………… Head of PersonnelAUTHORISED BYSigned: Hard copy signed by Gavin Boyle Appointing Director of Operations Signed: …………………………………………………..……………………….. Date …………………… Trust Director of Finance
  • 10. Hard copy signed by Dr Bill Bagnell CARP Chairman