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Job Description and Information Pack

April 2020

DIVISION OF SCHEDULED CARE

Appointment of Full Time (10 Sessions)*

CONSULTANT IN ANAESTHETICS

Special Interest: Intensive care Medicine

With Potential for Sessions in Pre-Hospital Emergency Medicine with EMRTS Cymru for interested candidates

Based at Royal Gwent Hospital, Newport, South East Wales



Job Reference: 040-CON398

Anticipated Start Date: IMMEDIATE

DIVISIONAL Contact for enquiries about this post

Dr Dave Hepburn, Interim Clinical Director – Critical Care, Tel ( 01633 234164

Dr Ami Jones, Clinical Lead Consultant EMRTS Cymru, Tel( 03003000057

|Links to Additional Information |

|Aneurin Bevan Homepage | |

|Aneurin Bevan Values and Behaviours Framework | |

|Aneurin Bevan Demography Profile | |

|Medical Training/Careers in Wales | |

|Visit Wales | |

|Train Work Live | |

| | |

Medical Resourcing Department, Ground Floor Portacabins, Llanfrechfa Grange, Cwmbran, NP44 8YN

Email ( medicalresourcing.abb@wales.nhs.uk Tel ( 01633 623935

Index

Index 2

Introduction 3

Details for Visiting 3

JOB DESCRIPTION 4

Purpose of the Post and General Responsibilities 4

Specific Responsibilities of the Post 4

Clinical 4

Teaching/Training (as agreed with Clinical Director) 5

Audit (as agreed with Clinical Director) 5

Quality and Standards 5

Learning Organisation 5

Patient Experience 5

Patient Safety 5

Personal Development 5

Management (as agreed with Clinical Director) 5

Location 5

Review 6

Provisional Job Plan 7

Person Specification 8

The Specialty.................................................................................................... 9

Introduction

The advertised split post is in Critical Care & Anaesthesia and will be predominantly based at the Royal Gwent Hospital in Newport. The successful candidate will have a 10 session contract and will participate in the ICU on call rota (frequency currently 1:11). The successful candidate may in future, with agreement following job planning, work flexibly to provide critical care and anaesthesia across the Health Board and may increase their total sessional commitment up to a maximum of 12 sessions.

The anaesthetic directorate provides a comprehensive service for all elective surgery (excluding cardio-thoracic and neurosurgery), critical care, emergency surgery, obstetric anaesthesia and acute and chronic pain.

If you are trained in Intensive Care Medicine alone, or with a CCT in a speciality other than anaesthesia please contact Dr David Hepburn – Interim Clinical Director for Critical Care for further discussion.

Facilities: Shared office accommodation, secretarial support and IT facilities will be provided.

The posts comprise 10 sessions with 7 DCCs and 3 SPAs.

The ratio of DCCs to SPAs may vary with the agreement of the post holder and the Health Board in advance or after commencement.

Job share applicants are welcome. If such a person is appointed, modification of the job content will be discussed on a personal basis.

Details for Visiting

Those wishing to discuss the post informally in the first instance, or visit the department are encouraged to contact:

Dr Dave Hepburn Dr Aida Nadra

Interim Clinical Director - Critical Care Clinical Director - Anaesthesia

Department of Anaesthetics Department of Anaesthetics

Royal Gwent Hospital Royal Gwent Hospital

Newport Newport

E-mail : David.Hepburn@Wales.nhs.uk E-mail : aida.nadra@wales.nhs.uk

Shortlisted candidates are encouraged to visit and contact:

Dr Sarah Aitken Mrs Judith Paget

Medical Director Chief Executive

Aneurin Bevan University Health Board Aneurin Bevan University Health Board

Tel: 01633 435971 Tel: 01633 435958

Please note that pre-interview visits to other AAC panel members are neither required nor expected.

Notes

A candidate for a consultant appointment shall not be reimbursed for more than three attendances. Where an authority invites such a candidate to attend prior to shortlisting, it may reimburse the candidate’s expenses provided that he or she is subsequently shortlisted, but not otherwise. In the case of candidates travelling from abroad, travelling expenses are payable only from the point of entry into the United Kingdom.

Applications are welcome from candidates wishing to work part time. If such a person is appointed, modification of the job content will be discussed on a personal basis.

Job Description

The Job Itself

Title: Consultant in Anaesthetics WSI in Intensive Care Medicine

Professionally responsible to: The Medical Director

Managerially accountable to: The Divisional Director, with ultimate accountability to the Chief Executive

Base: The Royal Gwent Hospital, Newport, SE Wales

Other hospitals at which duties are performed: The post holder will generally be expected to undertake their main programmed activities at the principal place of work with a selection of sessions at within the Health Board as agreed in the Job Plan. In view of the fact that the organisation is currently undertaking a review of its services and the locations at which they are undertaken, it is important to be aware that work patterns may change and the place(s) of duties modified and the post holder will be required to work at any site within the Health Board, including new sites.

The Clinical Strategy of the Health Board is under constant development and the job holder may be required to undertake different duties agreed at the time of appointment.

Purpose of the Post and General Responsibilities

Specific responsibilities of the post are listed in the next section.

As a senior employee of the Health Board the post holder will work in close co-operation with, and support other clinical, medical professional and managerial colleagues in providing high quality healthcare to the Health Board’s patients.

Integral to the responsibilities of the post are the following requirements:-

❖ To ensure the provision of a first class clinical service

❖ To provide effective leadership to all staff engaged in the specialty

❖ To sustain and develop teaching and research wherever appropriate

❖ To undertake all work in accordance with the Health Board’s procedures and operating policies

❖ To conduct clinical practice in accordance with contractual requirements and within the parameters of the Division’s and Health Board’s service plans

❖ To maintain the confidence of business plans and development strategies formulated for the specialty, the Medical Division or the Health Board

Specific Responsibilities of the Post

The post is based at the Royal Gwent Hospital, Newport providing Critical Care sessions in a block fashion and Anaesthesia for elective theatre work. Participation in the on-call rota will be for Critical Care alone.

Clinical

❖ To conduct clinical practice in accordance with contractual requirements within the parameters of the Division’s and Health Board’s agreed objectives.

❖ To participate in the undergraduate teaching programme

❖ To assist and participate with the development of postgraduate training for F1s, F2s, CTs, SpRs, STs and other staff as appropriate

❖ Where agreed, to act as Educational or Clinical Supervisor to junior and middle grade medical staff

❖ All clinical staff are accountable and responsible for their own clinical competence and should limit their actions to those for which they are deemed competent. Clinical staff are also required to comply with the requirements of their professional organisations regarding supervision

Teaching/Training (as agreed with Clinical Director)

❖ To provide conditions for improved training opportunities in line with national and local recommendations arising out of MMC and related requirements

❖ To participate in the undergraduate teaching programme

❖ To assist and participate with the development of postgraduate training for F1s, F2s, SpRs, STs and other staff as appropriate

❖ Where agreed, to act as Educational Supervisor to junior and middle grade medical staff

Audit (as agreed with Clinical Director)

❖ To promote evidence-based clinical practice

❖ To undertake regular audit

Quality and Standards

❖ To be familiar with and actively promote adherence to the regulatory framework including NICE and National Service Framework Guidance and to actively promote professional standards “The Duties of a Doctor”

❖ To undertake all work in accordance with the Health Board’s procedures and operating policies

Learning Organisation

❖ To be involved in and actively manage complaints and any medico legal claims in their area of practice, management of serious incidents and responsibility for sharing any organisational learning from these

Patient Experience

❖ To monitor and respond to measures of patient experience

Patient Safety

❖ To work actively to reduce unintended harm to patients

❖ To contribute actively to the content areas of the 1000 Lives Plus Campaign and any other subsequent patient safety campaign

❖ To adhere to the Health Board’s Clinical Incident Policy

Personal Development

❖ To attend accredited conferences and meetings to update personal level of clinical practice, teaching and management skills in line with CME requirements

❖ To participate in an annual Job Planning Review process

❖ To participate in the Health Board’s Annual Appraisal process

❖ The Health Board will provide support for CPD in accordance of the Royal College

Management (as agreed with Clinical Director)

❖ To provide medical information for the development of systems appropriate for Health Board needs

❖ To participate in departmental consultant and senior staff meetings

❖ To attend other departmental, Divisional and Health Board meetings as necessary

❖ To attend regional and national meetings as necessary

❖ To undertake all work in accordance with Health Board procedures and operating policies

❖ To work within the financial and other restraints decided upon by the Health Board. Additional expenses of any kind will not be committed without the approval of the appropriate manager/budget holder

The post holder has a general duty of care for their own health, safety and wellbeing and that of work colleagues, visitors and patients within the hospital. This statutory duty is in addition to any specific risk management or clinical governance accountabilities associated with the post.

Finally, the post holder is expected to:

❖ Observe the rules, policies, procedures and standards of Aneurin Bevan University Health Board together with all relevant statutory and professional obligations

❖ Observe and maintain strict confidentiality of personal information relating to patients and staff

❖ Be responsible, with management support, for their own personal development and to actively contribute to the development of colleagues

Location

The principal place of work for this post is currently the Royal Gwent Hospital. The post holder will generally be expected to undertake their programmed activities at the principal place of work or other locations agreed in the Job Plan. Exceptions will include travelling between work sites and attending official meetings away from the workplace. A planned and cost effective approach is expected, and is included in the DCC sessional allocation. The post holder may be required to work at any site within the Health Board, including new sites. The Health Board has a commitment to the Clinical Futures Project and opening of the Grange University Hospital for specialist services including all critical care. Further information is available on our website

A site visit to the Grange University Hospital may be possible by prior arrangement with applicants to help inform of service changes outlined on our website.

Review

This job description will be regularly reviewed. It 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.

Provisional Job Plan

(As required under paragraph 30a of the Terms and Conditions of Service)

The consultants work a pre-written and agreed block sessional critical care commitment (Mon – Thurs) and weekend blocks (Fri – Sun). The anaesthesia sessions are worked in non-critical care weeks. The on-call commitment is to critical care only with a handover period from the day consultant built in. There is a consultant Thursday MDT meeting to discuss all cases but particularly difficult cases ones where how to progress care is discussed. There is also a daily MDT (Mon-Fri) involving ICU and HDU consultants, nurse in charge for HDU & ICU and pharmacy, physiotherapy and dietetics staff. There is an educational programme which follows the Thursday MDT and this accounts for 1 SPA.

The daytime ICU commitment is 2.5 DCCs (0900-1800) with 1 DCC for evening cover (1700-2030) and 1 DCC for overnight commitment (unpredictable work).

The HDU session is separate and is 1.25 session (0900-1330)

Weekends (Sat and Sun) are 4 DCC for each 24 hour period for the ICU consultant.

In the future consultants will be expected to contribute to a multidisciplinary team which includes paediatricians and anaesthetists to help to stabilise and treat critically ill children whilst awaiting retrieval by the paediatric intensive care service.

Week 1 – Critical Care Week

|Day |Time |

Week 2- Anaesthetic Week

|Day |Time |

Week 3 – Critical Care Week

|Day |Time |

Week 4 – Anaesthetics Week

|Day |Time |

|Programmed Activity |Sessions |

|Direct Clinical Care (including unpredictable on-call) |7.00 |

|Supporting Professional Activities |3.00 |

|Other NHS Responsibilities | |

|External Duties | |

|Total Sessions |10.00 |

|On-Call Availability Supplement | |

|Agreed on-call rota |1:11 |

|Agreed Intensity Supplement |Band 3 |

In line with the terms and conditions, the final job plan is subject to the agreement of the Health Board through the Clinical Director and the appointee.

Internal directorate clinical management duties are not included in the present allocation of SPAs, but additional SPAs (up to a maximum of 2.5) may be available following discussion with the Clinical Director.

Person Specification

Consultant in Anaesthetics WSI in Intensive Care Medicine (040-CON390)

|Requirements |Essential |Desirable |Measurable by |

|Qualifications |Full GMC Registration and Licence to Practise |Relevant Higher Degree e.g. MD; PhD; MSc |Application |

| |On the GMC Specialist Register (including via CESR/European Community Rights) or will have a |Joint CCT in critical care medicine (or equivalent from overseas) and | |

| |CCT/CESR(CP) date within 6 months of interview |anaesthesia | |

| |Valid Certified Advanced Life Support Skills (or equivalent international qualification) |Evidence of working towards post graduate examination in critical care| |

| | |medicine (FFICM,EDIC or equivalent) | |

|Clinical Experience |Broad based experience in anaesthesia |Experience of NHS |Application/ |

| |Broad based experience in critical care |Wider experience, research and training in anaesthesia |Interview |

| |Able to work as part of an MDT to stabilise and manage critically ill children prior to retrieval by |Evidence of above average performance | |

| |the paediatric intensive care team. | | |

| |Knowledge of UK hospital systems (or equivalent) | | |

| |Knowledge and participation in CPD | | |

| |Able to apply knowledge | | |

| |Safe and effective written and verbal communication skills | | |

| |Meet the requirement of the GMC’s “Good Medical Practice” | | |

|Clinical Governance |Evidence of participation in clinical audit and understanding role of audit in improving medical |Knowledge of risk management |Application/ |

| |practice | |Interview |

| |Comprehension of core philosophy and building blocks of Clinical Governance | | |

|Research |Experience and knowledge of critical appraisal of evidence |Evidence of initiating, progressing and concluding research projects |Application/ |

| | |with publication |Interview |

| | |Research degree | |

|Teaching |Evidence of organising programmes and teaching medical students and junior doctors |Organisation of further teaching programmes in medical education |Application/ |

| |Willingness to teach medical undergraduates and postgraduates |“Training the Trainers” experience |Interview |

|Management |Knowledge of the management and structure of the NHS |Evidence of management training |Application/ |

| | | |Interview |

|Personal Qualities |Ability to cope with stressful situations and undertake responsibility |Evidence of leadership attributes |Interview |

| |Excellent interpersonal skills and team-working skills |Motivational skills | |

| |Ability to work as part of a multidisciplinary and multi-agency team | | |

| |Ability to work flexibly in response to the changing needs of the service | | |

|Other Requirements |Demonstrable skills in written and spoken English adequate to enable effective communication about |Ability to speak Welsh or willingness to learn |Application/ |

| |medical topics with patients and colleagues | |Interview |

| |Satisfactory pre-employment checks compliant with National Standards | | |

| |Ability to fulfil all duties of post, including on-call commitments and travel to meet requirements of | | |

| |the post | | |

The Specialty

The Anaesthetic, Pain and Critical Care Medicine Directorate,

Royal Gwent Hospital

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Trainee Grades: Other Staff:

20 - Specialist Trainees 6 Acute Pain Nurses 3 Junior Clinical Fellows

13 - Core Trainees 3 Trainee ACCPs 2 Post CCT Fellows

5 - ACCS Trainees 1 MTI – Medical Training Initiative

3 Foundation Trainees (F1 and F2)

WORK OF THE ANAESTHETIC and CRITICAL CARE DEPARTMENT

The Royal Gwent Hospital is the single largest district general hospital in Wales and is part of Aneurin Bevan Health Board which manages secondary healthcare for South East Wales, covering the local boroughs of Newport, Torfaen, Caerphilly, Monmouthshire and Blaenau Gwent. The Health Board includes Ysbyty Ystrad Fawr (YYF) and Nevill Hall Hospital in Abergavenny and serves a population of approximately 670,000. The Royal Gwent Hospital has approximately 800 acute beds, 17 operating theatres, a self-contained day surgery unit with two theatres and a busy maternity unit with more than 4000 deliveries per year. The anaesthetic department provides services for general, vascular, orthopaedic, ENT, ophthalmic, maxillofacial surgery, urology and gynaecology. In addition, there are comprehensive services for obstetric anaesthesia and analgesia, acute and chronic pain and cardioversions. The Critical Care Department in the Royal Gwent covers 9 level 3 and 6 level 2 beds, and there is a separate 3 bedded PACU unit. Altogether more than 1100 patients a year (ICNARC data) are admitted to the critical care unit, making it the third biggest unit in Wales. There are 7 Consultants covering both critical care and anaesthesia, and 3 full time Intensivists.

Departmental Profile

The Anaesthetic and Critical Care department at the Royal Gwent Hospital form part of the Division of Scheduled Care within Aneurin Bevan Health Board. The directorate is large requiring three clinical directors, Dr Peter Richardson, Dr Aida Nadra and Dr David Hepburn. The Chairman of the department is Dr J Tanaka. The Royal Gwent also manages anaesthetic services at Ysbyty Ystrad Fawr and St Woolos orthopaedic surgical unit.

NATURE AND SCOPE OF THE SERVICE

The Anaesthetic and Critical Care Department is the largest single medical speciality within the Royal Gwent Hospital and is involved in providing five key areas of patient care (in addition to elective surgery):

1. Emergency anaesthetic service

2. Critical Care Medicine

3. Obstetric analgesia and anaesthesia service

4. Day Surgery Unit

5. Chronic pain service

6. Acute pain service

1. Emergency Service

The Anaesthetic Department is compliant with the Junior Doctors New Deal. Currently trainee doctors and staff grades cover the following levels of on-call:

- ED1 emergency theatre cover

- ED2 emergency theatre cover

- Obstetric on-call

- Intensive Care on-call (a non-anaesthetic tier of 2nd on-call trainee has recently been rolled out)

- Senior specialist trainee on-call to provide second tier of cover for obstetrics, Critical Care and theatres.

Consultants provide cover for the emergency ‘CEPOD’ theatre from 0800-1830, Monday to Friday.

There is a general anaesthetic on-call consultant and a consultant on-call for the Critical Care Unit at all times.

Full details can be obtained from Dr Paul Nichols, Lead Clinician for New Deal and EWTD compliance within the Anaesthetic Department at the Royal Gwent Hospital

2. Critical Care Unit

Interim Clinical Director – Dr Dave Hepburn

We take great pride in being a friendly multidisciplinary unit. 50% of the consultants are female and we are flexible in job planning to maintain a work:life balance particularly for those with young children.

Number of beds = 9 ICU (level 3), 6 HDU (level 2) 3 PACU – 13 Level 3 equivalents

There are approximately 1100 admissions per annum. This is steadily increasing.

The unit has recently undergone complete refurbishment and expansion. Consultant cover meets national standards with 24/7 consultant cover provided by three full time intensivists and eight intensivist/anaesthetists.

There is comprehensive trainee involvement including ACCS, CT, ST, F1 and F2 grades and respiratory medicine trainees. It also includes an advanced intensive care medicine trainee post. We are also training Advanced Clinical Care Practitioners. The unit is approved for training at all levels. The senior specialist registrars in anaesthesia have regular commitments to the unit with the intensive care consultant providing direct support at all times. All consultants participate in clinical supervision of junior medical staff led by the educational lead for critical care - Dr Teresa Evans.

There is an expanding research programme with a lead (Dr Tamas Szakmany) with able support from dedicated research nurses. The unit has participated in recent portfolio studies and all consultants are up to date with their “Good Clinical Practice”.

There is regular morbidity and mortality review and an active audit programme.

There is an increasing use of simulation training on the unit and a number of POCUS trained staff. We can offer FICE and lung ultrasound training.

We provide an undergraduate block for Cardiff University medical students and support the SCC Special study component where students undertake a 7 week placement with an emphasis on quality improvement.

We are one of only a few units in the UK providing comprehensive undergraduate exposure and teaching.

Patient diaries have been a long standing part of the unit’s work and form part of a follow up programme which we are looking to expand further. There is currently a critical care follow-up clinic running fortnightly led by a team of consultant Intensivist, senior nurse and clinical psychologist.

The critical care service performs a multi-functional role covering all hospital specialities. An outreach service runs during daylight hours, 5 days a week and the critical care team regularly organise and participate in ALERT courses. The service is fully engaged with the South East Wales Critical Care Network and participates fully in the ICNARC case mix programme.

3. Obstetric anaesthesia & analgesia

The Royal Gwent Hospital delivery unit is one of the largest delivery units in Wales with more than 4000 births per year. The Welsh Assembly has recently committed significant funding to develop and extend obstetric facilities at the hospital.

The anaesthetic service provides a designated anaesthetist 24 hours per day plus 10 consultant sessions per week and is recognised for advanced training in obstetric anaesthesia.

Approximately 50% of all women in labour require the services of the anaesthetic department either for epidural analgesia or for caesarean sections.

4. Day Surgery Unit

This self-contained unit is closely supported by the Anaesthetic Department.

Protocols for patient care have been drawn up under the supervision of the Anaesthetic Department.

5. Chronic Pain Service

Newport pain clinic was set up by Dr Gwyn Thomas in the 1980s and has undergone considerable development since. The pain clinic is run by Dr T M Ivanova-Stoilova and Dr Sonia Wartan, with development plans to expand in line with the Welsh Assembly's review of pain clinic provision across Wales. There are multi-disciplinary specialist clinics, and a pain management programme.

6. Acute Pain Service

The Royal Gwent Hospital acute pain team was established in 1993, one of the first hospitals in Wales to have such a service. The Acute Pain Team consists of one consultant anaesthetist, five pain nurses, two of which are on a secondment basis (3.5 whole-time equivalents), a pharmacist and representatives from the recovery ward, orthopaedics, general surgery and paediatrics.

MEDICAL AUDIT

Formal clinical governance meetings are held monthly with morning sessions being allocated for audit activity, postgraduate education and morbidity and mortality meetings on a rolling basis.

DEPARTMENTAL TEACHING

There is a Thursday afternoon programme of critical care training which is consultant led and delivered.

At least three hours per week is devoted to the education of trainee anaesthetists, with additional training sessions on the anaesthetic simulator (Sim-Man).

Newport is a co-founder and major contributor to the Part 1 South Wales Anaesthetic Course. The course is directed at all trainees in South Wales sitting their primary fellowship examination.

There is also a course directed at the final fellowship examination that is run in Cardiff with regular contributions from Newport consultants.

An annual programme based on three academic terms is organised to cover topics which are relevant to the different parts of the Fellowship Examination. During these sessions time is devoted to reviewing publishing articles as well as case presentations with an educational interest.

There are also monthly departmental meetings with guest speakers from within and outside the speciality of anaesthesia.

DEPARTMENTAL ACCOMMODATION

The department benefits from good quality accommodation comprising offices for consultant staff, specialist registrars, specialty doctors and associate specialists, a large central administration office equipped with PCs and adjoining office for the departmental manager, large seminar room for sixty people, library, rest room with kitchen and toilet accommodation for female and male staff.

All offices are fully networked for computer terminals and telephone extensions. Personal computers for word processing, internet and intranet access and CD Rom teaching/learning are available.

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