CONSULTANT IN OPHTHALMOLOGY (Fixed Term)

Transcription

1 JOB DESCRIPTION AND INFORMATION PACK CONSULTANT IN OPHTHALMOLOGY (Fixed Term) SPECIALISING IN MEDICAL RETINA OR MEDICAL OPHTHALMOLOGY C O N T E N T S JOB DESCRIPTION Introduction The Scope of the Service The Division/department Work of the Ophthalmology Department Senior Medical Staff Other Medical Staff Nursing Staff Administrative and Clerical Staff Department Facilities Specialist Outpatient Services Other Clinical Services working closely with the Department Main duties of the post Clinical Duties Specialist Interest and Expertise Educational Supervision Clinical Audit Clinical Governance Research Administrative/Budgetary Responsibilities Management Arrangements Cover for Colleagues and Emergencies Appraisal, Job Planning and Mandatory Annual Training Programme of work Person Specification Visiting Arrangements

2 INFORMATION PACK Profile of Taunton and Somerset Health Services in Somerset The Taunton and Somerset NHS Trust The Taunton and Somerset Hospital at Musgrove Park Hospital Proposed Developments Management Arrangements in the Trust Research Audit Continuing Medical Education Somerset Academy Terms and Conditions Health clearance including hepatitis B and C Criminal Record Bureau check General Information 2

3 JOB DESCRIPTION CONSULTANT IN OPHTHALMOLOGY SPECIALISING IN MEDICAL RETINA OR MEDICAL OPHTHALMOLOGY INTRODUCTION This post is based in Taunton and Somerset Hospital, Musgrove Park, Taunton with duties at Taunton & Somerset Hospital and may include clinics at Community Hospitals. This is a fixed term post for a Consultant Ophthalmologist at Taunton & Somerset NHS Trust. The post is available through retirement and the successful candidate will join a dynamic retinal team of 3 other consultants, one fellow and three clinical nurse specialists. The latter provide the majority of the intravitreal injections. The post-holder will also join a vibrant consultant team which has recently expanded through the successful recruitment of 4 new excellent colleagues over the last 2 years, and will help to meet the growing demand for ophthalmology services provided within the Eye department. Consistent with national trends in the specialty, the Trust is exploring possible ways of re-configuring the future of the ophthalmic service and virtual clinic review is currently being piloted to meet the growing demand. SCOPE OF THE SERVICE The Department of Ophthalmology based at Taunton & Somerset Hospital, Musgrove Park provides a comprehensive ophthalmology service to the population of North, West and South Somerset, numbering 330,000. Outpatient clinics, and all surgery, are undertaken at Musgrove Park. Peripheral clinics are held at Bridgwater, Minehead, Chard, and Burnham on Sea, and Community Hospitals. THE WORK OF THE OPHTHALMIC DEPARTMENT The Ophthalmic Department has excellent facilities and modern equipment in Taunton. Consulting Rooms x 10 Ophthalmic Seminar Room - YAG and SLT Laser Pre-Op Assessment Unit - New Pattern/Micropulse Yellow Laser IP Ward Beds - Networked Digital Angiography Day Case Ward - 2 Spectral Domain OCTs 2 x Theatres - Corneal Topography Orthoptics & Visual Fields Testing and - HRT 3 optometry Ophthalmic Casualty/Treatment Room 3

4 Access Times The Ophthalmic Department is committed to reducing waiting times for elective patients in line with NHS Plan targets and service agreements with the CCGs. Education Teaching is actively encouraged at all levels in the Division and the Trust. Clinical Audit is well developed in the Trust. It has the largest clinical audit computerised database in the South West, which provides regular data for clinical audit, research and resource management. Trainee logbooks, acceptable to the Royal Colleges, are a special feature of this service. The department has a well-organised and co-ordinated audit programme with up to three departmental audits in place at any one time. Medical Staff The post holder can expect to share junior medical staff on an equitable basis with his/her colleagues and receive support from other senior Non-career grade Medical staff. Beds The post holder will have access to day case and in-patient beds on Blake Ward although beds are not designated for specific consultants. Office The post holder will have access to an office which may be shared at Musgrove Park with computer/internet access. 4

5 Workload of the Department Taunton County Wide: Approx. figures April 2010 March / / /2013 In-Patients Emergency Elective Day Cases 3,359 3,245 2,992 Total FCE s 6,283 6,020 3,667 Outpatient 2,516 2,382 3,892 Procedures Outpatients New 10,748 9,474 8,642 Follow Up 34,284 33,454 30,721 Total 45,032 42,928 39,363 Senior Medical Staff Mr AK Bates Miss JK Barnes Mr RH Gray Mr S Gudsoorkar Mr K Hakin Mr EN Herbert (Clinical Lead) Mrs HM Herbert Miss L Lim Mr JC Park Miss SM Rattigan (CollegeTutor) Mr JD Rossiter Corneal and external eye disease (part time) Paediatric ophthalmology Medical retina (retiring) Medical Retina and Uveitis Oculoplastic and lacrimal disorders Vitreo-retinal surgery and medical retina Oculoplastic Surgery (part time) Glaucoma (part time) Vitreo-retinal surgery and medical retina Paediatric ophthalmology Glaucoma Other Medical Staff (inc Trust doctors) Miss Julie Vodden Dr D Cadman Dr R Samarasinghe Associate Specialist Associate Specialist Associate Specialist Five Registrars on South-West Training rotation Nursing Staff Mrs Jane Kingett Nurse Consultant Mrs Isobel Parry Clinical nurse specialist Retina Mr Brian Kingett Clinical nurse specialist Retina Mrs Deborah Snell Clinical nurse specialist Retina Mrs Gill Hart Outpatient Sister Head & Neck Matron. Registered Nursing Support in Ophthalmic Outpatients, Theatre and on Blake Ward as required. 5

6 Management Mrs Helen Evans Ophthalmology Service Manager Administrative and Clerical Senior secretarial/ PA support will be provided between Consultants with a supporting typing and administration team. Department Facilities In-Patients/Day Case Inpatients are treated alongside ENT and Oral Maxillofacial patients in Blake Ward, which is designated the Head and Neck Ward. Blake Ward is located close to the Head & Neck operating theatres in the Queens Building. This purpose built modern ward has 19 inpatient beds, shared between the Head & Neck Services and a day case area. There are 2 ophthalmic theatres with ceiling mounted Leica microscopes. There are 2 separate, well-equipped examination rooms, with slit lamp, indirect ophthalmoscope, and B scan ultrasound. Children are looked after on the Children s Ward in the Old Building. Outpatient Services Ophthalmic clinics at Musgrove Park are held in a designated area within the main outpatients department in the Duchess building (opened 1995). The accommodation consists of 10 consulting rooms, a dedicated Ophthalmic Accident and Emergency room, orthoptic room, room for YAG/SLT and pattern Argon lasers (including binocular indirect delivery), visual fields testing room, photography and fluorescein (digital angiography) room, corneal topography room, minor procedures room, Optician s room; clean room for intravitreal treatment; OCT room. The following special clinics are currently held: Retinal: Provides comprehensive medical and surgical treatment for conditions such as macular degeneration, diabetic retinopathy, and retinal detachment. We run dedicated one stop AMD treatment; and AMD rapid access clinics with same day angiography. We aim, to set up, with the support of this new post one stop DMO/RVO injection clinics; and virtual imaging clinics for monitoring suitable patients in the community and centrally. Paediatric/Strabismus: Provides comprehensive medical and surgical care for children with eye problems such as strabismus (squint) and amblyopia, and also for adults with strabismus. Glaucoma: Provides specialised medical and surgical treatment, including laser, for patients with all forms of glaucoma. Corneal and external disease: Provides medical and surgical treatment for a wide variety of diseases affecting the conjunctiva and cornea, including corneal transplantation. Oculoplastics: Provides reconstructive eyelid/orbital surgery for a wide variety of diseases affecting the peri-orbital tissues. Rapid Access Casualty 6

7 Peripheral clinics are held at Bridgwater, Minehead, Burnham-on-Sea and Chard, Digital Diabetic Retinopathy Screening A County-wide screening program, conforming to National standards, is well established, with five screener/graders taking photos and carrying out Primary grading in six peripheral hospital locations throughout the County. Secondary grading takes place at Musgrove Hospital and, as above, it is anticipated that the new post will take over the directorship of this program. Nurse-led clinics in Pre-operative Assessment, Shared Glaucoma Care and Minor Lid surgery are held. Orthoptic Department The Orthoptic Service for West Somerset consists of 8 members of staff (5 wte) providing clinical support to a wide range of ophthalmic clinics. Patients with motility problems are assessed by the Orthoptist only and/or in Orthoptist/Optometrist shared care clinics, referrals being made for ophthalmic assessment when necessary using agreed guidelines. Specialist orthoptic clinics include paediatric/motility, diplopia, stroke rehabilitation and learning difficulties. Orthoptists are also involved in the shared care glaucoma clinic; provide visual field testing for all clinics, ophthalmic photography and topography. Secondary visual screening clinics are provided at all locations. Proposals have been put forward to establish a primary screening service for all school entrants in line with the National Screening Recommendations. Pre-operative Assessment Accommodation for pre-operative assessment and biometry (with Zeiss IOL master), run predominantly by the nursing staff, is situated adjacent to the main Eye Clinic. Nurse Practitioners The Department is keen to encourage and develop the role of Nurse Practitioners, who are already involved in Intravitreal injections, the running of glaucoma screening and monitoring clinics and operating clinics for lid cysts and other minor lesions. DIVISION This post is within the Surgical Directorate. Directorate Management Associate medical Director Directorate Manager Alan Dunkley (Consultant Orthopaedic Surgeon) Abbie Furnival 7

8 OTHER CLINICAL FACILITIES Intensive Therapy Unit This is a fully staffed 8-bed ITU, with an additional 6 HDU beds available. Beds are booked for specific major elective cases. Children s Ward The 34-bed (including 2 high dependency beds) ward provides excellent facilities and a high standard of care. It was rebuilt and refurbished in It is located in the Old Building, accessible to the General Theatres. Day Surgery Centre The stand alone Day Surgery Centre is a dedicated 30-trolley space unit including 6 Paediatric spaces. There are 3 theatres, and a surgical treatment room for local anaesthetic cases. The Unit was opened in July 1994 and enables a high turnover of Day Cases. The Centre is not presently used by the Ophthalmology Department. Parkside Parkside, the Trust's own 8-bedded private patient ward is located in the Old Building close to the Children s Ward and is accessible to the General Theatres. It has just been through a refurbishment programme and there are dedicated Private Patient Theatre sessions allocated in the Head and Neck Theatre Suite. Imaging There is a close working relationship with the Department of Diagnostic Imaging mainly located in Duchess Building, but with satellite services in the Old Building (for the Surgical Wards) and Queens Building (for Trauma). There is a nominated Head and Neck Radiologist to support the service. The comprehensive diagnostic imaging service includes Duplex Scanning, Digital Subtraction Angiography, and a new CT and MRI scanner. Ultrasound guided FNA and invasive sialography are provided in Taunton. Pathology This is provided on a countywide basis, with a nominated head and neck pathologist to support the weekly head and neck MDT meetings. In addition, an FNA cytologist lead clinic is available as part of the MDT on a monthly basis. MAIN DUTIES OF THE POST Clinical duties To provide, to a high standard, the full range of specialist diagnosis, treatment and care to patients requiring Ophthalmology services, as outlined in the proposed programme. To organise, manage and be responsible for the diagnosis and treatment of patients in Taunton Hospital in conjunction with the other consultants in the Ophthalmology Department. Specific responsibility for the Somerset Diabetic Eye Screening Program will be attached to this post (2 PA s-funded by the Somerset CCG). Except in emergencies or where otherwise agreed with your manager, you are responsible for fulfilling the duties and responsibilities and undertaking the Programmed Activities set out in your Job Plan, as reviewed from time to time. You are responsible for the associated duties set out in of the Terms and Conditions. The purpose of including agreed personal objectives in your Job Plan is to set out in clear and transparent terms what you and your clinical manager have agreed should reasonably 8

9 be achieved in the year in question. These objectives are not contractually binding in themselves, but you have a duty to make all reasonable efforts to achieve them. You will be required to participate in an on-call rota to provide emergency cover. When not on an on-call rota, we may in exceptional circumstances ask you to return to site for emergencies if we are able to contact you. You are not, however, required to be available for such eventualities. The post will be 1 in 8 on call. Locums are not normally employed to cover the absence of consultants who are away on leave. The number of consultants who are away on leave at any one time will be agreed with the Trust specialty policy. During the absence of colleagues on leave, consultants are expected to provide agreed levels of cover. Educational Supervision Consultants are required to supervise the education of doctors in training. The post holder will be involved with teaching and training junior doctors and should help with both their professional and personal development. Consultants must ensure that junior doctors in their care are not overwhelmed by clinical commitments or overburdened by responsibilities inappropriate to the experience required. Consultants are also responsible for the assessment and appraisal of trainees under their supervision and must keep the Clinical and/or College Tutor aware of problems that may arise. The post holder will contribute to the academic life of the Ophthalmology Department, the Division and the Trust and undertake and promote research initiatives within the Department. Clinical Audit The appointee will be expected to actively participate in audit. He/she will be expected to initiate and supervise audit projects related to his/her particular sub-specialty interest. He/she will liaise with the audit speciality Lead Consultant. All audit projects, including Trust directed audit are approved by the Clinical Effectiveness and Audit Committee. Participation in national audit is encouraged. To contribute to the development and reporting of Clinical Quality Standards. Clinical Governance 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. The appointee to become familiar with local clinical policies, guidelines, and protocols. To participate in the Trust s appraisal and continuing professional development processes for consultants. To participate in the Trust s incident reporting process, particularly in respect of the reporting of clinical incidents. To seek actively patient and user opinion in the development and delivery of patient care Research Undertake any research activities, which are an inherent part of the normal clinical duties. Research is encouraged, particularly when this is appropriate to the professional development of the successful candidate and to the service development of the department. Opportunities are available within the Trust with applications for funding coordinated by the Trust s Associate Medical Director. 9

10 Administration/Budgetary Responsibilities Responsibility for undertaking the administrative duties associated with the care of patients and the administration of the department. Management Arrangements Managerially accountable to: Chief Executive via Divisional Director Professionally accountable to: Medical Director via Clinical Lead and Associate Medical Director. Responsible for the effective and efficient use of resources under his/her control. To contribute to planning the development of Ophthalmology services. Cover For Colleagues and Emergencies To provide cover for colleagues in their absence and to deal with emergencies as the occasion demands. Appraisal, Job Planning and Mandatory Annual Training The successful candidate will be required to participate actively in the annual appraisal and job planning process. In addition they will be expected to attend the mandatory annual update training. PROGRAMME OF WORK You and your clinical manager will have agreed a prospective Job Plan that sets out your main duties and responsibilities, a schedule for carrying out your Programmed Activities, your managerial responsibilities, your accountability arrangements, your objectives and supporting resources. Responsibilities as a Medical Director, Associate Medical Director or Clinical Director may be reflected by substitution for other whole or part Programmed Activities or by additional remuneration agreed locally. Please note that it is likely that the successful applicant may be required to work some programmed activities during evenings and weekends but will have time off in lieu during the working week. This matter will be discussed with the post holder and the Associate Medical Director. This post is a Taunton-based appointment, but may include clinics in the peripheral hospitals. The appointee is expected to review and finalise the programme with Clinical Service Lead and the Associate Medical Director, within 3 months of commencing the post. 10

11 PROGRAMME OF WORK Example timetable for Medical Retina Consultant (NB - This is negotiable with the CSL and other retinal colleagues) 1.5 theatre sessions (on average) for cataract surgery 3 medical retina clinics including 1 laser 2 Sessions for diabetic screening 1 SPA session on site 0.5 session for CD of SDESP * The overall timetable will be based on 8 sessions of Direct Clinical Care and 2 of Supporting Professional Activities (1.5 basic allowance for developing the retinal service). Directorship of SDESP may be dependent on an interview process Example timetable for Medical Ophthalmologist (NB - This is negotiable with the CSL and other retinal colleagues) 3 medical retina clinics 2 sessions for diabetic grading 1 laser clinic 1 SPA session on site 0.5 session for CD of SDESP * The overall timetable will be based on 8 sessions of Direct Clinical Care and 2 of Supporting Professional Activities (1.5 basic allowance for developing the retinal service). It may be possible to include a Uveitis clinic. Directorship of SDESP may be dependent on an interview process 11

12 VISITING ARRANGEMENTS Candidates are welcome to visit the following people prior to short listing: MrJonathanRossiterConsultant Ophthalmology Mr Ed Herbert (Clinical Service Lead) Consultant Ophthalmology Mr Roger Gray Consultant Ophthalmology Mr Alan Dunkley Associate Medical Director and Consultant Orthopaedic Surgeon Surgical Directorate ( ) Mrs Helen Evans Ophthalmology Services Manager ( ) All short listed candidates will be expected to revisit the Division in addition they may also wish to meet the following: Dr Stuart Walker Medical Director via PA Mrs Sam Barrell Chief Executive Officer via PA Mrs Hayley Peters Director of Patient Care via PA

13 PERSON SPECIFICATION Ophthalmology Consultant QUALIFICATIONS & ATTAINMENTS Essential Desirable How Evaluated FRCOphth, or FRCS (Ophth) or equivalent. On Specialist Register of the GMC, or entry within 6 months. At least 12 months fellowship training in medical retina in a recognised programme or Medical ophthalmology CCST Clinical training and breadth of experience equivalent to that required for gaining UK CCST in Ophthalmology or Medical Ophthalmology. Experience of independent CLINICAL Ability to offer expert clinical opinion practice in macular EXPERIENCE on a wide range of problems, both treatment clinics. emergency and elective within the Speciality. Ability to take full and independent responsibility for the clinical care of patients Understanding of clinical risk Defined procedures AF management Experience of Clear, logical thinking showing an clinical risk AF analytical/scientific approach management Ability to mentor staff both medical and nursing CLINICAL SKILLS Ability to offer expert clinical opinion on a wide range of problems both emergency & elective within the Speciality. Ability to take full, independent responsibility for the clinical care of patients. To be able to demonstrate with audited results a high level of attainment in ophthalmic surgery if appropriate. 13

14 KNOWLEDGE ORGANISATION & PLANNING Essential Desirable How Evaluated Appropriate level of clinical Demonstrates AF, IV knowledge Shows knowledge of evidenceinformed practice breadth of awareness of issues Shows awareness of own limitations Ability to prioritise clinical need Understanding of IV, AF NHS, clinical Ability to organise oneself and own governance & work resource constraints; Active involvement in audit mgmt/financial awareness exp of IV, AF Willingness to take a lead in committee work developing/managing a clinical area Ability to organise and manage clinical work and priorities, including outpatient services, surgical waiting lists and operating sessions as appropriate AF,IV, CV Ability to both lead a clinical team and also be a team player Information technology skills Evidence of teaching Enthusiasm for AF, IV teaching Well experienced in post graduate, Exposure to particularly multidisciplinary, teaching different AF, IV TEACHING and training groups/teaching AF, IV SKILLS Ability to act as Consultant trainer at methods Higher qualification AF, IV speciality and pre-specialty levels. in medical education Management experience ACADEMIC/ RESEARCH Willingness to practice evidence based medicine Willingness to contribute to department teaching and training needs Research experience, presentations, publications, prizes and honours Experience in development and implementation of guidelines AF, IV AF, IV 14

15 CAREER PROGRESSION Essential Desirable How Evaluated Demonstrates consistent career AF progression. Ability to apply research outcomes to clinical problems. Evidence of being successful team player Ability to use a non-judgemental approach to patients and colleagues regardless of their sexuality, ethnicity, disability, religious beliefs or financial status PERSONAL SKILLS Ability to be able to change and adapt their work practices to respond to rapidly changing circumstances. Able to operate under pressure; cope with setbacks, self-aware. Able to be well prepared, shows selfdiscipline/ commitment, is punctual and meets deadlines. Able to show enthusiasm, drive (selfstarter, motivated, shows curiosity, initiative) Able to display honesty, integrity, aware of ethical dilemmas, respects confidentiality PHYSICAL REQUIREMENTS Meets professional health requirements 15