Trust Fellow (Equiv. ST5-8) in Paediatric Respiratory Medicine Paediatric Respiratory Medicine

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1 JOB ESCRIPTION Trust Fellow (Equiv. ST5-8) in Paediatric Respiratory Medicine Paediatric Respiratory Medicine GOSH Profile Great Ormond Street Hospital for Children NHS Foundation Trust (GOSH) is a national centre of excellence in the provision of specialist children's health care, currently delivering the widest range of specialist care of any children's hospital in the UK. It is the only specialist Biomedical Research Centre for paediatrics, the largest centre in the UK for children and young people with heart or brain problems, and the largest centre in Europe for children and young people with cancer. It works in partnership with the UCL Great Ormond Street Institute of Child Health (ICH), part of University College London, and together they form the largest paediatric research and teaching centre in the UK. The hospital at Great Ormond Street is the only exclusively specialist children's hospital in the UK. It does not have an Accident and Emergency department and only accepts specialist referrals from other hospitals and community services. The population of children and young people served by the hospital is characterised by those with multiple disabilities and/or health problems and rare and congenital (present at birth) conditions. Many children and young people need the help of different specialist teams. Improvements in health care and diagnosis mean that many children and young people have dramatically improved survival rates and more therapeutic options than was the case 10 years ago. Sadly though, many of the children and young people cared for at GOSH still have life-threatening or life-limiting conditions. The hospital receives over 250,000 patient visits (inpatient admissions or outpatient appointments) a year, and carries our approximately 18,800 operations each year. The hospital has 446 patient beds, including 44 intensive care beds (21 CICU, 15 PICU and 8 NICU). Many of the children and young people on our wards require high dependency care or are classed as ward intensive care, requiring one-to-one nursing. Around 4100 full-time and part-time staff work at the hospital. The ICH has around 600 staff. Many senior staff have roles in both organisations. The hospital has approximately 50 paediatric specialties, the widest range of any hospital in the UK, which uniquely enables it to diagnose and pioneer treatments for children and young people with highly complex, rare or multiple conditions. It has 19 highly specialised national services.

2 Job title ivision Responsible to Accountable to Type of contract Hours per week Location Budgetary responsibility Manages Trust Fellow in Paediatric Respiratory Medicine Charles West ivision Supervising Consultant ivisional irector Fixed Term until September 2018 with option for 12 month extension in this or another related fellow position, depending on performance 40 hours per week plus Out of Hours commitment Great Ormond Street Hospital for Children NHS Foundation Trust N/A N/A Trust Values and Expected Behaviours The Trust has developed the Always Values with our staff, patients and families that characterise all that we do and our behaviours with our patients and families and each other. Our Always Values are that we are: Always Welcoming Always Helpful Always Expert Always One Team These values are extremely important to us and we expect everyone who works at GOSH in any capacity, including employees, bank staff, contractors, agency staff, people who hold honorary contracts, students and volunteers to share and uphold Our Always Values. Each value is underpinned by behavioural standards and employees will be expected to display these behaviours at all times. You can find a full copy of Our Always Values on our intranet. The Trust also expects that everyone who works here shall act in such a manner as to justify public trust and confidence and to uphold and enhance the good standing and reputation of Great Ormond Street for Children NHS Foundation Trust. Individuals must therefore at all times carry out their duties with due regard to the Trust s Equality at Work Policy.

3 Scope of the role This is a post suitable for a doctor who has previous experience in paediatric medicine and is post MRCPCH or equivalent. They may be wishing to pursue a career in respiratory paediatrics or be keen to acquire further experience in the specialty. It is anticipated that the appointee will be functioning at a level of at least ST 5/6 or higher. Key working relationships Internal: Consultants octors Nurses Administrative team Allied Health Professionals Senior Medical Staff: r R Suri r C Wallis r P Aurora r F Abel r E. Chan r H Spencer r K Pike r M Samuels Consultant- whole time Consultant- whole time Consultant- whole time Consultant whole time Consultant whole time Consultant-part time (Transplant) Clinical academic Consultant-part time (Sleep) In addition to the consultants, there is a ward SHO/ST2-3, 2 registrars (1 Respiratory Grid trainee and 1 General Paediatric trainee), 4 Respiratory Fellows: CF; Sleep, Non-invasive ventilation, a Trust Respiratory Fellow. The lung transplant fellow is linked to the respiratory department, but is employed by the department of cardiothoracic transplantation. External: Patients Parents/Carers/Families of patients

4 Main duties and responsibilities Specific Clinical uties ay-time clinical duties The appointee will share responsibilities with the ward registrars and other respiratory trust fellows. uties to be covered include the care of patients on Leopard (respiratory) and Kangaroo (long-term ventilation) Wards. Specific duties will include clerking and follow-on care of children on Leopard Ward as well as outlying wards, attendance and presentation of cases at meetings and ward rounds, involvement in CF and respiratory clinics, managing inpatient admission within the complex asthma service for investigation and administration of biologics, and the clerking of sleep study patients. The respiratory team provides a consult service to the other disciplines within the hospital and these patients need to be seen by the registrars and reviewed by a consultant. The trust fellow will also join the other team members in taking referrals from outside hospitals and dealing with telephone and queries. When the appointee is working on Leopard Ward, they will be responsible for the supervision of the ward SHO/ST2-3. The appointee will quickly acquire skills in the management of Cystic Fibrosis, complex asthma, lung disease in children with complex medical conditions, non-invasive ventilation and abnormalities of sleep. He/she will become proficient in the interpretation of lung function, chest imaging and the interpretation of sleep studies. There will be an opportunity to become familiar with the basics of flexible bronchoscopy. WEEKLY TIMETABLE OF MEETINGS AN CLINICS Type of Work Time Monday am Respiratory Clinic Sleep Meeting 10:00-13:00 13:00-14:00 pm Consultant Ward Round 14:00-17:00 Tuesday am Registrar Teaching Respiratory clinic 08:30-09:30 10:00-13:00 Cystic Fibrosis Team Meeting pm Cystic Fibrosis Clinic 14:00-16:30 Wednesday am epartmental Respiratory Teaching NIV MT clinic Cystic Fibrosis Annual Reviews pm Hospital Grand Round Asthma MT Kangaroo/TCU Ward Round Radiology Meeting Thursday am Consultant Ward Round Cystic Fibrosis Annual Reviews 08:30-09:30 12:00-14:00 13:00-14: :00-15:00 16:15-17:15 10:00-13:00 pm Friday am Respiratory Clinic 10:00-13:00 pm Bronchoscopy List (two Fridays per month) Sleep /Respiratory Clinic 13:00-16:00 After hour duties The appointee will participate in the on-call night rota, including long day, weekend and night duties.

5 Audit and Research The appointee will be expected to participate fully in the departmental audit programme, to aid in development of clinical service guidelines. The appointee will also be expected to be involved in clinical research that is related to service delivery. Teaching The Respiratory Trust octor will participate in the weekly teaching programme of the Respiratory Unit (See Appendix 1). This may include presenting interesting cases or topics at these meetings. Cardio-Respiratory irectorate The hospital has adopted a system of Resource Group irectorates. Respiratory Medicine is a sub division of the Cardio-Respiratory irectorate. The Head of Clinical Services for Respiratory Medicine is r Colin Wallis. There is a General Manager - Anne Layther. There are 2 whole time secretaries to the Respiratory Unit and a Ward Administrative Assistant. irectorate/ivisional Information The Respiratory Unit at Great Ormond Street Hospital The Respiratory Unit at GOSH is one of the largest tertiary referral units for complex paediatric lung disease in the UK. Patients are admitted under an individual consultant but their care is shared by all senior staff while on the unit. There is a large outpatient service with weekly clinics for complex asthma, cystic fibrosis, respiratory sleep disorders and complex lung disease as well as additional multidisciplinary clinics. In-patient services are provided on Leopard Ward. This is a dedicated ward for respiratory patients with an identified area for children with cystic fibrosis. Approximately two hundred inpatients are admitted each year comprising mainly complicated lung disease, complex/complicated lung infections, congenital abnormalities of the upper airway and lungs, cystic fibrosis, asthma and those with disorders of respiratory control and sleep disturbance. There is also a 5-bedded Transitional Care Unit (TCU) [Kangaroo Ward], for children who are on long term ventilation managed by the respiratory team. Sleep studies are performed on the dedicated, 5 bedded staffed sleep unit as well as on Leopard Ward. A large outpatient service caters for a wide range of complex respiratory conditions each week. There is a dedicated cystic fibrosis service with a well-established multi-disciplinary team. There is also an NIV outpatient clinics service. The outpatient department (which includes the weekly CF clinic) is located in the Homeopathic Hospital next to Great Ormond Street Hospital. There is a fully staffed Respiratory Function Laboratory for the hospital housed within a modern lung function laboratory. Facilities exist for all types of respiratory function including basic spirometry, lung volumes, co-transfer, multiple breath washout, exhaled NO and infant lung function tests. The Sleep Unit provides complex polysomnography and undertakes over 1400 sleep studies per year. There is a large noninvasive ventilation service with dedicated NIV nurse specialists. The respiratory unit provides a paediatric bronchoscopy service for the hospital including a dedicated bronchoscopy list twice a month. This job description is intended as an outline of the areas of activity and can be amended in the light of the changing needs of the service and will be reviewed as necessary in conjunction with the post-holder.

6 Other information Please contact the Respiratory Consultants: r Paul Aurora, r Ranjan Suri, r Colin Wallis, r Francois Abel r Katy Pike or r Elaine Chan or the current registrars and fellows working on the ward for further information on this post. Great Ormond Street Hospital for Children NHS Foundation Trust is a dynamic organisation, therefore changes in the core duties and responsibilities of this role may be required from time to time. These guidelines do not constitute a term or condition of employment. Confidentiality On appointment you may be given access to confidential information which must only be disclosed to parties entitled to receive it. Information obtained during the course of employment should not be used for any purpose other than that intended. Unauthorised disclosure of information is a disciplinary offence. Risk Management You will be required to ensure that you implement systems and procedures at a local level to fulfil the requirements of the organisation s Risk Management Strategy including local management and resolution of complaints and concerns, management of SUIs/incidents and near misses. Your specific responsibility for risk management will be clarified to you by your manager at your local induction. Emergency Planning In accordance with the organisations responsibilities under the Civil Contingencies Act 2004, you may be required to undertake alternative duties as is reasonable directed at alternative locations in the event of and for the duration of a significant internal incident, major incident or flu pandemic. Human Rights You are required to comply with the regulations of the Human Rights Act 1998 during the course of your employment. Sustainable evelopment You will be required to demonstrate a personal commitment to the Trust s Sustainable evelopment Plan and to take personal responsibility for carrying-out your work duties in a way which is compliant with this Plan.

7 PERSON SPECIFICATION Essential: E esirable: Our always values Education, training and qualifications E Always welcoming open, positive, polite, prompt, thoughtful E Primary medical qualification - MBBS or equivalent E Always helpful respectful, caring, supportive, patient, flexible E E Always expert role model, vigilant, striving for quality, proactive E MRCP, MRCPCH or equivalent Full GMC registration with Licence to Practice or IELTS Certificate with an overall score of 7.5 E Always one team informative, mindful, appreciative, open, honest E Minimum of 2 years experience at paediatric registrar level 6 months experience in respiratory paediatrics 6 months neonatal intensive care 6 months PICU Higher degree MSc, MPhil related discipline Skills and abilities Knowledge and experience E Excellent written and oral communication skills E Experience of teaching and presenting E Ability to organise and prioritise own workload E Experience of audit activities E Ability to work under pressure in a multi-disciplinary environment E Understanding of principles of clinical governance E Ability to prioritise clinical needs E PALS / APLS E Ability to establish and maintain working relations with patients, carers and multi-disciplinary colleagues E Training in child protection E Familiarity and use of IT skills E Relevant general paediatric practical procedures E Personal involvement in audit project E/ Relevant inpatient and outpatient exposure in the NHS setting Clinical experience in related paediatric specialties Published research in peer reviewed journals Management / leadership experience