Brighton and Sussex University Hospitals NHS Trust Job Description. Specialty Registrar (ST3+)

Transcription

1 Brighton and Sussex University Hospitals NHS Trust Job Description Job Title Banding Department Base Division Specialty Registrar (ST3+) 1a Joint Medical Microbiology & Virology and Infectious Diseases Royal Sussex County Hospital Specialised Services Sussex Coast Training Programme Training programme director Dr Dan Agranoff BSUH Consultants in Microbiology /Infectious Diseases Consultants in Microbiology at other training programme sites in Sussex HPA regional microbiologist programme director Educational supervisors: Microbiology and virology: Dr A Alexander, Dr M Cubbon, Dr M Ibrahim, Dr J. Paul, Dr S. Mepham Infectious diseases: Prof J Cohen, Dr D Agranoff, Dr M Llewelyn, Prof M Newport Chichester: Dr M Greig, Dr S Jerwood; Crawley (and Redhill, Surrey): Dr K Knox, Dr D Lyon, Dr B Stewart; Worthing: Dr J Bates, Dr J Child, Dr J Legg Dr J Paul (Brighton) Dr Dan Agranoff (Consultant in Infectious Diseases, RSCH) Prof. Melanie Newport, Dr Martin Llewelyn, Dr Eli Alexander, Dr Dan Agranoff

2 What we do at BSUH BSUH is the regional teaching hospital working across two sites: the Royal Sussex County Hospital in Brighton and the Princess Royal Hospital in Haywards Heath. The Brighton campus includes the Royal Alexandra Children s Hospital and the Sussex Eye Hospital, and the Haywards Heath campus includes the Hurstwood Park Regional Centre for Neurosciences. We provide general acute services to our local populations in and around the City of Brighton and Hove, Mid Sussex and the western part of East Sussex and more specialised and tertiary services for patients across Sussex and the south east of England. Both hospitals provide many of the same acute services for their local populations. In addition, the Princess Royal is our centre for elective surgery and the Royal Sussex County Hospital is our centre for emergency and critical care. Our specialised and tertiary services include neurosciences, paediatrics, cardiac, cancer, renal, infectious diseases and HIV medicine. We are currently developing our capability as the designated major trauma centre for the region. We treat over half a million patients each year. Working as one hospital across two sites, and playing to the strengths of both, gives the flexibility to develop services which meet the needs of our patients at different stages of their treatment and care. Central to our ambition is our role as developing academic health sciences centre, a provider of high quality teaching, and a host hospital for cutting edge research and innovation; and on this we work with our partner, Brighton and Sussex Medical School (BSMS), the Kent, Surrey and Sussex Postgraduate Deanery and our local Universities. We also work in close partnership with our local GPs and commissioners to ensure that local health services are provided and improved in ways which best meet the needs of our patients and their families. Department Information The Microbiology and Infection Service, BSUH NHS Trust The department is based at the Royal Sussex County Hospital, Brighton and the Princess Royal Hospital, Haywards Heath. The laboratory in Brighton is a former Public Health Laboratory which transferred to the NHS in 2003, although it remains a Health Protection Agency (HPA) collaborating laboratory. There is a service level agreement between the Trust and the HPA. The Food,Water and Environmental (FWE) Microbiology services are now under Trust management. The budget holder is the Head BMS for microbiology and the budget manager is the Pathology Services Manager. The overall budget is 6.7 million; income 1.5 million, pay 2.5 million, non-pay 2.7 million. CPA status is conditional accreditation. The laboratory is accredited under the IBMS as a training laboratory for Bacteriology and Virology. The laboratory participates in a comprehensive range of quality control schemes (UKNEQAS). The department provides routine bacteriology and mycology services to Brighton and Sussex University Hospitals (BSUH) NHS Trust and general practices in the Brighton and Hove PCT and the Mid-Sussex PCT catchment areas. In addition virology and food/water/environmental work is undertaken for East and West Sussex, together with the southern part of Surrey. Virology and serology work is undertaken at the Brighton site. The laboratory serves a population of 460,000. Approximately 35% samples come from general practice. The laboratory provides specialist services for neurosciences, paediatrics, cardiac surgery, cancer, renal and HIV medicine. BSUH provides regional services for molecular virology and serology. Other laboratories served with specialist tests include Maidstone and Tunbridge Wells, Eastbourne and Hastings, Crawley and Redhill, Worthing, Ashford (Kent), Chichester, East Grinstead and Nuffield Hospitals. 2

3 With the future development of managed pathology networks, there may be opportunities to work in other laboratories across Sussex. Current annual workload figures are as follows: Bacteriology 250,000 Virology/Molecular/Serology 160,000 Food/water/environmental 18,000 The laboratory includes a recently commissioned and fully equipped molecular suite. This has allowed the phasing out of tissue culture methods and their replacement by PCR-based tests (e.g. for Herpes simplex) and the introduction of PCR-based tests for other agents such as influenza and cytomegalovirus. A Consultant Virologist has recently been appointed. This is a new post working alongside other clinical members of the service. Equipment includes: Abbott Architect, Diasorin Liaison, Rotagene 3,000, Roche Light-cycler 2.0 and 480, Magnapure Classic and Compact, Abbott M2000 and M2000 RT, BD Viper, Biomerieux BacTalert, BacTalert 3D,Vitek and Menarini Sedimax. Future developments include Abbott HIV protease sequencing, BD Bactec FX, Midgit and Phoenix plus BD Epicentre. The laboratory information management system is Clinisys for Clinical Microbiology and GP Order Comms (Anglia Ice) is being rolled out. There is electronic reporting to wards and general practice. Future links to other Trusts are possible. For food and environmental work we use QSYS LIMS with web-based reporting of results. Kiestra automation is being procured for automation and regionalisation of bacteriology work. The infectious diseases clinical team runs Grant ward, an 11-bedded infectious diseases isolation and cohorting ward and is directly responsible for inpatient care of between 6-12 patients at any one time. In-patient work comprises a mixture of healthcare associated infection, community acquired and imported infection. In addition the infectious diseases team receives an average of 18 consultation requests per month from other teams. The consultant on duty runs a weekly out-patient clinic with the ward specialist registrar. A new Rapid Access Infectious Diseases clinic has recently been set up, and takes place on Wednesday afternoons and in parallel with the routine ID clinic on Friday afternoons. The microbiology and infectious diseases consultants work closely together to provide an integrated Clinical Microbiology and Infection Service, to support teaching of medical students from the Brighton and Sussex Medical School and to support a training programme for joint trainees in Microbiology and Infectious Diseases. We currently have seven trainees rotating through a scheme involving Worthing, Chichester and Surrey and Sussex Hospitals. There are also close links with a busy HIV/GUM service and with the Health Protection Unit based in Lewes including a weekly joint clinical meeting. Consultant medical microbiology staff Dr Marc Cubbon Dr Eliza Alexander Dr Stephen Mepham Lead consultant in Microbiology and infection control doctor Consultant microbiologist and lead for antimicrobial governance Consultant in Microbiology and Infectious Diseases Dr Mohammed Hassan-Ibrahim Consultant virologist Dr Stephen Mepham Dr John Paul Consultant in Microbiology and Infectious Diseases Honorary Consultant Microbiologist 3

4 Consultant infectious diseases staff Prof Jon Cohen Dr Dan Agranoff Dr Martin Llewelyn Honorary consultant in infectious diseases (Dean of BSMS) Consultant in Infectious Diseases and Acute Medicine Honorary consultant in infectious diseases (Senior lecturer) Prof Melanie Newport Honorary consultant in infectious diseases Junior medical staff The department is the hub for the Sussex Training Programme in Microbiology and Infectious Diseases and offers joint Infectious Diseases/Medical Microbiology training with trainees rotating through neighbouring laboratories in Chichester, Worthing and Crawley. The number of posts is as follows: NTNs 7 (4 at BSUH; others at Chichester, Worthing and Crawley) Academic ST1-3 2 Academic F2 0.6 WTE (rotating post) F1 trainee 1 Biomedical Scientific Staff Head of Laboratory Mr Graham Terrey (Head Biomedical scientist, Band 8c) Bacteriology Staffing Chief Biomedical scientist (Band 8a) 4.0 Senior specialist Biomedical scientist 4.7 Specialist Biomedical scientist 14.4 Senior Medical Laboratory Assistant 11.4 Virology Staffing Lead Virology Biomedical scientist (Band 8c) 1.0 Chief Biomedical Scientist (Band 8a) 1.0 Senior specialist Biomedical scientist (Band 7) 2.0 Specialist Biomedical scientist (Band 6) 4.0 Senior Medical Laboratory Assistant (Band 4) 3.0 FWE Lead FWE Biomedical scientist /Deputy Head BMS (Band 8b) 1.0 Senior specialist Biomedical scientist (Band 7) 1.0 Specialist Biomedical scientist (Band 6) 1.0 MTO 1 (Band 5) 2.0 Senior Medical Laboratory assistant (Band 4) 2.0 Office Manager (Band 5) 1.0 Office assistant (Band 4) 0.5 Infectious diseases secretary

5 Infection Control The Director of Infection Prevention and Control is Mr Des Holden who is also a consultant obstetrician and Medical Director. He is supported by Dr Marc Cubbon, consultant microbiologist and infection control doctor, and Yvette Pickford, nurse consultant in infection control. The rest of the infection control team consists of Senior Infection Control Nurses Infection Control Nurses Surveillance and Audit Nurse Personal Assistant 2.0 WTE 2.0 WTE 0.9 WTE 1.8 WTE There are service level agreements to provide support to the infection control teams at several neighbouring non-acute trusts (Southdowns, East Sussex Downs and Weald PCT, Mid Sussex PCT, Brighton and Hove PCT) and there are close links with the local Health Protection Unit in Lewes. There is wider communication with infection control staff and environmental health officers via the East Sussex, Brighton and Hove Community Health Protection Committee. Microbiology and Infectious Diseases: Outline of post. The objective of the post is to produce specialists with adequate training and experience to be awarded a Certificate of Completion of Training (CCT) in Medical Microbiology and Infectious Diseases. This is up to a 5/6-year programme, which will be adjusted flexibly to meet the needs of individuals depending on previous experience and will comply with the Joint Training Programme of the JCHMT. The joint training offered in Medical Microbiology/Infectious Diseases is based in the integrated Microbiology and Infection Service at BSUH. Research opportunities are available. The training will be organised in two parts: 1 Medical Microbiology at BSUH/ rotation to Microbiology services at Chichester or Crawley or Worthing plus experience at HPA sites 2 Infectious Diseases at BSUH/London During the Microbiology training there will be an opportunity to enrol on the 2 year Medical Microbiology MSc course in London (1 day per week) Clinical Service Routine: The trainee is expected to take part in all aspects of the work of the department. A timetable of responsibilities will be drawn up to allow for the training requirements of the appointee. Sufficient time will be allocated for personal study and scientific research. Where necessary, the timetable will allow for training at other sites in order that the appointee is able to fulfil College training requirements. An appropriate timetable of service duties will be drawn up ensuring a balanced exposure to the full range of diagnostic reporting, clinical ward rounds, and Infection Control and 5

6 Management activities. Fixed timetabling is not in line with current work patterns and does not take into account the flexibility required of a reactive speciality. Outline work plan: Monday Tuesday Wednesday Thursday Friday AM 12pm 1pm PM Microbiology Ward/ clinical referrals weekend handover Clinical referrals Consultant ID C. diff. mtng Teaching medical ward round students SpR Teaching Infection Grand Rapid Access ID clinic Clinical referrals radiology round meeting Ward round Clinical infection meeting Consultant ward round Saturday Lab/Clinical 1:5 Sunday Lab/Clinical 1:5 Clinical on-call commitments: ID outpatients clinic Rapid Access ID clinic Once appropriately trained in microbiology, the SpR will be first on call on average 1:5 over the year s appointment. Calls will be received directly from clinicians or BMS staff. The SpR will be expected to work on-site on weekend daytime when on-call. Consultant cover will be provided. The work intensity has been calculated at Band 1A, but will be confirmed by diary card within 6 weeks of commencing the post. Plan: It is expected that the Specialist registrar will sit the FRCPath examination. 1) At least two years will be spent acquiring training in laboratory based infections and health protection (as agreed with the HPA). 2) At least two years of direct patient care on the infectious diseases unit and in related clinical disciplines. 3) There will be opportunities (depending on interest and availability) to spend additional time in research and to explore aspects of clinical microbiology, virology, public health microbiology and infectious diseases in greater depth (see below under elective options) Elective options: Elective rotations may be available by negotiation. Options include: - Infection Prevention and Control Genito-urinary Medicine 6

7 Attachment to an established Infectious Disease/Virology unit abroad. Attachment to an HIV unit in Brighton. Appraisals, Assessments and Examinations. Progress through the programme must follow the appropriate appraisals, assessments and examination organised by the RCP, RCPath and Deanery as agreed with PMETB. An example of combined training in Microbiology & Virology and Infectious Diseases A diagram of possible training programme is given. This content and order may be revised depending on circumstances and discussion. YEAR 1 Microbiology & Virology Bench rotation and modules in microbiology & virology. At Chichester, Crawley, Worthing or BSUH YEAR 2 Clinical Infectious Diseases At BSUH YEAR 3 Microbiology & Virology Consultative and specialist microbiology & virology. At Chichester, Crawley, Worthing or BSUH YEAR 4 Clinical Infectious Diseases At BSUH/London YEAR 5/6 Research and experience at specialist units at BSUH (e.g. clinical HIV) or elsewhere (e.g. Colindale) 7

8 Research The trainee will have opportunities to follow research interests in Brighton or elsewhere. Current departmental research interests in Brighton include involvement in multicentre studies on Staphylococcus aureus and Clostridium difficile. Audit Specialist trainees are required as part of their training to be able to perform audit projects. A list of audit projects is available for specialist trainees or they may elect to look at a subject of their own choice if approved by their educational supervisor. Study leave Standard study leave arrangements are available to the post-holder. Leave is by negotiation with consultant staff. Enrolment with college Specialist trainees are expected to enrol with the RCP at the commencement of joint training. A portfolio and a record of training will be maintained in accordance with the requirements for joint trains as required by the RCPath and RCP. Appraisal/RITAs/PYA/CCT Specialist trainees will have regular appraisals with educational and clinical supervisors plus a yearly ARCP with the training committee in accordance with PMETB guidelines. There will also be a formal penultimate year assessment. A joint RITA will be held in line with the requirement of the Joint Training Programme and the Joint Training Committee of the RCP and RCPath. The timing, composition and arrangements will be relevant to the Trainees experience and consistent with the advice of the Joint Training Committee. The CCT date for individual trainees depends on College approval for experience gained prior to entering this post and satisfactory performance during this training position. Absence of colleagues Duties will involve cover for absence of colleagues on annual and study leave. Brighton: the Trust, Microbiology and Infection Service and the Medical School Brighton and Sussex University Hospitals (BSUH) is the regional teaching hospital and provides general and specialist acute hospital services working as one hospital across two sites: The Princess Royal Hospital (PRH) in Haywards Heath The Royal Sussex County Hospital (RSCH) in Brighton These sites include the Hurstwood Park Neurological Centre, the Royal Alexandra Children s Hospital and the Sussex Eye Hospital. The RSCH and PRH provide many of the same acute services for their local populations. In addition, PRH carries out all the elective work for patients from both Brighton and Hove City and Mid Sussex, whilst RSCH is the emergency hospital for the same population. BSUH also provides specialist services including neurosciences, paediatrics, cardiac surgery, cancer, renal and HIV for patients from across Sussex and more widely. 8

9 We treat over half a million patients each year. Working as one hospital on two sites, and playing to the strengths of both, gives the flexibility to develop services which meet the needs of our patients at different stages of their treatment and care. This post is approved for Higher Specialist Training by the Royal College of Pathologists and the Royal College of Physicians (JCHMT), and the Postgraduate Dean has confirmed that this post has the required educational approval. Both the relevant local STC's have also given their approval for the job description and training programme. Possession of MRCP or equivalent is essential. Our Partner Medical School The school's first 128 students started their five-year course in October 2003 and it has proved an outstanding success, typically receiving more than 15 applications per place and consistently among the most competitive medical schools in the country. Students spend the first two years based mainly at the University campuses at Falmer, but with significant clinical exposure throughout the period, particularly in primary care. During year 3 the main focus is hospital based specialties at the RSCH, while years 4 and 5 are spent obtaining further basic science training and gaining experience in other medical disciplines. Year 5 is mainly based around regional attachments and will provide experience in shadowing house officers. The School aims to teach a research-rich curriculum in which basic and clinical science are prominent. In addition, we have developed an imaginative teaching programme that incorporates new technology (such as the innovative PDA project, MoMED) and the use of imaging alongside anatomy teaching, which has been a particular success. Feedback from the National Student Survey has demonstrated an exceptionally high level of student satisfaction. Close links have been developed with many NHS consultant colleagues and honorary academic titles are conferred for those who have a particular engagement with the School. BSMS is also closely involved with postgraduate education. BSMS has produced a new 5 year strategic plan ( ) that places growing its research capacity as the number one priority. We have made significant investments in research infrastructure, including a world-class Clinical Imaging Sciences Centre (CISC) and a Clinical Investigation & Research Unit (CIRU) dedicated to patient orientated research and early clinical trials. There has been a rapid increase in postgraduate research students and research income has more than doubled over the last five years. The research programme of the School is growing rapidly. It is focused around major themes that include neuroscience, oncology, and infection and inflammation. Within these we have particular strengths in elderly care medicine, primary care and epidemiology and in imaging. There is a joint Research Office that handles NHS R&D contracts and strong links between BSMS research faculty and NHS colleagues. Residency Rented accommodation is sometimes available at the Hospital, details of which can be obtained from the Residences Manager on ext Annual and Study Leave Staff are expected to discuss plans for leave with members of their Department well in advance or any proposed leave. 9

10 General Information EMERGENCIES The post holder accepts that he/she will also perform duties in occasional emergencies and unforeseen circumstances at the request of the appropriate Consultant, in consultation where practicable with his/her colleagues both senior and junior. It has been agreed between the profession and the department that while additional commitments arising under this subsection are exceptional and in particular that juniors should not be required to undertake work of this kind for prolonged periods or on a regular basis. Main Conditions The appointment is subject to the National Terms and Conditions of Service for Hospital Medical and Dental Staff (England and Wales) and to the General Whitley Council of Conditions of Service Medical clearance is required prior to taking up the post; Doctors must hold a licence to practice and be registered with the General Medical Council, and it is advisable to be a member of a Medical Defence Organisation; Useful websites BSUHT - University of Brighton - University of Sussex - BSMS - For further information about the City of Brighton and Hove and surrounding area - Competence The jobholder is required to participate in the Trust appraisal process and work towards meeting identified development needs. The jobholder is required to demonstrate on-going continuous professional development. At no time should the jobholder work outside their defined level of competence. If the post holder has concerns regarding this they should immediately discuss this with their Manager/Supervisor/Consultant. The jobholder has the responsibility to inform those supervising their duties if they are not competent to perform a duty. Registered Health Professional All staff who are members of a professional body must comply with standards of professional practice/conduct. It is the post holder s responsibility to ensure they are both familiar with and adhere to these requirements. Risk Management/Health & Safety The jobholder has a responsibility to themselves and others in relation to managing risk, health and safety and will be required to work within the policies and procedures laid down 10

11 by the Trust. All staff have a responsibility to access occupational health, other staff support services and/or any relevant others in times of need and advice. Infection Control Infection prevention and control is an essential aspect of patient care. All post holders have a personal obligation to act to reduce Healthcare Associated Infections (HCAIs). They must attend mandatory training in infection prevention and control and be compliant with all measures required by the Trust to reduce HCAIs. Post holders must be familiar with the Trust s Infection Control Policies, including those that apply to their duties, such as Hand Decontamination Policy, The Dress Code and Personal Protective Equipment Policy. Post holders who have clinical responsibilities must incorporate into their clinical activities up-todate evidence that supports safe infection control practices and procedures, for example the use of aseptic techniques and the safe disposal of sharps. Safeguarding Children and Vulnerable Adults Post holders have a general responsibility for safeguarding children and vulnerable adults in the course of their daily duties and for ensuring that they are aware of the specific duties relating to their role. Smoking Policy It is the Trust s policy to promote health. Smoking, therefore, is actively discouraged. It is illegal within the Trust s buildings and vehicles. Flexibility Statement This job description is not inflexible but is an outline and account of the main duties. Other duties may be required to be performed from time to time in line with the jobholder s grade, experience and job role. The job description will be reviewed periodically and at the time of the employee s appraisal, to take into account changes and developments in service requirements. Any significant changes that are proposed will be discussed fully and agreed with the post holder in advance. Confidentiality As an employee of this Trust you may gain privileged knowledge of a highly confidential nature relating to private affairs, diagnosis and treatment of patients, information affecting members of the public, personal matters concerning staff, commercial confidences of third parties, and details of items under consideration by this Trust. Such information should not be divulged or passed to any unauthorised person or persons, and the requirements of the Trust s Code of Conduct for Employees in Respect of Confidentiality, a copy of which is available from your Head of Department, must be adhered to with particular regard to the responsibilities of individuals and the Trust under appropriate legislation, notably the Data Protection Act. Failure to comply with this requirement may constitute gross misconduct under the Trust s Disciplinary Policy which may lead to summary dismissal. 11

12 PERSON SPECIFICATION Work Related Essential Desirable Qualifications Basic Medical Science degree Higher Qualifications: MRCP (or equivalent) Experience: Research 2 years of General Professional Training in approved posts Prior experience in clinical microbiology or infectious diseases. Experience in public health would be regarded favourably. Experience in research Teaching Evidence of interest in teaching Legal: GMC registered Skills/Attitudes Ability to work in a team. Good communication skills Well presented application form. Good organisational ability and evidence of leadership skills Career Aims Commitment to a career in Medical Microbiology & Virology and/or Infectious Diseases Commitment to public health or health protection Evidence of career progression Evidence of self motivation in learning Clear views on the reasons for joint training 12