NTN Grid - Programme Information. Neonatal Medicine

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1 NTN Grid - Programme Information Neonatal Medicine Please find below programme information for the above subspecialty for training programmes starting in August/September Page 2 contains a list of all submitted programmes of training; the job descriptions for each post follow on. Applications for the NTN Grid open from 12noon Monday 6 th September; closing at 12noon Monday 4 th October. Applications can only be accessed during this period from the College website. For more information on the grid process and to access the Grid Applicants Guide please visit: For specific subspecialty information, please contact: Prof Ben Shaw ben.shaw@lwh.nhs.uk Tel: For further information which is not answered after consulting the website and Grid Applicant Guide, please contact: Emma Jones ntngrid@rcpch.ac.uk (NTN Grid Administrator) Tel: (020)

2 Maximum Number of National Training Grid Appointments that may be made in 2011 for Neonatal Medicine 33 Deanery Programme of Training Places available Duration (ears) Page East Midlands North, orkshire and the Humber (South) and East Midlands South Joint Rotation East Midlands South, orkshire and the Humber (South) and East Midlands North Joint Rotation Nottingham University Hospitals and Jessop Hospital for Women or Leicester Royal Infirmary Leicester Royal Infirmary and Nottingham University Hospitals or Jessop Hospital for Women Eastern Norfolk and Norwich and Addenbrookes Hospital Eastern Luton and Dunstable and Addenbrookes Hospital London (North) and Eastern North London placement(s) and Addenbrookes Hospital London (North) University College Hospital London, Chelsea & Westminster Hospital, St Marys Hospital, Homerton Hospital, Queen Charlottes Hospital, Royal London Hospital London (South) St Georges Hospital, Kings College Hospital, Guys and St Thomas Hospital, Brighton Hospital Mersey and North Western Joint Rotation Liverpool Women s Hospital, St Mary s Hospital, Manchester and Salford Royal Hospital

3 Deanery Programme of Training Places available Duration (ears) Page North Western and Mersey Joint Rotation St Mary s Hospital, Manchester, Salford Royal Hospital and Liverpool Women s Hospital Northern James Cook University Hospital, Middlesborough and Royal Victoria Infirmary, Newcastle Northern Ireland Royal Maternity Hospital, Belfast Oxford Jon Radcliffe Hospital, Oxford Severn St Michael s Hosptial and Southmead Hospital Wales Department of Child Health, Cardiff, Royal Gwent Hospital, Newport and Singleton Hospital, Swansea Wessex West Midlands West of Scotland Queen Alexandra Hospital, Portsmouth and Princess Anne Hospital, Southampton Birmingham Womens Hospital, North Staffordshire Hospital, University Hospital of Coventry and Warwick, and Heart of England Princess Royal Maternity Unit, orkhill & Southern General Hospitals, West of Scotland Neonatal Transport Service orkshire and the Humber (East/West) Leeds Teaching Hospitals, Bradford Royal Infirmary, Hull Royal Infirmary and EMBRACE, Neonatal Transport

4 East Midlands North, orkshire and the Humber (South) and East Midlands South Hospital / Centre Placement Name Duration (Months) Educational Supervisor Compulsory (C) or Optional (O) Availability Guaranteed (/N) 1 2 Nottingham University Hospitals QMC or NCH Jessop Hospital for Women Sheffield OR NICU 12 NICU 12 3 Leicester Royal Infirmary NICU 12 Dr S Wardle steve.wardle@nuh.nhs.uk Dr P Bustani porus.bustani@sth.nhs.uk Dr J cusack jonathan.cusack@uhl-tr.nhs.uk C C or C Additional Information First ear: Queens Medical Centre or City Campus, NUH, Nottingham, UK AND Second ear: Jessop Hospital for Women, Sheffield, UK or Leicester Royal Infirmary, UK For further information on the Leicester placement please view the East Midlands South programme information on page 7 4

5 Subspecialty: Base Unit: Deaneries involved: Neonatology Nottingham University Hospitals East Midlands Workforce Deanery (North) Outline of Programme The Grid trainee will undertake their higher specialist training at the Queen's Medical Centre (QMC), or Nottingham City Hospital (NCH). Departmental Information - Demographics Nottingham is situated in the East Midlands with excellent transport links to other population centres. The Nottingham Neonatal Service serves over 10,000 births per year and is comprised of two neonatal intensive care units in Nottingham, at QMC and NCH resp.. Each admits around 450 babies p.a. with over 2000 intensive care days. NICU at QMC comprises 20 cots and provides neonatal surgery, including subspecialty work such as ENT and Neurosurgery. The NICU at NCH has 24 cots and is also a neonatal intensive care unit. The two Nottingam NICUs operate as a single service with joint educational meetings and guidelines. The Service also provides the regional tertiary neonatal services for the Trent Perinatal Network. - Team The specialist neonatal team includes nursing staff, ANNPs, dietician, pharmacist, physiotherapists and neonatal surgeons. The Service has 8 consultant neonatologists (Drs Deorukhkar, Dorling, Grant, Jayasinghe, Schoonakker, Smith, Wardle, Wynn-Davies) and 2 Associate Professors (Drs Budge and Sharkey). There are 6 Tier 2 trainees and 7 Tier 1 trainees on each of the NICUs. In addition, two University Lecturers and two other Tier 2 trainees provide out-of-hours support to the NICU Tier 2 rotas. - Supervisor(s) Dr Stephen Wardle and Dr Craig Smith,Consultant Neonatologists Clinical Training Responsibilities A broad range of medical and surgical neonatal patients will be managed. Supervised training in all aspects of the curriculum will be provided including neurodevelopment follow up, cerebral ultrasound and ECHO scanning, advanced ventilation, advanced renal support and communication in critical situations. Opportunities are available for specialised experience in Fetal Medicine and in the Regional Neonatal Transport Service Workload / Rota Arrangements / Example Timetable The post-holder will contribute to a full shift system on an eight week rota which includes night and weekend duties, day time on-service, daytime duties for neonatal transport (1 in 16) and educational time Non Clinical Training Responsibilities (expectations of research / audit / teaching) The trainee will undertake audit and multidisciplinary projects on the NICUs. They will be involved in the preparation of the Service's annual report and be trained in its use of routine data.the trainee will contribute towards the writing of practice guidelines and their implementation. They will have the opportinuity to undertake further training in teaching and participate in the teaching of junior medical staff and undergraduate medical students of the University of Nottingham Medical School. The Nottingham Neonatal Service and Academic Child Health (located in the University Department at Queen's Medical Centre) have excellent reputations in many aspects of research. The GRID trainee will have the opportunity to participate in this thriving academic environment and will also partipicate in the appropriate consent of newborn infants into clinical trials. Further training opportunities There is an active programme of multidisciplinary teaching in Nottingham and a programme with protected training days 6 times a year for all Neonatal Grid Trainees in Trent. As CCT approaches, the postholder will be expected to undertake periods of supervised work in a Consultant role. Any further information Further information is available from steve.wardle@nuh.nhs.uk Contact details for unit Dr Steve Wardle, Lead Neonatologist, steve.wardle@nuh.nhs.uk or Ext Curriculum Each subspecialty grid programme covers the RCPCH curriculum as specified on the RCPCH website: 5

6 Higher specialist trainee (NTN Grid) in Neonatal Medicine Jessop Wing, Sheffield Teaching Hospitals NHS Trust, Sheffield This is a 2 year training program, approved by the neonatal CSAC. The candidate will be based in Sheffield but will be expected to spend 12 months in one of the other two centres who participate in the regional rotation Nottingham and Leicester. Other hospitals contributing to Neonatal training rotations in Trent: Nottingham City Hospital, Queen s Medical Centre Nottingham, Leicester Royal Infirmary The Sheffield Neonatal Service The Sheffield Neonatal Service is based in the Jessop Wing of the Royal Hallamshire Hospital, which also houses the obstetric services. The neonatal unit is newly built having been completed in February Funded cot numbers are currently 12 intensive care, 8 high dependency, 18 special care and 6 transitional care with a further 6 intensive care cots scheduled to open by early There are approximately 700 admissions per year and nearly 2500 ventilator days. All currently available modes of ventilation are utilised. Neonatal surgery for the area is performed at the nearby Sheffield Children s Hospital Neonatal Surgical Unit. Many of the more immature surgical babies are cared for on the Jessop Unit. The neonatal unit has a dedicated 0.6T MRI machine. The Neonatal Consultants are Dr Alan Gibson (Director of Neonatal Services), and Drs Porus Bustani, Simon Clark, Vincent Kirkbride, Robert Coombs, Kirsteen Mackay, Helen Dyson and Elizabeth Pilling. The post holder will take part in the neonatal unit cover, which is provided by a shift system involving two grid trainees and 12 SpRs all of whom are based on the neonatal unit. The working rota is flexible and is modified to enable individuals to maximise the opportunities necessary for their own individual development. Higher specialist trainees will be expected to take part in the clinical duties of the unit and additional opportunities exist for clinics and attachments in high-risk fetal medicine, neonatal transport, infant and child development, genetics, metabolic disease, chronic lung disease, neonatal surgery and other particular interests when appropriate. In the later part of training the trainee will be expected to become more involved in managerial issues attending consultant meetings, neonatal executive meetings and neonatal network clinical and steering group meetings. Prior to CCT the trainee will be expected to do periods of cover in acting consultant capacity. The neonatal unit has a very active training program that the post-holder will be expected to participate in and become involved in the organisation of. The trainee will be expected to sign an educational agreement and maintain a personal portfolio. A large number of training courses are run and involvement in these will be expected. Interest in developing new courses is encouraged. Sheffield is an NLS training centre. The postholder will be expected to have this qualification or to obtain it as soon as possible after taking up post. The postholder will be expected to take part in the unit audit program and assist in the successful completion of at least one audit. There are three ward rounds on the neonatal unit each day and the post-holder will be expected to participate in these. With increasing seniority the post-holder will be expected to run some of these rounds, initially under close supervision and later with increasing responsibility. Research projects are currently being conducted in the unit and involvement in on-going research is welcome as are initiatives for new lines of research. The post-holder will be expected to contribute to the annual report of neonatal activity There are office facilities shared between the Neonatal SpRs. Computer terminals with , internet and library access are available Contact for further details:- Dr Alan Gibson, Director of Neonatology, ; Alan.Gibson@sth.nhs.uk Dr Porus Bustani, Consultant Neonatologist, Neonatal Grid co-ordinator ; Porus.Bustani@sth.nhs.uk 6

7 East Midlands South, orkshire and the Humber (South) and East Midlands North Hospital / Centre Placement Name Duration (Months) Educational Supervisor Compulsory (C) or Optional (O) Availability Guaranteed (/N) 1 University Hosptals of Leicester 2 Glenfield Hospital 3 4 Nottingham University Hospitals Jessop Hospital for Women, Sheffield Additional Information Neonatal Grid trainee Registrar in Paediatric intensive care and ECMO Neonatal Grid trainee Neonatal Grid trainee 12 Jonathan Cusack Jonathan.cusack@uhl.tr.nhs.uk 12 Peter Barry. Pwb1@le.ac.uk O Dr Judith Grant. Judith.grant@nuh.nhs.uk Dr Alan Gibson, Alan.Gibson@sth.nhs.uk C C or C The Neonatal Grid posts in Trent are 2-3 year rotational posts rotating between Leicester, Nottingham and Sheffield. Rotations are tailored to the individual trainees needs, but generally speaking trainees should expect to spend at least 12 months in each of two out of the three centres. Leicester will act as the Lead centre for this post. The trainee will commence with 12 months in Leicester and then rotate to either Nottingham or Sheffield First twelve months in Leicester; second 12 months in EITHER Nottingham or Sheffield. May then do a second 12 months in Leicester For further information on the Leicester placement please view the East Midlands South programme information on page 6 For further information on the Nottingham and Sheffield placements please view the East Midlands North programme information on page 4 7

8 Subspecialty: Base Unit: Deaneries involved: Neonatal medicine Leicester Royal Infirmary, Leicester. EMS, EMN,orkshire Outline of Programme This is a 2-3 year training program. The training is coordinated within Trent between Nottingham, Leicester and Sheffield. The three centres offer a combined training program incorporating rotation between two out of the three centres for each trainee. The Post-holder will train for one year in Leicester before gaining experience in a second centre. If a third year is required this may be undertaken in any one of the three units, subject to availability. Other hospitals contributing to the rotation include: Leicester General Hospital (LGH), City Hospital, Nottingham (CHN), University Hospital, Nottingham (UHN), Jessop Hospital for Women, Sheffield. At present within Leicester, neonatal services are spread across two sites (Leicester Royal Infirmary and Leicester General Hospital). The Neonatal Service is run as a combined service, with close links between both sites. The Leicester Royal Infirmary is accredited for subspecialty training in Neonates. Neonatal cardiac services are part of the Paediatric Cardiac directorate on a third site (Glenfield), which also incorporates the ECMO service. Departmental Information - Demographics The Neonatal unit consists of 26 cots; 9-10 intensive care, 8-10 high dependency and 6-8 special care. There are approximately 6000 deliveries per year within the LRI, which also provides a high-risk Fetal Assessment Unit. The Neonatal unit has admissions per year, of which around 100 are ventilated preterm infants. The LRI is the designated Perinatal centre for the Central Newborn Neonatal Network and is a sub-regional referral centre for Neonatal surgery, with a catchment area of 2.5 million people (excluding Cardiac and Neurosurgery). The full range of Neonatal intensive care modalities is provided for. - Team Eight Consultant neonatologists - Supervisor(s) Dr Jonathan Cusack, Consultant neonatologist, Clinical Training Responsibilities Tailored to individual training needs Workload / Rota Arrangements / Example Timetable 1:7 EWTD compliant full shift rota. Details from Dr Cusack, consultant neonatologist (see below) Non Clinical Training Responsibilities (expectations of research / audit / teaching) Research opportunities exist on the unit (as well as a formal attachment to the University). Registrars undertake one audit per year, and contribute to medical student, nursing and junior doctor teaching Further training opportunities Within Leicester the following Elective years may be available: months in Neonatal Epidemiology, attached to the University of Leicester months as ECMO Fellow at Glenfield. 3. Further 12 months clinical Neonatal training months clinical experience abroad. This would have to be done at an individual level, but a number of consultants in Leicester have worked abroad and would be happy to advise. Contact details for unit Dr Jonathan Cusack, Consultant neonatologist, ; Jonathan Cusack@uhl-tr.nhs.uk. Curriculum Each subspecialty grid programme covers the RCPCH curriculum as specified on the RCPCH website: 8

9 Eastern Deanery (Norfolk and Norwich and Addenbrookes) Hospital / Centre Placement Name Duration (Months) Educational Supervisor Compulsory (C) or Optional (O) Availability Guaranteed (/N) 1 Norfolk and Norwich Neonatal Grid 12 2 Addenbrookes Hospital, Cambroidge (may include 6-12 months ANTS) Neonatal Grid 12 Rahul Roy rahul.roy@nnuh.nhs.uk Amanda Ogilvy-Stuart amanda.ogilvystuart@addenbrookes.nhs.uk O O Additional Information 1 x NORFOLK AND NORWICH + CAMBRIDGE rotation One tailored rotation starting in Norfolk and Norwich in Sept 2011 for one year. The trainee will rotate to Addenbrookes Hospital, Cambridge for one year. There will be the opportunity for neonatal transport training in ANTS during the Cambridge placement. Trainees with more than 24 months training time before CCT at appointment to the start of their National Grid training in September 201, will be placed in either Norwich or Cambridge for the additional training time by the TPD and clinical leads in accordance with individual training needs, personal preferences and availability of posts. Trainees who express an interest in training to become a neonatal transport consultant would be able to spend 12 months training in neonatal transport. 9

10 Subspecialty: Base Unit: Deaneries involved: Neonatal Medicine Norfolk & Norwich NHS Foundation Trust Eastern Departmental Information - Demographics - The neonatal unit in Norwich is the second largest in the Norfolk, Suffolk, cambridgeshire and Essex(NSCE) network serving the 4 counties of Norfolk, Suffolk, Cambridgeshire and Essex and undertakes a wide range of neonatal intensive care, including neonatal surgery. The unit currently has 33 cots, 6 Intensive Care(IC), 5 High Dependency(HD), 17 Special Care(SC), 5 Transitional Care(TC). A business case for further expansion by September 2011 of 3 IC and 1 HD cots has been approved.there are over 800 admissions per year to the NICU which provides 3,500 days of IC/HD care and 5000 days of SC. Ventilation days provided per year is about 900 and CPAP days per year over The neonatal unit is adjacent to the labor ward and obstetric theatre. All modes of standard conventional ventilation are available including high frequency oscillation; facilities for treatment with nitric oxide are available. Norwich has a high use of nasal CPAP using Infant Flow Driver Advance, Viasys infant flow, SIPAP and Vapotherm (offering high flow nasal cannula support to selected babies).norwich was the first centre in the region to provide cooling and cerebral function monitoring for hypoxic ischemic encephalopathy.neonatal surgery is carried out in a dedicated children s operating theatre within the Trust s main theatre complex.the neonatal service has direct input from the local neonatal surgical team, paediatric gastroenterology, endocrinology, microbiology and paediatric dietician, with a weekly joint ward round on NICU. Paediatric radiologist visits the unit twice weekly to perform cranial ultrasound and there is a weekly joint radiology meeting. Paediatric ophthalmology, dietetics, and pharmacy services are locally available. In addition to the neonatal follow up clinics there are specialist clinics in cardiology, neurodevelopment and genetics.the unit has input from other specialists within the hospital with paediatric interests including orthopaedics, ENT, plastic surgery, pathology, dermatology and electrophysiology.a 24/7 neonatal transport is provided by the ANTS team based at Addenbrooke s Hospital, Cambridge for the NSCE network. - Team 5 full time neonatal consultants with commitment to the neonatal unit (Tier 3), 8 persons at Tier 2 (4 trainees, 4 ANNPs/Clinical fellows), 6 persons at Tier 1. There is a dedicated 24/7, 3-tier cover at a single site with no cross cover with general paediatrics. 4 neonatal and paediatric surgeons. - Supervisor(s) The neonatal grid trainee will be supported by all 5 neonatologists but Dr Rahul Roy will have a specific mentoring and educational supervisor role Clinical Training Responsibilities - Management of medical and surgical problems in the newborns under consultant supervision - To develop advance clinical knowledge, practical skills and to enhance competence in advanced resuscitation skills. - Develop skills in neonatal follow up and obtain knowledge and experience in neurodevelopmental follow up. - Supervision of SHOs in management of acutely ill and postnatal ward neonates. - Develop skills in antenatal counselling and to improve understanding in fetal medicine. - Attending and participating in the daily neonatal consultant ward rounds and weekly surgical and gastronutrition multidisciplinary grand round with paediatric gastroenterologists, neonatal srgeons, dietician and pharmacist. Workload / Rota Arrangements / Example Timetable Full shift EWTD compliant rota with middle grade staff- Band 1A This timetable lists the available options for commitments and training opportunities. A training programme will be agreed between the trainee and local education supervisor to meet individual requirements. 10

11 ACTIVIT Daily Consultant-led intensive care and high dependency ward round ( except Wednesday). Registrar or ANNP-led SCBU ward round (except Thursday) Monday Journal club/audit (joint with Paediatrics) Tuesday NICU nutritional ward round Wednesday Neonatal grand round with consultants(weekly) Registrar or ANNP lead NICU ward round Neonatal teaching, consultant-led (weekly) NICU communication meeting(weekly) NICU Guideline/Audit/clinical management meeting Thursday SCBU consultant-led ward round with Paediatric dietician Fetal Medicine Videoconference (monthly) Friday Neonatal Surgical grand round X-ray meeting Other regular meetings attended by neonatal Consultants Clinical Governance meetings Clinics Paediatric Directorate governance (bimonthly) and clinical management (monthly) meeting. O & G Risk management meeting (bimonthly) Monthly Labour ward forum Perinatal mortality and morbidity meeting (3 rd Friday, monthly) Consultant lead neonatal clinic, Tuesdays and Fridays(weekly) Paediatric Cardiology Clinic, Tuesday(monthly) Non Clinical Training Responsibilities (expectations of research / audit / teaching) - Organisation of monthly perinatal and morbidity meetings - Opportunities to take lead in initiation and implementation of appropriate guidelines - Involvement in neonatal audits, survey and research projects. - Oversight of the programme for weekly neonatal teaching and journal club Further training opportunities - Attendance at MDT meeting with obstetrics and paediatrics - To act as a representative for the junior doctors in the monthly neonatal unit clinical management meetings. - Develop advanced skills such as neonatal echocardiography under direct consultant supervision. Contact details for unit Dr Rahul Roy( Consultant Neonatologist) Norfolk & Norwich NHS Trust Colney Lane, Norwich, NR4 7U Tel: , Ext 3171, rahul.roy@nnuh.nhs.uk Curriculum Each subspecialty grid programme covers the RCPCH curriculum as specified on the RCPCH website: 11

12 Subspecialty: Base Unit: Deaneries involved: Neonatology Rosie Hospital, Cambridge University Hospitals NHS Trust Eastern Outline of Programme A comprehensive range of neonatal medical and surgical intensive care services are provided in Cambridge, with only cardiac surgery undertaken elsewhere. On-site services include high frequency oscillation, inhaled nitric oxide therapy, neonatal cardiology, neonatal general and urological surgery, neonatal neurosurgery, ophthalmology, and plastic/reconstructive surgery. In additional to neonatal follow-up clinics there are specialist clinics in neurodevelopment, cardiology and nephrology. The transport service for the East of England (ANTS) is based in Cambridge and is independent of NICU in terms of rotas and management. Over 350 acute transfers are performed annually by medical staff or nurse practitioners. The two medical posts in ANTs have been recognised for neonatal training. The department has strong links with obstetrics and is working toward the development of a formal Perinatal Service for both local and regional residents. This close working relationship with multidisciplinary ward rounds and meetings provide excellent training opportunities with fetal medicine colleagues. There is consultant neonatologist on-call at all times with duties exclusively to the neonatal service. There are daily consultant ward-rounds throughout the week and at week-ends. Trainees will have the opportunity to lead ward rounds across the service. There is active neonatal research programme with interests in endocrinology and metabolism, cardiology, neurology, follow-up and ventilation. Good links exist with the academic departments of Paediatrics and Obstetrics. Trainees will gain experience in clinical governance programme with experience in audit and patient safety. There is a full educational programme, including fetal medicine, perinatal mortality and morbidity, radiology, genetics, skills drills and protected SpR teaching. Departmental Information - Demographics The neonatal unit in Cambridge is situated in the Rosie Hospital, on the Addenbrooke s Hospital campus. There are over 5000 deliveries per year. The unit currently has 17 ICU / HDU cots in the NICU, 4 HDU and 11 special care cots on SCBU. The unit acts as a tertiary referral centre for Eastern England as well as taking referrals from outside this area. There over 600 admissions per year to the service providing over 4,000 days of ITU/HDU care and 2,600 days of special care. - Team There are 12 consultant neonatologists (8 WTE) in post providing a 1:7 service consultant rota. There are 12 middle grade (9 SpRs and 3 Fellows) working a compliant full shift. - Supervisor(s) The sub-specialist trainee will be closely supported by all 12neonatologists but in addition one consultant will have a specific mentoring and educational supervision role. Clinical Training Responsibilities The training programme is modular in design and together with the components in the other hospital in the GRID rotation is sufficiently flexible so that the individual training needs of the sub-specialist trainee can be met. Modules, which range from 3-6 months, include general intensive care, neonatal and infant cardiology, perinatal pathology, neonatal surgery, genetics, fetal medicine, neurodevelopment neonatal neurology and specialist support service such as ophthalmology, audiology and orthopaedics as well as dedicated management training. Dedicated time to allow for attendance at specialist training and development courses will also be identified to meet the needs of the individual trainee. There is ample opportunity to acquire and consolidate all of the technical skills required for the specified competencies and the formal SpR seminar and lecture programme is designed to cover theoretical and managerial aspects of the HST syllabus. Specific training in neonatal transport will be available depending on the needs of the individual trainee. Details of the weekly educational and training meetings, clinical and management meetings as well as the full training prospectus are available. The duration of attachments to the transport service can be tailored to suit the training needs. Workload / Rota Arrangements / Example Timetable Participation is required in a full shift band 1A rota which is fully compliant with the New Deal and EWTD. The successful trainee will be expected to take a full part in the clinical activities of the service Non Clinical Training Responsibilities (expectations of research / audit / teaching) The successful trainee will also be expected to take a full part in the educational, research and audit activities of the service. 12

13 Further training opportunities Protected time will be available to meet individually agreed training targets, progress against which will be regularly reviewed with the trainee Contact details for unit Applicants requiring further information should contact Dr Amanda Ogilvy-Stuart, Neonatal Unit, Rosie Hospital, Cambridge University Hospitals NHS Trust, Cambridge, CB2 2SW. Telephone: ; fax: ; Curriculum Each subspecialty grid programme covers the RCPCH curriculum as specified on the RCPCH website: 13

14 Subspecialty: Base Unit: Deaneries involved: Neonatal Transport Acute Neonatal Transfer Service (ANTS) for the East of England (EoE), based in Cambridge East of England (plus London for sub-speciality neonatal transport trainees) Outline of Programme Neonatal transport post with one of busiest teams in country. 6 month posts offered in the first instance. For trainees with a sub-speciality interest in transport medicine longer posts will be offered and rotation with NTS for London may be possible Departmental Information - Demographics ANTS is the 24.7 dedicated neonatal transfer service for all 18 EoE hospitals. Performs approx 100 transfers/month: 60% emergency, 40% elective. - Team The team is based at Addenbrooke s Hospital in Cambridge and comprises 1.5 WTE Neonatal Transport Consultants, 4 transport StRs / Clinical Fellows (all posts solely for transport and accredited for training), 2 ANNPs, 8 WTE experienced transport nurses plus management & administration staff including the associated emergency bed finding service (EBS) for EoE. We have our own ANTS dedicated drivers and vehicles - Supervisor(s) Dr Kate Farrer is the Lead Clinician for ANTS and you will not only be closely supported and mentored by the ANTS Consultants but there will be additional mentoring and supervision from the Addenbrooke's Neonatologists. Clinical Training Responsibilities The post offers an exceptional opportunity for comprehensive experience in all aspects of neonatal transport medicine. Trainees take the medical lead for transfers under close consultant supervision. The role involves taking the transfer calls, providing advice on initial stabilisation, leading the team to the referring hospital, stabilising the baby for transfer and transferring the infant to the receiving unit. Training received includes the competencies for transferring sick medical and surgical newborns and the associated complex and sensitive communication issues including those with the family and local hospitals. In addition, training will be given in single clinician competencies for elective transfers. Trainees are involved in the governance and risk aspects of the service and ANTS related audits projects. ANTS has state of the art, new and dedicated equipment including 3 purpose built neonatal ambulances and incubators plus up-to-date techniques and services including inhaled nitric oxide, end tidal CO2 monitoring and delivery of Therapeutic Hypothermia during transfer. Workload / Rota Arrangements / Example Timetable Duties involve both day and night emergency shifts. Additional daytime shifts provide extra clinical cover and allow time for audit, study leave and training. The hours of duty are Band 1A compliant. Non Clinical Training Responsibilities (expectations of research / audit / teaching) This post offers unique insight and exposure to non-clinical strategic and logistic neonatal competencies. In addition you will be encouraged to participate in the active ANTS audit programme and supported in presenting and publishing this work. There is also opportunity to be involved with delivering the 4 annual ANTS study days Further training opportunities There is ample opportunity to acquire and consolidate all of the skills required for the specified competencies for neonatal transport. The ANTS department works closely with the NICU team in Cambridge and ANTS trainees are encouraged to attend the teaching and training opportunities with NICU including the weekly fetal medicine, perinatal, surgical, radiology, genetics, skills drills and protected StR teaching. Grid trainees will also be encouraged to attend specialist Grid training. Contact details for unit Dr Kate Farrer, Lead Neonatologist, ANTS for EoE, Box 224, Addenbrooke's Hospital, Cambridge. CB2 0QQ Curriculum Each subspecialty grid programme covers the RCPCH curriculum as specified on the RCPCH website: 14

15 Eastern Deanery (Luton and Dunstable) Hospital / Centre Placement Name Duration (Months) Educational Supervisor Compulsory (C) or Optional (O) Availability Guaranteed (/N) 1 Luton and Dunstable Neonatal Grid 12 2 Addenbrookes Hospital, Cambroidge (may include 6-12 months ANTS) Neonatal Grid 12 Rahul Roy rahul.roy@nnuh.nhs.uk Amanda Ogilvy-Stuart amanda.ogilvystuart@addenbrookes.nhs.uk O O Additional Information 1 x LUTON + DUNSTABLE + CAMBRIDGE rotation One tailored rotation starting in Luton and Dunstable in Sept 2011 for one year. The trainee will rotate to Addenbrookes Hospital, Cambridge for one year. There will be the opportunity for neonatal transport training in ANTS during the Cambridge placement. Trainees with more than 24 months training time before CCT at appointment to the start of their National Grid training in September 2011, will be placed in either Luton or Cambridge for the additional training time by the TPD and clinical leads in accordance with individual training needs, personal preferences and availability of posts. Trainees who express an interest in training to become a neonatal transport consultant would be able to spend 12 months training in neonatal transport. 15

16 Subspecialty: Base Unit: Deaneries involved: Neonatal Medicine Luton & Dunstable Hospital NHS Foundation Trust Eastern and London Outline of Programme Neonatal medical intensive care is comprehensively provided on site at the Luton and Dunstable hospital. The intensive care services include,inhaled nitric oxide, high frequency oscillation and hypothermia therapy for neonatal encephalopathy. Surgical services are provided off-site (GOSH and Addenbrookes), although the onsite ROP service includes laser treatment provided by the local ophthalmology consultant. Subspeciality neonatal interests include cardiology, metabolic medicine, gastroenterology and neurology. There is a consultant of the week rota for each of the service areas and daily multidisciplinary consultant ward rounds are conducted throughout the week, with a trainee led round once a week on NICU and thrice weekly on the SCBU. A nutrition round involving the nutrition consultant and neonatal dietitian is held once a week. General and specialist neonatal clinics including neurodevelopment, cardiology and metabolics are provided by local neonatologists. The clinical governance structure is robust, with a designated Trust lead for neonatal patient safety and this is included within the training and educational programme. There is a rolling programme of audits which all trainees will take part in and an ongoing research programme which trainees will be given opportunities to be involved with. There is a comprehensive educational programme which includes protected time for trainees and covers fetal medicine, radiology, genetics, ophthalmology, physiotherapy,dietetics, journal club and skills and drills. Pathology within the local population is particularly extensive and complex and provides excellent opportunities for fetal medicine, perinatal mortality/morbidity and genetics education. This is supported by a twice yearly multidisciplinary perinatal pathology meeting with visiting perinatal pathologists and geneticist. Departmental Information - Demographics The Luton & Dunstable Hospital neonatal Unit is the lead tertiary centre for Beds & Herts Perinatal Network. The maternity unit has one of the busiest in the East of England with over 5100 deliveries per year. There are over 800 admissions per year resulting in over 5100 ITU/HDU cot days. The unit has 19 ITU/HDU cots, with 16 special care cots at present. A comprehensive range of neonatal services is provided at the L&D with close links to Great Ormond Street Hospital and Addenbrookes Hospital for surgical and cardiac care. The ethinic diversity and high degree of consanguinity of the local population is reflected in the greater than average number of genetic conditions and inborn errors of metabolism. This is supported by a dedicated paediatric genetics and metabolic clinics. - Team There are 6.75 WTE neonatal consultants, 4 locum acute neonatal consultants who provide resident out of hours cover, 1 associate specialist, 8 middle grade doctors and 8 ST1-3 posts. In addition, there is an AANP and a dedicated neonatal community nursing team based on NICU who provide an outreach service including home oxygen and support for home NGt feeds. - Supervisor(s) The sub-speciality trainee will be supervised by all 7 neonatal consultants and will also have a named consultant providing mentoring and educational supervision. Clinical Training Responsibilities There are daily consultant ward rounds including weekends. Trainees are encouraged to lead ward rounds across the service supervised by the attending consultant. Trainees are expected to contribute to the weekly neonatal nutrition round. There is a weekly supervised neonatal follow up clinic as well as opportunities within the rota to attend outreach specialist clinics including genetics, metabolic, neurodevelopmental and cardiac. There is formalised local echocardiography clinic supported by two consultant neonatologists as well as a telemedicine link with the cardiology team at Great Ormond Street Hospital. Workload / Rota Arrangements / Example Timetable Participation is required in a full shift band 1A rota which is fully compliant with the New Deal and EWTD. Non Clinical Training Responsibilities (expectations of research / audit / teaching) The successful trainee will be expected to take a full part in the clinical, educational, research and audit activities of the service. Trainees have a named supervisor and the Trust Clinical Audit Team to assist them in completing and presenting audit projects. The unit is involved in local and national research projects and trainees are actively 16

17 encouraged to participate in this. There is a comprehensive programme of teaching including part task and scenario based teaching as well as fetal medicine, perinatal morbidity & mortality and radiology. Further training opportunities The L&D is championing patient safety and is one of four hospitals involved in the national Human Factors Project to successfully manage human error. Trainees will gain grounding in improving patient safety methodology. Any further information Trainees are allocated specific management roles and are supported by a named consultant. A named trainee representative is encouraged to contribute to the monthly Paediatric and Obstetric Directorate meetings. In addition there are regular Clinical Management team meetings, clinical governance meetings, Departmental Audit and risk management meetings and Delivery Suite and Transitional Care forums. The neonatal network meetings also provide a forum for analysis of clinical governance issues and trainees are involved in the investigation and management of critical incidents within the network. Contact details for unit Applicants requring further information should contact: Dr Shanthi Shanmugalingam or Dr Sarah Skinner, Neonatal Unit, Luton & Dunstable Hospital, Lewsey Road, Luton LU4 0DZ. Tel ; Fax ; Shanthi.Shanmugalingam@ldh.nhs.uk; Sarah.Skinner@ldh.nhs.uk Curriculum Each subspecialty grid programme covers the RCPCH curriculum as specified on the RCPCH website: 17

18 Subspecialty: Base Unit: Deaneries involved: Neonatology Rosie Hospital, Cambridge University Hospitals NHS Trust Eastern Outline of Programme A comprehensive range of neonatal medical and surgical intensive care services are provided in Cambridge, with only cardiac surgery undertaken elsewhere. On-site services include high frequency oscillation, inhaled nitric oxide therapy, neonatal cardiology, neonatal general and urological surgery, neonatal neurosurgery, ophthalmology, and plastic/reconstructive surgery. In additional to neonatal follow-up clinics there are specialist clinics in neurodevelopment, cardiology and nephrology. The transport service for the East of England (ANTS) is based in Cambridge and is independent of NICU in terms of rotas and management. Over 350 acute transfers are performed annually by medical staff or nurse practitioners. The two medical posts in ANTs have been recognised for neonatal training. The department has strong links with obstetrics and is working toward the development of a formal Perinatal Service for both local and regional residents. This close working relationship with multidisciplinary ward rounds and meetings provide excellent training opportunities with fetal medicine colleagues. There is consultant neonatologist on-call at all times with duties exclusively to the neonatal service. There are daily consultant ward-rounds throughout the week and at week-ends. Trainees will have the opportunity to lead ward rounds across the service. There is active neonatal research programme with interests in endocrinology and metabolism, cardiology, neurology, follow-up and ventilation. Good links exist with the academic departments of Paediatrics and Obstetrics. Trainees will gain experience in clinical governance programme with experience in audit and patient safety. There is a full educational programme, including fetal medicine, perinatal mortality and morbidity, radiology, genetics, skills drills and protected SpR teaching. Departmental Information - Demographics The neonatal unit in Cambridge is situated in the Rosie Hospital, on the Addenbrooke s Hospital campus. There are over 5000 deliveries per year. The unit currently has 17 ICU / HDU cots in the NICU, 4 HDU and 11 special care cots on SCBU. The unit acts as a tertiary referral centre for Eastern England as well as taking referrals from outside this area. There over 600 admissions per year to the service providing over 4,000 days of ITU/HDU care and 2,600 days of special care. - Team There are 12 consultant neonatologists (8 WTE) in post providing a 1:7 service consultant rota. There are 12 middle grade (9 SpRs and 3 Fellows) working a compliant full shift. - Supervisor(s) The sub-specialist trainee will be closely supported by all 12neonatologists but in addition one consultant will have a specific mentoring and educational supervision role. Clinical Training Responsibilities The training programme is modular in design and together with the components in the other hospital in the GRID rotation is sufficiently flexible so that the individual training needs of the sub-specialist trainee can be met. Modules, which range from 3-6 months, include general intensive care, neonatal and infant cardiology, perinatal pathology, neonatal surgery, genetics, fetal medicine, neurodevelopment neonatal neurology and specialist support service such as ophthalmology, audiology and orthopaedics as well as dedicated management training. Dedicated time to allow for attendance at specialist training and development courses will also be identified to meet the needs of the individual trainee. There is ample opportunity to acquire and consolidate all of the technical skills required for the specified competencies and the formal SpR seminar and lecture programme is designed to cover theoretical and managerial aspects of the HST syllabus. Specific training in neonatal transport will be available depending on the needs of the individual trainee. Details of the weekly educational and training meetings, clinical and management meetings as well as the full training prospectus are available. The duration of attachments to the transport service can be tailored to suit the training needs. Workload / Rota Arrangements / Example Timetable Participation is required in a full shift band 1A rota which is fully compliant with the New Deal and EWTD. The successful trainee will be expected to take a full part in the clinical activities of the service Non Clinical Training Responsibilities (expectations of research / audit / teaching) The successful trainee will also be expected to take a full part in the educational, research and audit activities of the service. 18

19 Further training opportunities Protected time will be available to meet individually agreed training targets, progress against which will be regularly reviewed with the trainee Contact details for unit Applicants requiring further information should contact Dr Amanda Ogilvy-Stuart, Neonatal Unit, Rosie Hospital, Cambridge University Hospitals NHS Trust, Cambridge, CB2 2SW. Telephone: ; fax: ; Curriculum Each subspecialty grid programme covers the RCPCH curriculum as specified on the RCPCH website: 19

20 Subspecialty: Base Unit: Deaneries involved: Neonatal Transport Acute Neonatal Transfer Service (ANTS) for the East of England (EoE), based in Cambridge East of England (plus London for sub-speciality neonatal transport trainees) Outline of Programme Neonatal transport post with one of busiest teams in country. 6 month posts offered in the first instance. For trainees with a sub-speciality interest in transport medicine longer posts will be offered and rotation with NTS for London may be possible Departmental Information - Demographics ANTS is the 24.7 dedicated neonatal transfer service for all 18 EoE hospitals. Performs approx 100 transfers/month: 60% emergency, 40% elective. - Team The team is based at Addenbrooke s Hospital in Cambridge and comprises 1.5 WTE Neonatal Transport Consultants, 4 transport StRs / Clinical Fellows (all posts solely for transport and accredited for training), 2 ANNPs, 8 WTE experienced transport nurses plus management & administration staff including the associated emergency bed finding service (EBS) for EoE. We have our own ANTS dedicated drivers and vehicles - Supervisor(s) Dr Kate Farrer is the Lead Clinician for ANTS and you will not only be closely supported and mentored by the ANTS Consultants but there will be additional mentoring and supervision from the Addenbrooke's Neonatologists. Clinical Training Responsibilities The post offers an exceptional opportunity for comprehensive experience in all aspects of neonatal transport medicine. Trainees take the medical lead for transfers under close consultant supervision. The role involves taking the transfer calls, providing advice on initial stabilisation, leading the team to the referring hospital, stabilising the baby for transfer and transferring the infant to the receiving unit. Training received includes the competencies for transferring sick medical and surgical newborns and the associated complex and sensitive communication issues including those with the family and local hospitals. In addition, training will be given in single clinician competencies for elective transfers. Trainees are involved in the governance and risk aspects of the service and ANTS related audits projects. ANTS has state of the art, new and dedicated equipment including 3 purpose built neonatal ambulances and incubators plus up-to-date techniques and services including inhaled nitric oxide, end tidal CO2 monitoring and delivery of Therapeutic Hypothermia during transfer. Workload / Rota Arrangements / Example Timetable Duties involve both day and night emergency shifts. Additional daytime shifts provide extra clinical cover and allow time for audit, study leave and training. The hours of duty are Band 1A compliant. Non Clinical Training Responsibilities (expectations of research / audit / teaching) This post offers unique insight and exposure to non-clinical strategic and logistic neonatal competencies. In addition you will be encouraged to participate in the active ANTS audit programme and supported in presenting and publishing this work. There is also opportunity to be involved with delivering the 4 annual ANTS study days Further training opportunities There is ample opportunity to acquire and consolidate all of the skills required for the specified competencies for neonatal transport. The ANTS department works closely with the NICU team in Cambridge and ANTS trainees are encouraged to attend the teaching and training opportunities with NICU including the weekly fetal medicine, perinatal, surgical, radiology, genetics, skills drills and protected StR teaching. Grid trainees will also be encouraged to attend specialist Grid training. Contact details for unit Dr Kate Farrer, Lead Neonatologist, ANTS for EoE, Box 224, Addenbrooke's Hospital, Cambridge. CB2 0QQ Curriculum Each subspecialty grid programme covers the RCPCH curriculum as specified on the RCPCH website: 20

21 London (North) and Eastern Deanery Hospital / Centre Placement Name Duration (Months) Educational Supervisor Compulsory (C) or Optional (O) Availability Guaranteed (/N) 1 University College Hospital London NEO/UCH2 12 Dr Angela Huertas angela.huertas-ceballos@uclh.nhs.uk O 2 Chelsea & Westminster Hosp NEO/CWR2 12 Dr Enitan Ogundipe enitan.ogundipe@chelwest.nhs.uk O 3 St Marys Hospital NEO/SMH2 12 Dr Sunit Godambe sunit.godambe@st-marys.nhs.uk O 4 Homerton Hospital NEO/HOM3 12 Dr Ravi Prakash ravi.prakash@homerton.nhs.uk O 5 Queen Charlottes Hospital neonates 12 Dr Merran Thomson merran.thomson@imperial.ac.uk O 6 Royal London Hosp NEO/RHT3 12 Dr Anne Opute anne.opute@bartsandthelondon.nhs.uk O 7 Addenbrookes Hospital, Cambridge ( may include ANTS 6-12m) Neonatal Grid 12 Amanda Ogilvy-Stuart amanda.ogilvystuart@addenbrookes.nhs.uk O Additional Information 1 x NORTH LONDON + CAMBRIDGE rotation One tailored rotation starting in North London in Sept The North London placement will be allocated by the London Training Programme Director (Dr Ros Thomas) and lead consultant for training (Dr Jane Hawdon) in accordance with individual training requirements, trainee preferences and ranking at Grid interview of all trainees. The North London placement will be for at least 12 months in one of the following centres - University College Hospital Queen Charlottes Hospital Chelsea & Westminster Hospital St Marys Hospital Homerton Hospital Royal London Hospital Neonatal Transfer Service (NTS) 6mnths based at Royal London Hospital + RLH 6 months The trainee will rotate to Addenbrookes Hospital, Cambridge for at least 12mnths. There will be opportunities for neonatal transport training in NTS at RLH during the London placement and also in ANTS during the Cambridge placement. Trainees who express an interest in training to become a neonatal transport consultant and who would benefit from 12 months training in neonatal transport, may apply for 6 months placement with NTS in London + 6 months with ANTS in Cambridge. Trainees with more than 24 months training time before CCT at appointment to the start of their National Grid training in September 2011, will be placed for the additional training time by the London and Cambridge TPDs and clinical leads in accordance with individual training needs, personal preferences and availability of posts. For job descriptions please see the Eastern and London (North) programme information. 21

22 London (North) Hospital / Centre Placement Name Duration (Months) Educational Supervisor Compulsory (C) or Optional (O) Availability Guaranteed (/N) 1 2 University College Hospital London Chelsea & Westminster Hospital NEO/UCH2 12 NEO/CWR St Marys Hospital NEO/SMH Homerton Hospital NEO/HOM Queen Charlottes Hospital neonates 12 6 Royal London Hospital NEO/RHT3 12 Dr Angela Huertas angela.huertas-ceballos@uclh.nhs.uk Dr Enitan Ogundipe enitan.ogundipe@chelwest.nhs.uk Dr Sunit Godambe sunit.godambe@st-marys.nhs.uk Dr Ravi Prakash ravi.prakash@homerton.nhs.uk Dr Merran Thomson merran.thomson@imperial.ac.uk Dr Anne Opute anne.opute@bartsandthelondon.nhs.uk O O O O O O Additional Information 5 x NORTH LONDON programmes STARTING AT THE FOLLOWING Trusts University College Hospital Royal London Hospital Chelsea & Westminster Hospital St Marys Hospital Homerton Hospital Rotations will be tailored for successful applicants by the London Training Programme Director (Dr Ros Thomas) and lead consultant for training (Dr Jane Hawdon) in accordance with individual training requirements, trainee preferences and ranking at Grid interview. The neonatal medicine CSAC recommends that trainees should not usually be placed for more than 12 months in the same hospital. Trainees will therefore be placed for no more than 12 months in several of the following hospitals, depending on training time left before CCT and previous training placements - University College Hospital Queen Charlottes Hospital Chelsea & Westminster Hospital St Marys Hospital Homerton Hospital Royal London Hospital 22

23 JOB DESCRIPTION FOR THE POST OF SPR IN NEONATAL PAEDIATRICS NATIONAL GRID 2011 Neonatal Services NNU Medical Secretaries 2 nd Floor, North Wing 250 Euston Road London NW1 2PG Tel ext th July 2010 The Neonatal Unit The Elizabeth Garret Anderson new wing is one of eight hospitals of University College London Hospitals (UCLH) NHS Foundation Trust and houses Women s services including the Neonatal Unit. The Trust is closely associated with University College London (UCL), a multi-faculty university. The new Neonatal Unit comprises 17 intensive care and high dependency cots, including 3 neuro-cots, and 13 special care cots. Transitional care is provided in postnatal wards by neonatal nurses. The Unit is the designated perinatal centre for the North Central London Perinatal Network, working on close partnership with Great Ormond Street Hospital for specialist care, and admits about 400 infants each year. The fetal medicine unit provides exposure to clinics and ante-natal counselling, and to train in the pre and post surgical aspects of management of the surgical neonate. In addition to clinics for routine follow up, there is a long term follow up clinic which monitors the health of the very low birth weight survivors, a chronic lung disease clinic, and an infant feeding clinic. Medical/Advanced Neonatal Nurse Practitioners Staff Establishment Consultants: 8 WTE, ST 5-8 and Middle grades: 9, Research fellows: 2, STA 2-3 and trust doctors: 10, ANNPs: 6 Working arrangements - Registrars work in a full shift rota that completes a cycle every 9 weeks and includes Intensive care, special care, transitional care, clinics, administration, night shifts, time off and annual leave. There are working rounds for both intensive and special care patients every day and in addition there are two consultant teaching rounds each week. Within the rota there is time that is set aside for attending clinics, administration, and audit. - With the introduction of medical audit you may be required to enter relevant data on to computers and to abide by the rules and regulations of the Data Protection Act. - ou will be expected to organise and undertake presentations at departmental meetings and to supervise SHOs in preparation for their presentations. - Hours of work/ pay The jobs on the UCLH Neonatal Unit are non-resident but rented residential accommodation can be provided for those who require it. Registrars work an EWTD compliant full-shift system. - Education Registrars meet regularly with their educational supervisor to plan and discuss progress. They also act as mentors to at least one SHO. - There are ample opportunities for formal and informal teaching on the Neonatal Unit- Angela Huertas, NNU Training Director 23

24 Chelsea & Westminster Foundation Healthcare Trust NTN SpR Neonatal Medicine Mono - Subspecialty Training Outline of programme: A 1-2 year post as part of comprehensive rotations for training in neonatal medicine Supervisors: Neonatal Comnsultants Departmental Information: The neonatal intensive care unit is one of the two Lead perinatal centres in the North-West London perinatal network (NWLPN). The unit is adjacent to the labour ward, operating theatres and postnatal ward. Neonatal medical staff include 11 SHOs, 1 ANNP and 8 SpR grades working on a full shift system. There are 5 full-time consultant neonatologists and 0.5WTE 5 th consultant/ academic lead, 1 perinatal paediatrician and 5 paediatric surgeons. We have regular ward rounds with the paediatric gastroenterology team (Dr Fell and Dr Rawat), cardiologist (Dr Daubeney) and respiratory physician, Dr Balfour-Lynn. Activity / Workload: An expansion to 38 cots capacity on NICU has just been completed. 28 cots are currently fully funded. There are about 5000 deliveries a year. Neonatal surgical patients and tertiary referrals constitute a significant proportion of the patients. The obstetric unit offers a high risk service, for women with complex medical problems especially maternal diabetes mellitus, HIV, pre-eclampsia & cardio-respiratory disorders. We also are a referral centre for delivery and stabilisation of antenatally diagnosed fetal cardiac anomalies prior to transfer to the Royal Brompton Hospital close-by. Clinical Training and Responsibilities: Operational management of NICU under direct supervision of consultant neonatologists. Support of SHOs in the assessment and management of acutely ill and postnatal ward neonates and overseeing documentation and progress of discharge summaries Attendance at the weekly grand round with neonatal and paediatric surgical consultants. Daily consultant WRs and a weekly nutrition WR with paediatric gastroenterologists Weekly liaison meeting with NICU staff and social services Weekly perinatal grand round with all obstetricians and neonatologists Liaison with neonatal surgical team and anaesthetists Involvement in neonatal medical and neurodevelopmental follow-up clinics. Participate in neonatal transport Non-Clinical Training and Responsibilities: Organisation once a month of perinatal mortality/morbidity meeting Opportunities to further develop the clinical guidelines in operation Involvement in neonatal audit and on-going unit research studies Dedicated SpR monthly teaching in NW London hospital group Particular Training Opportunities: Surgical Neonatal training of varied disorders Neuro-developmental follow-up and research exposure Experience in the immediate peri-operative care of infants in a tertiary referral centre for surgery, including ENT and orthopaedics with a dedicated team of paediatric anaesthetists Rota arrangements: Full shift rota with 8 middle grade staff - Band 1A 24

25 Name of Trust: Post: Imperial College Healthcare NHS Trust, St Mary s Hospital, London Grid SPR in Neonatal Medicine Following Secretary of State for Health approval, the UK s first Academic Health Science Centre (AHSC), was formed on 1 October 2007, when St Mary s NHS Trust merged with Hammersmith Hospitals NHS Trust and integrated with Imperial College. The Imperial College Healthcare NHS Trust is the foundation for the AHSC, and the largest NHS Trust in the UK. Outline of programme This post offers experience in tertiary care of medically ill newborns in a Level 3 Neonatal Unit. There is particular expertise in non-invasive ventilation, infectious diseases and therapeutic hypothermia. Neonatal Consultants Dr Merran Thomson, Chief of Service, Division of Neonatology (St Mary s and Hammersmith) Dr Sunit Godambe (Lead Consultant, St Mary s NICU), Dr Geraldine Ng (Education and Training Lead), Dr Latha Srinivasan (Senior Lecturer), Dr Peter Chow, Dr Emma Porter, Dr Jenny Ziprin and Dr Karena Ghaus Departmental Information The Winnicott Baby Unit, located at Paddington is one of the 2 Level 3 NICUs of the Imperial College Healthcare NHS Trust. It is a part of the North-West London Perinatal Network. There are 19 cots comprising 7 ITU, 4 High dependency and 8 Special care spaces. There are approximately 4700 deliveries per annum and 321 admissions to the NICU in As part of the AHSC the neonatal unit has several ongoing research projects: eprime, Neonatal Pain, the International Multicentre NIPPV Trial, Microbiota of the Premature Neonatal Gastrointestinal Tract Study, Probiotics in Preterm Infants (PIPs) Multicentre Trial, Preterm Lactate and CPAP surveillance studies. All trainees are encouraged to participate in research and audit projects. The unit has strong links with high-risk fetal medicine departments, both at St Mary s and QCCH and SPRs are encouraged to attend these clinics. The Recurrent Miscarriage Clinic at St Mary s Hospital is the largest in Europe. The neonatal unit has been accredited as the first NIDCAP Training Centre in the UK. Staffing: 5.5 WTE consultants, 8 SpRs (full-shift), 8 SHOs (full-shift). Specialist Paediatrics There are strong links with the other Paediatric Specialties at St Mary s which include Paediatric Intensive Care, Paediatric Neurology, Paediatric Neurodisability, Paediatric Emergency Medicine, Paediatric Infectious Diseases, Paediatric Haematology, Paediatric Bone Marrow Transplant, Paediatric Oncology, Paediatric Allergy and Paediatric Nephrology. There are weekly joint educational meetings with PICU. The Neonatal department is actively involved in undergraduate training of medical students from the Imperial College Medical School. Clinical training and responsibilities Management of sick ELBW infants, meconium aspiration, HIE, complex antenatal problems Page 1 of 2

26 Attendance at weekly follow-up clinics (three times a week) and fetal-medicine clinic (once a week) Supervision of SHOs including day to day care of inpatients and postnatal infants Non-clinical Training and Responsibilities Organisation of NICU teaching and Junior Doctors Forum; chairing of weekly unit multidisciplinary business meeting, rostering, providing teaching for undergraduate medical students and medical students, and mentoring SHOs. Particular training opportunities Cranial ultrasonography, neonatal echocardiography, oscillation, non-invasive ventilation Experience in use of therapeutic hypothermia and use of nitric oxide Weekly Neonatal Neurology Video Conference teaching with QCCH In house multidisciplinary simulations (neonatal and paediatric) Participation in various research projects and audits, in-house and across site at QCCH Developmental care there is an opportunity to train in NIDCAP / developmental care Weekly NICU Education Program Monday Paediatric Grand Round Fetal Medicine Clinic Tuesday Neonatal Haematology Teaching Round (Alternate weeks) Wednesday Journal Club Neonatal SPR Follow up Clinic Paediatric SPR teaching PICU / NICU Meeting Neonatal SPR Follow up Clinic Thursday Video-conference Neonatal Neurology teaching (Dr Frances Cowan) with Queen Charlotte s Hospital Consultant facilitated case based discussion Neonatal Microbiology Rounds Consultant Follow up Clinic Friday Multidisciplinary Rounds Perinatal Morbidity and Mortality Meeting (monthly) Fetal Medicine Meeting (monthly) Page 2 of 2

27 Post: Specialist Registrar in Neonatology, Homerton University Hospital, London This post is approved for national grid training in neonatology. The programme is aimed at providing comprehensive training in neonatology, including the acquisition of appropriate technical skills and exposure to neonatal research. The Department: The neonatal unit at Homerton is a level 3 neonatal unit which has recently been extensively refurbished and expanded to provide a total of 20 intensive and high dependency cots. Homerton is one of the two perinatal centres in the North East London perinatal network. There are 8 Consultants, 6 NHS and 2 University posts in Barts and the London School of Medicine and Dentistry. There are nearly 5000 deliveries a year, with a high proportion of high risk obstetric cases. There is an active fetal medicine and welfare unit, offering a wide range of services, including various fetal interventions. The main network surgical centre is at the Royal London Hospital; the surgeons visit Homerton regularly and are available for consultation. Rota: The middle grade rota has 10 doctors and includes ST4+ trainees (6 posts), clinical fellows (3 posts) and a Specialty doctor. This is a full shift rota banded at band 1B. Annual leave is allocated as part of the rota. The registrars work closely with 12 junior trainees (ST1 3) and 3 advanced neonatal nurse practitioners. Training Opportunities: Clinical: There are excellent opportunities for the trainee to develop and consolidate clinical and practical skills on the busy neonatal unit with a high proportion of extremely low birth weight babies. The trainee will have opportunity to lead on the ward round once a week. The trainee is expected to assist with the weekly neonatal follow up clinic and specialist developmental and home oxygen clinics. Outreach specialist clinics in cardiology (4 times a year) and genetics (monthly) are held on Homerton site by consultants from Great Ormond Street. Audit: The trainee is expected to complete one audit during the training period at Homerton. Appropriate support will be provided. Research: The trainee will be expected to have an interest in research and will be encouraged to develop their own project or take part in one of the existing projects. Established research interests include perinatal infection and probiotic use, long-term outcomes following preterm birth and blood volume measurement. Communication: There are huge opportunities to consolidate communication skills in a range of settings including antenatal counselling, breaking bad news, end of life decision making and bereavement follow up in the context of a complex multi-cultural patient population. Management: The trainee will have opportunity to develop management skills and is encouraged to attend unit and directorate management meetings. Teaching skills: The trainee will be encouraged to take part actively in teaching junior trainees, nurses, midwives and medical students. Teaching programme: There is an internal programme of multidisciplinary service and training meetings and a weekly neonatal seminar, often with external speakers, attended by staff of networked hospitals. Every attempt will be made to achieve adequate flexibility for trainees to attend regional training meetings. All trainees are allocated an educational supervisor and progress is monitored and appraised as per deanery and college guidance. Study leave: Trainees are encouraged to utilize their study leave to attend appropriate courses and conferences. There is reasonable funding available for study leave. Contacts: For further information about the post, please contact Professor Kate Costeloe: Professor of Paediatrics, Consultant neonatologist & Clinical Director kate.costeloe@homerton.nhs.uk Dr Swee Fang: Consultant Neonatologist & Lead clinician for the neonatal unit Swee.fang@homerton.nhs.uk Dr Ravi Prakash: Consultant Neonatologist & Paediatrics Tutor ravi.prakash@homerton.nhs.uk 27

28 Post: Base Unit: National Grid Training Post in Neonatology Hammersmith and Queen Charlotte s and Chelsea Hospital Supervisor: Unit Information: Dr Merran Thomson Consultant Neonatologist Dr Frances Cowan Senior Lecturer in Neonatal Neurology Imperial College Healthcare NHS Trust is the UK's first Academic Health Science Centre and the largest NHS Trust in the UK. It is one of only 5 comprehensive biomedical sciences research centres in the UK designated by the National Institute of Health Research. This training post in neonatology provides excellent opportunities for clinical training as well as exposure to worldclass neonatal research. The busy tertiary neonatal unit has particular expertise in neonatal respiratory, circulatory and nutritional support. QCCH is a major referral centre for many fetal, obstetric and neonatal conditions. The service has a strong tradition in research and postgraduate teaching. Neonatal neurology is a particular focus: the only dedicated neonatal MRI system in the UK is situated within the NNU, facilitating the study of even the smallest, sickest neonates; the unit is a leader in the investigation and use of therapeutic hypothermia in cerebral protection; and there are excellent training opportunities for cranial ultrasound and MR imaging. The posts rotate through an exclusive placement in neonatal neurology. Activity/Workload Deliveries: 5300, admissions: 500 per annum. Cots: 34 (15 ITU/HDU & 17 LD & 2 readmission cots) as well as transitional care on postnatal ward making it one the largest in the UK. Network centre for therapeutic hypothermia. Neonatal Staff Dr Merran Thomson, Consultant Neonatologist, Chief of Service, Imperial College Healthcare Trust Dr Glynn Russell, Consultant Neonatologist, Clinical Lead QCCH site Dr Lidia Tyszczuk, Consultant Neonatologist Dr Jenny Ziprin, Consultant Neonatologist Dr Emma Porter, Consultant Neonatologist Academic Staff Professor David Edwards, Professor of Neonatal Medicine Professor Denis Azzopardi, Professor in Neonatal Medicine, Consultant Neonatologist Dr Alan Groves, Clinical Senior Lecturer in Neonatal Medicine Middle Grade Staff 5 ST4-8, 6 middle grade trust doctors, 10 ST1-3 posts and 4 junior trust grade doctors Clinical Training and Responsibilities: Management of complex neonatal medical problems including extreme prematurity, twinning problems, growth failure, neonatal neurological problems, congenital cardiac conditions and therapeutic hypothermia. Involvement in integrated perinatal care with fetal medicine, cardiology and high risk obstetrics Twice daily consultant ward rounds with SpR leading the morning round twice a week Daily management of inpatients, including planning of discharge, and liaison with community team Neonatal follow-up outpatients (1 per week) including specialist clinics, e.g. CLD Weekly departmental clinical meeting, X-ray meeting and psycho-social meeting. Neonatal neurology: organising the investigation of infants with neurological problems, attendance at weekly MRI meetings and 2-3 neonatal neurology outpatients per week Transport of sick neonates Non-Clinical Training and Responsibilities: Actively encouraged to take part in the research and audit activities of the department Teaching of nursing staff and STs with the development of training packages and simulation training 28

29 Management issues, staffing, equipment, clinical governance, risk management etc. Organisation of ST4/8 rota Development and implementation of protocols and guidelines The Trust has many relevant courses including an excellent management course aimed specifically at ST4/8 Encouraged to use study leave allowance to address any training needs not available within the Trust. Particular Training Opportunities: Improvement of all clinical skills including cranial ultrasound & advanced neonatal simulation. Understanding of neurological imaging techniques & training in the interpretation of all forms of brain imaging. Extensive training in neonatal follow up and neurology is offered. 29

30 Royal London Hospital Neonatal Unit Grid Specialist Registrar Training Programme The neonatal unit at Royal London Hospital has Thames Regional Perinatal Group Level 3 status and is approved for National Grid subspecialty training in Neonatal Medicine. Post-holders are provided with high quality neonatal training and assist in the provision of excellent neonatal care within an EWTD compliant middle grade rota. Individual job plans are tailored to the needs of individual post holders, allowing time for example to undertake a formal research or audit project, a major or acquire a particular clinical skill. Unit Structure: The unit has 9 intensive care, 7 high dependency and 13 special care cots with an integrated 7 cot (3 intensive /3 high dependency and 1 SCBU) neonatal surgical unit adjacent to the neonatal medical unit with joint management of patients on both units. The neonatal unit is embedded in the Paediatric Clinical Academic Unit and benefits from coexistence with the 110 bed general paediatric unit and a level 2 PICU unit. There are several paediatric subspecialty interests including the regional paediatric gastroenterology unit, paediatric neurology and paediatric endocrinology which allow for the local management of complex neonatal patients. Training: Training will be provided as appropriate for the individual in accordance with the curriculum for trainees in neonatal medicine following discussion with their educational supervisor. In general training opportunities occur in the context of - Consultant led ward rounds twice daily - Registrar led ward rounds in second half of post - Practical supervision dependent on experience. - Concise Topic teaching two mornings / week - Dedicated X-ray meetings - A Weekly Academic ward round and Case presentation/seminar - Formal training in cranial ultrasound and echocardiography - Managerial experience - Clinical Governance and Audit. Trainees are supported in developing and carrying out high quality audit projects. There is a research programme within the unit, the main focus being on Doppler-based studies of the cardiovascular system looking at strategies for blood pressure support and studies of splanchnic blood flow. Staffing: There are 7 whole-time Neonatal Consultants: Mike Hird, Ajay Sinha, Anne Opute, Rainer Ebel, Shazia Hoodbhoy, Divyen Shah and Angela Hayward in addition to the Senior lecturer-steve Kempley. In addition, the 2 neonatal transport consultants have attending duties on the neonatal unit and participate in the on-call rota. The middle grade rota is a fully EWTD compliant rota comprising 7 neonatal SpRs, 6 neonatal junior ST Doctors, 3 clinical fellows and two ANNPs working to a full shift rota make up the junior tier. Nursing staff as detailed in annual report. 1 whole-time PA, 1 typist, data administrator and 2 ward clerks. Training Lead - Anne Opute 30

31 London (South) Hospital / Centre Placement Name Duration (Months) Educational Supervisor Compulsory (C) or Optional (O) Availability Guaranteed (/N) 1 St Georges 12 Dr Nigel Kennear n.kennea@sgul.ac.uk O 2 Kings College Hospital 12 Dr Silke Lee silke.lee@kingsch.nhs.uk O 3 Guys & St Thomas 12 Dr Camilla Kingdon camilla.kingdon@gstt.nhs.uk O 4 Brighton 12 Dr Rob Bomont rob.bomont@bsuh.nhs.uk O 5 x SOUTH LONDON programmes Rotations will be tailored for successful applicants by the London Training Programme Directors (Dr Ros Thomas and Dr Susanna Hart) in accordance with individual training requirements, trainee preferences and ranking at Grid interview. The neonatal medicine CSAC recommends that trainees should not usually be placed for more than 12 months in the same hospital. Trainees will therefore be placed for no more than 12 months in several of the following hospitals, depending on training time left before CCT and previous training placements St Georges Hospital x 2 Kings College Hospital Guys and St Thomas Hospital Brighton Hospital 31

32 Subspecialty: Base Unit: Deaneries involved: Neonatology (Monospecialist Training Post) St George s Hospital NHS Trust, London. 12 month post St George's Hospital NHS Trust London Outline of Programme Departmental Information - Demographics - Births: > Neonatal admissions: >580 <32/40 ~160 <1000g ~120 infants >120 infants with Surgical diagnoses occupying >3000 bed days - Team - Consultants: - Dr Sandy Calvert, Chair Thames Regional Perinatal Group - Dr Laura De Rooy, Clinical Lead Neonatal Unit - Dr Charlotte Huddy, Consultant Neonatologist, - Lead for Developmental Follow up - Dr Nigel Kennea, Lead for Research, Education and Training - Dr Justin Richards, Clinical Lead for Simulation Training - Dr Anthony Williams, Consultant Neonatologist & Senior - Lecturer, Child Health - Dr Nasreen Aziz, Consultant Neonatologist Dr Ramakrishnan, Consultant Neonatologist 2 ANNPs and current programme to train further nurse practitioners and physician assistants. - Supervisor(s) All Neonatal Consultants undertake clinical and Educational supervision. Clinical Training Responsibilities Training and education objectives reflect RCPCH competencies for Higher Specialist Training 1. Develop clinical knowledge and practical skills with extensive experience in the management of sick medical and surgical newborn infants in an environment of enthusiastic teachers. 2. Enhance competence in advanced resuscitation skills and obtain/renew neonatal resuscitation qualifications. 3. Develop skills in neonatal follow up, bereavement counselling and outpatient management in weekly consultant-led clinics. 4. Improve understanding of fetal medicine, antenatal counselling and birth planning for infants with antenatal problems or congenital abnormalities. 5. Involvement in our developing simulation training programme. St George's has successfully piloted the ST3 Paediatric simulation programme and Neonatal simulation has been boosted by a recent charitable donation. These objectives are achieved by: * Formal consultant-led ward rounds in intensive care, high dependency and special care. Exposure to patients with wide range of multi-system medical and surgical disorders. Frequent opportunity to enhance practical skills and Cranial USS experience. Attendance at Regional Neonatal Grand Rounds, fetal medicine, fetal cardiology and genetics clinics. Attendance at Regional SpR study days is encouraged, as well as other relevant meetings * Weekly STR training programme and weekly Grand Round, Journal Club and multi-professional meetings in addition to weekly Child Health academic meetings. * Weekly (consultant supervised) structured outpatient clinics reviewing neonates with wide range of disorders. Emphasis on neuro-developmental follow-up. In addition there is great opportunity to attend many specialist Paediatric and Perinatal outpatient clinics. * Participation in monthly perinatal mortality and weekly perinatal morbidity, X ray, fetal medicine & genetics and neonatal surgical meetings. Liaison with local and referring obstetric and neonatal teams. Supported enhancement of antenatal and postnatal counseling skills 32

33 * Encouragement to attain Attain NLS instructor status. * Formal training given in Clinical Governance, Audit and Risk Management * Attend and present at monthly neonatal multidisciplinary management meetings and neonatal medical and surgical clinical governance & risk management meetings. Overall, our aim is to develop trainees autonomy in the management of sick term, preterm and surgical infants. Ultimately, leading ward rounds, managing rotas and supervision of junior colleagues. We strongly support attendance at management and consultant preparation courses. Workload / Rota Arrangements / Example Timetable Middle Grade Rota : 8 persons (currently 7 SpRs and 1 ANNP). Further funding has been negotiated for a further SPR post. Current Rota (this may be changed with a further new post) Teaching Timetable for NNU Morning Lunch Afternoon Monday Consultant Ward rounds 2 nd Monday: Multidisciplinary meeting Perinatal Meeting with monthly Mortality or Morbidity meetings Tuesday ST Teaching Programme Registrar Ward Rounds X ray meeting Echocardiograms Wednesday SPR Teaching Programme Outpatient Clinics Registrar Ward Round Joint Neonatal, Fetal Medicine and Genetics meeting Infectious Diseases (ID) Ward Round ID Journal Club Thursday Neonatal teaching meeting & Grand Round Hospital Grand Round Echocardiograms Friday Surgical Round Registrar Ward Round Dept of Child Health Grand Round Acedemic Meeting Journal Club CUSS Teaching GGKT Meeting NA 2010 Non Clinical Training Responsibilities (expectations of research / audit / teaching) * Participate and support current research projects. These include multi-centre trials evaluating brain injury, studies into neonatal infection control practice, and also study of the impact of simulation training. * Cement understanding and experience in management and clinical governance. This includes undertaking a good quality audit, the development and use of protocols, and training in patient safety and risk management. * Develop team-working and team-building skills with improved awareness of multidisciplinary team working and need for effective communication skills. * Develop and utilise effective teaching and assessment skills with opportunities to teach undergraduate and postgraduate students and others in the multi-professional team 33