Consultant Physicians in Elderly Care Medicine. Shrewsbury and Telford Hospitals NHS Trust JOB DESCRIPTION

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1 Consultant Physicians in Elderly Care Medicine Shrewsbury and Telford Hospitals NHS Trust JOB DESCRIPTION July 2017

2 INTRODUCTION These are new posts and will be based at the Royal Shrewsbury Hospital and they are aimed at expanding the Department of Elderly Care Medicine and developing the Acute Frailty Service in line with the national focus on delivering excellent care to Frail Older patients in Hospital and in primary care. The posts attract 10 Programmed Activities and On-call duties in general medicine (1 in 15) SHROPSHIRE AND THE LOCAL HOSPITALS Shropshire is the largest inland County in England. Shrewsbury, the County Town, with attractive medieval and 18th century streets and buildings, has a population of 90,000. Telford, a new town to the east of the County has a larger population of 140,000. The M54 motorway, which starts just outside Shrewsbury, provides quick access to the national motorway network and there is a fast dual carriageway connecting Shrewsbury and Telford which are twelve miles apart. Intercity trains to London and Birmingham are available at Wolverhampton although there are frequent regional railways trains from Shropshire. The Shrewsbury and Telford Hospitals NHS Trust has a catchment population of 550,000 between the two Hospitals located at Shrewsbury and Telford. The Royal Shrewsbury Hospital (RSH) is centered upon the County Town of Shrewsbury and also supplies services to a rural population in West Shropshire and neighbouring Mid-Wales. THE WORK OF THE ELDERLY CARE and STROKE DEPARTMENT There are 3 Elderly Care physicians and 2 Associate Specialists in post at SaTH: 1. Dr Shu Ho has special interest in Falls and leads the well orthogeriatric service (and also works at Robert Jones and Agnes Hunt Orthopaedic Hospital in Oswestry), 2. Dr Suzy Thompson has a special interest in Acute Frailty and Movement Disorders 3. Dr Nigel Mike has a special interest in GIM and Nutrition. 4. Dr Erica Capps (Associate Specialist) supports Elderly Care services at Telford and has expertise in Movement Disorders 5. Dr Sai Kumar (Specialty Doctor) specialises in Orthogeriatric liaison and rehabilitation at Shrewsbury. There are 4 additional Stroke Physicians based at the Princess Royal Hospital, Telford with Acute stroke services, Dr Uttam Sinha, Dr Meena Srinivasan, Dr Indranil Mukherjee and Dr Owen David. Specialist Nurses provide clinical services with all Consultants. There are 2 Parkinson s Disease Nurse Specialists, a Dementia Nurse Specialist and a Stroke Nurse specialist based at the Princess Royal Hospital. There is an active interest in teaching at all levels in the department in association with Keele Medical School and the West Midlands Deanery. The post holder will be encouraged to participate in teaching and supported in research that benefits the department. There are

3 ongoing audits of services including national audits in Falls, Dementia and Parkinson s Disease. THE POSTS The main aims of the post are to: a) Develop Acute Frailty Services at the front door There is a large ageing population in Shropshire and Telford and Wrekin which attend both acute Hospital s. The Trust and CCGs are working together to address patients needs and develop a responsive service for older frail patients. The post holder will be expected to be part of building on current services with Dr Suzy Thompson to deliver Comprehensive Geriatric Assessment in the Emergency Department and Acute Medical Unit at Shrewsbury initially. They will be expected to work closely with the teams in the ED and AMU to improve care for frail older patients. The post holder will supervise a team of 2 ACPs, the current Registrars in Elderly care you will be supported by therapies to deliver rapid assessment, treatment and as much as possible rapid discharge to community services. The Trust is being supported by both local CCGs and the Acute Frailty Network. b) Elderly care There are purpose built Elderly Care wards at both Hospitals. The post holder will be supporting the Unit at the Royal Shrewsbury Hospital, which comprises of 40 beds. The Unit provides general elderly care, rehabilitation older patients from across medicine and Orthopaedics. Currently there are also a small number of stroke patients repatriated from Telford for rehabilitation. There are close links to Primary Care and support from the discharge liaison teams to expediate discharge. There is an in-house mental health team (based on the RAID model) who support the unit for patients with delirium and dementia. The Unit is supported by 5 junior Doctors in training and 2 Registrars. c) General Medicine / On-Call duties The general medical take is run through the Admissions Units at both major Hospitals and delivered with a split-weekday take by Acute Physicians and Speciality Physicians on the oncall rota. The present on-call at RSH is 1/15 with prospective cover. The Trust admits approximately 25,000 Acute Medical presentations distributed almost evenly between both Hospitals. On-call Physicians (Acute or Speciality) maintain an on-site presence until at least 8pm with on-call thereafter and extended on-site working at week-ends (with subsequent compensatory rest period allotted). Gastroenterologists and Cardiologists operate separate speciality out of hour rotas. The Trust operates a Speciality ward system and patients requiring continuing care are allocated to a speciality ward from the AMU depending on their presentation. The general medicine out of hours work currently attracts an on call availability supplement 3% and 1.5PA s DCC on the job plan. Consultant Physicians within the Medical Directorate and those presently participating in acute GIM are identified below (*) and grouped by main site for GIM on-calls. Several Consultants work cross-site for speciality work as well GIM and all departments are fully integrated. As such it may be a requirement of the new post to occasionally work at RSH, particularly for leave cover.

4 Royal Shrewsbury Hospital CONSULTANT PHYSICIANS Dr Tom Ingram ( Imaging Specialist) Dr Dinesh Mistry Dr David Wallbridge Dr Jim Moorcroft Dr Saskia Jones-Perrott Dr Rich Heinink Dr Elin Roddy Dr Gordon Wood Dr Amruta Lacy-Colson Dr Kat Ibison Dr Graham Heyes Dr Probal Moulik Dr Srinivas Rangan Dr Prashant Singh Dr Shu Ho Dr Suzy Thompson Dr Steve Davies Dr Sunita Nair Dr Kevin Eardley Dr Anna Szczerbinska Dr Anna Green Dr Anuja Sagdeo Dr Amol Sagdeo SPECIALITY Diabetes and Endocrinology Diabetes and Endocrinology Diabetes and Endocrinology Care of the Elderly Care of the Elderly Renal Medicine Renal Medicine Renal Medicine / Acute Medicine Acute Physician Acute Physician Locum Acute Physician Locum Acute Physician

5 Princess Royal Hospital CONSULTANT PHYSICIANS Dr Ian Tanswell Dr Razi Khan Dr Chee Wah Khoo Dr Najeeb Azam Dr Jayesh Makan Dr Catherine Lee Dr Suman Kundu Dr Meena Srinivasan Dr Uttam Sinha Dr Nigel Mike Dr Indranil Mukhejee Dr Owen David Dr Darren Warner Dr David Barton Dr Ram Diwakar Dr Johann Nicholas Dr Sourabh Chand Dr Suresh Ramadoss Dr John Bowen Dr Piers Newman Dr Harmesh Moudgil Dr Koottalai Srinivasan Dr Nawaid Ahmad Dr Emma Crawford Dr Annabel Makan SPECIALITY AMU AMU CoE CoE / Stroke Medicine CoE CoE CoE Diabetes & Endocrinology Diabetes & Endocrinology Renal Medicine Renal Renal Renal Medicine Neurology Neurology

6 JOB PLAN This is a provisional plan and the new post holders will have a full job planning completed within 3 months of joining the Trust where we will try to accommodate any special interest as required. All Physicians across medicine work on a rotating basis on and off their speciality ward in a system determined within each department. This allows daily Consultant supervision of patient care on all acute medical areas, close supervision of junior Doctors and supports and develops and supports multidisciplinary team working. The Trust operates at two Hospitals and it is an expectation that all Consultants may have commitments at either Hospital to cross-cover services. Provisional Job Plan Day Time Location Activity Frequency(wks) DCC SPA Weekly PA Mon AM RSH Frailty work AMU/ED Mon AM RSH Ward Round COE Mon PM RSH Admin Tues AM RSH Frailty work AMU/ED Tues AM RSH Board round COE Ward and ward referrals Tues PM RSH OPD clinic speciality Wed AM RSH Frailty work AMU/ED Wed AM RSH Ward round COE Wed PM RSH SPA Thurs AM RSH Frailty clinic ambulatory care Thurs AM RSH Board round COE and ward referrals Thurs PM RSH Frailty AMU/ED Thurs PM RSH SPA Fri AM RSH SPA Fri AM RSH Ward round COE Fri PM RSH Frailty work AMU/ED Fri PM RSH SPA RSH On-Call (3% availability supplement) Total Weekly PA's 11.5 Direct Clinical Care 7.5 PAs direct clinical care (clinical activity, clinically related activity, administration, predictable and unpredictable emergency work) Supporting Professional Activities 2.5 PAs on average per week includes Clinical Governance/audit, grand rounds, Consultants Meetings, service development, CPD, junior doctor supervision (0.25PA/week)

7 WORKLOAD New Frailty Service in ED and AMU : It is estimated that the Frailty Team will have between 5 to 10 new referrals per day which will require a medical assessment from an AHP and overseen by the Consultant Geriatrician. The post holder will have one clinic to assess frail older patients in ambulatory care and follow up recent in patients if needed. Clinic template to be decided on need as a new service provision Elderly Care Wards: The ward base in Elderly Care at Shrewsbury totals 40 but each consultant in responsible for 20 beds and a small number of outlying patients on the supported discharge ward (patients waiting for social care) Elderly Outpatients: The post holder will be to have one outpatient clinic for general elderly care and their speciality (template depends on speciality, but other consultants in the department have 30 to 40 minutes per new patient and 15 minute follow up slots) General medical on call: The post holder will be part of a 1 in 15 on call. Admissions to AMU and the ED are seen by the AMU consultants during the day Monday to Thursday. The general physician takes patients admitted after 4pm overnight. They are expected to perform an evening ward round and remain on site until 9 pm. There is a post take ward at 8am by the general physician, after this care of patients remaining on AMU is taken over by the AMU team. On Fridays the take is split between two general phsyicians. RESEARCH It is usual for the Trust to be participating in many research projects at any time. Every effort would be made to accommodate a particular research interest of the successful applicant, particularly if trainee members of the department could be incorporated in the methodological and practical stages. APPRAISAL, REVALIDATION AND MENTORSHIP The successful applicant will undergo annual appraisal allowing jointly agreed development needs to be fed into their job plan. A formal review of the job plan will be performed at least annually. The Trust supports the requirements for Continuing Medical Education as laid down by the Royal College of Physicians and is committed to providing time and financial support for these activities. An annual job plan review at individual and departmental level is being introduced. The successful applicant will be expected to participate in this exercise. You will upon appointment be registered by Medical Staffing and set up on the Equiniti revalidation system; this will be completed as soon as possible upon commencing employment with the Trust.

8 Mentorship will be provided by an appropriate Consultant member of the department and after this the post holder may identify another Consultant colleague for this role. AUDIT There is a fully staffed Audit Department at both the Royal Shrewsbury and Princess Hospital with extremely well-organised teams. OFFICE AND SECRETARIAL FACILITIES Office accommodation and appropriate secretarial (which may be shared ) and IT support will be provided at the Royal Shrewsbury Hospital. TERMS AND CONDITIONS OF SERVICE The appointment is full-time and the successful candidate will be appointed on the Terms & Conditions Consultants (England) The trust would be willing to consider applicants wishing to work less than full time. The suggested job plan equates to 10 Programmed Activities. Candidates who wish to work a different work pattern part-time, flexible or job share may also apply, but the national contract only allows for 6 or more PAs to be offered The salary scale is based on the Consultant pay scale (MC72): Salary Scale: 2017) 76, ,490 per annum for 10 Programmed Activities (as of April The post is based on the recognition of 10 Programmed Activities. The post holder: will be in possession of a recognised medical / dental qualification and full registration with the General Medical Council and continue hold a licence to practice is advised to be a member of a recognised medical defence society or be suitably insured. Trust insurance does not cover work undertaken outside the Trust other than caring for patients and work of the Trust will be expected to make sure that there are adequate arrangements for hospital staff involved in patient care to be able to contact him / her when necessary will be expected to reside within 30 minutes or 10 miles by road of the base hospital whilst on call will not be permitted to commence employment until a full medical examination has been completed with a satisfactory result or the Occupational Health Physician has satisfied himself that a full examination is not necessary. The completion of a satisfactory health questionnaire is a condition of employment will not be permitted to commence employment until full clearance has been received from the Disclosure Barring Service

9 The Trust operates a no smoking policy. The Trust values its diverse workforce and is committed to taking all necessary steps to ensure that individuals are treated equally and fairly and to taking positive action to promote equal opportunities. ACCOMMODATION The Trust has residential accommodation for medical staff. OTHER FACILITIES There is an active Doctors Mess run by the Junior Doctors Mess Committee which organise social events, parties, outings etc. There are on-site fitness centres (a membership fee is payable) available to all members of staff. STAFF BENEFITS There are a number of staff benefits schemes which attract tax reductions if joined. This includes a discount on the staff car parking charge for full-time consultant staff, staff gym membership, on-site crèche/childcare provision and access to NHS Discounts schemes. VISITING Appointments to visit the Trust should be arranged with: Dr Suzy Thompson TConsultant Physician and Geriatrician: Dr Saskia Jones-Perrott Ass Care Group Medical Director Unscheduled Care: Dr Kevin Eardley Care Group Director Unscheduled Care:

10 STATEMENTS Health & Safety As an employee of the Trust you have a responsibility to: take reasonable care of your own Health and Safety and that of any other person who may be affected by your acts or omissions at work; and co-operate with the Trust in ensuring that statutory regulations, codes of practice, local policies and departmental health and safety rules are adhered to; and not intentionally or recklessly interfere with or misuse anything provided in the interests of health and safety. Infection Prevention and Control The prevention and management of acquired infection is a key priority for the Trust. Any breach of infection control policies is a serious matter which may result in disciplinary action. As an employee of the Trust you have a responsibility to: ensure that your work methods are compliant with the Trust s agreed policies and procedures and do not endanger other people or yourself; and be aware of infection prevention and control policies, practices and guidelines appropriate for your duties and you must follow these at all times to maintain a safe environment for patients, visitors and staff; and maintain an up to date knowledge of infection prevention and control, policies, practices and procedures through attendance at annual mandatory updates and ongoing continuing professional development; and challenge poor infection prevention and control practices of others and to report any breaches, using appropriate Trust mechanisms (e.g. incident reporting policy). Information Governance The Trust is committed to compliance with Information Governance standards to ensure that all information is handled legally, securely, efficiently and effectively. You are required to comply with the Trust s Information Governance policies and standards. Failure to do so may result in action being taken in accordance with the Trust s Disciplinary Procedure. Confidentiality and Security - Your attention is drawn to the confidential nature of information collected within the NHS. Whilst you are employed by the Trust you will come into contact with confidential information and data relating to the work of the Trust, its patients or employees. You are bound by your conditions of service to respect the confidentiality of any information you may come into contact with which identifies patients, employees or other Trust personnel, or business information of the Trust. You also have a duty to ensure that all confidential information is held securely at all times, both on and off site. Disclosure of Information - The unauthorised use or disclosure of information relating to the Trust s activities or affairs, the treatment of patients or the personal details of an employee, will normally be considered a serious disciplinary offence which could result in dismissal. Upon leaving the Trust s employment and at any

11 time thereafter you must not take advantage of or disclose confidential information that you learnt in the course of your employment. Unauthorised disclosure of any of this information may be deemed as a criminal offence. If you are found to have permitted the unauthorised disclosure of any such information, you and the Trust may face legal action. Information Quality and Records Management - You must ensure that all information handled by you is accurate and kept up-to-date and you must comply with the Trust s recording, monitoring, validation and improvement schemes and processes. Professional Standards and Performance Review As an employee of the Trust you have a responsibility to: participate in statutory and mandatory training as appropriate for the post; and maintain consistently high personal and professional standards and act in accordance with the relevant professional code of conduct; and take responsibility for the maintenance and improvement of personal and professional competence and to encourage that of colleagues and subordinates; and participate in the Trust s appraisal processes including identifying performance standards for the post, personal objective setting and the creation of a personal development plan in line with the KSF outline for the post. Safeguarding Children and Vulnerable Adults We all have a personal and a professional responsibility within the Trust to identify and report abuse. This may be known, suspected, witnessed or have raised concerns. Early recognition is vital to ensuring the patient is safeguarded; other people (children and vulnerable adults) may be at risk. The Trust s procedures must be implemented, working in partnership with the relevant authorities. The Sharing of Information no matter how small is of prime importance in safeguarding children, young people and vulnerable adults. As an employee of the Trust you have a responsibility to ensure that: o you are familiar with and adhere to the Trusts Safeguarding Children procedures and guidelines. o you attend safeguarding awareness training and undertake any additional training in relation to safeguarding relevant to your role. Social Responsibility The Trust is committed to behaving responsibly in the way we manage transport, procurement, our facilities, employment, skills and our engagement with the local community so that we can make a positive contribution to society. As an employee of the Trust you have a responsibility to take measures to support our contribution and to reduce the environmental impact of our activities relating to energy and water usage, transport and waste.