JUNIOR CLINICAL FELLOW IN EMERGENCY MEDICINE

JOB DESCRIPTION & BACKGROUND INFORMATION JUNIOR CLINICAL FELLOW IN EMERGENCY MEDICINE based at the NORTH MIDDLESEX UNIVERSITY HOSPITAL NHS TRUST Full Time

Description of posts In December 2016 the Emergency Department was awarded: CQC Good rating for Leadership and Caring Health Education England praise for providing a department juniors would recommend for training to their fellow colleagues These exciting posts in Emergency Medicine are aimed at doctors (SHO equivalent) preferably with experience working in Emergency Medicine. Our department ~180,000 patients per year offering a rich case-mix in all areas of the emergency arena. There is 24/7 middle grade support and a minimum of 15 hours a day of direct consultant clinical supervision during the week. As well as working in a dynamic department we can offer successful candidates the following: - Induction and weekly teaching; - Education supervisor for support with personal learning objectives - Study leave budget per annum - In addition separate funding for one life support course per year - Support with college examination preparation and further personal development - Experience in audit and quality improvement projects; - Opportunities for development of ultrasound by our in-house level 2 trainers. We currently have three vacancies on the Training SHO rota and two for Trust Doctors.

THE NORTH MIDDLESEX UNIVERSITY HOSPITAL NHS TRUST North Middlesex University Hospital NHS Trust is a single site, medium-sized hospital, located in Edmonton and is the local acute hospital for the boroughs of Enfield and Haringey. We provide high quality care across a full range of secondary care services and some specialist tertiary services that reflect the needs of the local population we serve. Over 3,000 staff work at the hospital and well over 2,000 patients use our services every day. After a period of major transformation, more than 90% of our clinical services are delivered from buildings that are either new or refurbished over the last 5 years. Implementation of the Barnet, Enfield and Haringey clinical strategy has resulted in a 20% increase in patient numbers, particularly in ED, paediatrics and maternity services. However, we also know there is still much to be done and we are determined to continue to improve the care we provide and our patients experience of our care. We are also changing the way we work together as a team. This year we have taken the opportunity to refocus our attention on our most important asset, our staff. We have established new staff values and are working hard to grow them. We have started to develop new staff training and learning opportunities, and we have created a range of exciting new events and activities for them. We know that by making the hospital an even better place to work, we can help our staff provide even better care for patients. Whatever your involvement with our hospital, thank you for taking the time to read our annual report and for your continued interest and support. The hospital has been on its present site for over 100 years and we were established as an NHS Trust in law by means of a statutory instrument in December 1990. We provide services in collaboration with a range of partners, including local GPs, acute, mental health and community health service providers. We are a founding member of University College London Partners, working to adapt academic and laboratory research to enable improved clinical outcomes for our patients. We also work closely with a number of universities to provide training for doctors, nurses and other healthcare professionals as part of both undergraduate and post-graduate programmes. Other key figures are: A&E attendances 178,863 Outpatient attendances 320,206 Admissions 74,543 Operations / procedures 36,065 Babies born 5,090 Approximate average daily patient numbers using the hospital s services are now as follows: 500 patients in A&E 450 inpatients on our wards 50 patients undergoing major or minor surgery 900 outpatients attending clinics 200 women attending maternity clinics 15 babies born in our maternity unit And in addition we provide approximately:

400 X-rays and radiology tests 500 blood tests. Income: 244m Executive Officers of the Trust: Chief Executive Libby McManus Medical Director - Dr Catherine Cale Director of Nursing Deborah Wheeler Chief Operating Officer (Interim) - Eileen Doyle Director of Strategic Development - Richard Gourlay Director of Finance David Stacey Director of Human Resources Helen Rushworth CBU 1 Management Team: Clinical Director - Dr Turan Huseyin (from 27 06 2016) CBU 1 and 2 Managing Director (Interim) Patricia Dunsmore CBU 1 and 2 Head of Nursing - Anna Langthorne CBU 1 Deputy Head of Nursing Christine Kerr Matron for Emergency Medicine Gemma Davis Matron for Emergency Medicine Terence Reeves INTRODUCTION TO THE DEPARTMENT North Middlesex Emergency Department was visited and assessed by NHS England, Health Education England and the GMC, and had an in-depth inspection by CQC in September. By the end of 2016: The CQC gave a Good rating for Leadership and Caring. The department was assesses as being well led and the level of care patients received was good. The CQC recognised that many improvement programmes were underway and the department was much better in many areas when compared to earlier visits Health Education England provided praise for turning around the training experience received by juniors. The juniors would now recommend the ED for training to their fellow colleagues The department moved into a brand new, state of the art, purpose-built air-conditioned unit new hospital in May 2010. The Emergency Department at the North Middlesex University Hospital has an annual attendance of ~180,000 new patients. There is a significant trauma workload; consequently there is an active Trauma Team. The department receives nearly 20% of its workload as ambulance borne. The brand new state of the art, purpose built air-conditioned unit comprises of a 6 bay resuscitation unit, 8 streaming rooms, a separate see and treat area, a 24 bay majors area and a separate paediatric unit and waiting area. There is also a 48 bedded Acute Medical Unit in close proximity to the department.

Current Department Medical Staff Consultants 14 Consultant Team Dr Turan Huseyin Dr Vijay Kumar Mr A Alkhamesi Mr D Sharma Dr C Pearce Mr K Alam Mr R Rajarajan (Locum) Dr Mashhood Ul Haque Qazi Dr Adrienn Fricska-Nagy Mr Arunachalam Sathyanandha (Honoury) Dr Sathiya Rajaraman (Locum) Dr Ashfaque Sorathia(Locum) Dr Andrea Annoni (Locum) Dr Gayle Hannah Special Interests Clinical Director Undergraduate Education Lead Major Incident / Rotas Trauma Lead / Ultrasound Governance and Safety Lead / Clinical Tutor Paediatric Resuscitation Pre-hospital/Trauma Newly appointed Risk management Audit Paediatric Consultant Trauma/Child protection Other Medical Staff: 1 Associate Specialist 2 Specialty Registrars (ST4-6) 16 Clinical Fellows/Specialty Doctors (Middle Grade, Registrar equivalent) 7 CT1 & CT2 (ACCS) (GPVTS) 12 FY2 10 Trust SHO 2 Clinical Assistant sessions Key Nursing Staff (or AHP): Deputy Head of nursing 1.0 wte Band 8b Matrons 2.00 wte Band 8a ENP 10.00 wte Band 7 Practice & Development Practitioner 1.00 wte Band 7 Sisters 11.00 wte Band 7 Staff Nurses 21.00 wte Band 6 Staff Nurses 22.78 wte Band 5 Health Care Support Workers 5.24 wte Physician Assistants 2 wte Band 2 Non-Medical Staff (Support Staff) Reception and Bed Bureau: Senior Team Leader 1.00 wte Admin & Clerical 11.25 wte Data Quality Assistant 1.00 wte Department Secretarial Support 2.00 wte There is an emergency Radiography Department adjacent to the ED which is staffed 24 hours a day. There is a CT scanner available at all times with excellent consultant based radiology support. Full emergency laboratory facilities including a well-resourced point of care testing room are available. An Acute Assessment Unit (AAU) is located alongside the ED.

SERVICES AND FACILITIES The Emergency Department at the North Middlesex University Hospital has an annual attendance of ~ 180,000 new patients. 27% of attendances are under the age of 16. The post holder will be required to play an active role in the development of our Paediatric emergency services. S/he will be required to work closely with their other colleagues in providing clinical cover for annual leave within the department. There is a significant trauma workload; consequently there is an active Trauma Team. The department receives nearly 20% of its workload as ambulance borne. The department has a philosophy of comprehensive patient care where the initial management of the patient is undertaken in the ED and the patient then handed over to in-patient teams. There is an excellent relationship with the in-patient teams with seamless referrals. The case mix has the highest acuity in the North East Thames region with preponderance towards medically unwell patients. Major Incident Plan There is close co-operation between the Ambulance, Fire, and Police in the area. The major incident plan is routinely updated. Ambulance Training The Emergency Department is served by London Ambulance Service. Paramedics from the services update their training in the department. DUTIES OF THE POST The successful candidates will be expected to be fully involved in all aspects of the work of the Accident & Emergency Department under the supervision of the consultant in charge, to whom he/she will be responsible. The clinical duties include all those that are normally expected in any major Emergency Department in the United Kingdom. The Junior Clinical Fellow will: 1. Provide and maintain a high standard of care for all patients in the Emergency Department 2. To review and appropriately manager patients presenting to the Emergency Department, with senior support as required. 3. Maintain accurate patient documentation 4. Ensure that patient confidentiality is adhered to at all times 5. To ensure that all Trust standards are maintained to ensure a high quality of care to all who come into contact with the services provided by North Middlesex University Hospital NHS Trust POSTGRADUATE EDUCATION & TEACHING There is a formal teaching programme in the department. The successful candidates will be actively involved in these sessions and also in the teaching of both the junior doctors and nursing staff. Any research projects under the guidance of the consultants in charge will be encouraged Soon after commencing the post you should expect an objective setting meeting with your Consultant, and regular appraisals during the post.

Teaching The North Middlesex University Hospital has gained a reputation for teaching excellence in the region due to our dedicated consultant teachers and a rich variety of clinical cases. Formal teaching sessions are organised differently in various departments. Undergraduate Education As a University hospital of the University of London, the hospital has a substantial commitment to training of medical students from the University College London (UCL) Medical School, and is one of the two centres outside the teaching hospitals for UCL Final MBBS examinations. Many consultants are recognised teachers of UCL. Medical students of St. George s International School of Medicine in Grenada also attend for varying periods in different specialties. On occasions, there are elective students from other overseas universities. Postgraduate Education The hospital has a modern, well-equipped Academic Centre for Post-graduate Medical Education with a comprehensive medical library and an adjacent Open Learning Centre. The Academic Centre is well used by the Hospital staff and local General Practitioners and offers an intensive programme of postgraduate lectures and demonstrations. The Hospital has an excellent reputation for its postgraduate medical education. There are regular FRCS, MRCP, DCH and MRCOG courses held and ongoing MRCP training. ALS and APLS courses have been conducted locally. CARE AND COMPASSION Ensure that any escalation of care concerns or safeguarding escalations are made robustly through the appropriate channel. Undertake audits and where appropriate cooperate with the corporate nursing team to maintain Trust standards of care. OUR VALUES At North Middlesex University Hospital we provide great care to our patients. As colleagues we are enthusiastic about being the local hospital of choice and this rubs off on our patients. But the way we do things is also important, and by demonstrating the values and behaviours chosen by staff and described in this leaflet, we can make North Mid an even better place to work and receive care. There are four core values that make us unique: Caring Being welcoming and approachable Being polite, friendly and courteous Being kind and understanding Showing empathy and compassion, putting ourselves in others shoes Treating people as individuals, seeing the whole person, looking out for people and their individual needs Reducing the anxiety of attending hospital Helpful Respecting privacy and dignity Being patient Listening and hearing

Giving clear explanations and information, checking people understand and avoiding using jargon Being interested in how to improve things and keep learning Guiding lost visitors and patients to their destination Open & Honest Being safe, calm and reassuring Being professional and accountable Acting on concerns about the safety of others and challenging poor care, service and behaviour Being fair and consistent Being a positive role model and striving for excellence Teamwork Involving people as equals Working as a team Communicating - within and across teams Being reliable, doing what we say we will Being prompt, efficient and well organised This job description is intended as a guide to the main duties of the post and is not intended to be a prescriptive document. Duties may change to meet the needs of the service or because of the introduction of new practices or technology. This job description may be reviewed from time to time and changed, after consultation with the post-holder. TRUST POLICIES Equal Opportunities Policy It is the aim of the Trust to ensure that no job applicant or employee receives less favourable treatment on grounds of sex, race, age, colour, nationality, or ethnic or national origin or is not placed at a disadvantage by conditions or requirements which cannot be shown to be justifiable. To this end, the Trust has an equal opportunities policy and it is for each employee to contribute to its success. Health & Safety Employees must be aware of the responsibilities placed on them under the Health & Safety at Work Act 1974 to maintain a safe environment for both staff, patients and visitors, to observe obligations under organisational and departmental Health & Safety policies, maintaining awareness of safe practices and assessment of risk. Data Protection and Caldicott To obtain, process and use information (held on computer and manual filing systems) in affair and lawful way. To hold person identifiable information for specific registered purposes and not to use, disclose or transfer person identifiable information in any way that is incompatible with the law and Caldicott requirements. To disclose person identifiable information only to authorised persons or organisations as instructed. Email must not be used to transmit person identifiable information between Trust and other premises without advice concerning additional document protection. Customer Care The aim of the hospital is to provide patients and clients with the best possible care and services. In order to meet this aim, all our staff are required at all times to put the patient and client first and do their utmost to meet their requests and needs courteously and efficiently. In order that staff understand the principles of customer care and the effects on their particular post and service, full training will be given.

Infection Control All healthcare workers have an overriding duty of care to patients and are expected to comply fully with best practice standards. You have a responsibility to comply with Trust policies for personal and patient safety and for prevention of healthcare associated infection (HCAI); this includes a requirement for rigorous and consistent compliance with Trust policies for hand hygiene, use of personal protective equipment and safe disposal of sharps. Knowledge, skills and behaviour in the workplace should reflect this; at annual appraisal you will be asked about application of practice measures known to be effective in reducing HCAI. Smoking Policy The Trust provides a smoke free work environment. Confidentiality Under no circumstances, either during or after the end of your employment (however it is terminated), may you divulge any unauthorised person confidential information relating to the Trust. This includes but is not limited to, information covering patients, individual staff records, industrial relations, financial affairs, contract terms and prices or business forecasts. Clinical Governance The staff are expected to provide patients with timely and effective care. Treatment and direct / indirect support must be based on best practice. Everyone is responsible for this and his/her job in the Trust is important in achieving this. Rehabilitation of Offenders Act This post is exempt from the Rehabilitation of Offenders Act 1974. Should you be offered the post it will be subject to a criminal check from the Criminal Records Bureau before the appointment is confirmed. This will include details of cautions, reprimands, final warnings, as well as convictions. Safeguarding Vulnerable People It is a basic human right of every child and adult to be protected from harm and NHS Trusts have a fundamental part to play in this. We expect all our staff to recognise signs of vulnerability and to report and act on any concerns in line with policy and guidance contained in 'Working Together - Every Child Matters' and 'No Secrets - guidance on developing multi-agency policies and procedures to protect vulnerable adults from abuse' on which our Trust Polices are based. Code of Conduct Staff are required to comply with the Trust s Staff Code of Conduct, a copy of which is available on the Trust s website. This policy is for all staff working at the North Middlesex University Hospital NHS Trust. Our Code of Conduct is based on the NHS Values as set out in the NHS Constitution and exists to help ensure that both patients and staff have the best experience possible from their time at North Middlesex University Hospital NHS Trust. ADDITIONAL INFORMATION Situated in Edmonton, North London with a multi-cultural community, the area provides a wide range of facilities and is close to the heart of London. On-site we offer subsidised restaurant facilities. We also offer subsidised car parking, although currently there is a waiting list. Central London is easily accessible, with Liverpool Street and Kings Cross approximately 30 minutes away by public transport. Other benefits include: childcare vouchers through Kids Unlimited, Cycle to Work Scheme and season ticket loans.

Road Access and Public Transport Situated on the North Circular Road, the hospital is within very easy reach of the M25, M1, A1, A10 and A12. The hospital is situated close to the residential districts of North London including Enfield and Winchmore Hill, which all have an excellent environment and schools. Silver Street main line railway station is a 5-minute walk away, with services direct to Liverpool Street Station and Seven Sisters underground Station. VISITS FOR APPLICANTS Intending applicants are welcome to visit the hospital (at their own expense). Please contact Dr. Turan Huseyin on turan.huseyin@nhs.net Clinical Director - ED at the North Middlesex University Hospital.

PERSON SPECIFICATION ESSENTIAL CRITERIA Qualifications MBBS or equivalent medical qualification WHEN EVALUATED form Eligibility Full registration with, and hold a current licence to practise from the GMC Have evidence of either: Current employment in a UKFPO-affiliated foundation programme or: 12 months experience after full GMC registration or equivalent, and evidence of achievement of foundation competences in the three years preceding the intended start date from a UKFPO-affiliated foundation programme or equivalent, in line with GMC standards / Good Medical Practice; including: Make the care or your patient your first concern Provide a good standard of practice and care Take prompt action if you think that patient safety, dignity or comfort is being compromised Protect and promote the health of patients and of the public Treat patients as individuals and respect their dignity Work in partnership with patients Work with colleagues in the ways that best serve patients interests Be honest and open and act with integrity Never discriminate unfairly against patients or colleagues Never abuse your patients trust in you or the public s trust in the profession. Be eligible to work in the UK form form, Interview form, Interview form Fitness Advanced to practice Life Support Certificate from the Resuscitation Council UK or equivalent Is up to date and fit to practice safely and is aware of own training needs Language skills Applicants must have demonstrable skills in written and spoken English, adequate to enable effective communication about medical topics with patients and colleagues; as demonstrated by one of the following: form, references form, Interview or Undergraduate medical training undertaken in English; Academic International English Language Testing System (IELTS) results showing a score of at least 7.0 in each domain (speaking, listening, reading, writing),with an overall score of at least 7.5, to be achieved in a single sitting and within 24 months of the time of application If applicants believe they have adequate communication skills, but do not have evidence in one of Health the above forms, they must provide alternative supporting evidence of language skills Applicants must meet professional health requirements (in line with GMC standards / Good Medical Practice). form, preemployment health screening

Career progression Applicants must: Be able to provide complete details of their employment history Have evidence that their career progression is consistent with their personal circumstances Have evidence that their present level of achievement and performance is commensurate with the totality of their period of training form, Interview ESSENTIAL CRITERIA Qualifications As above Clinical skills clinical knowledge & expertise Ability to apply sound clinical knowledge and judgement to problems Ability to prioritise clinical need Ability to maximise safety and minimise risk Recognition of, and ability to undertake the initial management Academic skills Research and audit skills: Demonstrates understanding of research, including awareness of ethical issues Demonstrates understanding of the basic principles of audit, clinical risk management, evidence-based practice, patient safety, and clinical quality improvement initiatives Demonstrates knowledge of evidence- informed practice DESIRABLE CRITERIA Additional related qualifications, e.g. intercalated degree, BSc, BA, BMedSci or equivalent Aptitude for practical skills, e.g. manual dexterity Previous A&E experience at SHO level - 3months plus Research and audit skills: Evidence of relevant academic and research achievements, e.g. degrees, prizes, awards, distinctions, publications, presentations, other achievements Evidence of involvement in an audit project, a quality improvement project, formal research project or other activity which: Teaching: focuses on patient safety and clinical improvement demonstrates an interest in and commitment to the specialty beyond the mandatory curriculum Evidence of interest in, and experience of, teaching Evidence of feedback for teaching Instructor status (or a recommendation for instructor status) in an advanced life support course (ALS, ATLS, EPLS, APLS) or equivalent course WHEN EVALUATED form, Interview, references form, Interview, references form, Interview

Personal skills Communication skills: Demonstrates clarity in written/spoken communication, and capacity to adapt language to the situation, as appropriate Able to build rapport, listen, persuade and negotiate. Problem solving and decision making: Capacity to use logical/lateral thinking to solve problems/make decisions, indicating an analytical/scientific approach. Empathy and sensitivity: Capacity to take in others perspectives and treat others with understanding; sees patients as people Demonstrates respect for all. Managing others and team involvement: Able to work in multi-professional teams and supervise junior medical staff Ability to show leadership, make decisions, organise and motivate other team members; for the benefit of patients through, for example, audit and quality improvement projects Capacity to work effectively with others. Organisation and planning: Capacity to manage/prioritise time and information effectively Capacity to prioritise own workload and organise ward rounds Evidence of thoroughness (is wellprepared, shows selfdiscipline/commitment, is punctual and meets deadlines.) Vigilance and situational awareness: Capacity to monitor developing situations and anticipate issues. Coping with pressure and managing uncertainty: Capacity to operate under pressure Demonstrates initiative and resilience to cope with changing circumstances Is able to deliver good clinical care in the face of uncertainty Values: Understands, respects and demonstrates the values of the NHS Constitution (e.g. everyone counts; improving lives; commitment to quality of care; respect and dignity; working together for Management and leadership skills: Evidence of involvement in management commensurate with experience Demonstrates an understanding of NHS management and resources Evidence of effective multi-disciplinary team working and leadership, supported by multisource feedback or other workplace- based assessments Evidence of effective leadership in and outside medicine IT skills: Other: Demonstrates information technology skills. Evidence of achievement outside medicine Evidence of altruistic behaviour, eg voluntary work Evidence of organisational skills not necessarily in medicine, e.g. grant or bursary applications, organisation of a university club, sports section, etc. form Interview References

Probity professional integrity Demonstrates probity (displays honesty, integrity, aware of ethical dilemmas, respects confidentiality) form, Interview, references Capacity to take responsibility for own actions. Commitment to speciality learning and personal development Shows initiative/drive/enthusiasm (selfstarter, motivated, shows curiosity, initiative) Demonstrable interest in, and understanding of, the specialty Commitment to personal and professional development Evidence of attendance at organised teaching and training programme(s) Evidence of self-reflective practice Extracurricular activities / achievements relevant to the specialty Attendance at training courses relevant to the specialty form, Interview, references