SECTION 1 SUMMARY OF POST Job Title: Stroke Consultant/Stroke Physician Grade: Consultant Managerial Responsible to: Clinical Director Professionally Accountable to: Clinical Service Lead and Clinical Director Base/Department(s): Neurology/Stroke Location(s): Southmead Hospital Job Plan: Proposed Job Plan is attached although the individual will be expected to work flexibly to fulfil high professional standards and contribute to Departmental and Trust priorities. SECTION 2 ABOUT THE TRUST North Bristol NHS Trust (NBT) is the largest Trust in the South West region, and one of the largest trusts in the country. Last year the Trust treated over 100,000 inpatients, over 300,000 outpatients, over 90,000 emergency department patients and helped deliver over 5,000 babies. It employs more than 8,500 staff, has approximately 1200 inpatient beds and a revenue budget in excess of 400 million. The Trust provides medical surgical, paediatric and maternity care for its local population of approximately half a million people in the North Bristol and South Gloucestershire area. The Trust also provides sub regional, regional and supra regional services in the fields of neurosciences, orthopaedics, pathology, plastic surgery and burns, renal medicine and transplant, and urology. The health service in Bristol, North Somerset and South Gloucestershire has been remodelled to concentrate acute facilities and where appropriate to provide more care close to patient homes through a network of community hospitals and facilities. All acute services are now provided within Southmead Hospital, Bristol. All adult neuroscience services including all stroke services are now delivered from the new world class facility in the Brunel building at The Southmead hospital, Bristol. The Trust has University Teaching status and is associated with both the University of Bristol and the University of the West of England
SECTION 3 THE WORK OF THE DEPARTMENT The Neurology Department at Southmead Hospital is a major part of the Regional Neurosciences Centre. It provides all in-patient specialist neurology services for Bristol (Avon), Weston and adjacent area, including a 24hr emergency neurology service including a fully integrated acute stroke service. It also provides outreach clinics and a consultative service for local DGH's. The other components include Neurosurgery, dedicated Neuropathology, Neuroradiology, Clinical Neurophysiology, Neuropsychiatry, and Neuropsychology. The Neurology Department provides all stroke services within NBT, currently with a team of 5 consultant stroke specialists leading the Trust s Comprehensive Stroke Centre including both acute and rehabilitation services. In addition to dedicated junior medical staff and specialist trainees, we provide acute thrombolysis and TIA clinics 365 days per year. We have an excellent neurovascular interventional radiology service. We also have a full time stroke specialist nurse. The post is advertised due to one of the existing Consultants moving to another Trust. There is a Brain Injury Rehabilitation Unit on the Frenchay site, run by Four seasons with close links to NBT. The new post-holder has been given appropriate secretarial support, 0.5WTE, band 4 senior secretary, who is already in post. Office space will be available within the Neurology department, named desk in the Consultant Office in Gate 3 has been made available. The appointee will be contractually accountable to the North Bristol NHS Trust for the provision of services. The appointee will be managerially responsible to the Chief Executive through the Medical Director and the Clinical Director. All consultants are required to undergo an annual appraisal carried out in accordance with the Trust policy. Consultants are also required to take an active and co-operative approach to their job planning, which will be reviewed on an annual basis by their Clinical Director. Consultants will, at all times, be expected to have exemplary standards of professional and personal behaviour, and to act as role models within the Trust. It is a requirement that if the employee has concerns about the professional performance of a member of the medical staff, they have a duty to speak to the person concerned. If the matter is potentially serious or satisfaction is not obtained with a direct approach, such concerns should be discussed with the Trust s Medical Director. The appointee will be expected to be fully involved in the developments of the Speciality, to take account of the Trust policies, including Risk Management Strategy and developments in Clinical Governance. The appointee may be asked to participate in managerial and administrative work and will be expected to be aware of the broader context within the NHS in which Consultants operate. The postholder will be a member of: a) The North Bristol NHS Trust Department of Neurology b) The North Bristol NHS Trust Medical Advisory Committee. The Neuroscience and MSK Division Working relationships Names of Senior Medical Staff and Specialities/Sub Specialities
The Neurology Department is currently staffed by 20 Consultants, 14 NHS and 5 University appointments, with clinical and research interests as follows: Dr Luke Bennetto (Neurophthalmology); Dr Andria Merrison (Muscle Disease); Dr Stefen Brady (Muscle Disease); Dr Justin Pearson (Neurovascular Disease/ stroke); Dr Olivera Martinovic (Gentrology/ stroke) Dr Alan Whone (movement disorders); Dr Konrad Krolikowski (Movement disorders); Dr Phil Clatworthy (Neurovascular Disease/Stroke); Dr Howard Faulkner (epilepsy); Dr Katarzyna Sieradzan (epilepsy), Professor Neil Scolding (multiple sclerosis and other inflammatory disorders) Dr David Cottrell (multiple sclerosis), Dr Alastair Wilkins (Senior Lecturer; Multiple sclerosis), Dr Claire Rice (Senior Lecturer; Multiple sclerosis); Dr James Stevens, Dr Elizabeth Coulthard (dementia); Dr Hilary Archer (dementia); Dr Catherine Pennington (dementia); Dr Sabine Klepsch; Dr Madhu Ramamoorthi (epilepsy). Numbers and Grades of Junior Medical Staff There are five specialist registrar posts in neurology and two registrar posts for stroke training fellowships in Bristol. All are based at Southmead hospital for the inpatient work. There are five SHO posts and one clinical fellow in neurology, together making sixteen neuroscience SHOs to cover neurosurgery and neurology using a split shift system. Future changes in numbered training posts may mean changes in the junior medical staff within the Directorate. Other Key Staff in the Department Additional staff members include a Nurse Practitioner, and an expanding team of Specialist Nurses (currently seven) in Parkinson s disease, epilepsy, epilepsy surgery, stroke and multiple sclerosis. The Divisional Manager is Ms Rhona Galt.
SECTION 4 DUTIES OF THE POST (i) Clinical Duties The postholder will be responsible for the clinical management of patients under their care, and, in liaison with consultant colleagues, continuity of care when the postholder is absent. The postholder will join the existing four stroke neurologists and share the supervision of the acute and rehabilitation stroke units at Southmead Hospital, during normal working hours including responsibility for thrombolysis. The successful applicant will be a team player, and be willing to work flexibly to provide cover for the other consultants who cover the Stroke Services. The successful applicant may be a neurologist with an interest in stroke and stroke rehabilitation or a stroke physician. In the case of the latter, the job plan & clinic commitment will be adapted to be suitable to the appointee. There is the opportunity to create a post shared between the neurology and care of the elderly departments (please ask for further information). The essential requirement is that the appointee be expert in and committed to the care & management of stroke patients in all phases of their care, be committed to helping building a stroke centre of excellence both in patient care and research. Excellent opportunities exist to build a research base collaborating with the other stroke consultants and also with the neuroradiology team and the neurosurgery team. The successful applicant would join the current 4 neurology consultants who cover the stroke activity on a rotation system. One week in five would be acute stroke admitting all stroke patients under their care. These patients remain under that consultants care for their entire admission on either the acute or rehabilitation units both within the Brunel building. One week in five would be covering the 5 weekday TIA clinics. Other clinical activity including outpatient clinic activity occurs in the remaining weeks. All weeks will contain stroke ward round activity and activity related to parent speciality. The postholder will be responsible for the clinical management of patients under their care and, in liaison with Consultant colleagues, continuity of care when the postholder is absent. (ii) Teaching and Supervision of Junior Medical Staff & Students The postholder will be responsible for the professional supervision and management of junior medical staff. Where appropriate, the postholder will be named in the educational contract of junior staff as the person responsible for overseeing their training and as an initial source of advice to such doctors regarding their careers. In liaison with the Director of Postgraduate Medical Education the postholder may be required to contribute to undergraduate and postgraduate education. (iii) Study & Research The postholder can request up to a maximum of 30 days study leave within a 3-year period (pro rata for part-time posts) as stated in the Terms and Conditions of Service. The Trust is committed to ensuring that support is given for Continuing Medical Education. The postholder will be required to fulfil the requirements laid down by the relevant Royal College, and to fulfil the requirements for revalidation laid down by the General Medical Council. The postholder will not necessarily be expected to undertake research however opportunities do exist and encouragement is given to develop collaborative projects with other departments within Trust or with the University of Bristol and the University of the West of England. The post-holder will be required to submit all research development plans which have resource
implications to the Clinical Director prior to implementation. There are professionally staffed Medical Libraries in the Medical Postgraduate Centre at Southmead Hospital, with a rapid service between this and the University Library situated in the centre of Bristol city. A computer literature search facility is available for which a charge is made and the library has links with other networks. The libraries are at the forefront of developments in electronic knowledge delivery. (iv) Audit The postholder will be required to take part in a Clinical Audit Programme. The Trust has an audit department which supports and monitors such activity. There is an active Trust Clinical Audit Committee. SECTION 5 LOCATION All posts are regarded as being Trust wide but the base Hospital will be: Southmead Hospital Please note that the base could change as a consequence of clinical requirements. The Neurology department has 15 designated general inpatient beds and 5 neuro-monitoring beds for epilepsy surgery and sleep service in the Brunel building with additional flexible bed capacity available. There are 22 beds on the acute stroke unit and 17 beds on the stroke rehabilitation unit all within the Brunel building. The Neuroscience department has a dedicated outpatient facility
SECTION 6 MAIN CONDITIONS OF THE POST The appointee will be expected to work within the facilities available to the Group and any new service developments are subject to the provision of necessary resources within the Trust. There is an active appraisal and development programme and all consultant staff will take part in this process. The post holder must be fully registered with the General Medical Council with a licence to practise and is advised to maintain up to date membership of a recognised medical defence organisation. The Trust has arrangements in place to ensure that all Medical staff receive an annual appraisal with a trained appraiser and supports all Medical staff through the revalidation process. The Trust has a list of identified Mentors which is used to allocate a suitable support to new consultants during the first year in post, this will be made available to post-holder upon arrival in the department. The appointee will be required to live within a distance that allows safe discharge of all clinical commitments and no more than a 10 mile distance from the base (unless there is prior agreement with the Medical Director) or 30 minutes travelling of your base hospital. An applicant who is unable, for personal reasons, to work full-time will be eligible to be considered for the post; if such a person is appointed, modification of the job content will be discussed with the Trusts on a personal basis in consultation with Consultant colleagues. The successful candidate is expected to be aware of local policies and procedures and comply with the standing orders and standing financial instructions of the Trusts. Consultant appointments are made to North Bristol NHS Trust as services are developed and changed, the base of posts may alter and any employee of the Trust will be expected, within an agreed clinical strategy, to move his/her sessions as the service requires. Your attention is drawn to the confidential nature of information collected within the NHS. The unauthorised use or disclosure of patient or other personal information is a dismissible offence and in the case of computerised information, could result in a prosecution for an offence or action for civil damages under the Data Protection Act 1998. The appointment is subject to pre-employment health screening
SECTION 7 PROPOSED JOB PLAN ACUTE STROKE WEEKS Day Time Location Work Categorisation No. of PAs 09:00-12.30 Southmead Board round and acute DCC 0.875 stroke ward round Monday 12.30-17:30 Southmead Stroke referrals and DCC 1.25 acute ward round and ward admin 09:00-11.00 Southmead Board round and acute DCC 0.5 stroke ward round Tuesday 11:00-14:00 Southmead Stroke referrals DCC 0.75 14.00-17.00 Southmead Neuro and acute ward round and admin DCC 1.5 09:00-12.00 Southmead Board round/mdt/acute DCC 0.75 Wednesday ward Round 12:00-16:00 Southmead Stroke MDT and referrals DCC 1.0 16.00-17.00 Southmead Acute ward round DCC 0.25 09:00-11:00 Southmead Acute/rehab stroke ward DCC 0.5 and board round 11.00-15.00 Southmead Stroke referrals and DCC 1.0 Thursday neuro ward round 15.00-17.30 Southmead Ward admin and DCC 0.625 acute/rehab stroke ward round 09:00-11.00 Southmead Board round and acute DCC 0.5 stroke ward round Friday 11:00-14:00 Southmead Stroke ward round DCC 0.75 14:00-18:00 Southmead Acute ward round and referrals DCC 1.0 TIA CLINIC WEEKS Day Time Location Work Categorisation No. of PAs 09:00-10.00 Southmead Board round and TIA DCC 0.25 Monday 10:00-13:00 Southmead Stroke Ward round DCC 0.75 13:00-17:30 Southmead TIA clinic and ward DCC 1.0 admin 09:00-11:00 Southmead TIA and neuro ward DCC 0.75 Tuesday round 12.30-13.30 Southmead Teaching SPA 0.25 13:30-17.00 Southmead TIA clinic and admin DCC 0.875 09:00-11.30 Southmead MDT/TIA DCC 0.625 11:30-12:30 Southmead Neuroscience academic SPA 0.25 Wednesday meeting 12:30-16:30 Southmead MDT/TIA clinic and admin DCC 1.0 09:00-13:00 Southmead TIA clinic and neuro and DCC 1.0 Thursday stroke ward round 13:00-14:00 Southmead Stroke Governance SPA 0.25 14:00-17:30 Southmead TIA clinic and admin DCC 0.875
Friday 09:00-13:00 Southmead TIA clinic DCC 1.0 13:00-15:00 Southmead Stroke ward round DCC 0.5 15:00-17.30 Southmead Admin DCC 0.625 GENERAL WEEKS Day Time Location Work Categorisation No. of PAs 09:00-12.30 Southmead Board and ward round DCC 0.875 Monday 12:30-13.30 Southmead Consultant meeting SPA 0.25 13.30-16.30 Southmead Admin DCC 0.5 09:00-12:00 Southmead / Neurology clinic DCC 0.75 Tuesday TBA 14:00-16:30 Southmead / Ward referrals and DCC 0.625 TBA admin 09:00-10.00 Southmead MDT DCC 0.25 10.00-12.30 Southmead Audit, Job Planning, SPA 0.625 Wednesday Revalidation etc; Academic neurosciences meeting 12.30-14.30 Southmead X-ray meeting/mdt DCC 0.5 09:00-13.30 Southmead/ General Neurology Clinic DCC 1.125 Thursday TBA and admin 14:00-16:00 Southmead Neuro ward round and DCC 0.5 admin Friday 09.00-12.30 Southmead Board round and stroke DCC 0.875 ward round Predictable emergency on call work Unpredictable emergency on call work (Max per week until 31 March) Variable On-site, at home on the telephone, and travelling to and from site Direct Clinical Care 0.55 Direct Clinical Care Summary Task Hours PA's Outpatients Clinics 7.98 1.995 Outpatients Admin 4.13 1.033 Neuro Ward Round 2.00 0.500 Stroke Ward Round 5.50 1.376 Acute Ward Round 3.47 0.867 Stroke Referrals 3.71 0.929 Ward Admin 1.37 0.343 Board Round 1.25 0.312 MDT 2.38 0.595 Travel 0.00 0.000 CPD 6.00 1.500 On Call 2.20 0.550 40.00 10.000
On Call Availability Supplement Frequency of Rota Commitment Value of supplement as a % of WT basic salary (please tick appropriate box) Category A Low Frequency: 1:9 or less 3.0% On call will include cover of Stroke and Neurology including local Thrombolysis advice and weekend TIA clinic. Frequency: 1:19 Programmed activity Number Direct clinical care (including unpredictable on-call) 8.5 Supporting professional activities 1.5 Other NHS responsibilities (to be discussed with Clinical Director) External duties (to be discussed with Clinical Director) Total Programmed Activities 10 NOTE This is a proposed job plan. Only those times that need to be fixed, such as the start and usual finish times of clinics are detailed. All other times must be discussed with the appointee. The timetable will be reviewed after the appointee has been in post for three months. It must therefore be regarded as a temporary work programme only.
SECTION 8 PERSON SPECIFICATION Assessment at Shortlisting stage Category Essential Desirable Scoring Matrix Qualifications And MRCP or equivalent Higher academic qualification (e.g. MD or MS). Qualifications Registration Maintain Full registration with the GMC. Must have CCT in neurology or CST in stroke and CCT in another speciality and have been entered on the GMC Specialist Register at the time of the appointment. Training And Experience Specialist registrars that do not hold a CCT must be due to be awarded one within 6 months of the interview date. Recent experience and familiarity of UK hospital systems and practices (or equivalent). Minimum of 6 years postgraduate experience including higher surgical/medical training, three years as a Senior Registrar in an approved training post, or equivalent. Part of this period may be in a post of equivalent responsibility and training potential. Some training in diagnosis and treatment of neurological conditions. Experience Further Training, Management, Audit Training in diagnosis and treatment of Cerebrovascular conditions. Evidence of recent CME/ reasonable training progression at this stage of career. Experience in audit project and written up Completion of a general management course or programme. Knowledge Knowledge of contemporary NHS management issues. Research, Teaching, Publications Knowledge of political context within which we operate. Proven teaching ability. Willingness to undertake teaching of medical under-graduates & postgraduates. Proven track record in research. Willingness to undertake further research. Skills Ability to gain the trust and confidence of colleagues and patients. Ability to teach effectively Evidence of relevant publications in peer reviewed journals. Demonstration of involvement in clinical directorate management.
Personal Requirements (eg. Communication Leadership Skills, Flexibility) Ability to lead a team and form effective working relationships within a team. Ability to inspire, motivate and develop junior medical staff. Ability to work independently as well as part of the Neuroscience Directorate. To balance individual requirements against those of the Directorate and Trust as a whole. Good written communication skills. Evidence of the ability to communicate with patients, colleagues and staff at all levels. Other