CARDIFF AND VALE UNIVERSITY HEALTH BOARD Caring for People, Keeping People Well CLINICAL FELLOW (Higher) IN EMERGENCY MEDICINE Job Description Cardiff and Vale University Health Board is the operational name of Cardiff and Vale University Local Health Board. Bwrdd Iechyd Prifysgol Caerdydd a r Fro yw enw gweithredol Bwrdd Iechyd Lleol Prifysgol Caerdydd a r Fro.
CARDIFF AND VALE UNIVERSITY HEALTH BOARD POST: BASE: CLINICAL FELLOW (Specialty Registrar pay level) EMERGENCY UNIT University Hospital of Wales, Cardiff 1. THE HEALTH BOARD Cardiff and Vale University Health Board was established in October 2009 and is one of the largest NHS organisations in the UK. We have a responsibility for the promotion of health and well-being of around 472,400 people living in Cardiff and the Vale of Glamorgan, the provision of local primary care services, running of health centres, community health teams, hospitals providing treatment and care when health and wellbeing isn t the best it could be. We are increasingly focussing the planning and delivery of our care based on neighbourhoods and localities to help ensure people receive care as close to home as possible where it is safe and effective to do so. We also provide specialist services for people across South Wales and in some cases the whole of Wales. The Health Board also serves a wider population of 2.5 million people across South and Mid Wales and manages a number of services of a regional and sub-regional nature namely cardiology, cardiac surgery, PICU, neurology, neurosurgery, ophthalmology, medical genetics, bone marrow transplantation, renal transplant and toxicology. On-site services include 24/7 PCI, stroke thrombolysis, maxillo-facial, trauma, general medicine, general surgery, urology and paediatrics. Phase II of the Children s Hospital for Wales was completed in 2015 and has seen redevelopment and consolidation of all paediatric specialities into a dedicated Children s hospital with five theatres, PICU, Medical and Surgical Wards OPD, Radiology and an admission and assessment unit. We are also a teaching Health Board with close links to Cardiff University which boasts a high profile teaching, research and development role within the UK and abroad; and enjoy strengthened links with the University of South Wales and Cardiff Metropolitan University. Together, we are training the next generation of clinical professionals. 1.1 Values & Behaviours In 2012, Cardiff and Vale University Health Board undertook a listening exercise entitled Picture the Future in which staff were invited to provide feedback about working within the Health Board. As a result of this feedback, a plan of action was devised - named Organising for Excellence - which aims to secure the kind of future we want to offer to the people we serve. Picture the Future also identified key Values and Behaviours which should underpin the work of its staff in order achieve success for the organisation. These can also be closely aligned with the principles of Good Medical Practice standards as published by the General Medical Council. 2
Our Values Care about the people we serve and the people we work with. Act with kindness because it costs nothing, and makes all the difference in the world. Show trust because our staff have been trained to do their jobs and we work at our best when we feel we are being trusted. Take and expect personal responsibility because everyone has a job to do and we are all responsible for doing our jobs as well as we can. Be respectful because this is what we want for ourselves. Always act with integrity because we build trust and respect if we keep our promises, do what we say we will do, and work as colleagues together. Our Behaviours How these values become part of our everyday behaviour:- Being enthusiastic and taking responsibility for what we do. Doing what we say we will do and being honest with ourselves and others Treating people as we would like to be treated, and always with compassion Thanking people, celebrating success and, when things go wrong, asking what can we learn? Looking for feedback on how we re doing and always striving for better ways of doing things Never letting structures get in the way of doing the right thing The Health Board needs to be sure that the staff they employ have values and behaviours that are aligned with those of the organisation thereby ensuring that appointees will be able to make an ongoing contribution to the positive culture of the organisation and meet the required standards of behaviour to patients, carers and the public and to one another. It is therefore likely that interviewees will be asked questions which encourage them to talk about themselves and provide insight into their personal values and behaviours. 2. THE HEALTH BOARD STRUCTURE Medical & Dental services are delivered via 10 main Clinical Boards:- General Medical specialties Emergency Medicine & Acute Medicine Specialist Services Dental Services Mental Health Surgery Cardiac Services Clinical Diagnostics & Therapeutics Children & Women s Services Primary, Community & Intermediate Care This post sits within the Clinical Board for Emergency Medicine & Acute Medicine which includes the Directorates of Emergency Medicine and Acute Medicine. Clinical Board Director Dr John Peters Clinical Board Head of Operations & Delivery to be appointed Clinical Director for Emergency Medicine Dr Jo Mower Directorate Manager for Emergency Medicine Loretta Reilly 3
3. THE JOB ITSELF Title: Clinical Fellow Higher (Specialty Registrar level) We are looking for motivated clinical fellows to join our enthusiastic and expanding team in Cardiff. We would support the individual to develop skills, supported by a diploma or masters degree if available, in the following areas Teaching and education Clinical Leadership Research Innovation/Quality improvement We would also support a successful candidate to complete 6 months rotations in acute medicine/itu/anaesthetics with a view to completing competencies to submit for Article 14 applications. Base location: Emergency Unit, University Hospital of Wales In view of the fact that the UHB is currently undertaking a review of its services and the locations at which they are undertaken, it is important to be aware that work patterns may change and the place(s) of duties modified. It may also (rarely) be necessary to undertake duties at the Barry Minor Injuries Unit. 3.1 Responsible to:- Clinical Director Emergency Medicine 3.2 Names of Consultant members of the Department Dr Sue Allen Mr Munawar Al-Mudhaffar Dr Katja Empson Dr Rupert J Evans Dr Lyndsey Thomas Dr Jo Mower Dr Krishna Nakirikanti Prof Tim Rainer Dr Melissa Rossiter Dr Duncan Thomas Dr Zoe Roberts Dr Sara Edwards Dr Jeff Morgan Dr Stephen Mullen EM Consultant (Stroke & Sepsis Lead, FP Tutor) EM Consultant (College Tutor, Psychiatric Liaison Lead) EM Consultant (Organ Donation / Simulation Lead) EM Consultant (Toxicology Lead) EM Consultant (CDU Lead) EM Consultant & Clinical Director (CG Lead) EM Consultant (Educational Lead) Professor & Honorary Consultant in Emergency Medicine EM Consultant (Major trauma Clinical Lead) EM Consultant (ANP Lead) Paediatric EM Consultant (Paediatric Lead) Paediatric EM Consultant Paediatric EM Consultant Paediatric EM Consultant 3.3 Other Medical Staff in the Department 3 Specialist Registrars (ST4/5) 1.2 Specialty Doctors 5 Clinical Fellows 0.8 Clinical Assistants 18 F2/ST/CT doctors 1 Foundation Programme (Year 1) 4
3.4 Other Relevant Staff Senior Nurse and 2 Clinical Nurse Leaders Consultant Nurse ANP s ENP s Autonomous Emergency + Paediatric Nurse Specialist 120 WTE nursing staff including a dedicated Nurse Practitioner service 2 Physiotherapists Receptionist staff Age Concern co-ordinator Directorate Manager and 2 Directorate Support Managers 3.5 Secretarial Support and accommodation Secretarial support and shared office accommodation will be provided 4.0 THE WORK OF THE DEPARTMENT The Emergency Unit is the only one in Cardiff and serves a nominal catchment population of circa 470,000. Cardiff is the main teaching hospital of Cardiff University s School of Medicine and by virtue of the various regional and supra-regional specialties, tends to attract patients from a much wider area. Reconfiguration of emergency services is being discussed in the South Wales Plan and separate to this are proposals for the development of a Major Trauma Centre in Wales. Total attendances this year at UHW are 134,000 and 11,000 at Barry Minor Injuries Unit. 36,000 patients attend by emergency ambulance each year and 26,000 patients are admitted through the Unit each year. The Emergency Unit completed a major re-build of the adult areas resulting in a 7- bedded Resus area with separate areas for majors, ambulatory care, streaming, and a Clinical Decisions Unit in 2014. Minors is a primarily 24/7 ENP-led minor injuries area within the Emergency Unit and we are developing a 24/7 ANP service. There is a separate paediatric area with 34,000 attendances per annum and it is envisaged this will undergo a major refurbishment in a combined GP / Emergency Assessment Unit. This is open 24 hours a day and is staffed by trained paediatric nursing staff including paediatric ENP s. There is juxtaposition of the 19 bay Medical Assessment Unit for patients referred by the General Practitioners and also from the Emergency Unit. The Surgical Assessment Unit is at present used by the surgical, urology, trauma, ENT and orthopaedic teams for patients referred by their GP and is located on the first floor above the Emergency Unit. There is a dedicated CT scanner within the Emergency Unit with the hospital housing two other CT scanners and an MRI scanner. The current CDU is run by the Emergency Physicians. There are well developed plans for a new seven day Ambulatory Assessment Unit to open early 2017 with care delivered by the Acute Physicians to enhance and support the work of the Emergency Unit. The Emergency Unit has been at the forefront of service innovation and working within the unit there are minor injury co-ordinators, extended scope physiotherapy practitioners with specialist acute knee and acute shoulder expertise and urgent physiotherapy followup. There is a general physiotherapist in the unit and support on a regular basis from Age Concern. In addition, staff include Domestic Violence Nurse, Child Protection Nurse 5
and Children s Play Therapist. There are outreach teams with an acute response team and an emergency care access scheme. There is close involvement in the Cardiff Anti-Violence Group, working collaboratively to reduce assaults within the catchment area. Recently, setting up the Alcohol Treatment Centre in town has been shown to reduce patients with acute alcohol intoxication attending the Unit instead receiving their treatment in town. There is close liaison with Acute Medicine, Critical Care, Coronary Care, Paediatrics, Trauma & Orthopaedics and Toxicology. There are facilities for 24/7 PCI and stroke thrombolysis / clot retrieval. The Out of Hours Primary Care service is based adjacent to the Emergency Unit. There is a PACS system in use throughout the hospital. An Emergency Unit work station (patient information and tracking system) is also in place. The Minor Injuries Unit at the Barry Hospital is staffed from 9.00am to 5.00pm by an experienced ENP team and overseen by staff from the Emergency Unit. There are examiners in FCEM and MCEM within the present consultant complement. There are close links with acute medicine where acute physicians are currently employed, critical care, coronary care, paediatrics and trauma and orthopaedics. We also have links to provide training in the following sub-specialties simulation, ultrasound, pre-hospital care and toxicology. We have close affiliations with Cardiff University s School of Medicine and are committed to providing teaching to undergraduate students. To this end there are also resources available to support teaching using simulation and a wide range of clinical teaching tools. All consultants and current middle grade doctors support teaching and provide clinical support on the shop floor. There is also good provision for training towards professional examinations and support in career development. The Emergency Unit provides a Consultant lead emergency Services between the hours of 08:00 and 22:00 on weekdays and extended hours of the weekend, outside these hours consultants are on-call from home. There is provision of 24 hour PCI, stroke thrombolysis, support from the trauma team, radiology and adult and paediatric intensivists. 5. DUTIES OF THE POST 5.1 Administrative responsibilities 5.1.1 You will be responsible for undertaking the administrative duties associated with the care of patients and the administration of the department in the UHB. 5.1.2 You will be required to comply with the appropriate Health and Safety Policies. 5.1.3 Travel as necessary between UHW and Barry Minor Injuries Unit may occasionally be required. A planned and cost effective approach will be expected. 5.1.4 You may have some input into the postgraduate and undergraduate teaching. 6
5.2 Research Excellent opportunities are available to pursue research, both those currently being undertaken in the Department and those of interest to the individual. 5.3 Clinical 5.3.1 You will provide a service in the speciality to the hospitals so designated, with responsibility for the prevention, diagnosis and treatment of accidents and acute emergencies. 5.3.2 You will have responsibility for the care of patients in your charge and for the proper functioning of the department in line with the Department s Operational Policy. 5.3.3 You will be responsible for the professional supervision and management of junior medical staff. 5.3.4 You will be required to participate in continuing medical education 5.3.5 You will be required to participate in and contribute to Clinical Audit in line with the UHB s policy on the implementation of Clinical Governance. 5.3.6 The successful candidate will participate in a rota together with their other colleagues to ensure cover of the Emergency Unit at the University Hospital of Wales and Minor Injuries Unit. 6. WORKING PATTERN INCLUDING OUT-OF HOURS COMMITMENT 6.1 Job Plan 6.1.1 The post holder will be part of a team of middle grade doctors supporting a 24 hour shop-floor rota. Details of the working pattern of this post will be provided prior to taking up the appointment 6.1.2 Medical posts within the Department are compliant with the New Deal and the European Working Time Directive. 6.1.3 The UHB is contractually obliged to monitor junior doctors New Deal compliance and the application of the banding system, through robust local monitoring arrangements supported by national guidance. You are contractually obliged to co-operate with those monitoring arrangements. 7. TEACHING The successful applicant will be expected to partake in the teaching commitments of the Emergency Unit, including teaching of undergraduates, nursing staff and postgraduate trainees. There is dedicated formal junior doctor teaching every Wednesday and informally on a daily basis. 8. CONTINUING EDUCATION 7
Access is available to the Medical Library at Cardiff University which provides excellent facilities. 9. FACILITIES FOR STUDY LEAVE 9.1 There is a Consultant led departmental teaching programme held weekly 9.2 Study leave may be granted for education purposes to attend courses at the discretion of the Clinical Director, provided the clinical service is covered and must be planned well in advance. At least six weeks notice is required. Study Leave Approval Form must be completed and authorised by Consultant and Clinical Director. 9.3 Postgraduate Training - This post does not attract postgraduate financial support. 10. MAIN CONDITIONS OF SERVICE 10.1 This post is covered by the terms and conditions of service, including pay, which apply to medical and dental staff employed in Wales as amended form time to time. Details of these may be obtained from the Medical Workforce Department. 10.2 The normal working pattern week is 40 hours. a) The Specialist Registrar salary scale will apply to this post. b) The appointment is designated as non-resident but you are required to remain on the premises during your rostered working hours. c) The appointee accepts that he will also perform duties in occasional emergencies and unforeseen circumstances at the request of the appropriate Consultant, in consultation with his colleagues both junior and senior. 10.3 Applications for annual leave must be submitted in writing to the rota co-ordinator at least eight weeks before leave is taken. It must also be requested having first taken into account your colleagues leave so as to enable adequate clinical cover to be maintained. 11. JOB LIMITATION At no time should you work at a level exceeding your competence. All medical staff therefore have a responsibility to inform those supervising their duties if they have any concerns regarding this or if they feel that they are not competent to perform a particular duty. 12. CONDITIONS OF APPOINTMENT 12.1 The completion of a satisfactory health declaration questionnaire and screening is a condition of the appointment. The postholder must comply with the UK Health Department guidance on "Protecting Health Care Workers and Patients from Hepatitis B" (PSM(93)12) as implemented by the ULHB. 12.2 Because of the nature of the work of this post it is exempt from the provision of Section 4 (2) of the Rehabilitation of the Offenders Act 1974 (Exemption Order 1975). Applicants are therefore not entitled to withhold information about convictions of the Act. In the event of employment, failure to disclose such convictions could result in dismissal or 8
disciplinary action. Any information given will be completely confidential and will be, considered only in relation to an application to which the order applies.' 12.3 You must hold current registration with the General Medical Council with a licence to practise throughout the duration of this contract. 12.4 You are normally covered by the NHS Hospital and Community Health Services indemnity against claims of medical negligence. However, in certain circumstances (e.g. in service for which you receive a separate fee or in an emergency situation outside of work) you may not be covered by the indemnity. The Health Departments, therefore, strongly advise that you maintain membership of your medical defence organisation. 13. DISCLOSURE OF CRIMINAL BACKGROUND OF THOSE WITH ACCESS TO PATIENTS It is the policy of the Health Board that in accordance with the appropriate legislation, pre-employment Disclosure Checks are undertaken on all newly appointed Doctors and Dentists. The Disclosure & Barring Service is authorised to disclose in confidence to the Health Board details of any criminal record including unspent and spent convictions, cautions, reprimands and final warnings. Applicants being considered for this post must provide this information on the application form before they can be considered. Any information disclosed will be treated in the strictest confidence and all circumstances will be taken into account before any decision is reached. The successful applicant will be required to complete a DBS Disclosure Check application form and to provide the appropriate documentation. Applicants should be aware that a refusal to comply with this procedure may prevent further consideration for the post. 14. THE IONISING RADIATION (MEDICAL EXPOSURE) REGULATIONS 2000 The Ionising Radiation (Medical Exposure) Regulations 2000 impose a legal responsibility on Health Boards for all staff who refer patients for medical radiation exposures such as diagnostic x-rays to supply sufficient data to enable those considering the request to decide whether the procedure is justified. 15. NO SMOKING POLICY Cardiff and Vale University Local Health Board operates a No Smoking Policy within the UHB. 16. REMOVAL EXPENSES Reimbursement of removal and associated expenses will only be offered in exceptional circumstances following consideration and agreement by the Medical Director and in accordance with the UHB policy for doctors in the training grades. 9
17. MONITORING The UHB is contractually obliged to monitor junior doctors New Deal compliance and the application of the banding system, through robust local monitoring arrangements supported by national guidance. You are contractually obliged to co-operate with those monitoring arrangements. 18. APPRAISAL / REVALIDATION All licensed doctors / dentists who are registered with the General Medical Council are required to revalidate every five years in order to maintain their licence to practise. To inform this process, it is important that GMC licensed doctors / dentists participate in the UHB s annual appraisal reviews which are based on the General Medical Council s Good Medical Practice principles and include a Patient and Peer Multi-Source Feedback process. The post holder will be expected to use the Medical Appraisal & Revalidation System (MARS) where applicable. 19. OTHER FACILITIES 19.1 Cardiff, the City and the Capital of Wales, has a typical air of a cosmopolitan city, being the administrative, business, cultural and education centre for Wales. Cardiff has much to offer, modern shopping centres, Edwardian arcades with exclusive boutiques and a large indoor market. 19.2 Cardiff Castle sits in the middle of the city along with impressive buildings such as the City Hall and the National Museum of Wales. For entertainment, Cardiff has many venues Wales Millennium Centre and St David's Hall for world class concerts, the New Theatre and Sherman Theatre, large cinema complexes as well as Chapter Arts Centre. 19.3 The city also contains the Welsh National Ice Rink, National Sports Centre, Millennium Rugby Stadium and two sailing clubs. The development of some 2,700 acres of Cardiff Bay has created a 500 acre lake, 8 miles of waterfront and a new commercial and leisure environment. The Vale of Glamorgan stretches to the coast and is dotted with small country villages. Situated in the Vale are the picturesque beaches of Southerndown and Llantwit Major. Within an hour from Cardiff is varied countryside - the Brecon Beacons and the Wye Valley. 19.4 Night Life - Restaurants in Cardiff are excellent and there is a wide choice of nightclubs, discos, a jazz centre and bars. 19.5 Clubs - All staff within the ULHB are eligible for membership of the University of Wales Hospital Sports and Social Club which includes facilities for squash, badminton, swimming etc, a sauna and jacuzzi together with a large social club. 10
19.6 Car Parking - There are parking facilities at UHW and Barry Minor Injuries Unit. A charge is applicable at UHW and a parking permit may be requested. Issue of a parking permit will be dependent on your circumstances 19.7 Shopping - Adequate shopping facilities within a convenient distance of all Hospitals. 19.8 Transport - All Hospitals are on regular bus routes with rail stations nearby. 20. DATE POST IS VACANT This post is available to commence immediately. Clinical Fellow appointments are not educationally approved for training purposes and do not therefore attract a National Training Number. Posts do however offer the post holder excellent specialty experience within a university teaching hospital setting. In accordance with Health Board principles regarding Clinical Fellow appointments, posts are offered for a period of 12 months in the first instance but may be extendable up to a maximum of 24 months by mutual agreement. 21. DETAILS OF ARRANGEMENTS FOR APPLICANTS VISITING THE HOSPITAL Candidates wishing to visit the hospital can make arrangements by contacting: Jo Mower, Clinical Director/Emergency Medicine Consultant 029 2074 8004 JD Clinical Fellow Higher EU Oct 2016 11
CARDIFF AND VALE UNIVERSITY LOCAL HEALTH BOARD Person Specification Form GRADE: Clinical Fellow SPECIALTY: Emergency Unit HOSPITAL: University Hospital of Wales REQUIREMENTS ESSENTIAL DESIRABLE 1) QUALIFICATIONS MBBS or equivalent MCEM Current GMC certificate with licence to practise Training in Radiation Protection or agreement to attend next available course ALS, ATLS, APLS provider status 2) PREVIOUS EXPERIENCE 2 years with suitable experience in Emergency Medicine 3) SKILLS, KNOWLEDGE, ABILITIES Demonstrable skills in written and spoken English adequate to enable effective communication about medical topics with patients and colleagues Intercalated Degree MSc or PHD Academic Excellence (Prizes, merits, distinctions etc.,) Instructor status in Life support Courses Paediatrics, Acute medicine, Orthopaedics & Trauma. Critical Care/Anaesthetics Audit Teaching 4) ATTIDUDE, APTITUDES PERSONAL CHARACTERISTICS Up to date with current medical practices Motivated and efficient Able to relate to patients, staff and medical colleagues Flexible, caring and hardworking Ability to work as part of a team 5) ADDITIONAL CLINICAL USS EXPERIENCE 6) SPECIAL INTERESTS Teaching Service Improvement Programme 7) OTHER REQUIREMENTS Satisfactory immigration status e.g. On-call duty for length of contract Satisfactory Health Clearance Satisfactory DBS Clearance 12