BIRMINGHAM CHILDREN S HOSPITAL NHS TRUST JOB DESCRIPTION CLINICAL FELLOW IN PAEDIATRIC ENDOCRINOLOGY & DIABETES 1
SUMMARY OF POST This is a full-time NHS training post in a tertiary training centre for paediatric endocrinology and diabetes. The applicant will join a busy and progressive team delivering paediatric endocrinology and diabetes services within Birmingham, the West Midlands and beyond. The fellow post is funded by two components. One part backfills the equivalent of 3PA consultant time to deliver the national specialist services for complex and atypical osteogenesis imperfecta. The other part comes from existing SLA agreements to deliver tertiary endocrine outreach services to Nottingham, Stoke, Hereford and Sandwell. This full-time tertiary training post is for a maximum of 2 years, designed to train the applicant to tertiary level, as defined by ESPE and BSPED (www.bsped.org.uk). However, it is not recognised for training by the Postgraduate Dean and does not form part of the paediatric run-through training programme. The applicant must have reached CCT in paediatrics or completed stage ST6 (or equivalent) in paediatric training. Therefore, this post is either a post-cct fellowship or an Out Of Programme Experience (OOPE) post, subject to approval by the applicant s local deanery. Applicants are expected to have previous paediatric endocrine exposure and research interest. The post involves a large outpatient clinic commitment covering the whole spectrum of paediatric endocrinology and diabetes, including highly specialised clinics, as well as inpatient care covering patients on wards and the Medical Day Care Unit. There is no commitment to acute/general paediatrics, hospital@night and on-call involved. The Department of Endocrinology & Diabetes sees 2500 Endocrine outpatients and 1400 Diabetic outpatients per year. This service also provides a number of specialist endocrine and diabetes clinics and also out-reach clinics in a number of district general hospitals within the region. THE BIRMINGHAM CHILDREN S HOSPITAL NHS TRUST The Birmingham Children s Hospital NHS Trust comprises of: Birmingham Children s Hospital Child and Adolescent Mental Health Services for the whole of the city The Children s Hospital moved to a new site at Steelhouse Lane in the centre of the city in May 1998. This marked the culmination of a long history of planning for a new Hospital to replace the overcrowded facilities at its previous home in Ladywood. The relocation involved a 30 million redevelopment of the previous Birmingham General Hospital site and has created a large, multidisciplinary, dedicated Children s Hospital with a capacity for almost 300 beds. Redevelopment included the construction of a new three-storey block which houses radiology, a 30-bed intensive care unit and four of seven operating theatres. In addition to upgraded clinical facilities, the site includes a parent accommodation block (Edward House), the James Brindley Hospital School and a new Education Centre. A dedicated Rare Diseases Unit is currently under construction. In 1999, all Child and Adolescent Mental Health Services (CAMHS) across the city were brought together under the management of the Trust resulting in an extensive network of community facilities and an additional inpatient unit located at Parkview Clinic in Moseley. 2
The Trust provides secondary level paediatric services for the child and adolescent population of much of the city of Birmingham. It is also the regional referral centre for the West Midlands region (population 5.2m) and many of its specialist services extend their referral base beyond the regional boundaries. In addition to general paediatric medicine and general paediatric surgery the clinical services provided by the Trust include: Accident and Emergency Medicine; Anaesthetics and Intensive Care; Bone Marrow Transplantation; Cardiology and Cardiac Surgery; Child and Adolescent Mental Health; Clinical Psychology; Dermatology; Endocrinology and Diabetes; ENT Surgery, Audiology and Cochlear Implantation; Gastroenterology and Clinical Nutrition; Haemophilia; Hepatology; Inherited Metabolic Disease; Neonatal Surgery; Nephrology including Haemodialysis and Renal Transplantation; Neurology; Neurophysiology; Neurosurgery; Non Malignant Haematology; Oncology; Ophthalmology; Orthopaedic and Trauma Surgery; Paediatric Dentistry; Plastic Surgery including Cleft Lip and Palate Surgery; Rehabilitation; Respiratory Medicine and Cystic Fibrosis; Rheumatology; Thoracic Surgery; Urology. The Children s Hospital is also a designated supra-regional centre for Craniofacial Surgery, Complex Liver Disease and Liver Transplantation, and is currently designated as a national centre for paediatric small bowel transplantation, the inherited rare diseases Alström syndrome, Wolfram syndrome, Bardet Biedl Syndrome and complex and atypical osteogenesis imperfecta. Plans for significant further development in plastic surgery are well advanced which have included the provision of an additional operating theatre. There is also a Specialist Burns Unit at the Children s Hospital. There is comprehensive provision of diagnostic and support services including all aspects of paediatric laboratory medicine, radiology and pharmacy. Therapy services include dietetics, physiotherapy, orthoptics, occupational therapy, and speech and language therapy. Pastoral and social support is offered by chaplaincy and by the social work department. The Trust is a major contributor to the teaching programme of the University of Birmingham Medical School and has close ties with the Health Care Faculty at the University of Central England. THE UNIVERSITY OF BIRMINGHAM The University was founded in 1900 by the citizens of Birmingham who wanted their own university to train and educate the people who would create and manage the burgeoning businesses and industries of the Midlands. It was natural, given the nature of Birmingham's industry, that the University should, from the start, teach the major scientific and engineering disciplines. It was also the first UK University to establish a Faculty of Commerce and incorporate a medical school. The modern University is equally distinguished in the humanities, education, social sciences and law. Academically, the University is organised into five Colleges, one of which is the College of Medicine, Dentistry and Health Sciences. This college is headed by Professor Eric Jenkison and is administratively split into Schools. The School of Clinical and Experimental Medicine covers the whole range of pre-clinical and clinical subjects. Interdisciplinary research is encouraged, as are links between the clinical and basic 3
science departments in other faculties. The College is justly proud of its library and reference facilities and has good working relationships with Trusts and Health Authorities. September 2000 saw the launch of The Black Country Strategy, to expand links with NHS partners to address concerns over the shortage of doctors in the West Midlands and also inequalities of health and healthcare in the Black Country. It has enabled medical students to have further opportunities to develop clinical experience in a district hospital setting. The Black Country Strategy presented an exciting development in the training of future doctors. By September 2003, the Medical School increased its annual intake by an additional 159 students. The project extends clinical training beyond Birmingham into General Practices and District hospitals in the Black Country and Worcestershire providing unparalleled clinical experience for its students in both urban and rural settings. The expansion programme allows access to clinical teaching and research on patients drawn from a population of 5 Million that is remarkably diverse in its socio-economic and ethnic make-up. ACADEMIC PAEDIATRICS AT BIRMINGHAM CHILDREN S HOSPITAL There are laboratory, office and teaching accommodation in the Clinical Research Block, Whittall Street, adjacent to the Children s Hospital in the centre of Birmingham. The Research and Development Directorate is collocated. Birmingham Children s Hospital is justly proud of its NIHR Wellcome Clinical Research Facility (CRF) on the hospital site. This is a satellite of the NIHR CRF at University Hospitals Birmingham (UHB) and is managed in partnership with UHB and University of Birmingham. Its facilities include 4 outpatient rooms, 6 inpatient beds, DXA body composition scanner and metabolic/exercise laboratory. Adjacent to the CRF is the NIHR 3T Imaging Centre. These developments have dramatically increased the research capacity of the Trust. The postholder will be expected to participate in clinical and translational research projects and research clinics held in the CRF. Current academic paediatricians Professor Timothy Barrett, Leonard Parsons Professor of Paediatrics and Child Health Professor Tauny Southwood, Professor of Paediatric Rheumatology Professor Andrew Peet, Professor in Paediatric Oncology Professor Pamela Kearns, Professor in Paediatric Oncology Dr Frank Mussai, Senior Lecturer in Paediatric Oncology Dr Carole Cummins, Senior Lecturer in Clinical Trials Dr Andrew Ewer, Reader in Neonatology THE PAEDIATRIC ENDOCRINOLOGY AND DIABETES SERVICE This is one of the largest such departments in the UK, delivering the full breadth of the speciality. In addition to general endocrine and diabetic clinics there are national specialist clinics in complex diabetes (Alström syndrome, Bardet Biedl syndrome, Wolfram syndrome), severe, complex and atypical osteogenesis imperfecta, as well as regional specialist clinics for type 2 diabetes, cystic fibrosis, coeliac disease, metabolic bone disease, osteogenesis imperfecta and disorders of sex development (DSD). There are also joint clinics held in conjunction with specialists in Genetics, Adolescent Endocrinology, 4
Rheumatology, Small Bowel Transplantation, Haematology, Thalassaemia, Oncology, Brain Tumour, Prader Willi syndrome, CHARGE syndrome, septo-optic dysplasia, Orthopaedics and Young Adult Diabetes. There is an established network of outreach Endocrine clinics in the West Midlands region. There are currently approximately 400 patients receiving Growth Hormone treatment, 75 patients on GnRH analogues, approximately 300 patients with Metabolic Bone Disorders and 350 patients with type- 1Diabetes. Special clinical and research interests within the department at present include growth & gonadal disorders, steroid metabolic conditions, atypical forms of diabetes, disorders of calcium & bone metabolism, osteogenesis imperfecta and paediatric osteoporosis. The hospital has a Medical Day Care Unit for daycase investigations (including the majority of the Endocrine investigations) and injections/infusions. This allows many children who would previously have required in-patient admission to undergo clinical investigation as day patients. It is expected that this service will increase, as it is less costly to the hospital than over-night admission, more efficient, and preferred by families. DUTIES OF THE POST The primary purpose of this post is to a tertiary endocrine training position where excellent tertiary training is delivered to suitable applicants with previous endocrine exposure. The applicant is expected to bring in an eagerness to learn, be either fully trained in paediatrics (CCT) or have completed minimum ST6 paediatric training level (or equivalent), is able to work within a large progressive team and help raising endocrinology and diabetes care at BCH to the best standards in Europe. Depending on previous endocrine training this is either a post-cct fellowship or an Out of Programme Experience (OOPE) post limited in duration to between 1 and 2 years. By the end of the training the applicant will be eligible to apply for consultant positions in tertiary care endocrinology & diabetes. The duties are to develop expertise in endocrinology and diabetes, including all aspects of tertiary endocrinology and bone disease, practical knowledge of paediatric diabetes education, intensive diabetes management, perform audit, deliver on CPD, and engage in teaching and in particular clinical research. Clinically, the applicant will share in the provision of the outpatient service for Endocrinology and Diabetes, contribute to inpatient care provision and support medical staff on the Medical Day Care Unit. Clinical duties will be in rotation with the registrars. Staff Consultants (alphabetic order) Professor Timothy Barrett, Professor of Paediatrics (Honorary Consultant Paediatric Endocrinologist) PD Dr Wolfgang Högler, Consultant Paediatric Endocrinologist (Clinical Academic Reader in Paediatric Endocrinology) Dr Melanie Kershaw, Consultant Paediatric Endocrinologist Professor Jeremy Kirk, Consultant Paediatric Endocrinologist Dr Ruth Krone, Consultant Paediatric Endocrinologist Professor Nick Shaw, Consultant Paediatric Endocrinologist Dr Renuka Dias, Consultant Paediatric Endocrinologist Dr Vrinda Saraff, Consultant Paediatric Endocrinologist 5
Dr Zainab Mohamed, Locum Consultant Paediatric Endocrinologist Junior medical staff Permanent rotating Clinical & Research Fellow in Metabolic Bone Disease Permanent rotating Clinical Fellow in Endocrinology and Diabetes (this job) Two Specialist Trainees (SpR) posts in Paediatric Endocrinology and Diabetes (Full time posts, as part of the West Midlands rotation. One post is generally for 6 months, and the other post is for a career Paediatric Endocrinology Trainee; a National Training Number (NTN) Grid Post for Paediatric Endocrinology and Diabetes) One Foundation Year (FY1) doctor One MRC Research Training Fellow (Honorary SpR) One Academic Clinical Fellow Visiting Clinical Research Fellows Endocrinology 2.5 Endocrine Nurses One Endocrine Research Nurse One NIHR Clinician Scientist Three Endocrine Secretaries Diabetes (total whole time equivalent) 2 Clinical Nurse Specialists 3.5 Diabetes Liaison Nurses (incl. Wolfram & Bardet Biedl) 0.6 Diabetes Liaison Nurse (Alström) 0.5 Diabetes Research Nurse (R & D) 2.5 Dieticians 1 Diabetes Home Care Administrator 3 Diabetes secretaries 1 Diabetes administrator 1.25 Clinical Psychologist 0.6 Social Worker 1 Family/ Youth Support worker 1 Diabetes Network Coordinator Metabolic Bone Disease (total whole time equivalent) 2.5 Osteoporosis Liaison Nurses 1.2 Occupational Therapist 1.4 Physiotherapist 0.4 Nuclear Physicist 0.5 Radiographer Research (total whole time equivalent) 0.5 endocrine and diabetes research administrator Medical Secretaries Office accommodation will be provided with a computer and Internet access. Appropriate medical secretarial support will be provided for this post. On-call arrangements There is no on-call commitment for this post. The consultant staff provide a 24/7 on-call service for Endocrinology and Diabetes. On-call cover for Diabetes Home Care is provided 6
by the Diabetes Specialist Nurses, and occasionally, to cover holidays and sickness, by the consultants. Teaching The successful applicant is expected to take active part in undergraduate and postgraduate medical education and the training of other relevant staff groups. This includes the mentoring of junior medical staff. Research The Department is heavily committed in clinical and translational research. The applicant is encouraged to engage in clinical research and assist in recruitment of clinical trials. Clinical Governance The appointee will be expected to participate in all aspects of the Clinical Governance structure developed by the Trust to monitor, maintain and develop the quality and effectiveness of care. The Trust is committed to the development of medical staff through individual appraisal. This will include audit of personal clinical practice as well as involvement in department/specialty reviews; attention to continuing professional development and to meeting the requirements for Continuing Medical Education defined by the relevant Royal College (and for which appropriate study leave support will be available); awareness of professional standards and the responsibility to undertake safe and ethical clinical practice; the importance of responding promptly to any circumstances which may result in increased clinical risk or adverse outcome. Funding is available for approved study leave as defined in the Trust s study leave policy. Cross-Cover For Clinical Duties With Colleagues The appointee will be expected to provide cross-cover for specialist registrars during periods of leave and short-term sickness absence. MANAGEMENT Clinical management in the Trust is organised through a structure of clinical directorates which are positioned within one of two clinical groups. The Department of Endocrinology and Diabetes forms part of The Medical Directorate which includes General Paediatrics, Oncology and Haematology, Gastroenterology, Dermatology, Respiratory, Rheumatology, Inherited Metabolic Diseases, Nutritional Care and Emergency Department. The Clinical Director is Dr. Ian Wacogne, Consultant in general paediatric medicine, the Clinical Lead of the Department is Dr Wolfgang Högler. Managerial support is provided to clinical staff through a Directorate Management Team comprising of a Directorate Manager, Assistant Directorate Manager, and Clinical Nurse Manager facilitated by senior Finance and Personnel Managers. Operational issues are directed to the Trust Board through an Assistant Director of Operations to the Director of Operations. The Medical Director (Vinod Diwakar) is a member of the Trust Board and has both Group and Corporate responsibilities. There is a Senior Management Forum where Clinical Directors meet with the Trust Executive Management Team on a monthly basis to discuss strategic and trust wide operational matters. Each Group has arrangements in place for meeting with Clinical Staff on a regular basis. 7
The post holder will be expected to take part in delivery and development of clinical services within the Trust s Service and Financial Framework and in line with the Trust s clinical strategy. EQUALITY AND DIGNITY The appointee is expected to adhere strictly to principles of fairness and equality in carrying out the role. At all times the post holder will be required to show respect for and maintain the dignity of patients, the public and work colleagues. The Trust will not tolerate any form of bullying or harassment, violence or aggression against its employees. COMMUNICATION (STAFF WITH SUPERVISORY/MANAGERIAL/LEADERSHIP RESPONSIBILITY) An integral part of the role of any manager or person with leadership responsibilities is to communicate effectively with their staff and colleagues. It is an expectation of this role that resources and time will be allocated to communicate fully with staff and involve them in the decisions affecting them. Arrangements should be made to ensure that local and Trust wide matters are communicated and discussed via appropriate means i.e., team meetings, written briefings etc. INDUCTION It is the responsibility of every employee and their line manager to ensure attendance at the Trust s Mandatory Induction Programme. A general induction programme is held monthly and a local induction is provided within all Trust Departments. In addition, a formal induction process for Junior Staff will be arranged by the Clinical Lead/Programme Director within your Group and a mentor will be appointed. APPRAISAL AND PERFORMANCE MANAGEMENT All staff will be expected to fully participate in the Appraisal/ Performance Management process. This obligation will include the preparation for and attendance at appraisal/performance management interviews and completion of the associated documentation. For an appointee for a 2-year Fellowship, an appraisal at the end of year 1 will be a contractual requirement. Failure to participate in any stage of the process will render the process incomplete. MAJOR INCIDENT In the event of a Major Incident involving the Children s Hospital it is expected that the post holder would make all reasonable efforts to attend and support the incident. 8
HEALTH AND SAFETY You have a legal responsibility not to endanger yourself, your fellow employees and others by your individual acts or omissions. The post holder is required to comply with the requirements of any policy or procedure issued in respect of minimising the risk of injury or disease. WORKING TIME DIRECTIVE The Working Time Regulations 1998 require that you should not work more than an average of 48 hours each week, i.e., in a 17-week period no more than 816 hours or 1248 hours in a 26 week period. To work more you must have the authorisation of your manager and you must sign an opt-out agreement that you choose to work more. Should you have more than one job with the Trust or have a job with another employer, then the total hours worked in all your jobs should not exceed the average of 48 hours as above. You are therefore required to inform your manager if you continue to work elsewhere and the number of hours you work, or if you take up work elsewhere during your employment with the Trust. CONFIDENTIALITY Your attention is drawn to the confidential nature of information collected within the National Health Service. The unauthorised use or disclosure of patient or other personal information not in line with the Trust s Caldicott Standards Staff Code of Conduct and/or Data Protection Act 1998 is a disciplinary offence and could result in a prosecution or action for civil damages under the Data Protection Act 1998. TERMS AND CONDITIONS OF SERVICE This appointment will be held in accordance with the terms and conditions of service of the Training Syllabus of ESPE (European Society of Paediatric Endocrinology). For ST6-8 trainees, their local deanery will need to approve the terms of this fellowship as an Out Of Programme Experience (OOPE) post. In the absence of tertiary endocrine training post CCT in the UK, and the limited endocrine NT grid training posts pre-cct, no accreditation by GMC, RCPCH or BSPED is presently feasible for this fellowship position. The appointee will receive a training plan and a completion certificate from the Department outlining the training and ESPE training syllabus conformity. PLEASE NOTE THAT THE NOTICE PERIOD FOR THIS POST IS THREE MONTHS FOR BOTH THE EMPLOYER AND THE EMPLOYEE. PERSON SPECIFICATION 9
Copies of the proposed Person Specification for potential candidates are attached to this job description. The job plan may be modified dependant on any special interests of the successful candidate. 10
PERSON SPECIFICATION CLINICAL FELLOW IN PAEDIATRIC ENDOCRINOLOGY AND DIABETES REQUIREMENTS ESSENTIAL DESIRABLE ASSESSED BY 1. QUALIFICATIONS Eligible For Full GMC Registration Eligible For Inclusion on Specialist Register or be within 24 months of CCT date. 2. CLINICAL EXPERIENCE CCT, or within 24 months of CCT in Paediatrics and minimum 12 months training in Diabetes & Endocrinology. Child Protection Training 3. CLINICAL SKILLS Eagerness to be trained in tertiary endocrinology and diabetes. Previous endocrine/diabetes training (minimum 12 months at secondary level). 4. RESEARCH/TEACHING Significant experience in supporting undergraduate learning Supportive attitude Willing collaborator Audit experience Higher Degree (MD, PhD, etc) Resuscitation Training Advanced paediatric life support provider, or equivalent (APLS) Previous Personal Research Experience & Publications GCP training Attendance at Training the Trainers teaching Application Form GMC Check Specialist Register Check Application Form Interview References Application Form Interview References Application Form Interview References 5. PERSONAL SKILLS/QUALITIES 6. PROFESSIONAL DEVELOPMENT Capable of building strong and effective relationships with colleagues Excellent verbal and written communication skills Able to respond to and cope with change Able to cope with pressure from unexpected/urgent clinical situations Demonstrates honesty, integrity and team working Commitment to continuing professional development Interview References Application Form Interview
Work Programme for Senior Clinical Endocrine Fellow MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY Ward / MDC Ward urgent reviews Ward / MDC duties Ward Round/Duties Ward urgent reviews Duties Endocrine Clinic Diabetes Education Session 10:00-12:00 Departmental Teaching (bleep free) General Endocrine Clinic alternate weeks Student Teaching 12:00-13:00 MDT meeting diabetes care Diabetes Education Clinic + Admin Audit / Research Admin Endocrine/ Notes Meeting Diabetes Clinic/ Admin Specialist Clinic Attendance CPD/ Research Diabetes Clinic / ward cover / Admin Endocrine Notes Meeting Endocrine ward round Admin There is no out of hours cover in this post.