JOB DESCRIPTION JOB TITLE DEPARTMENT REPORTS TO ACCOUNTABLE TO Consultant in Palliative Medicine Medical Team Lead Consultant Director of Patient Care GENERAL ellenor is a specialist palliative care provider for adults and children in Dartford, Gravesham and Swanley and for children in the London Borough of Bexley and South West Kent. The organisation has Inpatient and Day Therapy facilities at Gravesend, a comprehensive Hospice at Home service and a range of outpatient and community services, all supported and delivered through a multi-disciplinary team approach. This is available 24 hours a day, 365 days a year. The Inpatient Ward is registered for up to 15 patients but typically operates at around 8-10 beds. 2 beds are especially equipped for high dependency patients and respite is offered to young adults with complex needs and other high dependency patients with neurological conditions. The Day Therapy Unit has capacity for 20 patients and is open 4 days per week at present. Our Wellbeing model is being developed to provide a greater range of therapeutic groups and easier access for patients and carers. Medical Support is provided for assessments and therapies such as blood transfusions and bisphosphonate infusions. A range of complementary therapies are provided. The adult Hospice at Home Team provides specialist palliative care at home with regular contact by an Advanced Nurse Practitioner, Specialist Nurses (5 WTE) and Doctors to assess and address the patient and family s needs and problems. The team also includes senior staff nurses, staff nurses, health care assistants and volunteers who provide nursing care assist and relieve the family, providing hands-on care at the end of life and emotional and practical support where appropriate. There is also a team of nurses who support residents in care homes. This is achieved with the support of GPs and other local health and social care services. The Children s Hospice at Home service provides specialist palliative care, hands on nursing and short breaks to children with cancer or palliative care needs in their own homes (0 18 yrs). The team has a transition service for young adults and a youth worker. There is a large team of nursery nurses and support workers offering short breaks in the children s homes or to assist attending outside activities. There are two active youth groups and family drop-ins during school holidays. Nov 2016 1
The medical staffing includes 2 consultants (1 Lead consultant and 1 Consutlant), 3 speciality doctors (1 full time and 2 part time doctors) and 2 GP trainees on 2 days each. Although ellenor is not part of the NHS, care is offered free at the point of delivery, as is the case with all charitable hospices. The present NHS funding accounts for approximately 24 % of our expenditure on charitable activities. The remainder is found from voluntary sources. The organisation has a current contract from the local CCG to provide hospice and palliative care services. The population of the core area (Dartford, Gravesham and Swanley) is approximately 250,000 people, where both adult and children s services are provided. There are 34 GP practices. The children s service area also extends to Bexley and West Kent which serve an additional 700,000 (approx) population. The current hospice caseload is around 100 children and 250 adults. Consultant post The post holder will play a key role in the multi-professional specialist palliative care team at ellenor, providing clinical care to patients in the community and Hospital support team at Darent Valley Hospital. The post holder will also be supporting cross-cover to the inpatient unit and the Day Hospice as needed. This will include clinical supervision of non-consultant grade medical colleagues. He / she will also contribute to the development of Hospice services, particularly with a community focus, as well as to educational activities at the Hospice. Internal key relationships: Lead Consultant (advertised- vacant post) & Medical team Rest of Senior Management Team: Chief Executive Director of Patient Care (Line Manager) Director of HR Director of Finance and Resources Director of Income Generation Head of Adult Community Care Head of Children s Care Head of Inpatient Care Head of Wellbeing Services Head of Education and Research Head of Support Services Head of Service Development Head of Community and Corporate Fundraising Clinical multi-professional team PA to Medical team, Clinical administration department Chaplain Volunteers Nov 2016 2
External key relationships: Primary Care teams Greenwich and Bexley Cottage Hospice District nurses and community matrons Darent Valley Hospital team Care homes Clinical Commissioning Groups The post holder will be fully supported to take on the role of Community Lead consultant as appropriate, with an overview for community services across the whole catchment area, and be able to deputise for the Lead Consultant. The post holder will provide medical support to the Hospital Palliative care team (at Darent Valley Hospital) during the three sessions. The post holder will be able to cross cover on occasions, in the care of the patients on the Inpatient and Day Hospice units, ensuring a high standard of clinical care is delivered. The post holder will be expected to be involved in the development of all the clinical services with close liaison with the Lead Consultant and the Senior Management Team. The post holder will provide clinical supervision to the specialty doctors, GPSTs and other clinical staff. The post holder will perform his / her duties according to the philosophy of ellenor, acting at all times to safeguard the interests of individual patients and their families. The post holder will contribute to the on-call rota (currently 1:5 rota, see below). JOB PURPOSE The Consultant has responsibility for the delivery of medical care jointly with the Lead consultant at ellenor. The Consultant will be responsible for the day-to-day supervision of 3 speciality doctors (2WTE). Together with the Lead Consultant, Director of Patient Care, the post holder will work collaboratively to deliver the clinical care strategy to ensure the highest quality of care for patients and families in all settings. Clinical Duties 1. To provide specialist palliative care assessment and management of symptoms to support patients achieving their preferred place of care and death. 2. To assist in providing the required medical input to the Day Therapy Service, the Adult and Children s Hospice at Home services 3. To provide consultant medical input to the hospital palliative care team at Darent Valley Hospital, including management of patients and attendance at the specialist palliative care multi-disciplinary meeting. The Hospital palliative care team consists Nov 2016 3
of 1 Lead Nurse, 2.8 WTE CNS,1 trainee CNS,1 Senior Support Nurse. The consultant currently provides 3 sessions at the Hospital. The service is 7 days 8-5 pm with telephone advice on call cover by consultants. 4. To participate with the Lead Consultant in the planning and development of clinical services. The post holder could choose to rotate between the services (Inpatient, Community, Hospital) with the agreement of the Lead Consultant. 5. To ensure consultant input at all MDT meetings ensuring that all appropriate assessment tools are used. 6. To take part in the out-of-hours on call rota 1 in 5 (in combination with Greenwich and Bexley Cottage Hospice) providing telephone advice and support to the Clinical Nurse Specialist on-call and the first on-call Doctors covering the Hospice and Greenwich and Bexley Cottage Hospice and to professional staff in primary and secondary care. Telephone only calls are not usually allocated PA s but an addition of 2% payment of full time salary is awarded. In exceptional circumstances, attendance at the Hospice to review medical care of patients may be required, for which time in lieu may be taken. 7. To maintain good liaison with hospital consultants both locally and at tertiary treatment centres and with GPs and the PCTs/CCGs in the areas served by the Hospice. 8. To ensure that medical team members attend relevant professional meetings and other educational activities so as to attain the necessary points to satisfy the requirements for accreditation by the Royal College of Physicians and to stay updated in the latest medical knowledge. 9. To participate in the Hospice s Clinical Governance processes, working together with others to improve the standard of care to develop best practice. 10. To take an active role in the training and support of all staff within the Hospice, as appropriate. This will include supporting specialist nurses through clinical assessment skills and non medical prescribing programmes. 11. To provide support, training and supervision to GP trainees allocated to the Hospice. 12. Education: To play an active role in the induction and training of new staff. To develop opportunities for teaching on palliative care issues with Doctors and other care providers in the local hospital and community. To play an active role in ellenor s education programme for internal and external staff. To support teams through informal teaching opportunities during patient visits and team meetings, ward rounds and multidisciplinary meetings 13. Professional Development: To participate in continued professional development. To attend relevant professional meetings and other educational activities so as to attain the necessary points to satisfy the requirements for accreditation by the Royal College of Physicians and to stay updated in the latest medical knowledge. Nov 2016 4
14. Quality, audit and research: To play an active role to facilitate clinical audit to aid service improvement and development. To support the research agenda and participate in research studies as appropriate. To support the investigation of verbal and written complaints in line with the organisations policy. To actively investigate and report any recorded incidents including medication incidents. 15. General: Adapts and develops in line with the changing needs of the role. Acts as an ambassador for ellenor in order to raise the profile of the organisation at a local, regional and national level, as required. Works flexibly across sites and departments from time to time as may be requested by their managers. Undertakes other duties commensurate with the seniority of the post as may be requested by their managers. To follow all policies and procedures. The post holder shall work within their professional Code of Conduct at all times. This job description will be reviewed with the post holder annually. 16. Work Programme: It is envisaged that the post holder will initially concentrate clinically on work within the community team and Darent Valley Hospital. It is expected that the post holder will cross cover the Lead Consultant when required. 10 Programmed Activities (7.5 DCC 2.5 SPA) Community Team visits/advice (DCC -0.75) Monday a.m. Admin (DCC 0.25) Community Team- Outpatient Clinics (DCC-0.75). Monday p.m. Admin (DCC 0.25) Hospital patient reviews/ advice (DCC- 1.0) Tuesday a.m. (Travel 30 minutes)** Tuesday p.m. Personal CPD/Research (SPA 1.0) Community Team MDT (DCC 0.5) Wednesday a.m. Patient reviews/advice (DCC 0.5) Nov 2016 5
Wednesday p.m. Audit/Education planning (SPA 1.0) Hospital team MDM (DCC 0.5) Thursday a.m. Audit/Policy/Guidelines (SPA 0.5) Travel to Hospice (30 min)** Thursday p.m. Community team support/ Visits (DCC 1.0) Friday a.m. Hospital patients review/advice (DCC 1.0) Travel to Hospice (30 min)** Friday p.m. Outpatient Clinic at Hospice (DCC 0.5) Admin (DCC 0.5) Travel times included in the DCC** CONDITIONS OF SERVICE The post is covered by the Published NHS Terms and Conditions of Service Medical and Dental Staff (England and Wales). If you are a member of NHS pension scheme, you could continue with that. Consultant Salary Scale in line with current BMA s Central consultants and Specialist Committee and the Department of Health for Consultants in England. The Consultant is required to maintain professional indemnity cover. ellenor will reimburse this proportional to the number of sessions worked. The post is subject to satisfactory assessment of health and fitness by the Occupational Health Department. An office, PA and IT support are provided at the Hospice. This post is also subject to satisfactory security clearance by the police, due to Child Protection / vulnerable adult protection requirements. A full driving licence is required. Honorary contracts will be held with Darent Valley Hospital, West Kent PCT and Greenwich and Bexley Cottage Hospice. ellenor will support completion of CPD requirements and opportunities for the post holder to develop specialist interests commensurate with agreed objectives. Clinical supervision is provided for all clinical staff and if appropriate, mentoring will be arranged either in-house or with an external body. To maintain effective links with professional organisations regionally and nationally. ellenor will provide mentoring support for newly qualified consultants as appropriate. Appraisal and Revalidation Nov 2016 6
ellenor has the required arrangements in place, as per the RCP, to ensure that all medical staff have an annual appraisal with a trained appraiser and supports doctors to undertake revalidation. Appraisal is mandatory and will be carried out by the Lead consultant. The medical director of Darent Valley Hospital NHS Trust is the Responsible Officer (RO) for Revalidation. Signed and agreed with the current post holder. Name (please print):.... Signature:... Date:... Line Manager:...... Line Manager s Signature:... Date:... Nov 2016 7
Person Specification Criteria Essential Desirable Qualifications Basic medical qualification, e.g. MBBS. Qualifications of MRCP of MRCGP or other recognised post graduate qualification for specialist training in Palliative Medicine Full registration with GMC with Licence to practice. UK CCT in Palliative Medicine or be within the next 6 months. Clinical Experience and Abilities Management Experienc Experience of working in palliative medicine in hospice, hospital and community settings. Experience of palliative care in patients with non-malignant disease. Experience of Multidisciplinary Team working at senior level. Ability to take full and independent responsibility for clinical care of patients at consultant level Ability to organise and manage time and priorities. Knowledge of national, statutory and legal influences in palliative care. Teaching Experience and enthusiasm for teaching healthcare professionals at different levels. Diploma or MSc in Palliative Care or MA in Ethics or MD/PhD in a related area Experience of providing leadership Experience working with children and young people Experience of service innovation and development. Ability to supervise medical staff Teaching qualifications Research / Audit Experience and enthusiasm for audit and research Knowledge and experience of Clinical Governance issues. Ability to apply research outcomes to clinical problems. Other skills Excellent interpersonal and communication skills, both written and oral Negotiating skills. Leadership skills and the ability to work effectively as a member of a team. Experience of participation in research projects. Publication in relevant journals. Attendance on Advanced Communication Skills Course Nov 2016 8
Flexible and approachable. Enthusiastic and motivated. Full Driving Licence and good IT skills. Personal interests outside of work Nov 2016 9