Hospice Isle of Man Job Description and Information Pack Consultant in Palliative Medicine & Co-Director of Research & Development 1
1. Introduction Job Title: Consultant in Palliative Medicine & Co-Director of Research & Development Location: Hospice Isle of Man Professionally Accountable to: Medical Director Noble s Hospital Reports to: Chief Executive Officer Number of Hours: Full Time Pay Scale: 76,761 to 133,193 per annum Post to Commence: Spring 2018 2 This is a newly created full time post for a Consultant in Palliative Medicine in the Isle of Man. This is a unique opportunity for a motivated individual to shape and develop palliative services in a modern purpose built facility. There is ample scope for research and personal development in a supportive environment. Hospice Isle of Man is undergoing major changes with investment in new buildings, staff recruitment and research and development. Hospice Isle of Man is part of the North West Palliative Care Network and receives around 450 new referrals each year to its comprehensive range of holistic palliative care services. The caseload is 320 patients with specific services being provided to 150 relatives. Our 12 bedded adult In Patient Unit (IPU) admits around 200 patients each year for symptom control, respite care and end of life care, with approximately one third being subsequently discharged. The average bed occupancy is 70%-80% and the average length of stay 13 days. The adjacent Scholl Day Centre operates on two days per week with 600 patient attendances each year with additional Drop in Days on four days per week (with annual attendances of 2,500 patients). Rebecca House Children s service provides regular nurseled respite care as well as medical-led end of life care. Rebecca House currently has 33 children and families on its caseload and plans are in discussion to develop a Network Consultant in Paediatric Palliative Medicine. The Isle of Man is a self-governing Crown Dependency in the Irish Sea, and it is not a part of the United Kingdom (UK) or the European Union. The Health Service was introduced in 1948 and is administered by the Isle of Man Department of Health and Social Care. The healthcare model is similar to the UK NHS, with a publicly funded universal health service delivered free at the point of care. The Island is renowned for its natural beauty and motorsport (especially the world famous TT races) and, it has excellent facilities for all other outdoor activities such as water sports, cycling, golf and walking. The higher rate income tax is 20 pence in the pound. Hospice Isle of Man recognises the importance for all medical staff on the Island to maintain connections with medicine in the UK and encourages links with other hospices
as well as providing study leave with pay and expenses to attend approved conferences and workshops. 2. Organisational Structure / Key working relationships The post holder will work closely with Mrs Christine Bloomer, Director of Integrated Palliative Care, Supports the provision of consistently accessible, equitable and high quality palliative care across the Isle of Man, including Hospice, community and hospital settings. Responsible for Consultant Nurse Practitioners, Integrated Leads, Supportive Care Leads, Hospice at Home, Children s and Young Persons and Rebecca House. There are Two Nurse Consultants and five Clinical Nurse Specialists. Dr Ben Harris, Director of Quality Improvement, responsible for clinical data analyst and medical staffing team. The medical staffing team currently consists of the following; one Locum Consultant, four speciality doctors, one F1, and one GP trainee. Mrs Sarah McGhee, Co-Director of Research and Development, Co-directs and implements Hospice Isle of Man research and development policies, objectives and initiatives. Responsible for Research and Development team, Research and Development Officer, Grants Trusts and Foundations. There are also close working relationships with the Hospice Chief Executive and Board Members. Close links with Noble s Hospital Oncology Team and the Medical Director, who is identified as the Responsible Officer. 3. Clinical Duties and Responsibilities To provide, together with the existing Integrated Palliative Care Team, a comprehensive specialist care service to Hospice Isle of Man, and its community, through holistic assessment, management and treatment of patients with symptomatic life limiting illnesses and their families. To share in providing leadership, advice and support to the Integrated Palliative Care Team that consists of Clinical Nurse Specialists, who work collaboratively with General Practitioners and District Nurses. To share in delivering medical support / advice to the Hospice at Home Team and support the expansion and development of the remit of Hospice at Home. To attend the appropriate Multidisciplinary (MDT) meetings and be expected to provide seamless continuity of care between hospice, hospital and home including the provision of indirect care by supporting other healthcare professionals as part of an extended MDT. To work flexibly and collaboratively with other members of the team to ensure continuity of service provision, including out-of-hours and professional cover during periods of leave. Consideration will be made for time off in lieu (such as for weekend working) 3
To co-direct our research and development programme in line with Hospice Isle of Man strategy and any education programmes facilitated by Hospice Isle of Man. This will include work with medical students, junior doctors and other healthcare professionals. To participate in clinical audit and support the wider clinical governance agenda of Hospice Isle of Man including identifying and implementing evidence based practice and research with appropriate guidelines and standards for integrated care. To take part in activities which meet the requirements for appraisal and revalidation, including internal and external Continuing Professional Development (CPD). Hospice supports the requirements for Continuing Medical Education (CME) as laid down by the Royal College of Physicians and is committed to providing time and financial support for these activities. The successful candidate will have support and mentorship and a mentor will be provided as appointed by the Chief Executive Officer for a period of time until he/she is familiar with the organisation, work place and surroundings. The post holder will have identified office space with a personal computer linked to the hospice and government network. He / she will have the support of the secretarial team for administrative purposes. Hospice Isle of Man has a dedicated 4 bed children s hospice mainly covering respite care. The post holder will work in partnership with paediatricians at Noble s Hospital and the Children s and Young Peoples North West Network which includes Alder Hey and Manchester Children s Hospitals. 4. Job Plan A formal job plan will be agreed between the appointee and their Chief Executive within three months after the commencement date. Therefore the job plan for the first three months will be provisional. A Level 2 training / qualification will be provided to the role holder to be an educational/clinical supervisor (if such a qualification is not already held) The job plan will be a prospective agreement that sets out a consultant s duties, responsibilities and objectives for the coming year. It will cover all aspects of a consultant s professional practice including clinical work, teaching, research, education and managerial responsibilities. It will provide a clear schedule of commitments, both internal and external. In addition, it will include personal objectives, including details of their link to wider service objectives, and details of the support required by the consultant to fulfil the job plan and objectives. The job plan will be reviewed annually, following the appraisal meeting. 5. Provisional Assessment of Programmed Activities (PA) in Job Plan Direct Clinical Care (DCC): 6 PA s on average per week to include clinical activity, clinical related activity, predictable and unpredictable emergency work 4
Supporting Professional Activities (SPA): 4 PA s on average per week to include Research and Development, CPD, audit, revalidation, administration and teaching activities. The following provides scheduling details of the clinical activity and clinical related activity components of the job plan which occur at regular times in the week. Agreement should be reached between the appointee and the Chief Executive with regard to the scheduling of all other activities, including the SPA. Day Time Location Activity Hours DCC SPA Monday AM 09:00 Hospice Audit/Teaching/Leadership/revalidation 4hrs 1 PM 14:00 Noble s Hospital Joint oncology/palliative care clinic 4hrs 1 Tuesday AM 9:00 10:00 10:00-13:00 Hospice Community IPU MDT Adult Case Conference Review of Patients in the Community PM 14:00-17:00 Community Review Patients in the Community 4hrs 1 Wednesday 09:00 Hospice In Patient Ward Round + Admin 4hrs 1 AM PM 14:00 Noble s Hospital Palliative Care Outpatient Clinic 4hrs 1 Thursday 09:00 Hospice Research Session 4hrs 1 AM PM 14:00 Hospice Research Session 4hrs 1 Friday AM 09:00-11:00 Noble s Hospital Review patients 4hrs 1 PM 14:00 Hospice Audit/Teaching/Revalidation/Admin 4hrs 1 Total 6 4 1hr 3hrs 0.25 0.75 It is anticipated that the personal workload for the post holder would be approximately 25 consultations per week seen in Outpatient Clinics, (In patient Unit at Hospice Isle of Man, Nobles Hospital Outpatient Department and Hospice at Home). This post will include working towards 1:4 on-call duties On call activity would attract additional 1 PA The opportunity for extra PA s and SPA s may be available. 6. Requirements For The Post The appointee must hold a licence to practice in the UK and be fully registered with the General Medical Council (GMC), be in possession of the CCT in Palliative Medicine of the Royal College of Physicians or a recognised equivalent and be on the specialist register of the GMC or within six months of accreditation on the day of interview. Ability to apply research on outcomes to clinical practice and evidence of personal research publications in peer-reviewed journals is important. 5
7. Conditions of Service This post is covered by the terms and conditions of service of the Consultant Contract (2003), subject to beneficial locally agreed variations, approved by the BMA. Local variations include: Category A on-call supplement is payable to all Consultants in the Isle of Man taking non-resident on-call duties. There are no transitional arrangements for Consultants currently holding UK contracts. The post will be offered subject to the following: The post holder should hold the MRCP (UK) or equivalent qualification References covering the past three years of employment, of which one must be current or the most recent employer. One satisfactory reference from a Responsible Officer at the current Designated Body. Current full GMC registration with a licence to practice (CCT) On the Specialist Register (or within six months at time of interview) Evidence of the right to take paid employment within the UK. Occupational Health clearance including medical examination if required. The post holder will work collaboratively with and provide cover for members of the medical team, including out of hours, and will fulfil on-call commitments as per rota. Enhanced Disclosure and Barring Service clearance. The post holder will be indemnified by the Isle of Man Department of Health and Social Care for work undertaken as part of his / her Contract of Employment. Annual leave must be applied for at least 6 weeks in advance and approved by the Chief Executive. The annual entitlement is 33 days per year on a full time contract. The post holder will be paid in accordance with the Terms and Conditions for Medical Staff, and be assimilated onto the salary scale taking into account all Consultant service. Hospice Isle of Man expects all medical staff to work within the guidelines of the GMC Guide to Good Medical Practice which can be viewed on the GMC website www.gmc-uk.org. 8. Accountability For matters relating to the clinical management of patients, the post holder will be accountable personally and professionally to the General Medical Council. For general professional matters, the preparation of protocols and duties of the post, the post holder will be accountable to the Chief Executive Officer in the first instance. 6
For managerial matters, for example relationships with colleagues, accountability will be to the Chief Executive Officer. Hospice Isle of Man is committed to providing safe and effective care for patients. To ensure this, there is an agreed procedure for medical staff that enables them to report, quickly and confidentially, concerns about the conduct, performance or health of medical colleagues All medical staff practicing in Hospice Isle of Man should ensure they are familiar with the procedure and apply it. For professional practice issues the responsible officer is the Medical Director of Noble s Hospital and a professional appraiser will be nominated for the post holder. 9. Managerial The post holder will provide medical leadership and work with clinical and management colleagues to develop the service, adhere to Hospice policies, and ensure that all statutory Health & Safety regulations are observed. He/she will participate in clinical governance and risk management initiatives in line with service and organisational plans aimed at improving the quality of service delivery. The post holder will work with colleagues to ensure that processes are lean and effective, optimising productivity of the service. They will participate in developing effective and safe links with other services, external stakeholders and other agencies that enhance and develop innovative patient care. 10. Clinical Governance The appointee is expected to be committed to the improvement of quality of clinical care and development and to participate in incident reporting, risk management and Clinical Governance Meetings. He / she will Work with the Director of Quality Improvement and Director of Integrated Palliative Care to ensure continuous improvement in quality at individual, team and service level and will actively participate in and encourage clinical incident reporting and safeguarding of adults at risk and children where appropriate. 11. Appraisal The appointee is expected to compile an annual portfolio with evidence of Continuing Professional Development in accordance with Hospice Isle of Man s appraisal process. The post holder will be expected to produce a personal development plan that is aligned to priorities within the clinical service which will be negotiated with the Chief Executive Officer. The Responsible Officer is the Medical Director of Noble s Hospital. There will be an annual appraisal with a professional trained appraiser who will be appointed to support the post holder through the revalidation process as laid down by the Royal College of Physicians. 7
12. Research & Development The post holder will co-ordinate the development of research activity within our research programme, working closely with our Co-Director of Research and Development and in line with hospice policy and procedure. Research and Development is fundamental to patient safety. Research and Development activities are an important use of Supporting Professional Activities (SPA) time. Any time within job plans allocated to R&D should be evidenced in terms of agreed high quality outputs and linked to personal objectives as agreed at appraisal. 13. Audit The appointee will be expected to actively participate in audit including all relevant audits set out in Hospice Isle of Man s audit plan. He / she will be expected to initiate and supervise audit projects related to his / her particular interest. 14. Continuous Professional Development / Continuous Medical Education Hospice Isle of Man supports the requirements for CPD as laid down by the Royal College of Physicians and is committed to providing time and financial support for these activities. Taking study leave is a necessary part of CME / CPD. Application for study leave must be submitted six weeks to the dates requested. There is a study / professional leave entitlement of 30 days over a three year period. Study leave is agreed by the Chief Executive and should be linked to the individual s personal development plan. Evidence of CME participation will become part of the post holder s portfolio. Hospice Isle of Man recognises the importance for all medical staff on the Island to maintain connections with medicine in the United Kingdom and visits to other hospices and working with colleagues in other settings is encouraged as an important part of CPD. 15. Teaching The post holder will actively participate in the provision of multi-disciplinary teaching to support the Education Strategy of the hospice and undertake other teaching as requested. He / she will encourage teaching and support the development of Foundation Doctors and General Practitioners in training posts. This may include clinical and educational supervision as appropriate. Internal training may include team meetings in 8
relation to professional development and support for independent nurse prescribers and staff undertaking physical assessment modules. 16. Health & Safety/Security It is the duty of all employees to work in such a way that accidents to themselves and to others are avoided, and to co-operate in maintaining their place of work in a tidy and safe condition, thereby minimising risk. Employees will, therefore, refer any matters of concern through their respective line managers. Similarly, it is each person s responsibility to ensure a secure environment and bring any breaches of security to the attention of their managers. 17. Additional Information: The Isle of Man is an excellent place to work: Regular low-cost flights to several United Kingdom and European destinations, Liverpool, Manchester, London (City & Gatwick), Dublin, Belfast, Glasgow, Edinburgh, Newcastle, Bristol, Birmingham. Daily ferry links to the UK Basic rate of Income Tax 10%, maximum rate 20% High rate of personal allowance No Capital Gains or transfer tax No death duties High quality of family and individual life Wide variety of high class care facilities First class education Very low crime rate Attractive relocation package Cost of living benefits insurance, road tax etc. The post is superannuable through membership of the Isle of Man Government Unified Scheme 2011 which currently allows transfers to and from equivalent schemes. Future pension arrangements for the Isle of Man public sector workers are currently under review. In addition, personal tax allowances are very generous, and are fully transferable between husband and wife. There is a buoyant property market with a wide range of urban and rural housing. Property prices are comparable to the more expensive parts of the United Kingdom. There are no restrictions to residence or property purchase for British and Irish Nationals. Some tax relief is available on mortgage and loan interest. Isle of Man Social Security schemes are similar to those in the United Kingdom and there is an agreement with the United Kingdom under which contributions paid in one country can 9
count for benefit in the other. It should be noted, though, that a residential qualification needs to be satisfied in order to qualify for income-based benefits. People may transfer between the countries without the loss of accumulated rights. Many public and other services are better and cheaper than in the UK. For example, car insurance and registration are much cheaper than in the United Kingdom, though fuel is slightly more expensive. Further information on pension entitlements can be found at www.iomunifiedscheme.im Alternatively, if you wish to find out more about transferring your benefits to the Government Unified Scheme (GUS) we suggest you contact the pension administrators directly on 01624 685598. 18. Contact Information and Arrangements to Visit Mrs Anne Mills Chief Executive Officer, Hospice Isle of Man E-Mail: anne.mills@hospice.org.im Telephone: 01624 647444 Mrs Christine Bloomer Director of Integrated Palliative Care, Hospice Isle of Man E-Mail: Christine.bloomer@hospice.org.im Telephone: 01624 647478 Dr Ben Harris Director of Quality Improvement, Hospice Isle of Man, E-Mail: ben.harris@hospice.org.im Telephone: 01624 647437 Professor Sarah McGhee Co-Director of Research and Development, Hospice Isle of Man, E-Mail: sarah.mcghee@hospice.org.im Telephone: 01624 647424 Dr Jugnu Mahajan Medical Director, Noble s Hospital, Isle of Man E-Mail: jugnu.mahajun@gov.im Telephone: 01624 650051 Mr Robert Fayle (Chair of Patient Care Committee) Retired Consultant Obstetrician, Noble s Hospital, Isle of Man, Board Member Hospice Isle of Man E-Mail: fayle@free.com Telephone: 01624 612823 / 07624 231524 Mr Guy Sissons Consultant Radiologist, Noble s Hospital, Isle of Man, Board Member Hospice Isle of Man E-Mail: guy.sissons@gov.im Telephone: 01624 650445 19. Personal Specification 10
Requirements Essential Desirable Qualifications Professional Training in Medicine Teaching MBBS or equivalent MRCP (UK) or equivalent Licence to practice and full registration with GMC European Community Rights Holds CCT in Palliative Medicine or equivalent or will obtain within 6 months of interview date Name to be on Specialist Register (CESR) on date of taking up appointment or European Community Current ALS Certificate Experience of teaching all types of multi-disciplinary professionals from students to peers Additional qualifications related to Palliative Medicine An appropriate Higher Degree e.g. MSc, MD or PhD Teaching qualifications, e.g. Educational supervision courses, Cert Med ED Up to date educational appraisal Clinical Skills Experience in all aspects of Palliative Care and Oncology in varied settings Ability to offer expert clinical opinion on a range of problems Ability to take full independent responsibility for the clinical care of patients Able to demonstrate a sound understanding of Isle of Man Government Department of Health and Social Care Five Year Plan and Reform agenda Understanding of the place of Voluntary Hospice Services Research and Development Leadership Audit Motivation Experience of research, particularly in collaboration with other clinicians Ability to apply research outcomes to clinical practice Evidence of personal research publications Excellent leadership, influencing and motivational skills Adaptive leadership styles Effective in addressing poor performance in accordance with hospice policy Consciously reviews mistakes and successes Thorough understanding of principles of medical audit. Must have undertaken and completed audit projects. Punctuality, reliability, initiative Common sense Enthusiasm A sympathetic approach to patients Leadership and Management Training Track record of service improvement projects Proven ability to produce audit 11
Team Working Disposition Other and their relatives Have undertaken a postgraduate course on communication skills (or ensure that one is undertaken within one year of appointment) Ability to establish good professional relations with others Can demonstrate inclusivity, equality and diversity Experience of multi-disciplinary and multi-agency working Flexible approach to working Can learn from sharing experience and knowledge Can demonstrate honesty and integrity Can actively listen to comments/challenges and respond constructively Excellent communication skills in both written and verbal domains Can develop and coach an effective team to perform to the best of their ability Full driving licence Experience of speaking in public and at large meetings Experience of change management, financial management, business and service planning 12