Job Description For Consultant in Dermatology Page 1 of 18
GENERAL INFORMATION The Royal United Hospitals Bath NHS Foundation Trust provides acute treatment and care for a catchment population of around 500,000 people in Bath, and the surrounding towns and villages in North East Somerset and Western Wiltshire. The Royal United Hospital The Trust operates from two sites, the Royal United Hospital () which is situated about 1½ miles from Bath city centre and the Royal National Hospital for Rheumatic Diseases (RNHRD) which is located in the centre of Bath. The Trust provides 732 beds and a comprehensive range of acute services including medicine and surgery, services for women and children, accident and emergency services, and diagnostic and clinical support services. The Trust employs around 5,100 staff, some of who also provide outpatient, diagnostic and some day case surgery services at local community hospitals in Bath & North East Somerset, Somerset and Wiltshire. This fulfils part of the Trust's aim to provide high quality care to people in their local communities. The hospital provides healthcare to the population served by four Clinical Commissioning Groups (CCGs); Bath and North East Somerset CCG, Wiltshire CCG, and Somerset CCG (Mendip Federations), as well as one social enterprise, Sirona Health & Care CIC. Management Structure The Trust has a divisional structure. There are three clinical divisions, Medicine, Surgery and Women & Children s, supported by two additional divisions, Corporate Services and Estates & Facilities. Each Clinical Division is led by a senior management team, consisting of a medical Head of Division, Divisional Manager and a Head of Nursing. Each also has a Head of Governance in the senior divisional team. Anaesthesia, ICM and pain services sit within the division of surgery. The senior management team meets with other divisional colleagues to discuss both operational and strategic issues for the specialities within the division. Strategic operational management decisions are made by the Management Board which consists of the executive directors and representatives from the three divisions. The hospital is managed by a Trust Board, which consists of a chairman, five non-executive directors and seven executive directors. The overall Page 2 of 18
management of the hospital is the responsibility of the Chief Executive, assisted by the executive directors and supported by the three clinical divisions. Executive directors: Chief Executive; Chief Operating Officer; Director of Finance; Director of Nursing; Medical Director, Director of Human Resources and Director of Estates & Facilities. CONSULTANT IN DERMATOLOGY JOB OUTLINE Appointment This is a whole time post for a Consultant in Dermatology at the Royal United Hospital, Bath. An exciting opportunity exists for an enthusiastic and ambitious individual to join a dynamic team of Consultants. The post holder should have an interest in providing General Medical Dermatology services and undertaking specialist interest clinics to complement the other interests of consultant colleagues. The Department of Dermatology The Department is situated on the second floor of the C block in The Royal United Hospital (C42). We moved into these newly refurbished bright, modern premises in May 2012. The unit is equipped with six out-patient clinic rooms and 2 extra clinic rooms for occasional use and for clinical administration, 2 outpatient theatres, a state-ofthe-art dermatology out-patient treatment unit (providing nurse-led topical treatment for in patients and outpatients, iontophoresis and patch testing) which also houses phototherapy facilities (whole body (oral and bath) and hand & foot PUVA, TL-01 phototherapy) and a PDT treatment room. There is a large communal consultants office/library/meeting room with 5 computer stations and adequate space to carry out administrative work with access to a range of dermatology texts. The unit also houses a large secretarial office and spacious reception/waiting area. Regular out-patient clinics are also run in peripheral hospitals Trowbridge, Chippenham, Warminster, Devizes, Frome, Paulton and Shepton Mallet. We hold a weekly Skin Cancer LSMDT meeting which is also attended by a plastic surgeon, oral and maxillofacial surgeon, ENT surgeon, histopathologist, consultant medical oncologist and consultant radiotherapist. Mr Ayers (the consultant plastic surgeon) also holds regular skin cancer clinics within the department. Page 3 of 18
There is a strong academic link with Bristol University with weekly academic meetings held at United Bristol Trust (Thursday afternoons). These are for discussion of complex patients. There are also regular Departmental Management and Audit and Governance meetings and combined clinics both in the department and at Bristol Royal Infirmary. The Speciality comprises of the following medical staff with their sub-speciality interest: Dr. Inma Mauri-Sole Clinical Lead Cutaneous surgery, GP education, Chair of the BAD SAS Committee. Dr. William Phillips (Consultant, 5 PAs) Lead for Skin Cancer services, immunosuppressed patients, general medical dermatology and dermatopathology. Dr. Deirdre Buckley (Consultant, 5PAs) Contact Dermatitis and Allergy. Research. Joint clinical lead for dermatology. Dr. Sarah Woodrow (Consultant, 5PAs) General and vulval Dermatology. Joint clinical lead for dermatology. Lead for the Bristol medical student training in the Bath Academy. Dr Paola DeMozzi (Consultant, 10PAs) General/biologic patients. Dr Caoimhe Fahy (Consultant, 10 PAs) General dermatology. Paediatrics. Vulval Dermatology. Academic research. Dr. Chris Lovell (Consultant, 1PA) - Connective tissue disease/rheumatology, contact dermatitis, biologics and research. Dermatology Specialist Trainee (part-time) on rotation from the Dermatology training programme in Bristol. Present within the department for 2 days per week. GP registrar full-time post of 4 months duration. Sister Catherine Shanley senior Sister Liz Metcalfe (Skin Cancer Nurse Specialist) holds out-patient clinics seeing follow-up skin cancer patients and photodynamic therapy treatment clinics. Jaye Kissane (Skin Cancer Nurse Specialist) holds out-patient clinics seeing follow-up skin cancer patients and photodynamic therapy treatment clinics. Page 4 of 18
Nicola Congdon (Skin Cancer Nurse Specialist) holds out-patient clinics seeing follow-up skin cancer patients and photodynamic therapy treatment clinics. Emergency work: the appointee will be expected to see a proportionate share of emergency GP and ward referrals between 9am and 5pm on weekdays. The appointee will have secretarial support and a shared office with appropriate facilities. The successful candidate will be appointed with their own secretary and mentoring will be offered from one of the established consultants already in post. The Lead secretary is Teresa Hedges on 01225 826225. THE POST Details of the Post Clinical Duties: The holder of this post will be a Consultant Dermatologist and will be expected to provide principally a general dermatology service to include acute medical dermatology for inpatients of all ages including children. Paediatric dermatology outpatient clinics will also be included. The post will be based at the but with a commitment to undertake regular community clinics. The post holder will also participate in audit and directorate meetings and undertake administrative duties as required by the Lead Clinicians. The appointee is expected to participate in teaching and training of 4th year medical students from Bristol University, junior Medical and Nursing staff, GPs, and other clinical staff groups. A commitment to maintain professional expertise by attendance at meetings and courses is expected, and completion of diaries for CME is essential. It is also essential that you have an annual appraisal to comply with the Trust s appraisal and revalidation policy. The post holder will also be expected to comply with the Trust s mandatory training programme. An interest in research and teaching is expected with participation in projects, courses, etc. to enhance the standing and role of the Department and Trust. Attendance at, and organisation of, meetings is expected. Page 5 of 18
The post holder will be expected to cover urgent clinical administrative duties and emergency ward cover for colleagues when absent or on leave. Management Duties: The post holder will be expected to work with local managers and professional colleagues in the efficient running of services and will share with Consultant colleagues in the medical contribution to management. The holder will be expected to take an active role in the development of resource management and to assist in the preparation of business plans. Consultants are required to undertake the administrative duties associated with the care of patients and the running of clinical areas where they work. General Requirements: Subject to the provisions of the Terms and Conditions of Service, the post holder will be expected to observe the Trust's agreed policies and procedures, drawn up in consultation with the profession on clinical matters and to follow the standing orders, financial instructions and code of expectations of the Trust. Dermatology Rota There is a rota for emergency GP and ward referrals between 9am 5pm on weekdays, but no weekend or night on-call. Work Programme The work programme will be reviewed at regular intervals and agreed with the post holder, Divisional Manager and Lead Clinician. A regular timetable will be established, however the nature of the post requires the post holder to be flexible in order to maximise day surgery and clinic capacity. Local procedures will be followed in the event of any disagreement over proposed changes, culminating in an appeal to the Trust Board. Proposed Job Plan The job plan will be a prospective agreement that sets out consultants' 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, clinical governance, private practice and any other responsibilities. Programmed activities Direct clinical care 10 PAs 8.5 PAs Page 6 of 18
Supporting professional activities 1.5 PAs Example Timetable The following provides scheduling details of the clinical activity and clinically related activity components of a sample job plan for a full time consultant that occur at regular times during each week including supporting professional activities. Day Time Location Work Categorisation Hours 0900 1300 Clinical Management (C7, 2 of 4 weeks B and C). SPA 2 PAs/month 0900 1300 Patient related administration (C11, 2 of 4 weeks A and D). 2 PAs/month Monday 1400 1500 Management meeting (S7 clinical management, 1 in 4, week A) Meeting with Senior Nursing staff (1 in 4, week B) SPA 0.75 PAs/month. Journal club (S2 CPD, 1 in 4, week C) 1400 1500 Complex cases clinic (C7, 1 in 4, week D) 0.25 PAs/month Page 7 of 18
Day Time Location Work Categorisation Hours 1500-1630, PGMC Skin Cancer LSMDT (C7, multidisciplinary meetings about direct patient care) 1.5 PAs/month 1630 1800 Patient related administration, triaging GP referrals, emergency work (C11,C7) 1.5 PA/month 0900-1730 Devizes Hospital Out-patient clinic (C2, 1 in 4, week A) all day 2 PAs/month 0900 1300 Out-patient clinic (C2, 1 in 4, week B) 1 PA/month Tuesday 1400 1800 Minor ops clinic (C2, 1 in 4, week B) 1 PAs/month 0900 1730 Frome Medical Centre Out-patient clinic (C2, 1 in 4, Week D) all day 2 PAs/month 0900 1300 Out-patient clinic (C2, 1 in 4, week B) Minor operations (C2, 1 in 4, week A) 2 PAs/month Wednesday 0900 1300 Clinical Management (S7, 1 in 4, week D) SPA 1 PA/month 0900 1730 Devizes Hospital Out-patient clinic (C2, 1 in 4, week C) all day 2 PAs/month 1400 1800 Adult/Paediatrics (C11,1 in 4, Week D) 1 PA/month Page 8 of 18
Day Time Location Work Categorisation Hours 1400 1800 Patient related administration, (C11, 1 in 4, week B) 1 PA/month Paediatric outpatient clinic (C2, 1 in 4, Week B) 0900 1300 Adult out-patient clinic (C2, 2 in 4, weeks A and D) 4 PAs/month Minor operations (C2, 1 in 4, week C) Thursday 1330 1730 Out-patient clinic (C2, 2 in 4, weeks B and C) 2 PAs/month 1330 1730 BRI Bristol Combined Dermatology Clinic (week A) SPA 1 PA/month 1330 1730 Minor operations (C2, 1 in 4, week D) 1 PA/month 0900 1300 Out-patient clinic (C2, weekly) 4 PAs/month Friday Additional agreed activity to be worked flexibly 1330 1715 OPD Emergency ward/gp work/day Treatment Centre and ongoing management of medical cases (C2) Administration (C11) Travel to peripheral clinics (3 return 3.75 PAs/month 1.25 PAs/month 0.75PAs/month Page 9 of 18
Day Time Location Work Categorisation Hours journeys/month, C10) Undergraduate teaching, (S3) Clinical Management (S7) SPA SPA 0.25PAs/month 1 PA/month Predictable emergency on-call work Unpredictable emergency on-call work 40 Total Hours Total Hours 10 Total PAs Total PAs SUMMARY OF PROGRAMMED ACTIVITY Number Supporting Professional Activities 1.5 1.5 SPA to be allocated according to the individual s priorities; Direct Clinical Care (including unpredictable on-call) 8.5 Other NHS Responsibilities External Duties TOTAL PROGRAMMED ACTIVITIES Total 10 Page 10 of 18
ON-CALL AVAILABILITY SUPPLEMENT Agreed on-call rota (e.g. 1 in 5): 0 Agreed category (A or B): N/A On-call supplement (%): 0 COMMENCEMENT OF DUTIES This post is comprised of 10 PAs. The appointee will be required to take up the post as soon as possible. If you consider it is unlikely that you will be able to take up the appointment within such a period, you are advised to highlight this at the time of your application. Office and Secretarial Facilities Full time secretarial support will be provided, shared office space is available. Accountability The Chief Executive is managerially responsible for the services provided by the Trust and the Lead Clinician is responsible for the provision of the service. The post holder will be responsible for the discharge of their contractual duties through the Lead Clinician to the Chief Executive. The Trust will take direct responsibility for costs and damages arising from medical negligence in the treatment of NHS patients, where they (as employers) are vicariously liable for the acts and omissions of their medical and dental staff. However, it is strongly advised that the person appointed maintains defence body membership in order to cover any work, which does not fall within the scope of the hospital policy. A medical professional indemnity scheme is available to cover compensation (including claimants' costs and expenses) arising from medical negligence in the treatment of private patients at the Royal United Hospital. It is a condition of this policy that all employed and non-employed consultants involved in the business of the Royal United Hospital shall be a member of a Medical Defence Organisation. Page 11 of 18
HEALTH AND SAFETY Employees must be aware of the responsibilities placed on them under the Health and Safety at Work Act (1974) and any subsequent relevant legislation and must follow these in full at all times including ensuring that they act in line with all agreed procedures at all times in order to maintain a safe environment for patients, visitors and staff. Failure to comply with these policies may result in disciplinary action up to and including dismissal. Healthcare Associated Infections (HCAIs) All Trust staff have a reasonability to act and follow all instructions to protect patients, staff and others from HCAIs. All staff are required to follow the NHS Hygiene Code and all Trust policies and procedures related to it and the Health Act 2006. Failure to comply with any of these may result in disciplinary action up to and including dismissal. Medical Examination / Screening At any stage of your employment you may be required to undergo a medical examination to confirm your fitness to undertake your duties. All medical and dental practitioners are appointed subject to medical screening. Vaccinations and immunisations except Yellow Fever may be obtained by contacting the Occupational Health Department at the Royal United Hospital on Extension 4064. If this post has been identified as one involved with exposure prone procedures, satisfactory Hepatitis B status will be a condition of your employment with this Trust. You will be required to either undergo the immunisation process or produce written evidence of satisfactory Hepatitis B status prior to taking up this appointment. As this appointment will provide substantial access to children, an enhanced Criminal Records Bureau check on convictions will also be necessary. ACADEMIC FACILITIES The Royal United Hospital has two centres for academic support. The Post Graduate Medical Centre has excellent lecture and meeting facilities and a new surgical simulation suite. The Bath Academy Education Centre houses an excellent medical library, clinical simulation suite, resuscitation training and again has extensive meeting facilities. In addition to these facilities the Wolfson Centre houses a number of departments that are linked to Bath University with whom the hospital has excellent links. Bath University has a School for Health where academics Page 12 of 18
collaborate actively with hospital staff over a wide range of disciplines. The hospital is also closely linked with Bristol University Medical School. Undergraduate and post graduate training is undertaken on site. Many consultants have honorary appointments at Bath and Bristol Universities. There are strong links with several other universities and several members of staff have honorary chairs. There is a long tradition of research and education at the hospital and a regular supply of undergraduate students. All consultants are expected to take part in these teaching activities. There is an active research and development department which fosters and facilitates research in all medical disciplines. Formal medical audit in the Department is in operation. A weekly teaching session takes place on a Friday afternoon in conjunction with Severn Deanery, usually at the Avon Orthopaedic Centre, Bristol. A monthly case conference takes place in the PGMC, Bath. CLINICAL GOVERNANCE The NHS Executive has defined Clinical Governance as: A framework through which NHS organisations are accountable for continuously improving the quality of their services and safeguarding high standards of care by creating an environment in which excellence in clinical care will flourish In line with Government requirements, the Trust has established a clinical governance committee. The Chief Executive is the accountable officer and the lead is the Director of Nursing, who is responsible for ensuring that systems for clinical governance are in place and monitoring their continued effectiveness. As part of the requirements of clinical governance, the Trust s Committee is ensuring that all hospital doctors participate in audit programmes, including, where appropriate, specialty and sub-specialty national audit programmes endorsed by the Commission for Health Improvement. Procedures are in place for all professional groups to identify and remedy poor performance, including critical incident reporting, professional performance and supporting staff to report any concerns they may have about colleagues professional conduct and performance. Page 13 of 18
CONDITIONS OF SERVICE National terms and conditions of service (Consultants (England) 2003) cover the post. Consultants unable for personal reasons to work full-time will be eligible to be considered for this post. If such a person is appointed, modification of the job content will be discussed on a personal basis in consultation with Consultant colleagues. This post is open to applications from candidates who wish to job share. Residence within either 10 miles of, or thirty minutes by road (e.g. from ) is a requirement of this post. The appointee must have telephone contact and have a current driving licence. This post is subject to an Exception Order under the provisions of Section 4(2) of the Rehabilitation of Offenders Act, 1974. The post is subject to pre-employment checks such as police check clearance, Occupational Health, right to work checks and satisfactory references. You are required to be registered with the General Medical Council with a licence to practice throughout the duration of your employment and to comply with and abide by the relevant code of professional practice, as appropriate. Annual Leave 6 weeks and two days per annum pro-rata to be approved by the Lead Clinician. Requests should be submitted at least six weeks before leave is required. Requests for annual leave over three weeks should be submitted three months before leave is required. Up to 5 annual leave days may be carried over from one leave year to the next with the agreement of the Lead Clinician. Study and Professional Leave Study and professional leave of up to 30 days, including off duty days within the leave period, in any three years is available in line with the Trust s Study/Professional Leave Policy for Consultants, Associate Specialists and Staff Grade Doctors. Leave will only be given where it has been formally approved by the Lead Clinician. A minimum of eight weeks notice is required for any request. Canvassing Candidates should note that canvassing any member of the Advisory Appointments Committee or the NHS Trust will result in their being disqualified (see Statutory Instrument 1983 No 276 para 8,1,b). Page 14 of 18
Policies and Procedures The post holder is required to familiarise themselves with all Trust policies and procedures and to comply with these at all times. Failure to comply with any of these policies may result in disciplinary action up to and including dismissal. Confidentiality and Data Protection The post holder must maintain the confidentiality of information about patients, staff and other health service business and meet the requirements of the Data Protection Act (1998) at all times. The post holder must comply with all Trust Information and Data Protection policies at all times. The work of an NHS acute Trust is of a confidential nature and any information gained by the post holder in their role must not be communicated to other persons except where required in the recognised course of duty. Failure to comply with any of these policies may result in disciplinary action up to and including dismissal. No Smoking The Trust is smoke free and site and all Trust staff are not permitted to smoke on any part of the site at any time. Failure to comply with this policy is likely to result in disciplinary action up to and including dismissal. Equality and Diversity The Trust has adopted a Managing Staff Diversity Strategy & Policy covering all of its staff and it is the responsibility of all Trust staff to comply with these requirements at all times. The key responsibilities for staff under this Strategy and Policy are set out in the Trust Code of Expectations for Employees. Failure to comply with these policies may result in disciplinary action up to and including dismissal. Safeguarding Children All Trust staff have a responsibility to safeguard children. All staff must be familiar with, and adhere to, the trust child protection procedures and guidelines, in conjunction with the Local Safeguarding children s board (LSCB) policies and procedures. It is the responsibility of the postholder to be familiar with their role and responsibility around safeguarding children and to ensure that they have completed training at a level commensurate to their role. Page 15 of 18
Conflict of Interest All Trust staff are required to identify and report any potential conflict of interest in line with the Trust Code of Expectations of Employees and other Trust policies. Other Facilities a) There is a gym (the Oasis), tennis courts and swimming pool all on the site. b) There are a number of car parks scattered throughout the hospital site and a limited amount of garage accommodation for renting. c) The hospital is situated on the edge of the World Heritage City of Bath. There are good social and cultural facilities with the larger centre of Bristol being only 12 miles away. Bath has good transport links to the rest of the country and Bristol International Airport is only half an hour's drive away. Education in Bath is of a high standard and local schools consistently perform above the national average. Candidates will be short listed for interview by the advisory appointment committee following submission of an application within the defined time scale against the specification set out below. These criteria will be used throughout the appointment process to select the most suitable candidate. Candidates should ensure that the criteria are fully addressed in their applications. Page 16 of 18
Person Specification Consultant in Dermatology REQUIREMENTS ESSENTIAL DESIRABLE Qualifications Basic MRCP or equivalent Full GMC Registration CCST in Dermatology MD or PhD Postgraduate Clinical Experience Entry on the GMC specialist register in Dermatology or be eligible for entry (within six months of attaining Certificate of Completion of Specialist Training) at the time of interview Knowledge and experience of out-patient dermatology and management of acute dermatoses, chronic dermatoses, paediatric dermatology and skin cancer Clinical training and experience required for gaining UK CCST in Dermatology (or equivalent) Ability to offer an expert opinion on dermatological manifestations of acute and chronic general medical problems and their treatment, including care of adult and paediatric inpatients with complex problems. Ability to take full an independent responsibility for the clinical care of patients Ability to safely oversee and share care of adults and children with chronic skin problems with nursing and other staff Supervised training in an appropriate StR training programme or equivalent Management and Administrative experience Ability to assist in the efficient and smooth running of the Dermatology service Ability to organise and manage Page 17 of 18 Ability to manage and lead strategic developments in service delivery
Teaching Experience Research Experience Personal Attributes day to day service delivery e.g. out-patient priorities and dermatological surgery lists Experience of audit and evidence based management of clinical problems Ability and willingness to work within the Trust and NHS performance framework and targets Commitment to Continuing Medical Education and the requirements of Clinical Governance To have training and experience in appraisal systems Experience of supervising PRHOs, SHO and GP trainees. Ability to teach clinical skills Ability to apply research outcomes to clinical problems Publications in peer reviewed journals Caring attitude to patients Good personal interactive communications skills: clarity of expression and purpose The ability to work as a team member Acceptance of management and administrative duties by working within a structured hospital team for the greater good Ability to communicate effectively with patients, relatives, GPs, nurses and other agencies Ability to supervise research projects Experience/interest in clinical trials Page 18 of 18