Job Description Post Title Consultant in Palliative Medicine Inpatient Unit and Great Western Hospital Salary: Tenure: Reporting to: 76, 761-103, 490 pa pro-rata, according to level of experience Substantive. Full or part time applicants considered Lead Consultant Prospect Hospice Accountable to: Director of Patient Services Prospect Hospice The post holder will be employed by Prospect Hospice with an honorary contract held with Great Western Hospitals NHS Trust. Background Prospect Hospice is situated in Wroughton, in the North Wiltshire countryside. It is immediately south of Swindon, 4 miles from the Great Western Hospital and within commutable distance from Oxford, Bath and Bristol. Prospect Hospice is a registered charity providing a broad range of nd of Life Care services across Swindon and North ast Wiltshire. Our care is delivered in our 16 bed In-Patient Unit, Day Therapy Unit, Great Western Hospital, Well Being Centre and patients homes including care homes. The Hospice has an outstanding local reputation and is committed to ensuring that the patients and families we provide comfort and care for each year continue to receive an exceptional level of support towards the end of their lives as well as helping to influence and enhance best practice in nd of Life Care with other providers. The hospice The in-patient unit has 16 beds -two commissioned by the Great Western Hospital to support the smooth transfer of patients from the acute setting, one commissioned for continuing healthcare, one for planned respite for 7 days and also a rapid access bed for imminently dying patients. Patients on the in-patient unit are supported with medical imaging, pathology, blood transfusion and pharmacy services from the Great Western Hospital. There is an IT link to view patient medical records and results at Great Western Hospital. The appointee will join a medical team, which consists of: One part time Consultant in Palliative Medicine (Lead)
4 part time Speciality Grade Doctors supporting the in-patient unit 2 full time ST1 posts on the in-patient unit (4-6 month rotational post on Severn GP Speciality Training programme) There is no expectation that the consultant will act down to provide cover to the unit, apart from in exceptional circumstances. The inpatient unit is supported by 24 hour nursing care which is led by a dedicated nurse manager. The hospice provides 24/7 telephone advice to patients, carers and professionals through its Advice Line. Clinical Nurse Specialists cover this seven days/week, 9am-5pm. Out of hours the advice is provided by in-patient unit nursing staff in the first instance. Out of hours calls from professionals which can t be managed by nursing staff are directed to the doctor providing on-call cover, with access to consultant advice when required. The appointee will share an office, with access to a desk and computer, at Prospect Hospice and at the Great Western Hospital. Remote IT access is available. Full secretarial and administration support is provided both at Prospect Hospice and at the Great Western Hospital. Community services There is a team of 10.4 WT Clinical Nurse Specialists who provide an out-reach service to the community. The team works on a geographical basis allied to groups of general practices, and offers focused care for the patients and their carers during the course of the illness. There are an additional 2 Clinical Nurse Specialists who work exclusively with care homes providing a range of direct care services, education and advice. Together these services provide a 9am- 5pm 7 day service including face to face assessments if required. The community service is supported by the medical and wider multi-professional teams. This includes out-patient services, day hospice and a hospice at home service. There is no expectation that Consultants will provide out of hours home visits. The Great Western Hospital The Great Western Hospital is a new hospital, with modern facilities. It has in the region of 400 acute beds. The Trust provides general planned and emergency services to the local populations of Swindon and North Wiltshire and to parts of Gloucestershire, Oxfordshire and West Berkshire. Medical Oncology is provided by an acute oncology team. Clinical Oncology is provided by Consultants from the Oxford Cancer Centre. The majority of chemotherapy is administered locally in a dedicated day treatment centre and all radiotherapy and some complex solid tumour chemotherapy is provided in Oxford. There is a dedicated 10 bed haematology/oncology ward. Prospect Hospice has a strong relationship with the Great Western Hospital and provides an in-reach palliative care service comprising 3.6 WT of CNS time in addition to Consultant sessions. The team provides a weekday 9-5 advisory service to support the care of adult patients across the Trust. Activity involves direct patient reviews and the provision of advice and support to the clinical teams. Additionally the team provides education sessions and supports the implementation and governance around initiatives including the personalised care plan for dying patients, advance care planning and treatment escalation plans.
The Role The post holder will: Provide Consultant care, advice and support across hospital and hospice in-patient care settings and also to the community. Share medical clinical responsibility for hospice in-patients with the other Consultants Provide specialist advice, support and information to patients and carers through direct consultations and by providing advice and support to Clinical Nurse Specialists, primary care or hospital based clinical teams. Lead multidisciplinary team meetings across clinical settings. Contribute as a senior member of the patient services team, liaising with the other medical consultants, inpatient unit manager and other service department managers to ensure a seamless and integrated service for patients and families. Develop close working relationships with hospital clinical teams, providing clinical advice, undertaking clinical reviews and out-patient assessments. Promote good communication, information and integration of services for patients and their carers. Provide palliative care advice and input to the community. Provide specialist medical on-call services including supporting the out of hour s advice line. Workload The Consultant body provide a responsive and demand led service. There is Consultant attendance at three Hospital site specific Cancer MDT meetings (Carcinoma of Unknown Primary, Upper GI and Lung). The post holder will undertake a minimum of one Consultant ward round a week on the hospice inpatient unit, depending on full or part time employment. There will be flexibility in Consultant attendance at the in-patient unit bed meeting and weekly MDT meeting. Working alongside the other Consultants there is an expectation that the post holder will provide hospice and hospital inpatient reviews throughout the week and infrequent outpatient reviews as required. Clinical governance The post holder will:
Participate and contribute to relevant local, regional and national clinical governance programs relevant to the hospice and hospital settings, including undertaking at least one audit / year and supervising junior doctors in undertaking audit. Demonstrate a commitment to Continuing Professional Development and embrace opportunities to engage with local and regional networks. These may include regional palliative care physicians groups and grand rounds at the Great Western Hospital Promote evidence based practice and use of clinical guidelines. Actively contribute to the development of local clinical guidelines. Be encouraged to engage in research opportunities which arise. Contribute to the development of hospice strategy through engagement and involvement. Work to enhance and develop palliative care services including out-patient services. Participate fully in revalidation. The Consultants designated body is Great Western Hospitals NHS Foundation Trust. Responsible Officer Services are provided by agreement by the Great Western Hospital which includes provision of an electronic appraisal documentation system including the support of 360 degree assessments and patient surveys. ducation, training and influence The post holder will: Contribute to the design and delivery of a broad range of education initiatives in relation to Specialist Palliative Care and nd of Life Care. Provide teaching for doctors and extended clinical teams at Prospect Hospice. Support the supervision of the medical team on the in-patient unit including review, appraisal and undertaking the role of clinical supervisor for ST1 doctors. Participate in undergraduate teaching programmes through the Swindon Academy. On-call commitment Please note that BMA guidance has been sought on the calculation of PA allocation and remuneration for on-call work. Agreed monitoring will be undertaken. The Consultants currently contribute to the first on call rota. This currently equates to 1:8 1 st on call and 1:8 2 nd on call to the ST1 doctors. Weekday 1st on call work and all 2 nd on call work is largely telephone advice, with the expectation of 1-2 telephone calls in each on call period. It is exceptional to have to attend the in-patient unit. The unit does not currently accept out of hours admissions. Weekend admissions may occur between 9am-2pm. The
medical team support the advice line -there is always a consultant available to provide advice. This is shared between the Consultants on a rolling weekly rota. There is no expectation to provide face to face contact with community or hospital based patients out of hours. Consideration will be given to time off in lieu should unpredicted emergency work be undertaken. Key Contacts Accountable and reporting to: The post holder will report to the Lead Consultant and is accountable to the Director of Patient Services. The post holder will be actively encouraged to have the support of an external mentor. The post holder may wish to determine who this will be, however assistance can be provided with this if required. Other key contacts Chief xecutive Board of Trustees Directors /Heads of corporate functions and senior managers across the organisation Stakeholders / Partners Conditions of Service The post holder will be given a contract with pay, terms and conditions of service in line with the National NHS terms and Conditions of Service (Consultants (ngland) 2003). The contract is available on request. The Hospice supports the requirements for continuing medical education as laid out by the Royal College of Physicians and is committed to providing the time and financial support for these activities. Study leave provision is 30 days over a 3 year period. Only one Consultant may take annual leave at any one time. The consultants will cross-cover each others commitments by providing a trouble shooting service. This will for the most part involve telephone advice. However on occasion it may be necessary to provide face to face contact. The post holder must reside within a 1 hour drive of Prospect Hospice.
It is the post holders responsibility to familiarise themselves with agreed Prospect Hospice policies and procedures and adhere to these. The post is subject to pre employment checks such as criminal records bureau clearance (DBS), occupational health, visa clearance (where applicable) and satisfactory references. Consultants unable to fulfil the professional activity requirements of the post for personal reasons will be eligible to be considered for this post. This post is open to candidates who wish to job share. The successful applicant must be either on the Specialist Register or within six months of being eligible for inclusion on the Specialist Register at the time of the interview. The successful applicant will be required to be registered with the General Medical Council throughout the duration of employment and to comply with and abide by the relevant code of practice. They will be expected to have appropriate personal medical indemnity. The job plan is provisional. The job plan will be subject to regular review with the lead Consultant. It is recognised that much of the work is demand led. A flexible approach is therefore required.
Person Specification Skills, Knowledge & xperience RQUIRMNTS CRITRIA ssential () or Desirable (D) Qualifications Primary medical qualification MRCP or equivalent Full GMC registration ntry on Specialist Register for Palliative Medicine or within 6 months of obtaining CCST/CCT Higher degree (e.g. MA, MSc, PhD, MD) D Clinical xperience xperience in working effectively within a specialist palliative care unit / hospice and within a multidisciplinary team Ability to undertake palliative care assessments in a variety of settings including hospice, outpatient clinics, hospital wards and in patients homes Ability to provide palliative care advice and support to other healthcare professionals in the hospice, hospital and community settings Ability to take full and independent responsibility for clinical care of patients Sub-specialist interest D Management Administration Demonstrate ability to manage priorities Understanding and experience of all aspects of Clinical Governance vidence of management/ leadership skills training Computer literacy
Teaching and Research Personal Attributes Other Requirements An understanding of voluntary sector hospice funding and management. Current agendas within the NHS which have a bearing on the strategic vision of Specialist Palliative Care. xperience of teaching, including doctors and medical students xperience of multidisciplinary teaching xperience of research and ability to apply outcomes to clinical practice Committed to the ethos of hospice care and capable of fulfilling an effective ambassadorial function Ability to build effective internal and outward facing relationships across commissioning and health and social care nthusiasm, motivation and commitment to the development of hospice and palliative care services Ability to cope and be resourceful in sometimes challenging and stressful situations Caring and empathic approach with patients and families Ability to communicate effectively with patients, relatives, hospital staff, GPs and other agencies Commitment to Continuing Medical ducation Flexible approach to working Car driver with access to own car for work purposes, including business insurance Ability to undertake travel requirements of post D D IMPORTANT ADDITIONAL INFORMATION The line manager will discuss all elements of the job description with the postholder on an annual basis during appraisal, recognising that some elements may be developed.