ACCEA FORM A (Application Form) Employer-Based Award CLINICAL EXCELLENCE AWARDS SCHEME APPLICATION FORM 2012 Round It is the consultant s responsibility to ensure that this form is fully completed all boxes to be completed Surname: BARI Employer(s) name(s) with number of sessions per employer (Lead NHS employer first) University Hospital Of Morecambe Bay NHS Foundation Trust Part 1 to be completed by the applicant Forename: Professional Title: SHAHEDAL DR List of consultant appointments in date order 15.03.2010 to date: University hospital of Morcambe Bay NHS Foundation Trust 12.11.2007-14.03.2010 : North Cumbria University Hospital NHS Trust Application type: Level applying for: New CEA Level 7 Accredited Specialties (main first) Respiratory Medicine General Internal Medicine Year appointed to the consultant grade 2007 Primary Medical Qualification (Date and Institution) MBBS 1994 : Calcutta Medical College- University Of Calcutta Current level CEA LEVEL 4 Year awarded 2011-12 Ethnic origin Indian Subsequent Qualifications (Date and Institution) 2008 FRCP [Glas] 2006 : Physicians as Educator Diploma RCP[Lon] 2002 MRCP.Lon Preferred address for correspondence GMC/GDC Reg No. 4688037 Work tel (Direct Line) 01524583316 Email shahedal.bari@mbht.nhs.uk You cannot fill this form out without using the Guide to the Scheme, to which you must adhere strictly PERSONAL STATEMENT Give up to four examples that summarise your achievements. These should be since your last award. (Box limited to 1350 characters). 1.I run an effective Respiratory cross-bay service with teamwork. Through business cases I ensured new appointments of Consultant, Specialist Nurse, MDT coordinator, secretary [met RTT and targets]. I secured Respiratory ward-37 at RLI. I introduced team board round & reduced length of stay [LOS]. I started One Stop Lung Cancer [LC] Service at WGH [2nd in Trust, 5th in UK] reduced patient journey. I ensured availability of ward Ultrasound, blood gas machines at OPDs on both sites to ensure safe effective care & SPR training. 2.I standardised practices by agreeing with Radiology a protocol on follow up CT for lung nodules, thus changed practice, which reduced MDT & OPD & CT burden. I produced UHMB Respiratory disease specific follow up & discharge criteria agreed by all respiratory clinicians to reduce New to follow up ratio. 3.I participated in yearly National & local audits, showed better outcome in Pneumonia CQUINs, Asthma [8-22%] & surgical resection of LC-10% by taking action on audit outcome. 4.I delivered 60 hours of training sessions for consultants 2012-13[within my SPA] for GMC trainer revalidation [90% trainer recognised]. I changed Post Graduate Education Structure & successfully organised trust performance at GMC visit. I published papers, chaired divisional, National Review of Asthma Death & NSSG meetings. 1
JOB PLAN List agreed programmed or other activities relevant to the NHS. The Plan should itemise the number of remunerated direct clinical care PAs, the number of remunerated supporting PAs (SPAs), the number of other remunerated sessions / PAs for activities described in this application with a description of what these are, and also list unremunerated activities. (Box limited to1350 characters). I had a 10.5 PA contract untill July 13 when I was appointed as DME. Now it includes 6.75 DCCs & 2 SPAs & rest 4 DME. My weekly work includes: 2 ward [& board] rounds, 3cross-site clinics [weekly evening clinic], 0.5Bronchoscopy, lung cancer MDT [Thursday ] & Radiology meetings [Wednesdays I chair both] & unselected Acute Medical Take in 1in 12 rota. I ensured all Monday One stop clinics are covered for bank holidays by arranging extra clinics on Wednesdays. My SPAs [2] include FY1, FY2 CMT, SPR Clinical & Educational Supervision, SAMP, UG, FY-CT teachings, service developments, National & local audits and research. I have trained the trainers 14 half days before I became DME and taken the trust succesfully through the rigorous GMC review in 2013 as a new DME. I provided high quality care,maintained RTT & target, done extra paid clinical sessions on the top of my contractual hours. I contribute more than my contractual hours and I did the following roles with no PA allocation: Trust AQUA Pneumonia Lead 2010-Oct 2013 & achieved CQUIN, Lung cancer MDT Chair,Crossbay Resp. Clinical Lead for last 3 years. Consultant appraisals,mrcp PACES Examiner,RCP CCT question writer, RCP National Asthma death review, NSSG vice chair. I covered for Trust DME Feb- July 2013 when trust had no DME in post & also completed a PG Education Module Domains If you are applying for levels 1-9 you can include additional information for Domain 3 OR Domain 4 OR Domain 5. Please provide additional information for one domain only. DOMAIN 1: DELIVERING A HIGH QUALITY SERVICE (see Guide) (Box limited to 1350 characters). I achieved Respiratory RTT for last 18 months, 1st time in 8 years, reduced new to follow up ratio by agreeing disease specific safe discharge criteria cross-bay with all consultants, secured a Respiratory ward [37], accommodated level 2 patients [HDU level support with no extra doctor] at RLI. I introduced daily team board round for all patients at ward 37 [LOS reduced by 1.8 days]. With radiology we started day case lung biopsy and saving 4 bed days/week [patient survey done]. I ensured all 2ww patients get an offer of a clinic letter & more patient information on disease specific areas are offered. I agreed with all consultants to share inpatients and lung cancer, TB & any other outpatients [unprecedented] to avoid RTT & target breach and ensured faster safe care. I reduced LC-MDT Workload by writing Lung nodule follow up protocol thus standardised practice cross-bay. Our 96 % of LC referral seen within 2 weeks, 97% cases discussed at LCMDT, 94% had CT Scan before bronchoscopy thus increased rate of faster diagnosis & treatment >10%. I standardised care at all sites by ensuring nurse led clinic and B Gas machine is available in all clinics and on wards for faster decision making. I influenced change in AMU proforma to ensure Pneumonia CQUIN is met, thus improved AQUA data from 66 to 80% [ACS] & 80 to 90.6% [CPS] 2
DOMAIN 2: DEVELOPING A HIGH QUALITY SERVICE (see Guide) (Box limited to 1350 characters) As cross bay Respiratory chair I produced Respiratory vision-strategy and 5 year plan. I addressed demand capacity, submitted business cases and appointed full time consultant, specialist Nurse [increased nurse lead follow up clinic], MDT coordinator and Secretary thus all clinic letters are now delivered within 5 days. I ran team Advice & Guidance pilot with primary care successfully-ongoing. I secured Ultrasound machine funding [both sites-in place now] & training to comply with NPSA guide and secured SPR training. I trained locum consultants on Supervision to retain trainees at FGH. I reconfigured service at WGH & started one stop LC clinic where patient have all investigations including CT Scan before seeing a consultant & bronchoscopy at pm with no extra funding. This reduced number of patient journey to hospital. I standardised Bronchoscopy reporting & clinic template cross-bay. I engaged commissioners & ensured appropriate pay for CPAP service for the 1st time in last 10 years, CIU loss is reversed. With governance team I wrote Clinical Incidence SOP for reporting feedback to improve safety. I took part in yearly National Pneumonia, Asthma & LC treatment and resection audit [8-28% improvement of outcome in BTS standards, 30% Reduction on ITU admission, reduced LOS, smoking cessation, CURB Score, resection rate> 10% DOMAIN 3: MANAGING AND LEADING A HIGH QUALITY SERVICE (see Guide) (Box limited to 1350 characters) If a candidate at any national level completes form F to illustrate their leadership and management achievement it is not necessary to fill in domain 3; simply enter see form F. I engaged cross-bay team, ensured bimonthly meeting [I Chair] with clear role, accountability, inclusiveness at all staff levels. I sponsored nurses to go on training [SAMP funding], ran cross-bay monthly teaching at CIU by video link to up-skill staff. This helped retention. I organised Respiratory Study days for Nurses over 2 years attended by > 80 nurses. I mapped UHMB Respiratory services with future needs & proposed new model of care for BCT. I am running Electronic prescribing & dispensing-ippma pilot and electronic white board project. I piloted and agreed on OPD paper light project. As interim audit lead I changed medical audit programme, ensured AQUA & Mortality are discussed [DoH 3x2 matrix] thus AQUA data improved. Asthma data discussed with ED & pathway changed. As appraiser I appraised several colleagues in my own time. As LCMDT chair I agreed on role & conduct, presented LC resection audit data to BVH & at NSSG[as vice chair] thus thoracic surgical presence & resection rate improved at UHMB. I attended BCT roadshows & contributed to 5 year plan for Cumbria CCG [CLIC] for future plan meeting for UHMB. I led regional National Asthma Death audit and chaired RCP meetings and reviewed deaths [NRAD], I fed back data to Trust and engaged local GP leads and delivered training in Primary care. 3
DOMAIN 4: CONTRIBUTING TO THE NHS THROUGH RESEARCH AND INNOVATION (see Guide) (Box limited to 1350 characters) If a candidate at any national level completes form D to illustrate their research achievement it is not necessary to fill in domain 4; simply enter see form D. Agreed with colleagues Team based daily MDT board round where one consultant does discusses all the patients on ward 37 irrespective of who the patient is under.this reduced length of stay by 1.8 days. Weekly One stop Lung shadow clinic in WGH without capital investment where Patient have Spirometry ECG, bloods Consultation and Broncpscopy on same day. Persuaded colleagues to share the RLI Monday One stop Lung shadow clinic and to cover extra clinic on the same week on Bank holiday Mondays hence this clinic runs 52 weeks a year with no cancellation. Piloted IPPMA on ward 37 to go live on electronoic prescribing and dispensing without any extra doctor or nursing staff. Piloted and running Advice and Guidance to provide fast advice to primary care colleagues with a team approach with clear team accountability and rota. This is well received by primary care. Created UHMB Lung nodule guidance and pathway trust wide to reduce Lung cancer MDT discussion workload, time and number of clinic follow ups. Ensured same software bronchoscopy tool is used across three sites and the results are available instantly in lorenzo this resulted in CIP & better communication to GPs. My work in pneumonia AQUA has been nationally commended in advancing quality conference & accepted as a poster. We received the first prize in North West for AQUA. Within the last 5 years, indicate how many publications you have had, how many of these were in peer reviewed journals and list the 3 most important ones. No other text is allowed. (Text limit 1350 characters) Despite a busy job I have been able to contribute to reseach and had 8 publications in peer reviewed journals [USA, Europe, UK] in last 5 years, these also addressed some service reconfiguration. These includes Penumonia and hospital stay [USA], steriods and osteoporosis in COPD [USA], 2week wait and lung cancer diagnosis [UK- as a result BTS suggested inpatient 2ww upgrade and changed guidance] and congenital single lung agenesis case report [USA]. These are the three important ones: What affects the length of stay in community acquired pneumonia[cap] J Rafique,E shereston, G, Jifon, M Wiklinson, S BARI American Journal of Respiratory and Critical care Medicine [AJRCCM] A 2580,10.1164 page 32963May 2012 Do the Lung Cancer patients get abetter deal if they present by two week wait pathway? E Nuttall, K Mitton, MWilkinson, G, Jifon A Ansari S BARI Thorax page A76 Dec 2012 Vol67 Suppl 11 Incidental Finding Of Congenital Single Lung Agenesis and Emphysema B Lovell, L Huntley, S BARI American Journal of Respiratory and Critical care Medicine [ARJCCM] A6586 1.1164 May 2012 DOMAIN 5: CONTRIBUTING TO THE NHS THROUGH TEACHING AND TRAINING (see Guide) (Box limited to 1350 characters) If a candidate at any national level completes form E to illustrate their teaching and training achievement it is not necessary to fill in domain 5; simply enter see form E. As a RLI Tutor I delivered 14 half days of Trainer training to ensure 90% of our trainers are on GMC trainer databse by July 13 deadline. I produced training packs on Doctors in Difficulty, ARCP, Career guidance, Trainee Appraisal & Supervision. Even in time of no DME in post I completed all deanery and GMC quality control report, tariff feedback in time. I completed audit on Educational Appraisal with RO and a feedback system is in place through RO. I contributed to Recuitment, ARCP, teaching delivery of 4th year, PBL, SAMP, local FY CT and ST, zonal CMT, GP & regional SPR programme & delivered 2 Respiratory teaching days. As a Clinical appraiser I conducted colleagues appraisal and Educational Leads Education Appraisal.As DME[PG] from July 13 I changed the PG Educational Governance structure, included HR Director & MD, ensured all TOR.. I wrote trainee Clinical Incidence pathway, trainee & trainer forum guide & TSTL reporting table.. I have been successful to get board approval [TMB] to extend induction for tainess and revamped Induction information CD. I succesfully took Trust through GMC Monitoing visit and enagaged with HENW. I had yearly Clinical,Educational Appraisal and uptodate Job planning. I completed 20 modules of PG education certificate module. Please see enclosed additional information for domain 5. 4
Verification of Completion I declare that to the best of my belief this information is accurate and I am not aware of any disciplinary or professional conduct and performance issues against me Full Name Signature : DR SHAHEDAL BARI (The applicant needs to print a hard copy, which needs to be signed and retained.) Assessment by domain For each of the domains please indicate your assessment of the candidate in terms of contribution to work for the primary employer and the wider environment of health care locally, eg in the SHA or Deanery. You are not asked to judge national or international contributions, for which ACCEA will receive advice separately. X No contribution in this domain U Has not delivered contractual obligations at a level expected C Delivers contractual expectations at a level expected P Some aspects of delivery have been clearly over and above expectations E Outstanding delivery of service Domains 1. 2. 3. 4. 5. Please give your reasons if you have marked any domain U, P or E (box limited to500 characters) 5
GIVE YOUR ASSESSMENT OF THE CANDIDATE OVERALL FOR THIS LEVEL OF AWARD (Please give your reasons for your assessment of the candidate box limited to 500 characters) a) Is the consultant to the best of your knowledge working to the standards of professional and personal conduct required by the GMC and/or the GDC? Has the consultant during the last 12 months b) had a formal appraisal c) agreed his/her job plan d) fulfilled his/her contractual obligations e) complied with the private practice code of conduct? f) Are you aware of any actual or potential disciplinary or professional proceedings inside or outside the Trust? If the answer to (a-e) is No or the answer to (f) is Yes, further details must be supplied. (Box limited to about 500 characters) Name of person completing this form: Position Held: I, as Chief Executive, certify that the contents of Part 2 are accurate. The comments represent the considered opinion of the employer. Chief Executive Name: Direct Line tel: Direct email address: Date: Chief Executive of: Signed by Chief Executive Note to Chief Executive: Please sign personally and date the copy which the candidate will retain. 6