Job Description:
Locum Consultant in Palliative Medicine

Department / Medical Team
Responsible to / Medical Director
Reports to / Medical Director
Responsible for
Key working relationships: / Consultants, Director of Care Services, all clinical operational mangers
Salary grade / As per NHS 2003 consultant contract
Hours of work / Full time (10 PAs) but candidates wishing to work less than full time will be considered
Criminal Record Disclosure required (DBS) / Enhanced withbarring (adult)

Our Vision

A world where everyone can face death informed, supported and pain free.

Our Mission

Pioneering standards in expert support and care, for anyone facing death and bereavement.

Our Values

Our values define who we are and how we act. We are:

Human: We treat people with understanding, patience, respect and above all dignity. We are the welcoming smile, the talk over a cup of tea, the human touch.

Courageous: We stand firm, we do not flinch in the face of hard news, but always with humanity, sensitivity and respect for our community.

Energetic: Whether we're out running a fun run or at the hospice greeting our patients, we bring the energy and optimism to make the most of every day.

Connected: We are not an island, we thrive on partnerships and working with others, we believe we are better and stronger together.

Expert: We are looked up to by our community and our peers as the organisation to go to for knowledge, training, best practice and latest techniques.

JOB PURPOSE

This is a locum post to cover maternity leave. It is likely to be for 9 months in the first instance but may be extended to a year depending on the current post holder's plans.

The consultant’s role is to provide specialist medical care and leadership. It carries clinical, educational, managerial and governance responsibilities.

MAIN DUTIES AND KEY RESPONSIBILITIES

Clinical

  • To provide expert medical advice and support to professional colleagues working within St Catherine’s multi-professional team and externally
  • To provide senior medical care for in-patients admitted to St Catherine’s Hospice In PatientUnit
  • To participate in the medical assessment and continuing management of community patients, in the home, care home, community hospital or day hospice setting
  • To attend and contribute to multidisciplinary meetings
  • To provide cross-cover for consultant colleagues in their clinical areas as and when required
  • To contribute to the consultant on call rota to provide senior specialist medical cover
  • To ensure the maintenance of full, accurate, contemporaneous and confidential patientrecords
  • To adhere at all times to the GMC Code of conduct ‘Good Medical Practice’.

Education and research

  • To provide clinical supervision, advice and support to training grade doctors and specialty doctors working under the supervision of the post-holder
  • To participate in teaching and training of St Catherine's Hospice staff, and visiting Healthcare Professionals and Healthcare students as well as volunteers
  • To contribute to hospice research activity as appropriate

Continuing Professional Development

  • To identify personal development and training needs through the annual appraisal process
  • To participate in annual appraisal and job plan review and 5-yearly revalidation
  • To undertake all required mandatory training

Clinical Governance and Audit

  • To support the hospice’s Clinical Governance Programme, contributing to the process ofcontinuous quality improvement throughout the Hospice
  • To regularly participate in audit, and service evaluation projects which are relevant to service delivery at the Hospice, and to support and develop such work undertaken by other team members
  • To monitor, record and assist in investigations of any complaints from patients, visitors and staff, reporting these as appropriate

Management and service development

  • To attend meetings pertinent to organisational and professional responsibilities, representing the consultant team where appropriate
  • To participate as an active member of appropriate professional committees and working parties involved in End of Life Care strategy and policy.
  • To participate in the development and review of clinical policies and procedures
  • To be responsible and managerially accountable for the reasonable and effective use of Hospice and NHS resources.
  • To ensure that the hospice is positively represented in a professional manner to the public and to other stakeholders.

Policies and Procedures

In addition to your professional code of conduct, you must familiarise themselves with, and adhere to St Catherine's policies and procedures as listed in your team induction schedule, including the following:

  • Information Governance
  • Data Protection
  • Risk Management
  • Raising a Concern
  • Complaints
  • Safeguarding
  • Mental Capacity
  • Health and Safety at Work
  • Equal Opportunities
  • Infection Control
  • HR Management
  • Incident Management

You have a duty to undertake the relevant e-learning modules and facilitated training as detailed in the Compulsory Training programme.

If you manage staff and/or volunteers it is your responsibility to ensure that your team are made aware of and understand the policies and procedures relevant to their work.

Information governance and confidentiality

Employment by St Catherine's often involves access to personal information relating to patients, carers, staff, volunteers and supporters.This information is confidential andmust not be disclosed to anybody, other than when acting in a official capacity. Non authorised use, access of records or disclosure of personal or confidential information is a dismissible offence, andin the case of computerised information could result in prosecution for an offence or action for civil damages under the Data Protection Act 1998.

Safeguarding and Mental Capacity Act

All employees have a responsibility to safeguard and promote the welfare of adults, children and young adults. You must ensure you always act in the best interests of any person lacking mental capacity.

Health and Safety at Work Act

You have personalresponsibility to take care of your own health and safety and that of others who may be affected by your actions at work. Ensure you observe the Health and Safety procedures, and carry out your work as instructed.

Infection control

All employees have personal responsibility for Infection Prevention and Control practice. You should ensure you are familiar with, and comply with, all relevant Infection Control policies and training for minimising the risk of avoidable ‘Health Care Associated Infection’.

Conduct

Employees are ambassadors for St Catherine's, each responsible for promoting, maintaining and upholding the reputation of St Catherine's at all times in line with our values.

This is an outline job description designed to give an overview of the responsibilities of the role. We expect the job holder willwork flexibly, responding to organisational need and changes as they occur. You will also contribute to the wider corporate and organisation needs of St Catherine's such as supporting our fundraising efforts.

CONSULTANT IN PALLIATIVE MEDICINE - SUPPORTING INFORMATION AND DETAILS OF POST

SERVICES PROVIDED AND ACTIVITY DATA

St Catherine’s Hospice is a charity dedicated to providing specialised end of life care and support to local people, their families, friends and carers.

For over 30 years we have been providing high quality hospice care, free of charge, to people living in Crawley, Horsham, Mid Sussex and East Surrey. The catchment area covers a population of around 550,000 patients. Approximately 1200 patients are referred to the Hospice yearly. Just under 400 patients are admitted to the Inpatient Unit every year and the average length of stay on the unit is around 13 days with an occupancy of over 85%. Between 30 to 40% of patients are discharged. The Inpatient Unit has 18 beds. There is aDay Hospice - which operates on 2 sites and provides a combination of symptom monitoring, therapeutic groups, creative therapies and social and emotional support.

The community team service is divided into 3 geographical areas: East Surrey; Crawley & Mid Sussex; and Horsham & Surrey Downs. Each team of Nurse Practitioners is led by an Advanced Nurse Practitioner and has designated Consultant and Specialty Doctor / Registrar input. As well as providing specialist assessment and advice, the nursing team is able to provide 'hands-on' care at home to support people to die in their place of choice and to facilitate rapid discharge from the acute sector. The Therapies Team, (consisting of Physiotherapists, Occupational Therapist and Therapy Technicians) and the Patient and Family Support Team (who provide counselling, welfare support and spiritual care) complete the Multidisciplinary Team in the community.

The Patient and Family Support team also provide the Bereavement Service. There is also a specialist lymphoedema service.

Although StCH 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 30% of our expenditure on charitable activities. The remainder is found from voluntary sources.

STRATEGY AND REACH

St Catherine's Hospice has 3 key strategic objectives. These are: 1) Excellence 2) Reach and 3) Sustainability. Work is currently underway to re-specify the services provided by the hospice, to ensure that the support provided is appropriate to the needs of a wider range of patients. As part of this we are expanding our telephone advice service and are looking to develop a 24/7 rapid response service for community support.

MEDICAL TEAM STAFFING AND STRUCTURE

The post-holder will join an existing team of consultants Dr Patricia Brayden (Medical Director), Dr Catherine Gleeson - Medical Education Lead) and Dr Amanda Gregory Clinical Audit and Research Lead for the consultant team.) The current post-holder Dr Julia Fleming leads on Service Design and operational aspects for the consultant team.

Specialty Registrar posts and a GP ST2 post (as well as a CMT post shared with Care of the Elderly at East Surrey Hospital. We have a new FY2 post starting in August 2017. The registrar posts are usually filled by a more junior (ST3 / ST4) and a more senior (ST5 / ST6) trainee. The clinical focus for these posts varies depending on previous experience and educational needs. In general, however, the FY2, CMT and GP ST2 work predominantly on the ward and the Specialty Registrars have both ward and community responsibilities, usually working with one geographical team for continuity. We would expect the post-holder to provide clinical supervision to trainees.

In addition, there are 2(1 WTE) Specialty Doctors. They work predominantly in the community, in designated geographical areas, but provide cross cover for each other and for the trainees as needed.

The post-holder will have IPU (one 9 bedded ward) and community responsibilities. In the community he/she will provide support to the East Surrey community area, which received 466 referrals in 2013-14.. S/he would therefore be supported by a GP ST2 or FY2 and palliative medicine specialty trainee on the ward and LTFT StR and LTFT specialty doctor (0.4 WTE) in the community.

EDUCATION

St Catherine's Hospice is committed to a culture of learning and supporting the professional developmentof staff, students, professional colleagues and the local community. The post-holder, together with the other consultants,will be expected to support thisthrough input toSt Catherine's education prospectus and involvement with education initiatives. In particular, attendance at GSF meetings with local GP practices will be encouraged as an opportunity for regular informal education of primary care colleagues.

There are close links with the universities of Surrey (Guildford) and Sussex (Brighton) and the hospice regularly hosts medical student modules for students based at BSMS. There is access to a comprehensive catalogue of books and journals relevant to palliative care. Open Athens access is also available.

RESEARCH AND AUDIT

There is a comprehensive clinical audit programme. The post-holder will be encouraged and supported to participate. There is a thriving research group, supported by an NIHR-funded research nurse. We have participated a number of multi-centre projects and St Catherine's is beginning to generate its own research in partnership with other hospices and Hospice UK.

APPRAISAL, REVALIDATION AND CPD

The hospice supports the requirements for continuing professional development as laid down by the Royal College of Physicians and is committed to providing time and financial support for these activities.

St Catherine's Hospice has the required arrangements in place, as laid down by the Royal College of Physicians, to ensure that all doctors have an annual appraisal with a trained appraiser and supports doctors going through the revalidation process. The Hospice is a designated body for GMC Revalidation. Through an arrangement with Surrey and Sussex Healthcare NHS Trust (SaSH) Mr Adam Stacey-Clear, the Appraisal Lead and Responsible Officer for SaSH, also acts as the RO for St Catherine's Hospice, supported by Dr Patricia Brayden as the Medical Appraisal Lead.

MENTORSHIP AND SUPPORT ARRANGEMENTS

The team has close links with the hospital palliative care team and with neighbouring units. The post-holder will be encouraged to build external professional networks for support and informal mentorship. Should formal mentorship be required this can be arranged either internally or externally (e.g. via the APM mentorship scheme.) In addition, there is access to a confidential staff counselling service and arrangements can be made for clinical supervision if requested. We hold regular Schwartz rounds.

EXTERNAL LINKS AND RELATIONSHIPS

Our local NHS trusts are Surrey and Sussex Healthcare NHS Trust (SaSH) and Brighton and Sussex University Hospital. The main site for Surrey and Sussex Healthcare NHS Trust is East Surrey Hospital, Redhill, but some services are also provided at Crawley Hospital. Brighton and Sussex University Hospital has two main sites; the Royal Sussex County Hospital in Brighton and the Princess Royal Hospital at Haywards Heath. We have close links with the local palliative care teams, particularly at SaSH.

Our local cancer centres are St Luke’s Cancer Centre, Guildford (which also provides radiotherapy at SaSH), the Sussex Cancer Centre (Brighton) and the Royal Marsden Hospital, Sutton.

SUPPORT SERVICES

Surrey and Sussex Healthcare NHS trust provides radiology and pathology services. Kamsons, a local community pharmacy, supplies our drugs and provides a clinical pharmacy service.

There is a sophisticated information technology network with an intranet and internet site and remote working arrangements. An in-house IT team provides a responsive help-desk and support services. Crosscare is the electronic patient record used and the post-holder will be expected to contribute to the ongoing development and use of Crosscare.

The post holder will have office space allocated, with IT and secretarial support for clinical and non-clinical aspects of the role.

CONDITONS OF SERVICE AND CONTRACTUAL ARRANGEMENTS

The post is a full-time appointment, with 10 Programmed Activities over 5 days. Applicants wishing to work less than full time will be considered.

St Catherine’s Hospice will hold the contract of employment. Terms and conditions will be in line with those of the NHS 2003 consultant contract and pay will be in line with the NHS consultant pay scale. The post will be eligible for the NHS Superannuation Scheme . An honorary NHS consultant contract will be arranged with Surrey and Sussex Healthcare NHS Trust.

Fees earned from routine work done during hospice time (e.g. completion of DS1500 forms and cremation forms) are paid directly to the hospice. Lecture fees may be retained at the individual’s discretion if preparation work has been done in his/her own time. Domiciliary assessments are part of the service offered by the hospice and are not charged as a separate fee to GPs.

SAMPLE JOB PLAN

Monday / Tuesday / Wednesday / Thursday / Friday
Community (Oxted) / Ward round IPU / SPA / clinical admin
(WR IPU if colleague away) / Community visits (Oxted) / Ward round IPU
13.00 Journal club / 12.45-13.15Lunch / 12.45-13.15 Lunch / 12.45-13.15Lunch / 12.45-13.15Lunch
Community
SPA (includes
Consultant meetings) / Ward MDT
Education/ clin supervision) / SPA / clinical admin
(Ward MDT if colleague away) / Community MDT) / Community /
Ward review

Ratio of direct clinical care PAs: supporting professional activities PAs = 7:3

This job plan is indicative only and will be reviewed regularly.

On call

On call commitment is 1 in 6, 2nd on call. The rota is shared between the St Catherine’s Consultants and the Palliative Medicine Consultant at Surrey and Sussex Healthcare NHS Trust. 1st on (also 1 in 5) is shared between the trainees. On call support is provided for the hospice in-patient unit, Hospital Palliative Care Team patients and community patients. Most on call work consists of giving telephone advice, but the post-holder must be prepared to attend the hospice within a reasonable time frame to support less experienced doctors when needed. This may involve a planned weekend ward round. For planned weekend working (e.g a ward round with a less experienced trainee) or emergency call outs, payment and / or time off in lieu will be given and the post-holder will also be supported to take compensatory rest in order to meet the requirements of the European Working Time Directive. Should the out of hours workload increase in future as a result of 7 day consultant working in the NHS, the number of PAs in the job plan for weekend / evening working and the intensity supplement will be adjusted accordingly.

Person Specification

Locum Consultant in Palliative Medicine

App = assessed via application form / CV; Int = assessed at interview; Ref = assessed via references

Essential / Desirable
Qualifications
Entered on specialist register with palliative medicine as named specialty or within 6 months of CCT date
MRCP, MRCGP, FRCA, or equivalent qualification App / Postgraduate qualification in relevant field e.g. diploma, MA, MSc App
Clinical
Experience of managing complex patients in the palliative care in-patient setting App, Int
Experience of working in the community - App, Int, Ref
Experience of assessing patients by telephone and of giving telephone advice to other healthcare professionals
Excellent verbal and written communication skills App, Int. / Experience of close liaison with primary care through GSF or equivalent