Job Title: Locum Consultant in Palliative Medicine

Job Title: Locum Consultant in Palliative Medicine

Location: Community and LOROS

(This may change as a result of service reconfiguration)

Accountable to: Head of Service Palliative Medicine

Responsible to: Chief Executive LOROS

MAIN DUTIES AND RESPONSIBILITIES

The post is for a Consultant in Palliative Medicine to provide, with colleagues, an increasingly “wide” palliative medicine service for patients with cancer and non-malignant diseases, predominantly supporting patients at home.This post will be hosted by LOROS Hospice, with peer support from the Palliative Medicine Consultants across Leicester, Leicestershire and Rutland.

Candidates must be on the Specialist Register.

BACKGROUND

This is an exciting opportunity to shape the development of an Integrated Community Palliative Care Team and act as the Lead Palliative Medicine Consultant for this service. This service has come about as part of Leicester, Leicestershire and Rutland’s Strategic Transformation Plan. The Integrated Palliative Care Team will be an alliance arrangement with all key local providers who support patients with palliative and end of life care needs. This is a new post. The Consultant will support the establishment of this service, which aims to enhance the offer available to patients, families and those important to them. It consists of an enhanced service whereby they can rapidly access multi-disciplinary support to manage rapidly changing needs and enable them to remain at home or be rapidly discharged from hospital.

PRINCIPAL ELEMENTS OF THE POST WILL BE TO:-

• Provide medical input for the Integrated CommunityPalliative Care Team, including case conferences, domiciliary visits, case management and triaging.
• Engage in service development and evaluation of the Integrated Community Palliative Care Team
• Participate in multi-professional teaching
• Supervision of staff –including junior medical staff, nursing/allied health care staff e.g. with prescribing practice
• Support existing consultants and palliative care teams to strengthen links with community and hospital teams in order to provide a proactive and seamless service to patients
• Hold a regular outpatient clinic in the community, to help support the LOROS strategy to increase its support for patients at home.

APPOINTMENT

The appointment will be for 7 sessions. 5 sessions will be provided to the new Integrated Community Palliative Care Team and 2 sessions to provide Consultant support to community work provided by LOROS hospice.

WORK PROGRAMME (PA)

It is anticipated that clinical administration will be conducted within the appropriate allotted PA allowance. The post-holder will work closely with the other Consultants in Palliative Medicine at LOROS hospice and the University Hospitals of Leicester.

Supporting Professional Activity(SPA)

This post will have 2PA’s for Supporting Professional Activities (SPA).

1.5 PA’s are allocated for SPA in order to support the requirements of revalidation which include activities such as participating in audit, teaching, CPD and mandatory training.

An additional 0.5 SPA is assigned for the Service Development component of this role

Job Plan

The job plan will be reviewed after 3 months. This is a new post at a time of service reconfiguration and therefore the candidate should expect a degree of flexibility within the proposed job plan.

It is expected that the successful candidate will work with the Senior Management Committee at LOROS and with the Palliative Medicine Head of Service based at University Hospitals of Leicester to ensure that services are delivered efficiently and reflect best practice with processes and governance to match - this may require new and flexible ways of working in the future.

Programmed Activities

There is a 1:8 on-call for LOROS the Leicestershire & Rutland Hospice. This currently does not attract any PA allowance.

Working Relationships

The post-holder will work closely with Consultants based at the University hospitals of Leicester and LOROS the Leicestershire & Rutland Hospice. It is expected that peer support will be offered by these Consultants and that the post holder would actively participate in Consultant meetings and education activities. There will be office facilities available at LOROS hospice and hot desk arrangements available at the University hospitals of Leicester if required.

OTHER DUTIES

The successful candidate will be required to undertake managerial duties associated with the care of their patients and the running of the clinical department. They will have an understanding of the wider health agenda and modern NHS.

The successful candidate will be required to work in a multidisciplinary team with nursing staff and other allied health care professionals. The successful candidate will supervise juniors, specifically including the Community Palliative Medicine Registrar attached to LOROS.

Adequate office space and secretarial support will be made available

PALLIATIVE CARE SERVICES IN LEICESTER, LEICESTERSHIRE AND RUTLAND (LLR)

Medical staffing:

Consultants -5.6 WTE

• Dr Rosie Bronnert – University Hospitals of Leicester/ Glenfield Hospital
• Palliative Medicine Head of Service and End Of Life Care Lead UHL
• Interests in Heart Failure and Respiratory Palliative Care, Lead for Enhanced Supportive (early Palliative Care) Service in UHL
• Dr Luke Feathers – LOROS, including Community
• Clinical Lead for LOROS and community palliative care
• Interests - Motor Neurone Disease &neurological conditions, communication skills
• Dr Barbara Powell – LOROS/Community/Undergraduate Education Lead
• LOROS, community palliative care and MND.
• Lead for undergraduate teaching and Help with Breathlessness service.
• Dr CarolineCooke–LOROS and Leicester General Hospital.
• Palliative Medicine Lead for Leicester General Hospital.
• Medical lead for Lymphoedema, Dementia, Renal Failure.
• Dr ChristinaFaull–LOROS
• Education and Research Lead.
• Interests- MND, SpR Research Lead.
• Dr Laura Clipsham –LRI & LOROS
• Teenage Young Adult Lead. Interests in interface work with ED/MAU & Palliative Care
• Dr Laura Pal - Glenfield Hospital, LOROS
• COPD Lead.
• Dr Julia Grant - LRI
• Leading on Respect process and resuscitation work

Specialty Registrars - (ST3-6) 5 WTE (based at LOROS and UHL)

CMT/GPST1/2 - 3 WTE (based at LOROS)

Palliative care services in Leicestershire and Rutland are organised as follows:-

Community Services

This is an exciting time for Community Palliative Care services in Leicester, Leicestershire and Rutland, because this post is part of the growth and development of community palliative care services as part of Strategic Transformation Plan (STP). The shape and structure of services is likely to further change as a result of the STP. At present, existing palliative care services will be delivered as a combined alliance arrangement and an outline of the existing services is described.

The delivery of Specialist Palliative Care to patients in the community is provided by teams from LOROS the Leicestershire & Rutland Hospiceand Leicestershire Partnership Trust and Marie Curie.

Community palliative care specialist nurses currently work within two separate teams, at LOROS and LPT, depending on location of GP. All nurses are offered the opportunity to attendsessions at LOROS for clinical supervision of their caseload.

The Hospice at Home Team, which is part of Leicester Partnership Trust, provides assessment and support to patients in the last days of life, including those discharged from hospital because of a preference to die at home. They also support patients and families at different stages in their illness where there is significant complexity and specialist support is needed to help them remain at home.

Medical support is currently provided by Consultants and registrars based at LOROS hospice, offering clinics and domiciliary visits. There are close links between the hospice and hospice at home.

LOROS the Leicestershire & Rutland Hospice

Chief Executive:Mr John Knight

Director of Care Services:Mrs Jo Kavanagh

Funding:70% charitable

30% CCG funded

Inpatient Facilities:There are 31 inpatient beds - admissions are of patients with advanced cancer, motor neurone disease and a range of other terminal conditions. There are approximately 800 admissions per year with an average length of stay of 11 days. The multi-professional team includes doctors, nurses, occupational therapist, physiotherapist, social worker, chaplain and counsellors. A pain anaesthetist visitsregularly.

Outpatient Facilities: Daily clinics run by consultants/specialist registrar.

Doctor home visits:Visits to those too unwell to attend clinic.

Day Therapy:This runs from the hospice 4.5 days per week.

Lymphoedema:This is run by specialist nurses with the support of a consultant.

Counselling Service:The counselling service comprises two full time and three part-time counsellors.

Volunteers:There are a large number of volunteers who, amongst other duties, bring patients to outpatients and also provide a sitting service for patients at home.

UHL Team

A team of 10 FTE nurses, work in the three sites. The team offer symptom control, psychological support and help with advance care planning and advice about palliative care issues pertinent discharge planning. The team participates in multidisciplinary team working, including site specific cancer MDT and heart failure and COPD MDTs.The team are active in teaching all disciplines and play a significant role in nursing induction and essential for role training. Team members rotate into roles of end of life care facilitators, meaning that they can offer an up to date clinical perspective to this role. This work includes supporting care, training and education around care in the last days of life and supporting audit and service development throughout the hospital.

Research

The LOROS research team are actively involved in identifying and recruiting into Palliative Care Research. A research nurses for Palliative Care has also been recently appointed at the University Hospitals of Leicester and they will work with the CHUGGS Research Lead (Sarah Nicholson) to encourage and support the development of a clinical trials portfolio within the hospital.

EDUCATION: Teaching & Training

All consultants are expected to contribute to teaching and training of undergraduate students and postgraduate trainees as part of their role as a consultant.

At present, it is not anticipated that this post will provide the opportunity to take on additional undergraduate and/or postgraduate education and training responsibilities. However, if specific, identifiable, evidenced, recognised and appraised activity does take place by mutual agreement with the employing organisation and head of service, such additional teaching and training activity will be recognised within their SPA allowance. Enhanced undergraduate duties could include acting as examiners in medical school assessments, providing occasional seminar and small group teaching, lecturing & other Phase 1 teaching within the medical curricula, in addition to individual supervision of clinical students attached to them.

Postgraduate duties could include offering support for junior doctors – as a locum post it will not be possible to act as a clinical or educational supervisor.

CONDITIONS OF SERVICE

The appointment will be made on Trust Terms and Conditions which presently reflect the Terms and Conditions of Service for Consultants (England) 2003, as amended from time to time.

Residence

The successful candidate will be required to maintain his/her private residence in contact with the public telephone service and to reside 10 miles by road from base hospital unless specific approval for greater distance is given by the Trust.

Medical Excellence

The Trust 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 (Chief Medical Officer, December 1996). All medical staff, practising in the Trust, should ensure that they are familiar with the procedure.

Annual Leave

The postholder will be entitled to 32 days annual leave per year pro rata. After 7 years’ service, 2 additional days pro rata are awarded.

The Trust would normally require 6 weeks’ notice for leave booked.

Study Leave

A maximum of 30 days study leave pro rata with pay and expenses can be taken over a 3 year period, or 10 days each year.

Relocation

Where applicable, removal expenses will be paid to the successful candidate in accordance with the trust policy. It is advised that you seek advice before making any commitments.

Notice Period

The employment is subject to 3 months’ notice on either side, subject to the provisions of schedule 19 of the Terms and Conditions of Service for Consultants (England) 2003.

Disclosure & Barring Service

The successful candidate will be required to have satisfactory enhanced DBS check.

Salary

The starting salary of the appointment (exclusive of any distinction and meritorious service award payable to you) will be the appropriate threshold on the Consultant pay scale (MC72) ranging from £76,761- £103,490 (or the appropriate transition scale threshold on MC51).

The starting salary is normally set at the minimum of the scale unless dual accreditation or previous consultant service rules apply

Infection Control

The prevention of hospital acquired infection is a vital concern for the Trust. Infections harm patients. Infections also harm the Trust. The postholder is required to ensure, as an employee, that his/her work methods do not endanger other people or themselves.

All staff must be aware of infection prevention and control policies and guidelines, and follow them at all times. Any breach of infection control policies is a serious matter and may result in disciplinary action.

Consultant medical staff are the clinical leaders of their team and as such have a responsibility to provide and maintain a culture of vigilance across the team through their role in supervising and educating other staff.

All consultant medical staff are expected to lead by example and comply fully with the Trust’s infection prevention and control policies and to challenge non-compliance when observed. Consultant medical staff and Heads of Service have a particular role in persuading colleagues to change behaviour when this is not in line with infection control policies and procedures.

Safeguarding

The postholder is responsible for safeguarding the interests of children and adults who they come into contact with during their work. To fulfil these duties postholders are required to attend training and development to recognise the signs and symptoms of abuse or individuals at risk, to follow local and national policy relating a safeguarding practice and to report and act on concerns that they may have.

VISITING

Candidates are invited to visit and discuss the post further and may make arrangements to do so through:

Dr Rosie Bronnert

Head of Service for Palliative Medicine

Tel: 0116 2502817

or

Dr Luke Feathers

Consultant in Palliative Medicine, Medical Lead LOROS Hospice

Tel: 0116 2318437

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