Medical Examiners

344-7762CONCFZ

Dear candidate,

Welcome to East Kent Hospitals University NHS Foundation Trust. We are a pioneering Trust, on an exciting journey of healthcare transformation, with award-winning research and innovation, and a strong team ethos. We’re looking for positive clinical leaders who want to help us deliver first-class patient care to a fascinating and complex population and be part of something special.

As you would expect from a large teaching Trust, we prize training doctors, nurses and other health professionals and we already work closely with local universities and King’s College, University of London. We now have the exciting new opportunity of working with Kent and Medway’s new Medical School, jointly provided by the University of Kent and Canterbury Christchurch University, which opens in September 2020. The Trust has five hospitals providing a wide range of high quality services and opportunities for innovation. The William Harvey Hospital in Ashford has the full range of district general hospital services, as well as regional specialities, including the country’s best performing trauma unit. The Queen Elizabeth, The Queen Mother Hospital in Margate, also provides district general hospital services, while Kent & Canterbury Hospital in Canterbury is a specialist services hub which provides adult medical care, inpatient renal, urology and vascular services and robotic surgery. Our new hospital in Dover, the Buckland, and Royal Victoria Hospital, Folkestone, provide a variety of outpatient, diagnostic and minor injury services, alongside a range of services throughout the local area. We have a clear clinically-led strategy to transform secondary care in east Kent to deliver outstanding standards across all specialties which build services around the characteristics of our patients and a commitment to refreshing our estate and facilities. We support clinicians who see opportunities to make tertiary care available locally for our population, and we have a strong research ethic as a high recruiter to research studies. Our vision is to provide ‘great healthcare from great people’, and we are proud of what we have achieved to date for our population and are excited about what’s to come. If you would like to be pa rt of this exciting journey, your rewarding work-life will be complemented by the advantages of living in the Garden of England, with a choice of rural, seaside and picturesque places to enjoy and live in, alongside the essentials like excellent schools and easy access to London – and Europe. One of the largest acute trusts in England, we have a predicted turnover of almost £600 million. We serve a population of 695,000 people in East Kent and over a million through our regional services, employ 7,950 staff and have 1,000 beds across three main hospital sites.

If you think this could be the start of something special, please apply as quickly as possible using the electronic application form on the ‘Work Here’ section of the Trust website, because we will close the advert for this job once we’ve received sufficient applications. If you have a disability or long-term health problem, we are committed to offering reasonable adjustments throughout the recruitment process and employment. If you would like more information

https://www.ekhuft.nhs.uk/patients-and-visitors/work-here/latest-jobs/

or support, please contact the Resourcing Team on 01227 866450 or resourcing@nhs.net, who will be happy to help.

Yours faithfully, Susan Acott, Chief Executive

mailto:resourcing@nhs.net

Our Mission, Vision and Values Our mission is "Improving health and wellbeing"

Our vision is "Great healthcare from great people"

Our values are

People feel cared for as individuals People feel safe, reassured and involved People feel teamwork, trust and respect sit at the heart of everything we do People feel confident we are making a difference

Our strategic objectives

Our strategic objectives aim to lead us to: a Good and then Outstanding CQC rating; to drive performance, particularly in the key access standards; to make the Trust a great place to

work; deliver integration and a more sustainable future for our services across east Kent; develop our staff and teams and improve our finances.

You can find out more about what we do on our website at www.ekhuft.nhs.uk and view our

organisational structure charts here.

Job Description

THE CORPORATE CARE GROUP Executive Director responsibility in the medical director’s office sits with the Trust Chief Medical Officer who is supported in this role by site medical directors.

Duties of the post

Scrutinising and Confirming Causes of Deaths

In 2007, in response to the recommendations of the Shipman Inquiry, the Department of

Health (DH) called for reform of the current death certification process in England and Wales.

Based upon the Inquiry’s findings, the DH proposed that a new role of Medical Examiner be

established within healthcare environments. The introduction of the medical examiner system

will promote robust, transparent and independent scrutiny of death certification processes.

Dimensions of role

Medical examiners (MEs) are appropriately trained doctors who will verify clinical information

on Medical Certificates of Cause of Death (MCCDs) and ensure that the right referrals are

made to the coroner for further investigation. A practising medical practitioner who has been

on the general medical council register for a minimum of five years post registration can apply

to be a medical examiner. It is recommended that medical examiners are consultant grade

doctors from a range of disciplines (including GP principals). MEs will take a consistent

approach to the formulation of MCCD content, which must be clinically accurate and reflect

any discussions with the next of kin/informant. MEs must not have been involved in the care

of the deceased patients for deaths they scrutinise.

Main duties

To ensure compliance with the legal and procedural requirements associated with the

current and proposed reformed processes of certification, investigation by coroners

and registration of deaths.

http://www.ekhuft.nhs.uk/http://www.ekhuft.nhs.uk/patients-and-visitors/about-us/documents-and-publications/structure-charts/

To scrutinise the certified causes of death offered by attending doctors in a way that is

proportionate, consistent and compliant with the proposed national protocol.

To discuss and explain the cause of death with next of kin/informants in a transparent,

tactful and sympathetic manner. It is anticipated that such discussions will be

predominately conducted through telephone conversations where barriers to

understanding information may exist.

To ensure that all users of the ME system are treated with respect and are not

discriminated against on the grounds of sex, race, religion, ethnicity, sexual orientation,

gender reassignment or disability.

To maintain comprehensive records of all deaths scrutinised and undertake analysis to

provide information to the National Medical Examiner’s office.

To identify deaths that could potentially be reported as untoward serious incidents via

the trust governance systems and ensure referral for structured judgement reviews of

mortality where indicated.

To participate in relevant clinical governance activities relating to death certification

including audits, mortality review processes and investigations regarding formal

complaints about patient care.

To support the training of junior doctors in their understanding of death certification and

promote good practice in accurate completion of MCCDs.

To complete the Confirmatory medical certificate (Cremation Form 5) where indicated.

To work with medical examiner officers (MEOs), delegating duties as appropriate.

To engage with the site medical director, fellow MEs and the MEOs.

To adopt a collaborative working relationship with other MEs by sharing experiences

and expertise to support peer learning and set uniform standards of service delivery.

Behavioural attributes

MEs should be aware of how their personal communication style impacts on others and be

able to adapt their approach to suit a variety of situations and audiences. This will require:

Highly evolved self-awareness and empathetic skills to liaise effectively and

sympathetically with bereaved families

The ability to demonstrate and combine appropriate levels of compassion with

professionalism and discretion

Being open to constructive criticism, ideas and solutions

Acting as a positive role model and interacting appropriately with all stakeholders

including MEOs, other MEs, the bereaved and the coroner

Having the integrity to gain trust and comply with the independent nature of the ME

role in the context of other clinical specialty duties.

Performance criteria

Communications and key working relationships

To be a source of expert knowledge and advice for health professionals and wider

stakeholder groups; these include:

Internal within own organisation:

Chief Medical Officer and Hospital Medical Directors

All grades of clinicians

Clinical governance leads

MEOs and bereavement service staff

Mortuary staff.

External:

Coroners and their officers

Registrar of births and deaths

Local Authorities, including care homes and safeguarding teams

Spiritual and faith community leaders

Other health care providers including GPs

External MEs and MEOs

Regional and National Medical Examiner.

Knowledge

MEs must have up-to-date knowledge of medical conditions and treatments and be able to

exercise judgement about when to seek specialist advice.

MEs must have detailed knowledge of the relevant legislation and processes which apply to:

The determination of whether a death is natural or unnatural

Deaths that must be reported to the coroner

Deaths abroad where bodies are returned to England and Wales for disposal

Deaths where relatives wish to transport the body abroad for disposal

Certifying and registering deaths and the regulations to authorise cremation or burials

of stillbirths abroad.

Accountability

MEs will have professional independence in scrutinising deaths but will be accountable to the

employing organisation’s Board for achieving agreed standards or levels of performance.

MEs will have an independent professional line of accountability to a regional structure of

NHS Improvement/NHS England outside the employing organisation and immediate line

management structure.

MEs will comply with guidance issued by the National Medical Examiner when carrying out

ME duties.

Safety and Quality – Clinical Governance

MEs will be required to participate in any relevant governance activities relating to scrutiny

and confirmation of the cause of death where concerns have been raised by the next of

kin/informant of the deceased and/or clinical staff and ME scrutiny.

MEs will facilitate routine analysis of MCCD information to identify trends, patterns and

unusual features of deaths and report, as required, firstly to the regional Lead ME and

ultimately to the National Medical Examiner’s office.

MEs will provide information to local Child Death Overview panels in respect of all child

deaths which are not being investigated by the coroner.

Maintaining Trust

Equality and Diversity

MEs will act in accordance with Equalities and Human Rights legislation and the

organisation’s Equality and Diversity policies.

Independence

MEs must avoid any potential conflicts of interest. In cases where they have a personal or

professional relationship with the deceased person, next of kin/informant, or with the

attending doctor preparing the MCCD, they must transfer any scrutiny of the death to another

ME.

Continuing professional development

MEs are expected to take responsibility for their own continuing professional development in

accordance with any standards for maintaining a GMC licence to practice and membership of

any relevant professional body. The ME role should be included in the whole practice

appraisal.

MEs should maintain a Personal Development Plan in agreement with their appraiser.

There will be opportunities to attend local and national activities to maintain up to date

knowledge.

Working Conditions:

MEs may need to use a computer for prolonged periods of time. The ME system operates

within a reactive area of service delivery interacting with people in variable degrees of distress

and demonstrating potentially irrational/unpredictable behaviour.

Remuneration

The posts are remunerated as per job planned PAs, required sessions will need to be distributed across the week. Further details are available through discussion with our Lead Medical Examiner.

Person Specification

Criteria Group Essential Desirable Measurement/

Testing method

Experience

Minimum of 5 years experience as a registered medical practitioner

Application Form

Skills

The candidate must have been registered as a medical practitioner with a licence to practise throughout the previous five years as at the date of appointment.

Minimum of English Level 2 (GCSE grade C or equivalent), ILETS, or graduate of a UK Medical School

Candidates will have successfully completed the approved components of the national on-line training curriculum as a precondition of employment as a Medical Examiner. [Note: access to on-line training will be available to all medical practitioners registered & licensed to practice in the UK by the GMC] IT skills including use of email and commonly used software. Strong interpersonal skills demonstrating the ability to communicate in difficult and emotional situations with empathy and professionalism. Ability to work effectively and efficiently within own team and also closely with people in other disciplines Ability to work as part of a team and

Ability to act proportionately and report sub-standard clinical and organisational performance to relevant colleagues to protect patients. Ability to identify good practice and ensure the spread of knowledge amongst relevant colleagues Ability to put in place appropriate reporting, information sharing and feedback mechanisms

Application Form and interview

organise a fluctuating workload around competing priorities and numerous interruptions.

Knowledge and Performance

Broad Medical Knowledge to enable scrutiny of deaths and ability to recognise learning opportunities. Knowledge of legal framework and relevant jurisdiction relating to the process of death certification. Candidates must attend a face-to-face training session within the first three months in post. Knowledge of the special requirements of various faith groups and respect for equality and diversity. Knowledge of local and national clinical governance systems and an understanding of how the ME can work collaboratively to improve patient safety by identifying sub-optimal clinical and organisational performance.

Ability to manage and comply with sensitive information-based processes under tight timescales with a proportionate approach. Ability to undertake routine analysis of information on cause of death for local clinical governance and public health surveillance.

Ability to identify available data sources to support the detection and analysis of concerns and to recognise gaps in available knowledge.

Values and Commitments – People feel cared for as individuals Welcoming and polite; attentive and helpful; respect others’ time; speak up on behalf of those who can’t.

Interview

Values and Commitments – People feel safe, reassured and involved

Consistently safe; vigilant about safety; reassuringly professional; listen and clearly communicate

Interview

Values and Commitments – People feel teamwork, mutual trust and respect sit at the heart of everything we do

Respect people and their dignity; work as a team; take responsibility; be a leader

Interview

Values and Commitments – People feel confident we are making a difference

Delivers the best outcomes; appreciate good work; always improving our selves/services

Interview

Other Commitment to travel across sites if required. Have the resilience to manage own

Application Form and evidence bought to interview

reaction to frequently distressing situations and support others within the team. To sustain professional integrity and independence at all times, particularly where there is the potential for a conflict of interest.

Confidentiality The Post holder must maintain the confidentiality of information about patients, staff and other health service business in accordance with Trust Policy.

Data Protection

The postholder, for the purposes of the Data Protection Act 1998, consents to the processing of all or any personal data including sensitive personal data as defined under the Data Protection Act 1998 (in manual, electronic or any other form) relevant to their employment, by the Trust and/or any public body or any other third party as nominated by the Trust for the purposes of audit and bound by a duty of confidentiality.

Risk Management

The post holder will ensure compliance with the Trust’s risk management policies and procedures. These describe the Trust’s commitment to risk management, the recognition that our aim is to protect patients, staff and visitors from harm, and stress that all staff have a responsibility to minimise risk.

Infection Control

In accordance with the Health Act (2006) all staff are expected to comply with National and local Infection Control policies and procedures and any other related infection prevention policies or procedures. In addition all staff who‘s normal duties are directly or indirectly concerned with patient care should ensure they have received annual mandatory training (including hand hygiene).

Health and Wellbeing

The Trust is committed to improving the health and wellbeing of staff by supporting them to make healthy choices and lead healthy lives. Everyone employed by the Trust has a responsibility for promoting and participating in the staff health and well-being planned programmes, promotions and activities.

Equal Opportunities

The post holder will treat all colleagues, service users and members of the public with respect and dignity regardless of their gender, age, race, colour, religious beliefs, religion, nationality, ethnic origin, social background, sexual orientation, marital status, disability, real or suspected HIV/Aids status, criminal background and Trade Union status. The Trust has Policy for Equality and it is the responsibility of all staff to ensure that this is implemented.

Safeguarding Everyone employed by the Trust regardless of the work they do has a

Children statutory duty to safeguard and promote the welfare of children. When children and/or their carers use our services it is essential that all concerns for the safety and welfare of children and young people are both recognised and acted on appropriately. You have a responsibility to ensure you are familiar with and follow the Safeguarding Children procedures and the Trust’s supplementary Safeguarding Children Policy which is accessed electronically on the Trust's Intranet site. You have a responsibility to support appropriate investigations either internally or externally. To ensure you are equipped to carry out your duties effectively, you must also attend Safeguarding Children training and updates at the competency level appropriate to the work you do and in accordance with the Trust's Safeguarding Children Strategy.

Safeguarding Adults

Everyone employed by the Trust regardless of the work they do has a duty to safeguard and promote the welfare of vulnerable adults. When patients and/or their carers use our services it is essential that all protection concerns are both recognised and acted on appropriately. You have a responsibility to ensure you are familiar with and follow Trust policies in relation to safeguarding vulnerable adults. You have a responsibility to support appropriate investigations either internally or externally. To ensure you are equipped to carry out your duties effectively, you must also attend vulnerable adult protection training and updates at the competency level appropriate to the work you do and in accordance with the Trust's vulnerable adult protection training guidance

Health and Safety

All staff must be aware of the responsibilities placed on them by the Health & Safety at Work Act (1974) to ensure that the agreed safety procedures are carried out to maintain a safe condition for employees, patients and visitors.

Professional and NHS Codes of Conduct

You are required to act at all times in accordance with the relevant professional Codes of Conduct and Accountability (including, where applicable, those for Board Members). In addition, all management staff must comply with the ‘Code of Conduct for NHS Managers’ and ‘Standards of Business Conduct for NHS staff’.

Financial Management

and Control of Resources

All staff are responsible for the security and the property of the Trust, avoiding loss or damage, and being economical and efficient in the use of resources. Staff are required to act in accordance with the rules and regulations as described in the Trust’s ‘Policy Relating to the Financial Management and Control of Resources’.

Mandatory Training

All staff are required to attend mandatory training as designated by the Trust.

No Smoking

East Kent Hospitals University NHS Foundation Trust has a no smoking policy. Staff are not permitted to smoke within or on Trust premises

Please note that these terms and conditions are subject to change and may differ from your proposed contract should you be successful in your application.