Generic Job Description Foundation Year 2 Posts

INTRODUCTION The Whittington Hospital Trust is one of London pilot sites for the development of Foundation Year 2 posts, which are part of Modernising Medical Careers (MMC). These are equivalent to the first year of being a Senior House Officer (SHO). MMC will introduce a significant change in the way in which postgraduate education is offered in the UK. From August 2005, all UK graduates will undertake a 2 year Foundation Programme designed to ensure that at the end of the programme doctors have robust and assessed clinical skills in acute medicine, understand and can practice medicine using the professional practices required by the General Medical Council and have the opportunity to have experience, where appropriate, in several different specialties. The Whittington is participating in a pilot of the second year of such a programme.

The London Deanery educationally approves all the posts. All Emergency Dept posts and all the Medical Posts have educational approval from the Royal College of Physicians. All Emergency Dept posts and all the Surgical Posts have educational approval from the Royal College of Surgeons.

Posts availableThe posts available in this one-year programme are listed below:

Emergency dept (6 months) followed by Medicine (6 months) – 4 posts Emergency dept (6 months) followed by Surgery (6 months) – 4 posts Medicine (6 months) followed by Emergency dept (6 months) – 4 posts Surgery (6 months) followed by Emergency dept (6 months) – 4 posts

All Emergency dept FY2 posts will include a “taster” week in another speciality.

Candidates will be appointed to specific posts at the time of appointment, but should note that these may possibly be subject to some variation or change.

EDUCATION AND TRAINING PROGRAMME

Educational supervisor: each trainee will have a designated educational supervisor to support his or her education and training.

Induction: Trainees will receive an induction programme into the Foundation 2 year to introduce them to the Programme, the Hospital and their individual placement. Whenever a trainee moves to a different training placement during the year, there will be an induction into the new department. All trainees must participate in the induction.

Appraisal: regular appraisal will be held with the educational supervisor in “protected” time. These should take place at least every 3 months, but may be more frequent if required.

Training agreement: learning objectives will be agreed within 2 weeks of taking up post between the educational supervisor and the trainee. These will be documented in the Deanery learning portfolio (see below) and will be used to inform appraisals and progress.

Generic training programme: trainees will have a core-training programme in professional skills and attitudes. Attendance at this is mandatory and will part of the study leave allocation of the trainee.

Clinical training: clinical training will be largely experiential, focussed and supervised in order to ensure that the clinical competencies required are obtained.

Portfolio: each trainee will have a Deanery learning portfolio to support his or her education and training. It will be used for both formative development and to record summative assessments and should be used in appraisals. The portfolio is based on a curriculum, which has been designed to help the trainee develop the clinical and professional areas of competencies required to complete the Foundation Year 2.

Assessment: formative assessment will be undertaken using assessment tools which are being developed and validated by the London Deanery. These will be work place based and will be supported by the learning portfolio.

Clinical audit: all trainees will be expected to complete at least one audit project during their year of training.

Study leave: A proportion of the 30-day entitlement to study leave (subject to the requirements of the service) will be used to participate in the generic professional teaching programme. Study leave will need to be arranged through the Trust’s Director of Medical Education, according to local arrangements. As for other SHOs, Foundation Year 2 trainees will be entitled to 3 hours/week of bleep-free, relevant teaching or attendance at events such as grand rounds, journal clubs, clinical-pathological conferences, etc. In addition, it is anticipated that trainees will use some of their study leave time to undertake short, focussed “tasters” in other specialties by arrangement with their educational supervisors and the relevant departments. Some posts will offer the opportunity to spend ½ day/week in General Practice in focussed training opportunities.

THE HISTORY OF THE WHITTINGTON HOSPITAL

Medical services were first provided on the site of the Whittington in 1473. Originally a leper hospital during the reign of Edward IV, by the time of Elizabeth I the hospital was caring for the poor chronic sick who had been transferred from St Bartholomew’s and St Thomas’. In 1848, a new hospital was built on the St Mary’s Wing site. This had 108 beds and cared for patients with smallpox. During the great smallpox epidemic between 1855 and 1859, the hospital admitted 1185 patients of whom 20% died. The Smallpox and Vaccination Hospital is currently known as the Jenner Building and is used as office accommodation.

Independently managed hospitals were opened on the Highgate Wing site in 1866 the Archway Wing site in 1877. These hospitals had 543 and 625 beds respectively. In August 1900, Highgate Hill Infirmary with 780 beds opened adjacent to the Smallpox and Vaccination Hospital. The two hospitals soon amalgamated and the Smallpox Hospital was transformed into a nurses’ home.

Edith Cavell worked as a night sister for three years from 1901 at the Infirmary on the current Highgate Wing site. Florence Nightingale had described the Infirmary as ”by far the best of any workhouse infirmary we have” and indeed “the finest metropolitan hospital”.

In 1947/8 the hospitals were brought together under Dr Cecil Coyle, who as Medical Superintendent was responsible for the administration of all three sites. The three hospitals had between them just under 2000 beds. With the coming of the NHS in 1948, the sites began to modernise. The past 50 years have seen the consolidation of all clinical services onto the St Mary’s Wing site with a reduction of beds from nearly 2000 to around 500. In 1977 a new block was opened which currently houses the emergency department, outpatient clinics and the pathology laboratories. In 1992 the Great Northern Building opened with its modern ward accommodation, staff restaurant and education facilities.

As clinical services moved to the main site, so both Archway Wing and Highgate Wing changed function. Highgate Wing has been chosen by Camden and Islington Community Trust as the site for the consolidation and development of the district’s mental health services. Archway Wing is owned by UCL and The Middlesex University as an education and research campus.

Despite its two new buildings and a programme of continual refurbishment, much of the external fabric of our remaining mid 19th century hospital on the St Mary’s site is in poor condition and in urgent need of replacement. This has been recognised with the publication of the ‘Turnberg Report’ on health services in London. The report recommended urgent capital investment in the site and the hospital is now anticipating a period of very considerable redevelopment.

The future of our historic hospital is very bright. Praised by the Turnberg Report for our rôle as a community facing general teaching hospital, plans are currently being laid to develop the Trust as a model of the urban hospital of the 21st century.

THE HOSPITAL TODAY

The Whittington Hospital is a medium sized district teaching hospital. The site contains a mixture of modern, good quality accommodation and older buildings. A new build is well underway which will deliver new assessment; critical care and ambulatory care facilities and is due for completion in 2005. This new building will double the capacity of critical care and day surgery and will significantly improve the environment in which staff work. Planning for further site development is now in progress.

The hospital is well provided with equipment, with considerable ongoing investment to ensure that practitioners have the ‘tools to do the job’. The hospital is proud of its tradition of providing high quality medical education. We seek to provide academic and clinical excellence without losing sight of our rôle as a community based hospital supporting our local GPs.

We are located in Archway, North London and have traditionally served the populations of North Islington and West Haringey. Our catchment population is around 240,000. Our local population is a diverse mix in terms of social class, economic status and ethnicity and the communities we serve embrace Highgate, Finchley, Haringey, Camden and Islington. We have close working relations with tertiary centres at the Royal Free Hospital and the UCLH group of hospitals.

All main branches of medicine and surgery are provided at The Whittington Hospital with the exception of neurosurgery and cardiothoracic surgery. Plastic surgery and ophthalmology are represented by outpatient services.

A combined Diagnostic and Outpatient block is situated on the site. This block accommodates the newly upgraded Emergency Department, together with main supporting services such as

Pathology, Radiology and Pharmacy. The Radiology Department has an MRI scanner and a spiral CT scanner to provide a comprehensive investigatory facility. The first phase of a Picture Archiving and Communication System (PACS) has been rolled-out in Emergency, with electronic links to the Hospital for Nervous Diseases at Queen Square anticipated in the near future.

A seven-bedded General Intensive Care Unit (5 ITU, 2 HDU beds) is located adjacent to the six-bedded Coronary Care Unit. Both units are well equipped and well staffed.

An 89 bedded Mental Health Unit is located adjacent to Whittington Hospital on Dartmouth Park Hill and is managed by the Camden and Islington Mental Health Services Trust. The Sexual Health Clinic, managed by Camden & Islington Community Trust, is located in Archway Campus.

The hospital is divided into four main divisions each managed by a Divisional Manager who reports to the Director of Operations (Tara Donnelly) or her deputy (Kate Slemeck) as follows:

Divisional Manager Acute Medical Services: Fiona ElliottDivisional Manager Medicine and Clinical Services: Adam SmithDivisional Manager Surgery: Shaun StaceyDivisional Manager Children & Women’s Health: Anne Gibbs

Mrs Celia Ingham Clark is the Executive Medical Director for the Trust as a whole. Dr Jane Young is the Trust’s Director of Medical Education.

Apart from medical undergraduate and postgraduate training commitments, the hospital provides recognised training for nurses, midwives, Allied health Professionals, Biomedical Scientists and operating department practitioners.

APPROXIMATE BED NUMBERSSurgery 104Medical 221Orthopaedic 56Gynaecological 19Maternity 47Paediatrics 35 (of which 8 are day care)Neonatal Unit 18 (including 6 intensive care cots)Day beds 22Emergency 8ITU 7

All figures are approximate because beds are used flexibly and because ongoing strategic planning processes may affect individual speciality provision from time to time.

WHITTINGTON HOSPITAL NHS TRUST

EMERGENCY DEPARTMENTSENIOR HOUSE OFFICERS

FOUNDATION YEAR 2 PILOT PROGRAMMEJOB DESCRIPTION

THE DEPARTMENT

A purpose built, expanded Emergency Department opened in June 1995. About 77,000 new patients are seen each year with about 5,000 return visits.

The department comprises a four-bed Resuscitation room with one dedicated paediatric bay. There are fourteen adult cubicles, including those designated specifically for gynaecology, infectious disease and psychiatric patients. There is a specially equipped cubicle for children requiring close monitoring and separate children’s waiting area. There is a dedicated minor injury treatment area comprising consultation rooms and treatment cubicles for adults and children. An Emergency Nurse Practitioner service for minor injuries runs seven days a week. There is an eight-bed Clinical Decision Unit within the department for those patients who require a prolonged period of observation or further investigation. The department has rapid access to OT and Social work referral. A limited number of review clinics are run from within the department dealing with wound dressings and soft tissue problems.

Twenty four-hour reception cover is provided and a computerised record system is maintained. The department is provided with 24-hour biochemistry and haematology services.

A Radiologist is available during working hours on weekdays for help with interpretation of imaging and assistance with selection of further studies. The department has access to intravenous urography, same day ultrasound and to CT and MRI scanning. A computer based x-ray viewing and retrieval system (PACS) is in operation.

A teaching / seminar room with computer and Internet access is located within the department. There is a staff restroom within the department.

On site security provision is made on a 24-hour basis, with dedicated security personnel within the department at nights. The working areas are monitored by closed circuit TV.

ESTABLISHMENT

3 Consultants (full time)1 Locum Consultant1 Staff Grade2 Specialist Registrars (on rotation)3 Senior SHOs 12 SHOsClinical Assistant sessionsPrimary Care Practitioner sessions

1 Services Manager

1 Senior Nurse H grade Lecturer Practitioner2 Modern Matrons10 Emergency Nurse Practitioners12 Nursing Shift Leaders44 Staff Nurses (D and E Grades)

2 Communications Co-ordinators

SENIOR COVER

During daytime from 8 am there is a Middle Grade or Consultant present in the department. Middle Grade cover continues 24/7, except Tuesdays & Wednesdays when it is until 2am.

There are Primary Care Practitioner sessions every evening and at weekends.

Out of hours, the Consultants participate in a 1 in 3 rota and are contactable by pager or telephone at all times.

DUTIES OF THE POST

The assessment, diagnosis and initial management of all patients attending the Emergency Department at the Whittington Hospital except those already accepted for assessment / admission by the On Call teams. To ensure that the disposition of these patients is in accordance with Department and Trust policies.

To participate in the duty rota of the Emergency Department. This is a twelve-week rota for the Senior House Officers and is designed to provide the department with a sufficient number of SHOs on duty at all times.

To help the Consultants and Middle Grades in supervising the activities of the medical students attached to the department and to provide these students with “on the floor” teaching.

TEACHING

All ED SHOs will attend the two-day Whittington Hospital induction programme. Attendance is compulsory.

There is twice weekly teaching – in the department on a Tuesday lunchtime and in the Postgraduate Centre on a Thursday afternoon – for the full six months of the post. This is protected training time and no clinical duties are expected of the SHOs during these periods.

All SHOs will attend the Whittington Hospital Radiology course after induction and prior to commencing clinical work.

There are regular weekly and monthly meetings held in the hospital’s Postgraduate Centre. Programmes are regularly circulated.

Parts 1 and 2 MRCP (adult and paediatric), MRCS and MRCOG courses are available in the hospital.

The posts are recognised for MRCP, MRCS, MRCOG and MRCGP training.

There is a clinical skills laboratory within the hospital and some of the SHO teaching will take place in this facility.

All SHOs have a Consultant allocated as their Educational Supervisor for the duration of the post.

AUDIT

You will be expected to participate in a limited audit project whilst in the post.

RESEARCH

Research interests will be encouraged. The Academic Department of Health Informatics is available on site to facilitate research. There is also a Clinical Audit office.

INFORMAL VISITS

For an informal visit and / or discussion please contact the Emergency Department secretary on 020 7288 5699.

THE WHITTINGTON HOSPITAL NHS TRUST

MEDICAL DIRECTORATESENIOR HOUSE OFFICERS POSTGRADUATE TRAINING SCHEME IN

MEDICINE AND FOUNDATION YEAR 2 PILOT PROGRAMME

There are currently 18 posts (including 3 Foundation Year 2 posts) with educational approval included in the above medical SHO rotation at the Whittington Hospital. These posts rotate through the medical specialities as outlined below. All except the Foundation Year 2 posts and the GP Trainee post, rotate for a further 6 months at University College London Hospitals (UCLH). In order to allow continuity for the SHOs and the firms a rolling rotation operates. Each SHO is coded by a letter and rotates through 2 to 4 different specialities with periods of night duty between the periods on the specialist firms (see the rota plan). There are always 14 SHOs on the wards in the posts outlined below. As one SHO commences night duty, another returning from night duty moves into the post and continues in it for 14 weeks and then does night duty again.

SHO posts are appointed twice yearly: 8 posts start in February (and rotate for 6 months at UCLH) 9 posts start in August (6 posts for 12 months at the Whittington and 6 months at

UCLH and 3 Foundation Year 2 posts for 12 months at the Whittington Hospital).

MEDICAL SPECIALITIESCare of the Elderly Unit (3 SHOs)Consultants Dr Sheena Mitchell RCP Post No: 06/022/008

Educational SupervisorDr Celia Bielawska RCP Post No: 06/022/010Educational SupervisorDr Gurcharan Rai RCP Post No: 06/022/014Educational Supervisor (GPVTS)

While working in Care of the Elderly Unit (84 beds), the SHOs will gain expertise in the treatment of acutely ill patients of all ages, although the majority of those on the Unit will be over the age of 75. There is training in rehabilitation of the elderly both as inpatients and in the day hospital. The SHOs will also be trained in the assessment of new referrals in elderly care outpatient clinics. The SHO attached to Dr Rai will receive additional experience in management (acute & rehabilitation) of patients with strokes.

Each of the post-holders will be responsible for the management, jointly with a pre-registration House Officer, of approximately 28 acute beds, caring for the patients from acute admission to discharge. They will see new patients, under consultant supervision, in an outpatient clinic approximately once a week.

The SHO is expected to participate in the teaching of undergraduates attached to the firm.

Chest (2 SHOs)Consultants Dr Sara Lock RCP Post No: 06/022/004

& Dr Louise Restrick Educational SupervisorsDr Norman Johnson RCP Post No: 06/022/015& Dr Howard BranleyEducational Supervisors

Dr Myra Stern

The Department of Respiratory Medicine is based in the dedicated Chest Clinic. Inpatient care is on Nightingale ward, which specialises in respiratory medicine and also takes acute general admissions. Fibreoptic bronchoscopy is performed in a purpose-built endoscopy suite. Limited sleep studies and overnight oximetry are performed on a regular basis. Special interests of the department include asthma & COPD, lung cancer, tuberculosis, sarcoidosis, interstitial lung disease, obstructive sleep apnoea, CPAP and non-invasive ventilation.

The two SHOs are responsible for the care of the in-patients on Nightingale ward (average 14 each) working with the two House Physicians and for the care of patients on MAU admitted on acute take under their team. However, patient care is seen as a team role with cross-responsibility at times of annual leave, study leave or rostered night duty. The SHOs will take part in the acute medical take (Consultants on 1 in 12, i.e. Respiratory Consultants 1 in 6). As the Whittington operates a ward based system there are usually a couple of admissions per day to the ward.

The posts currently involve attendance at one outpatient clinic on alternate weeks under Consultant supervision, seeing and presenting new chest patients and follow-ups. There is an active teaching programme with a weekly Chest/Radiology multidisciplinary meeting, a weekly Chest/Oncology/Palliative Care/pathology meeting and a weekly respiratory educational meeting. This is in addition to the other organised teaching within the Hospital. There are 6-7 medical students attached to the Firm and the SHOs are expected to contribute to their teaching.

Haematology (1 SHO)Consultants Dr Bernard Davis RCP Post No: 06/022/012

Educational SupervisorDr Norman ParkerDr Farrukh Shah

The training available can be varied to meet the specific needs of each appointee. There are two Specialist Registrars, a Clinical Nurse Specialist in Haematology and one in Oncology. The SHOs work closely with these individuals, as they responsibility for much of the routine work. Outpatient attendance is not mandatory but is encouraged for training purposes only. You will not be required to undertake service work in outpatients except in very exceptional circumstances.

A large part of the inpatient work relates to problems with sickle cell anaemia. Despite the high proportion of patients who have a single diagnosis they produce an extremely wide range of problems with an increased risk of TB, dietary problems, psychological problems and a wide range of other medical problems. There is a weekly meeting with the psychologist who can often be helpful in guiding the doctors as to how to present information to the patients. This can be a very valuable learning experience. The service has an international reputation for dealing with thalassaemia.

Oncology (1 SHO)Consultants Dr Siow Ming Lee RCP Post No: 06/022/003

Educational SupervisorDr Alison JonesDr Jonathan LedermannDr Jeffrey Tobias

The Whittington Hospital is a designated Cancer Unit linked to the Joint Cancer care Centre at UCLH and the Royal Free Hospital. There are four Consultant staff working at the Whittington and Cancer Care Centre. Three Medical Oncologists provide inpatient services. Patients are seen in the joint Oncology outpatient clinics or as ward referrals and radiotherapy treatment is given at UCLH. Outpatient clinics are tumour site specialised.

The SHO duties involve the care of inpatients and assisting the Oncology Nurse Consultant, Specialist Registrar and Chemotherapy Nurse Specialist in treating and reviewing patients in the Day Care Unit. Most new patients are internal referrals from other Consultants and the SHO sees patients on referring wards and is involved jointly with other firms in managing new cases.

The SHO will gain experience in the investigation and management of patients with cancer, including oncological emergencies. He/she will also gain experience in the diagnosis and management of the complications of treatment. A Consultant in Palliative Medicine supports the Unit and Palliative Care Nurses and the SHOs will learn about palliative medicine. Attendance at outpatient clinics for training is voluntary. The SHO is paired with the Haematology SHO and cross-cover is provided to cover annual leave.

Diabetology/Endocrinology/Nephrology (1 SHO)Consultants Dr M Rossi RCP Post No: 6/022/007

Educational SupervisorDr M Barnard Dr Robin Woolfson Professor John Yudkin

The SHO will gain a wide experience in all aspects of diabetes management and general internal medicine, with additional responsibility for renal and endocrinology patients. The SHO takes part in the Acute General Medical Take and is responsible for the ongoing care of 16-20 general medical inpatients, covering all specialities including diabetes. They will work closely with the Consultants, 2 Specialist Registrars (Diabetes/Endocrinology and Nephrology) and House Physician.

A full multidisciplinary team including Specialist and Research Nurses, Podiatrist and Dietician provides the Diabetes and Endocrinology service. There is close liaison with the Academic Department of Medicine. The SHO will gain wide experience in all aspects of Diabetes and Endocrinology management by working with this team. Additional experience is available from specialised clinics (ante-natal care, renal disease, eye disease and adolescent diabetes). There are ample opportunities for academic

development with teaching sessions in outpatients, on the wards and in formal seminars. Supervision of the House Physician and teaching undergraduate students are important components of the job.

The Senior House Officer attends 2 outpatient clinics per week, one diabetic and one endocrine clinic. These are cancelled if the SHO is on the acute medical take rota for the day or if the Team have been on general medical take the day before. They review patients under consultant supervision. A full range of endocrine disorders are managed in the department, including pituitary disorders. The Endocrine Specialist Nurse normally undertakes endocrine studies. There is a weekly firm seminar on Diabetes, Endocrinology & General Medicine.

In addition, the SHO shares responsibility with the Nephrology Specialist Registrar and House Physician for the inpatient care of renal patients. The SHO is expected to join the Consultant and Registrar on ward rounds of renal patients and to visit nephrology referrals on other wards. There are no renal outpatient duties.

Gastroenterology (2 SHOs)Consultants Voi Shim Wong RCP Post No 06/022/002

Educational SupervisorDeepak Suri RCP Post No 06/022/001Educational Supervisor Robin Vicary

Staffing of the department: 3 Consultants, 2 Specialist Registrars, 3 Senior House Officers, and 1 House Physician. The SHOs and House Physician share the 20 GI and general medicine beds on Reckitt Ward and cover outliers on Trevor and Victoria when needed. The SHOs will take part in the acute medial take (Consultants on 1 in 12, i.e. Gastroenterology Consultants 1 in 6).

There is an attached Endoscopy Unit. The SHOs will care for general medical and general gastroenterology in patients, including GI bleeding. The Unit specialises in the care and management of GI bleeding and sees a considerable number of variceal bleeders. Due to the alcohol intake and hepatitis C prevalence rate in the population, there is a considerable amount of chronic liver disease. SHOs attend outpatients twice weekly, where they will see new and follow up outpatients and learn the outpatient management of common gastroenterological disorders under supervision.

There is a weekly teaching programme on Friday lunchtimes and a weekly combined GI (medicine, surgery, radiology, histopathology) meeting on Thursday mornings where clinical cases are discussed. The SHO is expected to participate in the undergraduate medical student teaching of the firm

Cardiology (2 SHOs) Consultants Dr Rosaire Gray RCP Post No: 06/022/005

Educational Supervisor Dr Suzanna Hardman RCP Post No: 06/022/006Educational Supervisor

Dr David PattersonDr Roy DaviesDr David Brull

These SHO posts are based on Montuschi ward (the Coronary Care Unit is located on this ward). The post-holders are responsible for all the patients and will participate in daily consultant ward rounds. As a result of their involvement in the acute general medical take, they will also be responsible for some general medical patients on MAU, McCarthy & Coyle wards. Each SHO is expected to attend one cardiology clinic per week. There are opportunities to observe Dr Hardman’s heart failure service, exercise stress tests, 24 hour tape reporting and echoes.They will be expected to attend the weekly cardiology education meeting held on Mondays at 4.30pm. There are often invited external speakers. They will be actively encouraged to participate in departmental audit projects.

Intensive Therapy Unit (1 SHO)Consultants Dr Chris Hargreaves RCP Post No: 06/022/046

Educational SupervisorDr N HarperDr R Davies

The unit has seven funded critical care beds. Patients are admitted to the unit under the care of their admitting consultant. The ICU staff advise on and co-ordinate the management of the patients so that there is a multidisciplinary approach to care.

There is a weekly training session on a Monday morning, which all five intensive care trainees are expected to attend. There is a consultant led ward round every morning. The five weekly rota is designed on a full shift basis and includes internal cover for annual leave.

The trainee will become competent in methods of vascular access for haemodynamic monitoring and the interpretation of such monitoring, as well as vascular access for renal support therapy. The trainee will be heavily supervised initially with a progression of responsibility depending on their expertise and skills.

The clinical duties of the post are within the Intensive Care Unit. But includes assessment of patients on wards and in A & E. The SHOs are expected to co-ordinate the management of the patients in discussion with more senior ICU staff and the admitting team.

Rheumatology (1 SHO) Consultants Dr Jenny Worrall RCP Post No: 06/022/018

Educational SupervisorProfessor Jane Dacre Dr I Wamou

This is a busy general rheumatology department, dealing with a whole spectrum of rheumatic diseases in the local population. The SHO is expected, in addition to their duties in general medicine, to look after any rheumatology in-patients and on a day-to-day basis. They are also invited to attend a teaching clinic on a Wednesday or Thursday morning where they will be supervised in their history taking and examination of patients with loco motor disorders. They will be taught how to inject joints. Within the department the following special clinics are held on a regular basis: early synovitis clinic, special spinal clinic, paediatric rheumatology clinic, electro diagnostic clinic and new drug assessment clinic.

There is a weekly Rheumatology teaching afternoon on a Friday. This begins with an x-ray interpretation session followed by a ward round and some in-house education for the trainees. There is also a monthly rheumatology orthopaedic combined meeting. In addition, the trainees at the Whittington Hospital are welcome to attend weekly rheumatology meetings at the Royal Free Hospital and the Middlesex Hospital. Whittington Hospital consultants contribute to this.

On call rota

The SHO rota is a full shift rota. The overall hours worked are less than 56 hours per week and should meet new deal requirements. The DMR rota is also a full-shift rota so the DMRs are available throughout the 24-hour period.

Each SHO has a letter code (as shown in the rota plan), which rotates through 3 to 4 posts with periods of night duty interspersed between the periods on the firms. Each consultant team is in call for general medicine on 1:12 and while attached to the firm you are rostered for the day takes when your consultant is on duty. The Oncology, Haematology and COOP 1 consultants do not do general medical takes and while working on these firms you will do some day takes for other consultant teams.

The night shifts occur on 1/17. Each SHO works a week of nights in A&E starting on a Wednesday and then has a week-off and then does a week of nights on ward cover with 4 working days off before returning to work the following Tuesday. In addition one SHO works late Monday to Friday to cover the wards from 17.00-21.00 and one SHO covers the wards on weekend days and bank holidays from 08.45–21.15. In order to meet the 4-hour wait in A&E an additional SHO is rostered for A&E in the afternoons to help out on busy takes.

6 SHOs are involved in the on-call as follows: SHO 01 covers A&E from 08.00 to 21.00 SHO 02 covers A&E from 20.30 to 09.30 SHO 03 covers wards from 20.00 to 09.00 SHO 04 covers wards from 17.00 to 21.00 SHO 05 covers week-end days and bank holidays from 08.45 to 21.15 SHO 06 covers A&E (if required by the on-call team) from 13.00 to 18.00

MARIE CURIE HOSPICE HAMPSTEADEDENHALL

PALLIATIVE CARE SENIOR HOUSE OFFICERFOUNDATION YEAR 2 PILOT PROGRAMME

JOB DESCRIPTION

Marie Curie Hospice Hampstead

The Marie Curie Hospice Hampstead is one of 10 Centres in the UK run by Marie Curie Cancer Care. It has 32 inpatient beds for symptom control, rehabilitation and respite care, a Day Therapy Unit and outpatient facilities. An active Education Unit was set up in 1987 and continues to expand. A multi-disciplinary approach to care is adopted. The staff establishment includes a Bereavement Counsellor, Social worker, Physiotherapists, Volunteers Organiser, Aromatherapist and an Art Therapist. The Marie Curie Hospice Hampstead works closely with the Whittington Hospital NHS Trust and the Royal Free Hospital NHS Trust. There are strong links in the community with the Whittington Palliative Care Team, the Royal Free Palliative Care Support Team and the Haringey Palliative Care Team.

Medical staffing establishment at the Marie Curie Hospice Hampstead Dr Tookman is Consultant in Palliative Medicine who spends 60% of his time as

Medical Director of the Marie Curie Hospice Hampstead and 40% as Consultant in Palliative Medicine at the Royal Free Hospital.

Dr Kurowska is Consultant in Palliative Medicine who spends 40% of her time at the Marie Curie Hospice Hampstead and 60% at the Whittington Hospital.

A third consultant (jointly with the Royal Free Hospital) is due to be appointed in March 2005.

Dr Brennan is Consultant in Haringey and spends one day a week at the Marie Curie Hospice Hampstead.

Full time Staff Grade in Palliative Medicine Full time Specialist Registrar post based at the Hospice. Specialist Registrar in Palliative Medicine at the Royal Free who provides on-call

cover for the Hospice. Two Senior House Officer posts (including this one) Research Clinical Assistant Post - 2 sessions per week.

The Post

This will be a full time non-resident post at the Marie Curie Hospice Hampstead offering comprehensive training in Palliative Care. The post would be of interest to doctors wishing to pursue a career in general medicine, general practice, palliative medicine,

radiotherapy or oncology. The post is educationally approved by the Royal College of Physicians for general professional training

Within the Marie Curie Hospice Hampstead, the post holder will be responsible to the Consultant Physician and the Medical Director of the Unit. The 2 SHOs, 2 Specialist Registrars and a flexible trainee provide the first on-call cover. Second on-call (consultant cover) is provided by covered by Dr Kurowska & Dr Tookman – shortly to be joined by a third consultant. It is a one-in-five rota on-call with prospective cover. The post will be for three months as part of the Whittington Foundation Year 2 Programme.

The Foundation Year 2 SHO will be responsible for the day-to-day management of patients admitted to a 14-bedded ward. Another SHO colleague will be responsible for an 18-bedded ward. The hospice SpR covers the ward when one of the SHOs is on annual or study leave. There will be opportunity to gain experience in the Day Therapy Unit (with the possibility of a weekly SHO Out-Patient Clinic). There is close contact with the Whittington and Royal Free Palliative Care Teams and experience can be gained in hospital based out-reach palliative care.

There is an in-house formal programme of education for the SHOs. The post-holder will also attend the weekly Thursday lunchtime medical education programme (including some half days devoted to generic training) at the Whittington. There will be one half day a week set aside for training purposes which will be flexible in order to meet the needs of the post holder.

The SHO will be expected to participate in training programmes, guideline development, audit and educational activities within the Marie Curie Hospice Hampstead.

The timetable will be flexible and will permit internal cover when one SHO is on leave. There will be no locum cover.

Leave

You are entitled to 5 weeks + 2 statutory days (total 27 days) annual leave. You are required to take all of your leave by the end of your appointment, and should take a proportionate amount of leave in each rotation. At least six weeks notice is required.

Any Bank Holidays worked for which provision has not been made in the rota during the tenure of this appointment, will be covered by payment in lieu.

All posts include prospective cover for the annual and study leave of colleagues, and locums are appointed only to cover prolonged sick leave. Leave dates must be co-ordinated with colleagues to ensure that adequate provision is made to cover the routine and emergency work of SHOs on leave. Holidays and study leave are important issues that are addressed as soon as possible after the SHO joins the rotation. Each firm will manage their own particular needs

TERMS AND CONDITIONS OF SERVICE

This post is covered by the Terms and Conditions of Service of The Whittington Hospitals NHS Trust and in particular to the pay and conditions of service relating to the Hospital Medical and Dental Staff Group.

Hours of duty

The five weekly rota is designed on a full shift basis, with internal cover. The hours of duty are New Deal and EWTD compliant.

When not on call the standard working day is 8 hours. SHOs need to try to keep to this as much as possible or hours will escalate. Teams based on the same ward will cross cover their colleagues as far as possible. The additional duty hours of the post will continue to be under review. Any change will be communicated to the post-holder in advance of implementation.

You should be prepared to perform duties in occasional emergencies and unforeseen circumstances. Commitments arising in such circumstances are, however, exceptional and you will not be required to undertake work of this kind for prolonged periods or on a regular basis. All efforts will be made to ensure that work of this kind does not result in continuous hours of duty that exceed the New Deal continuous hours of duty limits.

Length of Appointment

This is a whole-time appointment for 6 months Emergency Department & 6 months general medicine commencing 3 August 2005.

Conditions of appointment

1. Medical Clearance is required prior to the commencement of appointment

2. The post is available from 3 August 2005.

3. You will require a Core of Knowledge Radiation Protection Certificate. If you do not possess the necessary certification the appointment is conditional on your attending the next available accredited course.

4. No canvassing of consultants is permitted.

Salary Scale

The basic salary scale is £24,587 to £34,477 per annum plus £2,098 London Weighting and a pay band supplement, according to the rota being worked.

Health and safety policy

Employees must be aware of the responsibilities placed on them under the Health and Safety at Work Act (1974), to ensure that the agreed safety procedures are carried out to maintain a safe environment for employees and visitors.

Security

It is the responsibility if all employees to work within the security policies and procedures of the Whittington Hospital NHS Trust to protect the patients, staff and visitors and the property of the Trust. This duty applies both to the specific work area of the individual and to the Hospital in general.

Data protection

This post has a confidential aspect. If you are required to obtain, process, and/or use information held on a computer or word processor you should do it in a fair and lawful way. You should hold data only for the specific registered purpose and not use or disclose it in any way incompatible with such a purpose. To disclose data only to authorised persons as instructed. Breaches of confidence in relation to data will result in disciplinary action, which may involve dismissal.

No smoking

We have promoted a No Smoking Policy as part of our responsibility for the provision of health. You will be required to work within the framework of this policy.

Equal opportunities

This Trust operates an equal opportunities policy. It is the aim of the Trust to ensure that no job applicant or employee receives less than favourable treatment on the grounds of sex, race, colour, nationality, or national origins or is places at a disadvantage by conditions or requirements that cannot be shown to be justifiable. To this end the Trust has taken an equal opportunities policy and it is for each employee to contribute to its success.

Confidentiality

You are required to maintain confidentiality of any information concerning patients which you have access to or may be given in the course of you work, in accordance with current policy on confidentiality in The Whittington Hospital NHS Trust.

Method of payment

Payment of salary is made into bank account/ building society account by direct bank system. Details of a bank account or building society account will be required on the first day at work. There is no facility for any other form of payment.

Removal expenses

Removal expenses are paid in accordance with The Whittington Hospital NHS Removal Expenses Agreement.

Policies, Procedures and Agreements

These cover a wide range of employment-related matters, and special care and attention is taken to ensure that they are not only effective, but also accepted and implemented by employees. Staff side representatives are involved, through consultation, from an early stage in the identification and development of employment policies.

Copies of the following are kept in the Human Resources Directorate

Disciplinary Policy Discrimination, Harassment and Victimisation Code of Practice Disputes Procedures Agreement Equal Opportunities Employment Policy Grievance Procedure Health & Safety General Policy HIV/AIDS Training Policy Job Sharing Policy No Smoking Policy Policy for Staff Affected by Change Procedure for Occupational Health Referrals Protection of Children: Procedure for Requesting a Police Check of Criminal

Convictions Protection of Pay and Conditions of Employment for Staff Affected by Organisational

Change Recruitment and Selection Policy Removal Expenses Agreement Staff Arrangements During Adverse Weather Conditions/ Transport Disruption Sickness Absence Guidelines Study Leave Guidelines Time off for Trade Union Activities and Duties Policy Guidelines Violence Against Staff Workplace Alcohol and Substance Abuse

FY 2 posts for August 2005

Post 1 Post 2 Post 3 Post 4

Supervisor August –November

November- Feb

Feb – May May-August

Dr Kurowska Post B

Cardiol 111 weeksNights 2 wks

Palliative Medicine13 weeks

ED 26 weeks

Dr Kurowska Post B

Palliative Medicine13 weeks

Nights 2 wks Chest 111 weeks

ED 26 weeks

Dr Kurowska Post B

ED 26 weeks Chest 1 2 weeksNights 4 wksCOOP 37 weeks

Palliative Medicine13 weeks

Dr Kurowska Post B

ED 26 weeks Palliative Medicine13 weeks

COOP 39 weeksNights 4 wks

Dr Suri/Dr Vicary 6 months6 mths ED consultant

Post D

DM/Endo 5 weeksNights 4 wksGastro1 13weeks Nights 4 wks

ED 26 weeks

Dr Bielawski6 months6 mths ED consultant

Post J

COOP3 7 weeksNights 4 wksCardiol1 13 weeksNights 2 wks

ED 26 weeks

6 mths ED consultant Dr B Davis6 months

ED 26 weeks Haem 13 weeksNights 4 wks,Rheum 9 weeks

6 mths ED consultant Dr Johnson/Dr Branley6 months

ED 26 weeks Nights 2 wksChest 1 13 weeksNights 4 wksGastro 2 7 weeks

THE Whittington NHS TRUSTFOUNDATION PROGRAMME YEAR 2 (FP2) POST

PERSON SPECIFICATIONESSENTIAL WHEN

EVALUATEDDESIRABLE WHEN

EVALUATED

QUALIFICATIONS & EXPERIENCE

Eligible for full or limited registration with the GMC

MB BS (or equivalent)

Satisfactory completion of PRHO posts (or equivalent evidence of competence) at the time of taking up the post

AF

AF

AF

Distinctions, Scholarships, prizes

Satisfactory completion of course e.g. ALS, ATLS, ACLS, ALERT

Other qualifications

AF

AF

AF

CLINICAL CARE (knowledge and skills)

Competent in basic procedures e.g. CPR, infection control, physical examination, history taking etc

Able to prioritise clinical need

Aware of own limitations, consults senior colleagues appropriately and knows when to ask for help

Understands the principles of patient confidentiality and data protection

Understands the need for and appreciates the role of audit in clinical practice

Understands the principles of clinical governance – ensures patients are not put at risk

Understands the importance of working effectively in teams

AF, Ref

I/V, Ref

I/V, Ref

I/V, Ref

I/V

I/V

AF, I/V

Additional skills and procedures

Previous clinical experience

Knowledge of UK health systems, practices and values including the relationship between primary and secondary care and interprofessional relationships

Knowledge of current issues in the NHS

Computer literate

Understands the importance and impact of information systems in health care

Has participated in clinical audit

Has experience of working in teams

AF

AF

I/V, Ref

IV, Ref

AF

I/V

AF

AF, I/V

MAINTAINING CLINICAL COMPETENCE

Keeps professional knowledge and skills up to date

Ability to practise evidence based medicine

Potential to benefit from the training available

AF, Ref

AF, I/V

AF, I/V, Ref

Demonstrates a critical and enquiring approach to knowledge acquisition

I/V

ORGANISATION & PLANNING

Able to manage time and prioritise workload

I/V, Ref

ESSENTIAL WHEN EVALUATED

DESIRABLE WHEN EVALUATED

TEACHING AND RESEARCH

Contributes to teaching and learning of others in the clinical setting

Understanding of the basic principles of research

AF, I/V, Ref

I/V

Participation in clinical / laboratory research

Publications, abstracts, peer reviewed articles, book chapters

AF

AF

COMMUNICATIONS, RELATIONSHIPS AND WORKING WITH COLLEAGUES

Able to communicate clearly in written and spoken English e.g. able to write legible records

Able to discuss treatment options with patients in a way they can understand

Able to establish good working relations with patients, carers and multi-disciplinary colleagues

Understands the responsibilities of being an employee in the NHS

AF, I/V, Ref

I/V, Ref

Ref

Ref

PERSONAL ATTRIBUTES AND EXPERIENCE

Recognises stressful situations and responds appropriately

Demonstrates initiative, enthusiasm and common sense

Respects and promotes individual’s rights, interests, preferences, beliefs and cultures

I/V, Ref

I/V, Ref

Ref

Evidence of leadership qualities (not necessarily in medicine)

Other work experience / outside interests

AF

AF

PHYSICAL REQUIREMENTS

Meets professional health requirements

Pre-employment health screening

AF = Application FormI/V = InterviewRef = ReferenceAny attributes that are evaluated on the basis of the application form alone may be further explored at the interview stage.Printed: 22 May 2023

THE WHITTINGTON HOSPITAL NHS TRUSTINTERVIEWING SCORE SHEET – FOUNDATION PROGRAMME YEAR 2 (FP2) POSTMaximum score for each criterion is 2 (Range 0 - 2)

Notes Candidate's Score

Clinical care and maintaining clinical competence

Able to prioritise clinical need

Awareness of own limitations

Understands the principles of patient confidentiality and data protection

Understands the importance and impact of information systems in health care

Understands the principles of clinical governance and the role of audit

Demonstrates knowledge of UK health systems and current issues in the NHS

Demonstrates a critical and enquiring approach to knowledge acquisition

Potential to benefit from the training available

Organisation and Planning

Ability to organise own workload and to prioritise workload

Teaching and Research

Able to contribute to teaching

Understanding of research principles

Communications, relationships and working with colleagues

Able to communicate clearly

Able to discuss treatment options in a way that patients can understand

Demonstrates an understanding of team working

Personal attributes

Recognizes stressful situations and responds appropriately

Demonstrates initiative, enthusiasm and common sense

Total (max 32 points)