Specialty Doctor in Palliative Medicine



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Surgeon Introduction This is an exciting new post and the successful candidate will become part of the Sue Ryder West Berkshire and South Oxfordshire Palliative Medicine service. The post is full-time, though part-time applicants will be considered, and includes first-on-call responsibilities across both sites in a 1 in 5 rota. While the post-holder will be predominantly based at Duchess of Kent House, he/she is expected to be flexible and be prepared to work across both inpatient units Nettlebed Hospice and Duchess of Kent House - dependent on staffing need. Sue Ryder Sue Ryder is a national charity which provides specialist palliative and neurological care throughout the U.K. Sue Ryder was founded over 50 years ago as the Sue Ryder Foundation and has major experience as a provider of care to adults with complex needs. Currently with six specialist palliative care centres across the country, Sue Ryder is one of the largest independent providers of specialist palliative care in the United Kingdom. The Department of Palliative Medicine The current Department of Palliative Medicine was formed by the joining together of the Specialist Palliative teams from Berkshire West and South Oxfordshire in April 2011. The service consists of four community teams, a hospital team, four day therapy and outpatient units and two inpatient specialist palliative care units. The present medical staff consists of four consultants: Dr Maeve McKeogh Clinical lead based with the hospital Palliative care team (HPCT) at the Royal Berkshire NHS foundation Trust Dr Pat Strubbe Consultant at Sue Ryder Nettlebed Hospice, Henley RG9 5DF Dr Annabel Borthwick Consultant at Sue Ryder Duchess of Kent House covering the inpatient unit and community teams Post to be filled Second consultant at Duchess of Kent House covering the inpatient unit and community teams August 2014 1

Development of Integrated Palliative Care service across West Berkshire, South Oxfordshire and South Buckinghamshire In 2011, Berkshire West PCT looked for the best provider for the West Berkshire Palliative care service which consisted of the inpatient unit at Duchess of Kent House, and day therapy units at Reading, Newbury and Wokingham. Sue Ryder, who provided the service for South Oxfordshire and South Buckinghamshire with an inpatient unit based at Nettlebed Hospice, was the preferred provider for the PCT and an integrated palliative care service was formed April 2011. The exciting development has led to the creation of a consultant-led integrated Palliative care service across the West Berkshire, South Oxfordshire and South Buckinghamshire. The consultant job plans were restructured to pride a seamless service across boundaries as the aim is to provide a flexible and responsive service between the hospital, community and hospice. The consultant contracts are held by the Trust and the consultants are managed through the directorate system at the Trust. The palliative care service in the community and hospices is run by Sue Ryder, through contracts held by the 4 Clinical Commissioning Groups. The hospital palliative care team is managed directly by the Nurse Consultant and the Trust. Sue Ryder, Duchess of Kent Hospice The inpatient unit has 15 beds. It reopened in January 2014 following an extensive refurbishment and now consists solely of single rooms, all of which have access to the garden. Medical staffing. Dr Annabel Borthwick Consultant Monday, Tuesday and Thursday Consultant post (recruitment in progress) Dr Maggie Guy Locum Consultant Wednesday and Friday Dr Alison Talbot Associate Specialist 0.65 wte StR Monday, Tuesday and Friday FY2 (on rotation with RBH) Monday, Tuesday, Wednesday, Thursday, Friday The Day therapy unit, which runs 3 days a week and has 15 places, is staffed by 2 GPs who are present in total for 3 mornings. There is a well-developed multidisciplinary team including 2

physiotherapy, occupational therapy, chaplaincy, a clinical psychology service and a family support/ bereavement service. The Community Clinical Nurse Specialists (CNSs) for the Reading area have their offices based at Duchess of Kent House. Sue Ryder Nettlebed Hospice The inpatient unit has 12 beds. The day therapy centre has 15 places and is open 2 days a week. Medical staffing Dr Pat Strubbe Consultant Tuesday, Wednesday, Thursday and Friday Dr Maeve McKeogh Consultant Monday StR Tuesday and Wednesday Dr Jane Millar Staff Grade Monday and Tuesday Dr Desi El-Kabir Staff Grade Thursday and Friday Both hospices units admit 7 days a week and employ GPs to cover the units weekends and on bank holidays to clerk in patients. The four consultants in Palliative Medicine cover the service on a one in four second on-call rota with prospective cover. The Hospital Palliative care team This team is based at the Royal Berkshire Foundation Trust Hospital in Reading and is staffed by a Nurse Consultant Susi Lund (1WTE), Medical Consultant Dr Maeve McKeogh Tuesday, Wednesday and Thursday, CNSs (4.4 WTE), two palliative care nurses (2 WTE), Occupational therapists (1.6 WTE), Social worker (0.5 WTE), and Clinical psychologist (0.5 WTE). There are close links with the pain team at the hospital and much joint working. The Hospital Palliative Care Team work 7 days a week. Palliative Care Community Teams There are integrated community teams working at Wokingham, Reading and Newbury including CNS teams, day therapy staff, therapists and volunteers. The CNS teams are non-medical prescribers and work 7 days a week. The Appointment 3

Proposed Job Plan The job plan below is illustrative of programmed activities however the balance between Direct Clinical Care and Supporting Activities will be agreed with the post-holder in the final job plan. The job plan is reviewed annually by the Clinical Director. It is the responsibility of the post holder to have the job plan reviewed and this will continue on an annual basis. Continuing Professional Development The post-holder is expected to maintain his or her professional development in line with the guidance laid down by the Royal College of Physicians or Royal College of General Practitioners. He/she is expected to undergo annual appraisal. The Responsible Officer for the post holder is the Medical Director of Sue Ryder Dr John Hughes. Principal Duties In association with the other members of the medical team: to clerk and examine newly admitted patients and to plan their management with reference to senior medical staff members if necessary; to co-operate with the other members of the multi-disciplinary team in ensuring on-going optimum symptom control for inpatients and day patients, taking into account the physical, psycho-social and spiritual elements of those symptoms; to co-operate with other members of the multi-disciplinary team in the support of relatives and friends of patients; to maintain accurate and comprehensive records and provide patient discharge summaries as required; to participate in the weekly journal club rota; to contribute to the teaching of GPs who undertake placements at Duchess of Kent Hospice usually weekly for a term at a time to participate in the joint clinical forum held every 2 months at Duchess of Kent Hospice at which clinical cases known to both hospital and community teams are discussed Provisional Job Plan depending on the applicant s interests and skills 4

Activity Allocation PAs Mon 9.00 referrals meeting Handover Ward round with registrar - Ward work Tues Referrals 09.00 Handover Consultant Ward Round (Blue Team) - Consultant Ward Round (Red Team) Weds Handover. Referrals meeting /Net tlebed 09.00 Ward work 14.00-15.30 15.30-- Weekly MDT meeting Ward work Thurs Journal club SPA 0.25 Departmental Audit/CPD/R&D SPA 0.5 Grand Round RBH 12.00-1.00pm SPA 0.25 Consultant Ward Round (Blue team) Fri Consultant Ward round (Red 09.00 Team) 5

On-call Meet with community CNS Ward work One in five first on-call for Duchess of Kent House TOTAL: 10PA Total 10 PA consisting of: Ward rounds and clinics and community visits 9.0 PA ( DCC) Supporting Professional Activities 1.0 PA ( SPA) Clinical Governance The successful applicant will be expected to contribute to medical audit and clinical governance. Other information The successful candidate will be expected to live within a reasonable distance by road i.e. approximately ten miles or 30 minutes from Hospice. The successful applicant will be required to maintain registration with the General Medical Council and will be required to comply with the Trusts pre-employment checks prior to taking up the appointment. Referees are required upon application; one must be your current employer. References are required to cover a minimum of your last 3 years employment. An enhanced Disclosure and Barring check will be undertaken for this role. Interested candidates may visit the Department and Hospital by arrangement with Dr Maeve McKeogh, Consultant in Palliative Medicine and Clinical Lead Telephone 0118 322 7891 or e-mail maeve.mckeogh@suerydercare.org PERSON SPECIFICATION REQUIREMENT ESSENTIAL DESIRABLE 6

Qualifications Full GMC Registration Diploma in Palliative Medicine MRCP or equivalent. MRCMMMMMMMMMM Clinical experience 2 years experience in General Medicine. Sound clinical skills Experience in Palliative Medicine Academic Evidence of active involvement in audit. Understanding of clinical governance. Evidence of a good knowledge base of clinical research processes and ability to utilise evidence based practice Management skills Teaching Skills Able to organise oneself and prioritise clinical workload. Evidence of education expertise and experience.. IT skills especially use of databases Experience of using reflection on practice incidents and the ability to learn from incidents Communication and Interpersonal skills Physical Requirements Evidence of effective team working Caring attitude to patients.. Meets professional health requirements. Excellent communication skills. Excellent interpersonal skills. 7