Consultant Physician in Care of the Elderly (With interest in acute care, 2 Posts)

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POST: Consultant Physician in Care of the Elderly (With interest in acute care, 2 Posts)

LOCATION: Older Persons Services

Belfast Health and Social Care Trust REPORTS TO: The Clinical Director

RESPONSIBLE TO: The Chief Executive

GENERAL INFORMATION

The Belfast Health Care Trust

The Belfast Health and Social Care Trust was established in April 2007 and comprises the Belfast City Hospital, Mater Hospital, Musgrave Park Hospital, Royal Hospitals and South and East Belfast, and North and West Belfast Health and Social Services Trusts. Hospital Profiles

Musgrave Park Hospital is the Regional Orthopaedic Unit for Northern Ireland. The Musgrave Park Regional Orthopaedic Service is the largest in the British Isles with 29 consultant orthopaedic surgeons and staff. On site is the Queen’s University of Belfast’s Department of Orthopaedic Surgery which is the largest academic unit in Orthopaedics in the British Isles with an international reputation and an extensive research output.

The Royal Group of Hospitals is the largest hospital complex in Northern Ireland, comprising the Royal Victoria Hospital, the Royal Jubilee Maternity Hospital (RJMH), the Royal Belfast Hospital for Sick Children (RBHSC) and the School of Dentistry. It provides virtually all referral services in Northern Ireland and undoubtedly the vast majority of local research. Major re-developments of the Royal Group of Hospitals are underway, which includes the Royal Belfast Hospital for Sick Children. A new Critical care Building with ED and theatres is due to open in May 2013. The Royal Hospitals play a major role in clinical education, training and research, with most academic departments linked to the Queen’s University of Belfast Medical School on the Royal Hospital’s complex – medicine, surgery, ophthalmology, child health, obstetrics and gynaecology, and pathology.

Belfast City Hospital (BCH) is a major teaching hospital, most of which is housed within the Tower (opened in 1985). The Northern Ireland Cancer Centre opened on the campus in March 2006. A strong strategic focus on molecular medicine, cancer and renal services has enabled the development of a vigorous research programme,

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together with a large Cancer Clinical Trials Unit. There is a modern radiology department and substantial AHP Services (e.g. Physiotherapy, Podiatry, Occupational Therapy, Speech & Language Therapy, Nutrition & Dietetics, etc) and a comprehensive range of pathology.

The Mater Hospital is a long established general hospital with teaching status affiliated to the Queen’s University of Belfast. A new state of the art ward block, the McAuley Building, was opened in January 2002. The X-Ray Department is sited in the Dempsey Building, which was opened in 1991. The Dempsey Building also houses the Accident & Emergency Department, the Operating Theatres, the Intensive Care/High Dependency Unit, the Outpatient Department and the Maternity Unit. The main Psychiatric Unit occupies a separate building next to the Dempsey Building. There is also a Psychiatric Day Hospital on a separate site, approximately one mile from the main hospital.

A summary of the services across the different hospitals is provided in the table below:

Site General Services Specialist Services

Musgrave Park Hospital 225 Adult beds, 34

Paediatric beds

Anaesthesia Pain Management

Regional Orthopaedic unit Rheumatology

Rehabilitation

Regional Acquired brain injury unit

Care of the elderly unit Royal Hospitals

900 inpatient beds

A&E

Acute & General Medicine Anaesthesia (including critical care)

Pain Management

Recognised trauma centre Paediatrics (RBHSC) Obstetrics & Gynaecology (Royal Jubilee Maternity Hospital)

School of Dentistry

Regional services include: neurosciences,

medical and surgical cardiology,

thoracic surgery, ophthalmology and

specialised endocrinology, ENT,

general surgery, vascular surgery, hepatology Belfast City Hospital

800 inpatient beds

A&E (temporarily closed) Acute & General Medicine Anaesthesia (including critical care)

Pain Management

Adult Cystic Fibrosis Breast Services (including reconstructive surgery) Cardiology

Cochlear Implant Service Gynaecology &

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Haematology Haemophilia Service Medical Genetics Medical Oncology Nephrology (including Renal Dialysis) Radiotherapy Respiratory Medicine Transplant Surgery Urology Mater Hospital 287 inpatient beds A&E

Acute & General Medicine Anaesthesia (including critical care)

Pain Management

Surgical specialties, including Hepatobiliary, Ophthalmic and ENT Obstetrics & Gynaecology Psychiatry

The Belfast HSC Trust functions through a series of Directorates. Older People’s Services is part of the Social and Primary care Directorate.

Service Information

The Belfast Health and Social Care Trust is responsible for ensuring that the population of the Greater Belfast area receives a comprehensive range of medical services for older people. In addition the Belfast Trust provides Regional Stroke services. All age Mental Health Services are provided with Geriatric Medicine Services within the Social and Primary Care Directorate.

The provision of Care of the Elderly Services within the Belfast HSC Trust is currently undergoing modernisation and development to meet service needs and improve quality of care. There is a strong community based ethos and well developed multi-disciplinary methods of working.

Similarly the provision of stroke services has undergone significant reorganisation and further developments are planned. Plans for modernisation include further development of a single combined stroke unit, with improved access to early supported discharge and a streamlined TIA service.

Currently, Elderly Care Services are provided across 3 acute sites - Royal Victoria Hospital (RVH), Belfast City Hospital (BCH) and Mater Hospital, as well as a non-acute site - Musgrave Park Hospital. There is a strategic imperative to provide services closer to the patient’s own home and to avoid unnecessary hospital admissions.

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Royal Victoria Hospital

The RVH site has a large Acute Medical Unit where geriatricians work alongside colleagues in Acute Medicine and other specialties for unscheduled medical admissions. Patients are received from the greater Belfast area.

The stroke unit includes 6 hyper-acute beds that are used in the delivery of thrombolysis which is provided 24 hours a day in liaison with colleagues in neurology. The 6 hyper-acute beds are housed within a 36 bedded hyper-acute stroke unit.

Belfast City Hospital

On the BCH site there is a GP Direct Assessment/ Admissions Unit for frail older people. There are also 52 acute elderly care beds and 21 rehabilitation beds. Elderly patients are triaged from the AMU (RVH) and the Direct Assessment/ Admissions Unit (BCH). The vision is to increase the number of beds on the BCH site and expand the assessment/admissions facility for frail elderly so that the main pathway for admission will be directly to BCH, rather than via ED and AMU on the RVH site.

Mater Hospital

The Mater site has an 18 bedded rehabilitation unit which also accommodates a small number of stroke patients. Patients are generally received from North Belfast and south Antrim areas. An OPALS service operates on the Mater site in liaison with the general physicians.

Musgrave Park Hospital

The unit on the MPH site comprises of 3 wards providing rehabilitation for older patients from the greater Belfast area. Ward 1 is a 20 bed intermediate care ward providing fracture and general rehabilitation. Ward 2 is a 24 bed fracture rehabilitation ward and ward 3 a 24 bed general and fracture rehab unit. The unit is supported by a comprehensive multidisciplinary team with access on site to radiological services including ECHO, CT and MRI. A newly developed Ambulatory Care Centre to provide for the needs of older patients has recently been developed on site. This provides a community facing hub for rapid assessment including falls and osteoporosis.

Intermediate Care

There is a diverse range of intermediate care services delivered by the Trust for patients from the greater Belfast area. Home based rehabilitation is delivered across the city with support from consultant Geriatricians being provided to the N&W Belfast general rehab teams and fracture teams across the city.

A community stroke team works across the city providing early supported discharge and is supported with local consultant Stroke Physician input.

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Rehabilitation beds are also available in 3 residential homes located in the east, west and north of the city.

Acute Care at Home

The Trust is currently developing an acute care at home model involving geriatricians and other healthcare professionals to provide a range of medical and other services in patients’ own homes.

OPALS (Older Persons Assessment and Liaison Service).

This currently operates on all three hospital sites and provides a consultant led Comprehensive Geriatric Service to suitable acute medical inpatients with the aim of streamlining the patient journey through the system and expediting referral to appropriate services e.g. Inpatient Rehabilitation, Community Rehabilitation, Falls Service, Intermediate Care, Step Down services.

Outpatients

A range of specialist and general clinics are provided across the four hospital sites. These include falls, osteoporosis, neurovascular, movement disorder and memory clinics.

Fracture Rehabilitation/ Osteoporosis

These services are based at RVH (assessment) and Musgrave Park Hospital (rehabilitation). Osteoporosis services also operate from Musgrave Park Hospital.

Consultant Staffing

CONSULTANT LOCATION. SPECIAL INTEREST

Dr Lynne Armstrong MPH/BCH Falls

Dr Ivan Wiggam RVH Stroke/ Clinical Director

Dr Ken Fullerton BCH/RVH Interface geriatrics/Associate Medical Director Unscheduled Care

Prof Peter Passmore BCH/QUB Memory, hypertension / Academia

Dr Julia Foy BCH/MPH OPALS

Dr Maeve Rea BCH Ambulatory Care/Academia

Dr Jan Ritchie BCH/MPH/Community Community services

Dr Mark Magorrian Mater / RVH Stroke/ Acute Elderly Care Dr Amanda Crawford BCH/MPH Acute Elderly Care

Dr Enda Kerr RVH Stroke

Dr Dominic Hart BCH Rehabilitation

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Dr Catriona McCullagh BCH/MPH Rehabilitation Dr Cathy Patterson RVH/ Mater OPALS/Stroke

Dr Ian Steele MPH Bone Health/Postgraduate training Dr Paul Turkington BCH/RVH Acute elderly care

Dr Patricia Gordon RVH Stroke

JOB SUMMARY/MAIN PURPOSE:

The Consultant Physician in Care of the Elderly will be responsible for clinical leadership, alongside colleagues and the clinical director, in moving forward the development of elderly care services on the BCH site, including the acute assessment/admissions unit for older people. Along with 6 consultant colleagues, the post holder will provide cover for the BCH direct admissions unit (currently within hours, but likely to expand to 7 days per week) and share responsibility for approximately 70 care of the elderly beds (wards 1S, 7N and 7S) with an anticipated annual throughput of approximately 2500 patients. Junior medical support on the BCH site includes 4 specialty trainees (also rotate to MPH), 2 CT doctors, 4 F2 and 5 F1 doctors. The service is also supported by and OPALS practitioner and a full multidisciplinary team. The post holder will provide one outpatients clinic per week, aiming to deliver 42 clinics per year (approximately 400 patients).

The role will also involve input to a liaison service to the RVH AMU. In addition there will be opportunity to input to rehabilitation services at Meadowlands, as part of a team. Junior staff on the MPH site include 2.5 specialty doctors (1.5 primarily based in the day hospital) and 3 CT doctors.

On call will involve seeing new patients admitted to the BCH site at weekends and provision of cover for approximately 70 in-patient beds on the BCH site and 64 beds on MPH site.

The Consultant will ensure delivery of a high quality service to his/her patients in line with the Trust’s key strategic objectives. This will involve a close working relationship with consultant colleagues, managers, and other departments within the Trust, community staff and General Practitioners.

Main Duties / Responsibilities:

The Postholder will:

1. Have clinical leadership responsibilities in Care of the Elderly Services.

2. Be responsible for the delivery of a high quality service to his/her patients in line with the Trust’s key strategic objectives. This will involve a close working relationship with Consultant colleagues and managers, other community staff

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and General Practitioners.

3. Provide clinical leadership within a multi-disciplinary and multi-agency environment, within the Trust.

4. Work as a member of a team of highly motivated and dedicated geriatricians to provide advice on planning, monitoring, resource allocation and service development to the Senior Management Team within Elderly Care Services. 5. Join a consultant elderly care on-call rota within the Belfast Trust. The Trust will

ensure that working arrangements do not contravene the European Working Time Directive.

6. Participate in training of junior medical staff and medical students, ensuring this is of the highest quality.

Managerial Responsibilities

The post holder will:

1. undertake administrative duties associated with the care of his/her patients and the running of the department in conjunction with colleagues

2. To respond to Priorities for Action, regional and commissioners’ strategies and Trust and service group management plans.

3. To support the Belfast Trust reform and modernisation agenda, particularly relating to, unscheduled care arrangements. To support the delivery of access targets and emergency care reforms within the Belfast Trust.

4. To provide high quality, cost-effective care.

5. Delegate appropriate responsibility and authority to the level of staff within his/her control, consistent with effective decision making, while retaining overall

responsibility and accountability for results.

6. Take such action as may be necessary in disciplinary and grievance matters in accordance with the procedures laid down and approved by the Trust.

7. Identify objectives with the Clinical Director and agree an action plan ensuring personal development.

8. Participate in the selection and appointment of staff in accordance with hospital procedures

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Professional Responsibilities

1. The Post holder will deliver a high standard of inpatient and outpatient care. 2. The post holder shall, through leadership, encourage and maintain

multi-disciplinary work within his/her workplace.

3. The post holder will liaise with medical practitioners and other health care professionals in order to ensure a high standard in provision of services.

4. The post holder will be expected to liaise with medical staff within and across Boards in matters concerning DHSSPSNI planning, teaching and further education.

5. The post holder will be expected to engage in medical and clinical audit and resource management in order to further develop and further the evolution of his/her services. Audit is encouraged and time will be made available for this activity.

6. The post holder will assist with the provision of teaching, clinical supervision and appraisal of Doctors in training.

7. The post holder will contribute to undergraduate medical teaching within the directorate.

8. The Post holder will provide cover for colleagues when they are on professional or annual leave. Colleagues are not expected to provide cover for extended periods of sick leave.

9. The Post holder will maintain his/her own continuing professional development (CPD) in line with the Trust’s Strategy on Clinical governance. Reimbursement of expenses for study and professional leave will be in line with nationally agreed terms and conditions of service.

10. The Post holder will participate in the Consultant Appraisal system operational in the Trust.

11. The Post holder will participate in Annual Job Planning. The Trust has indicated that it will move towards a Team approach to Job planning in the near future. 12. The Post holder will maintain registration with the General Medical Council and a

Licence to Practise.

General Responsibilities

1. Employees of the Trust are required to promote and support the mission and vision of the service for which they are responsible and:

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2. At all times provide a caring service and to treat those with whom they come into contact in a courteous and respectful manner.

3. Demonstrate their commitment by their regular attendance and the efficient completion of all tasks allocated to them.

4. Comply with the Trust’s Smoke Free Policy.

5. Carry out their duties and responsibilities in compliance with the Health and Safety Policies and Statutory Regulations.

6. Adhere to Equality and Good Relations duties throughout the course of their employment.

7. Ensure the ongoing confidence of the public in-service provision. 8. Maintain high standards of personal accountability.

9. Comply with the HPSS Code of Conduct.

ADDITIONAL INFORMATION

Terms & Conditions

This appointment is subject to the Consultant Terms & Conditions of Service (Northern Ireland) 2004, and as amended.

Registration

Registration with the General Medical Council and License to Practice must be maintained.

Salary

As per current Consultant salary scale in line with the Consultant Terms & Conditions of Service and pay circular HSC (TC8) 1/2012.

Indemnity

Employees are normally covered by the HPSS and Community Health Service Indemnity against claims for medical negligence. However, certain circumstances may not be covered by the Indemnity, especially where a separate fee is received. The Department of Health, Social Services & Public Safety (DHSS&PS) therefore advises that membership of a medical defence organisation is maintained.

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Team working

The successful candidate will be expected to work with local managers and professional colleagues in the efficient running of clinical services and will share with consultant colleagues in the medical contribution to management.

Subject to the provisions of the Terms and Conditions of Service, the successful candidate is expected to observe the Unit’s agreed policies and procedures, drawn up in consultation with the profession on clinical matters and to follow the standing orders and financial instructions of the Trust.

The applicant will be expected to adhere to consultant terms and conditions of service (NI) 2004 as amended, in addition to all Trust policies and procedures.

The successful candidate will be expected to make sure that there are adequate arrangements for hospital staff involved in the care of his/her patients to be able to contact him/her when necessary.

Mentoring

In line with Trust policy, newly appointed consultants will be offered the opportunity of having a more senior mentor.

Consultant Appraisal

Appointees are required to participate in Consultant Appraisal processes in accordance with DHSS&PS requirements.

Quality

Patient satisfaction must be at the forefront of the concern of each member of staff. Every patient is to be treated as an individual and provided with high quality service in terms of courtesy, kindness, interest and efficiency.

Residence

In order to meet the on-call requirements of the post, the appointee is required to reside within a reasonable distance to their principal place of work, as per terms and conditions of service.

Type of Appointment

The appointment shall be on a whole time basis, or part-time by agreement, based on the needs of the service.

Medical Examination

Appointment to this post is subject to a satisfactory pre-employment health assessment with the Trust’s Occupational Health service.

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Pension

Membership of the Health Services Superannuation Scheme is voluntary. There is reciprocity between the Northern Ireland scheme and that in mainland Britain.

Private Practice

All private professional services and fee paying services that are not part of the Contract of Employment must be undertaken in accordance with Schedules 9, 10 and 11 of the Contract of Terms & Conditions of Service (NI) 2004.

Date on which post is available

The appointee may take up post upon satisfactory completion of essential pre-employment checks.

Visiting

For further information regarding this post, or to arrange a visit, you are encouraged to informally contact: Dr Ivan Wiggam, Clinical Director (028 9063 5570), and Mrs Marie Heaney, Co-Director Care of the Elderly Services (028 9504 9165).

Canvassing

Canvassing will disqualify. Any approach to a member of the Belfast HSC Trust or a member of any Committee or Panel of the hospital by or at the request of a candidate, will be treated as canvassing.

Removal Expenses

If eligible a fixed relocation grant may be available to assist with essential removal expenses, as outlined in the Trust’s “Re-Location and Associated Expenses Policy”. The amount must be agreed in advance of incurring expenditure.

Equality

Employees of the Trust are required to comply with the Trust’s Equality Scheme. A full copy of this scheme is available in the Human Resources Directorate, Employment Equality Team.

Ionising Radiation Regulations

The Ionising Radiation (Medical Exposure) Regulations (2000) require that any person clinically or physically directing a procedure which involves exposure to radiation should have appropriate training. This can be provided locally as necessary.

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Records Management

All employees of Belfast Health & Social Care Trust are legally responsible for all records held, created or used as part of their business within the Belfast Health and Social Care Trust, including patient/client, corporate and administrative records whether paper based or electronic and also including e-mails. All such records are public records and are accessible to the general public, with limited exceptions, under the Freedom of Information Act 2000, the Environment Regulations 2004 and Data Protection Act 1998. Employees are required to be conversant with the Belfast Health and Social Care Trust policy and procedure on records management and to seek advice if in doubt.

Environmental Cleaning Strategy

The Trusts Environmental Cleaning Strategy recognizes the key principle that “ Cleanliness matters is everyone’s responsibility, not just the cleaners” Whilst there are staff employed who are responsible for cleaning services, all Trust staff have a responsibility to ensure a clean, comfortable, safe environment for patients, clients, residents, visitors, staff and members of the general public.

Infection Prevention and Control

The Belfast Trust is committed to reducing Healthcare associated infections (HCAIs) and all staff have a part to play in making this happen. Staff must comply with all policies in relation to Infection Prevention and Control and with ongoing reduction strategies. Standard Infection Prevention and Control Precautions must be used at all times to ensure the safety of patients and staff. This includes:-

 Cleaning hands either with soap and water or a hand sanitiser at the appropriate times (WHO ‘5 moments’);

 Using the correct ‘7 step’ hand hygiene technique;

 Being ‘bare below the elbows’ when in a clinical environment;

 Following Trust policies and the Regional Infection Control Manual (found on intranet);

 Wearing the correct Personal Protective Equipment (PPE);

 Ensuring correct handling and disposal of waste (including sharps) and laundry;  Ensuring all medical devices (equipment) are decontaminated appropriately i.e.,

cleaned, disinfected and/or sterilised;

 Ensuring compliance with High Impact Interventions.

Clause: This job description is not meant to be definitive and may be amended to meet the changing needs of the Belfast Health and Social Care Trust.

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PERSON SPECIFICATION

POST: Consultant in Care of the Elderly LOCATION: Older Persons Services

Belfast Health and Social Care Trust

ESSENTIAL DESIRABLE QUALIFICATIONS  Full GMC registration plus Licence to

Practise

 MRCP(UK) or equivalent

 Higher degree

TRAINING AND

CLINICAL EXPERIENCE

 Entry on the GMC Specialist Register in Geriatric Medicine.

(i) CCT (proposed CCT date must be within 6 months of post-closing date), or

(ii) CESR, or

(iii) European Community Rights

 Experience in delivering acute medical care to frail older people

 Experience in interface geriatrics

PERSONAL SKILLS & ATTRIBUTES

 Good written and oral communication skills.

 All applicants to have demonstrable skills in written and spoken English that are adequate to enable effective communication about medical topics with patients and colleagues. Communication, reasoning and team-working skills to be demonstrated on application and at interview.

 Good personal and interpersonal skills.

 Good organisation and managerial skills.

 Leadership skills: ability to solve problems and motivate staff.

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TEACHING  Ability to teach medical and non-medical staff.

 Evidence of teaching undergraduate and postgraduates.

 Formal training in teaching.

 Experience of organising teaching programs or specific teaching events

RESEARCH  Understanding of research methodology

 Ability and commitment to practice of evidence based medicine

 Published research

MANAGEMENT  Experience of multidisciplinary working

 Good communication skills

 Completion of management training course

 Experience in clinical management

 Experience of service change and development

ELIGIBILITY  Eligibility to work in the UK as per UKBA Immigration Regulations

Applicants must hold a current full driving licence, valid in the UK with access to a car on appointment. This criterion will be waived in the case of an applicant whose disability prohibits driving but who is able to organise suitable alternative arrangements.

NOTE:

You will be required, if shortlisted for interview, to produce your registration qualifications. If successful you will be required to produce documentary evidence that you are legally entitled to live and work in the United Kingdom. This documentation can be a P45, payslip, National Insurance Card or a birth certificate confirming birth in the United Kingdom or the Republic of Ireland. Failure to produce evidence will result in a non-appointment.

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INDICATIVE CONSULTANT JOB PLAN

NAME:

JOB PLAN FOR PERIOD: Initial three months

GMC:

SPECIALTY: Care of the Elderly

CONTACT DETAILS:

SERVICE GROUP: Social and Primary Care

1. Whole time consultant in Care of the Elderly for Belfast Health & Social Care Trust. WTE: 1.0

General Provisions and Accountability Arrangements

2. You will be expected to work with management and professional colleagues in the efficient running of clinical services and will share with consultant colleagues in the medical contribution to management. You will be expected to make sure that there are adequate arrangements for hospital staff involved in the care of your patients to be able to contact you or another delegated consultant when necessary.

3. All medical and dental staff employed by Health and Social Care Trusts are expected to comply with the governance and assurance arrangements of the Trust. 4. The training and supervision of medical/dental students and junior medical/dental staff is an important aspect of most consultants’ jobs and should where appropriate be accommodated in your job plan. You may also be required to teach other

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members of the multidisciplinary team. Job Plan Review

5 This job plan is subject to review at least once a year by you and the Clinical/Associate Medical Director before being approved by the Service Group Director. For this purpose, a copy of the current job plan, (and job description if appropriate), including an up-to-date work programme, objectives agreed at annual appraisal and any notes provided by either side - of any new or proposed service or other developments need to be available. In the case of a new employee a review of the job plan will take place 3 months after commencement and annually thereafter as above. You can request a job plan review at any time if your workload changes.

6. If it is not possible to agree a job plan, either initially or at an annual review there are agreed procedures for facilitation and appeal with the final decision normally being accepted by the Trust Board.

7. Regional guidance on job planning is available and should be used to inform the process.

8. Job Purpose (including other NHS responsibilities as appropriate) Please set out the overall purpose and key functions of job

The Consultant Physician will be responsible for clinical leadership, alongside the clinical director, in moving forward these developments. The Consultant will ensure delivery of a high quality service to his/her patients in line with the Trust’s key strategic objectives. This will involve a close working relationship with consultant colleagues, managers, and other departments within the Trust, community staff and General Practitioners.

9. Objectives As above at 8.

Programmed activities (PAs) will be based on these objectives plus other duties, other HPSS responsibilities and the service to be provided for which you are responsible. An outline of activities against which PAs can be allocated and some general guidance is given in appendix 1 of this document. SPAs are divided between core and common SPAs. All consultants will receive 1.5 core SPAs for specified activities as outlined in appendix 1. Additional common SPAs will be by agreement between the consultant and his/her clinical manager and based on the objectives set out below. External duties will be considered within the job plan, either within PAs or through discretionary leave. Accepting external duties must be with the agreement of the service group. The onus will be on the consultant to

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demonstrate how the impact of an external duty, on direct clinical care, can be minimized.

9.1 Service Developments/Objectives

Outline service developments and key targets that you are committed to and will impact on your personal objectives and PAs.

Contribute to development of action plans for reduction in PA’s.

Continue to contribute to the development of services for older people, especially in relation to team & flexible working.

9.2 Personal Objectives

To support the development and delivery of holistic elderly care services in line with the strategic direction outlined above

Direct Patient Care

This post will be based primarily within the Elderly Care service on the BCH site. The appointee will take part in the on-call rota for Elderly Care.

The appointee will provide acute and rehabilitation care for patients, which may include work on other sites, including BCH or Musgrave Park Hospital

To deliver 1 outpatients clinic per week approximately 42 clinics over the year. To make all reasonable efforts to ensure that access targets in relation to outpatient and emergency care reforms and discharge targets are met, in particular:

Ensure that clinical ward rounds are scheduled to facilitate twice daily senior decision making and appropriate discharge of patients including supporting nurse facilitated discharge.

Ensure all your inpatients have a discharge-focused treatment plan within 24 hours of admission including an expected date of discharge.

To work proactively with patient flow teams to ensure effective bed utilisation. Actively engage in both simple and complex discharges.

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To meet Trust targets with regard to timeliness of discharge, clinic and results letters and response to complaints.

9.3 Team Objectives

To work with team members throughout the Belfast Trust to ensure continuity of care for patients within the service and agree activity objectives.

10. Education and teaching responsibilities

All consultants in the Belfast Trust are expected to undertake teaching arising in the course of clinical work. Additional teaching activities may be agreed as part of SPAs.

Undergraduate teaching for 3rd & final year students Supporting Professional Activity

To maintain skills and knowledge in geriatric medicine in line with the outcomes of the annual appraisal process.

You will undertake clinical management to assist in the development of services including unit and Trust activities both internal and external.

You will ensure research governance procedures are followed for research projects. 11. Research

NA - Research time will generally only be allocated within SPAs where there is an external funding stream to cover the costs and where trust governance procedures have been fully complied with.

12. Resources and Support required to meet job plan

12.1 Staffing Support

Appropriate secretarial support (0.5 wte) Junior medical staff

12.2 Any other required resources Office with PC

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Programmed Activities

13.1 The table below gives a breakdown of the total agreed PA’s on average per week and the agreed annualized PAs to due the nature of certain elements within the job plan.

Programmed Activity Number of PA’s per week Number of PAs annualised Direct Clinical Care 8.0 to include:

5.0 ward work 1.0 outpatients clinic 1.5 patient administration 0.5 clinical meetings Supporting Professional Activities -Core SPAs (Please list activities/responsibilities)

1.5 to include appraisal, audit, CPD, job planning Common SPAs (Please list activities/responsibilities) 0.5 to include teaching of undergraduates, service development University (joint appointments) Total SPAs 2.0 Total PAs 10.0 eekly Timetable

13.2 External duties/other NHS responsibilities NA – for job plan review

14. Weekly work schedule

The following example timetable indicates regular weekly commitments. It does not include activities that occur on an ad hoc basis. Ad hoc ward attendance to ensure continuity of care of patients and clinical administration time is included in your Direct Clinical Care (DCC) PA’s. The timetable does not include external duties unless timetabled in SPAs.

Day Time Work Activity Location PAs: PAs: Comment s (E.G. Agreed/

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DCC SPA Cancelled following Weekend On-Call) Monday 0900-1300 DCC BCH 1 1300-1700 DCC MPH 1 Tuesday 0900-1300 DCC BCH 1 1300-1700 DCC (Outpatients) MPH 1 Wednesday 0900-1300 DCC BCH 1 Thursday 0900-1300 SPA BCH 1 1300-1700 DCC RVH 1 Friday 0900-1300 SPA BCH 1 13.00–17.00 DCC BCH 1

Sat/Sun 08:00-14:00 DCC BCH/MPH 1 One in six

.

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15. Emergency Work

This section includesall of your prospective emergency on-call work and the agreedavailability for on-call.

Type Day/Time Location Allocated PA’s Predictable emergency on-call work As above Unpredictable emergency on-call work Out of hours cover On-site, at home on telephone and travelling to and from site

Time off in lieu

Agreed on-call rota 1 in 6 Agreed category A On-call supplement 5%

Statement of availability

As your agreed availability is category A when on-call you need to be available to be within 30 minutes travel time of the Trust to which you are on call.

16. Private Practice and Fee Paying Services TBC.

17. Programmed Activities

The above timetable represents a job plan totaling 10 PA’s per week for the period ….. This includes 0 PA’s above the normal expected commitment of 10 PA’s.

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22 | P a g e 18. Agreement

(to be completed and forwarded to Medical Director’s Office)

Signed: ……… Signed: ………

Consultant: ………. Clinical Director/

Associate Medical Director: ………. Date: ……….. Date: ………. Signed: ……… Signed: ……… Medical Director or Deputy: ………. Head of School: ………. Date: ……….. Date: ……….

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APPENDIX 1

PROGRAMMED ACTIVITES

Programmed activities (PAs) are linked in the job plan to each consultant’s service, personal and where appropriate, team objectives. They are

categorised as direct clinical care (DCC) and supporting professional activities (SPAs). For the purposes of job planning within the Belfast Trust the following guiding principles will be applied to ensure consistency across our service groups and sites.

DIRECT CLINICAL CARE (DCC)

DCC covers:-

 Emergency attendance  Out-patient or other clinic

 Operating session (including anesthetics)  Ward round

 Other patient treatment or relative consultation  Telephone advice to hospital

 Multidisciplinary meetings about direct clinical care  Investigative, diagnostic or laboratory work

 Public health duties

 Travelling time between sites, not to usual place of work  Patient administration

 Service Linked teaching (e.g. during ward rounds)  Clinics and operating sessions

 Clinical supervision

SUPPORTING PROFESSIONAL ACTIVITIES (SPA)

Core SPA - All consultants will be allocated 1.5 SPAs. Core SPA includes time for activities that will support re-licensing and recertification and ensure the quality and safety of services. These activities include:

 Appraisal  Job Planning

 Audit (attendance at audit meetings and general audit activity)  CPD

Core SPA also includes 2 hours (0.5 PA) to be used flexibly. The consultant and medical manager should agree appropriate use of this time, based on the consultant’s objectives, development needs and responsibilities. This needs to be defined and justified within the job plan.

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Appendix 1 continued

Common SPA

To be agreed on basis of both Trust and consultant’s requirements. Common SPA may include:-

 Clinical management (not directly affecting patient care)  Service maintenance and development

 Teaching responsibilities or specified roles

 Undertaking specific audit projects and / or audit responsibilities or lead roles/activities associated with clinical and social care governance.  Other trust duties

 Postgraduate training and supervisory responsibilities  Research

External duties (if small in quantity) may be accommodated in SPA time. If external duties are more substantial, either separate PA allocation or special leave should be used.

Research time will only be allocated within SPAs where there is an external funding stream to cover the costs and where trust governance procedures have been fully complied with.

The trust will expect that joint appointments meet their undergraduate teaching responsibilities from within their university time.

Discretionary leave will be considered for external duties, and must be agreed in advance with the clinical manager.

The consultant and the Trust should be flexible in order to minimise the impact of any external duty on DCC if possible. There is an obligation on all parties to ensure that the time required to undertake external duties is fairly allocated between consultants.

Figure

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References

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