JOB DESCRIPTION

Job Title: Locally Employed Doctor at F2/Core Trainee Level (Rotational) x 16

Specialty: Rotational posts available in the following Specialties:

Acute Medicine
Diabetes
Emergency Medicine
Gastroenterology
Geriatric Medicine
Respiratory
Stroke Medicine (Wycombe Hospital)
Each post will rotate between 2 specialties. 6 months will be spent in each specialty.

Dates of post: Fixed term for 12 months from 07 August 2019 – 04 August 2020

Base: Stoke Mandeville Hospital / Wycombe Hospital

Remuneration (Salary Scale): MN15 £29,213 - £33,034 (Depending on experience)

MN39 £31,217 - £41,300 (Depending on experience)

Full Time / Part Time: Full time

Standard Hours: 40

Banding:
Acute Medicine – 1B 40%
Diabetes – 1B 40%
Emergency Medicine – 1A 50%
Gastroenterology – 1B 40%
Geriatric Medicine – 1B 40%
Respiratory – 1B 40%
Stroke Medicine – 1B 40%

Managerial Accountability & Professional Accountability: Clinical Supervisor, SDU Lead

Study Leave Arrangements: At least 6 weeks’ notice and must fit in with arrangements for
cross cover

Annual Leave Arrangements: Six weeks’ notice of annual leave must be given.

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THIS POST IS GOVERNED BY THE MEDICAL AND DENTAL TERMS AND CONDITIONS OF
SERVICE

MAIN PURPOSE OF THE POST

This post commences on the 07 August 2019 and is for a period of 12 months with 6 months
working in 2 different specialties.

RESPONSIBILITITES

Acute Medicine
The post holder will be part of the junior doctor team of the Acute Care Hub.

The commitments will consist of daily ward rounds and inpatient care within the Acute
Medical Unit (AMU) and Short stay ward (SSW). The SSW and AMU are run by the Acute
Care Physician (ACP) Mon-Fri and Bank holidays and a Specialty Physician or ACP at the
weekend. The SSW is also supported by a FY1 who rotate on a weekly basis and a FY2 over
the weekend and are in addition to the on-call team.

The post holder will also be required to support the consultant led Ambulatory Emergency
Care Unit (AECU). This is a great opportunity to treat medical emergency patients in an
outpatient setting. The role will include virtual ward rounds, clerking and treating patients
including follow ups. There will be a close interaction with the nursing staff in AECU.

Workload will be shared amongst the junior team who are distributed within the Acute Care
Hub in a departmental junior rotation.

The post holder will be expected to prioritise and time-manage effectively according to the
activity of the department and to utilise appropriately the available senior staff for advice.

The post holder will take part in the medical on call rota to support the acute medical take,
working with the Medical Registrars, FY1 and Physician of the Day (POD).

Other responsibilities
 To have regular meetings with the Educational Supervisor and have a yearly appraisal
 To follow Trust guidelines and pathways
 To actively participate in departmental teaching
 To reflect on clinical practice and use the e portfolio to demonstrate learning and
progress
Administration and Management
The successful candidates are expected to help with the smooth running of the team and
with the setting up of regular audit & clinical governance work.
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Diabetes/Endocrinology
The post holder will be part of a team of juniors looking after the diabetes/endocrinology
wards. The 2 wards have patients with GIM conditions as well as specialist diabetic and
endocrine problems.

This post is an opportunity to gain experience in GIM but also to gain some specialist
knowledge in management of diabetes emergencies and chronic diabetes complications as
well as common endocrine problems seen in inpatients.

The post holder will take part in the medical on call rota to support the acute medical take,
working with the Medical Registrars, FY1 and Physician of the Day (POD).

Emergency Medicine
The Emergency Department (ED) is at the centre of the acute work of all Trusts. EM
specialists are responsible for assessing and resuscitating patients with serious illness and
injuries before their transfer to hospital wards or operating theatres. Other patients are
assessed, treated and sent home for follow up and ongoing care with their General
Practitioner.

The post holder will work as part of the junior tier (FY2/CT1 / CT2 level) and will take part in
a full shift rota pattern. The pattern of work is compliant with the European Working Time
Directive and will be compliant with 2016 Junior Doctors Contract. There is a middle grade
doctor on the shop-floor throughout the 24 hour period and consultant presence 16 hours a
day. The post holder will be expected to work as an integral part of a multidisciplinary team
providing direct clinical care.

Typical duties may include:

i. Resuscitation and initial management of emergency cases in a team.
ii. Management of other patients presenting to the ED
iii. Admission of patients to inpatient teams for further management.
iv. Admission of patients to the AOU, their ongoing management, discharge and referral
when necessary.

We are expanding the number of junior doctors in the department and also working towards
making a new and attractive rota with inbuilt time to pursue any special interests/audit.
There are opportunities to be involved in research projects, learn point of care ultrasound
skills, involve in organising different courses.
The post holder will be expected to prioritise and time-manage effectively according to the
activity of the department and to utilise appropriately the available senior staff for advice.

Gastroenterology
The post holder will be in a team responsible for ward care of gastroenterology and general
medical admissions and work with a team of consultant, ST3+, CT, FY2 & FY1 doctors. The
post holder will attend daily consultant ward rounds and may also have the opportunity to
attend outpatients according to the timetable. The post holder will be expected to take part
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in the ward work of seeing patients, organising investigations, discharge planning and
working with the MDT team. The job is well supported and has excellent feedback.

The post holder will participate on the acute medical on call rota working under the
supervision of the Physician of the Day (POD).

The post can be flexible to the needs of the post holder according to their current level and
can be aimed at different levels of competency above FY1. It would also be suitable for those
seeking further experience in gastroenterology prior to application to specialist training.

Geriatric Medicine
The post holder will be responsible for ward care of acute elderly medical admissions and
work with a team of SpR, CT, GPVTS, FY2 & FY1 doctors. The post holder will attend
Consultant ward rounds and may have the opportunity to attend the Outpatient Department
according to the timetable.

Every doctor has a responsibility for safe and effective handover, when they complete a
period of duty, and the care of their patients is transferred to another colleague or team.
Record keeping in the case of clinical case notes should be comprehensive and clear, with
decisions and care plans recorded.

Daily Commitments will include daily ward round of inpatients, mainly Elderly Care plus a
proportion of GIM patients with junior teams and Consultant supervision. On call will be part
of the general medicine rota.

Respiratory Medicine
The post holder will be in a well organised, consultant led team responsible for ward care of
acute respiratory and general medical admissions and work with a team of consultant, ST3+,
CT, FY2 & FY1 doctors on each of the 2 respiratory wards.

The post can be flexible to the needs of the post holder according to current level and can be
aimed at different levels of competency above FY1, and this will be confirmed with a
designated clinical supervisor to guide you to the best use of your six months. It is suitable
for those seeking FY2 experience, as well as those seeking further respiratory or medicine
experience at FY3 prior to application to GPVTS or CMT; or a CMT doctor looking for more
experience in respiratory medicine prior to application to specialist training. We have 2
former programme directors and college tutors in our department and trained educational
supervisors, and interviewers. We can give career advice for IMT and registrar applications if
requested.

We can offer extensive opportunities for teaching and feedback, audit or QiP.
There are opportunities for presentations which are well supported by the registrars and
consultants to develop your teaching and add to your CV.

The post holder will be expected supervise and informal teach the FY1 and medical students
in the department. The post holder will take part in mortality reviews, and teaching
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presentations as part of their experience.

The respiratory department works well together as a mega firm and runs 2 wards, with a
consultant and team for each. The consultants change every 2 weeks, and run 4 ward rounds
a week. The 5th day is run by a registrar or CMT doctor supported by the consultant. Senior
supervision and trainee development are our aim for the ward. The post holder will attend
morning Consultant ward rounds. The post holder will be expected to take part in the ward
work of seeing patients with support, investigations, discharge planning and working with
the MDT team. The job is well supported. The post holder will be on the acute medical
rota. There are respiratory XR meetings, morbidity meetings weekly. The consultants take
part in clinics, bronchoscopy lists, pleural lists and management meetings and the post
holder according to their needs, will be able to sample these. The respiratory department
has an excellent feedback from junior doctors for teaching and training.

There is teaching in GIM and respiratory on ward rounds, and in respiratory departmental
teaching and XR meetings. There is also the opportunity to perform pleural procedures
under supervision for those interested as well as learning about NIV and Hi flo oxygen.
Simulation teaching is also available. The post holder can join FY2 teaching or CMT teaching
depending on their level with discussion from their supervisor.

Stroke Medicine
At Buckinghamshire Healthcare NHS Trust the Stroke and Cardiology services are based in
Wycombe Hospital. There are two Stroke wards at Wycombe, with one 18-bedded ward
including 12 Hyperacute Stroke Unit (HASU) beds, and an adjacent 23-bedded Rehabilitation
Stroke Unit. The Stroke service at Wycombe Hospital admits about 1400 patients annually,
with approximately 850 confirmed stroke patients and 550 patients with conditions
mimicking stroke. This makes it the largest Stroke Unit in Thames Valley. It performs very
well in the Royal College of Physicians SSNAP audit (Stroke Sentinel National Audit
Programme), and consistently achieves an A rating, a level only achieved by about 20% of
sites nationally.

The doctor in this post will join the current juniors already based in Stroke and Cardiology at
Wycombe: 6 posts at SpR level (2 in stroke), 11 posts at FY2/IMT/GPVTS level (7 in stroke),
and 8 at FY1 level (4 in stroke). They will be based on the Acute and Rehabilitation Stroke
Unit, and spend week-long blocks of time on both the 12-bedded Hyperacute Stroke Unit
(HASU) and the Cardiac and Stroke Receiving Unit (CSRU). On the CSRU the duties will be to
clerk and admit patients with neurological or cardiological problems, supported by a
registrar and by on-call Stroke Physicians / Neurologists and Cardiologists. The working week
will be Monday to Friday from 9am- 5pm with an on-call team taking over at 5pm. On the
HASU the week will also be Monday to Friday, and will vary between 8am-4pm and 10am-
6pm. The appointee will be directly supervised by the Stroke Physician On-Call when on the
HASU. The post involves weekend working on the HASU on a 1 in 5 basis from 9am-6pm
Saturday and Sunday, but does not involve any evening or overnight working.

The successful applicant will have a Clinical Supervisor and an Educational Supervisor, with
access to the Health Education England electronic portfolio. It is possible for the post holder
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to have Foundation competencies signed off to enable application to Core training
programmes, and previous post-holders have achieved this. There is active departmental
teaching as well as teaching within established trust-wide programmes. We also encourage
doctors to take part in departmental Quality Improvement Projects (QIPs), and previous
post-holders on the unit have achieved poster presentations through such projects.

Other Information

The posts may also involve simulation training, medical student teaching and feedback, the
opportunity to join in FY2/CMT training days, management, education or the opportunity to
gain a certificate in a certain area of practice if individual candidates are interested.

GMC Training can be provided for those candidates that are new to the NHS.

Visiting the Department

Arrangements can be made by contacting:

Acute Medicine
Dr. Tina O’Hara, Consultant and SDU lead for Acute Medicine via
tina.ohara@nhs.net or tel. no. 01296-315490

Diabetes
Dr. Henrietta Brain, Consultant and SDU Lead for Diabetes via
henrietta.brain@nhs.net or tel. no. 01494-526161

Emergency Medicine
Dr. Monojit Choudhury, Consultant and SDU Lead for Emergency Medicine via
Monojit.choudhury1@nhs.net or tel. no. 01296-316514

Gastroenterology
Dr. Emily Johns, Consultant and SDU Lead for Gastroenterology via
emily.johns@nhs.net or tel. no. 01494-425267

Geriatric Medicine
Dr. Chi Yau, Consultant in Geriatric Medicine via
chi.yau@nhs.net or tel. no. 01296-316540

Respiratory Medicine
Dr Charlotte Campbell, Consultant and SDU Lead for Respiratory via
Charlotte.campbell2@nhs.net or tel. no. 01296 31 5572

Stroke Medicine
Dr. Amulya Misra, Consultant in Stroke Medicine via
amulya.misra@nhs.net or tel. no. 01494-426311

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All doctors are expected to attend the Trust induction programme at the beginning of their
post.

Audit
All doctors will be expected to participate in clinical audits including audits of clinical record
keeping. Help will be given to candidates according to their needs to enable them to make
the most of quality improvement projects and add to their CV

Hospital at Night
The Trust operates a Hospital at night team system. Doctors are expected to participate in
this where applicable and to observe the Responsibilities/Code of Conduct that applies to
members of the team.

Education
The directorate runs a formal teaching programme. In addition, lunchtime teaching is also
available (journal club, registrar-led teaching, Rheumatology, Cardiology). All doctors are
encouraged to contribute to the teaching programme.

You will be allocated a clinical supervisor for your time and will set personal development
plans with your supervisor. Career advice and advice regarding application to jobs and
interview practice can also be arranged

The Trust has a reputation for teaching and training excellence in medical education.

The Trust has a strong partnership with Oxford clinical school and a number of other medical
schools, and provides teaching attachments for clinical students in a range of specialties.
Consultants who contribute substantially to teaching students are eligible for an honorary
senior clinical lectureship. Further expansion in student numbers, with development of a
faculty model for delivering undergraduate education, is planned.

There are modern, well-equipped education centres and libraries on all three sites with an
active programme of continuing education for senior medical staff, training grade doctors
and general practitioners. The education centres are fully equipped with lecture theatres,
seminar rooms and state of the art audiovisual equipment.

The Libraries are housed within the education centres and are accessible 24 hours a day
providing access to many healthcare databases and access to over 1000 journals in
electronic full text that can be accessed at work or at home from any computer with internet
connection.

Each directorate undertakes monthly academic, audit and governance meetings, which are
multidisciplinary and involve staff from other sites. Routine clinical commitments are usually
cancelled to enable all staff to fully participate

References & Health Screening

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Any offer of appointment will be subject to the receipt of three satisfactory references (one
most recent employer at time of interview) and a health interview.

Conflict of Interest
The Trust is responsible for the service to the patients in its care and to meet the highest
standards. Equally, it is responsible for ensuring that staff do not abuse their official position
for personal gain or for the benefit their family or friends.

Car Parking
On site parking is available in designated areas on all three sites with applications available
through the Estates Department.

Accommodation
Both single and married accommodation may be available on site and a limited amount of
married accommodation may be available off site.

ADDITIONAL INFORMATION

Trust Values

Health and Safety at Work Act

The post holder is required to take responsible care for the health and safety of him/herself
and other persons who may be affected by his/her acts or omissions at work. The post
holder is also required to co-operate with Buckinghamshire Healthcare NHS Trust to ensure
that statutory and departmental safety regulations are adhered to.

Rehabilitation of Offenders Act

Because of the nature of the work for which you are applying, this post is exempt from the
provisions of Section 4 (2) of the Rehabilitation of Offenders Act 1974 by virtue of the
Rehabilitation of Offenders Act 1974 (Exception) Order 19. Applicants are therefore not
entitled to withhold information about convictions, which for other purposes are ‘spent’
under the provision of the Act, and, in the event of employment, any failure to disclose such
convictions could result in the dismissal or disciplinary action by the Trust. Any information
given will be completely confidential and will be considered only in relation to an application
for positions to which the Order applies.

[For relevant posts - Within the terms of DHSS Circular (HC)(88) – Protection of Children –
applicants are required when applying for this post to disclose any record of convictions,
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bind-over orders or cautions. The Trust is committed to carefully screening all applicants
who will work with children and you will be expected to undertake a 'disclosure' check.]

Confidentiality
The post holder has a responsibility to maintain confidentiality and ensure the principles of
the Data Protection Act 1998, the Confidentiality: NHS Code of Practice and Trust policy on
confidentiality and Data Protection are applied to patient, staff and Trust
business/information.

Equal Opportunities
The Trust welcomes all persons without regard to age, ethnic, or national origin, gender or
sexual orientation, religion, lifestyle, presenting illness, marital or parental status or
disability. We aim to provide a non-judgemental service at all times.

Managing Risk: Maintaining skills and learning from problems

Reducing risk is everyone's responsibility. All staff in the Trust must attend training identified
by their manager, or stated by the Trust to be mandatory. The Trust uses risk assessments
to predict and control risk and the incident reporting system to learn from mistakes and near
misses and so improve services for patients and staff. All staff are expected to become
familiar with these systems and use them The Trust has designated the prevention and
control of infection as a core issue in the organisation's clinical governance, managing risk
and patient safety programmes. In consequence, all employees are expected to:-

i) Follow consistently high standards of infection control practice, especially with

reference to hand hygiene and aseptic techniques,
ii) Be aware of all Trust infection control guidelines and procedures relevant to their
work.

Safeguarding of Children and Vulnerable Adults

During your employment with the Trust, you have a responsibility to safeguard children and
vulnerable adults. You are required to complete statutory and mandatory training and take
appropriate action as set out in the Trust’s policies and procedures.

Governance
Post holders will aim to ensure that areas of the trust under their responsibility comply with
“Standards for Better Health” Core and Developmental Standards and bring deficiencies to
the attention of their Director”

Information Management/ Data Quality

The post holder must ensure that Trust records are documented, secured, stored and
disposed of appropriately and in accordance with the Records Management: NHS Code of
Practice and Trust policy. In addition, information recorded must be fit for purpose -
accurate, relevant, up to date and complete.

Freedom of Information
The post holder must be aware that any information held by the Trust in theory could be
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requested by the public, including emails and minutes of meetings. It is therefore essential
that records are accurately recorded and maintained in accordance with the Trust's policies.

Travel to other sites

You may be required to travel to other Trust locations. Please complete travel expense using
the online system. Details of allowances can be obtained from the Human Resources
Department.

Smoking statement
Smoking is not permitted in any premises or grounds managed, leased or owned by the
Trust. Smoking is not permitted in Trust vehicles or in any vehicle parked on Trust premises.

General
The duties outlined above are not intended as a restrictive list and may be extended or
altered to include other tasks that are commensurate with the grade. Should you have any
queries or concerns relating to the contents of this letter, please contact the Medical HR
Department, Wycombe Hospital, Queen Alexandra Road, High Wycombe, Bucks, HP11 2TT.

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