Job Description

Role Title: Junior Clinical Fellow in Ophthalmology

Grade: MT03
Contract: Fixed Term Contract – Full Time
Responsible to: Professor Ahluwalia – Clinical Lead
Accountable to: Clinical Director of Surgery
Location: University Hospitals Coventry & Warwickshire NHS Trust

Key working relationships:

Our Vision, Values and Behaviours

At University Hospitals Coventry and Warwickshire (UHCW) NHS Trust our vision is to be a national
and international leader in healthcare, rooted in our communities. Our Organisational Strategy More
than a Hospital (2022-2030) was shaped by the views of our staff, patients and stakeholders and sets
a clear plan for improvements in healthcare.

We aim to deliver the best care for our communities, being exceptional in everything we do. We do
this by providing proactive, joined up support for local people and we deliver specialised services for
those with the most complex health conditions. We set out to create the best experiences for our staff
and work positively in partnership with other organisations to achieve the best healthcare outcomes.

Our vision and purpose are underpinned by a clear set of values that reflect the culture we
want to create: Compassion,Openness, Pride, Partnership, Improve, Learn and Respect.
Developed by our staff, our seven values guide what we do daily. Whatever our role or
level, we commit to uphold these values as we work together to deliver world class care.

Net Zero and Sustainability.

UHCW NHS Trust, by virtue of its Green Plan, is committed to ensuring that the way we provide
services minimises the impact on the environment and the future health of the public e.g. zero waste
to landfill, reducing our carbon footprint and increasing our recycling and reuse percentages.

Job Summary

To work as a Junior Clinical Fellow in the Ophthalmology Department working across a large multi-
disciplinary department providing outpatient, surgical and emergency services at University Hospitals
Coventry & Warwickshire and St Cross Hospital, Rugby.

UNIVERSITY HOSPITALS COVENTRY AND WARWICKSHIRE NHS TRUST

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Key Result Areas and Performance
As a valued member of the Ophthalmology Team, the post holder will be involved in a wide
range of sub specialism including;
• Outpatient Activity – Undertaking general, specialist, eye casualty clinics as directed on
your timetable
• EERS/Emergency Duties (Eye Emergency Referral Service) - Providing referral triage,
emergency and urgent diagnosis and treatment. Including liaison with senior medical
staff, either registrars, non-consultant career grade doctors or consultants regarding all
cases requiring admission or general anaesthesia. Assistance of senior medical staff with
emergency surgery. Provide cover for colleagues on leave as indicated in the duty rota. It
may be necessary to attend other hospitals in order to see patients on an emergency
basis. Performing duties during emergencies and in unforeseen circumstances at the
request of the appropriate consultant, consultation where practicable with colleagues both
senior and junior. As stressed by this Secretary of State, it has been agreed that they will
perform such duties with the understanding that additional commitments arising under this
subsection are exceptional.
• Theatre Activity – Provide support in theatres
• Ward Rounds - Attending ward rounds and examination of pre-and postoperative
patients. Ward duties to cover leave and provide continuity of care.
• On-Call – Depending on your rota you may be included in the on-call rota. It’s a basic 40
hour week, on call commitments are offered based on experience and departmental need.
Speciality doctors participate in the first or second on-call rota based on experience and
availability. The rota is 1:8 or 1:9 with prospective cover. The post is non-resident on call
and the working pattern is defined as "on call rota". When on weekend call, the Specialty
doctor on duty will attend the ophthalmic unit each morning to participate in the ward
round and attend eye casualty.

The person for this role will be able to:

• Form effective relationships with staff and external colleagues
• Be flexible and able to adapt to different situations
• Be self-motivated and able to organise own workload
• Be confident and self-assured in delivering ophthalmology services
• Relate to patients / relatives in an understanding and sympathetic manner.

As part of our commitment to patients and delivery of a world class service for all we have
created the UHCW Improvement (UHCWi) System in partnership with the Virginia Mason
Institute in Seattle; this involves a structured approach to removing waste and putting the
patient first using a lean management system and methodologies. Our culture and ways of
working reflect and embed the practices and methodologies of UHCWi. You are expected,
where identified, to attend and complete relevant training and development opportunities to
support this. This may include Lean for Leaders, Advanced Lean Training, and the Human
Factors Programme, amongst others. Full attendance and completion of identified courses is
considered essential and a pre-requisite for this post.

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Departmental Staffing Structure

Management Structure

Ophthalmology Services fall within the Surgical Services Group.

Clinical Director Surgical Services Mr Nick Matharu

Clinical Lead Ophthalmology Professor Harpreet Ahluwalia

Group Manager Ophthalmology Services Sarah Roddis

The Eye Unit at University Hospital in Coventry is a purpose-built ophthalmic unit within the hospital,
which provides integrated ophthalmology services for the whole of Coventry & Warwickshire.

There is a dedicated ophthalmic day unit which can accommodate up to 15 patients at any one time.
Paediatric ophthalmic cases are also accommodated on one of the three age dependent paediatric
wards.

The two dedicated ophthalmic theatres have ceiling mounted Leica microscopes, with video camera
attachments. There are two Alcon Infinity phaco and one centurion phaco machine (with advanced
settings particular relevant to glaucoma cases) and one theatre is equipped for vitreo-retinal surgery,
with Alcon Constellation phaco/vitrector and indirect argon and diode laser. There is also an indirect
video camera for teaching purposes. All theatre lists are supported by an ophthalmic trained
anaesthetist.

The department of ophthalmology also provides ophthalmic services at Rugby St Cross in the
general outpatient area and a dedicated macular unit. Day case theatre facilities are also available at
the hospital for adult cataract surgery with similar UH specifications, with plans to expand ophthalmic
theatre services there in the near future.

All offices and clinic areas have access to the Trust network and Intranet, with most rooms hosting
floating licenses to view eye images stored on the network (Visupac and Spectralis).

Clinics

The Eye Unit has a large outpatient department, with up-to-date facilities at both sites, the University
Hospital in Coventry, and the Hospital of St. Cross in Rugby.

Coventry

Each of the consulting rooms is equipped with a slit-lamp and indirect ophthalmoscope. Most of the
rooms have a reclinable chair to facilitate indirect ophthalmoscopy. Portable slit lamp and tonometer
are also available on both sites.

There are three Humphrey field analysers in the department that feed into a single server to allow
progression analysis on any machine. Two Goldmann perimeters are also used for those patients
that are unsuitable for automated perimetry. Two additional Octopus machines with the facility for
automated Goldmann perimetry are due to be purchased in the near future. The visual field service is
run by orthoptic and nursing staff.

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Disc photography is also available via the ophthalmic imaging department and a dedicated glaucoma
OCT machine has been recently commissioned. Training is currently in progress for all ophthalmic
technicians and glaucoma nursing staff to perform disc OCT imaging on demand.

Anterior segment imaging is provided at present through the ultrasound clinic and anterior segment
OCT.

The medical retina suite is equipped with 2 Zeiss FF450 fundus digital cameras connected via
Visupac to 6 viewing stations. Two Ocular Ultrasound, one of which with UBM (Optikon), Stratus and
Cirrus OCT, Heidelberg retinal angiography for fluorescein and indocyanine green angiography and
fundus autofluorescence (SLO) are also available to aid diagnosis. One Staurenghi system for wide-
field fluorescein angiography and indocyanine angiography is available. Anterior segment OCT is
also available on our recently installed Spectralis.

The unit has latest PASCAL laser machine, dual action YAG, with the facility to perform SLT, Argon,
Diode, a multi-wavelength laser as well as a Quantel PDT laser.

St Cross Rugby

Ophthalmic clinics take place in the general outpatient area. Each room is equipped with a slitlamp,
with a portable slit lamp, indirect ophthalmoscope and pachymeter which is shared as required. The
glaucoma clinic is also supported by disc photography and OCT provided by the macular unit.

The Macular Unit at the Hospital of St. Cross, Rugby was opened in January 2011. It provides almost
200m2 floor area in addition to the existing outpatient facilities to accommodate the expanding
imaging needs of medical retina and the treatment rooms required to deliver intraocular injections
and minor operations. The Macular Unit also provides office space hosting the AMD/anti-VEGF
coordinators and research activities.

All clinic rooms are equipped with double high-resolution monitors to facilitate review of images and
data from multiple software packages.

There is also a conference room with large plasma screen and two PCs with double high-resolution
monitors for tutorials, case discussions and review of records in virtual settings.

Ophthalmology Service Staff

The department is staffed by 16 consultants each with complimentary areas of sub-specialisation.

GRADE NAME Special Interest

Consultant Professor H Ahluwalia Clinical Service Lead

Oculoplastics – Lids and Lacrimal

Consultant Mrs P Mehta Oculoplastics – Lids

Consultant Miss R Lee Vitreo – retinal surgery and EERS Lead

Consultant Mr D Park Vitreo-retinal surgery

Consultant Mr M Rana Complex Cataract, Cornea and External Eye Disease,

Ocular Surface Inflammation

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 Consultant VACANT Cornea and External Eye Disease

Consultant VACANT Medical retina

Consultant Mrs P Kulkarni Medical retina and Uveitis

Consultant Mr S Pagliarini Medical retina and Uveitis

Consultant Mr. NP Manjunatha Medical Retina and Diabetes

Consultant Miss Arambage (Locum) Glaucoma

Consultant Mr A Bansal Glaucoma and Cataract Lead

Consultant Mr M Otri Glaucoma

Consultant Ms S Turner Glaucoma

Consultant Mr J William Paediatric Ophthalmology and Strabismus

Consultant Ms S Kasbekar Paediatric Ophthalmology and Adult Strabismus

Non-Consultant Career Grades and Doctors in Training

Two junior (ST1-2) and five senior specialist trainees (ST3-6) rotate to Coventry on a six-monthly
basis and an 8th senior trainee (ST6/7) receives advanced sub-speciality training in oculoplastics
(TSC) on an annual basis, as part of the HEE, West Midlands.

In addition, there are 15 specialist doctors.

Contractual Responsibilities

Clinical Governance: Everyone is expected to participate in all aspects of clinical governance.

Clinical audit is an established facet of the hospital. The appointee is required to participate actively.
The post holder will ensure that all services are provided in an effective and efficient manner and that
the principles of risk management and clinical governance are maintained at all times.
Teaching:

• Confidentiality: The post holder must maintain confidentiality, security and integrity of
information relating to patients, staff and other Health Services business. In the discharge of
your duties, you may often be in possession of confidential/personal information. You must
not disclose or discuss such information outside your place of work, or within your place of
work except in the proper discharge of your duties. Failure to observe confidentiality may
result in disciplinary action.
• Health and Safety: All staff must be familiar with the Trust Health and Safety Policy,
including a thorough understanding of personal responsibilities for maintaining own health
and safety and others.
• Risk Management: All staff need a basic working knowledge of risk management to enable
them to participate in identification and control of all business risks they encounter in their
area of work.

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 • Equality and Diversity: Everyone has the opportunity to be treated with dignity and respect
at work and has a clear responsibility to comply with the detail and the spirit of the Dignity at
Work Policy.
• Infection Control and Prevention: The Trust is committed to minimising risks of healthcare
associated infection to patients, visitors and staff. All employees are required to be familiar
with and comply with Infection Prevention and Control policies relevant to their area of work.
• Safeguarding Vulnerable Adults and Children: The Trust is committed to ensuring the
safeguarding of vulnerable adults and children in our care. All employees are required to be
familiar with their responsibilities in this area and to raise any concerns as appropriate.
• Conflict of Interest: The Trust is responsible for ensuring that the service provided for
patients in its care meets the highest possible standard. Equally, the Trust is responsible for
ensuring that staff do not abuse their official position for personal gain or to benefit their family
or friends. The Trust’s Standing Financial Instructions require any officer to declare any
interest, direct or indirect, with contract involving the Trust. Staff are not allowed to further
their private interests in the course of their NHS duties.
• Working Time Regulations: The Working Time Regulations 1998 require that you should
not work more than an average of 48 hours in each working week. For example, in a 26-week
period you should work no more than 1,248 hours. Employees may choose to opt out by
providing written notification as appropriate.

The post holder will be appointed by the University Hospitals Coventry and Warwickshire NHS Trust.
Terms and Conditions will be in accordance with nationally agreed conditions of service for Hospital
Medical and Dental Staff and Doctors in Public Health Medicine and the Community Health Service
in the National Health Service as approved by the Secretary of State for health and amended from
time to time.

The post holder is required to act in accordance with local policies agreed by the Trust and the Local
Negotiating Committee.

The above duties and responsibilities are intended to represent current priorities and are not
meant to be an exhaustive list. The post holder may from time to time be asked to undertake
other reasonable duties and responsibilities. Any changes will be made in discussion with
the post holder according to service needs.

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 Person Specification

Job Title: Junior Clinical Fellow

Supporting Evidence
In the supporting evidence of your application form, you must demonstrate your experiences by
giving specific examples for the criteria within the person specification.

Factors Essential Desirable

Qualifications • Full GMC Registration (with a ‘Licence to • FRCOphth or equivalent
Practise’) by examination.

Experience
Three satisfactory references • Extensive UK experience
• Extensive UK experience in ophthalmology
• Development through the audit process • Experience of service
• Completed the foundation training development
programme or equivalent • Evidence of involvement
• Ideal for those seeking ST1-ST3 training with research
post • Foundation training in
ophthalmology

Knowledge • Commitment to continuing professional • Refraction certificate

development and Ophthalmology • FRCOphth final written or
full

Skills
• Ability to work well with colleagues and to • Ability to run clinical
relate to patients / relatives in an sessions under
understanding and sympathetic manner supervision
• Audit and research skills
• Good communication skills
• Good organisational skills
• Ability to organise and participate in
training and teaching

• Underpinned by the GMC‘ Good Medical • Ability to work in a large

Personal Practice team
Qualities • Commitment to own continuing education
and professional development

Commitment to • Must be able to demonstrate behaviours

Trust Values consistent with the Trust’s values.
and Behaviours (As detailed in UHCW’s Values in Action
document below)

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Contractual Responsibilities

• Confidentiality: The post holder must maintain confidentiality, security and integrity of
information relating to patients, staff and other Health Services business.
• Health and Safety: All staff must be familiar with the Trust Health and Safety Policy,
including a thorough understanding of personal responsibilities for maintaining own health
and safety and others.
• Risk Management: All staff need a basic working knowledge of risk management to enable
them to participate in identification and control of all business risks they encounter in their
area of work.
• Equality and Diversity: Everyone has the opportunity to be treated with dignity and respect
at work and has a clear responsibility to comply with the detail and the spirit of the Dignity at
Work Policy.
• Infection Control and Prevention: The Trust is committed to minimising risks of healthcare
associated infection to patients, visitors and staff. All employees are required to be familiar
with and comply with Infection Prevention and Control policies relevant to their area of work.
• Safeguarding Vulnerable Adults and Children: The Trust is committed to ensuring the
safeguarding of vulnerable adults and children in our care. All employees are required to be
familiar with their responsibilities in this area and to raise any concerns as appropriate.
• Conflict of Interest: The Trust is responsible for ensuring that the service provided for
patients in its care meets the highest possible standard. Equally, the Trust is responsible for
ensuring that staff do not abuse their official position for personal gain or to benefit their family
or friends. The Trust’s Standing Financial Instructions require any officer to declare any
interest, direct or indirect, with contract involving the Trust. Staff are not allowed to further
their private interests in the course of their NHS duties.
• Working Time Regulations: The Working Time Regulations 1998 require that you should
not work more than an average of 48 hours in each working week. For example, in a 26 week
period you should work no more than 1,248 hours. Employees may choose to opt out by
providing written notification as appropriate.

The above duties and responsibilities are intended to represent current priorities and
are not meant to be an exhaustive list. The post holder may from time to time be asked
to undertake other reasonable duties and responsibilities. Any changes will be made
in discussion with the post holder according to service needs.

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Our values in action
We live our values in action in our work with patients, visitors and colleagues.

✓ Being polite and introducing ourselves to everyone we meet.

✓ Treating everybody as individuals and respecting their needs.
✓ Being approachable, caring and helpful at all times.
✓ Communicating with patients, visitors and colleagues, respecting confidentiality and privacy.
✓ Taking the time to actively listen and understand individual needs.
✓ Being open and honest.
✓ Acknowledging that we don’t always get it right.
✓ Speaking out when we see things aren’t right and supporting others to do the same.
✓ Giving praise and saying thank you for a job well done.
✓ Celebrating and recognising personal, team and organisational achievements.
✓ Using the skills, experience and diversity of staff to better deliver our objectives and services.
✓ Actively working with patients and visitors to improve services.
✓ Seeking and adopting best practice from colleagues and other teams within UHCW.
✓ Taking personal responsibility for our own learning.
✓ Keeping up-to-date with mandatory and professional development
✓ Developing ourselves and others, independent of our job role or profession
✓ Taking personal responsibility to make improvements by suggesting new ways of doing things
✓ Taking opportunities to learn with and from others
✓ Embracing change and supporting others through it
✓ Putting in place ways to receive feedback and acting to change things
✓ Seeking and adopting best practice from colleagues and other teams within UHCW
✓ Working across boundaries to improve the experience of patients, visitors and colleagues

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