Specialty Grade Doctor in Palliative Medicine

Job responsibilities

The Hospice opened in 1989 and provides a full range of specialist palliative care services to Ipswich and East Suffolk area and extends into Waveney and parts of Norfolk. The hospice operates 6 specialist palliative care beds within Beccles Hospital, a 24 hour SPC advice line, a Community Clinical Nurse Specialist service, specialist Day Services and an in-reach hospital advisory service to James Paget University Hospital. There are 18 beds in Ipswich, a specialist palliative care day centre, outpatient clinics, a 24 hour community service (provided by specialist nurses) and an education centre and library. The consultants at St Nicholas Hospice (Bury St Edmunds) and St Elizabeth Hospice (Ipswich) work collaboratively together and share a second on-call consultant rota. The medical team in Ipswich provide on call cover for the 18 beds in Ipswich

There is a full multi-professional team including an Emotional Wellbeing Team, Occupational Therapists, Physiotherapists, and Spiritual Care, with Art and Music Therapists and Complementary Therapists based at Ipswich.

The hospice has been a regional leader in developing services for Young Adult Care and Transition. Working closely with the local childrens hospice, the Young Adult Care team proactively support those who are transitioning into adult services or who develop progressive illness at a young age. Services offered include short break respite care, peer support events to support social needs, carer support, cross site multidisciplinary clinics as well as clinical reviews. These services continue to evolve as part of the hospices wider strategic objectives to reduce inequalities and widen access to care.

The Hospice has a Chief Executive and a Senior Leadership Team which includes the Medical Director (Dr A Blaken), Director of Care, Director of Income Generation and Chief Operating Officer. There are six Consultants in Palliative Medicine posts - one is currently filled by the Medical Director (the others are Dr C Wright, Dr C Bates, Dr A Hensley, Dr J Zeppetella, Dr J Sawyer,). Across the two sites there are two Specialty Registrars on the East of England Palliative Medicine Specialty Training Scheme. There are also 4 middle grade doctors (including this post) providing support to both the IPUs as well as the outpatient clinical areas. There are six GP vocational training scheme doctors on attachment rotating with other specialties and two Foundation Year doctors. There are three Nurse Consultants, one of whom provides clinical and service development support for Great Yarmouth and Waveney services.

There are close links with Ipswich Hospital as part of East Suffolk and North East Essex Foundation Trust with a Hospice Consultant working at Ipswich Hospital a day a week. Direct support to Ipswich Hospital is not a part of this post.

James Paget University Hospitals NHS Foundation Trust

The James Paget Hospital is part of James Paget University Hospitals NHS Foundation Trust and provides care to a population of approximately 230,000 residents across Great Yarmouth, Lowestoft and Waveney. The main site is in Gorleston and the Hospital formed a Foundation trust in 2006.

The Trust provides a full range of general acute services and works collaboratively with a number of local primary care colleagues, community services and other acute trusts, to ensure that patients receive the best care in the right place. The Trust has approximately 500 inpatient beds located on the James Paget Hospital site. These are a mix of critical, intensive and high dependency care, general surgery and medicine, maternity, paediatrics and neonatal, and escalation beds used when experiencing high demand. They employ over 3,000 staff, both part and full time, making them the largest local employer in the area. As a University Hospital, the Trust trains over one third of the medical students from the University of East Anglia and has a strong national reputation for research and excellence in the quality of training facilities.

Specialist Palliative Care input to the Hospital is currently 9-5, at least 5 days a week with face to face visits Monday to Friday and is run jointly with the community service with the aim of optimising continuity as much as possible and to provide robust service provision across clinical areas. The new service will continue with the joint service model whilst providing palliative medicine consultant input to support clinical services, education and service development. The Hospital Team currently assesses approximately 150 patients a month. Clinical Nurse Specialist numbers are detailed in the community section below.

East Coast Community Healthcare CIC (ECCH)

ECCH is a staff owned Social Enterprise, providing community based NHS and social care in Norfolk & Suffolk with at least 70,000 people registered as service users. In addition to providing adult community services for the Great Yarmouth and Waveney area, ECCH run the Beccles Hospital. ECCH hold the contract for local community services of which the specialist palliative care service provision provided by St Elizabeth Hospice is a component.

Beccles Hospital

Beccles Hospital is an intermediate care unit with in-patient facilities for those requiring medical care or therapy that do not require acute care in a general hospital. The ward is staffed by registered nurses, health care assistants, therapists and with regular support from Beccles Health centre GPs (weekdays) to the non specialist beds.

The six specialist palliative care beds for GYW are situated in Beccles Hospital. Emergency out of hours support is provided by the local out of hours GP service (based on site) with specialist advice available via St Elizabeth Hospice Onecall and the consultant on call.

The hospital's 18 non specialist beds can provide longer term care for patients from across Great Yarmouth and Waveney who need longer term care due to medical and/or social/domestic complexities. This may include intravenous therapies or transfusions, care after complex cancer treatment, or short term rehabilitation.

Physiotherapy and occupational therapy services are also available at Beccles Hospital with access to speech and language therapists, social workers, spiritual care support and mental health workers, as required.

Day Care services for patients with specialist palliative care needs will be provided in the hospices Community Care Units located in Martham, Beccles, Pear Tree centre in Halesworth and Louise Hamilton Centre in Gorleston. Outpatient clinic sessions are available, held by Medical Consultants and the Nurse Consultant. Remote consultations via telephone or videoconferencing facilities are offered, where appropriate.

Community Specialist Palliative Care

The service for the Great Yarmouth and Waveney area currently has 7.2 WTE clinical nurse specialists providing cover for the community and James Paget Hospital. The post holder will provide clinical support with outpatients, domiciliary visits, MDT meeting attendance and advice line support (in conjunction with other consultants and Nurse Consultants).

DIRECT PATIENT CARE

1.1 Ensure that inpatients receive appropriate medical assessment and appropriate medical care as part of the multidisciplinary care plan ensuring that medical care is evidence based where possible and best practice. There are up to 6 patients on the ward at a time; if not full we can admit up to 2 patients a day. Flexible use of beds in collaboration with ECCH may at times increase bed numbers to 7 patients.

1.2 To sometimes visit patients at home or in community hospitals, and in day services, in order to do assessments.

1.3 To review inpatients regularly with other members of multidisciplinary team

1.4 Ensure that all prescribing is in accordance with hospice policy and statutory requirements

1.5 Ensure that full and accurate clinical information is maintained on all inpatients and other patients seen

1.6 Liaise with primary and secondary carers as appropriate to ensure continuity of medical care

1.7 Participate in multidisciplinary team meetings held weekly to plan patients care. The multi-

disciplinary team includes Nurses, HCAs, specialist nurses, Physiotherapy and Occupational Therapists, Psychosocial workers, Art, Music and Complementary Therapists and Spiritual Care workers.

1.8 The post holder may on occasion need to provide medical cover to patients attending day services (now called Community Care Unit) and to the outpatient clinics. This will include outpatient assessments and domiciliary visits when needed.

1.9 Ensure that the clinical practice complements and facilitates the provision of multidisciplinary care, recognising the physical, psychological, emotional and spiritual needs of the patient and family

1.10 Within reason, to be available to advise and support primary and secondary carers from other agencies involved in the provision of palliative care. Such advice to be available prior to formal referral

1.11 To participate in the provision of on-call medical cover for inpatients on weekends; entails a ward round on both days to see the inpatients, which usually lasts 3 hours depending on the patients needs. Other than this most of the on-call is non-resident and telephonic. On-call is 1 in 4 first on-call. When on call there is a need to be within 30 minutes travel time of the hospice IPU in case the postholder needs to come in to see a patient. A Consultant is always available for advice when the post holder is on-call. Time (plus/minus one hour) will be allocated on Friday before the weekend on call and after the weekend on Monday for handover of patients. Remuneration of 1 PA extra per week for 1:4 on-call rota. The postholder who is in full time employment will be entitled to finish their duties at lunchtime on the Monday following a full weekend on call.

Qualifications

Essential

• Full registration with the GMC.

Desirable

• MRCP, MRCGP, or equivalent Diploma e.g. Diploma or MSc in Palliative Medicine or MD.

Management

Essential

• Possession of basic management skills.

Desirable

• Management course and / or qualification.

Audit / Research / Publications

Essential

• Thorough understanding of principles of medical audit.
• Experience in undertaking and completing audit projects.
• Knowledge of the principles of medical research.

Desirable

• Presentation or publication of audit results.
• Research experience.
• Publication of research and /or review article(s).

Experience

Essential

• Completed at least 4 years full time postgraduate training or its equivalent on a part time or flexitime basis,at least 2 of which will be in a specialty training program in a relevant specialty or as a fixed term specialty trainee in a relevant specialty or shall have equivalent experience and competencies.

Desirable

• Experience in palliative care and other specialties such as oncology, care of the elderly, general practice.
• Attended a Communication skills training course or have a qualification.

Administration

Essential

• Familiarity with information technology and general computer skills including outlook, word, excel and PowerPoint.

Desirable

• Familiar with current structure of NHS and conversant with recent initiatives and changes.
• Electronic patient record system.

Teaching

Essential

• Experience of junior doctor, other clinical staff and medical student teaching.

Desirable

• Teaching skills course and / or qualification.

Personal Qualities

Essential

• Able to work in a close knit team and co-operate with all medical, nursing and other healthcare staff.
• Professional attitude towards work, reliability, good record of attendance and tidy personal appearance.

Desirable

• Effective communicator.

Disclosure and Barring Service Check

This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.

UK Registration

Applicants must have current UK professional registration. For further information please see NHS Careers website (opens in a new window).