Specialty Doctor in Palliative Medicine

Job responsibilities

To be a member of a multidisciplinary team providing high quality, holistic care under the supervision of the medical consultants. It is expected that the post holder will work flexibly alongside colleagues to provide the best possible service for patients and those close to them.

1. To provide a medical service to hospice inpatients

2. To provide medical care to outpatients and patients at home on an ad hoc basis (dependent on experience)

3. To provide clinical and educational support to junior medical staff

4. To contribute to wider MDT education

Key Working Relationships

The consultant-led medical team comprising 5 consultants (3.5 WTE across hospice, community and hospital settings), 4 specialty doctors (2.0 WTE), GP VTS ST1/ST2 and FY2 doctors, 1 Clinical Fellow.

The multi-professional team in the Inpatient Services

The multi-professional team in the Hospice Outpatient Services

The multi-professional Hospice at Home Service

The support staff and volunteers across the hospice services

The hospital Palliative Care Teams of Frimley Health NHS Foundation Trust and Royal Berkshire NHS Foundation Trust, as well as other hospital-based clinicians

Primary care colleagues, including GPs, District Nurses and Community Matrons

Disease-specific teams such as the AIR, Heart Failure and neurological teams

Main Responsibilities and Duties

CLINICAL - INPATIENT

1. To share in the provision of holistic medical care, working closely with other members of the medical and wider multi-professional team. This will include:

contributing to the planning of admissions

clerking in of new patients

review of patients

constructing a management plan, seeking advice appropriately

planning discharges

facilitating advance care planning

2. To attend and support daily ward handover meetings, provide specialty doctor led ward rounds/patient reviews and to participate in consultant ward round

3. To support and supervise more junior medical staff (1 Clinical Fellow, GP trainees and FY2 doctors) in their day to day practice on the units

4. To undertake interventions such as venepuncture, cannulation and urinary catheterisation

5. To be a core member of the multi-disciplinary team (MDT) meetings

6. To support and meet with relatives and carers

7. To liaise with primary and secondary care colleagues, community palliative care nurses and other community services as appropriate

September 2024

CLINICAL - OUTPATIENT AND AT HOME

1. To provide ad hoc medical outpatient support to patients attending the Hospice Outpatients or medical outpatient clinic

2. To provide ad hoc medical support to patients at home, in conjunction with the Hospice at Home team (dependent on experience)

3. To share in providing medical advice and support to the 24/7 advice line, CNS and Rapid Response team, along with consultants during normal working hours (out-of-hours support provided by consultants)

CLINICAL - GENERAL DUTIES

1. To keep accurate, clear and up-to-date medical records

2. To support and engage with the implementation of a new hospice electronic health record and other electronic palliative care systems

3. To complete discharge summaries for primary care within 24 hours of discharge, and provide other written communications to relevant teams as required

4. To use electronic record systems to keep accurate, clear and up-to-date medical records

5. To use the electronic prescribing system to safely prescribe required medications; full training will be provided

6. To inform senior medical staff of any clinical or management issues requiring consultant review or advice

TEACHING

1. To support hospice junior medical staff (Clinical Fellow, FY2 and GP trainees) with informal and bedside teaching/training

2. To devise and deliver regular tutorials for our junior medical staff (Clinical Fellow, FY2 and GP trainees)

3. To contribute to the educational programmes provided by the hospice for multidisciplinary health professionals

4. To support any visiting health professionals (e.g. GP registrars; medical, nursing or paramedic students) to benefit their hospice visit or placement

EDUCATIONAL / QUALITY IMPROVEMENT

1. To participate in regular team meetings, clinical and audit meetings

2. To contribute to the weekly medical education meeting

3. To support service improvement projects and audits in progress, including mentorship of junior doctors in this area

4. To actively identify areas for service improvement and audit

5. To attend and contribute to relevant in-house educational meetings

September 2024

6. To participate in continuing professional development activity as agreed at appraisal with your consultant supervisor

OUT OF HOURS (OOH) SERVICE

The on call commitment is non-residential, covering the inpatient unit on a 1st on-call rota

This is currently a 1 in 6 rota with prospective cover, involving one weekday night per week and one in five weekends (Fri pm to Mon am)

OOH work includes inpatient ward reviews and clerking new admissions, and it is expected that the doctor will be on-site on both Saturdays and Sundays (9am-5pm, or until the jobs are completed)

Bank holidays are shared amongst the rota participants

This on call work attracts an on-call supplement as per the NHS SAS contract, as well as rostered TOIL (time-off-in-lieu)

The 1st on call doctor is supported by a 2nd on call consultant

PROFESSIONAL SUPPORT AND DEVELOPMENT

It is essential that the candidate participates in annual appraisal, which will allow discussion of professional development and training needs

Mandatory training must be completed and kept up to date as per the hospice requirements

All medical staff will have regular one-to-one meetings with their line manager

The medical team is supported by a visiting Clinical Psychologist who offers individual sessions

The hospice runs quarterly Regroup sessions for all staff, and reflective sessions for clinical staff

Clinical supervision is scheduled and run by trained facilitators for all staff

CONDITIONS OF SERVICE

The post holder will have a Thames Hospice contract of employment. This will mean loss of NHS continuity of service.

1. The post holder must be fully registered with the General Medical Council

2. The post holder must have adequate and appropriate medical indemnity cover the hospice will contribute to a proportion of any medical defence/protection costs for the period of employment

3. The salary will be guided by the NHS staff grade/specialty doctor salary scales

4. The post holder may be able to continue with the NHS superannuation scheme

5. Annual leave entitlement is 6 weeks per year plus bank holidays pro rata

6. Study leave and a study budget is provided

7. Thames Hospice is committed to being an equal opportunities organisation. It is committed to promoting equal opportunities and preventing discrimination. This policy applies to both its service delivery and to its own employment practices. You will be willing and able to demonstrate commitment to Thames Hospice Equal Opportunities Policy

Please note this job description is intended as an outline of the duties of the post other duties may be required according to the needs of the service. The job description may be subject to agreed amendment depending on the experience or training needs of the post holder.

Job planning will take place with the Medical Director and Consultant Team at the start of the post, taking into account both the post holders developmental and service needs.

Experience

Essential

• Evidence of achievement of foundation competencies from a UKFPO-affiliated foundation programme or equivalent
• Completion of at least 3 years full time postgraduate training (or equivalent gained on LTFT basis)
• Training must include at least 12 months experience of acute medical specialties with a minimum of 4 months managing patients on unselected medical take or equivalent
• Experience of Palliative Medicine
• Competence in common practical procedures
• including venepuncture, cannula insertion, basic CPR, urethral catheterisation, naso-gastric tube placement

Desirable

• 4 months + in a palliative medicine placement
• Experience of palliative medicine in various settings (e.g. hospital, community, hospice inpatient)

Research and Audit

Essential

• Evidence of experience in clinical audit

Desirable

• Evidence of leading an audit project
• Research experience
• Publication / Conference presentation

Language and Teaching Skills

Essential

• Demonstrate adequate written and spoken English to enable effective communication about medical topics with patients and colleagues
• Evidence may include: undergraduate medical training undertaken in English; or IELTS results with minimum of 7.0 in each domain, and overall score of at least 7.5 achieved in the last 24 months; or alternative supporting evidence of language skills
• Experience of teaching to various audiences

Desirable

• Experience of supervising junior medical staff

Qualifications

Essential

• Have MBBS or equivalent medical qualification
• Be eligible for full registration with, and hold current licence to practice from, the GMC at intended start date
• To be up to date and fit to practice safely

Desirable

• MRCP (UK) or MRCGP or MRCS or FRCA (full diplomas) or equivalent higher training confirmation by the required deadline
• Degree or diploma in Palliative Medicine or related field

Employment History

Essential

• Be able to provide complete details of employment history
• Evidence of experience in Palliative Medicine

Desirable

• 4 months + in a palliative medicine placement

Personal Attributes

Essential

• Ability to organise time effectively, create work schedules, prioritise workload and meet deadlines
• Experience of taking responsibility for own actions and know when to seek advice appropriately
• Ability to remain calm under pressure
• Be a skilled communicator, with a commitment to continuous improvement
• Ability to develop effective and supportive relationships with colleagues with a commitment to multidisciplinary working
• Have an interest in complex decision-making and ethical issues, working as part of a team and with patients and families to find the best approach
• Commitment to Continuing Professional Development
• Commitment to Thames Hospice Values

Desirable

• Advanced Communication Skills training

Administrative and Management

Essential

• IT skills (including Microsoft Word / Excel / Powerpoint)
• Ability to work effectively within a multidisciplinary team and recognise when the need for medical leadership arises

Desirable

• Experience of supporting junior medical staff

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).