Consultant in Rheumatology

Job description

Job responsibilities

The Department

The strengths of the department

It is a friendly department with supportive colleagues especially important when starting out as a consultant. We offer a consultant led and delivered service which allows long term doctor patient relationships to develop which are rare in the current NHS. If you enjoy patient care then this is the place to work.

There are opportunities to develop a special interest as well as undertake research to allow you to grow your career. There are no on call duties nor GIM commitments.

Facilities and support services

There are dedicated out-patient facilities within the main hospital. Patients are routinely weighed, BMI checked and urine tested at each appointment. There is direct access to the electronic patient record as well as the paper notes.

We no longer have dedicated in-patient beds, so if a patient needs admission they are admitted under the acute medical take and then we will review as necessary.

There is a shared day case facility (12 chairs and 4 beds) with others requiring chemotherapy and biologics etc. It is run by highly skilled nurses who are chemotherapy trained. There is rarely a significant wait for therapy. Rheumatology patients are reviewed by the nurse specialist on the day.

We have dedicated physiotherapy and unusually have access to two hydrotherapy pools, one of which is on site.

Our occupational therapists can do home visits, are expert at splinting, hand therapy and can teach pacing and mindfulness as needed.

The hospital has an in house orthotics service with a dedicated gait analysis laboratory.

The osteoporosis service is based at the hospital and provides both scanning and an out -patient service as needed. The department has excellent relationships with the orthopaedic surgeons. Patients unknown to the rheumatologists who present with an acute hot joint are usually cared for by them. We have a good arthroplasty service including wrist and elbow replacements.

Ultrasound scans of joints are undertaken in the radiology department. We have good access to CT, MRI and PET scanning. We have a vascular ultrasound service for patients with suspected giant cell arteritis (GCA). Intra-articular joint injections that require imaging are undertaken by our orthopaedic colleagues or the radiologists as appropriate.

The hospital doesnt yet have a chronic pain service although the acute pain team will help where possible. There is an established consultant led pain service in Sheffield.

Clinical services provided by Rheumatology

New patient clinics are unselected and each referral is read and prioritised by a consultant. Few patients with soft tissue problems are seen as they are seen by the local physiotherapy led MSK service. We are given 40 minutes per patient and are expected to see 6 patients in a session. We have dedicated/protected early inflammatory arthritis and GCA, ensuring speedy delivery of care to these patients.

Most follow up clinics are mixed although both Consultants hold one connective tissue disease clinic each per month. Patients are seen from the age of 16 and above. Twenty minutes is allocated per patient with 12 follow-ups booked per session.

The specialist nurses undertake the counselling for patients starting new DMARDS/biologics and provide the monitoring for the first 3 months. At that point local GPs enter into shared care monitoring. Two out of three nurses are both non-medical prescribers with the third just about to start their training. They are trained to teach patients how to use Acupins to manage methotrexate nausea.

Locally we do not have to ask individual permission to start a patient on a biologic as long as it fulfils NICE guidance. Data on our compliance is gathered on Bluetech by the CCG.

Ward referrals are divided across the consultant team.

Governance

Rheumatology governance meetings are held monthly and are followed by a team meeting.

Clinical Effectiveness

Rheumatology clinical effectiveness meetings are held bi-monthly. Each member of the team is encouraged to contribute to an audit / service review annually.

Teaching and supervision

Medical students from the University of Sheffield rotate to Rotherham and can choose to do a specialist attachment with the team.

It is expected that each consultant will present a Grand round once to twice a year. There are many other opportunities to teach including foundation year doctors and other specialists across the Trust. Once to twice a year the consultant will lead a post graduate afternoon alongside a specialist trainee.

There is an opportunity to act as the clinical / educational supervisor for both the F2 and specialist trainee.

Liaison with local rheumatologists/specialists

There is a monthly MDT with colleagues across South Yorkshire to discuss difficult cases as well as those where an application to NHS England is to be made. This is a supportive environment and is a great place to learn. There is an excellent connective tissue disease service at the Royal Hallamshire Hospital in Sheffield. They provide specialist clinics for SLE, scleroderma, vasculitis and Behcets. MDT services are provided for neurovasculitis, pulmonary hypertension (national service) and pregnancy. Patients can be referred for an opinion. Renal clinics are held within the Trust. The genetics service in Sheffield have a special interest in collagen vascular disease. An in depth neurophysiology service is provided in Sheffield whilst more simple testing can be undertaken within the department of orthopaedics.

Continuing Professional Department

- Grand round weekly within the Trust

- Postgraduate meeting weekly within the Trust covering a wide range of topics with both internal and external speakers

-Fortnightly post graduate rheumatology meetings with colleagues from South Yorkshire.

Once a month a difficult case discussion forms part of this meeting. Many external speakers are invited.

- Yorkshire wide meetings are held several times a year

Research

There are many opportunities to enter into a research project and this is encouraged by the Trust.

Consultant Staff

Dr Fiona Fawthrop

Dr Leticia Garcia

Specialist Trainee

Rotherham is part of the South Yorkshire rotation which also covers Sheffield Teaching Hospitals and Doncaster General Infirmary. The trainee may undertake low intensity general medicine whilst in Rotherham spending one day a week on the Acute Medical Unit.

F2

We have a dual post with health care for the elderly. When not working in rheumatology they are based on an orthopaedic ward caring for those with complex medical needs peri-operatively. They also take part in the general medical on call rota. The post holder rotates on a 4 monthly basis to General Practice and Paediatrics.

Nurse Specialist

Sister Louise Hale 30 hours Non-medical prescriber

Kerry Hopewell 30 hours

Sister Sue Elsey 15 hours Non-medical prescriber

Secretarial Staff

There are two whole time equivalent secretaries supported by one whole time typist.

Person Specification

Education and Training

Desirable

• Teaching experience/qualification

Experience

Desirable

• Subspecialty training or equivalent such as in connective tissue disease

Ability and Skills

Desirable

• Training in musculoskeletal ultrasound

Research and Audit

Essential

• Evidence of audit and the implementation of change following the audit

Desirable

• Relevant research published in peer review journal

Management Skills

Essential

• Demonstrate effective team working skills
• Time management/organisational ability. An example may be they have developed and run training programmes.
• Proven knowledge of systems and process of NHS or equivalent
• Sense of understanding and commitment to corporate responsibility
• Commitment to and understanding of their responsibility to the organisation. Examples may include previous involvement in management roles, management courses
• Demonstrate innovation and problem solving abilities

Qualifications

Essential

• Full registration and a licence to practise with the GMC
• Please confirm your GMC Registration number
• On the GMC Specialist Register or within 6 months of CCT from the date of interview

Desirable

• Higher Medical Degree

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.

Certificate of Sponsorship

Applications from job seekers who require current Skilled worker sponsorship to work in the UK are welcome and will be considered alongside all other applications. For further information visit the UK Visas and Immigration website (Opens in a new tab).

From 6 April 2017, skilled worker applicants, applying for entry clearance into the UK, have had to present a criminal record certificate from each country they have resided continuously or cumulatively for 12 months or more in the past 10 years. Adult dependants (over 18 years old) are also subject to this requirement. Guidance can be found here Criminal records checks for overseas applicants (Opens in a new tab).

UK Registration

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

Employer details

Employer name

The Rotherham NHS Foundation Trust

Address

The Rotherham Nhs Foundation Trust

Moorgate Road

Rotherham

South Yorkshire

S60 2UD

Employer's website

https://www.therotherhamft.nhs.uk/ (Opens in a new tab)