Job responsibilities
The Obstetric Service
The Consultant Obstetric Unit is located at the Princess Royal Hospital with two midwifery led units in Shropshire. Midwifery practice in mid-Wales is also supported by the Consultant Unit. The Consultant unit conducts approximately 4500 deliveries per year with a further 300 deliveries occurring in the alongside and freestanding midwife led units.
The Consultant Maternity Unit currently has 56 beds and a Level 2 neonatal unit of 22 cots. 14 of the 18 Consultants are responsible for acute labour ward practice (four Consultants conduct pure gynaecology practice). Consultant presence on the Delivery Suite is 87.5 hours a week, expanding to 168hr cover with recruitment to some additional new posts.
We have a very active maternal and foetal medicine unit run by three of the Consultant Obstetricians, two of who are sub-specialty trained in maternal and foetal medicine. Antenatal practice is divided up into specific speciality clinics to which expectant mothers are allocated. The vast majority of routine and detailed scans with invasive diagnostic procedures are performed within the department. Specific antenatal clinics are supported by consultant physicians and Nurse Specialists. External cephalic version is promoted and conducted weekly. ANC are staffed with two consultants in each clinic and Tier1 or Tier 2 staff are supernumerary and there for education & training.
The Neonatal Service
The neonatal unit is designated as a Local Neonatal Unit (level 2) working in conjunction with the Neonatal Intensive Care Units in the Royal Stoke and Royal Wolverhampton Hospitals as part of the Shropshire Staffordshire and Black Country Neonatal Network (SSBCNN). Care is supplied by four Consultant Neonatologists; two Consultant Paediatricians with a specific interest in Neonatology and supported by three ST4+ trainees, 3 ST1 3 trainees in paediatrics and five ANNPs. There are 22 cots including six intensive/high dependency cots. The department works in close conjunction with the obstetric unit and the SSBCNN to ensure effective care of extreme prematurity and complex antenatal problems.
The Gynaecology Service
The gynaecological inpatient unit is located at the Princess Royal Hospital. At present, there are 12 beds with the use of further beds in the day surgery unit at both the Royal Shrewsbury Hospital and Princess Royal Hospital. Each year we perform:
1900 day case procedures
- 600 elective inpatient procedures
- 7500 new outpatients
- 11000 FU patients
- Community (GP practice) gynae OPD clinics are held 4 times a week
A full range of gynaecology procedures are provided including advanced laparoscopic and urogynaecology surgery advanced ambulatory procedures and colposcopy. There is a large and very active ambulatory care unit performing MyoSure, NovaSure and other outpatient techniques. There is specific Consultant-led practice in cervical pathology; oncology; fertility; ambulatory care and urogynaecology; and full facilities are available for the support of minimal access gynaecological surgery. Early pregnancy assessment is supported by nurse lead practice in both the Princess Royal and the Royal Shrewsbury Hospitals. The gynae-oncology service is provided at the unit level at SaTH with tertiary level cancer centre support provided by the University of North Midlands and the Royal Wolverhampton Hospitals. Gynae-oncology MDT meetings are held every Wednesday morning with support provided at the meeting by Gynae-oncologists from nearby tertiary centres.
Job Plan
A formal job plan will be agreed between the successful candidate and their Clinical Director and consultant colleagues, on behalf of the Medical Director within 3 months of starting in post. A full-time job plan is based on a 10 PA working week. The job plan will be reviewed annually and is a prospective agreement that sets out the consultant's duties, responsibilities, and objectives for the coming year. It covers all aspects of a consultants professional practice including clinical work, teaching, research, education and managerial responsibilities. It will provide a clear schedule of commitments, both internal and external and will include personal objectives, detailing links to wider service improvements and trust strategic priorities.
For a full-time contract, the job plan will be divided on average per week (pro-rata for a part time post) as:
- 8.5 Programmed Activities (PAs) of Direct Clinical Care - includes clinical activity, clinically related activity and predictable and unpredictable emergency work.
- 1.5 Supporting Professional Activities (SPAs) - includes CPD, audit, appraisal, guidelines, teaching and research.
- There is an option for a further 1spa in addition to the basic 10pa. This would be to support the MDT & PROMPT Training programme or the Governance and Risk team
The allocation of PAs is reviewed and may be subject to adjustment when a further diary exercise is undertaken or if the service demands a review of the team job plan.
Any applicant who is unable, for personal reasons, to work full-time will be eligible to be considered for the post. If such a person is appointed, modification of the job content will be discussed on a personal basis with the Trust in consultation with other consultant colleagues.
On-Call Arrangements
Obstetric on calls are staffed as follows:
Daytime 830am-9pm Consultant, T2, T1, 7 days a week
Second Tier 2 8am to 7pm 7 days a week to support triage and acute Obstetrics and Gynaecology activity.
Nights 830pm-9am resident Consultant, T2 & T1 with additional non-resident consultant support 7 days a week.
There is a separate team for elective CS comprising of a consultant + trainee Monday to Friday mornings.
When on call you are solely performing your resident obstetrics on call duties and no other spa or DCC work is scheduled during this time or allowed.
Gynaecology on calls are staffed as follows:
8am-6pm resident gynae consultant with FY1 +/-T1 support + Triage 2 support
*There are always two consultants either on site or non-resident 24/7 to cover Obs & Gynae
** there are no gynae on calls with this post**
Resident Night Duties
This post involves resident on call nights (see below) with no non-resident shifts. Night shift times are 830pm until 9am and all these hours are resident. An ensuite room adjacent to labour ward is provided which has a bed, shower, and mini kitchen facilities available for you to utilise overnight. You are not expected to deliver consultant level acute gynae care or acute gynaecological surgery.
When on resident nights there will always be a gynae consultant who will attend to conduct all emergency gynae surgery. Your role does not include acute gynae consultant on calls. There is always a non-resident consultant who can come and assist when needed, i.e., high workload, complex cases. This non-resident consultant will always attend for cases such as any return to theatre or C/Section hysterectomy etc.
Ward rounds are only expected to be conducted when you are on call (you will see all Obs patients) or prior to your C/Section list where you will see your pre-op C-section patients). Ward round are not expected at any other time. Ward rounds whilst resident on call is part of the core DCC time. Ward rounds for pre & post op time are included within the C-Section list session time which is 1.25pa.
