Consultant in Frailty

Job description

Job responsibilities

BASIC PROGRAMMED ACTIVITIES: 10

TOTAL PROGRAMMED ACTIVITIES: 10

ON-CALL COMMITMENT: 1:8

This post is an exciting opportunity to join the newly formed Elderly Care & Frailty Department. The role will mainly focus on the development of frailty services for the island of Jersey as well as having ward commitments for both general internal medicine. The role will lead on the development of the frailty unit interfacing secondary care with primary care. The role will have a rotational commitment for rehabilitation which is situated on-site at Jersey General Hospital as well as outpatient clinical sessions.

Clinical Duties

· Build & develop a service of excellence for frailty services which ensures a seamless integration between primary & secondary care across the stroke pathways aligned to the Jersey Care Model.

· Develop & lead on a frailty strategy for the island of Jersey

· To work in close partnership and liaison with Primary Care, Neurology and other specialist services.

· To support the prevention agenda for frailty on the Island of Jersey supporting patient independence

· To undertake inpatient management of patients in frailty & elderly care as well as general internal medicine & rehabilitation

· To provide clinical leadership for the development of a frailty service including a dedicated frailty unit

· Participation on the frailty post-take ward round rota

· To undertake outpatient clinics for both frailty & elderly care

· To provide clinical advice & support to primary care colleagues and other consultants within Health & Community Services medical model

· To deliver personalised, evidence informed medical care plans to all patients that are appropriately documented and regularly evaluated.

· To provide advice and timely medical reviews and interventions as part of the interdisciplinary model of care.

· To set-up, lead, participate and attend relevant services’ MDTs

· To liaise with tertiary referral centres as appropriate to provide patient centred care & service improvements

· Maintain good quality up to date medical records including timely discharge letters and summaries.

· To ensure appropriate documentation and coding is used to provide consistent audit and monitoring of the service.

· To adhere to local prescribing guidelines.

· Development of a delirium recovery pathway

· Development of the Care Home in-reach service

· Further develop advance care planning on the island of Jersey

· The post holder is expected to provide cross cover for colleagues during absences including stroke medicine

· The post holder should be adaptable, flexible and innovative in order to meet the ongoing challenges within the service. The responsibilities of the role may change from time to time

· To comply with infection prevention & control requirements including the latest COVID-19 guidance and policies.

Leadership & Management

· Take part in management and audit activities to support the Care Group Leadership team & Public Health in planning for services and ensuring the service meets key performance indications including excellent patient care.

· The post holder will be expected to take part in management and audit activities and represent the service at Hospital meetings, as agreed with colleagues.

· The post holder will be expected to be fully involved in a ‘Risk Management” program and support the Governance agenda.

· Represent the service at Hospital meetings, as agreed with colleagues.

Teaching and Research

The department is recognized for junior doctors from the Wessex deanery and medical students from Southampton and active teaching is encouraged in this role. It is expected that the post holder is participating in the training of Medical staff and that the candidate will ensure that the training and learning needs are identified and facilitated. This includes educational support for the clinical fellows recruited directly to Health & Community Services.

The post holder should deliver training to a range of professionals across the multi disciplinary team in stroke medicine to create a service of excellence for Jersey.

Opportunities for participating in research are supported when appropriate. The Health & Community Services has a policy for professional leave and is supportive of external duties for the good of the wider profession.

The appointee may take part in the General Medicine on-call rota of one in eight however this will be in line with the development of the service provision according to the Jersey Care Model & Medical Services Medical Model.

During the on-call the consultant will cover all medical inpatients in the event deterioration or medical emergencies. For weekday on-call a post take ward round is undertaken at 5pm, the following morning the on-call consultant is only required to post-take patients who are not on the Emergency Assessment Unit. During weekends and bank holidays the consultant will undertake post take ward rounds and discharge ward rounds in line the medical model at 8am & 5pm.

Weekday on-calls operate 8am-8am the following day. Weekend on-calls operate from 8am on Friday to 8am Monday.

Include statistics on department

Total admissions 2020 = 31,475

Total admissions aged >65 2020 = 12182

Department of Elderly Care & Frailty

The department of Elderly Care & Frailty has been established in 2021 and will consist of 3 new consultant roles:

- Consultant Stroke Medicine & Elderly Care (with rehab)

- Consultant Elderly Care & Frailty (with rehab)

- Consultant Elderly Care & Frailty (with rehab)

At present stroke patients are admitted to Corbiere Ward a 16 bedded general medical ward, patients who have received thrombolysis are currently not admitted directly to Corbiere Ward and their initial stay will be on the Emergency Assessment Unit’s Enhanced Care Area whereby a period of close monitoring can be undertaken.

Thrombolysis is available on-island 24/7, at present a thrombectomy service does not operate on Jersey however the post holder will have the opportunity to develop pathways so patients can access a thrombectomy service either on-island or via a tertiary centre.

For rehabilitation a dedicated rehabilitation ward is situated on-site at Jersey General Hospital consisting of 16 beds and a gym area. The ward is staffed by:

- 1 FTE Staff Grade

- Nursing establishment

- Therapy establishment

Outpatient stroke services are currently provided by the Consultant Neurologist Dr Howard Gibson as well as two associate specialists:

Dr Jessica Vaz – Associate Specialist in General Medicine & Neurology

Dr Marion Croft – Associate Specialist in General Medicine & Elderly Care/Stroke

Outpatient elderly care services are currently provided by the Dr Michael Richardson Consultant GIM/Rheumatology & Dr John Bevan Consultant Acute Medicine/Rheumatology as well as one associate specialist Dr Marion Croft

Dedicated TIA clinics are operated by Dr Marion Croft

The establishment of the department comes at an exciting time whereby the Jersey Care Model depicting how healthcare will be delivered on Jersey has been approved, as part of this an intermediate care strategy has been developed supporting some of the following:

- Development of an Acute Frailty Unit

- Improvements across rehabilitation provision

- Introduction of Tele-care & Tele-guidance

- Introduction of Care & Reablement Team to provide early supported discharge to patients own home

- Development of individual patient centred care plans with the focus on maintaining independence

There is a significant opportunity for private activity, private outpatients may be seen and treated within the outpatients. However any private practice must be undertaken outside of contractual obligations. Consultants will be billed for the use of Outpatient clinic rooms for private patients at the rate of £9 per 30 minutes & £16 per 60 minutes for standard outpatient clinic. The post holder has admitting rights to the Private Wing.

Person Specification

Qualifications

Essential

• Primary Medical Degree
• Full Registration with the General Medical Council (GMC) with a Licence to practise (for overseas candidates it is mandatory that a licence is obtained prior to appointment).
• Higher Specialty qualification: MRCP or equivalent European Qualifications for Specialist Registration
• Inclusion on the GMC Specialist Register/Certificate of Completion of Training (CCT) or equivalent in the relevant Specialty (or be within 6 months of obtaining this at the date of the interview - documentary evidence of this must be provided to support your application) or equivalent
• Experience in general and acute medicine
• Participation on a general medicine on-call rota at a consultant level
• Evidence of sucessful interface between secondary and primary care
• Enthusiastic Teacher
• Clinical management of stroke patients throughout their pathway from hyper-acute, inpatient stroke, rehabilitation & community management
• Experience in prevention and management of frailty
• Clinical management of rehabilitation patients for both general, stroke & neurological patient groups
• Treatment and manangment of patients with delerium
• Ability to work flexibly with colleagues to develop & provide stroke, elderly care/frailty & rehabilitation services
• Ability to Work Effectively with a Multi-Disciplinary Team, motivating and influencing others through their enthusiasm.
• Ability to communicate effectively with colleagues, patients, relatives, GPs, nurses, management and other agencies.
• Highly motivated
• Able to work within a team
• Experience of Teaching,Training & Supervision of Junior Medical Staff and undergraduate students
• An understanding of and ability to demonstrate your ability to:
• Empower others
• Lead through change
• Influence strategically
• Collaborative working
• Drive for Improvement
• Integrity
• Participation in Clinical Audit & Risk Management Activiities
• Demonstrates a commitment to safeguarding young people and vulnerable adults
• Evidence of annual appraisal
• Experience of service development
• Able to work flexibly in a changing health service
• Hepatitis Vaccination

Desirable

• Higher Degree MSc, MD or PhD or equivalent
• ALS/ATLS trained
• Relevant experience at a consultant level in a similar setting
• Leadership skills in managing change in frailty services at a local or regional level
• Management Responsibility / Leadship Experience
• Experience in establishing a delerium recovery programme in a community setting
• Establishing a frailty unit with interface with primary care
• Specialist interest (e.g delerium, community frailty)
• Evidence of research and publication in peer reviewed journals

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

Health and Community Services

Address

Government Of Jersey

19-21 Broad Street

St. Helier

Jersey

Channel Islands

JE2 3RR

Employer's website

https://www.gov.je (Opens in a new tab)