Job responsibilities
Clinical Duties
The post holder will be one of seven Obstetrics and Gynaecology consultants delivering secondary health care to the women of Jersey. The post holder is expected to be a generalist obstetrician and gynaecologist.
The successful candidate should be adaptable, flexible and innovative in order to meet the ongoing challenges within the service.
Each successful candidate will fulfil a clinical role and participate in administrative, management and teaching responsibilities shared within the Consultant cohort.
Specific duties include clinical responsibilities for patients presenting to the Obstetrics and Gynaecology department and administrative responsibilities for efficient functioning of the Department.
There is an understanding that successful candidates will have an appreciation that the scope of current practice within the Obstetrics and Gynaecology department is changing and this will influence the delivery of care to patients and Consultant working practices.
As such this job description is intended as a guide to the general scope of duties and is not intended to be definitive or restrictive. It is expected that some of the duties will change over time and this job description will be subject to review in consultation with the post holder.
All duties will be based at the Jersey General Hospital or peripheral sites.
The unique location, geography and constitution of the Island means that the Department provides a much wider range of services than would be expected in a comparative health authority in the United Kingdom.
Close links are maintained with the Wessex Deanery and other major centres in the UK such as Southampton. The post holder will be expected to participate in the training of Junior Middle Grade Staff and Medical students for whom he/she is responsible and ensure that training and learning needs are identified and facilitated.
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 programme and support the Governance agenda. There will also be an expectation that they will take on leadership roles where necessary and within their area of expertise.
The post holder will deputise from time to time for absent colleagues, performing additional duties in occasional emergencies and unforeseen circumstances. Being available for such irregular duties is essential for the continuity of patient care.
On call rota
The post holder will be required to participate in a 1:6 oncall rota with prospective cover. Currently there is requirement to be on site between 08:00 -20:00 hours on weekdays and 8:30 to 12:30 on a Saturday and Sunday. Off site with on-call cover at other times is expected. There are plans to move to a 1:8 on call rota in the future with further expansion of the service.
The Gynaecology Service
The Gynaecology service carries out approximately 2,000 operations a year, and there are over 350 emergency cases a year admitted through the Gynaecology Ward. The Gynaecology Department carries out a considerable amount of laparoscopic surgery, with facilities available in both Day Surgery Unit and Main Theatre. A nurse-led pre-admission service operates for gynaecology.
Each year there are approximately 3500 referrals to the Gynaecology Outpatient Department. There is a shared Surgical Ward (Rayner Ward) that serves as the base for Gynaecology. Attached to the ward is the Gynaecology Outpatient Department.
Nursing staff rotate between the ward and the Outpatient area providing continuity of care. There is a fully equipped Colposcopy and Outpatient Hysteroscopy Unit. There is a dedicated Early Pregnancy Service for five days a week. There is an Assisted Reproductive Unit (ARU) supported by an Infertility Specialist Nurse. There are approximately 300 referrals each year. A satellite Assisted Reproductive service exists between Jersey and UK Fertility Units for egg recovery and embryo transfer for IVF patients.
The gynaecology outpatient department runs regular special interest clinics in Urogynaecology, Colposcopy, Outpatient hysteroscopy, Psychosexual Medicine and Gynae-Oncology. In addition, there are nurse-led smear clinics and nurse-led pessary clinics. The service is supported by an Oncology Specialist Nurse.
Jersey established a service to provide for termination of pregnancy after the relevant law was passed in 1997. Social terminations can be carried out until the end of the 12th week although, in cases of severe fetal abnormality or serious maternal health problems, terminations can be carried out until 24 weeks gestation. Depending on gestation, women are offered medical or surgical terminations. The termination service is led by a consultant and assisted by staff grade doctors, family planning nurses, counsellors and nurses with a special interest.
There is an excellent community contraception service provided on the island with a dedicated family planning clinic at Le Bas Centre and for the under 21-year-olds, Brook Jersey. There are close working relationships with the Genito-Urinary Medicine clinics.
The Obstetric Service
There are approximately 1000 births per annum in Jersey and maternity services are delivered in a variety of settings. Most of the low-risk antenatal care is shared care between General Practitioners and Community Midwives, with increasing numbers of low-risk women requesting home births.
There are dedicated Antenatal Clinics for women with multiple pregnancies, diabetes in pregnancies, high risk cases and perinatal mental health clinics. It is intended that there will be more consultant clinics with the new appointments.
There are five delivery rooms on Labour Ward at the hospital with intrapartum monitoring and blood gas analysis available. One of the delivery rooms is equipped to facilitate the use of a birthing pool. There is a designated Maternity Operating Theatre within the main operating theatre complex.
Refurbishment of the Neonatal and Maternity areas is currently ongoing with aim to finish the project in April 2024.
Twenty-four hours on call anaesthetic cover is provided. There is a mix of obstetric cases with the Unit having to deal with high-risk obstetrics as well as low risk because of the geographical isolation of the island. Every antenatal patient is offered a booking scan and combined screening for aneuploidy. All fetal abnormalities are recorded, and the Unit is involved with the National Congenital Anomaly and Rare Disease Registration Service (NCARDRS) run by Public Health England. Responsibility for fetal medicine currently rests with two of the Consultants. Invasive investigative procedures including Chorionic Villus Sampling and Amniocentesis are available on Island. All obstetric outcomes are monitored and the department reports outcome data to the National Perinatal Epidemiology Unit for Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK (MBRRACE), and to the Royal College of Obstetricians and Gynaecologists for Each Baby Counts.
The Neonatal Service
The Paediatric specialist supports a level 1 Neonatal Unit located next to our Labour Ward. The team frequently need to stabilise preterm babies prior to transfer to tertiary unit. Appropriate cases are transferred to NICU by our own team, but the Southampton PICU will retrieve particularly unstable newborns. Our policy is that complicated pregnancies, including antenatally diagnosed malformations, and deliveries expected before 30 weeks gestation, deliver in tertiary units in the UK. Similarly, the paediatric teams will occasionally need to provide urgent care to critically ill children prior to the arrival of the PICU retrieval team.
Operating Theatres
The main theatre suite is made up of six theatres including the designated maternity theatre, each with an adjoining anaesthetic room. There is a patient reception area and a recovery unit. There is availability to perform one elective caesarean section every weekday morning. Elective surgery in Gynaecology and other specialties is carried out Monday- Friday, an emergency theatre is available 24/7. The theatre unit undertakes an average of 4500 elective and emergency procedures per annum. There is a sterile services department separate to the hospital which processes all surgical instruments.
Physiotherapy Services
The physiotherapy services aim to provide effective rehabilitation for patients with a variety of musculoskeletal, neurological and respiratory conditions. Treatment may take place on the ward, in an out-patient setting or in the community. There are specialist physiotherapists who provide pelvic floor assessments for women who have sustained perineal trauma in childbirth, and they are an important part of the Urogynaecology service.
Radiology Services
The radiology department provides CT, MRI, ultrasound, mammography and general X-ray services. An on-call service is provided for CT, ultrasound and general X-ray. There is a separate obstetric ultrasound service. An obstetric ultra-sonogapher provides a first, second and third trimester ultrasound scanning service, supported by two midwife sonographers to perform third trimester scanning, and obstetric consultants who provide a fetal medicine opinion in Jersey.
Graduate Education /Governance
There is a weekly clinical risk management meeting in Obstetrics to discuss clinical incidents and risk issues. This occurs monthly for gynaecology. There are also weekly clinical risk management meetings for paediatrics which incorporates our neonatal clinical incidents.