Specialty Doctor

Job responsibilities

Phyllis Tuckwell

JOB DESCRIPTION

Job Title: Speciality Doctor in Palliative Medicine

Salary Range: Pre 2021 Contract - £46,958 - £87,568

2021 Contract - £52,530 - £82,400

Base: Phyllis Tuckwell Hospice

Accountable to: Medical Director

Job Description

This post comprises 4-6 PAs per week with 1st on-call out of hours rota for Phyllis Tuckwell (PT).

The appointee will be expected to provide medical input to predominantly the Community team in hours and the ward at weekend as part of the 1st on call rota.

The Specialty Doctor will be professionally accountable to the Medical Director and ultimately to the Trustees of the PT. On a day-to-day basis the appointee will be under the supervision of community palliative medicine consultants

The Specialty Doctor will be expected:

1. Undertaken solo or joint domiciliary visits to patient known to the community team and work with the primary care clinicians in supporting the patient at home/nursing homes.
2. To support palliative meetings and forums based on the community/ primary care
3. To review the patients progress at regular meetings with the multi-disciplinary team.
4. To keep accurate records that are individual, timely and identifiable, using the PT electronic record system.
5. To work in partnership with patients and their families and carers as a member of the multi-disciplinary Specialist Palliative Care Team.
6. To clerk patients on admission to the inpatient unit (IPU) assessing and documenting patients physical, psychological, social and spiritual needs and devising a treatment plan when working on the IPU
7. To review patients during ward rounds, and when clinically appropriate, reviewing and changing the treatment plan, in collaboration with the multi-disciplinary team, to provide good quality palliative care
8. To agree a discharge and follow up plan and write a discharge letter to the GP as appropriate.
9. To complete the medical certificate of cause of death and cremation papers as needed
10. To reassess the patients problems as necessary and to communicate changes of treatment and new diagnoses to the GP.
11. To be involved in the provision of out of hours cover to the In Patient Unit.
12. To participate in Phyllis Tuckwells educational programme and help with informal teaching of visiting doctors or medical students on ward rounds and to participate in audit as requested.
13. To be familiar with, and to adhere to, PT policies and guidelines.
14. Engage with appraisal and with continuing professional education sufficient to maintain fitness to practise. Funding for study leave will be made available.

Background information about the PT

The Phyllis Tuckwell situated On the Surrey Hampshire border in the CCG of North East Hampshire and Farnham. it interacts with both the Frimley ICS and The Surrey Heartlands CCG.

PT is in its 46th year. It was named after Sir Edward Tuckwells wife, who died from cancer. As an independent charity, PT is largely self-supporting, receiving approx. 20% of its revenue costs from the NHS. Over the next two and a half year the organisation will be based over a number sites, some of them being temporary. The inpatient unit is temporarily located in Kings Ledge nursing home in Camberley. Most of the support staff and the large part of the community staff will be working out of offices in Farnham. This location is also temporary. In Guildford there is a smaller permanent site called the Beacon Centre in the grounds of the Royal Surrey County Hospital, in Guildford. This holds all of the Living Well Services and the some of the community team

The catchment area for the PT covers West Surrey and North East Hants. This includes three place based areas: Guildford & Waverley of Surrey Heartlands ICS, and North East Hants & Farnham plus Surrey Heath, which both sits in the Frimley ICS. Within this area there are five Community Hospitals at Farnham, Fleet, Haslemere, Milford and Cranleigh. The population (approx. 550,000) is mixed urban and rural, with small areas of deprivation and ethnicity, which present a challenge to ensure services are accessible and responsive to local needs.

Across all our service areas during the year 2022-2023 2150 patients were supported by PT. The number of patients admitted to the IPU was 303 with a bed occupancy of 92%. Approximately a quarter of patients were discharged home. 85% of our care is delivered in the community and within our Living Well services (delivered on site) we supported 660 patients. 68% of our patients die at home.

Our largest noncancer groups are patients with Motor Neurone Disease and chronic respiratory diseases but we now support more than ever before patients with non-malignant conditions.

The community team consists of over 16 WTE CNS, 38 sessions of consultant time from five colleagues covering clinical, research, management and educational activities and 19 sessions of Specialty Doctor specialist registrar time. Community support is available from all members of the MDT. As well as nursing and medical this includes physiotherapists, occupational therapists, complementary therapists, pharmacist, chaplains, social workers, counsellors, patient welfare officers, and a bereavement team. PT offers a number of group sessions e.g. the rolling programme of wellbeing workshops, Storm - the teenagers support group and coffee mornings to support bereaved adults.

PT has strong links with Frimley Park Hospital, the Royal Surrey County Hospital, Woking and Sam Beare hospices and the Macmillan Community Team Midhurst, Sussex.

Key Relationships

• Primary and Community Services

Guildford & Waverley Place

North East Hampshire & Farnham Place

Surrey Heath Clinical Commissioning Place

• NHS Acute Hospitals

The Royal Surrey County Hospital NHS Foundation Trust, Guildford

Frimley Health NHS Foundation Trust

• Local Specialist Palliative Care Teams

Macmillan Community Team, Midhurst, Sussex

Woking and Sam Beare Hospices, Woking, Surrey

Princess Alice Hospice, Esher, Surrey

St. Catherines Hospice, Crawley, Sussex

St. Michaels Hospice, Basingstoke, Hampshire

Qualifications

Essential

• MB BS or equivalent medical qualification

Desirable

• MRCGP or MRCP or other Postgraduate qualification e.g. Diploma palliative medicine

Commitment to clinical governance/impoving quality of patient care

Essential

• Clinical governance:
• Capacity to be alert to dangers or problems. Demonstrates awareness of good decision making. Aware of own limitations. Track record of engaging in clinical governance: reporting errors, learning from errors.
• Audit:
• Understands principles
• Teaching:
• Teaching & presentation skills
• Commitment to ongoing professional development
• Learning and personal development:
• Demonstrates interest in the specialty required for the job. Demonstrates a commitment to maintaining professional skills and knowledge relevant to the job. Demonstrates a willingness to fully engage in appraisal. Self-awareness and ability to accept and learn from feedback.

Desirable

• Understands principles of research
• Evidence of active participation in audit.
• Evidence of teaching training
• Flexible outlook in view of changing service needs

Communication Skills

Essential

• Effective communication skills:
• Demonstrates excellent ability in written/spoken English communication and capacity to adapt language as appropriate to the situation.
• Empathy and sensitivity:
• Capacity to listen and take in others perspectives.
• Works in partnership with patients:
• Always considers patients preferences when discussing treatment options.
• Always considers the full impact of clinical decisions on the patients. Practice shared decision making.
• Directs and supports patients to access the information they need to support decision making.

Desirable

• Advanced communication skills training

Fitness to practise and Health

Essential

• Must hold full GMC registration and belong to a medical defence organisation
• Applicants knowledge is up to date and is fit to practise safely
• Current licence to practice held with the GMC
• Meets professional health requirements (in line with GMC standards in Good Medical Practice).

Experience

Essential

• At least 3 years post graduate experience in relevant specialities
• Full clean driving licence

Desirable

• Previous palliative care experience post-registration

Knowledge

Essential

• Sound knowledge of basic science and ability to apply this to clinical practice
• Clinical Skills:
• Clinical knowledge relevant to palliative care: Capacity to apply sound clinical knowledge relevant to the job including: symptom control, demonstrable skills in communication around end of life care, understanding of ethical issues relevant to palliative care etc.
• Clinical judgement: Experience in making clinical decisions and managing risk. Knows when to seek help, able to prioritise clinical need.
• Practical Skills:
• Show aptitude for practical skills, required in the job. E.g. venepuncture, catheterisation
• IT Skills:
• Good IT literacy and a willingness to learn use of new application related to the post
• Ability to use outlook, word and PowerPoint

Desirable

• Evidence of understanding and application
• Specialty knowledge exam.
• Experience of managing
• end stage of non-malignant
• disease palliatively
• Ability to use excel

Personal skills and motivation / Management

Essential

• Team working:
• Demonstrated experience working in a team, values the input of other professionals in the team
• Managing others and team involvement:
• Capacity to work co-operatively with others and demonstrate leadership when appropriate. Capacity to work effectively in multi-professional teams.
• Coping with pressure:
• Capacity to operate under pressure. Demonstrates initiative and resilience to cope with setbacks and adapt to rapidly changing circumstances.
• Problem solving and decision making:
• Capacity to use logical/lateral thinking to solve problems and make decisions.
• Organisation and planning:
• Capacity to organise oneself and prioritise own work. Demonstrates punctuality, preparation and self-discipline. Understands importance of information technology.
• Flexible approach to work:
• Able to adapt and work with employers to deliver improved patient care.
• Equality and diversity:
• Promotes equality and values diversity.
• Management ability:
• Show interest and enthusiasm or demonstrate ability

Desirable

• Leadership skills
• 360 degree feedback

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).