JOB DESCRIPTION

Job title Consultant in Palliative Medicine

Reports to Medical Director

Responsible for

2 doctors out of Specialty Doctors, Associate Specialists, Specialty Registrar or Specialty Trainee (as agreed with Medical Director)

Scope & Role Purpose To act as a Consultant Specialist Palliative Medicine resource to the Hospice multi-disciplinary team, the Hospital Palliative Care Team, as well as those in Primary Care across the catchment area. To work to ensure a proactive integrated model of palliative care service delivery to all patients within the catchment area.

Key responsibilities 1. Deliverables/outcomes To act as a Consultant Specialist Palliative Medicine resource to the

Hospice multi-disciplinary team as well as those in Primary Care across the catchment area.

To be the medical lead for either the In-Patient Unit or Hospice in the Home as agreed with the Medical Director and to provide medical input to Hospice Day Service as required.

To provide regular sessions to support the hospital palliative care team at Maidstone and Tunbridge Wells NHS Trust, identifying patients for early transfer to the hospice or for discharge with increased support. To increase the profile of palliative care in the area of acute admissions and to educate staff to facilitate early discharge.

To cross cover the other consultant when absent, taking up their regular clinical commitments and meetings as appropriate.

To clinically supervise the doctors in training, Specialty Doctors and Associate Specialists in the Hospice, providing them with expertise and leadership around clinical decision making. To act as Clinical Supervisor and/or Educational Supervisor for the doctors in training as appropriate.

2. Management & Leadership To liaise with managers of the appropriate services, looking at

performance outcomes and ensuring excellent documentation and evaluation of services.

To line manage hospice Specialty Doctors and/or Associate Specialists, meeting with them regularly and undertaking their annual reviews, setting their objectives and job plans.

To be an active member of the Clinical Leadership Team, helping to represent the medical team and disseminate information back to the team

To contribute to the requirements of Clinical Governance within the Hospice.

To ensure effective working relationships with those agencies 1

concerned with the provision of health and social care services and those representing the interests of patients

To attend external working parties as appropriate to contribute to the development of Palliative Medicine in the wider context.

To continue to develop Specialist Palliative Care clinical provision in line with local priorities and the discerned needs of the catchment population.

3. Communications and Teamwork To strive to achieve excellent verbal and written communication with

patients, carers, staff and volunteers within and outside the organisation.

To be a co-operative and supportive member of the hospice staff team, ensuring that the line manager is aware of any issues in the workload which may affect other members of the hospice team

To maintain confidentiality of all information acquired especially with regard to patients, carers, staff and volunteers.

To respect and guide all volunteers and to develop effective working relationships including, when requested, providing regular feedback on their performance.

4. Audit and Research To participate in clinical and other service audits and developments

with the aim of ensuring a high standard of patient care and to encourage and support other staff undertaking audits.

To contribute to the development of policies and clinical guidelines within the organisation, using an evidence-based approach.

To be the medical lead for research within the hospice, working to encourage, support and disseminate research projects throughout the hospice. To work in collaboration with the Kent and Medway Palliative Care Research Group helping to identify projects suitable for HitW involvement and actively recruiting patients for trials. To act as Principle Investigator when appropriate and ensure excellent documentation for research files.

To actively contribute to the Acute Trust’s Education and Clinical Governance programme alongside the current consultant.

5. Training and Development To play a key role in the delivery of teaching in palliative medicine to

healthcare professionals served by the Hospice and within the Acute Trust

To share the responsibility of post-graduate training and clinical supervision of the Specialty and training Doctors working at the hospice

To be involved with the placement of medical students at the hospice and to coordinate and evaluate their teaching

A proactive interest in life-long learning is expected along with engagement in continuing professional development.

To undertake an annual appraisal both at the hospice and at MTW NHS Trust and through self-development, continuously update and improve knowledge and competencies. To be proactive in undertaking any additional activities required to be revalidated

6. General To ensure compliance with the General Medical Council’s published

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guide “Good Medical Practice” including the Duties of a Doctor. Maintain professionalism through adherence to recognized Codes

(e.g. GMC) and work within the boundaries of Hospice in the Weald policies.

Maintain personal development through the Hospice Personal Development Plan, and NHS Appraisal PDP, continuously updating and improving knowledge and competencies.

Engage in the use of information and communication technology (ICT) in the area you are working and achieve the required level of competence.

Any other duties that may be reasonably requested. Recognise the growing need for 24/7 working patterns and flexibility. Strive for excellence at all times

Person Specification

Essential DesirableQualifications Entry on the General Medical

Council (GMC) Specialist Register via one of the following:

1. Certificate of Completion of Training (CCT) (the proposed CCT date must be within 6 months of the interview)

2. Certificate of Eligibility for Specialist Registration (CESR)

3. European Community Rights

MRCP, MRCGP, FRCA, FRCR or equivalent(s)

Further postgraduate qualification, e.g. MSc, MA, PhD

Formal training in teaching techniques

Experience Recent palliative care experience and breadth of awareness of palliative care issues

Knowledge of evidence-based practice

Demonstrates knowledge of oncological and haematological malignancy

Experience of teaching in a multidisciplinary setting

Knowledge of research methodology and experience of conducting research in palliative care

Experience of committee work

Essential Skills Excellent communication and interpersonal skills

Computer Literacy

Management skills. Leadership skills Basic Ultrasound skills Project Management Skills

Personal attributes Ability to work under pressure Strong team player

Awareness of own limitations

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Enthusiastic and Motivated Committed to striving for

Excellence Ability to reflect on own practice

FundraisingHospice in the Weald is a registered charity and not part of the NHS. We rely on support from the community we serve, both through volunteering time and donating money, to enable us to continue our existing services. It costs over £7 million to run the Hospice every year – the majority of which comes from voluntary contributions from the general public. In addition, there are over 900 volunteers giving their time to the Hospice helping in every Service and Department. For this reason, it is expected that all members of staff will also support the fundraising activities of the Hospice. We encourage every staff member to help at, participate in, or support at least two fundraising activities every year. Opportunities to support fundraising activities are varied, and could include helping at fundraising and shop events, taking part in an event and raising sponsorship, attending a cheque presentation or giving a small talk about the work of the Hospice to an interested group in the community. Staff members will be asked as part of their Annual Review which events they have supported

THIS JOB DESCRIPTION IS NOT EXHAUSTIVE AND IS SUBJECT TO REVIEW IN CONJUNCTION WITH THE POST HOLDER AND ACCORDING TO FUTURE CHANGES/DEVELOPMENTS IN THE SERVICE.

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Consultant Job Plan

Full Time 10 PAs + 0.5 on callMonday Tuesday Wednesday Thursday Friday

AM0900- 1300Consultant Ward Round

1 DPA

0900-1245Hospital session TWH

1245-1300Travel time

1 DPA

0830-1230Ward Reviews including some direct supervision of junior doctors

1 DPA

0900-1300Consultant teaching Ward RoundJunior doctor WBAs & supervision

1 DPA

0800-0945Oncology MDT

0945Travel time

1000-1200Outpatient clinic

1 DPA

PM1330-1530Consultant Ward Round and follow up family meetings

1530-1730CPD, audit work, administration

0.5 DPA0.5 SPA

1330-1430Consultant Meeting

1430-1730Administration

1 SPA

1300-1500Journal club & junior doctor supervision

1500-1700Ward Multi-Disciplinary Meeting

0.5 SPA0.5 DPA

1330-1730Management meetings (1.5 meetings per month)Teaching preparation, Mentoring meetings

1 SPA

1230-1430Outpatient clinic

1430-1630Ward reviews with registrar prior to weekend

1 DPA

DPA 7.0 SPA 3.0On call 0.5 1st on call one day/ fortnight, 2nd on call 1 week in 2 (with the option of a Kent-wide 2nd on call, 1 in 6, currently being explored)

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Background Information

This post has arisen as result of a relocation for the current post-holder. The successful candidate will be working alongside the current Consultant and Medical Director, Dr Helen McGee, continuing to strengthen Palliative Care Services across the 400 square mile catchment area of the Hospice and ensure joined up working with the Maidstone and Tunbridge Wells NHS Trust Palliative Care team and Primary Care.

The appointee will be based at the Hospice and will be responsible for shared clinical leadership for the medical team. First on call duties would involve one evening per fortnight and very occasional weekends in the event of an unexpected absence. Second on call responsibilities, which are very light, would be held by the consultants on a 1 in 2 basis and are remunerated at 0.5PA per week. We are currently exploring the option of joining a Kent-wide consultant 2nd on call rota which would reduce the frequency to 1 in 6 by providing cover for all the units in Kent.

The post offers ample opportunity to participate in education programmes for all levels of healthcare professionals both internally through our we:train training centre and externally, delivering GP education, care home sessions and in teaching for medical students and trainee doctors. Active involvement with audit, clinical investigation and research will be encouraged, seeking opportunities to expand the Hospice’s research activity along with Kent and Medway Palliative Care Research Group and the University of Kent.

Hospice in the Weald:The palliative care service was established in 1980 as 'Hospice at Home', an independent charity with no religious affiliation. This home care service rapidly took on a central role in the delivery of palliative care across West Kent and East Sussex. The fifteen-bed purpose-built hospice was opened in 1998. In addition to the Inpatient Ward, it houses a busy Hospice Day Service that offers a range of treatments, both complementary and conventional, as well as other supportive and creative therapies. There is also a Hospice in the Home Service offering true 24/7 support to patients at home, with the aim of enabling patients to remain at home for their end of life care if that is their wish. Counselling, bereavement support and information provision are also key aspects of the specialist palliative care service available across the catchment area that has a population of some 300,000. In 2019 we will be opening the country’s first ever Cottage Hospice, an innovative service that aims to de-medicalise death, allowing families and carers to remain the primary caregiver, continue to care for the patient, supported by our highly skilled Volunteer and Nursing workforce.

Hospice Mission Statement:Hospice in the Weald strives to ensure that the community we serve has access to: Compassionate, individualised, holistic and supportive care for all patients with terminal illnesses, their families and carers.

Our Core Values that underpin this Mission statement are To put patients first To support patients, their families and carers To deliver the most effective palliative care we can To respect and value all staff, trustees and volunteers To be open, honest and transparent in all we do To make best possible use of funds to ensure value for money

We have a 3 Year Strategy 2017-2020 (accessible on our website here) and this is supported by our one-year Operational Business Plan 2018-19.

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Statistics: 2017-18The Hospice received 1643 referrals last year. The majority of these patients were assessed by the Hospice in the Home Service and offered ongoing support from Doctors, Advanced Nurse Practitioners, Clinical Nurse Specialists, Staff Nurses, Nursing Assistants and Volunteers. Last year we were able to enable 77% of our patients to die in their Preferred Place of Death. There is the facility to see patients in our Hospice Appointments, enabling patients to have ‘one to one’ sessions at the Hospice with the Consultant and other Hospice specialists. Over 500 patients and family members attended our Hospice Day Service which takes up to 30 patients a day and is open 6 days a week. There were 356 patients admitted to the Inpatient Ward and our average occupancy during the year was 77%. Approximately 1050 patients and their families benefited from counselling and bereavement support from our Counselling & Support Team.

Finances and Management:The Hospice is an independent charity with a body of Trustees to whom the Chief Executive, Mr Rob Woolley, is accountable. The Hospice Leadership Team (HLT), consists of the CEO and 5 Directors and meets monthly and attends Trustee Board meetings. The Clinical Leadership Group is a sub-group of the HLT and consists of the Heads of Services, the Consultant, the Care Director, Medical Director and the CEO. This also meets monthly with the role of implementing changes to practice and disseminating best clinical practice. The Hospice cost £7 million to run in 2017-18 and the CCGs fund approximately 11% of the current budget. The Hospice is on a sound financial footing, thanks to successful year on year fundraising.

Staff members:Chief Executive Mr Rob WoolleyMedical Director Dr Helen McGeeCare Director Ms Lisa Hatcher (maternity leave) Interim Care Director Ms Michelle FordHead of Ward Ms Carolyn KeysHead of Hospice in the Home Mr Graham TurnerHead of Hospice Day Service Ms Nell MellerickHead of Counselling & Support Services Mr Paul Madden

Multidisciplinary Team:The post holder would be a member of the multidisciplinary team. This includes:ST 1/2 (GP trainee), StR, 2 Specialty Doctors, Associate Specialist, Medical Consultant, Care Director, Advanced Nurse Practitioner, Clinical Nurse Specialists, Staff Nurses, Nursing Assistants, Paramedics, Chaplains, Counsellors, Creative Therapists, Music Therapists, Occupational Therapist, Physiotherapist, Wellbeing Therapists and many volunteers.

On call:First on call duties would involve one evening per fortnight and very occasional weekends in the event of an unexpected absence. Any weekend first on call cover will be separately remunerated or exchanged for TOIL. The workload is usually light, but you must be available to return to work at any time if needed. Second on call is covered by the two consultants on a 1 week in every 2 basis. The workload is very light with the consultant available for telephone advice to the 1st on call doctor or hospital staff as needed. We are currently exploring the possibility of moving to the Kent-wide Consultant on call rota, which would reduce the frequency of 2nd on call to 1 in 6 or 1 in 7. The consultant would be available for telephone advice for any of the 6 Hospices in Kent and the hospital staff. The successful applicant could have a say in whether we move to this system or not and in shaping how it works for Hospice in the Weald.On call is currently categorised as Category B, high frequency and is remunerated at 0.5PA per week (5%).

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Accommodation:An attractive office will be provided at the Hospice site for the post holder together with the other consultant and the Specialty Doctors. Robust administrative support is available through the Care Records Department with a dedicated administrator present in the doctors’ office every morning. Personal computer with access to Intranet, Internet and Electronic Healthcare Record (EMIS) as well as tablet for mobile access to EMIS, a laptop and a mobile phone will be provided.

Support:As well as the aforementioned administrative support, clinical support is provided by the wider multi-disciplinary team including the existing consultant. Time is allocated during the working week to ensure adequate handover of patients in the Hospice in the Home service and for in-patients for on-call purposes. There will be an element of cross-cover between the consultants to cover for periods of leave.There is regular group supervision for the whole medical team, facilitated by a senior counsellor. This is a useful space to discuss challenging cases confidentially and to work through any issues that have arisen. Post-holders who are newly appointed to the consultant grade would be able to access mentoring and the Hospice is committed to supporting this. This may be an external local consultant or via the Association of Palliative Medicine or the Royal College of Physicians as agreed with the Medical Director.

Appraisal and Revalidation:Hospice in the Weald supports the requirements for continuing professional development (CPD) as laid down by the Royal College of Physicians and is committed to providing time and financial support for these activities.The Hospice has the required arrangement in place as laid down by the Royal College of Physicians to ensure that all doctors have an annual appraisal with a trained appraiser (via Maidstone and Tunbridge Wells NHS Trust) and supports doctors going through the revalidation process. For revalidation purposes the Hospice is a designated body and our Responsible Officer is the Medical Director at MTW NHS Trust. An NHS appraisal will also take place via the Trust and there are facilities available to access their mandatory training, 360’ feedbcak and Clinical Excellence Award schemes.It is a contractual and professional requirement that each member of staff working within the Hospice has an annual review. The Hospice annual review system is outlined in the Hospice staff handbook. This is a positive exercise designed to assist doctors in their educational and professional development and aims to improve and consolidate existing good practice and will be undertaken by the Medical Director

Working alongside the current consultant:The current plan is for this post to be the medical lead for the In-patient Ward and for Dr Helen McGee to remain the consultant lead for the Hospice in the Home Service, but these arrangements may be subject to change in the future, depending on individual’s circumstances and preferences.It is anticipated that the non-clinical responsibilities can be allocated between the consultants, allowing each of them an opportunity to be the lead for either clinical audit, teaching or research. This job plan has been written to suggest this post-holder takes on responsibility for teaching but again this can be subject to change in the future. This job plan has 3 SPAs allowing plenty of time for a newly appointed consultant to take up Mentoring as well as leading on one or two non-clinical roles.

Leave Management:All annual and study leave must be agreed by the Medical Director. The post holder would be entitled to 30 days’ annual leave per year and 30 days’ study leave over 3 years. The Hospice supports study leave with expenses for CPD activities and within agreed financial limits. Leave management should ensure adequate and safe cross cover arrangements with colleagues.

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Locality:The area includes the charming and thriving towns of Sevenoaks, Edenbridge, Crowborough, Tunbridge Wells, Hawkhurst and Cranbrook, many of which are situated in areas of outstanding natural beauty. Charing Cross is just 45 minutes by train and there is easy access to the M25, the Hospice itself being a few minutes from the A21. Excellent Primary and Secondary schools serve the population.The Hospice is situated just off the A228 within a mile of the intersection with the A21 and the map below shows a major portion of the catchment area.

MAIDSTONE & TUNBRIDGE WELLS NHS TRUST:Maidstone and Tunbridge Wells NHS Trust was formed in April 2000. The Trust provides general hospital services to a population of approximately 460,000 in West Kent and North East Sussex, and some specialist services to a considerably larger population. Its major hospitals are Tunbridge Wells Hospital at Pembury and Maidstone Hospital. The Trust’s Chairman is Mr David Highton, the Chief Executive is Mr Miles Scott and the Medical Director is Dr Peter Maskell. Clinical services are organised into nine clinical directorates.      The Clinical Director of the Kent Oncology Centre is Dr Henry Taylor. The Palliative Medicine Consultant is Dr Dag Rutter Its major hospitals are The Tunbridge Wells Hospital at Pembury near Tunbridge Wells and Maidstone Hospital. The Kent Oncology Centre in West Kent is based at Maidstone Hospital. The Trust manages the Oncology centre based at Maidstone and Canterbury. These services form an integral part of Kent’s Cancer Services. MAIDSTONE HOSPITAL:Maidstone Hospital is a modern 410 bed hospital situated at the western edge of Maidstone, two miles from junction 5 of the M20. It provides general hospital services to a catchment population of around 220,000. The Accident & Emergency Department has approximately 50,000 attendances per year. The hospital has a full range of diagnostic services, including multi-slice CT and MRI scanners and a mobile PET scanner. The Kent Oncology Centre is based at the Maidstone Hospital, with a second centre in Canterbury and is managed by the Trust. Acute medicine and elective in-patient surgery is provided on this site. A state-of the-art laparoscopic theatre is sited here and will enable the development of the Postgraduate Centre into a world-class laparoscopic training centre. TUNBRIDGE WELLS HOSPITAL AT PEMBURY:Tunbridge Wells Hospital is adjacent to the A21 and is the largest all single bed NHS hospital in England and provides 510 single rooms with modern new facilities. It was built as a PFI and it opened in 2011. It provides outpatients, orthopaedics, obstetrics and gynaecology, and children’s services. The hospital palliative care team works across both sites, under the leadership of Dr Dag Rutter, consultant and Ms Shelley Badcott, Manager. The sessions provided by the Hospice consultants are 9

always at the Tunbridge Wells site (5 mins away from the Hospice by car), reviewing Hospice patients who are in hospital and seeing complex patients along with the palliative care team CNS. As the cancer centre is at Maidstone there is a larger non-cancer workload at Tunbridge Wells and opportunities to link in with heart failure and chronic lung disease MDTs as well as Oncology MDTs as needed.Currently there are no hospital-based palliative care out-patient clinics, but this is an area we would like to introduce with this post.

TERMS AND CONDITIONS OF EMPLOYMENT:

Salary will be based on the current NHS Consultant pay scale e.g. a starting salary of £76,761 pro-rata

The post is pensionable within the NHS Superannuation Scheme unless the appointee opts out or is ineligible.

Clinical Excellence Awards are honoured by the Hospice. Applications for new awards are dealt with via MTW NHS Trust and are encouraged by the CEO.

The contract is currently held with Hospice in the Weald and terms and conditions of employment are available in the staff handbook.

30 days’ annual leave together with Bank Holidays (or days in lieu) and 10 days’ study leave (or 30 days in any three years). All leave is subject to appropriate arrangements for cover having been made.

The post is offered on a full or part-time basis. The time scale for achievement and standards of performance relating to the duties and

responsibilities identified in this job description will be agreed via the annual job review with the post holder.

The post holder’s private residence shall be maintained in contact with the public telephone service and shall not be more than 45 minutes driving time from the Hospice unless specific written approval is given by the Hospice to the post holder.

The post holder must maintain personal indemnity by one of the main medical insurance bodies. Mileage will be paid at the maximum Inland Revenue agreed rates for travel related to reaching

venues necessary in fulfilment of the duties of the post. Travel from home to Hospice and Hospice to home is only reimbursed when this relates to visits out of hours.

TERMS OF APPLICATION

a) The applicant must have CCST in Palliative Medicine OR be on the Specialist Register OR, if of Specialist Registrar status must be within six months of being admitted to the General Medical Council Specialist Register.

b) Any offer of appointment will be subject to receipt of THREE satisfactory references of which one should be the current employer.

c) Appointment will be subject to satisfactory health screening by the Hospice Occupational Health Department.

TO APPLYInterested candidates are welcome to contact Dr Helen McGee (01892 820503) or via helen.mcgee@hospiceintheweald.org.uk to discuss this post and arrange an informal visit. Application forms are available from our website www.hospiceintheweald.org.uk or by phoning HR on 01892 820546.

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