Paediatrics: ST1, ST2 and ST3 level Job Description - South West ...

Paediatrics: ST1, ST2 and ST3 level
Job Description
January 2010

PAEDIATRICS: ST1, ST2 & ST3
PROGRAMME DESCRIPTION
The South West Peninsula Deanery offers Paediatric training at ST1, ST2 and ST3
level.
The Trusts offering these programmes are as follows:
• Plymouth Hospitals NHS Trust
(http://www.plymouthhospitals.nhs.uk/Pages/Home.aspx)
• Royal Devon and Exeter NHS Foundation Trust
(http://www.rdehospital.nhs.uk/)
• South Devon Healthcare NHS Trust
(http://www.sdhct.nhs.uk/)
• Northern Devon Healthcare NHS Trust
(http://www.northdevonhealth.nhs.uk/)
• Royal Cornwall Hospitals NHS Trust
(http://www.rcht.nhs.uk/RoyalCornwallHospitalsTrust/)
Initial appointment at ST1 level will normally be in Plymouth, Exeter or Cornwall.
These placements will usually be for 24 months. The next 12 months will be provided
through rotation to placements at some of the other Trusts. Precise arrangements for
the 12 months will depend on the vacancies available and the assessed training
needs of the individuals. There is the expectation of experience in the smaller DGH’s
where there is greater responsibility and also “level 3 Neonatology at Plymouth.
At ST4 trainees will be expected to gain the necessary experience and
competencies outlined in “A framework of Competencies for Core Higher specialist
training in Paediatrics (RCPCH 2005). To achieve this placements will normally be
for 2 years and may involve rotation between two of the Trusts in the Peninsula.
During ST6 and ST7 most trainees from the Peninsula will be expected to spend
some time in sub-speciliaty training posts based in the Severn Deanery. These are
in Bath and Bristol. Some sub-speciality training is also provided within the
Peninsula.
For your ST8 year you will be expected to return to the Peninsula rotation.
The length of time in each post may vary and is dependant on training needs of
individuals within the rotation and acquisition of necessary competencies.
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Duties and responsibilities throughout the rotations
There will be minor variations in different posts in different hospitals but this list is
aimed at covering the majority of duties:
1. Supervise, monitor and assist the F1 doctor in the day-to-day management of inpatients
in posts with an attached F1.
2. Maintain good liaison between patients, relatives & carer’s, nurses, other junior
medical staff, senior medical staff and such other Trust and community based
staff as is necessary.
3. Attend and participate in ward rounds as timetabled
4. Attend outpatient clinics as timetabled.
5. Take part in rostered on call and emergency work.
6. Maintain good communication with professional colleagues through telephone
calls, dictated discharge summaries and letters as appropriate..
7. Study for higher examination’s and maintain continued professional development
which will be evidenced through the personal portfolio.
8. Attend any timetabled educational and multidisciplinary sessions.
9. Participate in Trust Clinical Governance activity and in particular undertake
audit’s regularly throughout the rotations.
10. Participate in all necessary assessments and appraisals.
11. Support and teach attached medical students as directed.
12. Co-operate with members of the personnel department when monitoring hours of
work and other personnel issues.
13. Attend induction in each hospital or new department
14. Comply with all local policies including dress code, annual and study leave
Related Sites
• The Royal College of Paediatrics and Child Health
http://www.rcpch.ac.uk/
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Barnstaple
Medical Staff
Consultants
Dr J Cox
Dr A Arend
Dr A Bosley
Dr Rebecca Rub
Dr Jonathan Walsh
New post - community
Special interest
diabetes
neurology
cystic fibrosis, respiratory
Other Paediatric Hospital Staff
Staff Grade 3
ST4-8 1
ST3 3
GP VTS 3
Postgraduate Education
The library in the hospital has a large stock of Paediatric texts and journals. The staff
are efficient and helpful with any requests for information.
There is an active teaching programme for junior staff which includes both clinical
and non clinical aspects of paediatrics, guidance on teaching methods and applying
evidence based medicine.
Within the Medical Education Centre you can hire rooms, audio visual equipment,
obtain help with presentations, apply for study leave and expenses, borrow videos
and CD Roms, use video editing facilities and use networked computers. The
majority of undergraduate and postgraduate teaching sessions take place here.
RCPCH Tutor
Dr Rebecca Rub.
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Exeter
General Information
Acute paediatric services are based at the Royal Devon and Exeter Hospital
(Wonford) and Neonatology has now moved to a purpose built unit on the Wonford
Hospital site. We serve a catchment population of 350,000 with 75,000 children
aged 0-16 years. There are 49 acute paediatric beds including four for high
dependency and a six bedded day case unit. Paediatric oncology and cystic fibrosis
services are multidisciplinary and provide hospital care and community back up for
patients from both the Exeter and Torbay districts. General and specialist surgery is
accommodated on the acute ward and includes plastics, ENT, maxillo-facial,
ophthalmology and orthopaedics. There are paediatric trained consultants in
ophthalmology and orthopaedics. General paediatric and Neonatal consultant cover
during working hours and at weekends is based on a 4day/3day split week on
service model.
Neonatal intensive care is provided as part of the Peninsula Neonatal Network in
which the level 3 unit is based in Plymouth. We cater for 3,500 deliveries including
those in three community midwifery led units. There is a foetal medicine unit, and
fertility treatment, and an excellent relationship with the maternity services. We take
all infants ≥26 weeks gestation, offer ventilation, oscillation, total body cooling on the
TOBY register. Day time cover is provided by a week on service model by the
consultants with a neonatal interest as well as an associate specialist. There is night
time cover from a separate rota of neonatal consultants.
Community paediatric services are based in the 3 community Joint Agency Teams
and at Newcourt House. There is regular consultant community paediatric input into
the workings of the Joint Agency Teams. The Honeylands Child Development Centre
provides a multidisciplinary assessment and therapy for pre-school children along
with respite care for children up to the age of 12 yrs. Amongst the numerous special
schools are the School for the Physically Handicapped (Vranch House), adjacent to
Honeylands, The Royal School for the Deaf and the West of England School for
Children with Little or No Sight.
Medical Staff
Consultants
Dr Vaughan Lewis
Dr Patrick Oades
Dr Andrew McNinch
Dr Ron Smith
Dr Michael Quinn
Dr Corinne Hayes
Dr Andrew Collinson
Dr David Mabin
Dr Richard Tomlinson
Dr Hazel Curtis
Dr Nigel Osborne
Dr James Hart
Dr Simon Robertson
Dr Emma Davis
Dr Karen Street
Dr Simon Parke
Special Interest(s)
Lead Clinician, General paeds, neonates, nephrology
Respiratory, Cystic Fibrosis
Endocrine, general paediatrics
Community (Exeter)
Head of School Neonatology, neurodisability
Paediatric Oncology, General paediatrics
General paeds, immunology, neonatology
PMS, Cardiology, Neonatology
Community (Mid-Devon), Neurodisability, Gen paeds
Community (Honeylands Children’s Centre)
Neonatal, cardiology, rheumatology
General paeds, neonatology, Gastroenterology, PMS
College Tutor, General Paeds, Diabetes, CF
General Paeds, Diabetes, Endocrinology
General paeds, Community paeds, ED Liaison
Paediatric Oncology, General Paeds
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Postgraduate Education
There is a new state of the art medical library based in the newly built Peninsula
Medical School building on the Wonford site. There are weekly hospital grand
rounds, weekly neonatal and acute paediatric departmental teaching afternoons and
regular community child health meetings and teaching sessions. In addition there are
regular meetings for radiology, tertiary neurology, joint ED, resuscitation scenarios,
M+M, Drug and Bug, and a joint maternity and neonatal weekly meeting.
RCPCH District Tutor – Dr Simon Robertson
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Plymouth
General Information
Child health services are provided for a population of approximately 100,000 children
and adolescents under the age of 16 years living in West Devon and East Cornwall.
In addition, the neonatal service is the tertiary service provider for the whole
Peninsula. Plymouth is the largest city west of Bristol situated in an otherwise rural
area. As such the catchment profile includes a large under-privileged inner-city
population and areas of rural deprivation. The clinical experience available is
enormous.
The Department of Hospital Paediatrics moved to accommodation at Derriford
Hospital in January 1994. Babies, children and teenagers with medical and surgical
problems are cared for on the 12 th floor of the main hospital tower. There are two
main wards (Woodcock and Wildgoose). In addition, there is a Paediatric High
Dependency Unit capable of providing non-invasive ventilatory support, a dedicated
Children’s Admission and Assessment Unit (Whitehorse Ward) and a Children and
Young People’s Unit providing outpatient and day care facilities.
In addition to general paediatric outpatient clinics, the Plymouth paediatricians hold
special interest clinics in asthma, cardiology, cystic fibrosis, diabetes, epilepsy,
allergy, headache, metabolic paediatrics, gastroenterology, growth & endocrinology
and oncology. Combined clinics are held with Plymouth consultants in haematology,
rheumatology, immunology, audiology and congenital hip disorders. Visiting subspecialty
paediatricians hold combined clinics in cardiology, nephrology, paediatric
surgery, urology, oncology, endocrinology, neurology, neuromuscular disease,
plastic surgery / cleft lip & palate management and metabolic medicine.
The Department of Neonatal Medicine is based in the Neonatal Intensive Care Unit
(NICU) situated on Level 5 of the Maternity Wing within the main hospital.
Approximately 4,700 babies are born in Plymouth each year. Plymouth is the
designated Level 3 facility for neonatal intensive care within the South West
Peninsula. 2005 saw a significant uplift in senior medical and nurse staffing of the
service and the NICU has seen a year on year increase in ICU/HDU activity following
strategic realignment of referrals for care of both the most pre-term infants and also
sick term infants with multi-system dysfunction. The unit plays a pivotal role in
neonatal transport for the Peninsula undertaking >90% of all moves (240 transports
undertaken in 2007). The unit provides full intensive medical care, including
oscillatory ventilation, inhaled nitric oxide, total body cooling and cerebral function
monitoring for all babies. Those with major surgical or cardiac problems are
transferred to appropriate tertiary centres for ongoing support. Training in cranial,
cardiac and hip ultrasound is available, with opportunities to participate in neonatal
follow-up, cardiology, neuro-developmental, genetics and hip clinics. A 20-bed
Transitional Care Ward is situated adjacent to NICU, which provides augmented
care over and above routine post-natal requirements for babies beyond 34 weeks
gestation alongside their mothers.
Community services are centred on the Plymouth Child Development Centre located
at Scott Hospital. Experience may be gained in Child protection work, adoption and
fostering, audiology, child health surveillance, immunisation, neurodevelopment and
disability clinics. Facilities are provided in purpose-built accommodation, which
allows the multidisciplinary assessment, investigation, and management of children
with neuro-developmental problems including hearing and vision difficulties. The
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service also holds clinics in special schools.
Medical Staff
Consultants
Dr CR Adcock
Dr ACL Allwood
Dr A Cade
Dr AJ Cronin
Dr J Eason
Dr S. Glass
Dr I. Guarino (locum)
Dr R Howells
Dr RWA Jones
Dr JA Lilley
Dr T Lopez
Dr RJ Madar
Dr N Maxwell
Dr GL Richardson
Dr R Smith
Dr P Sundaram
Dr PS Ward
Dr. R Vaitkute
Dr D Vinthagen
Specialist interest
General paediatrics, epilepsy
Neonatology, cardiology, medical education,
medical informatics
Respiratory paediatrics, general paediatrics,
allergy, RCPCH tutor
Neuro-developmental paediatrics & community
child health, immunisation, general paediatrics
Neonatology, cardiology, infant nutrition, medical
education, clinical director for neonatology, GUM,
O&G and breast
Community child health
Community child health, general paediatrics
Neurology, intensive care, general paediatrics,
medical education
General paediatrics, nephro-urology, epilepsy,
rheumatology
Neonatology, neurodevelopmental outcome,
General paediatrics, gastroenterology, Lead
Paediatrician for Peninsula Medical School
Neonatology, cardiology, Medical Director of
Peninsula Neonatal Care Network
Neonatology, Research, medical education
Neonatology, respiratory, medical education
Diabetes, Endocrine, medical education
Diabetes, Metabolic, medical education
Paediatric oncology, growth & endocrinology,
general paediatrics, Clinical Director Paediatrics
Neonatology, hips, medical education
Community child health, allergy, medical
education
Trainees
ST1-3 7
ST4-8 10
Postgraduate Education
The new Peninsula Medical School has resulted in medical education achieving a
very high profile within the department. Trainees are encouraged to participate in the
provision of undergraduate paediatric teaching. In addition to a full range of
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departmental activities, opportunities exist to undertake higher degrees in, for
example, medical education, clinical sciences and health service management under
the aegis of the University of Plymouth. IT facilities are readily available and allow
access to many on-line resources. The postgraduate centre within the hospital
grounds provides a venue for many educational activities including APLS, PLS, NLS
and GIC courses.
Trainees have a named educational supervisor and are issued with the locally
produced, regularly updated guidelines. The regular departmental activities are
timetabled below, in addition to which are many other meetings.
Monday 13.00 – 14.00 Paediatric X-ray Meeting (Neuro
monthly)
Tuesday 08.30 – 09.30
09.00 – 10.00
13.00 – 14.00 (1 st )
13.00 – 14.00 (2 nd
/4 th )
Evidence Based Medicine /
Journal Club
PMS neonatal undergraduate
teaching
Perinatal Morbidity/Mortality
Fetal medicine meeting
Wednesday 08.30 – 09.30
12.30 – 13.30
13.00 – 14.00
Thursday 08.30 – 09.30
12.30 – 13.30
15.00 – 16.00
Friday 08.30 – 09.30
13.30 – 15.30
SHO teaching: Neonatology
NICU / TCW Child in Need
Meeting
Middle Grade Teaching
Clinical Presentations / Child
Protection
Neonatal imaging meeting
Neonatal middle grade teaching
(protected)
Neonatal Grand Round
SHO Teaching: Paediatrics
(Protected)
The programme of activities is under continuous review by the Directorate Education
& Training Steering Group (general paediatric and neonatal representation) and
College Tutor and is subject to change.
Higher Specialist Trainees are allocated a place on a multi-disciplinary Level 1 Child
Protection Course as early in their appointment as is practicable.
RCPCH District Tutor – Dr Alan Cade
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Torbay
General Information
Acute Paediatric services are based at Torbay Hospital, a medium sized District
General Hospital of 669 beds serving a catchment population of around 250,000 and
a Paediatric population of around 55,000. There is a significant increase in the
population in the holiday season.
In-patient care for acutely unwell children is provided on the recently refurbished
Louisa Cary ward, which is a 32 bed/cot ward and is used by other specialities
including general surgery and orthopaedics. This includes a newly built addition to
the main ward (commissioned Nov 2005) and comprises an adolescent unit, an
assessment and diagnosis unit, parents rooms and Doctors’ working and on call
rooms. An additional in-patient area for children, the John Parkes Unit, is located
just off-site and provides care for 8 children with special needs and chronic and subacute
conditions. Three of these 8 beds are used for medical respite for severely
handicapped children. The Special Care Baby Unit is managed by Obstetrics but inpatient
care is supervised and given by the Paediatrics team and provides 10 cots.
Neonatal Intensive Care is provided at the Derriford Hospital, Plymouth and the two
units work in close co-operation. Transfers between units are usually undertaken by
a team from Derriford.
Community Paediatrics is a strong specialty in Torbay. Services are based at the
Child Development Centre on the John Parkes Unit. Community support to children
with special needs in special schools is provided by a team of Associate Specialists
& SCMO’s & supported by two Community Consultants, Dr Dibble and Dr Singh.
Medical Staff
Consultants
Dr C Sainsbury
Dr J Broomhall
Dr A Janzen
Dr S Imong
Dr B Fraser
Dr L Dibble
Dr B Singh
Tutor
Special Interest(s)
Cystic fibrosis , Rheumatology
Diabetes and endocrinology;
Nephrology,
Neonatology, gastroenterology, Clinical Director
Respiratory and A/ E Liaison
Community paediatrics, Child protection
Community paediatrics, Disability and Epilepsy, RCPCH
Trainees
ST1-2 2
ST4-8 3
Postgraduate Education
There is an active post-graduate medical centre with a well-stocked library. The
library has six computers with internet access. There is a Weekly hospital grand
round. There are weekly Friday morning Clinical meetings in Paediatrics as well as
structured ST1-3 teaching on Thursday morning as well as weekly Clinical
Governance meetings. There is weekly Monday mornings ST4-8 teaching. Trainees
are also expected to attend monthly regional study days. There is also a bi monthly
Paediatric X-Ray meeting, monthly audit and perinatal meet. Trainees are expected
to participate in audit , presentation at clinical meetings and take an active part in
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teaching. Study leave for special interests and exams are strongly supported
RCPCH District Tutor – Dr Alison Jansen
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Truro
General Information
Royal Cornwall Hospital Trust is the main acute health provider for over 385,000 of
Cornwall’s 500,000 residents. Community Paediatric Services are provided for the
whole of Cornwall for children aged 0-16 years (a population in excess of 100,000).
The Child Health Directorate is responsible for acute paediatric services for all
children and young people up to their 17th birthday and is based at the Royal
Cornwall Hospital (Treliske).
The Department offers wide experience of the whole range of General Paediatrics
including high dependency and intensive care. Acute admissions into the recently
opened 50 bedded Children’s Unit are distributed between 2 wards with an additional
14-bedded specialist surgical ward. A separate medical day case (4 beds) and
outpatient facility opened in December 2000.
Recent departmental activity included 7,583 admissions, 2,080 new outpatients and
7,816 follow ups.
The 20-cot (7 ICU) Neonatal Unit serves some 4,000 deliveries per annum. Recent
activity levels were over 400 admissions with some 70 infants ventilated. The
Neonatal Unit is capable of high frequency oscillation ventilation and the use of nitric
oxide. One of the Obstetricians has a special interest in foetal medicine. There are
good ultrasound diagnostic facilities.
There are 4 Community Assessment Units with a completely new and updated
facility on the Treliske site. There are 4 special schools. Cornwall has a large number
of children with special needs integrated into mainstream schools. Cornwall has
been at the forefront of developing collaborative services for children subject to
abuse or neglect and the multidisciplinary Joint Consultancy Team based on the
Treliske site is the focus of this collaboration.
Medical Staff
Consultants
Hospital Based
Dr John Ellis
Dr Nicki Gilbertson
Dr Sian Harris
Dr Paul Munyard
Dr Yadlapalli Kumar
Dr Ann Prendiville
Dr Graham Taylor
Dr Matt Thorpe
Dr Katie Mallam
Dr Chris Williams
Community Based
Dr Roger Jenkin
Dr Jo Lewis
Dr John Lewis
Dr Eleanor McCartney
Dr Debbie Galbraith (SCMO)
Special Interest(s)
Cardiology
Oncology
Haematology & Oncology
Neonatology
Neonatology, Endocrinology
Respiratory diseases and Cystic Fibrosis
Diabetes, Lipidology & Rheumatology
Education & Gastroenterology
Diabetes
Gen Paediatrics & Education
Neurodisability
Social Paediatrics / education
Population Paediatrics
Looked After Children
Child Protection
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Trainees
ST1-2 6
ST4-8 7
Postgraduate Education
There is a modern Postgraduate Centre on the Hospital site. It has a well-stocked
medical library with well-qualified full time librarians and support staff. There is on
line information retrieval services as well as Medline, Cochrane Library and British
Nursing Index on CD-Rom. There is Internet access both from the Library and
elsewhere in the hospital available to all junior medical staff. Computers for general
use are available within the library itself and also within the Child Health Directorate.
Within the Department there are regular weekly clinical meetings including one with
Clinical Imaging and also a Journal Club. In addition, there are regular daily teaching
sessions for trainees. Trainees also attend the monthly regional teaching sessions.
There are monthly perinatal mortality and separate perinatal morbidity meetings.
Audit and Clinical Governance meetings alternate bi-monthly. There is a hospital
induction programme for all staff and a specific departmental induction programme
for trainees on taking up their appointments. The Department is committed to the
development of training opportunities for all grades of staff.
RCPCH District Tutor -
Dr Matt Thorpe
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General Information
This document forms part of the job description for Specialist Trainees working in the
South West Peninsula Deanery.
The Terms and Conditions of Employment (including those related to leave and sick
pay) are in accordance with the nationally agreed Terms and Conditions of Service
of Hospital Medical and Dental Staff (England and Wales) and General Whitley
Council Conditions of Service currently in force and as amended from time to time.
Appointments are superannuable unless you opt out of the scheme or are ineligible
to join, and your remuneration will be subject to declaration of superannuable
contributions in accordance with the National Health Services Superannuation
Scheme.
Hours of Work
Your duty hours will be between 40 and 56 hours per week (part-time staff pro rata)
depending upon the pattern of work offered by the employer, which should be in
accordance with paragraph 20 of the TCS. This may include work in the evenings, at
night and weekends. The TCS may be viewed at http://www.nhsemployers.org/payconditions/pay-conditions-467.cfm
Salary scale
You should be paid monthly at the rates set out in the national terms and conditions
of service for hospital medical and dental staff and doctors in public health medicine
and the community health service (England and Wales), “the TCS”, as amended
from time to time. The payscales are reviewed annually. Current rates of pay may be
viewed at http://www.nhsemployers.org/pay-conditions/pay-conditions-2339.cfm.
Part-time posts will be paid pro-rata.
Pay supplement
Depending upon the working pattern and hours of duty you are contracted to
undertake by the employer you should be paid a monthly additional pay supplement
at the rates set out in paragraph 22 of the TCS. The current payscales may be
viewed at http://www.nhsemployers.org/pay-conditions/pay-conditions-2339.cfm. The
pay supplement is not reckonable for NHS pension purposes. The pay supplement
will be determined by the employer and subject to monitoring.
Study Leave
The employer is expected to offer study leave in accordance with paragraphs 250 –
254 of the TCS. Local policy and procedure will be explained at induction.
Assessment of Training
Training appointments are subject to regular local and annual assessment
confirming satisfactory progress through the programme. The requirements of the
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assessments will be detailed in the “Gold Guide” which may be viewed at
http://www.mmc.nhs.uk/default.aspx?page=457.
Disclosure of Criminal Background
This position is exempt from the Rehabilitation of Offenders Act 1974. This means
that you must declare all criminal convictions, including those that you would
otherwise be considered “spent”.
Where the appointment involves substantial access to children and/or vulnerable
adults, the appointment is subject to a police check. The Criminal Records Bureau
will be asked to verify that you have no convictions and cautions or pending
prosecutions, convictions, cautions and bind-over orders. This will include local
police force records in addition to checks with the Police National Computer and the
government departments lists held by the Department of Health for Education and
Employment, where appropriate.
Police checks will only be requested for candidates recommended for appointment
and will be carried out by the employing Trust.
Medical Clearance
Offers of employment to the rotation will be subject to satisfactory medical clearance
including Hepatitis B status.
Medical checks will only be requested for candidates recommended for appointment
and will be carried out by the employing Trust.
Relocation Expenses
The employer will have a local policy for relocation expenses based on paragraphs
314 – 315 of the TCS and national guidance at http://www.nhsemployers.org/payconditions/pay-conditions-467.cfm.
You are advised to check eligibility and confirm
any entitlement with the employer before incurring any expenditure. The current
Relocation Expenses guidelines can be accessed via the South West Peninsula
Deanery website (www.peninsuladeanery.nhs.uk).
Less Than Full Time Working
Less than full time working is available for doctors in the training grades for whom
full-time training is not practical for “well-founded individual reasons”. However the
funding for flexible training is a finite resource and it may be necessary to place
applicants in an order of priority. A copy of the “Less Than Full Time Working” policy
can be obtained from the South West Peninsula Deanery website
(www.peninsuladeanery.nhs.uk). Doctors wishing to work on a less than full time
basis should be aware that they will be expected to “slot share” with another less
than full time trainee.
Amended 05/10/09 (YK)
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