Job Overview

The Post

The successful candidate will be able to combine service commitment with significant professional development through a rotational program between clinical specialties. To support the post holder’s continuous professional development and career aspirations participation in a consultant led clinic of 1 session per week will be facilitated.

Duties

General Medicine and Acute Medicine

The posts are designed to support the FY1 and Middle Grade doctors (Staff Grade and Associate Specialists) In the management of acute medical admissions on their respective wards. The three main medical wards look after general medical admissions – Plemont Ward, Rozel Ward, Corbiere Ward. Attachments to these firms and a dedicated period of experience on the Acute Medical Admissions Unit in one of the rotations will provide comprehensive training in all the key medical sub-specialties.

The role of the on-call twilight and weekend cover is to act as an effective second on-call (the first on-call being the Medical Registrar). This involves taking calls for admission from GP’s, reviewing admissions on their arrival in the Acute Admissions Unit and Emergency Department and providing additional support to the FY1 when needed. In hours work will be Monday to Friday 8am to 5pm. Out of hours working is 6 pm to 8am weekdays and 24 hours on Saturday and Sunday, worked in a shift rota pattern.

Flight Transfer

Patients being transferred acutely to tertiary centres such as the Cardiothoracic Unit in Oxford and to the Neurosurgical Unit in Southampton for further specialist treatment are accompanied by a doctor and a trained nurse. Courses in in-flight transfers are provided, and post holders will be on a rota of 1:7 for such activity during normal working hours and at weekends, if rostered on-call. Accompanying transfers that take place out of hours will be on a voluntary basis and will command additional remuneration.

Additional Professional Development

Medical students from Southampton University are attached for 8-week rotations in their final year. Clinical Fellow post holders have enjoyed interaction with these enthusiastic trainees and have provided bedside teaching in addition to that provided by Consultants and Middle Grade Doctors. Clinical Fellows have organised mock OSCE in the 7th and 8th weeks of their attachment in preparation for their final examinations. This has been a mutually beneficial exercise.

The Education Centre is a shared facility for Health & Care Jersey Department and is equipped with a newly built Clinical Skills Lab which has assisted Clinical Fellows in self-learning, particularly in procedural work and optimising their cardio-respiratory resuscitation skills, and in teaching their more junior colleagues both medical students and nursing staff.

The medical library is well stocked with books, journals and computer facilities, including internet access.

The following is an example schedule of a typical working week. The duties of the post holder are expected to be flexibly worked, as inevitably a number of activities run concurrently.

The Specialty

The Medical Service

Medicine in Jersey is fully age and specialty integrated. There are three medical wards, Plemont, Rozel and Corbiere. There is a sixteen-bedded Acute Assessment Unit situated on a separate ward. Currently there are four Acute Consultant Physicians who run the Acute Admissions Ward, and the remaining eight Consultants are responsible for in-patient care, ably supported by 8 Staff Grades/Associate Specialists, Clinical Fellows (the advertised posts) and 8 FY1/FY2 doctors.

The timetable shows that a ward round is conducted on a daily basis by senior clinical staff, either Consultant or Middle Grade and so Clinical Fellows and Foundation Doctors are well supported in their day-to-day work. There should be a maximum of 3 junior doctors per team. If there are more, then they will be asked to support other colleagues and teams to cover shortages and workload.

Whilst on call, the SAS doctor is responsible for seeing patients referred to by the Emergency Department and reviewing patients admitted to the AAU by GPs in conjunction with the AAU FY2. Clinical Fellows tend to see new patients admitted through the ED but support the Clinical Fellow on the Admissions Unit when it is particularly busy, and FY1 on the wards.

Department Statistics

• There are 83 medical beds
• 5 bed enhanced care area
• There are 10-20 acute medical admissions on average during each 24-hour period on call
• Medium stay of 2 1/2 days
• There are approximately 4,500 medical admissions annually

Future New Hospital

We are well advanced in the process of securing planning permission for a future new hospital. In preparation for these working practices will change, and a key element will be the development of an Acute Assessment Unit inclusive of an Enhanced Care Area for level 1 patients. This exciting new project may lead to some alteration in the job plans for Clinical Fellows.

Management Structure

Health and Care Jersey are a directorate of the Government of Jersey that is responsible for the delivery of specialist health care and the running of the general hospital. The directorate is led by a Chief Officer, who leads an executive team. Health and Care Jersey is organised as a series of Care Groups, each with a leadership team led by a Chief of Service as detailed below. This post is set within the Medical Care Group.

Leadership Teams

Medical Services
Chief of Service: (Interim) Dr David Hopkins
General Manager: Gaurika Kapoor
Assistant General Managers: Karen Gardner, Natalia Miller and Gordon Barrett
Lead Nurses: Alice Rait and Joann Morse

Medical Services Care Group

The department sits within the Medical Care Group which comprises the following range of services:

Acute Assessment Unit
Cardiology
Clinical Investigations Department
Diabetes
Emergency Department
Frailty
Gastroenterology & Endoscopy
Haematology
Medical Day Unit
Medical Outpatients
Medical Wards - Plemont, Corbiere, Bartlett and Rozel Wards
Neurology
Oncology
Palliative Medicine
Pathology
Renal Medicine
Respiratory
Rheumatology
Sexual Health
Stroke

Medicine in Jersey is fully age and specialty integrated. There are 4 medical wards, Plemont, Rozel, Bartlett and Corbiere. A 5-bedded Enhanced Care Area is sited on AAU and there is a separate intensive care unit led by intensivists. There is also an Ambulatory Emergency Care Unit led by the Acute Medicine Department. There is a 25-bed Acute Assessment Unit.

SAS doctors are responsible for the day-to-day management of their patients on the wards with the help of clinical fellows, FY1 or FY2 doctor whom they closely supervise.

On call, the SAS doctor is responsible for seeing patients referred to by the Emergency Department and reviewing patients admitted to the AAU by GPs in conjunction with the Acute Medicine team. A core responsibility of the Medicine Care Group is the provision of a safe acute medical service. The Care Group always provides named Consultant supervision for non-Consultants and ensures that prompt review and treatment is provided for acute medical emergencies referred to by General Practitioners or the Emergency Department.

Consultants are responsible for producing and updating guidelines for the management of acute medical emergencies in their specialist area.

Care Group Statistics

There are 87 medical beds. 12-20 acute medical admissions on average during each 24-hour period on call within a range of approximately 6-24. There are approximately 4,500 medical admissions annually.

In addition to outpatient clinics and 4 general medical wards containing 83 beds, the Medical Service Care Group is involved in the management of several specialist facilities. These include:

20 bedded Acute Assessment Unit (AAU)
5 bedded Enhanced Care Area (ECA)

A well-equipped Clinical Investigations Department providing echocardiography, exercise ECG, respiratory assessment and GI physiology.

An endoscopy suite providing a full range of endoscopy and bronchoscopy services.

Diabetes Centre providing outpatient care for the diabetic population of Jersey, including retinal photography and specialist nursing support.

Renal/Dialysis unit, providing emergency, acute and longer-term renal support as well as management of transplanted patients and assessment and treatment of renal conditions.

6 bedded isolation area for infected or neutropenic patients.

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 description will be subject to review in consultation with the post holder.

Qualification and Skills

Essential: 

Primary Medical Degree
Full GMC Registration and License to Practice
Current ALS Certificate

Desirable:

Computer Skills
MRCP Part 1

General Experience

Essential: 

Completion of foundation training or Equivalent
6 months Clinical Experience In Jersey or an NHS environment

Desirable:

Enthusiastic Teacher
Previous Management Responsibility
Leadership Experience

Specialist Experience

Desirable:

Specialty Experience Acute Medicine

Management Skills

Essential: 

Ability to work flexibly with colleagues to provide 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
Ability to prioritise administrative and clinical tasks
Commitment to learning

Personal Attributes

Essential: 

Able to work flexibly in a changing health service
Hepatitis vaccination

Other

Essential:

Participation in Clinical Audit & Risk Management Activities
Demonstrates a commitment to safeguarding young people and vulnerable adults
Evidence of annual appraisal