Job Overview

Here in Jersey we have our own Health Care system, separate from the NHS. We are looking to develop and improve our healthcare services towards a modern, fully digitised and future-proof system, in advance of our new hospital (planned to open in 2029). To do so we need fresh eyes, new ways of working and the next generation of consultants to make our healthcare the best it can be. We aim to provide high quality, safe and effective care to the 110,000 people living on the Island and those who visit. The hospital benefits from a fantastic educational centre with a full SIM lab and dedicated time for all to learn. Aligned to the Wessex Deanery, we support and develop Foundation trainees as well as Clinical Fellows and SAS doctors. We encourage all our consultants to fully engage with the education and training of our future generation of consultants.

Health & Community Services is seeking to appoint an enthusiastic and dynamic substantive consultant in Respiratory Medicine to join our already passionate consultant body.  The respiratory team current cover an inpatient ward with NIV facilities and out-patient activity. There is also a bronchoscopy list once every two weeks. Jersey is easily accessible from most regional airports in the UK and has good links with NHS tertiary centres especially in Southampton and London, which affords the successful candidates to maintain links within the NHS and the private sector working.  To support your transition to Jersey, we can provide a generous relocation and remuneration package, which is benefitted by lower taxation than within the UK. The Government of Jersey is committed to safeguarding and promoting the welfare of vulnerable people (to include children) and requires all staff and volunteers to share this commitment. As this position will work with vulnerable people, the selection process will involve safeguarding measures and include an enhanced DBS check.

For an informal discussion regarding any of the above roles please contact Dr Matt Doyle, Chief of Medicine, by email m.doyle@health.gov.je to arrange a telephone conversation. For recruitment and relocation queries please contact Sol Bradbury s.bradbury@gov.je

The Post

Jersey General Hospital is seeking to appoint an enthusiastic and dynamic substantive Consultant Physician specialist in Respiratory Medicine. This is a replacement post and the successful applicant will join an expanding team of currently eight Consultant Physicians to provide a comprehensive service in Respiratory Medicine and provide support to general medical in-patients.

Duties

The appointee must have a CCT/CESR in Respiratory Medicine and General Medicine and be able to offer a diagnostic bronchoscopy service and expert opinion in respiratory medicine. They should also have a strong background in acute unselected medicine on-call. They must have management and administrative experience, and be prepared to audit and manage audit within the Medical Services Care Group. The appointee will have inpatient ward commitments as the named treating consultant, depeandant on the ward allocated inpatient workload will consist of between 13-18 patients. The appointee will provide consultant supervision of the inpatient medical team consisting of 1x middle grade, 1x clinical fellow & 1x foundation year doctor. The appointee will also provide respiratory medicine input to other wards where requested through the specialist referral process. The successful candidate should be adaptable, flexible and innovative in order to meet the ongoing challenges within the service. A mentor shall be provided on arrival from a named acute medicine consultant in addition to a dedicated appraiser. 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.

On Call Rota

The appointee will take part in the General Medicine on-call rota of one in eight however this will be in line with the development of the service provision according to the Medical Services Medical Model where the successful appointee may focus on respiratory medicine provision for the island of Jersey. During the on-call the consultant will cover all medical inpatients in the event of deterioration or medical emergencies. For weekday on-call a post take ward round is undertaken at 5pm, the following morning the on-call consultant is only required to post-take patients who are not on the Emergency Assessment Unit. During weekends and bank holidays the consultant will undertake post take ward rounds and discharge ward rounds in line the medical model at 8am & 5pm. Weekday on-calls operate 8am-8am the following day. Weekend on-calls operate from 8am on Friday to 8am Monday.

The Specialty

The Respiratory Service The legacy of cheap tobacco in the past has resulted in a high incidence of smoking related illnesses. The South West Cancer Registry indicates that Jersey has an incidence of lung cancer 30% above the average for the U.K. There are an equivalently high number of patients with COPD. In 2019 Respiratory Medicine had 740 outpatient referrals and 49 bronchoscopy procedures were undertaken. The average weekly referrals to the respiratory service is as follows: 2019 = 17 per week 2020 = 14 per week 2021 to date = 15 per week Currently Respiratory Clinics typically consist of a portfolio of 8 to 10 patients, depending on the type of consultation required. Number of patients seen per bronchoscopy list is 3. The consultant establishment for Respiratory Medicine is as follows: Vacant, Consultant in Respiratory & General Medicine (2 posts) The Clinical Investigation Unit (Manager Andrew Norman, who is a Senior qualified Respiratory Physiologist) provides a comprehensive range of services for patients with respiratory illnesses incorporating: 1. Full lung function testing using body plethysmography 2. Sleep studies and provision of CPAP 3. LTOT and nebulizer services 4. A dedicated ‘drop in’ Asthma clinic 5. Histamine/Methacholine challenge testing The respiratory services are supported by a comprehensive radiological department offering CT and MRI. One of the consultant radiologists, Dr Salman Zaman, have a special interest in respiratory disease offering expert opinion and biopsy 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.

The Specialty

The Radiology Department has undergone extensive development and renovation in the last few years. A new GE PACS/HSS CRIS system (with access from home) went live in 2010. A new GE 750 Dual source 64 slice CT (inc CT Fluoro) was commissioned in October 2010. A Phillips 1.5T Intera MRI was commissioned in 2007. 4 new General rooms with either CR or DR were commissioned with the new PACS in 2010. There is a new Phillips screening/interventional suite with a C arm and remote control and a dedicated US machine for biopsy/drainage. We comply with the guidelines on ultrasound guided chest drain insertion and expect the successful candidate to continue this service. When the Consultant is not available, the Radiology department performs ultrasound of the chest to guide drain insertion. We have presented the successful introduction of this service at the National Emergency Medicine conference. There are 2 new Phillips IU22 Ultrasound machines (2009/10) in the main department. The department recently became ISAS accredited. Community outreach service supported by 1 full time and two part time respiratory specialist nurses who are providing care to patients with asthma/COPD. 1 T.B specialist nurse and 1 lung cancer nurse, continue to support patients in the community and support early discharge. The respiratory department works closely with the Consultant Microbiologist in the Management and Control of TB and HIV. Lung cancer surgery is performed in Southampton General Hospital. The Thoracic Surgeon, Dr Martin Chamberlain, visits four times each year. Surgery is provided to NSF guidelines. The hospital participated in the NLCA ( National lung cancer audit) and our performance ranks among the best performing centres nationally. PET-CT scans are performed at Southampton and we have an electronic link for sharing x-ray and CT images. Weekly lung cancer meetings are held are attended by the following: Consultant Radiologists (Salman Zaman), One Consultant Histopathologist Miklos Perenyi or Bruce Lyons), Consultant Respiratory Physician (this post), Acute Physician with specialist interest in respiratory medicine Dr Petra Schinle, Consultant Medical Oncologist (Mohammad Butt) Nicola Bailache Associate Speicalist Palliative Care, MDT coordinator who helps organising the meeting and keep records. There are 3 Consultant General Histopathologists (as above) providing general histology and cytopathology, and there is full laboratory back up for immunohistochemistry. There is access to specialist referral centres for molecular and gene analysis of tumours.

The Specialty

We have close links with Southampton to coordinate the management of interstial lung disease and severe Asthma, the successful applicant will have the opportunity to develop further tertiary links. The respiratory service is supported by the ambulatory care service located and supported by the acute medicine physicians delivering ultrasound guided pleural procedures including pleural aspirations , ambulatory drainage and pleurex drains. An Endoscopy unit is based at Jersey General Hospital consisiting of two procedure rooms, the Respiratory Medicine service has dedicated bronchoscopy sessions within this unit. Respiratory Medicine has access to the Medical Day Unit providing day case treatments Monday – Friday consisting of 5 treatment couches. The island has a dedicated chemotherapy unit with clinical oncologist & medical oncologist support on island. Palliative care facilities are provided by a charitably funded body called Jersey Hospice Care and operates from an independent facility called Clarkson House. Jersey Hospice Care provides in-patient beds for respite services both hospital discharges and in the community. An Associate Specialist in Palliative Care with nursing support has recently been appointed with responsibility and funding split between the Hospice and Hospital. The respiratory service in Jersey has a close links with Southampton to coordinate the manage interstitial lung disease.

The Medical Division

The Respiratory Service sits within the Medical Services Care Group which comprise the following range of services, a full structure chart of the care group can be found in the appendix: Ambulatory Emergency Care Cardiology Dermatology Diabetes Emergency Admissions Unit (EAU) Emergency Department Medical Day Case Unit Medical outpatients Medical Wards - Bartlett, Corbiere and Rozel Wards Neurology Oncology Haematology Palliative Medicine Rehabilitation Ward – Plemont Ward (Interim Rehabilitation Unit) Renal Medicine Respiratory Rheumatology Pathology Sexual Health Medical Services Care Group Medicine in Jersey is fully age and specialty integrated. There are 3 medical wards, Bartlett, Rozel and Corbiere. A 5-bedded Enhanced Care Area is sited on EAU and there is a separate intensive care unit led by intensivists. There is also an Ambulatory Emergency Care Unit on EAU led by a SAS doctor with consultant support.There is a 16 bed Emergency Assessment Unit. Currently there are 11 consultants, 8 SAS doctors, 7 FY1 and 2 FY2 doctors who between them comprise 8 medical teams and the EAU team. 6 Clinical Fellows offer further support to the teams. 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. 

The Medical Division

On call, the SAS doctor is responsible for seeing patients referred by the Emergency Department and reviewing patients admitted to the EAU by GPs in conjunction with the EAU team. A core responsibility of the Division of Medicine is the provision of a safe acute medical service. The Division provides named Consultant supervision for non-Consultants at all times and ensures that prompt review and treatment is provided for acute medical emergencies referred by General Practitioners or the Emergency Department. The Consultants share on-call cover for the general medical take on a rolling 24hr rota, 8am-8am. Consultant-led post take ward rounds take place at 5pm and 8am. Being on an Island, the physicians need to be able to cover the full range of medical emergencies while on call. The Consultants share responsibility for ongoing management of patients admitted acutely to the wards. At present, Consultants have responsibilities for ongoing management of inpatients for a 4- week period of each 8-week rota cycle. Leave is by preference taken during the remaining 4 weeks with the remainder of the time allocated to an increased intensity of specialist elective work. THE MEDICAL DIVISION Health and Community Services Consultant job description Consultants are responsible for producing and updating guidelines for the management of acute medical emergencies in their specialist area.

The Medical Division

Care Group Statistics There are 63 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 Specialty Medical Staff There are currently 11 Consultants providing acute and specialist medical care to the island population. Dr D Hopkins, General Medicine, Endocrinology and Diabetes Dr M Duku, General Medicine, Gastroenterology Dr A Mitchell, Consultant Cardiologist Dr P Le Paige, Consultant Cardiologist Dr M Richardson, General Medicine, Care of the Elderly and Rheumatology Dr H Gibson, General Medicine, Neurology and Rehabilitation Vacancy, General Medicine, Respiratory medicine (covered by Dr S Alapati) Vacancy, General Medicine, Renal Medicine Dr M Hanna, General Medicine, Gastroenterology Dr E Chacko, Acute Medicine with interest in Diabetes and Endocrinology In addition to outpatient clinics and 3 general medical wards containing 60 beds, the Medical Service Care Group is involved in the management of a number of specialist facilities. These include: 16 bedded Emergency Assessment Unit (EAU) 5 bedded Enhanced Care Area (ECA) 6 chair Ambulatory Emergency Care (AEC) 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. Medical/Secretaries/Offices There is a dedicated medical secretary supporting the consultant. The consultant has shared office space with IT facilities.

Other Hospital Departments

The following Departments are located outside of the medical division: 3 Surgical Wards - Surgical Floor, Beauport and Rayner Ward Critical Care Unit which includes Medical and Surgical Intensive Unit Endoscopy Unit on Aubin Ward Designated Day Surgery Theatre Main theatre Suite. Health and Community Services Consultant job description Outpatient Dental Department Outpatient ENT facilities Outpatient Ophthalmology Department 1 Private Wing Ward (beds with admitting rights) Private Patient Services Radiology Department Physiotherapy Department Anaesthetic Department ENT and Ophthalmology Departments. 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.

Proposed Job Plan

All consultants have a 10 PA contract for public work. The final job plan will be agreed with the consultants in the Department, the Clinical Lead, Chief Operating Officer and ratified by the Medical Director. The post holder’s job plan will be reviewed annually and will be appraised according to the current guidance. Modifications may be made dependant on the needs of the service. Subspecialist in-reach & cover for periods of leave. Additional clinical outpatient activity should be undertaken when consultant ward presence not required. Timings on this table are indicative, there will be provision for a lunch break between morning & afternoon sessions.

Qualifications and Skills

Essential:

Primary Medical Degree.

Higher Specialty qualification: MBBS or equivalent, MRCP.

Full Registration with the General Medical Council (GMC) with a Licence to practise (for overseas candidates it is mandatory that a licence is obtained prior to appointment).

Inclusion on the GMC Specialist Register/Certificate of Completion of Training (CCT) or equivalent in Respiratory Medicine/GIM (or be within 6 months of obtaining this at the date of the interview - documentary evidence of this must be provided to support your application).

Desirable:

Respiratory Medicine SCE.

Clinical Experience in an NHS environment.

MS or MD.

ALS/ATLS trained.

General Experience

Essential: 

Broad experience in General Medicine and Respiratory Medicine.

Desirable: 

Enthusiastic Teacher.

Previous Management Responsibility / Leadership Experience.

Experience of providing respiratory service in similar geographical locations.

Specialist Experience

Essential: 

Maintaining NIV service.

Maintaining a CPAP service.

Desirable: 

Bronchoscopy.

Pleural u/s chest drain insertion (seldinger and surgical).

Sleep study.

Leadership and Management Skills

Essential: 

Evidence of Clinical Leadership.

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 Experience of Teaching, Training & Supervision of Junior Medical Staff and undergraduate students.

An understanding of and ability to demonstrate your ability to: 

-Empower others 

-Lead through change

-Influence strategically 

-Collaborative working

-Drive for improvement 

-Integrity 

Personal Attributes

Essential: 

Able to work flexibly in a changing health service.

Hepatitis Vaccination.