Job Purpose

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 system 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 medical leaders.

Health and Care Jersey are seeking to appoint an enthusiastic and dynamic substantive Consultant in Respiratory Medicine to join our welcoming consultant body. 

Jersey is easily accessible from most regional airports in the UK and has good links with NHS tertiary centres , particularly with Southampton and London, which affords the successful candidates the ability to maintain links within the NHS. 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 any recruitment related queries, please contact Sol Bradbury, HR Consultant, by emailing S.Bradbury@gov.je directly. 

Please be advised that we are unable to consider CV's submitted by recruitment agencies. All applicants must apply directly.

The Post

Jersey General Hospital is seeking to appoint an enthusiastic and dynamic substantive Consultant Physician specialising in Respiratory Medicine. The successful applicant will join an expanding team of eight Consultant Physicians, providing a comprehensive Respiratory Medicine service while supporting the care of general medical inpatients.

The successful applicant will work closely with the Chief of Service to support the ongoing development and expansion of Respiratory Medicine services across the Medical Care Group.
For newly appointed consultants, a mentor will be allocated to support induction into the role and facilitate a smooth transition into the organisation.

The successful applicant will be expected to participate actively in clinical governance activities and continuing medical education. Regular clinical governance meetings are held to support service improvement, patient safety, and professional development.

The post holder will be expected to contribute to the ongoing development of patient care within the Medical Care Group, support the education and training of junior medical staff, nursing staff, and allied health professionals, and play an active role in the governance and management of the department. They will also be expected to promote collaborative working and foster strong team relationships across the wider medical service.

The Hospital is committed to supporting this appointment and will aim to provide appropriate office accommodation, IT facilities, and administrative support to enable the consultant to undertake their clinical and non-clinical responsibilities.

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, dependant on the ward allocated inpatient workload will consist of around 18 patients.

The appointee will provide Consultant supervision of the inpatient medical team consisting of 1x middle grade, 1x clinical fellow and 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.

There are excellent opportunities to develop private practice in Jersey and participation is encouraged by Health and Care Jersey.

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. The on-call Consultant currently 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 and 1pm.
Weekday on-calls operate 8am-8am the following day. Weekend on-calls operate from 8am on Friday to 8am Monday.

The Specialty

The legacy of cheap tobacco in the past has resulted in a high incidence of smoking related illnesses. The Southwest 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.

Current outpatient referrals average approximately 150 per month with approximately 5 procedures per month.

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.

Community outreach service supported by 5 full-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.

The Specialty

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), Consultant Medical Oncologist (Mohammad Butt) Nicola Bailache Associate Specialist 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.

We have close links with Southampton to coordinate the management of interstitial lung disease and severe Asthma; the successful applicant will have the opportunity to develop further tertiary links.

The respiratory service is 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 consisting 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 and 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.

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.

Medical Care Group

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

Medical Care Group

The Respiratory 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. There is a 25-bed Acute Assessment Unit with a 5-bedded Enhanced Care Area is sited on AAU and there is a separate intensive care unit led by intensivists.

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 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 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.

Proposed Job Plan

All consultants have a 10 PA contract for public work; this is not negotiable. The final job plan will be agreed with the Chief of Service for the Medical Care Group 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.

Provision will be made for a lunch break between morning and afternoon sessions if both are clinical.

The Job Plan can be discussed at the time of employment but will broadly be based on the provisional timetable outlined below. The Job Plan will be authorised by the Chief of Service and is subject to annual review. However, it should be noted that this service requires a flexible approach.

The final job plan will be agreed with the Consultants in the Department, with the Chief of Service and ratified by the Medical Director. The post holder’s job plan will be reviewed annually with the Chief of Service and Medical Director and will be appraised according to the current guidance.

Qualifications and Skills

Essential:

Primary Medical Degree
Full Registration and specialist registration with the General Medical Council (GMC) with a current License to practice (for overseas candidates it is mandatory that a license is obtained prior to appointment).
Higher Specialty qualification: MRCP or equivalent Qualifications for Specialist Registration
Applicants that are UK trained, must ALSO be a holder of a Certificate of Completion of Training (CCT), or be within six months of award of CCT by date of interview.
Applicants that are non-UK trained, will be required to be on the GMC specialist register or provide evidence that they are entitled to specialist registration in GIM and Respiratory Medicine
Relevant experience at a Consultant level in a similar setting

ALS/ATLS trained
Leadership skills

Desirable: 

Higher Degree MSc, MD or PhD or equivalent

Respiratory Medicine SCE

General Experience

Essential:

Broad experience in General Medicine and Respiratory Medicine
Experience of providing Respiratory service in similar geographical locations
Enthusiastic Teacher

Desirable:

Management Responsibility / Leadership Experience

Specialist Experience

Essential:

Bronchoscopy

Maintaining NIV service

Maintaining a CPAP service

Desirable:

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

Sleep study

Leadership and Management Skills

Essential:

Ability to work flexibly with colleagues to develop and provide Respiratory services
Evidence of Clinical Leadership
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 and 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

Other

Essential:

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

IT literate

Desirable:

Evidence of research and publication in peer reviewed journals