1. SUMMARY
Applications are invited for the post of Consultant / Honorary Senior Lecturer in Emergency Medicine at the Whittington Hospital NHS Trust. This is an exciting time for the Trust and the Emergency Department, with a major site PFI redevelopment project ongoing and due for completion in late 2004 and an Emergency Department rebuild due to be completed in mid 2005. The post holder will have the opportunity to help shape the future configuration of the department and take part in hospital wide initiatives to improve Emergency Care and the patient’s experience, in line with the NHS Plan and Reforming Emergency Care agendas.
You must be accredited in Emergency Medicine and be on the GMC’s Specialist Register or within three months of being admitted to the Specialist Register.
2. THE DEPARTMENT
The Whittington Hospital’s Emergency Department serves the culturally diverse and often deprived North London inner city populations of North Islington and West Haringey. The department sees some 70,000 new patients annually. A major refurbishment 7 years ago has been followed up with continued investment and remodelling to improve queue management and facilitate patient streaming and provide facilities for initial assessment and Emergency Nurse Practitioners. The first phase of a Walk-In Centre development is due for completion in May 2004.
The Emergency Department has a 4 bay resuscitation room with one bay equipped for Paediatrics. The Majors area has 15 cubicles and there are separate areas for Minors and children. There is a dedicated 4 bed children’s area and separate children’s waiting room. An eight bed area adjacent to the main department has recently been refurbished to provide an ED led Clinical Decision Unit.
From August 2004 the Emergency Department will take part in a hospital pilot for the second Foundation Year 2 as part of the Modernising Medical Careers initiative.
The department is equipped with a PACS system for digital radiology viewing and image retrieval. An electronic Emergency Department Information System for patient tracking, electronic ordering and data collection went live in the department in January 2004.
The department has office accommodation for medical, clerical and managerial staff and there is a seminar room and a rest room. The department is equipped with a pneumatic air tube for specimen transport to the pathology laboratories. A bench top haematology analyser, blood gas analyser and a lab grade urine analyser are based in the department.
3. THE CURRENT ESTABLISHMENT
Dr Rachel Landau Dip IMC RCS Ed, FACEM, FFAEM - Clinical Lead
Mr GMA Heaton FRCS Eng, FRCS Ed (A&E), FFAEM
Current vacancy covered by locum – advertised post
Ms Paula Mattin BSc (Hons), RGN, Nursing & Service Manager
2 Specialist Registrars
1 Staff Grade Practitioner
4 Clinical Fellows
10 Senior House Officers
16 Clinical Assistant and PCP sessions per week
1 H grade Lecturer Practitioner
2 H grade Modern Matrons (with responsibilities for Majors / Resuscitation & Minors / WIC)
6 G grade Emergency Nurse Practitioners
3 G grade Sisters 7 F grade Sisters
20 E grades 23 D grades
1 Occupational Therapist
1 social worker
1 Department secretary
8 Facilities Support Assistants
2 Communications Co-ordinators
1 Reception Manager / 10 Receptionists
1 Phlebotomist
1 Play Specialist
4. TIMETABLE
· There is a fixed schedule for Consultant shop floor clinical Programmed Activities on weekdays.
· The On Call rota is 1:3 nights & weekends.
· There are scheduled Programmed Activities for teaching, audit and attendance at Grand Rounds & CME.
Provisional timetable
Monday / Tuesday / Wednesday0900-1300 / AH
Clinical
Session / Third Consultant Clinical Session / AH Clinical Session / SHO teaching
Medical Student teaching (RL)
Department Management meeting
Grand Round
1400-1800 / RL Clinical Session / Medical student teaching
(AH) / AH Clinical Session / Medical Student teaching
(Third Consultant) / Third Consultant
Clinical
Session
Thursday / Friday / Weekend
0900-1300 / RL
Clinical
Session / Third Consultant Clinical Session / Consultant 1:3 On Call
1400-1800 / RL Clinical Session / SHO teaching / Weekend Consultant Clinical Session
5. DUTIES OF THE POST
· Maintain a strong leadership presence on the shop floor in terms of both clinical & organisational issues
· To work with hospital inpatient teams in streamlining the clinical management of patients requiring admission, in order to achieve nationally set ED performance targets
· Continue & strengthen the programme of medical education to SHOs and SpRs attached to the department
· Review and develop a coherent and innovative medical and nursing manpower strategy for the department
· Together with the other Consultants and Senior Nursing staff devise & implement further service developments
· Strengthen the department clinical audit programme and undertake research
· Provide active medical support to the ongoing development of the ENP service
· Participate fully in the redevelopment planning for the Emergency Department
5.1 As part of a team of three, the post holder will participate in providing a consultant led medical service in the Emergency Department. Other duties will include a mix of clinical work, supervisory activities, management and administrative activities and audit.
The post holder will work with other hospital Consultants to develop guidelines and care pathways to ensure the systematic delivery of evidence based care to patients presenting via the Emergency Department. The successful candidate will be encouraged to work with clinician colleagues to ensure ‘joined-up’ working between the Emergency Department and the rest of the hospital.
Since the Emergency Department is very much at the primary-secondary care interface, the successful candidate will have an understanding of the needs of primary care and the way in which the PCTs might affect working relationships and arrangements. S/he will be expected to contribute to the development of innovative services that span the primary-secondary care interface.
Consultants have continuing responsibility for the care of patients in their charge and for the proper functioning of their department. They are expected to undertake administrative duties associated with the care of their patients and the running of their clinical departments. The appointee will be expected to take responsibility for maintaining their continuing medical education to the standard set by the relevant Royal College and to plan their continuing professional development jointly with the Trust to develop the clinical service. The appointee is encouraged to organise and develop their research interest. They will be expected to encourage and supervise the research of other members of the department.
Consultants are expected to assume responsibility both singly and corporately for the management of junior medical staff. In particular, they are expected to be responsible for approving and monitoring junior staff rotas, leave and locum arrangements.
Consultants are expected to act as a professional lead to ensure the continued personal and professional development of their trainees. This will include the need to performance manage medical staff where required. In this respect each consultant acts as a personal educational adviser to one or more trainees.
Consultants are required to participate in setting learning agreements and formally appraising junior staff and will themselves be appraised in accordance with the policies of the Trust.
The successful applicant will be encouraged to establish informal links with the other consultants in the hospital, and it is hoped that s/he will establish collaborative research with other departments.
The Consultant is responsible to the Chief Executive through the Medical Director (Operations) and professionally accountable to the Medical Director for the satisfactory conduct of his/her professional duties.
5.2 It is expected that the appointee will participate (not less than one session per week) in delivering the undergraduate curriculum, both to the medical students attached to the department and where appropriate to the student body as a whole. S/he will also participate in post-graduate education, including working with other colleagues in helping to deliver the hospital’s MRCP and MRCS courses. It is expected that the appointee will help in the development of special study modules in the Emergency Department.
5.3 The appointee will be expected to take part in the administration of the department and work with colleagues, including the Service Manager, on matters relating to the efficient delivery of high standards of clinical service. The appointee will also be encouraged to take part in management concerning the hospital as a whole.
5.4 The appointee will be required as part of their duties to take part in the audit and clinical effectiveness activities overseen by the CEAD department.
5.5 The Trust has a very large research programme for a district teaching hospital and receives funding of £750,000, which is spent on the support of R&D. All staff are actively encouraged to undertake R&D. There are particular strengths in Health Care Informatics, Diabetes, Lipids and Women’s Health. The Trust has an agreement with a private partner company, INTERCERN, which sources and manages commercial R&D projects at the hospital.
6 SHORTLIST
Candidates will be advised within three weeks of the closing date.
7 INFORMAL VISITS
Applicants for the post are welcome to visit the Trust or call for further information. Arrangements can be made with:-
Dr R Landau
or 020 7288 5699 (secretary )
Mr A Heaton
Short listed candidates are encouraged to arrange an informal visit with:-
Andrew Riley - Chief Executive 020 7288 3939
Dr Norman Parker - Trust Medical Director 020 7288 5437
Mrs Celia Ingham-Clark - Medical Director (Operations) 020 7288 5047
Dr David Patterson - Vice-Dean & Campus Director 020 7288 5292
(Whittington Campus, Royal Free and University College Medical School, UCL)
THE HISTORY OF THE WHITTINGTON HOSPITAL
Medical services were first provided on the site of the Whittington in 1473. Originally a leper hospital during the reign of Edward IV, by the time of Elizabeth I the hospital was caring for the poor chronic sick who had been transferred from St Bartholomew’s and St Thomas’. In 1848, a new hospital was built on the St Mary’s Wing site. This had 108 beds and cared for patients with smallpox. During the great smallpox epidemic between 1855 and 1859, the hospital admitted 1185 patients of whom 20% died. The Smallpox and Vaccination Hospital is currently known as the Jenner Building and is used as office accommodation.
Independently managed hospitals were opened on the Archway Wing site in 1877 and the Highgate Wing site in 1866. These hospitals had 625 and 543 beds respectively. In August 1900, Highgate Hill Infirmary with 780 beds opened adjacent to the Smallpox and Vaccination Hospital. The two hospitals soon amalgamated and the Smallpox Hospital was transformed into a nurses home.
Edith Cavell worked as a night sister for three years from 1901 at the Infirmary on the current Highgate Wing site. The Infirmary had been described in 1870 by Florence Nightingale as ”by far the best of any workhouse infirmary we have” and indeed “the finest metropolitan hospital”.
In 1947/8 the hospitals were brought together under Dr Cecil Coyle, who as Medical Superintendent was responsible for the administration of all three sites. The three hospitals had between them just under 2000 beds. With the coming of the NHS in 1948, the sites began to modernise. The past 50 years have seen the consolidation of all clinical services onto the St Mary’s Wing site with a reduction of beds from nearly 2000 to around 500. In 1977 a new block was opened which currently houses Emergency, out patients and the pathology laboratories. In 1992 the Great Northern Building opened with its modern ward accommodation, staff restaurant and education facilities.
As clinical services moved to the main site, so both Archway Wing and Highgate Wing changed function. Highgate Wing has been chosen by Camden and Islington Community Trust as the site for the consolidation and development of the district’s mental health services. Archway Wing is owned by UCL and The Middlesex University as an education and research campus.
In October 2002 the Whittington agreed a 30-year contract with Jarvis plc to design, construct and maintain a new £30 million clinical services building. Work is now underway and completion is due in late 2004. This new building will double the capacity of critical care and day surgery and will significantly improve the environment in which staff work. Planning for further site development is now in progress.
THE HOSPITAL TODAY
The Whittington Hospital is a medium sized district teaching hospital. The site contains a mixture of modern, good quality accommodation and older Victorian building which are in need of replacement. Despite the age of the older buildings, ongoing refurbishment has been carried out to ensure ward and other accommodation is suitable for modern medical practice. The hospital is well provided with equipment, with considerable ongoing investment to ensure that practitioners have the ‘tools to do the job’. The hospital is proud of its tradition of providing high quality medical education. We seek to provide academic and clinical excellence without losing sight of our rôle as a community based hospital supporting our local GPs.
We are located in Archway, North London and have traditionally served the populations of North Islington and West Haringey. Our catchment population is around 240,000. Our local population is a diverse mix in terms of social class, economic status and ethnicity and the communities we serve embrace Highgate, Finchley, Haringey, Camden and Islington. We have close working relations with tertiary centres at the Royal Free Hospital and the UCLH group of hospitals.
All main branches of medicine and surgery are provided at The Whittington Hospital with the exception of neurosurgery and cardiothoracic surgery. Plastic surgery and ophthalmology are represented by outpatient services.
A combined Diagnostic and Outpatient block is situated on the site. This block accommodates the newly upgraded Emergency Department, together with main supporting services such as Pathology, Radiology and Pharmacy. The Radiology Department has an MRI scanner and a spiral CT scanner to provide a comprehensive investigatory facility. The first phase of a Picture Archiving and Communication System (PACS) has been rolled-out in Emergency, with electronic links to the Hospital for Nervous Diseases at Queen Square anticipated in the near future.
A seven bedded General Intensive Care Unit (5 ITU, 2 HDU beds) is located adjacent to the six bedded Coronary Care Unit. Both units are well equipped and well staffed.