Specialty Training Programme in Specialty Programme in Wessex Deanery

Programme Description

SUB SPECIALITY TRAINEE IN COMMUNITY SEXUAL AND REPRODUCTIVE HEALTH IN WESSEX DEANERY

The post is for a period of at least two years, based at The Ella Gordon Unit, St Mary’s Hospital, Portsmouth and rotating to Portsmouth Hospitals NHS Trust.

This post is for senior trainees who hold the MRCOG or equivalent and have satisfactorily completed all the core skills in line with the RCOG logbook or have obtained their CCT or have specific training needs approved by their Postgraduate Dean.

Wessex Deanery is a relatively small deanery with a defined geographical area which does lead to there being a single unit of application. In the majority of cases successful candidates will be asked to preference their choice of location for either one or two years. Some specialties will require successful candidates to preference both commencing location and specialty. Future placements will be based, as normal, on individual training and educational needs. Please note that applications are to the Wessex Deanery as a whole. This may mean that you may be allocated to any geographic location within the Wessex Deanery depending on training needs.

The Wessex Deanery covers a geographical area from Basingstoke in North Hampshire to Dorchester in West Dorset and the Isle of Wight to the South; in addition some programmes rotate to Jersey and Chichester in West Sussex. This is a spread of approximately 65 miles North to South and 76 miles East to West. The Wessex Deanery serves a population of around 2.8 million people.

The Wessex Deanery is part of NHS Education South Central within South Central Strategic Health Authority which covers Berkshire, Buckinghamshire, Oxfordshire in the north (under Oxford Deanery) and Hampshire and Isle of Wight. In addition, Wessex Deanery provides training programmes within Dorset and South Wiltshire under a formal agreement with the South West Strategic Health Authority. The Wessex Deanery is responsible for the training of some 2,500 trainees.

The Department, population and services

The area covered by the Portsmouth and South East Hampshire Contraception and Sexual Health Service borders on the Solent and English Channel and includes the City of Portsmouth and the Boroughs of Gosport, Fareham and Havant. The District extends from Warsash in the west to Emsworth on the Sussex border and its Northern boundaries encompass Petersfield and Liss.

Portsmouth City is essentially an urban area, having grown around the Royal Naval Establishment in Portsmouth and Gosport. It now provides a wide range of modern high-tech industry and the facilities associated with a modern port and cross-Channel ferry terminals. The Havant & Petersfield and Gosport & Fareham localities are largely suburban and rural areas. Both Southsea and Hayling Island are holiday resorts.

The City population is densely distributed and very varied, being made up of comparatively large numbers of single parents and older people living alone. There is also a small prison on Portsea Island. The City is multicultural and has a number of smaller ethnic groups within its boundaries. There is a still a strong Navy presence within the City and a thriving modern University both of which have their own “transient” populations. The City is proud of its heritage and attracts large numbers of tourists. There are areas of significant deprivation existing almost side by side with areas of relative affluence underlying the need to tailor health and social care services to the particular needs of local populations.

Service Philosophy

In 1999 the Contraception service moved to purpose built premises on the St Mary’s Site, known as The Ella Gordon Unit. This is one of the largest Contraceptive and Sexual Health services in England. The service offers an accessible confidential non-judgemental approach to anyone seeking advice about contraception, sexual health and unintended pregnancy. It works to minimise the effects of sexually transmitted infections and unintended pregnancy in those affected and the community. Most of the services are open access with clients electing to be seen in the appropriate clinic for their perceived need.

Types of Service

General contraceptive clinics.

Most clinics are non appointment, open access.

These run in the main department and 8 other clinic sites, the majority based in health centres.

Specialist contraceptive sessions

There are several IUD and appointment sessions weekly. These are also menopause and PMS counselling clinics and vasectomy assessment and operations under local anaesthetic.

Young People’s Service (Sex Sense)

In 1993 the Service also set up a dedicated young people’s service (Sex Sense). This area has a lower rate of teenage pregnancy than similar districts and the services continue to develop according to the strategy set by local teenage pregnancy implementation groups.

Clinics for young people are based in non health centre premises. The emphasis is on health promotion and the clinics are run by a team of young people’s workers and senior nurses. The workers also undertake outreach work in collaboration with the 2 local teenage pregnancy teams.

Hospital based service

There are close links with the Gynaecology service and GUM.

Outreach Service

Senior nurses visit vulnerable clients at home or day centre. They work with other agencies in contacting difficult to reach groups.

Termination Service

The department provides a 100% service for the district. Clients over 13 weeks gestation are assessed by the department, but passed to BPAS for their operation. The gynaecology department manages women requiring termination for foetal abnormality. Assessment clinics are held in the Ella Gordon Unit. Approximately one-third of women choose early medical abortion and the department runs day-case surgical lists in Queen Alexandra Hospital. The service includes a qualified Counsellor who is available to offer pre and post termination support.

Psychosexual counselling

There are 3 BASRT accredited counsellors who also work closely with the urology dept who provide the treatments necessary for some of the men with impotence.

Chlamydia Screening

The Service as one of the initial 2 pilot projects for Chlamydia screening and now coordinates Chlamydia screening services for Portsmouth and Hampshire Primary Care Trust.

Training and Education

Portsmouth is accredited as one of the centres offering training for the sub speciality of sexual and reproductive health leading to a CCST in O&G and for Faculty career grade training.

The department organises and provides training for several faculty Special Skills modules, the DFSRH and the LOCs IUT and SDI. It also runs annual women’s health days with the GP education dept and has attached students from Southampton Medical School as well as midwives and various nurses in training. Second year foundation grade Doctors undertaking a 4 month GP post are attached to the service for 2 days a week.

Research

The department is part of the Faculty Clinical research network.

KEY RESONSIBILITIES OF POST : -

The post holder will,

- be responsible to the consultants running the department and will work as part of a multi-disciplinary team with the Associate Specialists, Nurse Team leader and Admin Team leader.

1. Clinical

i.  Counsel regarding and provide all available methods of contraception to clients appropriate to their needs and circumstances.

ii.  Undertake cervical cytology screening and other investigations appropriate to reproductive health

iii.  Discuss and advise on preventative health measures, pre-conceptual care, premenstrual syndrome and the menopause.

iv.  Counsel regarding and provide STI testing, screening and treatments, for level 2 sexual health care and refer to GUM for further testing treatment as required.

v.  Within his/her clinical knowledge and skill, advise, counsel and manage women attending with unplanned pregnancy. This will include training, if required, to undertake surgical and medical termination of pregnancy for women who are less than 14 weeks pregnant

vi.  Within his/her clinical knowledge and skill, advise, prescribe for and support women undergoing early medical abortion and follow-up consultations

vii.  Shared clinical responsibility for contraceptive service provision.

viii. Support the development of service policy in response to national, local and Trust priorities.

ix.  have an interest in working with and helping to develop services for young people and other vulnerable groups

x.  Source of specialist information for primary care, including GPs, Practice Nurses, Health Visitors and other member of the Primary Health Care Team and to secondary care including Obstetrics and Gynaecology Consultants, other medical staff, nursing and midwifery staff.

xi.  Implementation of clinical effectiveness and clinical governance standards within the service.

xii.  Emergency cover for clinics as required.

2. Managerial

i.  Undertake the administrative duties associated with the care of clients and the running of clinical services and travel as necessary between units.

ii.  Support the Clinical Leads in the management of the Contraceptive and Sexual Health Service in collaboration with DGM and Team Leader, Sexual Health Nurses and Admin staff.

iii.  Participate in clear communication processes within the service in collaboration with the Divisional Director, DGM and Team Leader, and the nursing staff.

iv.  Attend, when appropriate meetings including departmental management, sexual health services meeting, Local Implementation Team, Teenage Pregnancy Unit, Trust Child Protection Committee.

Secretarial support and office accommodation is provided.

3. Training and Development

i.  Support the dissemination of good practice, implementation of clinical governance, development of guidelines for departmental, trust and local primary care use. Co-ordinate and develop audit projects within the department.

ii.  Assist the maintenance of continuous professional development by staff in department including updating of colleagues in primary and secondary care.

iii.  Participation in the development of a programme for health education in schools and further education colleges.

iv.  Contribute to professional teaching programmes for doctors, nurses and other health professionals.

v.  Undertake and facilitate agreed projects and research. The appointee will have one day a week for research (unless exempt)

There is a Research and Development Support Unit (RSDU) at PortsmouthHospital’s Trust Post Graduate Education Centre, providing support for research. There are regular opportunities to attend courses run by them. There are links to Portsmouth University that is active in providing

research based educational sessions and clinical support in research

projects.

vi.  Be involved in the implementation of clinical governance. The department holds a monthly clinical governance meeting

The post-holder will participate in clinical governance activities by using the best and latest evidence of effective good clinical practice and modify working practice to take into account the latest findings around professional practice and clinical effectiveness.

The post-holder will regularly critically appraise the standard and effectiveness of his/her and others work through the use of supervision mechanisms and the clinical governance framework. Additionally, the appointee will monitor and evaluate service development based on evidence gained through continuous evaluation and audit.

The post-holder will also co-ordinate and participate in the development and implementation of a range of strategies involving service users and carers in ongoing service development.

4. Continuous professional development

Time is provided for continuing professional development within the timetable.

The organization of the timetable has to be flexible to ensure the needs of the service can be met. The sample job plan gives an idea of the balance of duties expected of the doctor and will be finalised with the appointee. However there are times when the service may ask the doctor to cover alternative sessions.

EDUCATIONAL CONTRACT

Educational supervision: There will be a named educational supervisor and regular appraisal will occur throughout the appointment. Appraisals will be done jointly between the applicant and Educational Supervisor.

Administration:. Secretarial and office support would be available from the Ella Gordon Unit.

Study leave: Standard study leave is allocated.

Participation in CPD: An allocation of 10% of timetabled workload.

Main Conditions of Service

The posts are whole-time and the appointments are subject to:

1.  The Terms and Conditions of Service (TCS) for Hospital Medical and Dental Staff (England and Wales)

2.  Satisfactory registration with the General Medical Council

3.  Medical Fitness – You may be required to undergo a medical examination and chest x-ray. Potential applicants should be aware of the Department of Health and GMC/GDC requirements with regards to HIV/AIDS and Hepatitis viruses. Candidates must be immune to Hepatitis B. You will be required to provide, in advance of appointment, evidence of immunity or have a local blood test (as deemed necessary by the Occupational Health Department)

4.  Right to work in the UK

5.  Criminal Records Check/POCA check carried out by the Trust Medical HR department.

6.  Pre-employment checks carried out by the Trust Medical HR department.

Hours

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 [insert Deanery link and/or] http://www.nhsemployers.org/pay-conditions/pay-conditions-467.cfm All posts on the rotation are working towards compliance with the European Working Time Directive regulations.

Pay

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 [insert Deanery link and/or] 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 should be made clear in their offer of employment and subject to monitoring.

Pension

You will be entitled to join or continue as a member of the NHS Pension Scheme, subject to its terms and rules, which may be amended from time to time. Further information can be viewed at http://www.nhspa.gov.uk/nhspa_site/index.htm