Consultant Clinical Immunologist

William Harvey Hospital

344-5652CONCSZ-B

Dear candidate,

Welcome to East Kent Hospitals University NHS Foundation Trust. We are a pioneering Trust, on an exciting journey of healthcare transformation, with award-winning research and innovation, and a strong team ethos. We’re looking for positive clinical leaders who want to help us deliver first-class patient care to a fascinating and complex population and be part of something special. As you would expect from a large teaching Trust, we prize training doctors, nurses and other health professionals and we already work closely with local universities and King’s College, University of London. We now have the exciting new opportunity of working with Kent and Medway’s new Medical School, jointly provided by the University of Kent and Canterbury Christchurch University, which opens in September 2020. The Trust has five hospitals providing a wide range of high quality services and opportunities for innovation. The William Harvey Hospital (WHH) in Ashford has the full range of district general hospital services, as well as regional specialities, including the country’s best performing trauma unit. The Queen Elizabeth, The Queen Mother Hospital (QEQMH) in Margate, also provides district general hospital services, while Kent & Canterbury Hospital (K&CH) in Canterbury is a specialist services hub which provides adult medical care, inpatient renal, urology and vascular services and robotic surgery. Our new hospital in Dover, the Buckland, and Royal Victoria Hospital, Folkestone, provide a variety of outpatient, diagnostic and minor injury services, alongside a range of services throughout the local area. We have a clear clinically-led strategy to transform secondary care in east Kent to deliver outstanding standards across all specialties which build services around the characteristics of our patients and a commitment to refreshing our estate and facilities. We support clinicians who see opportunities to make tertiary care available locally for our population, and we have a strong research ethic as a high recruiter to research studies. Our vision is to provide ‘great healthcare from great people’, and we are proud of what we have achieved to date for our population and are excited about what’s to come. If you would like to be part of this exciting journey, your rewarding work-life will be complemented by the advantages of living in the Garden of England, with a choice of rural, seaside and picturesque places to enjoy and live in, alongside the essentials like excellent schools and easy access to London – and Europe. In March 2018 the Government and Health Education England announced that a joint bid by Canterbury Christ Church University and the University of Kent to establish a medical school was successful. The medical school opens its doors in September 2020, offering 100 undergraduate medical places on a yearly basis. The five year programme will be taught at the Canterbury campuses of both universities with medical placements within Primary, Community and Secondary Care across Kent and Medway. The Kent & Medway Medical School (KMMS) will be Kent and Medway’s first ever medical school, bringing together the existing centres of excellence in health and medical education provided by the two universities, and local healthcare organisations such as East Kent Hospitals University Foundation Trust. It will offer a new model of patient-focused medical education.

The KMMS will also play a key part of the solution to the challenges of recruiting and retaining medical professionals for this region. You will have the chance to be there at the start of what is expected to be an exciting and productive relationship and help to shape the doctors of the future. One of the largest acute trusts in England, we have a predicted turnover of almost £600 million. We serve a population of 695,000 people in east Kent and over a million through our regional services, employ 7,950 staff and have 1,000 beds across three main hospital sites.

If you think this could be the start of something special, please apply as quickly as possible because we will close the advert for this job once we’ve received sufficient applications. If you have a disability or long-term health problem, we are committed to offering reasonable adjustments throughout the recruitment process and employment. If you would like more information or support, please contact the Resourcing Team on 01227 866450 or resourcing@nhs.net, who will be happy to help.

Yours faithfully, Susan Acott, Chief Executive

Our Mission, Vision and Values Our mission is "Improving health and wellbeing"

Our vision is "Great healthcare from great people"

Our values are

People feel cared for as individuals

People feel safe, reassured and involved

People feel teamwork, trust and respect sit at the heart of everything we do

People feel confident we are making a difference

Our strategic objectives Our strategic objectives aim to lead us to: a Good and then Outstanding CQC rating; to drive performance, particularly in the key access standards; to make the Trust a great place to work; deliver integration and a more sustainable future for our services across east Kent; develop our staff and teams and improve our finances.

You can find out more about what we do on our website at www.ekhuft.nhs.uk and view

our organisational structure charts here.

Job Description

Job title Consultant clinical immunologist

Band Medical consultant, full time (10 PAs)

Care Group* Clinical Support Services

Reports to* Head of Service Clinical Biochemistry and Immunology

Accountable to* Clinical Director of Pathology/Chief Medical Officer

Based at*

William Harvey Hospital, Ashford, Kent

*Note that this is a joint post at senior lecturer level with the Kent and Medway Medical School (KMMS), based in Canterbury. The KMMS aspects of the role will be delivered within 3 programmed activities (0.3 WTE, annualised). Full details of the academic aspects of the role, including reporting line, may be found in the accompanying KMMS job description. Whilst the NHS post is primarily located within the Pathology Department, clinical activity will be supported by the General and Specialist Medicine Care Group. Alignment within one of the care group’s speciality departments (e.g. respiratory medicine) may be considered depending on the appointee’s clinical interests. The Clinical Director of the General and Specialist Medicine Care Group is Dr Richard Kingston. In relation to the laboratory service, the post holder will initially report to the Head of Service for Clinical Biochemistry, who has overall responsibility for providing the service as agreed with the Clinical Director of Pathology and Medical Director. Note that it is the intention that the immunology service will become a stand-alone pathology discipline in its own right with its own head of service.

THE CLINICAL SUPPORT SERVICES CARE GROUP

Clinical Director: Sally Hall

Operations Director: Chris Hudson

The Care Group formed in 2018, bringing together the six clinical support and diagnostic departments of Pathology, Outpatients, Pharmacy, Radiological Sciences, Audiology and Therapies with a combined budget of £73 million. The six distinct departments all have differences ranging from their regulatory bodies through to ways of working. One common theme is that our services are required in virtually all sectors of healthcare, be it acute or primary. The Care Group is based across all five Trust sites, as well as other sites within the local community. The Care Group will earn the autonomy to operate as a Board in its own right and be accountable for service development strategy and delivery of first class clinical, research and teaching outcomes, creating excellent quality care and an improved patient experience.

THE PATHOLOGY DEPARTMENT Pathology provides a full clinical biochemistry, immunology, haematology, blood transfusion,

laboratory haemophilia, cellular pathology and microbiology service to the patients of East

Kent Hospitals University Foundation Trust (EKUHFT), general practitioners and private

hospitals in east Kent. The major proportion of blood science analyses, including all work

arising from primary care, takes place in relatively new purpose built facilities on the WHH

site. All immunology, cellular pathology and laboratory microbiology is centralised at WHH.

A phlebotomy service is provided on the main sites WHH, K&CH and QEQMH and also at

Buckland Hospital, Dover and Royal Victoria Hospital, Folkestone. Point of care testing

(POCT, where the sample is analysed at adjacent to the patient) is well established

throughout the Trust.

East Kent Hospitals is participating in the Sustainability and Transformation Plans (STP) for

Kent and Medway to develop an integrated pathology service across the county. Further

information about the Department may be found at http://www.ekhuft.nhs.uk/pathology.

OUTPATIENT SERVICES Outpatient Services (OS) comprises Outpatient Clinical Departments and Health Record

Departments across the Trust and the centralised booking functions of the Outpatient

Appointment Centre. The Department is currently responsible for approximately 1.69 million

acute healthcare records (including legacy records), 1.2 million A&E cards and

approximately 1 million Community Paediatric healthcare records, following trust mergers in

1999. There are six working record libraries; three main libraries at William Harvey Hospital,

Ashford, Queen Elizabeth the Queen Mother Hospital, Margate and Kent & Canterbury

Hospital. There are smaller libraries at Buckland Hospital, Dover and the Ashford sub-store.

The Outpatient Appointment Centre is on the Kent & Canterbury Hospital site. Its purpose is

to provide a centralised service specifically designed for outpatients including the booking of

appointments, clinic maintenance and a central point of contact for patients, staff and GPs.

In addition the centre also supports referrals made through the Choose & Book system.

AUDIOLOGY

Audiology provides routine and complex clinical diagnostic assessments and rehabilitation in

support of ENT otology at EKHUFT. The audiology clinical areas include hearing, tinnitus

and balance. Audiology clinics are carried out across the Trust’s three acute sites plus Royal

Victoria Hospital, Folkestone, Buckland Hospital, Dover and Victoria Hospital, Deal.

Audiology staff also provide on-site diagnostic services for the ENT GPwSI ENT Clinics at

Kingsnorth GP Surgery. Additionally, audiology provides direct referral hearing aid provision

for GPs across East Kent. EKHUFT audiology has close links and works with the Hi Kent

Hard of Hearing Charity and the Thanet Tinnitus Group.

PHARMACY The vision for the delivery of pharmacy services is expressed in the statement:

‘Hospital pharmacy will protect the patients’ right to make informed choices about their

medicines, and will collaborate with the patient to ensure the safe and effective use of

medicines within a knowledge-based and integrated healthcare system.’

There are a range of services that underpin the clinical function:

Dispensary Services

Technical Services (Comprising of technician led procurement, distribution, over-

labelling and Pharmacy IT Support)

Aseptic Services (including Radio-pharmacy) - The Technician-led Trust Aseptic

service is an MHRA licensed unit which is able to batch manufacture chemotherapy.

Quality Assurance - to ensure compliance with all local and national guidelines for

the production of medicines, to maintain responsibility for gas quality testing, and to

manage authorised document control within the directorate.

Medicines Information and Prescribing Policy Clinical Trials

Education & Training

RADIOLOGICAL SCIENCES Radiological Sciences deals with the study and application of imaging technology to

diagnose and treat disease. Radiologists, radiographers, sonographers and technicians are

able to do this by utilising an array of imaging technologies, such as ultrasound, computed

tomography (CT), nuclear medicine and magnetic resonance imaging (MRI). The

Department is supported by a professional and dedicated nursing team, and a flexible and

highly effective administrative, operational and management team. The Department has

introduced extended working days and seven day working, encompassing the previous 24/7

acute service.

Breast Screening is increasing with rollout of age extension of the screening programme.

The Trust and Department has invested in two new MRI scanners, fluoroscopy equipment,

digital mammography equipment and the refurbishment of facilities. The Department also

employs clinical scientists, technologists, engineers and technicians, who, as Healthcare

Scientists, play a central role in safe and effective patient care. The Department is a training

centre for both Medical Physics and Nuclear Medicine. In Nuclear Medicine, hard work has

led to both UK and Australian registration and the team look to exploit this more in the future.

THERAPIES The Therapies Department is responsible for the provision of Physiotherapy, Occupational

Therapy, Adult Speech Language Therapy, Dietetics and Podiatry and Orthotics across the

Trust’s five acute sites. Therapy staff also work out of GP surgeries and satellite clinics. The

Therapies Unit also runs a Day Hospital which assesses and treats patients referred from

GPs, ICTs, consultants and other therapists. Most of the patients have neurological

disorders (mainly Parkinson’s disease, multiple sclerosis and strokes). They also treat

elderly patients who have fallen (there is a falls group) and patients who have had lower limb

amputations. They offer follow up for Botox patients and link in with TIA clinics. There are

satellite clinics from the Gillingham Disability Service, at WHH and KCH for amputee patients

which are supported by the therapy teams on each site.

IMMUNOLOGY

Background

When EKHUFT was initially formed as a Trust in 2000 laboratory immunology tests were

undertaken by all of the pathology disciplines. This fragmented service was unacceptable to

Clinical Pathology Accreditation (CPA) and a decision was made to bring all of these tests

under the managerial direction of clinical biochemistry, with clinical support for the service

being provided through a 1 PA (0.5 PA on site, 0.5 PA remote advice) arrangement with a

consultant clinical scientist (Dr Joanna Sheldon) from St George’s Hospital, London. This

arrangement has worked extremely well and has steered the laboratory through three cycles

of CPA inspection and most recently in 2017 successful attainment of UKAS ISO15189:2012

accreditation. Immunology currently holds full UKAS accreditation as part of the clinical

biochemistry and immunology service (UKAS reference no. 8636).

The immunology laboratory is centralised at the William Harvey Hospital, Ashford. The

laboratory provides services to the patients of east Kent and additionally provides laboratory

immunology services to all other acute hospital Trusts in Kent and Medway (Maidstone and

Tunbridge Wells NHS Trust, Medway NHS Foundation Trust and Dartford and Gravesham

NHS Trust) and their primary care partners.

To date the immunology service has been restricted to a laboratory service. The

management of the laboratory has been conducted within the structure of a combined

clinical biochemistry and immunology service, with some more junior staff rotating between

the two laboratories. The current head of service for clinical biochemistry and immunology is

Dr Sally Stock and the head BMS is Mr Ian Rafferty. The repertoire and workload of the

laboratory has grown in recent years. The service now requires its own dedicated clinical

immunology consultant (this post) to establish and develop the clinical and laboratory service

in east Kent and beyond. The main purposes of this new post are to:

• Establish a clinical immunology and allergy service to provide outpatient and day

case adult services on behalf of the Trust.

• Provide support and guidance to the EKHUFT diagnostic laboratory service.

Facilities

The laboratory area is divided into:

Immunology sample reception

Proteins - Beckman Immage 800, Sebia Capillarys 3 Tera, Sebia Hydrasys 2

Autoimmune serology - 3 x Werfen ASP1200

Immunocaps – 2 x Phadia Immunocap 250

The laboratory computer system is Apex. The majority (circa 90%) of requests received from

both primary and secondary care are electronic using Allscripts PAS and DartOCM.

Implementation of Sunrise ordercoms is planned for secondary care in 2020. Documentation

and the quality management system use an electronic document control system (Q-pulse).

The appointee will be provided with an office on site. This includes a personal computer with

e-mail and internet access.

The post will be supported by a 0.5 WTE band 4 clinical secretary and other new appointments as detailed below.

Video conferencing links within the Trust and to neighbouring trusts are available.

The Trust has outpatient areas on all of its sites where a consulting room will be provided

together with a day treatment area for immunoglobulin infusions, allergy food and drug

challenges and immunotherapy sessions. The clinic will support skin prick testing facilities

(allergen reagents, skin prick test lancets), food challenge, lung function testing (spirometry)

and subcutaneous immunotherapy. Nursing support for the clinics will be as described

below. Specialised laboratory support (e.g. component resolved diagnostics) will be

available.

Laboratory service and workload 2018/19

The immunology laboratory provides a range of services supporting allergy testing,

vasculitides, rheumatology, coeliac testing, thyroid antibody testing and, in collaboration with

clinical biochemistry, specialist protein testing including plasma cell dyscrasias. We currently

offer a laboratory immunology service for Kent. Immunology work is derived predominantly

from direct access, EKHUFT activity and from other Trusts in Kent and Medway (Maidstone

and Tonbridge Wells NHS Trust, Medway Maritime Hospital Foundation Trust, Dartford and

Gravesham NHS Trust). There is a small amount of private work including Spencer Wing

and One Ashford.

Annual number of requests 116,929

Annual number of tests 257,672

Proportion from primary care 32%

Proportion from secondary care 29%

Proportion from private patients 2%

Proportion form external (non-east Kent) sources 37%

Tests done within EKHUFT Method Equipment Tests in

2018/19

Liver autoantibodies Indirect

immunofluorescence

ASP1200 5,093

ANA Indirect

immunofluorescence

ASP1200 34,148

ANCA Indirect

immunofluorescence

ASP1200 7,556

Skin Antibodies Indirect

immunofluorescence

ASP1200 402

dsDNA antibody Phadia EliA Phadia 250 2,306

ENA antibody screen Phadia EliA Phadia 250 2,189

TPO antibody chemiluminescence Abbott

Architect

2,107

IgA Endomysial antibody Indirect

immunofluorescence

ASP1200 453

IgG Endomysial antibody Indirect

immunofluorescence

ASP1200 56

Neuronal antibody screen Indirect

immunofluorescence

ASP1200 523

TTG antibody Phadia EliA Abbott

Architect

34,535

GBM antibody Phadia EliA Phadia 250 412

Intrinsic Factor Abs Phadia EliA Phadia 250 3,891

Rheumatoid factor Nephelometry Immage 800 24,983

CCP antibody Phadia EliA Phadia 250 4,635

Myositis antibodies 161

Total IgE Phadia Immunocap Phadia 250 12,438

Allergen Specific IgE Phadia Immunocap Phadia 250 43,740

Aspergillus IgG Phadia Immunocap Phadia 250 891

C3 quantitation Nephelometry Immage 800 3,636

C4 quantitation Nephelometry Immage 800 3,636

IgG Nephelometry Immage 800 14,574

IgA Nephelometry Immage 800 14,612

IgM Nephelometry Immage 800 14,554

Haptoglobin Nephelometry Immage 800 319

Alpha-1 antitrypsin quantitation Nephelometry Immage 800 1,790

Serum protein electrophoresis

(SPE)

Capillary

electrophoresis

Sebia

Capillarys 3

Tera

14,559

Serum immunofixation Gel electrophoresis Sebia

Hydrasys 2

999

Serum immunotyping Immuno-subtraction Sebia

Capillarys 3

Tera

399

Serum paraprotein quantitation Capillary

electrophoresis

Sebia

Capillarys 3

Tera

2,457

Urine BJP screen Kappa/lambda

immunofixation

Sebia

Hydrasys 2

4,797

Urine full immunofixation Gel electrophoresis Sebia

Hydrasys 2

245

Cryoglobulin studies Visual examination

nephelometry,

immunofixation

Immage,

Sebia

Hydrasys 2

142

Alkaline phosphatase

isoenzymes

Gel electrophoresis

with wheatgerm lectin

inhibition

Sebia

Hydrasys 2

434

A significant volume of more specialist immunology testing is referred to tertiary centres, in

particular to St George’s Hospital and to Oxford Churchill Hospital immunology laboratories.

Test referred externally Tests in 2018/19

Myeloperoxidase antibody 1,119

Proteinase 3 antibody 1,115

Alpha-1 antitrypsin phenotyping 118

ENA antibody identification 273

Acetylcholine receptor antibody 542

Adrenal antibody 63

IgG subclasses 147

Ovarian antibody 3

Skeletal muscle antibody 5

C1q antibody 6

Ganglioside antibodies 95

MAG antibody 76

Neuronal antibodies (confirmation) 157

GAD antibody (neurology) 375

Voltage gated calcium channel antibody 84

Voltage gated potassium channel antibody 394

MUSK antibody 96

Aquaporin 4 antibody 208

NMDA receptor antibody 376

Diabetes autoantibodies (GAD, IA-2, ZnT8) 558

Myositis specific antibodies 161

Phospholipase A2 receptor antibody 30

C1 esterase inhibitor 181

Serum free light chains 427

CSF oligoclonal bands 229

Serum tryptase 214

Staff

Current staff WTE/PA

Visiting consultant Immunologist from St George’s Hospital 1 session a week

Band 8a BMS and clinical scientist 1.0

Band 7 BMS 3.0

Band 6 BMS 2.0

Band 5 BMS 1.0

Band 2 2.9

Clinical biochemistry clinical scientist band 8 0.2

As part of the support for this post the Trust has agreed to the appointment of the following additional staff:

Proposed staff WTE/PA

Consultant immunologist (new post)

Vacancy (this post), 10 PA

Band 7 specialist immunology nurse 0.5

Band 5 nurse to assist with preparation of challenge materials, skin prick testing and immunotherapy vaccines

0.5

Band 6 BMS 1.0

Band 4 clinical secretary 0.5

Band 3 A&C 0.5

The anticipation is that the support of the visiting consultant will no longer be required once the new post is established. Clinical service

Since no clinical immunology service has ever existed in east Kent it is difficult to provide

exact workload data. The predominant need in EKHUFT is likely to be in the fields of allergy

and primary immunodeficiency, with allergy predominating.

Allergic diseases are highly prevalent and represent an enormous health burden. Currently

there is little provision for these services in EKHUFT. For example, dermatologists in

EKHUFT have no access to adult skin prick testing and either refer patients directly to Kings

for these services or advise the local GPs to do so. Some paediatric skin prick testing is

undertaken in the Trust by Dr Ola Smith, consultant paediatrician, who offers clinics in Dover

and Ashford. The population served by EKHUFT is of the order of 695,000. Of this

population, the prevalence of allergic disease from national prevalence figures is predicted to

be:

Disease Prevalence

Asthma 44,520 children

22,260 adults

2,226 adults with chronic, severe asthma qualifying for

omalizumab therapy

Allergic rhinitis 148,400 children and adults

14,500 potentially benefiting from allergen immunotherapy

Urticaria/angioedema 115,000 episodes of acute urticaria and angioedema of which

at least 11,000 will require unplanned use of medical services

1,000 cases of chronic urticaria/angioedema requiring

specialist management

Food allergy 26,000 children with food allergy (4,600 are likely to have

peanut allergy alone)

5,600 adults

Drug allergy 56,000 adults, predominantly allergies to antibiotics and

anaesthetic induction agents, aspirin and related NSAIDs

Insect venom allergy 11,000 adults with hymenoptera venom allergy, of which

1,000 may require allergen immunotherapy

Eczema: specialist allergy

input into exacerbation by

contact and aeroallergens,

food allergens

64,000 children

22,500 adults

The minimal prevalence of primary immunodeficiencies (PID) requiring treatment is

estimated at 3·5/100 000 of the UK population, suggesting a prevalence in east Kent of

approximately 20-30 cases. Currently (2018) there are 35 patients receiving long-term

intravenous immunoglobulin (IVIG) in EKHUFT, including 14 for PID and 4 for secondary

immunodeficiency. Prescription of IVIG has been undertaken by Trust haematologists but

they do not actually deliver the therapy, which is currently commonly done in ambulatory

care or chemotherapy areas.

It should be noted that other areas of Kent also lack a clinical immunology service and there

is likely to be strong support for this service provision from beyond east Kent.

Duties of the post

The general responsibilities of the post will be those expected of a senior clinical employee

of the Trust. These include provision of a first class clinical service, effective leadership to all

staff involved in supporting the service, conducting clinical practice in accordance with the

highest ethical standards, support for other clinical specialities and contribution to education

and post graduate teaching.

The post holder is expected to provide and develop a clinical service for the investigation

and management of patients with disorders of immunity. This is principally primary (and

secondary) immune deficiency and allergy, but also, as necessary, of patients with other

clinical conditions in which disordered immune function is thought to play a role (for example,

autoimmunity, vasculitis, autoinflammatory disorders).

The service should be for GPs and other hospital practitioners, and will be conducted by

regular outpatient clinics, day-case attendance and by hospital, telephone and written liaison

and consultations.

Indicative draft job plan:

Day Time Activity

Monday AM Immunology clinic

PM Administration/laboratory activity

Tuesday AM KMMS

PM Supporting professional activity

Wednesday AM Allergy clinic

PM Laboratory activity/ward referrals

Thursday AM KMMS

PM KMMS

Friday AM Supporting professional activity

PM Laboratory activity/ward referrals

The post holder will be required to:

As a joint appointee at senior lecturer level, strengthen academic links with KMMS,

including teaching provision to the undergraduate programme (see separate job

description).

Participate as an active member of the East Kent Pathology Service and contribute to

overall service provision, planning and development.

Participate in Multidisciplinary Meetings in the relevant specialities.

Participate in clinical audit. Internal audit takes place on a regular basis and there are

appropriate facilities and secretarial support.

Participate in continuous quality improvement.

Participate in the annual enhanced appraisal process.

Participate in the Royal College of Pathologists Continuing Professional

Development Scheme. An adequate number of CPD approved local meetings are

held which will allow participants to broaden their general medical education. In

addition, the appointee will be required to attend regional and national meetings

approved for CPD in immunology and allergy. Resources including study leave

expenses within the Trust guidelines (£1,000 per annum) will be provided for these

activities.

Develop strong working relationships with other consultant colleagues and hospital

senior management in the Trust, particularly with neurology and gastroenterology,

with dermatology and respiratory services to develop allergy services and with

haematology and general medical services to develop PID services.

Provide an expert emergency service for dealing with drug, radiocontrast and

anaesthetic allergy.

Work with microbiology, pharmacy and the infection control team to improve

antimicrobial stewardship in relation to penicillin allergy.

Provide essential specialist services such as the NICE mandated omalizumab

service and NICE mandated insect venom immunotherapy service.

Form a focus of liaison and learning to improve allergy care and the lot of allergy

sufferers throughout east Kent from primary care management to the management

and subsequent investigation of acute episodes presenting to A&E.

Work with local CCGs to commission services and work across the K&M STP

footprint to provide a service for the whole of K&M.

It is the intention that the Trust should aspire to UKPIN (immunology) and IQAS (allergy)

national standards and that the service should be accredited as an allergy training centre

with a trainee immunology SpR. The appointee will be responsible for developing these

initiatives.

Other responsibilities include: Junior staff: Recruitment, appointment and educational supervision including educational contracts, regular appraisal, organisation of study leave, annual leave and rotas. Budget: Co-operate with the Care Group Clinical Director and Care Group Operational

Director on budget issues. Communication: This will include responsibility for and arrangement of:

- Communication and liaison with all other medical and service departments within the hospital including: General Management, Medical Records, and Social Work Department

- Communication with General Practitioners will include telephone discussion of problems and writing of letters about cases seen in the department

- Communication with other hospitals and special departments in other hospitals Teaching: Junior doctors and medical students, biomedical scientists, clinical scientists, nurses and other paramedical staff in the team. Non-Emergency Work in Premium Time: The Trust will require you, in line with service needs to undertake non-emergency work during premium time. On Call Arrangements: No on call cover is required.

The duties and responsibilities in this job description may need further discussion in the future to ensure that they continue to meet the needs of the service, future service developments and the post holder.

Patient Safety, Clinical Governance, Education and Training

The Trust is fully committed to improving patient safety and experience. Consultants are expected to comply with GMC guidance and all Clinical Risk Management processes. They must audit their own clinical outcomes, report clinical incidents, alert the trust to risk, participate in annual appraisal and work to foster good team relationships. It is expected that the appointee will plan a programme of personal development and continuing medical education and through the appraisal process ensure that adequate training is undertaken both to maintain their skills, knowledge and expertise and to ensure revalidation. There is extensive local support and the Trust provides reasonable costs for formal study leave. An annual review of the job plan will take place between the Clinical Director/Clinical Lead and the Consultant in accordance with the arrangements in the new contract. This will include discussions regarding the needs of the service, with agreement of objectives for clinical standards, goals and workload.

Each of the three main hospital sites has a well-equipped multi-disciplinary Education Centre, including internet facilities and a library. Each runs full programmes of educational meetings. The Trust is designated as an Associate University Provider NHS Trust for undergraduate education. Doctors in Training are recruited to the Trust from London medical schools on matching schemes. All Consultants have responsibilities for teaching doctors, students and non-medical healthcare professionals, and should ensure they use the time allowed in their working week for duties of teaching and supervision. New Consultants are required to enrol on the Deanery Certificate of Teaching programme within the first 12 months of appointment. All Consultants should include some element of educational development within their personal development plan, using at least one half day per year of their external study leave to this end.

Research and Innovation

The Trust wishes to “make a difference to the experience and outcomes of health care to the people of Kent, the NHS and internationally through Research, Enquiry and Innovation" and we have an ambitious strategy to deliver this vision from 2016 to 2020. You can read more about our approach to research on our website. We are one of the most research-active acute Trusts in the Kent, Surrey and Sussex region, with over 120 NIHR CRN Portfolio studies open to recruitment across more than 20 specialty areas, with at least 15 new industry funded/sponsored studies opening each year. All newly appointed Consultants are encouraged to take on the role of Principal Investigator and considerable training and support is available. Trust clinicians are also actively supported in developing their own research ideas and participate in local, regional & international academic collaborations. We have been awarded research funding (£100k to £2m) by NIHR (RfPB and HTA), MRC, Pfizer and other major funding bodies in recent years. The Trust also has internal funding schemes to assist researchers, including those without previous experience, to gain pump-priming monies for individual projects, or to support individual sessional research time.

We have a strategic alliance with University of Kent’s KentHealth, and have active

collaborations between the Trust and all our local universities (UoK, Canterbury Christ Church University (CCCU) and Medway School of Pharmacy) as well as many other UK and international partners. A number of staff hold joint University-Trust appointments, including Centre for Health Services Studies at UoK, and the England Centre for Practice Development at CCCU with its expertise in sustainable transformation and development. The Trust Director of Research and Innovation is Ms Jessica Evans, Consultant Colorectal and General Surgeon.

Infection Control

In accordance with the Health Act (2006) all staff are expected to comply with National and local Infection Control policies and procedures, and any other related infection prevention policies or procedures. In addition, all staff whose normal duties are directly or indirectly concerned with patient care should ensure they have received annual mandatory training (including hand hygiene). It is expected that all Consultants will lead by example in this area which receives maximum attention.

Summary Terms and Conditions of Appointment

The post will be appointed to under the Terms and Conditions of Service for Hospital Medical and Dental Staff as amended from time to time. The post holder is required to hold full and specialist registration (and with a licence to practice) with the General Medical Council (GMC), or be eligible for registration within six months of interview. 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 show evidence of equivalence to the UK CCT. The appointee will be required to reside not more than 30 minutes away from their main base, unless specific approval is given by the Chief Executive and Medical Director. The post-holder's private residence shall be maintained in contact with the public telephone service. The passing of a medical examination is a condition of employment. Every Consultant must adhere to the Trust policies and procedures including documentation of all activity both in outpatients and theatre. Any Consultant, who for personal reasons is unable to work full-time will be eligible to be considered for this post; if such a person is appointed modification of the job content will be discussed on a personal basis in consultation with the Divisional Medical Director.

Salary

The Consultant salary scale is currently £79,860 - £107,668 per annum (pro rata where applicable).

Annual leave

The annual leave entitlement is six weeks and two days and applications are subject to approval by the Care Group Clinical Director. A minimum of eight weeks’ notice of leave arrangements is requested so that adequate cover arrangements can be made. Annual leave entitlements increased for consultants with seven or more years of completed service with effect from 1 April 2005 by an additional 2 days.

Study leave Study leave is available according to local agreements. All clinical staff are required to give eight weeks’ notice.

Removal Expenses

Where a practitioner intends to claim reimbursement of removal or associated expenses, it is important that he/she first obtains a copy of the Trust's policy on removal expenses and should discuss the proposals with the Personnel department prior to taking up duty.

Visiting Arrangements

Further details and information may be obtained by contacting:

Dr Edmund Lamb, Clinical Director of Pathology, East Kent Hospitals, direct line 01227 864112, elamb@nhs.net

Mrs Sally Hall, Clinical Director of Clinical Support Services Care Group, East Kent Hospitals, Sally.Hall10@nhs.net Dr Rebecca Martin, Chief Medical Officer, East Kent Hospitals, rebecca.martin27@nhs.net Dr Paul Stevens, Medical Director, East Kent Hospitals, direct line: 01227 868750,

pstevens@nhs.net

Candidates who are shortlisted for interview will be expected to attend a site visit as part of the selection process. Details on how this can be arranged will be sent to you with your invitation to interview.

Person Specification

Criteria Group Essential Desirable Measurement/ Testing method

Experience

Clinical experience in all aspects of allergy and immunology

Understanding of wider health agenda and modern NHS

Knowledge of clinical governance issues

For those on the specialist register, evidence of satisfactory completion of CPD in allergy and immunology since registration

Application Form

Skills

Full and specialist registration (and with a licence to practice) with GMC, or be eligible for registration within 6 months of interview

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 show evidence of equivalence to the UK CCT

MRCP or equivalent

FRCPath or equivalent

Minimum of English Level 2 (GCSE grade C or equivalent), ILETS, or graduate of a UK Medical School

• Higher degree e.g. MSc, PhD, MD or equivalent

Application Form and evidence bought to interview

Values and Commitments – People feel cared for as individuals

Welcoming and polite

Attentive and helpful

Respect others’ time

Speak up on behalf of those who can’t

Interview

Values and Commitments – People feel safe, reassured and involved

Consistently safe

Vigilant about safety

Reassuringly professional

Listen and clearly communicate

Application Form Interview

Values and Commitments – People feel teamwork, mutual trust and respect sit at the heart of everything we do

Respect people and their dignity

Work as a team

Take responsibility

Be a leader

Values and Commitments – People feel

Delivers the best outcomes

Appreciate good work

Always improving our

Application Form Interview

confident we are making a difference

selves/services

Other Most roles require travel across sites. Candidates must be able to demonstrate the ability to travel effectively between sites

Upholds and models the Trust values

Application Form and evidence bought to interview

Additional Terms and Conditions Summary

Confidentiality The Post holder must maintain the confidentiality of information about patients, staff and other health service business in accordance with Trust Policy.

Data Protection

The postholder, for the purposes of the Data Protection Act 1998, consents to the processing of all or any personal data including sensitive personal data as defined under the Data Protection Act 1998 (in manual, electronic or any other form) relevant to their employment, by the Trust and/or any public body or any other third party as nominated by the Trust for the purposes of audit and bound by a duty of confidentiality.

Risk Management

The post holder will ensure compliance with the Trust’s risk management policies and procedures. These describe the Trust’s commitment to risk management, the recognition that our aim is to protect patients, staff and visitors from harm, and stress that all staff have a responsibility to minimise risk.

Infection Control

In accordance with the Health Act (2006) all staff are expected to comply with National and local Infection Control policies and procedures and any other related infection prevention policies or procedures. In addition all staff who‘s normal duties are directly or indirectly concerned with patient care should ensure they have received annual mandatory training (including hand hygiene).

Health and Wellbeing

The Trust is committed to improving the health and wellbeing of staff by supporting them to make healthy choices and lead healthy lives. Everyone employed by the Trust has a responsibility for promoting and participating in the staff health and well-being planned programmes, promotions and activities.

Equal Opportunities

The post holder will treat all colleagues, service users and members of the public with respect and dignity regardless of their gender, age, race, colour, religious beliefs, religion, nationality, ethnic origin, social background, sexual orientation, marital status, disability, real or suspected HIV/Aids status, criminal background and Trade Union status. The Trust has Policy for Equality and it is the responsibility of all staff to ensure that this is implemented.

Safeguarding Children

Everyone employed by the Trust regardless of the work they do has a statutory duty to safeguard and promote the welfare of children. When children and/or their carers use our services it is essential that all concerns for the safety and welfare of children and young people are both recognised and acted on appropriately. You have a responsibility to ensure you are familiar with and follow the Safeguarding Children procedures and the Trust’s supplementary Safeguarding Children Policy which is accessed electronically on the Trust's Intranet site. You have a responsibility to support appropriate investigations either internally or externally. To ensure you are equipped to carry out your duties

effectively, you must also attend Safeguarding Children training and updates at the competency level appropriate to the work you do and in accordance with the Trust's Safeguarding Children Strategy.

Safeguarding Adults

Everyone employed by the Trust regardless of the work they do has a duty to safeguard and promote the welfare of vulnerable adults. When patients and/or their carers use our services it is essential that all protection concerns are both recognised and acted on appropriately. You have a responsibility to ensure you are familiar with and follow Trust policies in relation to safeguarding vulnerable adults. You have a responsibility to support appropriate investigations either internally or externally. To ensure you are equipped to carry out your duties effectively, you must also attend vulnerable adult protection training and updates at the competency level appropriate to the work you do and in accordance with the Trust's vulnerable adult protection training guidance

Health and Safety

All staff must be aware of the responsibilities placed on them by the Health & Safety at Work Act (1974) to ensure that the agreed safety procedures are carried out to maintain a safe condition for employees, patients and visitors.

Professional and NHS Codes

of Conduct

You are required to act at all times in accordance with the relevant professional Codes of Conduct and Accountability (including, where applicable, those for Board Members). In addition, all management staff must comply with the ‘Code of Conduct for NHS Managers’ and ‘Standards of Business Conduct for NHS staff’.

Financial Management

and Control of Resources

All staff are responsible for the security and the property of the Trust, avoiding loss or damage, and being economical and efficient in the use of resources. Staff are required to act in accordance with the rules and regulations as described in the Trust’s ‘Policy Relating to the Financial Management and Control of Resources’.

Mandatory Training

All staff are required to attend mandatory training as designated by the Trust.

No Smoking

East Kent Hospitals University NHS Foundation Trust has a no smoking policy. Staff are not permitted to smoke within or on Trust premises

Please note that these terms and conditions are subject to change and may differ from your proposed contract should you be successful in your application.