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Iceni Clinical Fellow in Gastroenterology

BASED AT COLCHESTER GENERAL HOSPITAL

Colchester General Hospital Turner Road Colchester CO4 5JL

Essex United Kingdom

Accredited by the Royal College of Surgeons of England

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Table of Contents

1.0 Introduction .............................................................................................................. 3

2.0 The post & job summary ………………………………….............................................5

3.0 Key Information about the Duties and Responsibilities ....................................... 7

4.0 Draft Timetable (Total 10 PAs) ................................................................................. 8

5.0 Person Specification ................................................................................................ 9

6.0 Training and Postgraduate Education .................................................................. 10

7.0 General Terms and Conditions and Information .................................................. 10

8.0 Information specific to international Doctors………………………………………..13

9.0 Contact details for further information & arranging a visit………………………..13

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1.0 Introduction

East Suffolk and North Essex NHS Foundation Trust (ESNEFT) www.esneft.nhs.uk

ESNEFT was formed on 1 July 2018 from a merger of Colchester Hospital University NHS Foundation Trust and The Ipswich Hospital NHS Trust. ESNEFT is one of the largest NHS organisations in the region, employing over 10,000 staff and serving a population of almost 800,000 residents. As a large Trust we hope that can develop new services and provide the latest treatments locally.

For our staff and our patients, we have the same philosophy: time matters. This way of working will remove unnecessary stress and frustration caused by the systems we use and the way we work. We will concentrate on removing or improving the things we do that don't work for our patients. For our staff, this means more time to care for patients and greater opportunities to develop skills and experience.

To be the best, we need to attract and keep the best staff. Our size puts us in a strong position to grow, providing more of the latest services. Our scale provides exciting opportunities for development, innovation, research, education and training. Support from technology and logistics will help us see patients at the right time.

Our Trust will provide you with great opportunities to develop skills and experience, and our time matters philosophy will help us to see patients at the right time, attract and retain the best people and provide the latest treatments locally.

Our vision for the future is simple: to provide the communities we serve with excellent healthcare and build a better future for east Suffolk and North Essex. We look forward to you joining us and being part of this vision.

So, if your ambition matches ours, it’s time to work together.

Iceni Centre www.icenicentre.org The Iceni centre, located at The Colchester General Hospital, is an internationally renowned centre of excellence for medical training mainly in laparoscopy in gastrointestinal surgery. It is expanding to include medical gastroenterology training too. The Centre is named after Iceni, a Brittonic tribe of eastern Britain during the iron age & early Roman era. In AD 60-61, Boudica, Queen of the Iceni, led a Celtic revolt against the Roman Colchester.

Colchester www.visitcolchester.com

Colchester (Roman name Camulodunum) is the former capital of Roman Britain and the

‘Oldest recorded town in Britain’ with a wealth of history to explore, including the landmark

Norman era Castle. It is also a thriving and vibrant place to live and work. Offering great

transport links to London, Colchester is also very close to the coast and the beautiful and

peaceful ‘Constable’ countryside. Colchester is a vibrant town offering a great lifestyle for

families and young professionals alike, with more affordable housing than city areas, highly

rated schools, one of Europe’s best Zoos and great shopping. Some of the very best state

and independent schools in the country are to be found in the area.

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The Department of Gastroenterology, Colchester General Hospital The Department consists of four consultant gastroenterologists (Dr Ian Gooding, Dr Achuth Shenoy, Dr Mary McStay and Dr Simon Ralphs), 2 locum consultant gastroenterologists (Dr Donagh O’Riordan and Dr Asim Jafri), a specialty doctor and two specialist registrars. There is a nurse consultant (Mrs Anna Wordley), a nurse endoscopist, two IBD nurse specialists, a nutrition support nurse, three colorectal nurse specialists, and two upper GI nurse specialists. There are five secretaries. Endoscopy services are based in the Elmstead Day Unit. This is a purpose-built medical and surgical day case centre. We have three endoscopy rooms and two recovery areas, which is compliant with single-gender accommodation requirements. Endoscopies for cases of upper gastrointestinal bleeding are performed at 8.30am, prior to the main lists and also at the weekend. There is pooling of patients between surgeons and physicians and lists are generally a mixture of diagnostic and therapeutic gastroscopy and colonoscopy, with ERCP performed by Dr O’Riordan, Dr Gooding and Mr Menzies. Other therapeutic procedures include endoscopic polypectomy including endoscopic mucosal resection, oesophageal variceal banding, metal stent insertion and argon plasma coagulation. Procedures requiring x-ray screening are performed in the unit using an image intensifier. CHUFT is a BCSP centre with a satellite unit at Ipswich Hospital. The BCSP colonoscopists are Dr O’Riordan, Dr Shenoy, Dr McStay and Dr Ralphs. There is a video capsule endoscopy service and an oesophageal physiology service. Day case liver biopsies, hydrogen breath tests, and therapeutic paracentesis are also performed on the unit. There is a consultant gastroenterologist working every Saturday and Sunday morning. The duties include emergency endoscopy (mainly upper gastrointestinal bleeding cases) and then attending Langham gastroenterology ward. A total of 5 hours work each weekend morning is expected. In the near future a 24-hour on-call bleeding rota will be established. The department has a reputation for being friendly and supportive with particularly good

working relationships. Our busy endoscopy unit performs over 10,000 procedures annually,

including a full range of interventional endoscopy procedures and ERCP. We are a bowel

cancer screening centre. Oesophageal physiology and capsule endoscopy services are

available. There are IBD and nutrition nurse specialists. Close links exist with Barts and The

London for IBD and undergraduate clinical training and with Addenbrooke’s for hepatology.

The post will involve weekend morning gastroenterology work at a frequency of 2 weekends

in 17 and general medicine at a frequency of 1 weekend in 17. A 24-hour endoscopy rota

will be established, and this post will take part in this rota.

There are close links with GI surgery department. Mr Don Menzies and Miss Jo Reed, are Consultant Upper Gastrointestinal Surgeons. There are seven Consultant Colorectal Surgeons (Mr Tan Arulampalam, Mr Ralph Austin, Mr Matt Tutton, Mr Subash Vasudevan, Ms Sharmila Gupta, Mr Chandima Halahakoon & Ms Nienke Waarnar). Miss Sharmila Gupta performs IBD surgery. Ms Reed & Ms Warnaar also perform adrenal surgery. We have close links with Radiology department who perform complex interventional radiology work including transjugular liver biopsies, arterial embolization for uncontrolled gastrointestinal bleeding etc. Weekly multi-disciplinary team meetings are held for upper GI, hepato-pancreato-biliary, and colorectal cancers. Other meetings are the Inflammatory Bowel Disease (IBD) MDT (monthly), radiology (three weeks in four) and histology (monthly). In addition we have quarterly meetings with hepatology specialists from Addenbrookes Hospital, Cambridge and

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IBD specialists from The Royal London Hospital. There is a combined monthly gastroenterology-surgical IBD clinic, a liver transplant follow up clinic, a viral hepatitis clinic and a combined specialist Neuroendocrine tumour (NET) clinic. We are proud of our multidisciplinary approach to IBD. Further details of our work (Colchester IBD Centre) can be found at www.colchesteribd.nhs.uk. The department has been involved in several National Institute of Health Research (NIHR) clinical trials (CONSTRUCT, Halt-it, TP03, BOSS, IBD Bioresource, ICare, BEST 3 etc). There is a close working relationship with colleagues in Ipswich Hospital. Following the merger this is expected to develop further.

2.0 Post and Job Summary

JOB TITLE: Fellow in Gastroenterology GRADE: Specialist Doctor/Post CCT Fellow ACCOUNTABLE TO: Managerial Accountability – Clinical Director for

Gastroenterology & Endoscopy Professional Accountability – Medical Director DIRECTORATE: Division of Medicine DEPARTMENT: Gastroenterology PRINCIPAL ACTIVITIES: CLINICAL The post holder’s duties will be primarily at Colchester General Hospital, Colchester but his/her presence may be required in other parts of the Trust and at outreach clinics. THE POST Applications are invited for the post of Fellow in Gastroenterology at Colchester Hospital

University NHS Foundation Trust, based at Colchester General Hospital. This Fellowship

post (for up to 2 years) is open to UK & international doctors.

An exciting opportunity has arisen for an enthusiastic and motivated Iceni Clinical Fellow to work within our dynamic and fast paced Gastroenterology department. This post is available to UK and international doctors. This post offers excellent opportunities for developing expertise in wide areas of clinical practice in Gastroenterology depending on the level of training & interests of the applicant. This is a fixed-term role for a minimum of 12 months with the possibility to extend upon mutual agreement.

The post is suitable for doctors who have completed their basic gastroenterology training and obtained the MRCP (or equivalent) examination but are looking for further experience at senior registrar level. This post is ideal for those who have an UK certificate of completion of training (CCT) in Gastroenterology or equivalent and looking for top up training & experience

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before taking up a consultant post in the NHS. CCT or MRCP are not essential, a candidate who has adequate basic training, experience & expertise is welcome to apply. We will design the job and the training around the requirements of the appointee and the department.

In undertaking an ICENI Centre Fellowship at ESNEFT our commitment to the trainee is that they will have access to:

Working alongside a team of eminent gastroenterologists with a range of subspecialty interests:

Exposure to advanced colonoscopy in our Bowel Cancer Screening Centre

Exposure to interventional endoscopy including ERCP, EUS, stenting and GI bleeding

Experience in management of Inflammatory Bowel Disease

Work as part of the Nutrition Support Team

Experience of Neuro-endocrine Tumour Management in our regional clinic

Experience in viral hepatitis & liver transplant clinics

Multi-Disciplinary Team working: We have 3 cancer related MDT meetings (upper GI, lower GI & hepatobiliary-pancreatic), Inflammatory Bowel Disease, Gastro histology & gastro-radiology.

Clinical governance: The trainee will be able to develop leadership skills by participating in the departmental clinical governance activities

Mentorship & appraisal

Opportunities to take part in supervised audits and research projects

Up to 2 years of excellent training at ESNEFT, including – o Weekly teaching programmes and grand rounds in the Postgraduate Medical

Centre o Attendance on ICENI Centre course(s) of your choosing worth up to £750 plus a

Human Factors course, all free of charge o Access to a range of courses and other seminars, as available

o Regular and free access to the ICENI Centre Skills Lab, simulation equipment,

and a clinical mentor

o Where relevant, an induction into the NHS system

o A 2-week placement arranged for you undertaking clinical services in a partner

hospital in China. Flight tickets will be covered by the Trust; however, you would

need to pay for your own accommodation and other expenses whilst in China

An opportunity to develop teaching skills through the ICENI Centre, including –

o Attendance on a “Train the Trainer” course, free of charge

o Becoming a certified member of our teaching faculty

o Being invited faculty on ICENI Centre courses, and where appropriate Royal

College Accredited courses dependant on level of experience

There will be the opportunity for career development in this post. Applicants with

subspecialty interests or skills would be encouraged to use and develop them within the

work of the department.

Appointment is subject to a satisfactory selection process based on evaluation of the curriculum vitae, formal interview, satisfactory professional references & health screening. The candidate is required to sign a detailed contract for minimum of a year which may be terminated with a notice period of 3 months.

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3.0 Key Information about the Duties and Responsibilities

The appointee will be expected to provide a specialist clinical gastroenterology service, including mainly endoscopy and outpatient gastroenterology work. A broad knowledge of gastroenterology and general medicine is essential as is expertise in diagnostic and therapeutic endoscopy. There is a daily early morning bleeder service. The post-holder will participate in a rota to provide the acute gastroenterology services at the weekend. Emergency endoscopy cases are performed in the endoscopy unit. We are working towards providing an out of hours rota for emergency endoscopy within the next three months. The candidate is expected to participate in such a rota General The post holder will:

Work with medical colleagues and the extended multi-professional team to provide the highest standard of consultant-led care

Develop care pathways and clinical guidelines with the multi-professional team

Help maintain good working practices, including delivering education, across the wider health economy

Collaborate and promote close working links with colleagues in tertiary centres and primary care

Offer support and leadership to junior medical colleagues, nursing colleagues and other members of the multi-disciplinary team

Work across all sites as required

Clinical The post holder will:

Participate in the Postgraduate and Undergraduate teaching programmes, and teaching of other healthcare professionals, within the department, Trust and across the wider health economy.

Support, mentor and teach other colleagues on a day to day basis to provide effective clinical leadership for all the staff within the service.

Participate in appraisal and assessment of junior medical colleagues as delegated.

Provide the highest quality of clinical care for all patients referred to the service.

Develop protocols, guidelines, clinical pathways and care standards for gastroenterology conditions in line with National and local priorities.

Have clinical and administrative responsibility for the department in achieving national and local waiting list targets.

Provide a responsive consultation and advisory service to medical colleagues in other specialities across the Trust.

Education & Training The post holder will:

Complete mandatory training required by the Trust

Participate in the Postgraduate and Undergraduate teaching programmes, and teaching of other healthcare professionals, within the department

Support and teach colleagues on a day to day basis

Participate in appraisal and assessment of junior medical colleagues, as advised by the Unit Training Director

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Clinical Governance

The post holder will:

Comply with the Trust’s Clinical Governance policy, including clinical risk management, data collection and regular departmental audit projects

Attend the departments Governance meeting

Contribute to the Division’s Mortality and Morbidity reviews and meetings. Continuing Professional Development The post holder will:

Participate in the annual appraisal process, in line with the Trust’s appraisal guidelines

Maintain an up to date job plan and personal development plan

Register and participate in the Royal College of Physicians Clinical Professional Development (CPD) scheme

Office accommodation with a computer and secretarial support with be provided. The appointee will be offered mentoring.

4.0 Draft Timetable (Total 10 Programmed Activities)

This weekly timetable is indicative and may be subject to change depending on the clinical

preference and on service need. A detailed programme, with personal objectives and any

support identified will be agreed with the lead clinician on appointment.

MONDAY

TUESDAY

WEDNESDAY

THURSDAY

FRIDAY

8 AM

Histology/ X-Ray Meeting

AM

Outpatient Clinic

Endoscopy

Ward Round

Endoscopy

Outpatient Clinic

LUNCH TIME

UGI/HPB MDT Meeting

Radiology Meeting

Journal Club

Medical Meeting

PM

Endoscopy

Admin

Outpatient Clinic

Admin/ Subspecialty interest

Admin

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5.0 Person Specification

POST OF: CONSUTANT PHYSICIAN AND GASTROENTEROLOGIST

REQUIREMENTS ESSENTIAL DESIRABLE

Qualifications/Training

(a) What professional

qualifications are needed?

MB,BS or equivalent; MRCP

MD or PhD

Previous Experience

(a) What work experience is

needed?

Extensive experience of clinical

gastroenterology at senior SpR

level or equivalent.

Extensive experience working in

National Health Service in the UK

or similar for international doctors

Training in a sub-

specialty complementary

to that of the existing

consultants.

Skills and Knowledge

What special skills or knowledge

does the post-holder require?

(a) Leadership skills

(b) Communication skills

(c) Organisation skills

(d) GI Endoscopy skills

Ability to provide leadership at

multi-disciplinary team level.

Must have good written and verbal

communication skills and be able to

communicate effectively with

patients, colleagues, managers and

staff at all levels.

Ability to organise and prioritise

work effectively and to be involved

in the organisation of the

department.

Ability to perform diagnostic

gastroscopy independently.

Experience of committee

work/project

management.

Teaching experience at

undergraduate and

postgraduate level.

Computer literate.

Ability to perform

diagnostic colonoscopy

independently.

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6.0 Training and Postgraduate Education

General There is an excellent Postgraduate Medical Centre with a lecture theatre. The centre includes seminar rooms and a small but extensive library with very helpful staff on a site adjacent to Colchester General Hospital. Time will be allowed for the appointee to attend meetings for the purposes of Continuing Medical Education (30 days over a 3 year period). The Trust will fund such CME related activities up to a local ceiling which is currently £700 per annum, per person. The post-holder will be required to participate in programmes for teaching medical students, training junior doctors and in clinical examinations. It is expected that this will be an integral part of everyday clinical activity. The post-holder will be required to keep himself/herself fully up-to-date with their relevant area of practice and to be able to demonstrate this to the satisfaction of the Trust. Professional or study leave will be granted at the discretion of the Trust, in line with the prevailing Terms and Conditions of Service, to support appropriate study, postgraduate training activities, relevant CME courses and other appropriate personal development needs. The post-holder will attend relevant mandatory training including the Trust’s ‘At Our Best’ programme. Undergraduate Education Colchester Hospital University NHS Foundation Trust is an associate university teaching hospital and medical students from Bart’s and the London School of Medicine are regularly attached to the department.

7.0 General Terms and Conditions and Information

The post is covered by the Terms and Conditions of Service of Hospital Medical and Dental Staff (England and Wales). The salary scale will be determined based on the candidate’s experience, expertise & agreed work schedule at par with UK national salary scales. A post CCT appointee’s basic salary will be set at a threshold as an NHS consultant. Part-time staff will be paid pro-rata. Shortlisted candidates will be required to complete a Health Statement and the Trust may require an officer to pass a medical examination as a condition of appointment. Because of the nature of the work of this post it is exempt from the provisions of Section 4(2) of the Rehabilitation of Offenders Act, 1974 by virtue of the Rehabilitation of Offenders Act 1974 (Exemptions) Order 1975. Applicants are, therefore, not entitled to withhold information about convictions, including those which for other purposes are "spent" under the provisions of the Act, and, in the event of employment, any failure to disclose such convictions could

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result in dismissal or disciplinary action by the Trust. Any information should be sent to the Trust Medical Director in an envelope marked for his/her personal attention and will be completely confidential and be considered only in relation to an application for positions to which the order applies. The successful candidate will be expected to devote substantially the whole of his/her professional time to this appointment and to give it priority on all occasions (subject to consultants' ethical obligations to all their patients when emergencies arise) whether opting for a full-time or part-time contract. The successful candidate will be required to live less than ten miles by road from the main unit or a distance equating to travelling time of 30 minutes or less. The private residence must be maintained in contact with the public telephone service. Assistance may be given to newly appointed Consultant towards removal expenses. However, this is subject to eligibility in accordance with the Colchester Hospital University NHS Foundation Trust’s Policy and Procedure on Reimbursement of Relocation Expenses. ‘The Trust is committed to providing safe and effective care for patients. To ensure this, there is an agreed procedure for medical staff that enables them to report, quickly and confidentially, concerns about the conduct, performance or health of medical colleagues’ (Chief Medical Officer, December 1996). All medical staff practising in the Trust should ensure that they are familiar with the procedure and apply it. Medical Negligence The Fellow agrees to:

Co-operate fully with The Trust and its Legal Advisors in the investigation of any Patient Complaint/Incident involving but not limited to any allegation of negligence or misconduct on the part of the Consultant.

To provide The Trust, on request, with a full written statement concerning the said Patient Complaint/Incident.

Clinical Governance The post-holder will participate in clinical governance activities, including clinical audit, clinical effectiveness, risk management, quality improvement activities as required by the Trust, and external accrediting bodies. Management The post-holder will be required to work within the Trust's management policies and procedures, both statutory and internal, accepting that the resources available to the Trust are finite and that all changes in clinical practice or workload, or developments requiring additional resources must have prior agreement with the Trust. He/she will undertake the administrative duties associated with the care of his /her patients and the running of his/her clinical department under the direction of the lead clinician and/or directorate chair.

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Infection Control Infection Control is everyone’s responsibility. All staff, both clinical and non-clinical, are required to adhere to the Trusts’ Infection Prevention and Control Policies and make every effort to maintain high standards of infection control at all times thereby reducing the burden of Healthcare Associated Infections including MRSA. All staff employed by the Trust have the following key responsibilities:

Staff must wash their hands or use alcohol gel on entry and exit from all clinical areas and/or between each patient contact.

Staff members have a duty to attend mandatory infection control training provided for them by the Trust.

Staff members who develop an infection (other than common colds and illness) that may be transmittable to patients have a duty to contact Health & Wellbeing Department.

Amending the Job Description It is expected that as the organisation develops and changes, it may be necessary to vary the tasks and/or the responsibilities of the post-holder. This will be done in consultation with the post-holder and it is hoped that agreement can be reached to any reasonable changes. Confidentiality The post-holder must at all times maintain complete confidentiality of the material and information that they handle. Any matters of a confidential nature, or, information relating to diagnoses and treatment of patients and individual staff records must not, under any circumstances, be divulged or passed on to any unauthorised person or persons. The post-holder must respect patient named confidentiality in keeping with “Caldicott principles”. Data Protection The post-holder must at all times respect the confidentiality of information in line with the requirements of the Data Protection Act G General Data Protection Regulations (GDPR). This includes, if required to do so, obtaining, processing and/or using information held on a computer in a fair and lawful way, holding data only for the specified registered purposes and using or disclosing data only to authorised persons or organisations as instructed. General The post-holder will be expected to be responsible for his/her continuing professional development and to take a proactive approach to maintaining personal and professional effectiveness in an evolving role. The duties and responsibilities described in this Job Description are intended to be indicative but not exhaustive of the responsibilities of the post-holder. As the Trust develops, the requirements of the job may change, and the post-holder is expected to adapt to these changes.

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Health and Safety Employees must share responsibility for abiding by health and safety policies and regulations, infection prevention and control policies and act in accordance with the Risk Management Policy. This includes compliance with The Health Act 2006 Code of Practice for the prevention and control of healthcare associated infection (available on the Trust Intranet). In addition, be aware of the responsibilities placed on them by the Health & Safety at Work etc. Act (1974) to ensure that the agreed safety procedure is carried out to maintain a safe environment for themselves, other employees and visitors. Equal Opportunities Policy and Anti-Harassment The post-holder will immediately report to their line manager any breach or suspected breach of both equal opportunity and anti-harassment guidelines. Smoking Control Policy The Trust has adopted a smoking control policy. The policy applies to all staff, patients and visitors, and extends to the hospital grounds as well as internal areas.

8.0 Information specific to international doctors: The fellowship programme will provide

an opportunity to train in British way of medical practice with exposure to multidisciplinary team (MDT) working & evidence-based cost & clinically effective healthcare. Appointee will be able to experience the National Health Service (NHS) system of egalitarian healthcare. Command in English language is essential. General Medical Council registration is required. We can facilitate attending self-funded external courses (e.g., Endoscopy courses) in the United Kingdom. We will support appointees who wish to attempt specialist examinations e.g., MRCP (UK) provided the trainee meets the Royal College requirements.

9.0 For further details / informal visits contact:

Should you wish to visit the hospital, please make the necessary arrangements through the Gastroenterology Department, Colchester General Hospital. Telephone: 01206 742382. Informal enquires should be made by email to Susan. Trower, PA to Dr Achuth Shenoy. Susan.Trower@ colchesterhospital.nhs.uk.