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About Southend University Hospital

Southend University Hospital NHS Foundation Trust provides acute services from our main Prittlewell Chase site and at outlying satellite clinics across the region. We maintain nearly 700 inpatient beds, serving a local population of 338,800. We have 4,567 staff comprising 190 consultants, 316 doctors, 1,210 nurses and 2,851 support staff.

We provide a comprehensive range of acute services including acute medical and surgical specialties, general medicine, general surgery, orthopaedics, ear, nose and throat, ophthalmology, cancer treatments, renal dialysis, obstetrics and gynaecology, and children's services.

Southend University Hospital is the South Essex surgical centre for uro-oncology and gynae-oncology surgery and is considered to be a centre of excellence for the care of stroke. We also offer breast screening, ophthalmology and orthodontic services to the wider south Essex population.

Our Vision and Values

We strive to provide excellent care from excellent people.

The NHS is currently facing the most radical structural changes and financial challenges in its history. New treatments and innovations mean that healthcare today is more effective than ever. At the same time NHS hospitals are facing uncertainty about how services will be commissioned and regulated, as well as more competition from other healthcare providers. This means we need to provide increasingly better healthcare while keeping within our budget. We will need to be selective in which services we offer, whether they are provided here at the hospital, out in the community or in patients' own homes.

Our Key Priorities

Expand what is excellent

Improve what is good

Deliver what is essential

Cease what is done better elsewhere

Grow excellent services to achieve £300m income within five years

Make our staff feel proud to work at Southend University Hospital

We will continue to expand our areas of research and innovation so that we can attract more excellent staff and enhance our reputation for high quality care from committed staff.

Our Objectives

Patient focus - keep getting better

To ensure the care and experience of patients and their families is as excellent as the clinical outcomes that the Trust delivers.

Sustainability - keep the core strongTo ensure we get the basics right every time.

Sustainability - grow selectivelyTo seek opportunities to grow services in which we excel.

Research, education and innovation - invest in our futureTo develop our areas of expertise in research and training, and build on our existing innovation.

Staff – feel proud to work here and be making a differenceTo foster the skills required to create and excellent organisation with excellent leaders.

Partnership - our hospital and our communityTo support our relationship with the community and stakeholders to shape services in our hospital which we can all be proud of.

Our quest for excellence can only be achieved by developing the skills of staff at all levels, ensuring that we all have the same set of values and attending to detail. We are passionate about doing a good job and providing quality care for our patients. In short, we believe:

Everybody matters Everything counts Everyone's responsible

We will continue to strive to:

Listen to our patients and their carers

Give clear, concise information

Treat patients and each other with respect

Maintain high standards

Adapt to new ways of working

Use our resources to avoid waste

Encourage innovation and creativity

Learn from experience

Take responsibility for our own mistakes

Seek to constantly improve our care

Protect our reputation

Our Services

In addition to our main Prittlewell Chase site, we provide services from a further 47 locations around the region. We have almost 700 inpatient beds and specialise in providing acute care to patients with a range of complex medical and surgical conditions.

Our services include accident and emergency, surgical services, general medical services, critical care, stroke care, ophthalmology, maternity services, care of the elderly, neonatal and children’s services, orthopaedics and sexual health services.

In addition we provide a number of support services including outpatient services, pharmacy, nutrition and dietetic services, pathology, diagnostic services, radiology, physiotherapy, rehabilitation, occupational therapy and pain management.

Key Achievements - Improving Patient Care, Safety and Experience

Last year, Southend became the only hospital in Essex to offer intensity-modulated radiation therapy (IMRT) which targets the dose of radiation to the precise shape of a cancer tumour, sparing healthy adjoining tissue. The technology is able constantly to adjust the shape and intensity of the beam as the machine rotates around the patient.

Our stroke unit was named top centre in the world for the number of patients recruited to a study to help patients get back to normal quickly. The stroke team also introduced a rapid-access TIA clinic for low-risk patients to prevent them going on to a full-blown stroke.

The Trust’s maternity department – responsible for the delivery of around 4,000 babies every year- was awarded CNST Level 2 - the first time it has achieved this elevated ranking, and under a tougher new set of standards recently introduced. The criteria had been strengthened to reflect the increase in childbirth risks such as women having babies at a later age and larger babies at birth.

A collaboration between obstetrics and gynaecological services and colorectal specialists enabled a new perineal clinic to be set up to help treat women who tear badly during childbirth. A specialist clinician deals with all aspects of the problem – diagnosis, investigations and treatment, its purpose to focus on early detection rather than waiting for problems to get worse.

In June 2011we introduced the ‘care rounds’ initiative, designed to ensure inpatients are visited by a member of nursing staff every hour of the day to check on their individual needs. This attracted the interest of minister for public health Anne Milton MP, who visited the hospital in February this year to see the care rounds in action. Evidence gathered by the Trust shows a clear improvement in patient care.

Key Achievements - Research and Development

Research in the Trust’s stroke unit has led to the use of external compression devices for the prevention of deep vein thrombosis in acute stroke patients.

Clinical drug trials at Southend University Hospital have also brought new therapies to patients, such as the use of the drugs lapatinib and neratinib for the treatment of breast cancers and cediranib and saracatanib for the treatment of renal cancers. Trials have also brought novel biologic agents such as golimumab and tocilizumab in the treatment and management of rheumatoid arthritis.

Local research has contributed to the development of new radioactive materials for use in positron emission tomography (PET) scanning in order for the best imaging of ovarian cancers.

Three new grant awards for research projects in renal medicine were added to existing grants in rheumatology. During last year, three clinical research forums were held featuring presentations from several surgical specialties, ophthalmology, renal medicine, oncology, anaesthetics, obstetrics and gynaecology. A collaborative bid between research and development and innovation for a NIHR health technology collaborative is in preparation. This will feature several hospital specialties, the Comprehensive Local Research Network (CLRN), Anglia Ruskin University, Essex University, industry partners and primary care.

There were awards during the year for a number of our research nurses in the CLRN best practice awards ceremony, as well as one to Professor Bhaskar Dasgupta, the Trust’s clinical director of research and audit, for ‘promoting local NHS contribution to the National Institute for Health Research life sciences industry research portfolio’. Professor Dasgupta also gained the distinction of having work on polymyalgia rheumatica (PMR) published simultaneously in three prestigious international medical journals.

Facts and Figures

Hospital activity for the last three years

2011/2012activity

2012/2013activity

2013/2014 activity

Elective inpatients 9,599 8,564 9,219

Emergency inpatients 39,859 41,791 43,148

Day cases 41,664 42,979 43,077

Outpatient attendances 545,880 537,697 540,098

Accident and Emergency 91,750 93,433 89,960

Total 728,752 724,464 725,502

Hospital acquired MRSA bacteraemia numbers for the last three years

2010/2011 2011/2012 2012/2013

MRSA 2 2 3

Hospital acquired Clostridium difficile numbers for the last three years

2010/2011 2011/2012 2012/2013

Clostridium difficile 27 32 24

Our Team

A total of 4,567 staff are employed by the Trust comprising 190 consultants, 316 doctors, 1,210 nurses and 2,851 support staff. We pride ourselves on our ability to attract a high calibre of staff and aim to provide an environment that encourages continual development and progression.

Our Clinical Management Structure

The Trust implemented a new corporate structure at the start of the 2011/12 financial year. Six business units were established within clinical areas, previous care pathways were crossed and the business units were established to co-exist with active corporate directorates. These are:

Anaesthetic and Critical Care

Diagnostic and Therapeutic

Medicine

Musculoskeletal

Surgery

Women’s and Children’s

Business Unit Directors were put in place and made accountable for delivery of our cost improvement programme without affecting the quality of care. Each supported by a variety of clinical leads.

Our Foundation Trust

We were authorised as a Foundation Trust on 1st June 2006 by the regulator, Monitor. As such we have a membership scheme; any member of the local population having the required criteria (public, patient, carer, staff or volunteer) can become a member of the Trust. Our total Foundation Trust membership currently stands at just under 18,000.

Governors are either elected from the membership by the membership, which allows the community to have ownership of its local hospital or appointed by partner organisations. Our board of governors provides a critical link between the hospital and the people it serves in the local area. Governors are also responsible for holding the board of directors to account for the Trust’s overall performance and are pivotal in shaping and endorsing our vision, values and strategy.

Further Information

A range of information about our Trust and the services we provide is available on our website: www.southend.nhs.uk

http://www.southend.nhs.uk/

Trust Board

Executive Directors

Sue Hardy, RGN, RM, MSc

Acting Chief Executive

Sue joined the Trust in April 2011 from Northampton General Hospital, where she was director of nursing, midwifery and patient services.

She qualified as a nurse in 1984 and as a midwife in 1989, and went on to become head of midwifery at Yeovil District Hospital and director of nursing at

Hereford Hospitals NHS Trust. During her career she has worked at a number of hospitals around the UK, and has extensive experience in quality management and leading organisational cultural change.

Sue is a committed champion for delivering a positive patient experience, and is dedicated to ensuring that our patients continue to receive the best possible care in a safe environment.

James O'Sullivan

Chief Financial Officer

James joined the Trust as chief financial officer in April 2014.

During his early career James qualified as an accountant while working in the oil industry. He has also worked in other sectors, latterly spending 18 years with EDF Energy, and has held a number of finance director

roles over the years.

Immediately prior to joining us he was a non-executive director at East Sussex Healthcare NHS Trust.

James doesn't just see finance as number crunching. For him it's about supporting and empowering people to do things that make a difference.

Neil Rothnie, MS, FRCS

Medical Director

Neil qualified as a doctor from St. Bartholomew's Hospital in London in 1981. He undertook postgraduate surgical training in and around London, including a stint as a surgical registrar at Southend Hospital in the 1980's. A period in cancer research at Bristol Royal Infirmary and The Royal Free Hospital led to the award of a Master of Surgery degree from the University of

London.

He was a senior registrar at St. Bartholomew's Hospital prior to his appointment as a consultant general surgeon at Southend Hospital in 1994.

Neil established the specialist breast unit at Southend and developed the 'open access' hernia service. He is the director of screening for South Essex Breast Screening Service and lead clinician for breast services.

He has spent 16 years as the surgical lead to the Regional Quality Assurance team for the NHS Breast Screening Programme and has chaired the National Breast Screening Audit for the last five years.

Neil was appointed as medical director in December 2012.

Jon Findlay

Chief Operating Officer

Jon joined us as chief operating officer in January 2014.

Jon has come to us from Guy's and St Thomas' in London, and is coming back to his roots as he began his NHS career here in 1987.

Working for a time in the private sector, Jon returned to the NHS and has had experience at Basildon, Dartford and Whipps Cross hospitals before his role at Guy's, which is the largest Trust in the NHS.

Jon is pleased to be returning to Southend and is looking forward to being able to have a direct influence on patient care.

Jan China, MBA, MSc, BSc, RGN

Director of Estates and Facilities

Jan has committed her entire working career to the NHS and came to Southend from Mid Essex Hospitals in 1988.

Initially undertaking roles in health care and general management, Jan moved into service redesign, construction project management and more recently estates maintenance services.

Jan is looking forward to improving the patient environment and ensuring that we have a hospital that gives our clinical teams the support needed to deliver modern day treatments.

Keith Warrior, MCIPD, BA (Hons)

Acting Director of Human Resources

Keith joined the Trust's human resources team in 2005, initially as a HR relationship manager having gained a wide range of HR experience with a number of local authorities.

In 2007 he was appointed head of HR operations and more recently associate director of HR.

Keith is committed to working with our staff and their representatives to provide the best possible patient care in a rewarding and positive workplace.

SOUTHEND-ON-SEA

Southend-on-Sea is a mid-sized town on the north bank of the Thames estuary, close to its ending in the North Sea. It is a seaside tourist resort with seven miles of award-winning beaches, and the longest pleasure pier in the world. It has good commuter links to London and is also a popular retirement choice. Southend retains a selective secondary school system, and its Grammar Schools rank highly for the quality of education and GCSE and A level results. Major employers are the Hospital, Keymed (manufacturers of endoscopes and diagnostic ultrasound machines etc) and London Southend Airport. Southend also has a brand new, state of the art building for the South East Essex College, part of the University of Essex.

GEOGRAPHY

The area is well served by roads and public transport to the City of London. There are two separate rail lines travelling to London Liverpool Street station and London Fenchurch Street station, the journey time being approximately 45 minutes. There is easy access to the M25 and Dartford Tunnel, the travel time being approximately 30 minutes.

Job Description - Specialist Registrar 1 year NTN post in Stroke Medicine. of 24

http://www.southend.gov.uk/content.asp?content=587

http://www.southend.gov.uk/content.asp?content=4862

SOUTHEND UNIVERSITY HOSPITAL NHS FOUNDATION TRUST

MEDICAL BUSINESS UNIT

SPECIALTY REGISTRAR – 1 YEAR POST IN STROKE MEDICINE

DEPARTMENT PROFILE

PART 2

Medicine Business Unit Profile

The Medicine Business Unit comprises the following services:

Accident & Emergency Acute Medical Unit Cardiology Diabetes & Endocrinology Gastroenterology Infectious Diseases Medicine for the Elderly Neurology Renal Medicine Respiratory Sexual Health Stroke

Recent developments include expansion of our award winning stroke service, a new cardiac catheter laboratory and renal unit expansion.

A particular emphasis in the department is placed on teaching, both undergraduate and postgraduate, and excellent training for junior staff. There is a Clinical Guidelines Committee (as part of our Clinical Governance arrangement); Dr Moro-Azuela is the Chair.

Intensive Care: There is a ten bed critical care unit in which care is shared between one of the renal/ITU physicians and consultant anaesthetists, Dr Higgins being the lead clinician.

ARCU: There is a 10 bed Acute Respiratory Care Unit which is supervised by the Respiratory team.

HASU: There is a 15 bed Acute Stroke Unit. Patients are admitted directly to it after thrombolysis and with acute stroke. Recent investment enabled increased staffing levels to deliver hyperacute stroke interventional unit level care.

CCU: There is an 11 bedded Coronary Care Unit with state of the art monitoring facilities.

Job Description - Specialist Registrar 1 year NTN post in Stroke Medicine. of 24

Acute Medicine

Gastroenterology: The Endoscopy Unit provides a wide range of GI investigations and procedures. These include upper and lower GI endoscopy, therapeutic ERCP, oesophageal metal stenting, biliary lithotripsy and argon beamer therapy. There are three endoscopy rooms, one with screening facilities. Urea breath testing, biochemical GI tests and ERCP are also available. Clinics are also organised by nurse specialists in coeliac disease and inflammatory bowel disease. Over 50% of GI patients are directly booked for endoscopic procedures on an open access basis. Weekly multidisciplinary meetings are held to review all cases of GI cancer. There are three specialist nurses for GI cancer patients, one nurse endoscopist and two Specialist Registrars / ST3+. There are also regular clinics managing chronic liver disease and viral hepatitis.

Renal Services: The renal unit has 22 chronic haemodialysis stations split between the purpose built unit and ward where there are additional stations for acute dialysis. Outpatients are seen in the Renal Unit, main outpatients and the Diabetes Centre. There are general medical and nephrology outpatients as well as specialist clinics which include transplant, low clearance, dialysis and a combined diabetic renal clinic. Both acute and chronic renal failure is managed at Southend. Acute haemodialysis is managed on the ward; haemodiafiltration on the Critical Care unit. All aspects of renal care are performed at Southend apart from transplantation which is performed mostly at the Royal London with transfer of care at 3 months. At present there are over 120 patients on haemodialysis and 24 on peritoneal dialysis. There are plans and funding to increase the haemodialysis facilities.

Respiratory Medicine: A full range of respiratory services including pulmonary function, cardiorespiratory exercise tests, pleural investigation, sleep studies and flexible bronchoscopy (which are done in the endoscopy unit) are performed. The department has a special interest in the epidemiology of lung cancer and sleep disorders. Assisted ventilation for respiratory failure is provided on the ward where the specialist respiratory nurse is based. There is a prevention of admission and early discharge service for COPD and a Pulmonary Rehabilitation Service.

Diabetes and Endocrinology: There is a diabetes centre - this is run by the Consultants, specialist diabetic nurses and diabetic team with strong community links. Joint clinics are held to manage pregnant diabetics, diabetic renal failure and paediatric cases. Endocrine investigations are coordinated by the consultants a team of three with assistance from clinical pathology.

Medical Specialties

Neurology: There are five neurology consultants Dr Everett, Dr Coward, Dr Sanvito, Dr Gallagher and Dr Cheesman. There is a full time neurology SpR/ST3+ on the East London rotation. Dr Mendis provides a full neurophysiology service (Nerve conduction studies, EMG and EEG). In addition to general neurology clinics there are specialised clinics in epilepsy (including a rapid access clinic), Parkinson’s disease and Multiple Sclerosis (including a MS

Job Description - Specialist Registrar 1 year NTN post in Stroke Medicine of 24

disease modifying clinic). Neurology also has close links with the stroke service with Dr Coward specialising in stroke and neurology.

The neurology service is linked to the Regional Neuroscience Centre at the Royal London Hospital and academic meetings are held weekly at the Royal London. There are active links with the Royal London MS service. There is excellent neuroradiology support, i.e. 2 MRI scanners (1 + 1.5 Tesla), spiral CT, multi slice CT, DatScan and PET access.

As well as a referral service there are neurology beds on Paglesham ward for investigation and management for patients with neurological problems. There are two full time specialist nurses working with patients with Parkinson’s disease and a full time and one part time specialist nurse working with patients with MS and one nurse with patients with Epilepsy.

Stroke Medicine: Drs, Paul Guyler, Devesh Sinha and Tony O’Brien are the Stroke Physicians with Dr Lucy Coward neurology and stroke. There is an Acute Stroke Unit (HASU) of 15 beds opened in Oct 2007. We have thrombolysed over 750 patients with stroke since then, approximately 20% of acute stroke admissions. This is one of the highest rates of thrombolysis in the UK. We have linked active stroke intervention services with interventional neuroradiology. There is a Neuro-rehabilitation unit adjacent to the HASU with 16 beds for stroke. There is an established Early Supported Discharge (ESD), Community Stroke Team and Stroke Clinical psychology services with regular OPD and daily TIA clinics.

We have Professor Iris Grunwald to develop stroke research and interventional stroke treatments linked within stroke services.

Cardiology: The Department of Cardiology consists of 5 Consultants, with variable special interests. There is a strong link with Essex Cardiothoracic Centre where tertiary services of PCI and surgery are provided. Each Consultant also has weekly commitment at the Cardiothoracic Centre. Cardiology is managed with an 11 bedded CCU and 19 bedded ward. Two FY1 and one FY2 doctor provides daily management of patients with supervision from a Speciality Doctor/SpR and a Consultant on a weekly basis.

The Department provides state of the art facilities to perform a wide range of diagnostic investigations, including invasive coronary angiography, pacemaker implantation and ICD implants and follow up. The Department has fully established services for Nuclear Cardiology, CT based coronary angiography and advanced echocardiography including TOE and stress echo’s. Several specialist Nurse lead clinics are in place.

Medicine for the Elderly: The department has particular expertise in Orthogeriatrics, Stroke, Memory, Elderly screening, DVT, cellulitis, Tilt table testing, Falls.

HIV and Sexual Health Medicine: The inpatients with HIV are currently managed on Westcliff Ward. This ward has two negative pressure rooms. The inpatient HIV patients are managed by the infectious Disease Consultant, Dr John Day. The HIV outpatients are currently seen by the Sexual Health Consultant Dr Henna Jaleel and the Infectious Disease Consultant Dr John Day. The HIV Service is supported by two Clinical Nurse Specialists.

Consultant Staffing:

Endocrinology / Diabetes


Dr J Ahlquist General Physician and Endocrinologist and Honorary Senior Clinical Lecturer

Dr K Metcalfe General Physician and Endocrinologist and Honorary Senior Clinical Lecturer

Dr A Siddiqi General Physician and Endocrinologist (part-time)

Dr I Chakraborti Consultant in Diabetes, Endocrinology and Acute Medicine

Renal Medicine

Dr J F Moro-Azuela General Physician in Nephrology & ITU Physician and Honorary Clinical Senior Lecturer

Dr M K Almond General Physician, Nephrologist & ITU Physician and Honorary Clinical Senior Lecturer

Dr S Krishna Kumar

Dr G Balasubramaniam

General Physician & Nephrologist

Acting General Physician & Nephrologist

Respiratory Medicine

Dr D Powrie General and Respiratory Physician

Dr S Ansari General and Respiratory Physician and Honorary Clinical Senior Lecturer

Dr G Lingam General and Respiratory Physician and Honorary Clinical Senior Lecturer Visiting Fellow, University of Essex

Dr M Ali Respiratory Physician

Gastroenterology

Dr J D O’Brien General Physician and Gastroenterologist

Dr G P Bray General Physician and Gastroenterologist

Dr Z Ahmed Gastroenterologist

Locum Consultant Gastroenterologist

Acute Medicine

Dr P R Harnett General Physician, Nephrologist & ITU Physician

Dr J Peasegood Locum Consultant Acute Physician


Cardiology

Dr A Khokhar Cardiologist

Dr T Nageh Cardiologist

Dr S Mazhar Cardiologist

Dr J Davies Cardiologist

Dr T Keeble Cardiologist (P/T)

Neurology / Neurophysiology

Dr C Everett Neurologist

Dr L Coward Neurologist and Stroke

Dr A Cheesman Neurologist (part-time)

Vacant Neurologist

Dr RD Mendis Neurophysiologist

Dr D Gallagher Neurologist

Dr I Grunwald Neurologist

Sexual Health / Infectious Diseases

Dr H Jaleel Consultant in Sexual Health/HIV Medicine

Dr M Abu Bakar Consultant in Sexual Health/ HIV Medicine

Medicine for the Elderly

Dr P Liakas General Physician, DME Physician, DAU

Dr N Ballah General Physician, DME Physician, Lead Consultant Orthogeriatrics

Vacant DME Physician

Dr F Huwez DME Physician

Dr H Al-Sardar General Physician, DME Physician, DAU Physician

Dr L Bafadel Community Elderly Medicine

Stroke Medicine

Dr P Guyler Lead Stroke Physician

Dr L Coward Neurologist and Stroke


Dr T O’Brien Community Stroke Physician

Dr D Sinha Stroke Medicine

Prof Iris Grunwald Neuro interventionist for Stroke

Associate Specialists

Dr J Whitear Medicine for the Elderly

Dr F Eltaie Respiratory Medicine

Medical Administration of the Business Unit

Business Unit Director Mrs Chris Cole

General Manager for Medical Specialties Ms Traci Maton

General Manager for Cardiology and Respiratory Miss Zoe Gregori

Mrs Wendy George

Royal College of Physicians Tutor Dr P Harnett

Clinical Tutor for Medicine Dr J Kinnear

Undergraduate Tutor Dr Moro-Azuela

Junior Staff liaison Dr J D O’Brien

MRCP teaching Dr K A Metcalfe

Governance Lead Dr Henna Jaleel

Unit Training Director Dr K Metcalfe


DEPARTMENT OF MEDICINE FOR THE ELDERLY –CLINICAL STAFF

Consultant Specialist InterestDr Tony O’Brien DME / Stroke PhysicianDr Hussain Al-Sardar Non-invasive cardiology & Medical EducationDr Paul Guyler Stroke Medicine Clinical LeadDr Ioannis Liakas Dementia & Clinical Lead for DMEDr Nina Ballah OrthogeriatricsVacant DMEDr D Sinha Stroke Medicine

Non-consultant career grade Specialist InterestDr John Whitear – Associate Specialist

Syncope & Falls, Clinical Lead for Day Assessment Unit (DAU)

Dr Thayalini Loganathan – Specialty Doctor

Stroke

Trainees:3 Specialist Registrars in DME2 Specialist Registrar in Stroke Medicine5 Junior ST doctors (including 2 GP trainees)6 Foundation Year 2 doctors6 Foundation Year 1 doctors


SOUTHEND UNIVERSITY HOSPITAL NHS FOUNDATION TRUST

MEDICAL BUSINESS UNIT

SPECIALTY REGISTRAR – 1 YEAR POST IN STROKE MEDICINE

JOB PROFILE AND FURTHER PARTICULARS

PART 3

INTRODUCTION

THE DEPARTMENT OF STROKE MEDICINE

The Stroke department at Southend University Hospital NHS Foundation Trust is recognised as a regional centre of excellence, it provides a caring and comprehensive service for the treatment of hyperacute stroke, stroke and rehabilitation for the population of Southend and Essex.

A team comprising of four Consultant Stroke Physicians, one Interventional Neuro-radiologist, two doctors in specialist training (Specialist Stroke Registrars), 1 speciality doctor, 5 clinical fellows, 16 Stroke Clinical Nurse Specialists, Stroke Research Nurses, Clinical psychologist and members of the multidisciplinary stroke team provide individualised care based on multi-disciplinary holistic assessment of the individual care needs of people who present with stroke. There is a 24/7 Consultant rota. As the Trust has a single independent specialist hyper acute Stroke Unit in one geographical location and a specialist stroke team this has led to: a 50% reduction in mortality and dependency; and almost all stroke inpatients spend all their hospital stay on the Stroke Unit. All NICE guidelines have been incorporated into protocols. There are monthly governance meetings to continually improve care. There is a very active research unit with reputation of among the top recruiter in many trials. .

Recently there has been a complete revision of the imaging services, so that now there is: a Consultant-led service with the ability to initiate correct scanning; instant access to scans for urgent cases; maximum 24 hour wait for routine cases and pre-booked slots for routine CT, MRI imaging and clinician led carotid doppler ultrasound. This unit has won 2 national awards in 2013 and one in current year..

The Stroke Unit provides: • a 7 day service • Interventional Stroke service• There are TIA clinics which run seven days a week at present. These clinics are for

all high risk TIA patient’s investigation and treatment within 24 hours, and all low-risk TIA patients seen in a daily TIA clinic within 7 days of referral.

• tailored rehab programmes for each individual patient• in-house state-of-the-art gym on the ward• kitchen facilities on site• Early supported discharge

Clinical Services for training


1. A first class opportunity to undertake a clinical assessment of a suspected stroke or TIA in an adult patient referred as an emergency to hospital or in an out-patient setting

2. A supervised learning to arrange and interpret appropriate investigations, self-sufficiency in imaging like brain scan and carotid Doppler to support or exclude diagnosis of a suspected stroke or TIA and its cause

3. A learning to manage hyperacute treatment for stroke TIA and common stroke mimics with current and emerging interventional management of patients undergoing cerebral reperfusion therapies in acute ischaemic stroke

4. A learning to manage immediate post-acute care of stroke including end-of-life care for stroke patients

5. A training to able to manage secondary prevention strategies following stroke or TIA

6. An ability to assess rehabilitation requirement for patient and initiate appropriate input from other members of the multidisciplinary team including clinical psychology

7. Contribute to the on-going rehabilitation process by providing appropriate medical management to maintain patient fitness for rehabilitation

8. Provide leadership of a multidisciplinary team and contribute to effective decision making for discharge planning

9. Contribute to post-discharge medical care, rehabilitation and longer term social and vocational integration

10. to able to recruit in multicenter trials of stroke as an independent recruiter and able to design and help existing research projects.

11. Contribute to the development of a stroke service and provide leadership to such a service

12. Undertake teaching and training of stroke related topics for medical undergraduates, post-graduates and other healthcare professionals

Junior Medical Staffing

The Stroke Service has the following non-consultant medical staff:

1 Specialist Stroke doctor

2 Specialist Registrar/ST3 in Stroke sub-speciality Medicine. He/ She takes an active role in both in-patient and out-patient management.

5 Clinical fellow in Stroke.

2 FY2’s in Neurology and Stroke.


1 FY1 who spends 4 months in Cardiology/Neurology/Stroke, 4 months in Respiratory Medicine and 4 months in General Surgery.

MAIN DUTIES AND RESPONSIBILITIES

Title: SPECIALTY REGISTRAR – 1 YEAR NTN POST IN STROKE MEDICINE

Reports to: Dr Paul Guyler at Southend University Hospital

Duration: 4th August 2015 to 4th August 2016.

DUTIES OF THE POST

Trainees will be expected to show qualities of leadership but also to know their limitations and call for help and advice appropriately

Trainees will also begin to work independently ST3 level trainees will be expected to gain the necessary competencies by

rotating through the region in order to gain the relevant experience Liaise between nurses, other junior doctors, patients, relatives and senior

medical staff Attend to the day to day management of day case, out-patient and in-patients Attend and participate in ward rounds and operating theatre sessions as

timetabled Attend general and specialist out-patient, diagnostic and pre-assessment

clinics Teach medical students as directed Supervise, monitor and assist the F1 doctors in posts with an attached F1 Take part in rostered emergency work To keep up-to date with all administrative duties including letters, results and

discharge summaries as required Study for higher examinations and maintain continued professional

development Undertake and assist in audit projects at various times throughout the

rotations Attend weekly educational and multidisciplinary sessions To co-operate with members of the HR department when monitoring hours of

work Attend induction in each hospital or new department Attend post mortem demonstrations – when required Comply with all local policies including dress code, annual and study leave

CLINICAL GOVERNANCE


To provide clinical services in line with the Trust’s clinical governance arrangements which is designed to ensure that agreed quality standards are achieved. These requirements include:-

AUDIT – To undertake audit of clinical practice within the department to ensure that current standards and evidence-based practice are applied.

CONTINUING MEDICAL EDUCATION – All staff are required to maintain and develop their clinical skills. Individual training and development needs will be identified through an appraisal process taking into account Southend University Hospital NHS Foundation Trust requirements.

RISK MANAGEMENT – To work within the Trust’s clinical risk management policies and in particular to participate as appropriate in clinical incident reporting.

APPRAISAL – All Consultants in the Trust participate in the Trust’s appraisal process.

TEACHING & TRAINING ACTIVITIES

The hospital has Associate University status. Consequently the training of medical students, junior hospital doctors, nurses and physiotherapists has a high priority. The new colleague will be actively encouraged to pursue any interest in this area.

Clinical Governance is a major part of our daily practice. The hospital is at the forefront of providing same, with a separate department and allocated clinical and ancillary staff to service same.

There is a well-stocked medical library with audio-visual teaching aids, CD-ROM and a full time librarian. The library has a Medline facility. There is a thriving Postgraduate Medical Centre with regular clinical meetings and a general education programme.

ON-TAKE DUTIES

Duty Rota is Full Shift with prospective cover for annual and study leave. Early planning is essential to enable the rota to be complied in advance.

BANDING

To be advised by medical staffing.

PROSPECTS FOR CHANGE

The proposals set out in the High quality care for all: NHS Next Stage Review final report (Darzi report) are likely to impact on current working arrangements. NHS South East Essex has recently published its 5 year strategic plan and the Trust is moving towards a new model of specialty ward based inpatient working. Together these may entail considerable change to the job plans of Consultants and Specialty Doctors, and to the distribution of junior medical staff (this may include the appointee. The Trust will consult the members of staff concerned at the appropriate


time, but meanwhile wishes to draw the attention of applicants to the possibility of change in the future.

IT SUPPORT

The post holder will have IT support with access to Word, the Hospital intranet, internet and email facilities.

Main Terms and Conditions of Service

The appointment is subject to the Terms and Conditions of Service of Hospital Medical and Dental Staff and Doctors in Public Health Medicine and the Community Health Service in England and Wale's made by the Board on the recommendation of an Advisory Appointments Committee, constituted in terms of the Guidance on Advisory Appointments Committees – NHS Circular (2007)1. Any person suitably qualified and experienced who is unable for personal reasons to work full-time, will be eligible to be considered for the post.

POLICIES & PROCEDURES

You are required to comply with our Policies and Procedures as may from time to time be in force.

INFORMATION SECURITY AND CONFIDENTIALITY

All person identifiable information must be held in the strictest confidence and must be disclosed only to authorised people in accordance with the 1997 Caldicott recommendations, 1998 Data Protection Act, ratified information sharing protocols and patient consent.

Where there is any doubt, the post holder must seek advice from the Caldicott Guardian or deputy. A breach of confidentiality may result in disciplinary action being taken in accordance with the Trust’s disciplinary procedure.

It is the responsibility of the post holder to abide by all organisational policies and procedures, particularly those in the information security section of the policy folder.

To meet the requirements of the 1998 Data Protection Act the post holder is responsible for the maintenance of up to date and timely data entry and to ensure that information processed is safeguarded, securely stored and safely disposed of.

To maintain data quality, it is essential that clinical information extracts and reports are validated by the appropriate clinician prior to distribution.

EQUAL OPPORTUNITIES AND DIVERSITY

The Trust has an absolute commitment to equal opportunities based on sound management practice, respect for the individual and legislative compliance. The post-holder must at all times carry out his/her responsibilities with regard to the Trust’s Equal Opportunities Policy & the Race Equality Scheme.

HEALTH AND SAFETY & RISK MANAGEMENT


Employees must be aware of the responsibilities placed upon them under the Health and Safety Work Act 1974, to ensure that the agreed safety procedures are carried out to maintain a safe working environment for patients, visitors and employees.

Employees must wear personal protective equipment where provided.

All employees are expected to comply fully with the Trust and Departmental fire policies and procedures to meet their responsibilities in relation to fire safety. All staff are also expected to maintain safe infection control practices at all times.

All employees are responsible for reporting any accidents, untoward occurrence and potential hazards to their Head of Department even no injury or property damage has resulted.

RELOCATION EXPENSES

Relocation expenses may be available subject to eligibility in line with the Trusts policy.

HEALTH CLEARANCE

The appointment is made subject to satisfactory fitness for employment. The candidate will therefore be required to complete a pre-employment health screening questionnaire and may/will subsequently be required to attend for health screening.

REGISTRATION

The person appointed will be required to be fully registered with the General Medical Council (GMC) and have a licence to practice.

REHABILITATION OF OFFENDERS ACT

Because of the nature of the work of this post, it is exempt from the provision of section 4(2) of the Rehabilitation of Offenders Act 1974 (Exemption 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 result in dismissal or disciplinary action by Southend University Hospital. Any information given will be completely confidential and will be considered only in relation to an application for positions to which the order applies.

MEDICAL INDEMNITY

The Trust is financially responsible for the negligent acts and omissions of Consultant medical and dental staff in the course of their Trust employment. If, however, any private practice, within a NHS hospital or any other private hospital is undertaken, the appointee will be personally responsible for subscribing to a recognised defence organisation. The Trust will not be responsible for category 2 (e.g. reports for insurance) or ‘Good Samaritan’ Acts. Health Circular HC (89) 34 provides full details of ‘Claims of Medical Negligence against NHS Hospital and Community Doctors and Dentists’.


The Department of Health advises practitioners to maintain defence body membership in order to ensure they are covered for any work which does not fall within the scope of NHS Indemnity.

PLACE OF WORK

The appointee will be based at Southend University Hospital, however he / she may be required to work at other sites in accordance with the Trust’s aim of flexible working by staff to enhance patient care.

NO SMOKING POLICY

It is the policy of the Trust to promote positive health. Smoking, therefore, is prohibited in all buildings and the grounds of the hospital.

SECURITY

In the interests of safety and security the appointee will be required to wear Hospital Staff Identification Badge at all times whilst at work.


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