Consultant Palliative Medicine

Detailed job description and main responsibilities

Clinical and operational responsibilities

• To provide medical input for the BHRUT hospital multidisciplinary palliative care team, alongside the existing medical workforce.
• To work closely with other local specialist palliative care providers to ensure excellent service delivery across settings.
• To contribute to medical and other staff training and to service development and quality improvement alongside Consultant colleagues.
• To give medical advice and support to GPs, District Nurses, the Hospice Referrals Hub and other key community based partners in care who are managing complexity in the community as a contributor to safe hospital discharge planning.

With optional Community component:

• To provide medical input for the Redbridge Specialist Community multidisciplinary Palliative Care Team, alongside the existing medical workforce.

Clinical

• Medical input to inpatients and outpatients within BHRUT. Workload consists of face to face hospital patient contacts, including new and follow up patients in the wards or outpatient settings, patient telephone contacts and patient discussion in MDT meetings. The post-holder will be supporting a multidisciplinary team with around 50 patients on their books at any one time. The personal workload is expected to be around 4 complex patient reviews per day during DCC time, in addition to telephone advice to the CNS team, doctors and other healthcare professionals.
• Specialist palliative care input to BHRUT Cancer, Nutrition, and Critical Care MDT meetings.
• To provide palliative medicine telephone support or general advice to clinical colleagues in hospital teams.

With optional Community component:

• Medical input to home/care home based service users under the care of the Redbridge Community Specialist Palliative Care Team. Workload consists of face to face home visits, new or follow up, with focus on complexity and support of/joint visiting with the CNS team, and via patient telephone contacts and clinical discussion in MDT meetings. The multidisciplinary team will be supporting around 40 people on their books at any one time. Expectation is that the post holder will see up to 4 complex home visits/joint assessments in the day during DCC time, alongside giving clinical advice to CNSs/trainee doctors/GPs at the frontline of care.

And

• To be responsible for keeping accurate and full medical records, both paper and electronic.

Education

• Clinical supervision of hospital doctors (Registrars and Specialty Doctors), in conjunction with Consultant colleagues.
• To be involved in ongoing multidisciplinary teaching at undergraduate and postgraduate level within BHRUT, including the multidisciplinary teaching meetings within the Palliative Care Team (equally relevant to optional Community component)
• Mentorship and support of medical, nurse and other visiting professionals to enhance their knowledge and skills (equally relevant to optional Community component).
• Collaborative contribution into local education programmes for hospital based (+ optional Redbridge based) and external partners in care, with collaboration with local providers and partners in provision of education to the wider locality.
• Clinical supervision of non-medical prescriber CNSs in training.

Audit and Research

• To participate in and fully support audit and quality improvement work within BHRUT (+ optionally into Redbridge community), leading to improved care for people with palliative care needs across all settings. This includes supporting the embedding of the OACC suite of outcome measures into clinical practice.
• To work with Trust, hospice, local and regional groups towards ensuring that relevant policies are written or adopted so that clinical palliative care is practised within the current evidence-base.
• To be an ambassador for audit and research.
• To mentor and support medical learners and the wider MDT to develop and deliver high standard quality improvement and audit work.
• To audit own practice as necessary for continued professional development

Management and Administration

• To work cooperatively with the existing consultants and leaders in this locality in the strategic planning of Specialist Palliative Care services.
• To attend relevant strategic and managerial forums within both BHRUT (and optionally in Redbridge) in conjunction with consultant colleagues to ensure appropriate team/medical team representation, as a shared responsibility alongside senior BHRUT palliative care colleagues and hospice senior colleagues, as a skilled representative and ambassador for palliative care.
• To attend other relevant specialty meetings as needed and able.
• To undertake the administrative duties usually expected of a consultant, including use of the IT systems in place to support patient care.

Office and workspace Information

• At Queen’s Hospital office space will be shared with the existing palliative care doctors, based in the Oncology/ Haematology zone. There is also office space at King George hospital shared with other members of the multidisciplinary team. There will be secretarial support based at Queen’s but covering both sites. A laptop computer will be provided.
• At Redbridge office space will be shared with the CNS team. Administrative support will be provided by the PA to the Redbridge team.

Mentorship and support

• The post-holder will be joining an established, experienced multidisciplinary team where a culture of supporting one another is prioritised by senior leaders and embedded within team functioning.
• The hospital and hospice are strongly supportive of mentorship and of external clinical supervision for Consultants. Guidance to identify support will be provided if needed.
• Within BHRUT the clinical lead for palliative care services is Heather Wright. She manages day to day issues, but specifically consultant management issues will be led by Dr. Jo Howard, Divisional Director Cancer and Clinical Support Services.

• Within Redbridge Dr. Corinna Midgley, Medical Director, Saint Francis Hospice will provide support/line management to the postholder. 

Medical Administration

• The person appointed will be a member of the regional Consultant team.
• The postholder agrees their Job Plan annually and undergoes an NHS annual appraisal with a nominated BHRUT appraiser on behalf of the BHRUT Chief Executive.
• The job plan is inclusive of hospice community sessions, which will be shaped and developed with the hospice team. Annual NHS appraisal will bring together the postholder’s whole scope of practice, i.e. hospice and hospital.
• The Job Plan for this post will take into account the new Terms and Conditions – Consultants (England) 2003. It will also reflect individual consultants’ special interests, current levels of activity and the need to distribute work fairly amongst colleagues to ensure the service responds to the needs of its users.
• The person appointed will be committed to the revalidation process, every 5 years, which is overseen by the Responsible Officer, BHRUT.

On call commitment

BHRUT Macmillan Team runs a 7 day a week 9-5 CNS face-to-face service.

Community palliative care services (Saint Francis Hospice and Redbridge) run a 7 day a week 9-5 CNS/Clinical Specialist face-to-face service. 

The hospice inpatient unit admits daily, 9-5pm, with a 1st on call rota of trainees and specialty doctors, 24/7 (including weekends and bank holidays).   

Out of Hours Consultant cover (advice/support by phone 5pm to 9am Mon-Friday, and at the weekend) is provided by the Saint Francis Hospice and BHRUT Consultants in their on-call rota, with Supportive Care UK (SCUK) supporting. The rota is currently a 1:5 week rota, Category B.

In exceptional circumstance the local Consultant on call would be required to come in to support a trainee with an inpatient unit crisis. This would be exceptional. Recompense would be as time off in lieu.