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JDN-CONOG-2021 with interest in Gynae Oncology

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SECTION 2 JOB DESCRIPTIONTitle Consultant in Obstetrics and Gynaecology Location Based at James Paget University Hospital 1.. We work very closely with our tertiary referral centre in

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Gorleston Norfolk NR32 6LA Hospital Switchboard:  01493 452452 Medical Staffing:  01493 452677/3869/2676/3415

Website:  www.jpaget.nhs.uk

Appointment of:

Consultant Obstetrician & Gynaecologist

Post Reference No:

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177-MDELEC-James Paget University Hospitals NHS Foundation Trust

CONTENTS

SECTION 1 PERSON SPECIFICATION

SECTION 2 JOB DESCRIPTION

SECTION 4 THE TRUST AND LOCAL AREA

SECTION 5 EDUCATION AND FURTHER INFORMATION

SECTION 6 GENERAL CONDITIONS OF APPOINTMENT

SECTION 7 APPLICATION INFORMATION

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SECTION 1 PERSON SPECIFICATION

Desirable Criteria

Assessment Method

Education and Qualifications

Hold a certificate or being within 6 months of completion of training or

being on or eligible for the UK Specialist Register at the date of interview. E

Experience & Knowledge

Ability to provide expert clinical opinion across a wide range of problems

Ability to exhibit leadership and management skills and participate in

Willingness to participate in and lead a multi-disciplinary team, balancing

Ability to manage obstetrics and emergency Gynaecology independently E

Academic Achievements

Key Skills

Ability to communicate clearly with colleagues, laboratory staff, and other

Willingness to participate in clinical governance, including guideline

Other

Awareness and respect for colleagues, patients and relatives’ dignity,

Physically fit for post Completion of Trust’s Occupational Health

assessment Full immunisation status including Hep B & Hep C status

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James Paget University Hospitals NHS Foundation Trust

Assessment Criteria A= Application, I= Interview, T= Test, R= References

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SECTION 2 JOB DESCRIPTION

Title Consultant in Obstetrics and Gynaecology

Location Based at James Paget University Hospital

1 Share with consultant colleagues the Obstetric and Gynaecology workload.

2 Out-of-hours responsibilities, including participation in Consultant on-call rota where applicable;

3 Cover for colleagues’ annual leave and other authorised absences;

4 Give a consultation and advisory service to medical colleagues in other specialities in the Trust.

5 Liaise with medical staff in other specialities and participate in the regular clinical meetings and other post-graduate activities of the hospital.

6 Take part in the Royal College of Obstetrician & Gynaecologists Continuing Professional Development The Trust will provide study leave expenses in line with national terms and conditions of service.

7 Play a full part in the teaching and audit activities of the department.

8 Participate in the trust’s appraisal process and attend mandatory training.

9 Participate in the Trust’s Clinical Governance processes

10 Contribute to management of the service and, in due course, take on roles

of responsibilities within the department.

11 Comply with the outline Consultant work programme (under provisions of Circular HC90/16) and the weekly timetable of fixed commitments (ie: regular scheduled NHS activities in accordance with paragraph 30B of the TCS)

12 Deploy unallocated, flexible professional time on liaison, emergency work, travel, continuing clinical responsibility, teaching, research, medical audit,

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James Paget University Hospitals NHS Foundation Trust

13 Academic input is optional but there is the opportunity for developing research Significant academic contribution will entitle the appointee to apply to be an Honorary Senior Lecturer.

To observe local and national employment and personnel policies and procedures, and to comply with Regional and Trust Health and Safety policies.

To assume responsibility for and facilitate contact from members of staff with delegated duties for personally accountable patient care.

This is for a 10 PA contract The following provides scheduling details of the fixed clinical activity and

clinically related activity components of the job plan which occur at regular times in the week Agreement should be reached between the appointee and their Clinical lead/Divisional Director with regard to the scheduling of all other activities, including the Supporting Professional Activities Modifications may be made depending upon the needs of the service, sub specialist interests and to cover periods of leave The timetable is only indicative Consultants participate in covering the on-call one week CDS session which at present works out to be 1 in 8 rotas

On Call Availability

The appointee will provide an out of hour’s emergency service (Mon - Fri from 5pm to 9am or weekends Fri 5pm till 9am Mon) on a 1: 8 shared basis with other Consultants within the department, covering both Obstetrics and Gynaecology and liaising with other specialties as required

The Hot week and the out of hours on call covers both obstetrics and gynaecology which maintains the required skills to perform emergency gynaecological surgery We work very closely with our tertiary referral centre in Norfolk and Norwich University Hospitals for the management of complex emergency gynaecological surgery

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2WW Clinics 1,2,3,7

Thursday 08:30

13:0013:30

13:0013:00 17:00

Team meetings / education

(part of core)

Agreed on-call rota – Prospective/Non Prospective cover for

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James Paget University Hospitals NHS Foundation Trust

SECTION 3 THE DEPARTMENT

The Post

The James Paget University Hospitals NHS Foundation Trust is seeking to appoint onepermanent Consultants in Obstetrics and Gynaecology applicant with interest in GynaeOncology

The positions provide an excellent opportunity for a suitably qualified specialist to activelycontribute to a modern Obstetric & Gynaecological and Gynaecological service within this highlyregarded Trust with its wide range of acute and community services, which will afford highprofessional visibility

These posts will attract 10 PA’s on the new Consultant contract These posts will include a hotweek (Monday to Friday 0900 to 1700) on the delivery floor every 8 weeks

There will be a dedicated part time secretary for each posts A personal office will be shared withone other consultant

The Division

Obstetrics and Gynaecology is fully integrated in the Division of Surgery and Women’s &

Children’s Services at the James Paget University Hospitals NHS Foundation Trust

The Division has its own secretarial and information support team

Bed Complement

The bed complement of the Division is:

 20 Obstetric beds

 5 bedded antenatal day care unit

 25 Surgical beds for Gynae Inpatients shared with Breast Care and General

Surgery

 Access to Day Care Unit for Gynae Day Cases

 9 SCBU cots (including 2 equipped ITU cots)

 16 Paediatric beds

 10 Surgical paediatric beds

 6 Adolescent unit beds

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James Paget University Hospitals NHS Foundation Trust

The Department

Obstetric and Gynaecology Activity Need up to date activity data

Gynaecology inpatients: 904 Total inpatients

(384 were emergencies, 520 were planned admissions)

Outpatient attendances: 10754 Total attendances ( excludes ward attendees’)

(New outpatients 4414, Follow up cases 6340)

Obstetric service

The department of obstetrics provides the care for a population with increased complex socioeconomic, mental and medical problems The levels of social and economic deprivation, smoking, increased BMI is considered to be among the highest in England Despite of these challenges the level of care we provide and the outcomes were considered to be Good in the last CQC assessment Our annual delivery rate is about 2400

The labour ward consists of 7 single en-suite rooms, a dedicated theatre and recovery areaand a four-bedded observation bay A full epidural service is available and there is activeanaesthetic involvement in the care of high-risk patients

We have a new antenatal clinic, with three ultrasound rooms We are currently running amultidisciplinary diabetic antenatal clinic on weekly basis, regular preterm prevention onestop clinic and regular mental health problem clinics with multidisciplinary input There is also

a plan for the introduction of high risk pregnancy clinic with the expected expansion of theconsultant body There is also a dedicated anaesthetic clinic for high risk obstetric cases.MDTs are arranged as and when needed and we have a policy in place for urgent ones

Attached to the antenatal clinic is the Maternity assessment Unit which provide day to daycare and monitoring of high risk cases

The unit has a Team of very active and experienced midwives called the Eden Team wholooks after women with mental health problems Their care and dedication has made a lot ofdifference to this extremely vulnerable group

The department has a comprehensive and robust governance system All the team membersare invited to it, Midwives, Obstetricians, Obstetric anaesthetists, trainees, sonographers andany other speciality is invited if needed There is a plan to expand the time allocated for thegovernance to 4 hours every other week i.e 16 hours in 8 weeks It is currently 12 hours only.The Division has a Midwifery Led Care unit since 2010, as recommended from “Towards theBest, Together” (NHS East of England) 10-15% patients deliver in this midwifery led unit andour home delivery rate is 1%

Special Care Baby Unit – Level 1

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The Special Care Baby Unit is collocated with the delivery floor and contains 9 cots and isable to ventilate two babies, thus providing intermediate level care within the regionalneonatal network It is normal practice to retain babies of >30 weeks for singletons or >32weeks for twin gestations and over but to generally transfer to Norwich or Cambridge beforethis gestation Triplets generally are referred to the Norfolk and Norwich Hospital for theircare We have easy access to fetal medicine services are located at the Norfolk and NorwichHospital – we have a twice yearly joined perinatal morbidity meeting with our fetal medicinespecialists at JPUH.

Gyaecological Oncology

The James Paget University Hospital and Norfolk & Norwich Hospital form jointly a CalmanCancer Centre Radiotherapy and Oncology services are based at Norwich with outpatientclinics at the James Paget University Hospital Patients are treated between the two units onagreed protocols Efficient videoconference multi-disciplinary meetings are held on a weeklybasis with the Norfolk and Norwich Hospital Management plans are discussed andauthorised at these meetings Oncological surgery for advanced disease, Wertheim’shysterectomy and radical vulvectomy and extensive ovarian surgery are referred to the leadoncological surgeon at the Norfolk and Norwich University Hospital but all other surgeryincluding TLH / BSO for early stage endometrial cancer are carried out at JPUH A SpecialistGynaecology Oncology Surgeon, Mr J Nieto based at the Norfolk & Norwich UniversityHospital, deals with Gynae Cancer cases at the James Paget with a weekly Oncology Clinic

A full time clinical nurse specialist covers this service and coordinates the care pathways forthe patients with our full time PPC (patient pathway co-ordinator) Chemotherapy can begiven at JPUH in the Sandra Chapman Centre and we have a fully function cancerinformation centre adjacent to the hospital The Louise Hamilton Centre for patients and theirrelatives to visit Radiotherapy is only available at the Norfolk and Norwich Hospital

2WW clinics are undertaken each week with on-site radiographer support for ultrasoundscanning Outpatient procedure rooms are also available to these clinics on-site A fullyequipped outpatient diagnostic hysteroscopy service is available but we have a plan toextend this to cover therapeutic hysteroscopy services in the near future

Colposcopy

Currently clinics are undertaken by three consultants on weekly basis There are two fullyequipped rooms which run simultaneously; outpatient treatments (LLETZ, diathermy ablation)can be performed in each room There is a chance for accommodating one traineecolposcopist in each clinic who can work under direct supervision of an accreditedcolposcopist Community practice nurses often visit for updates/experience

The two clinics have recently been equipped with new colposcopies, new monitors anddiathermies A new software (Infoflex) has also been introduced to cover all aspects of thecolposcopy service The colposcopy suite has dedicated recovery rooms

There is a monthly videoconference colposcopy MDTs with the Norfolk and Norwich cellularpathology department to discuss complex cases We also have regular colposcopy businessmeetings and operational meetings

We see about one hundred and fifty colposcopy patients per quarter And we fulfil all the criteria

of KC65 data set which occurs every 3 months

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James Paget University Hospitals NHS Foundation Trust

Infertility Unit

The Infertility Unit is staffed with two consultants’ obstetrician & gynaecologist with an interest

in reproductive medicine, one full time Infertility nurse and a receptionist

The James Paget unit is Level 2 Infertility Unit

Ultrasound Facilities

Ultrasound facilities are well established both in the ante-natal clinic and gynaecology clinicfor both the inpatients and outpatients and provided by a team of trained ultrasonographers.Specialist ultrasound facilities and amniocentesis / CVS are available via referral to Norfolk &Norwich Hospital or tertiary centres in London

The radiographers give a fabulous service and provide an emergency service on a Sundaymorning

Accredited Physiotherapists who specialises in Women’s Health sees about 230 new patients

a year A full variety of physiotherapy tools are available within the trust, includingbiofeedback

There is close co-operation with the Trusts Urologist as well as local Nurse ContinenceAdvisers (NCAs) There are also links with Colleagues from the Norfolk & Norwich Hospitaland representation on the Norfolk Core Continence Panel

A monthly multidisciplinary meeting is held where patient management is discussed

Various surgical modalities are used to treat stress urinary incontinence and prolapse andBotox is available for persistent bladder over activity

Paediatric Gynaecology

There is a dedicated paediatric and Adolescent Gynaecology Service run by Dr JanePreston This has a regular monthly clinic in the paediatric department run to BRITSpagrecommendations There is a play specialist in the clinic and dedicated paediatric nursingstaff in attendance in addition Tertiary referral when required is to Addenbrooke’s or UCL inLondon as required

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