Download Role Specification - Faculty of Physician Associates

Role Specification
Post:
Neurosurgery Physician Associate
Grade:
Band 7
Hours:
37.5 hours per week
Responsible to:
Clinical Lead, Neurosurgery
Accountable to:
Qualifications:
Clinical Lead, Neurosurgery
Physician Associate (Assistant) Studies Postgraduate Diploma
Term:
Full time
Background
The Royal London Hospital
Barts Health NHS Trust comprise of Newham University Hospital, The London Chest Hospital, St
Bartholomew’s Hospital, The Royal London Hospital and Whipps Cross Hospital. The hospitals are
located in both the City and the East End of London, and are able to provide specialist care with a
complete range of major services.
Barts Health NHS Trust was identified as a major provider of these services in both the Tomlinson
Report and the subsequent reviews of specialist medical services. Following the publication of the
Turnberg Report, a new hospital was built at The Royal London site, whilst Cardiac and Cancer
Services are relocated at St Bartholomew’s Hospital, in improved and up-dated facilities.
The Neurosurgery Department at the Royal London Hospital is one of four Major Trauma Centres
(MTCs) in London and is home to the London Air Ambulance. It is also the most active MTC in the UK
accounting for approximately 10% of all MTC admissions. We have recently instituted neuro-trauma
as a consultant delivered supra-specialist service which complements the consultant delivered
general trauma service.
This is a new role in the department of neurosurgery intended to support the work of specialist
trainees and junior clinical fellows in the department. The physician’s associate is a new healthcare
professional who, while not a doctor, works to the medical model, with the attitudes, skills and
knowledge base to deliver holistic care and treatment within the general medical and /or general
practice team under defined levels of supervision
Departmental Description/information
There are 9 Consultant Neurosurgeons whose subspecialist interests cover all aspects of
neurosurgical practice.
1.
Mr Jonathan Bull: complex spine
2.
Mr Habib Ellamushi: Neurotrauma and functional neuosurgery
3.
Mr Andrew Elsmore: Neuro oncology
4.
Mr Edward McKintosh: Neuro oncology
5.
Mr Ganesalingam Narenthiran: Neurotrauma and hydrocephalus
6.
Mr Dimitris Paraskevopoulos: Neurotrauma and skull base surgery
7.
Mr Suresh Pushpananthan: Complex spine surgery
8.
Mr Chris Uff: Neurotrauma and neurovascular surgery
9.
Mr John Wadley: Pain and neurovascular surgery
The department currently has a staffing of 10 registrar level trainees. At present these consist of 3
SpR’s with National Training Numbers and seven clinical neurosurgical fellows. In addition to
maintain compliance with junior doctor’s hours, a 1 in 10 on call rota is in place. There is also 1 ST
1-3 trainees.
Academic and Training Facilities
The post holder will also expect to perform Head Injury research and participate in the academic
activity of the Department. The department is supported by close links with the Trauma Sciences
Centre at the Blizard Institute, Queen Mary University of London which is located on the same
campus as the Royal London Hospital.
An academic morning is scheduled for Thursday and is compulsory for all junior neurosurgical staff.
The physicians associate will be encouraged to attend. The timetable is as follows:
08.00 am – Neuroradiology Meeting
09.15 am – Clinical Meeting – Neurosciences
10.30 am – Subspecialty Clinical Meeting
11.30 am – M&M/Journal Club/ Junior Medical Staff Teaching
Study leave is available as provided for under the Terms and Conditions of Service and
Hospital Medical and Dental Staff. There are training sessions for all medical staff.
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Introduction
The physician’s associate will support the specialist trainees and junior clinical fellows in the
delivery of high quality care to elective and emergency neurosurgical patients.
The Physician Associate will have been trained to exercise autonomy in medical decision making
from within the physician-PA relationship. This includes:
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formulating a differential diagnosis based on history and physical examination;
developing and delivering appropriate treatment and management plans on behalf of the
supervising physician;
performing diagnostic and therapeutic procedures;
prescribing medications (subject to the necessary legislation);
requesting and interpreting diagnostic studies.
Professionally, the PA’s training has been designed to ensure that PAs are:
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aware of the limits of their competence and committed to acting within these limits;
highly skilled at working in a multi-professional team environment;
life-long learners who engage in active professional development.
The PA will always act within a predetermined level of supervision and within agreed
national guidelines. Although there may be circumstances when the supervising doctor is not
physically present, they will always be readily available for consultation. With experience, it is
expected that the PA’s scope of practice will increase. Thus, it is expected that over time the
supervisory relationship will mature and that although the doctor will remain in overall control of the
clinical management of patients, close supervision will diminish.
Qualified PAs may develop specialist expertise through practice learning and continuing
professional development (CPD) that reflects the speciality of their supervising physicians. This
may be within any of the neurosurgical subspecialties that are represented in our department.
Although they may develop specialty expertise, PAs are expected to maintain their broad clinical
knowledge base through continuing professional development (CPD) and will be required to sit for
a national recertification exam every 5 years. An annual appraisal will be carried out with the lead
clinician in neurosurgery or their nominated deputy.
Presently national legislation does not exist which would allow independent prescribing by the
physician’s associate. This may change in the future. Subject to such legislation prescription of
medications will require sign off by a supervising doctor or designated prescribing pharmacist.
Clinical Organisation or Key Relationships
The physician’s associate will be responsible to the lead clinician, department of neurosurgery
and will work under the direct supervision of junior clinical fellows and specialist trainees in
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neurosurgery. Specialist registrars, Senior Fellows,
Neurosurgeons, provide further senior clinical supervision.
Trust
Specialists
and
Consultant
Job Description or Job Summary
DUTIES
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To conduct daily ward rounds with the medical team, review patients and formulate appropriate
clinical plans.
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To ensure continuity of a high standard of care, assessing the health needs of the patients and
taking appropriate actions including:
o Ordering of diagnostic tests
o Making and receiving referrals
o Discharging patients within agreed protocols
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To provide advice and support to patients, their families and other healthcare professionals
following diagnosis through to treatment.
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To accept responsibility for own caseload, ensuring all patients have an accurate plan of care
recorded, which reflects the assessments undertaken and incorporates the issues and
recommendations made, ensuring clear documentation in the patient’s records.
To be actively involved in in-patient care, liaising with ward staff and other members of the
clinical team as appropriate.
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To assess patients in the neurosurgical pre-assessment clinic and arrange appropriate
investigations including neuroradiological imaging.
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To review patients for discharge and prepare appropriate documentation of their in-patient stay
for the information of their family practitioner.
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To carry out procedures which will include:
 Venepuncture
 Intravenous cannulation
 Blood gas sampling and analysis
 ECG
And subject to satisfactory demonstration of competence within the department:
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Setting up and maintenance of a ventricular access device
Sampling of cerebrospinal fluid from a ventricular access device or lumbar drain
Insertion and maintenance of an intracranial pressure monitor.
To work with the supervising physician(‘s) to ensure appropriate medications are
prescribed to patients being discharged from the unit.

To liaise with referring units regarding the transfer of neurosurgical patients and ensure
appropriate transfer of clinical information and imaging for patients moving between institutions.
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To be accountable for care given and to comply with the Fitness to Practice and Code of
Conduct standard as established by the UK Managed Voluntary Register for Physician
Associates (and subsequently the appropriate statutory regulating body when in place). To
work within the framework of the scope of professional practice.
Service Development
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To participate in departmental service reviews and initiatives in terms of clinical effectiveness,
clinical excellence and best use of resources.
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To audit and present data as required in order to identify areas of success/for improvement
within the department.
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To participate in the delivery of training programmes to hospital staff as appropriate.
Education and Training/Self-Development
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Identify own training and development needs and undertake appropriate training/education as
required e.g. attendance at least one annual conference such as the UKAPA conference or
society of British Neurological Surgeons conference
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Participate in an annual individual performance review process where objectives will be agreed,
performance monitored and personal development needs discussed.

To take and pass the national re-certification examination every five years, as recommended
by the National Examination Sub Committee of the UKUBPAE (UK Universities Board of
Physician Associate Education) and subsequently as required by the statutory regulating body
when in place.
To be trained in and demonstrate fair employment practices, in line with trust policies.
Act responsibly in respect of colleague’s health, safety and welfare following safe work
practices and complying with the Trust’s Health and Safety Policies.
Adhere to all Trust Policies as applicable.
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General
The post holder has a general duty of care for their own health, safety and well being and that
of work colleagues, visitors and patients within the hospital, in addition to any specific risk
management or clinical governance accountabilities associated with this post.
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To observe the rules, policies, procedures and standards of King’s College Hospital NHS
Foundation Trust together with all relevant statutory and professional obligations.
To observe and maintain strict confidentiality of personal information relating to patients and staff.
To be responsible, with management support, for their own personal development and to actively
contribute to the development of colleagues.
This job description is intended as a guide to the general scope of duties and is not intended to be
definitive or restrictive. It is expected that some of the duties will change over time and this
description will be subject to review in consultation with the post holder.
All employees must hold an 'nhs.net' email account which will be the Trust's formal route for email
communication. You are therefore required to check this regularly and to deal with such
communication promptly.
Infection Control Statement
The post holder has an important responsibility for and contribution to make to infection control and
must be familiar with the infection control and hygiene requirements of this role.
These requirements are set out in the National Code of Practice on Infection Control and in local
policies and procedures which will be made clear during your induction and subsequent refresher
training. These standards must be strictly complied with at all times.
PERSON SPECIFICATION
Qualifications
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Essential
Primary science degree
Postgraduate diploma in physician associate
studies from an accredited UK training program
Member of UKAPA
Member of UK managed voluntary registry
Basic life support qualification
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Desirable
Subspecialist
experience or
training in
neurosciences
ILS/ALS/ATLS
qualification
Experience
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Ability to organise and prioritise workload
effectively
Ability to exercise sound judgements when faced
with conflicting pressures
Ability to implement and interpret policies and
procedures
Experience of conducting clinical audit
Awareness of current developments and
initiatives in emergency medicine services.
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Skills
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Other
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Ability to work well independently as well as as
part of a team
Ability to adhere to regulations as well as work
flexibly to meet the needs of the Trust
Excellent verbal and written communication skills
Ability to maintain confidentiality
Ability to respond to questions in a tactful and
professional manner
Ability to impart complex and sensitive
information to patients, relatives and carers, with
different levels of understanding.
Energy and enthusiasm and the ability to work
under pressure
An inquiring and critical approach to work
Caring attitude toward patients
Ability to communicate effectively with
colleagues, patients, relatives, nurses, other staff
and agencies
Commitment to CME and professional
development.
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Knowledge of medical procedures and
terminology
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Meets occupational health requirements for role
CRB check including that allowing work with
children and vulnerable adults
Ability to motivate
and develop the
multi-disciplinary
team
Ability to manage and
lead a working group
Assist in the
development of the
role of Physician
Associate locally and
Nationally
Proven experience of
service development.
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