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PORTSMOUTH HOSPITALS NHS TRUST An Equal Opportunity Employer CONSULTANT IN DIAGNOSTIC IMAGING Whole Time or Part Time JOB DESCRIPTION CONSULTANT IN BREAST IMAGING INTRODUCTION Portsmouth Hospitals NHS Trust is a provider of Acute Health Services under contract to a range of Purchasers in the area of the Hampshire basin and Western South Downs. The catchment population is in excess of 650,000 (people). The area served by the Trust is on the Solent and English Channel and includes the City of Portsmouth and the Boroughs of Gosport, Fareham and Havant extending from Warsash in the west to Emsworth on the Sussex border and its northern boundaries encompass Petersfield and Liss. With the exception of the rural north, it is essentially an urban area that grew up around Royal Naval establishments in Portsmouth and Gosport. It now provides a wide range of modern high-tech industry and facilities associated with a commercial port and cross Channel ferry terminal. Portsmouth is a thriving naval city, steeped in history, on the South Coast. It is ninety minutes from central London and has good transport links, including regular ferries to France and Spain. The major airports are easily accessible. It has some of the best water sports facilities in Europe, with sandy beaches within easy reach. Developments within the city itself and on the Gosport side of the harbour suggest a vibrant future for the area. Inland from the hospital is the beautiful and relatively unspoilt countryside of rural Hampshire, and the recently designated National Park of the South Downs. The New Forest is also close by. The area combines the advantages of city life with pleasant villages and seaside towns. There are a number of first rate schools both in the state and private sector and it is an excellent place to raise a family. PORTSMOUTH HOSPITALS NHS TRUST Portsmouth Hospitals NHS Trust has a vision to be recognised as a world-class hospital, leading the field through innovative healthcare solutions, focusing on the best outcomes for our patients, delivered in a safe, caring and inspiring environment. At present PHT provides the following services, Emergency Medicine, Trauma and Orthopaedic Surgery, Oncology, Radiology, Orthodontic and Oral Surgery, General and Specialist Medicine, General Surgery, Breast Screening and Surgery, Plastic Surgery, Renal Services, Acute Medical Admissions, Ophthalmology, Maxillofacial, ENT, Critical Care, Coronary Care, Elderly Medicine, Rheumatology, Elderly Medicine, Rehabilitation, Dermatology and Neurology. THE JOB Consultant Radiologist Portsmouth Hospitals NHS Trust Accountable to: Chief of Service for Clinical Support PORTSMOUTH BREAST UNIT 1 The Breast Unit is situated in the Outpatients facility in the new hospital build on the Queen Alexandra Hospital site, close to the main Radiology department. The breast team is multi-disciplinary with 4 consultant radiologists contributing to the service and 1 Breast Physician. Other members of the team include 4 breast surgeons, 1 dedicated onco-plastic surgeon, 4 dedicated breast pathologists, 2 clinical oncologists, 2 medical oncologists, close links with the military plastic surgeons, 3 advanced practitioners in radiography who are fully involved with screen reporting, a consultant nurse, 5 specialist breast care nurses and within breast radiology alone, a dedicated team of radiographers, radiographic department assistants, admin and clerical staff. DUTIES OF THE POST Portsmouth Hospitals NHS Trust is looking to appoint an enthusiastic, forward-thinking Consultant in Breast Radiology. The appointee will join the Breast Imaging Team as a Breast Radiology Consultant and will be expected to participate in all facets of departmental activity. A potential secondary role for the appointee may be to support the Women’s Imaging service by contributing to the Gynaecology imaging reporting, the gynaecology MDT meeting and an HSG list. This is a new post to support the NHS BSP age extension trial and increasing symptomatic breast workload. The successful candidate will have a specialist interest in breast imaging and will be expected to participate fully in the breast screening and symptomatic breast programmes in the department. A minimum of 4 PAs will be dedicated to this work. The successful candidate who wishes to work full time would normally be expected to contribute to the acute work of the radiology department. DUTIES Reporting of screening and symptomatic mammograms. Assessment clinics are Consultant Radiologist led. You would be expected to carry out the clinical assessment of the patient as well as radiological investigation. All patients have the opportunity to also see a breast care nurse and there is a surgeon in attendance to see patients who have a malignant biopsy result. Involvement in symptomatic fast-track clinics. Patients are triaged so may be seen initially by a surgeon or a radiologist. The radiologists perform the majority of biopsies, where appropriate, at the time of the initial clinic appointment. Participation in Breast MRI would be desirable. Contribute to the general workload of the department including ultrasound, CT and plain film reporting. Share with colleagues in the training of Specialty Trainees on the Portsmouth Radiology Training Scheme. Share with colleagues in the training, supervision and support of trainee and qualified ultrasonographers, and when appropriate of Radiographers undergoing skill mix training for example, intravenous injections, appendicular reporting and barium enemas. Participate in the development of the Radiology department by involvement with departmental or Trust projects/committees, equipment procurement, administration and management, audit, teaching, research, fostering good working relations within the department and good liaison with hospital clinicians and GPs. Currently 25 consultants partake in the on-call rota. They also work in and working weekend sessions to support the emergency corridor and inpatient CT. Time for this commitment is recompensed with time off in lieu The consultant’s job plan is subject to change at any time, by negotiation with the consultant, Chief of Service and Trust management. 2 STAFFING BREAST RADIOLOGY Dr M King Breast and Oncology Radiology, Clinical Lead for Breast Imaging and Director of Breast Screening Dr A Beling Breast and Gynae Radiology. Vacancy Breast Radiology. Dr J Nash Breast and General Radiology. Dr J Langham-Brown - Symptomatic Breast, Intervention and GI Radiology. Ms Jo Helsdon, Breast Screening Programme Manager Mrs Susan Saunders, Superintendent Radiographer & Advanced Practitioner WORKLOAD The Breast Unit provides a full symptomatic imaging service, Family History Screening and screening for 74,000 women aged 50-70 eligible for the NHS Breast Screening Programme. Age extension trial for NHSBSP began in June 2013. Annual workload (approximate): Screening mammograms - 20,000 Symptomatic mammography (fast track, follow up and family history) - 5,700 Ultrasound examinations - 4000 Stereotactic and ultrasound localisations - 200 Breast MRI – 150+ EQUIPMENT The breast imaging department has 3 static mammography units with full field digital mammography. The double ended mobile screening unit employs digital mammography and started service in March 2013. Breast MR is currently performed on the Siemens 1.5T Symphony unit, but is expected to be also performed on the new GE 1.5T 3T and GE 1.5T = GE 450w Optima MRI scanners (installation currently underway) 3 GE Full field static digital mammography units. 1 GE DS with stereotactic attachment 1 Faxitron sample x-ray cabinet with small field digital display + hard copy printer. 2 Esaote u/s machines (2008, 2009) 1 two-roomed trailer with Siemens Inspiration digital mammography units. Encore Vacuum Assisted Biopsy device. Newly upgraded filmless SECTRA PACS, with NBSS integration planned for August 2014. RADIOLOGY WORKLOAD 3 CT MRI Obstetric Ultrasound Non-obstetric Ultrasound Nuclear Medicine Radiographs Fluoroscopy/Intervention Total 2012-13 39,030 11,627 20,560 40,935 5,797 181,516 10,109 309,574 2013-14 54,585 13,432 16,960 51,517 4,594 185,306 13,772 340,166 RADIOLOGY STAFF RADIOLOGISTS Member of Staff Dr J Atchley MA, MBBS, MRCP, FRCR Dr R Beable MB ChB, MRCS, FRCR Dr J Bekker (Netherlands) Dr S Coles BSc. MBBS. FRCR Dr K Colquhoun BSc, MBBS, MRCP, FRCR Dr J Domjan MBBS, AKC, MRCP, FRCR Dr M Firth MBBS, FRCR Lt Col I Gibb MBBS, FRCR Dr D Gibson MBBS, BSc, MRCS, DLO, FRCR Dr R Harrison MRCP, FRCR Dr A Higginson DA, MRCP, FRCR Dr C Ihezue MBBS, MRCP, FRCR Dr J Latham FRCR Dr J Langham-Brown MA, BMBCh, FRCS, FRCR Dr P McParland MBChB, MRCP, FRCR Dr H Megadmi MBBCh, FRCS, MSc Dr P Osborn BSc, MBBS, FRCR Dr M Taylor BSc, MBBS, FRCR Dr E Tilley MRCP, FRCR Dr A Wallis BSc MBChB, MRCP, FRCR, FHEA Dr S Ward MBBS, MRCP, FRCR Dr F Witham BSc, MBBS, MRCP, FRCR Diagnostic Imaging Services Manager: Clinical Director: Total PAs 12 11 10 9 8 11 11.5 4 NHS 11 11.5 12 11.5 4 11.5 10 11 11 10 11.5 10 11.5 11.5 Specialty IR, Cardiovascular, Renal GI Neuro, Head and Neck IR Musculoskeletal Neuro, ENT Musculoskeletal Musculoskeletal, General Head and Neck, MSK Paeds GI Oncology Chest, Oncology IR, Breast Chest, Cardiac Nuclear Medicine Physician Uro-radiology, IR Paeds Head and Neck, Neuro Chest, Cardiac Oncology Musculoskeletal Mrs Sarah Skelton. Dr Louis Merton FRCP (Clinical Neurophysiologist). 14 Radiology Speciality Trainees 4 Proposed timetable (areas in bold are current fixed requirements (June 2014) Mon 09:00 - 17:00 09:00 - 17:00 Assessment Clinic Oncology / Gynae CT reporting 9 10 11 12 Tue 1 Wed 09:00 17:00 Fri 09:00 - 17:00 ? Gynae MDT Breast Assessment clinic Breast Fast Track clinic SPA SPA 1.3 2 2.3 Thu 09:00 17:00 Breast Fast Track clinic Reporting 3 3.3 4 5 Screen reading MDT Symptomatic Stereo Biopsy Consensus Read Screen reading MRI reporting MDT cases Summary The job plan comprises 8 PA’s DCC and 2 PA’s SPA. The job plan will be reviewed within 6 months of commencement of post. GOVERNANCE, EDUCATION AND RESEARCH The Wessex Deanery contracts Radiology training to 2 schemes based in Portsmouth and Southampton. Portsmouth trainees are trained mainly at QA Hospital but also rotate to Chichester, Southampton and Kings College Hospital, London. Subspecialty training happens at these and other hospitals throughout Wessex. Intake has recently increased to 3 trainees per year. The teaching and training of Junior Medical Staff is regarded to be of paramount importance by this department. The teaching standards are in line with the agreement between the Trust and Post Graduate Dean. The successful candidate may opt by agreement to act as Clinical or Educational supervisor to Radiology Trainees. It is expected that the appointee would contribute to the active teaching programme for undergraduates / clinical medical trainees, GPs, radiographers and nurses. Quarterly departmental governance meetings are held at Queen Alexandra Hospital. These are attended by all available Consultants, Radiology trainees, nursing staff, radiographers and support staff. There are opportunities to attend, on a monthly basis, the monthly Breast and Plastic surgery morbidity and mortality meeting. CONDITIONS OF SERVICE The post is covered by the Terms and Conditions of Service Consultant Contract (2003). The Trust expects all Medical and Dental staff to work within the guidelines of the GMC ‘Guide to Good Medical Practice’ which can be viewed on the GMC website www.gmc-uk.org. Where the post holder manages employees of the Trust, he/she will be expected to follow the local and national employment and personnel policies and procedures. 5 ACCOMMODATION Shared office accommodation will be made available within the main Radiology Department together with secretarial support. MANAGEMENT The post holder will be expected to work with local managers and professional colleagues in the efficient running of services and will share with Consultant colleagues in the medical contribution to management. Subject to the provisions of the Terms and Conditions of Service, the post holder is expected to observe agreed policies and procedures drawn up on consultation with the profession on clinical matters and follow the standing orders and financial instructions of the Portsmouth NHS Trust. In particular, Managers of employees of the Portsmouth Hospitals NHS Trust are expected to follow the local and national employment and personnel policies and procedures. The post holder will be expected to ensure that there are adequate arrangements for hospital staff involved in the care of patients to be able to contact him/her when necessary. All medical and dental staff are expected to comply with the Portsmouth Hospitals NHS Trust Health and Safety Policies. STUDY LEAVE 30 days within a three-year period, subject to national and local policies will be allowed. STATUS OF POST This is a full time post but candidates who wish to work part-time/job share are welcome to apply. RESIDENCE Residence within either 10 miles or 30 minutes by road from Queen Alexandra Hospital is usually required unless alternative arrangements agreed with the Trust management. His/her private residence must be maintained in contact with the public telephone service. SAFE GUARDING Act in such a way that at all times the health and well being of children and vulnerable adults is safeguarded. Familiarisation with and adherence to the Safeguarding Policies of the Trust is an essential requirement for all employees. In addition all staff are expected to complete essential / mandatory training in this area. INFECTION CONTROL In compliance with the Trust's practices and procedures associated with the control of infection, you are required to: Adhere to Trust Infection Control Policies assuring compliance with all defined infection control standards at all times. Conduct hand hygiene in accordance with Trust policy, challenging those around you that do not. Challenge poor practice that could lead to the transmission of infection. HAND HYGIENE POLICY The Trust has adopted "Naked Below the Elbow" strategy which means that when involved in patient care and direct physical contact with patients, you must wash or decontaminate your hands as per the Hand Hygiene Policy. 6 Compliance with the Hand Hygiene Policy is mandatory; you must wear short sleeved shirts / blouses / uniform, remove any out jackets and roll up your sleeves. No jewellery should be worn below the elbow (except a plain wedding band) and wrist watches must be removed. Compliance with this policy will be monitored and any non compliance may be subject to disciplinary action. REHABILITATION OF OFFENDERS Because of the nature of the work for which you are applying, this post 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 (exceptions) order 1975. Applicants are therefore not entitled to withhold information about convictions. This could result in dismissal or disciplinary action from the Trust. Any information given will be completely confidential and will be considered only in relation to an application for positions to which the order is applied. POST VACANT The post is currently available and the appointee will be required to take up the post no later than four months from the date of the offer of an appointment, unless a special agreement has been made between the appointee and Portsmouth Hospitals NHS Trust If you consider it unlikely that you will be able to take up the appointment within such a period, you are advised to point this out at the time of your application. VISITING ARRANGEMENTS Intending applicants may obtain further information and/or arrange a visit by contacting Dr Mike King, Director of the Breast Unit via 02392 286000 ext 5302. Meetings with Dr Merton can also be made via the same number. Please note that Portsmouth Hospitals NHS Trust will reimburse expenses for one pre interview visit in respect of short listed candidates. Due to the high volume of recruitment and our desire to treat all applicants fairly it is not possible to meet with the Chief Executive, Miss Ursula Ward, prior to the Appointments Advisory Committee. However, arrangements to meet with Mr Simon Holmes, Medical Director, can be made by contacting Claire Woodward on 023 9228 6801. Both Mr Holmes and Ms Ward are extremely committed and supportive of this appointment and to appointing the right candidate and, as part of the induction programme the successful applicant will have an opportunity to meet with them. 7 PERSON SPECIFICATION / SELECTION CRITERIA CONSULTANT IN BREAST RADIOLOGY Requirements Essential Desirable Qualifications Professional qualifications:- BSc MD Higher professional Radiology. training in MRCS, MRCP or equivalent. Full GMC registration with license to practice Clinical Experience Entry on the GMC Specialist Register via CCT (proposed CCT date must be within 6 months of interview) CESR or European Community Rights Experience of certified training at a UK Breast Screening Teaching Centre. Clinical Skills Demonstrable experience of Breast Demonstrable skills in Oncology Radiology to Sub-specialty level. imaging or Gynaecology imaging (Women’s Imaging). Experience of presenting at MDT. Understanding management. Knowledge of clinical risk Experience of Vacuum Assisted Biopsy. Able to demonstrate appropriate level IT skills. of clinical knowledge. Knowledge and use of evidence Breadth of experience in and based practice. outside speciality. Organisation and Planning Able to organise oneself prioritise clinical need. and Evidence of managerial skills: - Experience and ability to work in - achievements multi-professional teams. Understanding of: - course attended - NHS - Clinical Governance 8 - resource constraints Teaching skills Academic Research Evidence of teaching experience – particularly junior medical staff. Willingness to contribute to teaching. / Understanding of the principles of research. Evidence of participation in audit. Research experience. Publications. Regional presentation. Prizes and honours. Career progression Personal Attributes Appropriate progression of career to date. Evidence of: - Evidence of: - Good communication skills: - Oral - Written Decisiveness/accountability. - logical thinking problem solving decision making Interpersonal skills. Non-judgemental patients. Flexibility. approach to Resilience. Thoroughness. Initiative/ drive/ enthusiasm. Probity. Leadership skills. Presentation Skills Effective, confident presentation ability. The opportunity to take up additional PAs may be offered. Programmed activity Number Direct Clinical Care (Including unpredictable On-Call) 8 PA’s 32 hours Supporting professional activities 2 PA’s 8 hours Other NHS responsibilities External Duties TOTAL PROGRAMMED ACTIVITIES 10 PA’s 40 hours 9 1. On-Call availability supplement Agreed on-call rota: 1 : 20 Agreed category: A On-call supplement: 3% 2. Objectives Objectives 1. 2. 3. 4. 5. 6. 3. To contribute to the radiology service. To supervise non-consultant staff in clinic. To fulfil college and CPD requirements. To participate in the teaching of undergraduates, postgraduates and GP’s or nurses. Keeping up to date in areas of specialist interest. Contribute to the team working within the department. Supporting Resources Staffing support: Accommodation: Equipment: 4. Resident junior staff (SPR/SHO) for theatre and unit work as deemed appropriate by Department. Secretary and administration staff. Nurse practitioners for pre op clinics and trauma. Hospital practitioners for outpatient and fracture clinics. Adequately equipped shared office with desk, telephone, computer with internet access. Access in office to printer, photocopier and fax. Suitably equipped out patient consulting rooms, theatre suites, day case and procedure rooms. Meeting room to accommodate whole department with AV facilities. Access to drinking water and beverage facilities. Conveniently located secure car parking with 24 hour access. Access to internet in units/theatre/department. Library and database links. Access to confidential telephone and fax facilities. Teaching, training and simulation equipment. IT for data collection and analysis. Out patients department and theatres equipped to standard set by RCS and BOA. Other Comments or Agreements 1. An annual report detailing research progress and evidence of SPA would be required. 10