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Consultant in Public Health /Consultant in Public Health Medicine Employing Organisation: NHS Dumfries and Galloway Accountable to Director of public Health Salary – Agenda for Change – 8d/New Consultant Contract Managerially responsible for : 1 Health Protection Nurse Consultant 2 Public Health Nurses 1 Screening Services Manager Appointment: This is a full time post for a CPH/CPHM in NHS Dumfries and Galloway based at Crichton Hall, Dumfries. This is a replacement post following the retirement of the previous post holder. Job summary: Whilst there may be a requirement to contribute to all public health domains, the main purpose of the post is to oversee and manage all of the Health Protection and Screening functions of the Board and to oversee the Board’s immunisation programmes. This post is a demanding one. The post holder will be expected to be able to cope with multiple changing demands and to meet tight deadlines. A high level of intellectual rigour, political awareness, negotiation and motivation skills and flexibility are required. The post holder will deal with complex public health issues, advise the Health Board and make recommendations regarding Health Protection, Screening and Immunisation Programmes. A high level of tact diplomacy and leadership is required and an ability to challenge and advocate to enable effective working across organisational boundaries, and influencing without direct authority. Because of the extensive nature of the responsibilities of this post it is not suitable for part-time working. 1.1 The post holder will have responsibility for the development implementation and delivery of national regional and local policies developing interagency and interdisciplinary strategic plans and programmes with delegated Board authority to delivery key public health targets. 1.2 The post holder will provide expert public health advice and leadership to support and inform an evidence based approach within ethical frameworks for commissioning, developing and delivering high quality equitable services across Primary, Secondary and Social Care with respect to the duties of this post. 1.3 The post holder will develop and utilise information and intelligence systems to underpin the programmes covered by this post. 1.4 The post holder will manage a team of staff and will design and deliver training both to staff within the department, and to specialty registrars/trainees in public health. 1.5 The post holder will be responsible for the day to day management of the staff team including recruitment, objective setting and supervision, including appropriate personal development plans are in place and dealing with issues of annual/study leave, travel expenses and disciplinary matters. 1.6 The post holder will be an authorised signatory and budget holder for the areas of responsibility of the post. 1.7 The post holder will both carry out and commission research/audit projects and will translate research findings into appropriate public health practice. 2. NHS Dumfries and Galloway NHS Dumfries and Galloway serves a population of 152,000 patients across a predominately rural area of 2500 square miles. There are two main towns; Stranraer in the West (catchment population 20,000) and Dumfries towards the east of the region (catchment population 35,000) with the remaining population spread throughout the area in small towns, villages and individual settlements. The NHS Board and Local Authority areas are coterminous. Particular challenges for both organisations in providing services are: A higher than average (and rising) percentage of older people in the population The low population density in most of the region A relative low wage economy associated with rural deprivation. Despite these challenges life expectancy and many other measures of population health are slightly better than the average for Scotland. 3. Directorate of Public Health 3.1 Current Staffing There are currently (April 2013) 74 staff working within the directorate of public health, ranging across Health Protection and Screening, Health Improvement, Health Intelligence, Dental Public Health and Oral Health and Contributing to the Strategic Planning and Monitoring of Health Services (see organisational chart) . The Directorate has a Specialist Trainee and this is expected to continue for the following 5 years. 3.2 IT, Secretarial Support and other internal resources The Consultant will have access to modern IT facilities including wireless internet access throughout the NHS estate. The Consultant has dedicated secretarial support but also where necessary has access to the other admin support available within the Directorate. The Directorate has a significant Health Intelligence resource which is available as necessary to the Consultant. There is a Library and Post Graduate Education Centre in Dumfries and Galloway Royal Infirmary located 200metres away from the place of work. 3.3 Training and CPD Arrangements The Directorate is approved for the training of Public Health Specialists (normally one at any one time). There are three Universities on the Campus within walking distance of Crichton Hall (Glasgow University, Strathclyde University, and the University of the West of Scotland) and there are opportunities there for visiting lectureships. 4. Management Arrangements The post holder will be professionally accountable to NHS Dumfries and Galloway and managerially accountable to the Director of Public Health. Professional appraisal will be required and an initial job plan will be agreed with the successful candidate prior to the individual taking up the post. This will be based on the draft job plan attached. The job plan will be reviewed as part of annual job planning process. 4.1 The post holder will be managerially responsible for a team of 15 staff of whom four are directly line managed by the consultant, including recruitment, allocation of duties, appraisals, disciplinary and grievance responsibilities. 4.2 The post holder will manage a budget of £570,000 per annum and this will increase with the introduction of Abdominal Aortic Aneurysm Screening. 4.3 It is a requirement of the post that the post holder take part in on call arrangements for communicable disease control/health protection. The current rota is 1 in 4 (prospective). The post holder is required to have sufficient training and experience to be a “competent person” under the Public Health Etc (Scotland) Act. 4.4 The post holder will be expected to deputise for the Director of Public Health if required (this shared with the other consultants in the directorate) 4.5 The post holder will manage the Speciality Registrar/Trainee in Public Health when working within the Health Protection Team and if appropriate may be the trainer for such trainees. 5 Professional Obligations The postholder will be expected to: participate in the organisation’s staff appraisal scheme, departmental audit and clinical governance responsibilities, and ensure appraisal and development of any staff for which s/he is responsible. contribute actively to the training programme for Specialist/ Specialty Registrars in Public Health as appropriate, and to the training of practitioners and primary care professionals within the locality. pursue a programme of CPD in accordance with Faculty of Public Health requirements, and undertake revalidation, audit or other measures required to remain on the GMC Specialist Register, or UK Public Health Register. With regard to this paid study leave is always supported, and payment and travel expenses for attendance at relevant conferences and training events are available. practice in accordance with the Faculty of Public Health’s ‘Good Public Health Practice’. 6. Key tasks The key result areas relate to the public health contribution to health protection for all of Dumfries and Galloway. In each of the key areas listed below, the post holder will be required to provide a consultant level service, in accordance with appropriate professional standards. UK standards for public health practice are currently specified by the Faculty of Public Health, and will be subject to periodic amendment. For some areas of practice, additional standards are specified at a national or local level. Surveillance, assessment of population health (analysing, interpreting information, knowledge and stats) To maintain and develop an effective system for the surveillance of communicable disease and environmental hazards in Dumfries and Galloway, and ensure that the local surveillance systems feed into national and UK surveillance appropriately. To design, develop and utilise information and intelligence systems to underpin local public health improvement and action across disciplines and organisations. To write and/or contribute to national and local policy reports as appropriate on the health of the population of Dumfries and Galloway with particular regard to health protection issues. Assessing the evidence of effectiveness of health and healthcare interventions, programmes and services To provide expert public health advice and leadership to support and inform an evidence-based approach to communicable disease control and dealing with non-infectious environmental hazards, working in potentially contentious and hostile environments where barriers to acceptance may exist. To be responsible for leading on service development, evaluation and quality assurance of services to reduce the impact of communicable diseases and environmental hazards to health and for preparing and adjusting action plans in line with changing needs and changing geographical boundaries. Policy and strategy development and implementation To provide public health advice and perform the duties of the NHS Competent Person under the Public Health etc. (Scotland) Act 2008 and Public Health Regulations 1988 as agreed with the Local Authority in Dumfries and Galloway, ensuring proper arrangements for emergency on call arrangements outside office hours and providing relevant reports to the appropriate Local Authority Committee. To supervise and co-ordinate activities for the prevention of communicable disease and noninfectious environmental hazards, leading on the local implementation of national programmes as appropriate, such as those for the prevention and control of individual infectious disease such as hepatitis C. Specifically the consultant will be responsible for contact tracing for cases of tuberculosis and for the implementation of national guidelines concerning BCG immunisation. To be an active participant in both hospital and community control of infection programmes and play a leading role ensuring the preparation of contingency plans for the control of major outbreaks and incidents both in hospitals and community settings. To discharge the responsibilities for NHS emergency public health responses as specified and agreed between local agencies, and to take the responsibility for the preparation and revision of all major emergency plans as they relate to health protection. Leadership and collaborative working for health To identify problems, define objectives, prepare plans and set targets for the control of communicable disease and non-infectious environmental hazards in Dumfries and Galloway, taking into account the need to improve health and reduce health inequalities. To lead the development of infection control arrangements for the wider community (schools, nursing homes, prison, etc) working closely with infection control specialists, service providers and regulators and with relevant national standard setting bodies. To be a member of, and contribute to, relevant liaison groups in communicable disease control and health protection within Dumfries and Galloway and Scotland as required. To assist communicable disease control, health protection and public health colleagues in neighbouring areas during major communicable disease or other health protection incidents. Health Improvement/prevention To work with local communities in helping them in addressing the issues of communicable disease control and non-infectious environmental hazards, using community development approaches as appropriate. To reduce inequalities, and work with groups at high risk of communicable diseases and environmental hazards. To co-ordinate, monitor and support the implementation of national immunisation programmes and the development of the local immunisation policy for the area, working with Directors of Public Health, immunisation co-ordinators and other relevant partners at local level. To take responsibility for the efficient and effective working of all call/recall systems for all national screening programs. To manage the screening services team responsible for all call/recall systems and the recording of immunisations. Health Protection To assume overall responsibility for the control of cases, incidents and outbreaks of infectious disease working with relevant local, national or UK guidelines as appropriate. This will entail coordinating control of major outbreaks and working closely with the infection control doctor and other relevant staff in hospitals and primary care, and those involved in the local and national health protection functions. To lead/contribute to the control of non-infectious environmental hazard incidents using relevant local, national or UK guidelines as appropriate. This will entail working closely with those involved in the local, national and UK health protection functions. To contribute to the provision of an emergency 24 hour “competent person” rota for health protection covering Dumfries and Galloway. The rota currently operates with 1 in 4 (prospective) on call frequency and ad hoc arrangements are put in place to cover unplanned absences. To undertake duties in relation to public health aspects of emergency planning. Service Improvement To support and encourage relevant activities to manage risk and reduce hazards (including clinical governance) with respect to the control of communicable disease and non-infectious environmental hazards within the designated area. To provide advice as required to NHS planners on the provision of services within Dumfries and Galloway for the prevention, diagnosis, treatment and control of communicable diseases. Public Health Intelligence To analyse and evaluate quantitative and qualitative data and research evidence from a range of sources to make recommendations and inform decision making which has long term impacts. To compare, analyse and interpret highly complex options for running projects identified as key health protection priorities, and communicate this information across organisations and the local community. To lead on, plan and design agreed aspects of the assessment of health needs, health inequalities, and health impact assessment with respect to communicable disease control and non infectious environmental hazards. To identify areas for action within the local population based on the best available evidence, and to be responsible for short and long term planning and for providing advice on the treatment of groups of populations. Academic Public Health/ Research and Development 7. To work with others to develop the research evidence base required to support the control of communicable disease and the health protection function, both initiating and collaborating with research as appropriate and linking with relevant academic institutions. To undertake and commission literature reviews, evaluative research surveys, audits and other research as required. To assist with education, training and competency development and assessment in public health for the wider health protection team and the specialist public health workforce within the region. There are local campuses of three universities (Glasgow, Strathclyde, and the University of the West of Scotland). There are opportunities with these universities for visiting lectureships. Communications and working relationships The list below is not exhaustive and is intended to act only as a guide: Internal Director of Public Health, Consultants and Specialty/Specialist Registrars in Public Health Public Health Directorate staff NHS Executive Directors NHS Chief Executive Clinical consultants Other NHS Dumfries and Galloway staff Chairman and Non-executive Board members Professional advisory committees Medical Directors and other senior officers of NHS Dumfries and Galloway General medical and dental practitioners and other independent contractors Locality Health Improvement Teams External Local Authority Chief Executive Local authority environmental services team Local authority elected members NHS Health Scotland Academic and specialist institutions Third sector and independent organisations The Scottish Government Central Legal Office Members of Parliament and Members of the Scottish Parliament 8. Most challenging aspect of the job To be recognised, locally and nationally, as an expert source of advice, information and action on specialist health protection areas. To influence the actions of others without managerial authority Person specification Education/Qualifications Inclusion in the GMC Specialist Register in Public Health or the UK Public Health Register If included in the UK Public Health Register by a route other than through the formal public health training scheme, candidates must have such equivalent training and/or appropriate experience of health protection as to make them eligible to become a “competent person” under the Public Health Etc. Scotland Act (2008) Applicants who are not yet on the GMC Specialist Register or the UK Public Health Register must provide verifiable signed documentary evidence that they are within 6 months of gaining entry at the date of interview Applicants already on the GMC Specialist Register or the UK Public Health Register must meet minimum CPD standards in accordance with the requirements of the Faculty of Public Health Personal qualities Essential X Desirable X X X Strong commitment to public health principles X Able to prioritise work, and work well against a background of change and uncertainty X Adaptable to situations, can handle people of all capabilities and attitudes X Commitment to team-working, and respect and consideration for the skills of others X Self-motivated, pro-active, and innovative X High standards of professional probity X Experience Project management X Staff management and training Practical experience in facilitating change X X Budget management X Experience of communicable disease control in a wide variety of settings including out of hours on call Experience and demonstrable competency in dealing with environmental hazards/chemical incidents Experience of public health emergencies (real or exercised) X Experience of working with other agencies X X X Training and mentoring X Scientific publications, presentation of papers at conferences, seminars, etc X Skills Strategic thinker X Excellent oral and written communication skills X Skilled at dealing with the public and the media X Effective interpersonal, motivational and influencing skills X Ability to respond appropriately in unplanned and unforeseen circumstances X Sensible negotiator with practical expectation of what can be achieved X Substantially numerate, with highly developed analytical skills using qualitative and quantitative data X Using computer packages – Microsoft Office suite mostly X Ability to design, develop, interpret and implement policies X Ability to concentrate for long periods (e.g. analyses, media presentations) X Resource management skills X Knowledge Understanding of epidemiology and statistics, public health practice, health promotion, health economics and health care evaluation. Understanding of key agencies involved in health protection X Knowledge of methods of developing clinical quality assurance, quality improvement and evidence based clinical and/or public health practice X Understanding of social and political environment X Familiarity with the symptoms, signs, investigations and treatments used in the diagnosis and management of health protection problems X Understanding of laboratory microbiology services X Understanding of clinical infectious diseases services X Understanding of clinical toxicology services X Understanding of the principles of radiological protection X X Organisational chart Director of Public Health Directorate Co-ordinator Admin staff Consultant in Public Health, DG Health and Wellbeing (adults and older people) Consultant in Public Health/Public Health Medicine – Health Protection (This post) Consultant in Dental Public health/Public Health Consultant in Public Health Medicine (Health intelligence, tobacco and alcohol, health service development) Health protection team Consultant in Public Health, DG Health and Wellbeing Children and Young People) Screening services team OUTLINE JOB PLAN Name: Specialty: Public Health Principal Place of Work: Crichton Hall, Glencaple Road, Dumfries DG1 4TG Contract: 1.0 wte Programmed Activities: Availability Supplement: 9 SPAs: 1 New Consultant Contract 8% AfC £17 per session On-Call Rota: 1:4 (prospective) Premium Rate Payment Received: Nil Managerially Accountable to: Responsible for: Director of Public Health Leading the Health Protection function for NHS Dumfries and Galloway: managing the health protection and screening services teams. Contributing to the wider public health responsibilities of the directorate. a) Timetable of activities which have a specific location and time DAY Monday Tuesday Wednesday Thursday Friday Saturday Sunday HOSPITAL/ LOCATION Crichton Hall Glencaple Road Dumfries DG1 4TG Crichton Hall Glencaple Road Dumfries DG1 4TG Crichton Hall Glencaple Road Dumfries DG1 4TG Crichton Hall Glencaple Road Dumfries DG1 4TG Crichton Hall Glencaple Road Dumfries DG1 4TG - TYPE OF WORK See section (b) See section(b) See section (b) See section (b) See section (b) - b) Activities which are not undertaken at specific locations or times Whilst the office base is in Dumfries, any of the types of work listed may be undertaken at different locations in Dumfries & Galloway depending on appropriateness. Occasionally, the work may need to be undertaken outwith Dumfries & Galloway, e.g. to attend a meeting in Glasgow or Edinburgh. The timing of work in the area of Health Protection, as well as any contribution to the wider public health responsibilities, management of people and administration would normally be at times that fall between 8:30am to 5pm Monday to Friday, but with flexibility in exceptional circumstances. Supporting professional activities may be carried out at the most appropriate time during the week. This is subject to fitting in with the overall number of programmed activities for supporting professional activities stated in the job plan. On-call public health work may be undertaken at any time as appropriate, including evenings or weekends. Activities include: c) Desk work – Reading and responding to e-mails and letters, reading reports and papers, preparing reports and papers, receiving and making telephone calls, preparing for meetings, general administration. 1:1 discussions Attendance at/chairing of meetings. Travelling to/from meetings. Staff management Trainee supervision (if appropriate) Teaching SPA Activities during Premium Rate Hours of Work e.g. hours outwith 8am-8pm Monday to Friday Emergency public health work undertaken at unpredictable times during an on-call period. Other aspects of work would only be undertaken outwith 8am-8pm Monday to Friday in occasional or exceptional circumstances. d) Extra programmed activities – see separate contract and schedule (None undertaken)