Consultant in General Surgery with an interest in Colorectal Surgery
We are seeking to recruit an enthusiastic, progressive consultant to join our general surgery and colorectal department. The post will include managing elective and emergency general surgery as well as colorectal patients. There are distinct training and supervisory roles to mentor medical students as well as trainees. The appointee must possess advanced laparoscopic skills. An understanding of streamlining of care and continued adherence with best-practice guidelines is essential. Colorectal surgical training and endoscopy experience are also essential as well as logbook evidence of recent colorectal surgery practice in the emergency and elective setting. The appointee should be a fully trained general and colorectal surgeon.
Main duties of the job
The job plan will consist of ten programmed activities (10 PAs), including 1.5 SPAs and emergency work. The successful candidate will be expected to participate in an internal arrangement to provide cross-cover during absences. These fixed commitments within the timetable may be subject to change depending on the needs of the department. The post-holder will be expected to demonstrate flexibility in frequency and arrangement of outpatient and theatre sessions.
This is an exciting time to join the surgical department as we develop a wider clinical community and focus on expanding our surgery services. The future plan for clinical services will provide the ideal opportunity for innovation and developing new approaches to patient care across a wide catchment population. Being part of a wider clinical community will also provide greater opportunity for professional development.
All applicants must hold full registration and CCT with the GMC by the start date.
Job responsibilities
1. Clinical
1. Provide consultant care at an early stage to patients presenting to secondary care with presumed emergency general surgical problems.
2. Facilitate early senior review to ensure all patients are reviewed within 1 hour of referral to specialty.
3. Facilitate early decision making for investigation or surgical intervention.
4. Promote early and safe discharge through regular consultant review of emergency and elective surgical inpatients.
5. Deliver consultant review of all non-elective admissions within 12 hours of admission in conjunction with the on call emergency surgical consultant.
6. Establish new patient pathways alongside colleagues working in the Trust emergency department and local GPs to establish direct, rapid access and assessment of patients with potential acute general surgical conditions.
7. Promote expert clinical practice in the care of emergency laparotomy patients.
8. Develop, support and provide education for multidisciplinary teams in the care of patients undergoing emergency laparotomy surgery.
9. Support and contribute to service development that enhances care of emergency laparotomy patients.
10. Identify areas of care that do not meet NELA standards and lead on change to improve them.
11. Work with existing lower GI surgeons to provide care in a team-based approach.
12. Collaborate with General Surgeons to achieve the 18 week referral to treatment targets for both general and specialist workload.
13. Work with Service Managers to ensure compliance with national clinical guidelines in the areas of emergency general surgery and major incident planning.
14. Undertake complex laparoscopic colorectal procedures.
15. Provide elective benign Lower GI Surgery including inflammatory bowel disease.
16. Work independently and unsupervised as an expert Advanced Practitioner in performing diagnostic lower GI endoscopy procedures, demonstrating advanced levels of clinical judgement, discretion and clinical decision making.
17. Provide training in general and lower GI surgery for trainees.
18. Contribute to the continued development of a first class colorectal service.
19. Participate in postgraduate teaching.
2. Provide High Quality Care to Patients
1. The post holder must adhere to the standards outlined by the GMC for Good Medical Practice.
2. Develop and maintain the competencies required to carry out the duties required of the post.
3. Ensure prompt attendance at agreed direct clinical care Programmed Activities.
4. Ensure patients are involved in decisions about their care and to respond to their views.
5. Demonstrate, model and encourage Trust Values at all times to all patients and staff.
6. Lead on the completion of National Emergency Laparotomy Audit data and National Bowel Cancer Audit data.
3. Research, Teaching and Training
1. Provide high quality teaching to medical undergraduates and members of other health care professions as agreed with the Service Lead. To contribute to training and teaching of medical trainees, medical students, other doctors in training and other staff groups.
2. Act as a clinical supervisor and appraiser as delegated by the Clinical Director/Service Lead to ensure external accreditation of training post.
3. Where possible to collaborate with academic and clinical colleagues to enhance the Trusts translational research/audit portfolio, at all times meeting the full requirements of Research Governance.
4. Ensure that your mandatory training is up to date as per Trust policy.
5. The Trust expects all consultants to participate fully in continuing professional development to ensure that skills and knowledge are updated in line with relevant medical developments. Consultants may apply to the study leave budget for help with associated expenses in line with the terms and conditions of their contract. In addition consultants will be expected to undertake some non-clinical training and development at the discretion of the trust management, for example, Leadership Training.
4. Performance Management
1. Work with medical, nursing and managerial colleagues to ensure high performance in the following areas:
* Clinical efficiency e.g. Length of Stay (LOS) reductions, admission on day of surgery, reducing cancelled operations and DNA rates.
* Quality of outcomes e.g. infection control targets, reducing re-admission rates.
* Financial management e.g. identification, implementation and achievement of cost improvement programmes and participating in efforts to ensure services are provided cost effectively e.g. managing locum agency spend, monitoring and managing the drug budget to target, ensuring accuracy of clinical data for the team.
* Operational efficiency e.g. day-case rates, waiting list activity and demand management.
5. Medical Staff Management and Accountability
1. Work with colleagues to ensure Junior doctors hours are compliant in line with EWTD and New Deal.
2. Ensure that Trust systems and procedures are in place and followed to control and monitor leave for junior medical staff and to ensure that there is appropriate cover within the clinical areas, including on-call commitments.
3. Adhere to Trust / department guidelines on leave, including requesting and reporting absence, and professional and study leave, and to ensure that members of staff for whom you are responsible do the same.
4. Participate in the recruitment and induction of junior medical staff as delegated by the Clinical Director/Service Lead.
5. Participate in team objective setting as part of the annual job planning cycle.
6. Be responsible for ongoing assessment and regular appraisal of all doctors in training, Trust doctors and non-consultant grades as delegated by the Clinical Director/Service Lead /General Manager.
7. Participate fully in regular departmental activities including department meetings and team building activities.
6. Governance
1. Adherence to referral pathways for surgical oncology is expected. While the postholder is not expected to be a member of a cancer MDT, from time to time representation of patients may be required.
2. Review clinical outcomes in designated area using external benchmarking data where appropriate, to identify and advise variances to the Clinical Director/Service Lead.
3. Participate in clinical audit, incident reporting and analysis and to ensure resulting actions are implemented.
4. Work closely with the Directorate in relation to clinical and services developments as delegated by the Clinical Director/Service Lead.
5. Participate in ensuring NICE, NSF, CNST and other national guidance requirements are reviewed and implemented and monitored in the speciality areas.
6. Ensure clinical guidelines and protocols are adhered to by junior medical staff and any other staff for whom the post has responsibility and that these are updated on a regular basis.
7. Keep fully informed about best practice in the speciality areas and ensure implications for practice changes are discussed with the Clinical Director/ Service Lead.
8. To role model good practice for infection control to all members of the multidisciplinary team and adhere to the Trust Infection Control measures (available on the Trust Intranet).
9. To report all clinical and non-clinical accidents or incidents promptly, and to co-operate accordingly with any investigations undertaken.
7. Strategy and Business Planning
1. Work with medical managers and general managers to take forward the business planning and objective setting process for the directorate and Trust where appropriate.
2. Represent the Trust at appropriate clinical networks/other external clinical meetings, as delegated by the Clinical Director/Service Lead.
3. To attend and contribute at regular Departmental meetings as identified by the Clinical Lead.
8. Leadership and Team Working
1. Demonstrate appropriate leadership skills with regard to individual performance, clinical teams, the Trust and when participating in national initiatives.
2. Participate in any necessary management and leadership development courses as required by the trust.
3. Work collaboratively with all members of the multi-disciplinary team and Imperial College as required.
4. Set up and chair meetings relevant for clinical domain.
5. To promote local resolution of any conflict or differences of opinion. To involve appropriate parties for mediation, negotiation or discussion as appropriate.
6. Provide commitment and leadership in relation to equality and appropriate senior level management of diversity issues, particularly as they apply to training, people management and service delivery.
7. The successful candidates will be invited to a mentoring program for newly appointed consultants with the Medical Director with the same level of support and mentoring available during weekday and weekend working.
Person Specification
Qualifications
* Full GMC Registration and Licence to Practice
* MB BS or equivalent
* FRCS (Gen Surg) or equivalent
* On the GMC specialist register or within 6 months of obtaining this
* PhD / MS / MD / MSc
Clinical Experience
* Wide experience of emergency general surgery with evidence of practice within 6 months of appointment
* Good experience of elective and emergency colorectal surgery with evidence of practice within 6 months of appointment
* Knowledge of UK hospital systems
* Laparoscopic Colorectal Surgery experience
* Lower GI diagnostic endoscopic experience (JAG accredited)
* Colorectal subspeciality experience and training
* Experience in establishing and improving patient pathways to improve patient outcomes
Clinical Audit
* Experience of clinical audit
* Demonstrable understanding and acceptance of the principles of Clinical Governance
* Experience and evidence of involvement in Quality Improvement
Teaching Experience
* Evidence of organizing programmes and teaching medical students and junior doctors
* Willingness to teach all grades of professional multidisciplinary team
* Formal course for training
* Completed 'Training the Trainers' course
Management and Administrative Experience
* Willingness to participate in clinical management
* Awareness of new developments in the specialty with ability to critically assess the impact of these on the service
* Attended management training
* Evidence of rota management
Research Experience
* Ability to convert research evidence into clinical practice
* Evidence of active participation in surgical research
* Thesis
* Published papers
Other Attributes
* Evidence of team working ability and supporting colleagues
* Ability to work flexibly in response to the changing needs of the Service
Disclosure and Barring Service Check
This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.
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