Job Description

Full Time
Clinical Fellow (CT LAS)
General Internal Medicine

SPECIALTY CONTACT FOR ENQUIRIES ABOUT THIS POST

Dr Chris James, Consultant, Tel 01437 773493

Dr Angela Puffett, Consultant Tel 01437 773885
Dr Iain Robertson-Steel, Hospital Medical Director, Tel  01437
764545
Mr John Evans, General Manager, Tel  01437 764545

Links to Additional Information

Hywel Dda Health Board Homepage http://www.hywelddahb.wales.nhs.uk/

Our 10 pledges
http://www.wales.nhs.uk/sitesplus/862/page/53848
Useful Links
http://www.wales.nhs.uk/sitesplus/862/page/46875

Medical Training/Careers in Wales http://www.doctorstrainingwales.tv/

Wales, the Smart Choice www.walesthesmartchoice.co.uk
NHS Employers website
http://www.nhsemployers.org/Pages/home.aspx

Don't forget you can follow us on our social media channels via your own devices and keep up
to date with the latest news:
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www.linkedin.com/company/hywel-dda-university-health-board

Medical Recruitment, Hafan Derwen, St David’s Park, Jobswell Road, Carmarthen SA31 3BB

Tel  01267 239737 / Fax  01267 239860 / Email  Medical.Recruitment.HDD@wales.nsh.uk

INTRODUCTION

We are seeking to appoint clinical fellows within the Pembrokeshire division of

Hywel Dda University Health Board based at Withybush General Hospital for
up to a two year period. The post will rotate through specialties within the
Medical Department. The training programme for Clinical Fellows is tailored to
individual need however mirrors that of Deanery Trainees at core training
level. Many of the Clinical Fellows progress to Deanery Training posts having
passed the MRCP. Training and teaching uses our clinical skills laboratory
which is equipped with the latest technology and teaching aids.

The Department of Medicine has a strong educational ethos with protected

teaching times within the working week with specific teaching focused on the
MRCP exams. All clinical fellows will be provided with the University Health
Board e-portfolio and be allocated a Clinical and Education supervisor
throughout their time in post.

Full GMC registration, completion Foundation Programme Year 1& 2 or

equivalent is essential.

Withybush General Hospital is a modern district general hospital (opened

1979) of approximately 241 beds situated 1 mile from the centre of
Haverfordwest the County town of Pembrokeshire. The hospital serves a local
population of approximately 115,000 which rises significantly during the
summer where a broad range of services in General Medicine (including
rheumatology and Palliative Care), General Surgery (with a special interest in
Colorectal Surgery), Emergency Medicine, Obstetrics and Gynaecology,
Paediatrics and Trauma and Orthopaedics are provided. The Anaesthetic and
Critical Care Team interface with all specialties and deliver ITU services.

Visiting specialities include ENT surgery, Urology and Ophthalmology with the
main centre for the three services based at Glangwili General. Other visiting
specialities include Maxillofacial Surgery, Oncology, Plastic Surgery,
Genitourinary Medicine and Medical Genetics. The service is supported by 6
operating theatres including new day surgery facilities, a recent endoscopy
suite and critical care support with ITU and HDU facilities.

The Emergency and Urgent Care Centre and ACDU (Adult Clinical Decision
Unit) on site as well as a newly built Renal Unit which opened in 2014. The
Radiology Department provides a comprehensive service including Spiral CT,
MRI, Nuclear Medicine. Recent investments have taken place in the re-
provision of state of the art CT and MRI.

The Hospital is supported by helicopter emergency medical services inter-

hospital transfer facilities, operating from on-site with services at Withybush
General are supported by Clinical Nurse Specialists and extended role
clinicians.

We offer excellent conditions of employment and West Wales provides

wonderful lifestyle opportunities. Pembrokeshire is a coastal county with
beautiful coast line with the Preseli Mountains in the North of the County.
There are opportunities to undertake such as climbing and mountain biking as
well as surfing, fishing, sailing and hiking. Property prices are lower than
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many parts of the UK with excellent State and Independent Schools within a
short distance of the Hospital. There are excellent road and rail connections
to London and the larger cities. Oversees applicants are encouraged to apply
for these posts and although previous NHS experience is desirable it is not
essential.

The Post Graduate Education Programme includes weekly protected

departmental teaching, weekly Grand Rounds with Whole Hospital Audit days
occurring every two months. Videoconferencing facilities allow trainees to link
in to teaching sessions held both at the University Hospital of Wales and Royal
Colleges. Library facilities on site offer excellent IT facilities and are part of
an extensive interlibrary lending network. Dedicated IT facilities, audiovisual
and conferencing equipment is on site along with separate areas for private
study.

The Health Board is fully committed to supporting employees to achieve an

appropriate work life balance. We are continually developing ways in which to
support greater flexibility. Job sharing and part-time working is already
widespread throughout the organisation. Training and education are central to
the function of the Health Board, forming a core element of the Clinical
Governance Strategy. Hywel Dda is the prescribed connection for
approximately 800 Doctors, with a dedicated Medical Appraisal and
perspective candidates can be interviewed by Skype if not resident in the UK.

Details for Visiting

Those wishing to discuss the post informally in the first instance, or visit the
department are encouraged to contact:

Dr Chris James/Dr Angela Puffet, Consultants

Withybush General Hospital
Tel: 01437 764545

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 JOB DESCRIPTION

The Job Itself

Title: Clinical Fellow (CT LAS) – General

Medicine

Professionally responsible to: The Medical Director

Managerially accountable to: Consultant within the Team/Clinical

Team Lead, with ultimate
accountability to the Chief Executive

Responsibility for Staff as Part of this Post: Junior medical staff

(where applicable)

The Clinical Strategy of the Health Board is under constant development and
the job holder may be required to undertake different duties to those agreed
at the time of appointment.

The Post itself

This is a Fixed Term Post for a 12 month to 2 year period.

Relationships
The holder of the post will be responsible to the Medicine Consultants.

There are close relationships with the Nursing Staff in the Wards, the Theatre,
Outpatients and Accident Unit, Technical Staff in Radiology, Pathology. You
will also liaise with Physiotherapists, Occupational Therapists, Speech
Therapists and Social Workers with regard to the treatment and rehabilitation
of patients.

General Medicine Department

The Department of Medicine has a strong educational ethos with fixed
teaching afternoons every Thursday. This provides educational development
based on small group working and simulation training as well as traditional
case based learning.

Each successful candidate will be allocated an Educational Supervisor who will

offer close support and supervision whilst encouraging learning opportunities
throughout the tenure of the post. This will include participation in the Royal
College of Physicians E-portfolio which will be provided by the University
Health Board

The Department of Medicine works on a ward based system where there are
currently 9 Consultants in the department participating in the acute medical
on call rota – This is based on 6 separate wards including an Acute Clinical
Decisions Unit. There are 22 junior posts within the department and 11
Middle Grade posts.

The position is also suited to overseas doctors who have not previously
worked in the UK as the Department has a structured induction period for at
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least one month. After the induction period the doctors will be expected to
undertake supervised participation within the on-call rota.

The Department provides a comprehensive service for the community in

General Medicine in its widest extent.

The Medicine Directorate provides care to the people of Pembrokeshire and

some from the adjacent Carmarthenshire and Cardiganshire areas of Dyfed.
Outpatient clinics are held at Withybush Hospital, with outlying clinics at Tenby,
Pembroke Dock, Milford Haven and Narberth.

There are 4 general medical wards and 8 medical (which will increase to 10)
firms with their special interests.

Dr A Vaishnavi – Consultant Physician/Gastroenterology

Dr F Ali – Consultant Physician/Gastroenterology & Clinical Lead for Endoscopy
Dr C M James – Consultant Physician/Care of the Elderly
Dr A Puffett – Consultant Physician/Care of the Elderly
Dr S Davidson – Consultant Physician/Care of the Elderly
Dr P Underwood – Consultant Physician/Diabetes
Dr Will Backen – Consultant in Orthogeriatrics
Dr M Akram – Locum Consultant General Internal Medicine
Dr Y Rashid – Locum Consultant Acute Physician
Dr A Hameed – Locum Consultant Physician/Cardiology
Dr K Mukherji – Locum Consultant Physician/Cardiology
Dr Nigel Jowett – Locum Consultant Physician/Cardiology

Patients with general medical problems are admitted to all 8 firms regardless of
their age on a 1:10 rota basis.

There are 22 junior medical staff and 11 Middle Grade medical staff in the
Department of Medicine, the Department is made up as follows:- Due to
vacancies this will be a 1:8 non prospective rota in the short term.

1 Associate Specialist
7 Specialty Doctors
2 MTI’s
1 Trust Registrars
1 SPRs
5 Clinical Fellow (CT level)
6 CMT’s
2 F2s
2 GPSTs
7 F1s

Duties of the post

During the initial stages of your appointment you will be given advice/instruction
on when to contact a senior Doctor. During your on-call period you will also be
on-call with a middle grade Doctor (i.e. Associate Specialist or Specialty doctor)
and a nominated Consultant. If you require advice regarding the admission,
diagnosis and treatment of patients you should normally contact the middle
grade doctor on-call with you; however, this does not prohibit you from

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contacting the Consultant on-call if you are at all concerned about the welfare of
a patient.

The duties will entail:-

The supervision of all admissions to the Wards, clinical investigations, diagnosis
and treatment of all patients admitted, including the maintaining of clinical notes
and completion of discharge summaries.

Additionally the Clinical Fellow may be required to assist the Consultant in the
running of the Outpatient Clinics.

During the period of your appointment you are likely to be attached to one of
the Consultants within the Clinical Team, although during on-call periods you
may be responsible to other Consultants. If you feel that you are required to
undertake tasks/duties for which you are not competent, it is your responsibility
to inform the Consultant to which you are attached or responsible to at that
time.

If you feel you are required to undertake tasks/duties for which you are not
competent, you should inform one of the Consultants and also your Educational
Supervisor. It is also important that you discuss your deficiencies with your
Educational Supervisor in order that the necessary training can be arranged.

Location of Duties
These duties will be located mainly at Withybush General Hospital.

Withybush General is a modern District General Hospital of approximately 241

beds and is the only general hospital in Pembrokeshire. The population of
Pembrokeshire is in the region of 120,000 increasing significantly during the
summer months with tourists.

The junior accepts that he/she will also perform duties on occasional
emergencies and unforeseen circumstances, at the request of the appropriate
consultant in consultation where practicable with his colleagues both senior and
junior. It has been agreed between the profession and the department that
while juniors accept that they will perform such duties, the Secretary of State
stresses that additional commitments arising under this sub-section should not
be required to undertake work of this kind for prolonged periods or on a regular
basis.

On occasions, the junior doctor may be asked to perform escort duties of

patients on transfer to other hospitals.

There is a modern well-equipped Pathology Department with individual

departments of Histopathology including Cytology, Haematology, Blood
Transfusion, Clinical Chemistry and Microbiology.

Study and Training

The Post Graduate Education Programme includes weekly protected
departmental teaching, weekly Grand Rounds with Whole Hospital Audit days
occurring every two months. Videoconferencing facilities allow trainees to link
in to teaching sessions held both at the University Hospital of Wales and Royal
Colleges. Library facilities on site offer excellent IT facilities and are part of
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an extensive interlibrary lending network. Dedicated IT facilities, audiovisual
and conferencing equipment is on site along with separate areas for private
study.

Full hospital induction and orientation is provided for all new doctors, including
extra training session to assist with integrating to the hospital and the NHS.
Weekly departmental occurs following the CMT core curriculum along with
simulation, communication and ethical teaching. We join the monthly
webstream ‘Evening Medical Update’ provided by the Royal College of Physicians
Edinburgh.

The library offers a wide ranging book collection, with interlibrary lending
network, excellent IT facilities, audio-visual and conferencing equipment.

The Area
You will enjoy excellent conditions of employment, whilst building your future
in one of the beautiful locations in the UK. Haverfordwest is a vibrant seaside
town offering a relaxed lifestyle and picturesque countryside. There is an
abundance of outdoor pursuits for those who love the outdoor life, from hill
climbing, sailing, surfing to the more relaxing activities of coastal path walks
along stunning countryside.

There is public transport running regularly from the town to outlying rural areas
although it should be remembered that is in rural areas, the public transport
service is not always regarded as being completely adequate.

You will gain experience in a modern busy General Medicine unit in a rural
setting. We also have a helipad on site at Withybush where you would gain
experience in a treat and transfer model for some patients. The department
has regular teaching and a friendly atmosphere.

Overseas applicants should demonstrate a breadth and depth of experience

comparable to that obtainable in the UK. Previous NHS Experience is
desirable, but not essential. Full structured induction into the NHS and
Department will be made available as well as a Mentoring scheme for the
successful applicants.

Quality and Standards

To be familiar with and actively promote adherence to the regulatory
framework including NICE and National Service Framework Guidance and
to actively promote professional standards “The Duties of a Doctor”
To undertake all work in accordance with the Health Board’s procedures
and operating policies

Learning Organisation
To be involved in and actively manage complaints and any medico legal
claims in their area of practice, management of serious incidents and
responsibility for sharing any organisational learning from these.

Flexibility Statement
The developing and rapidly changing nature of the organisation will require
considerable flexibility from the post holder. This job description indicates
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 the main functions and responsibilities for the post and is not intended to
be a fully inclusive list and the duties and responsibilities specified in this
job description are subject to change as the needs of the HB evolve. On
agreement with the post holder, this job description will be amended, as
necessary, in the event of future organisational and professional changes
and/or personal development.

Equal Opportunities
It is the aim of the Hywel Dda HB to ensure that no job applicant or
employee receives less favourable treatment on grounds of gender,
religion, race, colour, sexual orientation, nationality, ethnic or national
origins or is placed at a disadvantage by conditions or requirements which
cannot be shown to be justifiable. To this end, the HB has an Equal
Opportunities Policy and it is for each employee to contribute to its
success.

Patient Experience
To monitor and respond to measures of patient experience

Patient Safety
To work actively to reduce unintended harm to patients
To contribute actively to the content areas of the 1000 Lives Campaign and
any other subsequent patient safety campaign
To adhere to the Health Board’s Clinical Incident Policy

Personal Development
To attend accredited conferences and meetings to update personal level of
clinical practice, teaching and management skills in line with CME
requirements
To participate in an annual Job Planning Review process
To participate in the Health Board’s Annual Appraisal process
To be involved in and actively manage complaints and any medico legal
claims in their area of practice, management of serious incidents and
responsibility for sharing any organisational learning from these

Conditions of Service
The successful candidate will be required to be registered with the General
Medical Council throughout the duration of their employment and to carry out
their duties in line with the GMC booklet “Guide to Good Medical Practice”.

The successful candidate will also be required to undergo a medical

examination in the event of this being the candidates first appointment in the
NHS, or where he/she has not worked in the NHS for as period in excess of 12
months or when requested by the employing authority.

The opportunity is given to candidates attending for interview to visit the

hospital prior to interview to meet the staff and assess the facilities available.

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 HYWEL DDA UNIVERSITY HEALTHBOARD
PERSON SPECIFICATION
Post: Clinical Fellow – Emergency ./ General Medicine

REQUIREMENTS ESSENTIAL DESIRABLE METHOD OF

ASSESSMENT

MBBS MRCS 1or Certificates

GMC registration MRCP 1
QUALIFICATIONS ALS + ATLS

Completion of one CT Level - Application form

year F1 Medicine 6 months Interview
EXPERIENCE Completion of one Clinical Attachment
year F2 in Medicine
A&E Experience
Basic Emergency Interview
skills
SKILLS Good level of
communication

Up to date in Previous Medicine Interview

KNOWLEDGE Medicine Knowledge experience
Previous NHS
Experience
Caring attitude Interview
Honesty
PERSONAL Reliability
ATTRIBUTES

Good command and

understanding of the
OTHER English Language

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