Trust Senior Clinical Fellow (ST4 Level) in Paediatrics

(General)

Job Description

Full time

Start Date: 2nd March 2020

End Date: 6th September 2020

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 CONTENTS

Section Page

Section 1. Summary of Post ............................................................................................................ 3

Section 2. General details of the post .............................................................................................. 3
Section 3. Personal Specification ..................................................................................................... 5
Section 4. General information about Division of Children and Young People…………………………………..6

Section 5. General Information about the Trust ............................................................................ 10

Section 6. Application and Visiting Information ............................................................................. 12

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 Section 1. Summary of Post

This is a replacement post and ideal opportunity for a suitably qualified individual looking to
develop skills within a busy general pediatric department. The position will also allow the
candidate to continue to meet their training and education objectives within their clinical
responsibilities.

The post holders would take part in the General Paediatric middle grade Rota. There are no
neonatal duties as part of this post. The post holder would be offered the same training
opportunities as the specialist registrars on the rota with dedicated teaching sessions,
educational supervision and opportunities for study leave. Lewisham Hospital has a long
track record in supporting its doctors who are not on the paediatric training scheme and
supporting them where appropriate in successful entry to paediatric run through training.

Section 2. General details of the post

Trust Fellow (ST4 Level) in Paediatrics

Title:

University Hospital Lewisham , part of The Lewisham &

Location:
Greenwich Healthcare NHS Trust

New or Replacement
Replacement Post
Post:

To work in a team of junior doctors within Paediatirics and

Prime responsibility:
continue with training and Educational Objective

Accountable to: Consultants in Paediatrics

Consultant Paediatrician Dr Joanna Lawrence (College Tutor)

Reports to:
Senior House Officers ( paediatric StR, GPVTS & F2) in
General Paediatrics
Pre Registration House Officer (F1) General Paediatrics
Works with: Paediatric Surgery Specialist registrars (Honorary from
Evelina)
Other SpR and mid-grade staff in the Trust and Hospital
 To share with SpR responsibility for the day to day running
of the Paediatric Department
Key tasks:
 To continue with developing skills

 To continue training and Educational Objectives

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Rota
The post holder would take part in the Paediatric acute rota.
The rota is EWTD (European Working Time Directive) compliant.

Two separate middle grade full-shift rotas run; one team covers the A&E/ ward area with the
other team covering the NICU/ labour ward. This post is for the ward and A & E rota.

3 Community SpRs from the Lewisham Community Paediatric team participate in the acute
on-call rotas.

There are 8 SHOs who are on a full shift rota in general paediatrics. There is also a pre-
registration house officer F1.
The Children’s A&E and NICU have separate full shift teams of SHOs.

At times there may be adult A&E middle grade staff on secondment to the Children’s A&E
department.

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 Section 3. Personal Specification

REQUIREMENTS
ESSENTIAL DESIRABLE ASSESSMENT

METHOD

Qualifications  MB BS or equivalent medical  MPCH Part II APPLICATION/

qualifications EVIDENCE
 MRPCH/MRCP (part I)
 Full current GMC registration
Training & Experience  NLS/APLS/PALS Course  Paediatric A&E post INTERVIEW/
 Minimum of 2 years in recognised middle grade APPLICATION/
Paediatric SHO training post and must Experience
have appropriate neonate experience
at SHO level
 Outpatient experience of at least 20
(post registration) paediatric clinics
Clinical Skills /  Able to work without direct supervision INTERVIEW/
Knowledge where appropriate, according to level APPLICATION/
or experience EVIDENCE
 Sound manual dexterity and
competent routine practice procedures
as expected for experience
 Clear Logical thinking/shown an
analytical/scientific approach
Understanding of evidence informed
practice
Career Progression N/A
Organisation &  Ability to organize oneself, to manage INTERVIEW/
Planning time and task and prioritise clinical APPLICATION/
need within limitations of experience. EVIDENCE
Experience and ability to work in multi-
professional teams
Administration  Familiar with current structure of  Some understanding INTERVIEW/
health service and knowledgeable of clinical risk
about recent initiatives and changes management
 Appreciation of
clinical governance
issues
Audit  Through understanding of principles of INTERVIEW/
medical audit EVIDENCE
 Evidence of participation in audit
project
Research & N/A
Publications

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Personal Skills  Effective communicator; able to work  Familiarity with INTERVIEW
attribute in a team and co-operate with medical information
and paramedical staff technology and
 Sound note keeping
general computer
 Excellent written and spoken English
skills
Language skills
 Flexible, able to cover colleagues’
absences
 Able to change and adapt, respond to
rapidly changing circumstances
 Professional attitude towards work,
reliable, with tidy personal appearance
 Desire to continue personal
professional development and enhance
quality of patient service
 Able to operate under pressure, cope
with setbacks, self-aware
Teaching  Experience of teaching and exam  Teaching of medical INTERVIEW/
preparation and case presentations students, nursing staff APPLICATION
and other
professional groups

Section 4. General information about CYP division

Lewisham & Greenwich Trust – Division for Children and Young People

The Lewisham and Greenwich NHS Trust was formed 1st October 2013 with the merger of
Lewisham Healthcare NHS Trust and Queen Elizabeth Hospital, Woolwich. The Trust
organises its clinical services in a Divisional structure. The Division for Children & Young
People has three Clinical Directorates – Neonatal, Acute and Community. The three
Directorates are headed by a Clinical Director, each supported by a Service Manager. The
acute Directorate has a Clinical Director for each site. Lewisham Community Health Services
and University Hospital Lewisham had recently merged in April 2010.

Acute Paediatric Service at University Hospital Lewisham

The Children's Hospital, Lewisham was established in May 1991 following the closure of the
Children's Hospital, Sydenham.

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The Women's & Children's Wing was opened in October 1996, and houses the Children’s
Inpatient Services, including medical and surgical specialties, and the Neonatal Intensive
Care Unit (NICU).

In September 2010, the tertiary Paediatric Surgical Service incorporating complex,

emergency and neonatal surgery moved to the Evelina Children’s Hospital (ECH),
Paediatric General Surgical and ENT Day Case Surgery continues to be delivered primarily
from the UHL site.

The current acute service comprises the Children’s Inpatient Ward, the Children’s Day Case
Unit, Children’s Theatres and the Neonatal Intensive Care Unit. There is a dedicated
Paediatric Emergency Department incorporating a 4 bedded Short Stay Unit, and a separate
Children’s Outpatient Department.

The paediatric unit delivers secondary paediatric services to the local community as well as
a range of more specialist services including a Regional CF service (with Kings College
Hospital). Specialist outpatient clinics include diabetes, CF, TB, haemoglobinopathy ( Sickle
Cell), gastroenterology, epilepsy, cardiology, rheumatology, joint nephrology clinic, paediatric
surgery and joint neurology clinics, some of which are delivered in conjunction with visiting
tertiary specialists. Patients with complex medical problems are largely supervised by
consultants with a special interest or expertise in that area, although the consultant team will
provide support and advice across the whole range of conditions out of hours and as an
emergency.

Junior staff work entirely within the paediatric medical directorate and include full tiers at both
SHO and SpR level. Junior staff are on a shift pattern which ensures compliance with
EWTD. Within the constraints of this system SpRs are identified as having specific
attachments to a particular area and encouraged to attend the relevant clinics/MDT meetings
and ward rounds.

There are close links with our colleagues in the Children’s Community Service, Hospital
@Home team, and special needs nurse teams. Consultant colleagues attend the weekly
multi-disciplinary grand round whenever possible. Community and Acute Services for
Children and Young People are integrated within the trust and are under the same
management structure.

The Paediatric Emergency Department

The Paediatric Emergency Department (PED) is open 24 hours a day and sees
approximately 30,000 patients per year. There are eight dedicated SHO equivalents (2
Emergency Medicine trainees at ST3, 3 Paediatric trainees at ST3, and 3 GPVTS trainees at
ST2) and one middle grade post, who may be a sub-specialty trainee in Emergency
Medicine, or a Paediatric Staff Grade. Registrar support is always available from the SpRs
within General Paediatrics as one SpR is always allocated to cover the PED.

The management of the PED is within the remit of Children and Young Peoples Services,
day to day clinical management falls under the Paediatric EM consultants with support from
the general paediatric consultants when there is no cover and out of hours.

The department has a full complement of Children’s trained nurses, and a senior
nurse/lecturer, who works closely with medical staff in all aspects including teaching.

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 The Emergency Department at UHL has recently been comprehensively renovated and
upgraded (April 2012). The Paediatric Unit is co-located but separate from the Adult ED and
incorporates a 4-bedded Short Stay Unit, dedicated paediatric resuscitation bay, isolation
facilities and HDU cubicles. There is an adjacent Urgent Care Centre with GP sessions and
ENP sessions. The ENPs will see both children and adults, as will the GPs.
There is close working between medical and nursing staff. Nursing staff have extended roles
and can prescribe according to PGDs, they can order xrays at triage, and many have
phlebotomy skills and place intravenous cannulae.
There is also close working with the Adult ED espeically with regards to the management of
trauma, and some Consultants undertake sessions within the PED to maintain their skills in
looking after children.

The Paediatric Surgical Service

Currently, most Day Case Surgery takes place on the Day Care Unit here at UHL. This
includes general paediatric surgery, as well as ENT and trauma orthopaedics.

A General Paediatric surgeon from the Evelina Children’s Hospital (ECH) is on the UHL site
each weekday (except Friday) for an outpatient clinic and a day case list. Neonates with non-
complex neonatal surgical problems can be operated on on-site (Eg hernias, Broviac line
insertion. They can be available for advice although patients who need surgical review or
admission are transferred to ECH.

Paediatric ENT services are on site and the unit accepts referrals from the rest of South East
London. Non-trauma Paediatric Orthopaedics is based at ECH and KCH.

There is a regular Paediatric Ophthalmology operating session , as well as regular outpatient

clinics, and a weekly NICU ROP screening session.

Lewisham profile in brief

Lewisham is the fourth largest Inner London borough in terms of population size and the 12 th
largest in Greater London (2011 Census *)

Population data:
Lewisham Population * 275,900 (248,922 2001)

Population served by hospital approx. 300-350,000 (Lewisham and beyond)

Lewisham CYP population 0-19 years * 70,100 (63,000 2001)

Births per annum (Lewisham residents) * Over 5000
UHL births per annum (2011) 4000
Black & minority ethnic community
(Census 2001): All ages 33%
0-19 years 48 % of 0-19

Inpatient admissions:
 Neonatal (2010-11) 400 admissions
>500 ventilator days
>1000 ITU days)
 Paediatric Medical admissions 2500 approx

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 Daycare admissions:
 Paediatric Surgical day cases 970
Outpatient and ED attendances:
Hospital CYP outpatient attendances 2,500 New
5,300 Follow up
Paediatric ED attendances up to 30,000 (75-80 daily)

Hospital Consultants

Acute general and neonatal Paediatricians

Dr Jauro Kuna Consultant Neonatologist (Clinical Director Neonatal )

Dr Ozioma Obi Consultant Neonatologist (Safeguarding – NICU)

Locum Consultant Neonatologist

Dr Theresa Reyes Consultant Neonatologist

Dr Mahesh Nanjundappa Consultant Neonatologist

Dr John Stroobant (P/T) Consultant Paediatrician,
(Respiratory/Rheumatology)
Dr Charlotte Daman Willems(P/T) Consultant Paediatrician (Respiratory/Gastro)

Dr Tina Sajjanhar Consultant Paediatrician , Divisional Director

(Emergency Medicine; Haematology – non-Hb’opathies)

Dr Kum Gomez Consultant Paediatrician, (Epilepsy)

Dr Bobby Ruge Consultant Paediatrician (Respiratory)

Dr Joanna Lawrence Consultant Paediatrician

(Clinical Director, UHL site and Diabetes)

Dr Sarmad Kalamchi Consultant paediatrician (Gastroenterology)

Dr Farhana Khalil Consultant Paediatrician

(PEC – Paediatrician with expertise in cardiology)

Dr Suniti Bisht Consultant Paediatrician (Allergy)

Dr Sarah Wilkinson Consultant Paediatrician (Sickle)

Dr Anastasia Alcock Consultant Paediatrician ( Emergency Medicine)

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 Section 5. General Information about the Trust

Trust Profile
Lewisham and Greenwich NHS Trust was established in October 2013, following the
integration of Lewisham Healthcare NHS Trust and Queen Elizabeth Hospital in Woolwich.
The Trust provides a comprehensive portfolio of high quality acute healthcare services to a
critical mass of more than c.526,000 people living across the London Boroughs of
Lewisham, Greenwich and North Bexley together with a broad portfolio of community
services, primarily, but not exclusively, for those living in Lewisham. We are responsible for
NHS services at University Hospital Lewisham, Queen Elizabeth Hospital in Woolwich and in
a number of community settings throughout Lewisham. In addition, we provide some
services at Queen Mary’s Hospital in Sidcup. The Trust employs more than 6,000 staff on
both the hospital and community sites, which makes us one of the biggest employers in
South East London.

University Hospital Lewisham itself is in the centre of the London Borough of Lewisham and
provides a wide range of elective and emergency healthcare to an urban residential
population including people from a broad sweep of socio-economic and ethnic backgrounds.
The Trust also provides some emergency and tertiary elective services to residents of
neighbouring Primary Care Trusts, particularly Greenwich, Bexley and Bromley. The hospital
site, University Hospital Lewisham, is a campus for the Guy's, King's and St Thomas' School
of Medicine.

Our health professionals also provide care to adults and children across a range of health
centres, community clinics, and in patients’ own homes within the borough of Lewisham.
Adult services include community matrons, district nurses, the diabetes team, the Home
Enteral Nutrition (HEN) Team who provide care to people who need to be fed by a feeding
tube, and the sexual and reproductive health team. Services for children and young people
include health visiting, occupational therapy, physiotherapy and speech and language
services.

Queen Elizabeth Hospital is located in Woolwich, Greenwich and provides a broad portfolio
of primarily acute services for those living in Greenwich and North Bexley. The site currently
houses over 520 beds, 7 main theatres, 2 day theatres and state-of-the art imaging and
laboratory facilities.

Management Structure
The Trust Board is responsible for policy and the Trust Management Executive is
responsible for operational management. The Trust Chief Executive is Ben Travis
and the Acting Trust Board Chair is Val Davison. The Medical Director is Dr Elizabeth
Aitken.

Lewisham and Greenwich NHS Trust has five clinical directorates, each led by a
director who is a practicing healthcare professional. These directorates are:
 Surgery
 Women and Sexual Health
 Long Term Conditions and Cancer
 Acute and Emergency Medicine
 Children and Young People
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This structure helps us to draw upon the knowledge of experienced healthcare
professionals in the community and hospital, who work closely together. Our focus is
on providing the best services where they are needed – be it a hospital, community
health clinic or in a patient’s own home.

Medical Services
The Trust provides the full range of acute general hospital services: medical, surgical and
emergency services for the local community. We also provide a range of specialist surgical
services: ear, nose & throat, vascular and paediatric day care surgery, and services for
patients with cystic fibrosis.

As well as hospital services, Lewisham and Greenwich NHS Trust has over 700 staff
members in the community, providing and supporting a range of adults’ and children’s
services.

University Hospital Lewisham has 500 beds including a well-equipped 14-bed Critical Care
Unit providing level 3 and level 2 care, a 5-bed Cardiac Care Unit and a 46-bed Medical
Admissions Unit with 8 monitored beds providing level 1 care. The hospital has a highly
rated Stroke Unit linked to the Hyper-acute Stroke Service at Kings College Hospital. The
Vascular Surgery Unit at Lewisham Hospital specialises in carotid artery surgery. The
hospital has 11 operating theatres of which 2 are dedicated paediatric theatres and 1 is a
dedicated obstetric theatre.

Queen Elizabeth Hospital currently houses over 520 beds, 7 main theatres, 2 day theatres
and state-of-the art imaging and laboratory facilities.

Academic Activities and Research

The Trust has a well-developed partnership with Kings Health Partners (KHP), an Academic
Health Science Centre (AHSC) for South East London and works closely with them in the
delivery of local clinical services, research, education and training activities. The Trust is part
of the London (South) Comprehensive Local Research Network and of the South London
Academic Health Science Network (AHSN). The Trust plays a part in the well-established
clinical networks, predominantly for specialist services, including Cancer, Cardiac, Stroke,
Maternity and Neonatal services, across South East London. Participating in these networks
provides access for local people to tertiary centres for high quality specialist care whilst
ensuring patients are able to receive much of their care closer to home

Location, Housing and Transport

There is a wide variety of housing available in the North Kent area and many of the
consultant staff live in nearby Blackheath, Bromley, Beckenham or Greenwich where there
are good state and public schools as well as a variety of shopping centres.

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University Hospital Lewisham
Most of the hospital wards overlook the Ravensbourne River and Ladywell Park with lawn
tennis courts and a recreation area. The hospital is located on Lewisham High Street and is
very well served by public transport: bus, rail and DLR. Ladywell station is only five minutes
walk from the hospital through Ladywell Park and provides a convenient quarter hourly train
service. Ladywell Station is on the railway line between Hayes in Kent and London Bridge or
Charing Cross in Central London. Lewisham Station is 10 minute walking distance or a short
bus ride away from Lewisham Hospital. Trains from Victoria, Cannon Street and London
Bridge Stations run through Lewisham Station to all areas of Kent. The DLR terminates at
Lewisham Station.

Bus routes to Lewisham High Street are as follows:

208-Orpington via Bromley, 54-West Croydon, P4-Brixton, 199-Canada Water, 47- Deptford,
284-Grove Park Cemetry, 75-Croydon via Sydenham, 122-Crystal Palace/Plumstead,
136-Peckham/Grove Park, 185-Victoria, 484-Camberwell.
Furthermore, a cycle-to-work scheme is actively promoted by the Trust.

Queen Elizabeth Hospital

The hospital is located on Stadium Road and is well served by public transport: bus and rail.
Charlton, Woolwich Dockyard, and Woolwich Arsenal are only a short bus ride away from
the hospital. All stations are a short train journey from London terminals.
A number of buses stop outside or close to the hospital, including: 161, 178, 244, 291, 386,
469, 486.

Section 6. Application and Visiting Information

Applications for the post should be submitted in the form of the completed on line application
form.

For further information regarding the programme please contact Dr Joanna Lawrence via switchboard
on 0208 333 3000

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