DIVISION OF MEDICINE

JOB DESCRIPTION

TRUST JUNIOR CLINICAL FELLOW IN GENERAL MEDICINE & SPECIALTIES

(ST1-2 LEVEL)
Ref: 365-A-21-157549

POST SUMMARY:

 Applications are invited for ST1-2-level training posts offered by the Worcestershire Acute Hospitals
NHS Trust, based at the Worcestershire Royal Hospital. These posts are for a minimum of 1 year, with
a further 1 year period available. Some are new posts to support the expansion of the medical bed
base. Others are replacement posts for current staff.

 These posts are not Deanery posts. However, the posts are structured to provide a portfolio-based
Postgraduate Training Programme similar to the Deanery model. The Trust is committed to providing
the medical training content.

 The posts are for 1 to 2 years. The new wards that require extra support will be for General Medical
and Renal patients. However, we also have clinical fellows working in Respiratory Medicine, Stroke,
Acute Medicine, Infectious Diseases, Renal, Geriatrics, Cardiology, Gastroenterology and
Diabetes/Endocrinology. There will be opportunities to rotate to these other specialties in periods of
4-6 months, in part depending on the post holders’ preferences. The posts may also include Acute
Medicine participation in the on-call rota and/or ward cover in the evenings and weekends.

 The successful candidates will be welcomed to join the weekly teaching sessions and Grand Rounds.
In-house training will be provided for PACES/MRCP part II, and study leave will be available to help
candidates prepare for the examinations. At the end of the post a Certificate of Postgraduate Training
will be available

 Duties of the posts include care of acute medical admissions to hospital, short stay inpatients,
specialty outpatient clinics and portfolio-based procedures and competencies. Participation in audit
and research is encouraged. Training will be supervised by a named consultant.

 The typical candidate should have taken, or be preparing for Part I MRCP. The successful candidates
should be planning to take Part II MRCP during the period of the rotation. Completion of the post
should help prepare the candidate for further specialist training in the UK or abroad.

WORCESTERSHIRE GENERAL BACKGROUND

Worcestershire is a largely rural County, with four main towns, Bromsgrove, Kidderminster, Redditch and
Worcester, lying between the Cotswolds, Welsh Border and Birmingham. There are four further substantial
market towns of Malvern, Pershore, Evesham and Droitwich. Acute medical services are provided by two
District General Hospitals, a Treatment Centre and a number of Community hospitals.

The major motorway network of the M42, M5 and M6, providing excellent communications, intersect the
county. Local leisure facilities are well developed and the area has easy access to Birmingham/Solihull where
the National Indoor Arena, International Convention Centre with the Birmingham Symphony Hall and the
National Exhibition Centre are located. Stratford and the Royal Shakespeare Company are on the doorstep.
Worcester City lying on the banks of the River Severn has the world famous cathedral, County Cricket Ground,
Premiership Rugby and is home to the Royal Worcester Porcelain Factory. The Malvern Hills and the Wyre
Forest are in the locality.

Worcestershire has many sites of historical interest and natural beauty. The economy of the county is based
on agriculture, horticulture, light engineering and increasingly service industries.

There are a number of high quality state and private schools across the county and the University of Worcester
is continuing to expand and develop. The University has a £100m investment programme to provide for new,
improved and refurbished facilities. Recently completed projects include its new City Campus, home to the
Worcester Business School.

TRUST PROFILE
Worcestershire Acute Hospitals NHS Trust runs services from three main hospital sites: The Alexandra
Hospital, Redditch; Kidderminster Hospital and Treatment Centre; and The Worcestershire Royal Hospital.

We also run some services and clinics at The Princess of Wales Hospital, Bromsgrove (outpatient clinics);
Evesham Community Hospital (Burlingham Ward); Malvern Community Hospital (outpatient clinics); and
Tenbury Community Hospital (outpatient clinics).

We have three main commissioners: Redditch and Bromsgrove Clinical Commissioning Group; South
Worcestershire Clinical Commissioning Group; and Wyre Forest Clinical Commissioning Group.

We have an annual budget of £350million and service a population of more than 550,000 providing a wide
range of surgical, medical and rehabilitation services. We have nearly 6,000 staff and provide services
predominantly to the people of Worcestershire. However, patients do also come from further afield, most
notably from Herefordshire, Dudley, South Staffordshire, Shropshire, Warwickshire and Birmingham. Every
year we care for nearly 800,000 patients including 90,000 people who need operations, 130,000 people in A&E
and 500,000 outpatients. More than 6,300 babies are born in our Trust every year.

ALEXANDRA HOSPITAL, REDDITCH

The Alexandra Hospital in Redditch opened in 1985. It serves a population of approximately 200,000 and has
360 beds. The hospital is the major centre for the county’s urology service. The hospital has seven operating
theatres, MRI and CT scanners and cancer unit status for breast, lung, urology, gynaecology and colorectal
cancers. There is a multi-disciplinary education centre with library, teaching and study areas.

Our plan for the Alexandra Hospital is to increase the amount of planned elective activity carried out at the
hospital, especially in orthopaedics.

KIDDERMINSTER TREATMENT CENTRE

Kidderminster Hospital houses Kidderminster Treatment Centre which offers outstanding clinical facilities and
patient accommodation for a wide range of daycase, short stay and inpatient procedures. The nurse-led minor
injuries service is open 24 hours a day and treats more than 2,000 patients every month. It can deal with a
wide variety of injuries including simple fractures, soft tissue injuries, lacerations, bites, burns and scaled.
Other facilities at the Kidderminster site include a full range of outpatient clinics – including outpatient cancer
treatment in the Millbrook Suite – MRI and CT scanners and a renal dialysis unit. There is also a modern
education centre with seminar rooms, IT suite, library and break out areas.

Our plan for Kidderminster is to increase the number of daycase, short stay and inpatient procedures
performed and for it to become an elective centre for the Trust.

WORCESTERSHIRE ROYAL HOSPITAL

Worcestershire Royal Hospital is the latest of the Trust’s three sites. The main hospital was built under the
private finance initiative (PFI) and opened in 2002. It provides specialist services for the whole of
Worcestershire including stroke services and cardiac stenting. The hospital has nine operating theatres
including four laminar theatres. It has a level 2 neonatal intensive care unit and a cardiac catheterisation
laboratory. The 24/7 Primary Percutaneous Coronary Intervention (PPCI) service began in October 2013. It has
500 beds and serves a population of more than 550,000.
The county’s brand new, state-of-the-art Oncology Centre was officially opened by HRH the Princess Royal in
April 2015. Developed in partnership with University Hospitals Coventry and Warwickshire, the £25 million
Worcestershire Oncology Centre will enable 95 per cent of radiotherapy to be delivered within
Worcestershire. For patients, their families and their carers, who previously had to travel to Coventry,
Cheltenham or Wolverhampton for radiotherapy treatment, cancer services will be more accessible than ever,
saving an estimated one million miles of travel every year.

The Meadow Birth Centre has four birthing rooms and up to 1,000 women are expected to give birth in the
unit every year. The brand new £500,000 birth centre is run by 14 experienced midwives and 7 maternity
support workers, and opened in March 2015. The Centre offers a safe and comfortable environment for ‘low
risk’ women who have had no complications or medical problems during their pregnancy to give birth in.
University of Worcester Vice Chancellor Professor David Green has praised the Meadow Birth Centre following
a visit to celebrate the success of a joint working partnership.

Our plan for the Worcestershire Royal is for it to specialise in more complex and tertiary services for patients
from across the county, giving them access to services that they would previously have had to travel out of
county for. We have recently opened our state-of-the-art Worcestershire Oncology Centre, which will provide
radiotherapy services in county for the first time. Other developments include a dedicated Breast Unit which
opened in 2016.

MANAGEMENT STRUCTURE OF THE TRUST

Overall responsibility for the Trust rests with the Trust Board. Operationally the Trust is divided into five
divisions – Specialist Medicine, Urgent Care, Surgery, Women’s and Children’s and Specialised Clinical Services
Division. Services are run on a countywide basis.

JUNIOR CLINICAL FELLOW POST

These posts are designed to offer experience and training to doctors who wish to obtain the MRCP
qualification, and to pursue further training in acute or specialty medicine in the UK.

Working as a Junior Clinical Fellow (ST1-2 grade) in this Trust will combine exposure to acute unselected
general medicine, medical specialty training and a structured teaching programme similar to the Deanery
Programme.

Fellows will be allocated a consultant Programme supervisor.

Fellows will be welcomed to join the weekly teaching sessions and Grand Rounds. In-house training is
provided for PACES/MRCP part II, and study leave will be available to help candidates attend courses to
prepare for the examinations. At the end of a 2-year post a Certificate of Postgraduate Training will be
available.

All posts will rotate between the specialties in periods of 4-6 months, and many will include a component of
acute General Internal Medicine (GIM) on call and/or evening and weekend ward cover.

Specialty training will include care of inpatients, ambulatory care clinics, specialty outpatient clinics, and
portfolio-based procedures and competencies. Training will be supervised by a named consultant.

The typical candidate should have taken, or be preparing for Part I MRCP. The successful candidates should be
planning to take Part II MRCP during the period of the rotation. Completion of the post should help prepare
the candidate for further specialist training in the UK or abroad.

Undergraduate and Postgraduate Teaching.

The Trust’s inpatient hospitals are Associate Teaching Hospitals with the University of Birmingham Medical
School, and take part in undergraduate teaching of medical students in their third, fourth and final years.
There is also an active postgraduate training programme co-produced with the West Midlands Postgraduate
Deanery for Internal Medicine and GP VTS training, as well as Specialist Registrar training in most specialties.
These programmes include consultant supervision through consultants acting as clinical and educational
supervisors, weekly protected teaching time, and a training portfolio logbook of clinical competencies and
procedures. The Trust is already working closely with the University of Worcester’s Institute of Health and
Society and seeking ways of extending this collaboration.

DUTIES OF THE POST

General Duties - the details will differ in different Departments.

 Inpatients –consultant and registrar ward rounds, ward referrals.

 Acute medicine on-call
 Outpatients 1-2 clinics per week.
 Observation and assisting the consultant or registrar with relevant procedures and investigations.
 Attendance at multidisciplinary team meetings
 Attendance at Grand Rounds and other Medical Meetings
 Attendance at scheduled teaching sessions
 Participation in audit projects.
 Participation in Mortality & Morbidity case reviews.

TEACHING, AUDIT AND RESEARCH

The Consultants are keen to encourage audit and research projects. There is an active Clinical Audit Programme
and audit meetings are held once in two months for a full afternoon. All Medical Departments take part in the
audit projects regularly and the Fellow will be expected to contribute by undertaking and presenting audits.

CONTINUING PROFESSIONAL DEVELOPMENT

Worcestershire Royal Hospital’s Medical Department has regular lunchtime meetings on Mondays which includes
Journal Clubs, junior case presentations and teaching of Junior Doctors.

Clinical Audit and Governance meetings are held in most Departments once in two months. These meetings are
accredited for internal CPD and attendance is encouraged.

REVIEW OF JOB DESCRIPTION

This job description, together with the job plan, will be reviewed annually (if applicable) and agreed with the
Clinical Director and Lead Consultant to ensure that it continually reflects the areas of work, clinical
responsibility of the post and Trust requirements. It is expected that new appointments will carry out a diary
exercise.

RESEARCH AND DEVELOPMENT

Research is a key activity for Worcestershire Acute Hospitals NHS Trust, and we recently launched an ambitious
research strategy to double our activity in three years, believing this will enable patients to access the highest
quality services and retain health professionals. As such, post-holders are expected to engage with research, to be
aware of the trials taking place and make appropriate referrals where necessary. Many of our appointments are
active Principal Investigators for international clinical trials, having built up an excellent reputation with academic
and commercial sectors. Activity can be accommodated in supporting PAs ad negotiated in job plans.

Post-holders have access to a strong R&D department including a research nursing team and support to conceive,
design and conduct innovative research projects using state-of-the-art technology. The Trust has its own Islet
Research Laboratory, a purpose-built research unit that has conducted several pre-clinical proof-of-concept
studies in islet cell replacement therapy and stem cells. We are an active partner of the Clinical Research Network
West Midlands and work with clinical academic leads to attract research to the Trust. The Trust is also the host to
the Herefordshire and Worcestershire Research Consortium, a collaboration with Worcestershire Health and Care
NHS Trust and Wye Valley NHS Trust to streamline research between the Trusts. We also have links with academic
departments, including the University of Worcester.

Research activities are led by the associate medical director for research and development, and research
operations lead, who are overseen by the Research Expert Forum. Further information regarding the Department
can be obtained directly from R&D on 01905 760221 or contacting Emma Rowan, emma.rowan@nhs.net

CREMATION FORMS
The completion of cremation forms is considered a contractual obligation and forms part of your duties as a
doctor at this Trust. It is the Trust’s expectation that you will support the bereavement process by completing
relevant documents when asked and required to do so. All fees paid to the Trust, in relation to bereavement,
will be retained by the Trust.

COMPETENCE
The post holder is responsible for limiting his/her actions to those which s/he feels competent to undertake. If
the post holder has any doubts as to his or her competence during the course of his/her duties then s/he
should immediately speak to their line manager or supervisor.

CODES OF CONDUCT
All employees of the Trust who are required to be registered with a professional body, to enable them to
practise within their profession, are required to comply with their code of conduct and requirements of their
professional registration. Those staff who are not required to be registered with a professional body are
required to comply with the Trust’s codes of conduct.

CONFIDENTIALITY
The post holder must maintain confidentiality, security and integrity of information relating to patients, staff
and other Health Service business.

RECORDS MANAGEMENT
All employees of the Trust are legally responsible for all records that they gather, create or use as part of their
work within the Trust (including patient, financial, personnel and administrative), whether paper or computer
based. All such records are considered public records and all employees have a legal duty of confidence to
service users. Employees should consult their manager if they have any doubt as to the correct management
of records with which they work.

HEALTH AND SAFETY

Employees must be aware of the responsibilities placed on them under the Health and Safety at Work Act
(1974) and the Manual Handling Operations Regulations (1992) and all relevant Trust Health and Safety
Policies and Guidance. This ensures that the agreed safety procedures are carried out to maintain a safe
environment for employees, patients and visitors to the Trust.

INFECTION CONTROL
Employees must accept personal responsibility and accountability for Infection Prevention and Control
practice. Employees should ensure they are familiar with, and comply with, all relevant Infection Control
policies for minimising the risk of avoidable ‘Health Care Associated Infection’. All Employees must undertake
annual mandatory updates in Infection Control.

RISK MANAGEMENT
It is a standard element of the role and responsibility of all employees of the Trust that they fulfil a proactive
role towards the management of risk in all of their actions. This entails the risk assessment of all situations,
taking appropriate actions, and reporting all incidents, near misses, and hazards promptly. It is a contractual
obligation that all employees must co-operate with any investigations undertaken.

CHILDREN AND VULNERABLE ADULTS

You have a responsibility for promoting and safeguarding the welfare of the children/young people/vulnerable
adults that you come into contact with or are responsible for in your job role and sphere of competence.

DISCLOSURE AND BARRING SERVICE (FORMERLY CRB)

The Trust aims to promote equality of opportunity for all, with the right mix of talent, skills and potential.
Criminal records will be taken into account for recruitment purposes, only when the conviction is relevant.
The Trust will undertake the relevant Standard or Enhanced DBS disclosure in accordance with 2012 Protection
of Freedom Act and DBS guidance. In summary, a Standard Check will be used where an individual work is
concerned with the provision of healthcare services which is of such a kind to enable the holder of that
employment to have access to recipients of such services in the course of their normal duties. An Enhanced
DBS Check including the DBS/ISA barred lists if they engage in what is defined as “Regulated Activity” which
are jobs that involve caring/supervising or being in sole charge of children/ vulnerable adults.

EQUAL OPPORTUNITIES
The Trust has a clear commitment to equal opportunities for all in employment practices based on an
applicant’s ability, skills and aptitude for the post. A range of equality & diversity policy initiatives are in place
and all successful applicants are expected to familiarise themselves with these. It is therefore the duty of every
employee to comply with the detail and spirit of these policies and the law at all times. Any issues or concerns
you have should be taken up with the recruiting manager or the human resource team as soon as possible.

CONFLICT OF INTEREST
The Trust is responsible for ensuring that the service provided for patients and its care meet the highest
standard. Equally, it is responsible for ensuring that staff do not abuse their official position for personal gain
or to benefit their family or friends. The Trust’s Standing Orders require any member of staff to declare any
interest, direct or indirect, with contracts involving the Trust. Staff are not allowed to further their private
interests in the course of their NHS duties.

SMOKING POLICY
The Trust’s approach to smoking is in line with the government’s on-going initiatives for an eventual smoke-
free environment. It aims to adhere to the Worcestershire Health Community Campaign to help
Worcestershire stop smoking.

A no smoking environment policy exists within all Trust premises including entrances and exits to hospital
buildings and on other Trust property (with the exception of staff resident in staff residences, as these are the
homes of staff). In June 2014 a ban was implanted which meant staff, contractors and volunteers were no
longer permitted to smoke in any of the hospital grounds, including car parks.

Further to this, The Alexandra, Kidderminster and Worcestershire Royal Hospitals, have all become smoke free
to all patients and visitors as of 17 June 2015. This means that, as well as staff, members of the public,
patients and visitors are not allowed to smoke in any of the acute hospital grounds, including car parks.

DIGNITY
All employees must treat each person as an individual, offering a personalised service respecting people’s
dignity and modesty at all times.

The purpose of this post should remain constant, but the duties and responsibilities may vary over time within
the overall role and level of the post. The post holder may from time to time be asked to undertake other
reasonable duties. Any such changes will be made in discussion with the post holder in the light of service
needs.

Post Holder’s Signature:

Name: Date:

Manager’s Signature:

Name: Date: