Clinical Fellow Job Description - Nov 2016

YG ED Clinical Fellow in EM with PHEM, MedEd or MMQI

Job Description Nov 2016 v1.0

Betsi Cadwaladr University Health Board

JOB DESCRIPTION (COMBINED)



Nov 2016 v1.0

Title:

Clinical Fellow in Rural Emergency Medicine and either Pre-hospital Emergency Medicine (PHEM), or Medical Education/Simulation or Medical Management/Quality Improvement (MMQI)

Location:

Emergency Department, Ysbyty Gwynedd (Gwynedd Hospital)



Contents Introduction Who are these posts designed for? Community COTE

Our ED Rota, duration & pay PHEM, MedEd & Management/QI The hospital The city Lifestyle & Leisure Conditions of Service

Application procedure

General requirements NZ exchange option

Basic information about the posts An overview of the post requirements and options for flexible dates, post duration & job planning

Pages 2-3

Our wild-card option: can we tempt you to spend 4 months in community Care of the Elderly and really get to grips with keeping frail older patients in their homes? What to expect from our ED and the Clinical Fellow posts 12 months? 6 months? Shifts or on-call? Annualised hours, sessions? More detailed information about the “activity” options available (we can mix ‘n’ match!) Basic information about Ysbyty Gwynedd A few facts about Bangor A taster of life in North Wales – see website for more! Mostly, exactly what you would expect, with a little extra for the PHEM posts Check the Person Specification, contact us for a chat and apply via NHS Jobs. Applies to all BCUHB staff Fancy a period in NZ? We have links to a super ED in North Island & you might be eligible for a streamlined application process if you fancied working there.

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Visit our website The unofficial Emergency Department website – containing comprehensive FAQs about these posts and a wealth of other information about our ED and living in North West Wales – is at www.mountainmedicine.co.uk. Do have a look!

Prepared by Dr Linda Dykes, Consultant in EM – [email protected]

1

YG ED Clinical Fellow in EM with PHEM, MedEd or MMQI

Introduction



Job Description Nov 2016 v1.0



Our original Clinical Fellow posts (EM with 20% PHEM) were created six years ago and have been a roaring success. They were originally intended to provide a fun yet productive “year out” after ACCS, with the added attraction of pre-hospital activities. However, pre-hospital Emergency Medicine doesn’t appeal to everyone who might enjoy a year as part of our team, so we now offer three different varieties in our Clinical Fellow programme: • • •

Medical Education (which can include Simulation) Pre-Hospital Emergency Medicine Medical Management & Quality Improvement (MM/QI).

Having overflowed with Clinical Fellows in 2015/16 we expanded the number of posts for 2016/17 and filled them too: we are due to peak at 15 Fellows plus an ST3 and an ST5 in the second half of the 2016/17 academic year, although some are LTFT (easily accommodated). All our Clinical Fellow posts are designed to enable the post-holder to start/consolidate EM middle-grade responsibilities in the well-supported environment of a friendly rural DGH, with the added bonus of living in a very beautiful part of Wales, sandwiched between Snowdonia National Park and the glorious beaches of Anglesey. 80% of the post involves rural EM in a thriving ED that sees around 50,000 patients/year. Our tertiary units are around 100 miles away, so it is rare for our ED to be bypassed, and unlike many urban DGHs, we have kept most of our major trauma (quite a lot in summer!), STEMIs (we don’t yet have a PCI lab working 24/7 in North Wales), and acute strokes. 44 days per 12 months is spent undertaking one of our special activity packages, and, as well as this “activity time” (i.e. PHEM, MedEd or MMQI) there’s a weekly SPA session. We expect every Fellow to get involved with projects to enhance their CV such as protocol development, teaching, audit and research. We are also highly skilled at helping Fellows get their first publications and most of our Fellows gain their first conference posters whilst in Bangor: we help you make it happen! When it comes to the “Activity Time” (aka “playtime”), there are three activity packages available (see page 11 & our website for more detailed info): 1. PHEM: primarily consists of shifts with Welsh Ambulance Service Trust (on ambulances, rapid response vehicles, and – assuming you want to go flying - on Helimed). We can provide unique insights into the work of our local SAR colleagues (Mountain Rescue & SAR helicopters) via the Bangor Mountain Medicine Project, although sadly we are no longer able to access flying experience on the SAR aircraft since the replacement of RAF SAR with the new MCA SAR Helicopter. There is also the option of becoming involved in paramedic training. 12-month posts include your choice of funded pre-hospital course (usually PHTLS or ATACC) in PHEM time, in addition to the standard 10 days of study leave per year. Unlike most PHEM opportunities, we do take pre-hospital beginners and our PHEM Clinical fellows are encouraged to sit the DipIMC as soon as they have gained sufficient PHEM experience to become eligible. The posts are designed as “prep school for PHEM”, and are designed to equip post-holders with as many of the “essential” and “desirable” attributes required by the PHEM sub-specialty Person Specification as possible, as well as gaining a wide appreciation of the world of the ambulance service. Most importantly, we ask our paramedic colleagues to train our Fellows to become the kind of doctors they welcome at scene. Prepared by Dr Linda Dykes, Consultant in EM – [email protected]

2

YG ED Clinical Fellow in EM with PHEM, MedEd or MMQI

Job Description Nov 2016 v1.0

2. Medical Education (+/- Simulation): love teaching, but want more practice? We can offer a range of medical education opportunities. From teaching our medical students and junior doctors, to supporting paramedics and trainee ANPs, our MedEd Fellows will refine their teaching skills on the shop floor and in the classroom (lecture, small groups and one-onone tutorials), plus gaining experience of mentoring juniors. We can also access sessions teaching pre-registration paramedic students. Ysbyty Gwynedd has a well-equipped Simulation Suite, and the ED simulation programme is finally gaining traction since the appointment of our first MedEd Clinical Fellows in 2015/16, so an interest in medical simulation can be indulged. There is a well-established simulation programme for undergraduates & training in running simulation scenarios is available. 12-month posts commencing in time for the start of the academic year include funded enrolment onto a Post-Graduate Certificate in Medical Education course. For posts commencing mid-year, we will endeavour to find suitable short course(s) to attend. 3. Medical Management & Quality Improvement (MM/QI) – whether you are interested in medical politics, want to improve your Clinical Leadership skills, start your management portfolio or would like to gain experience designing and evaluating a quality improvement project, this variant of the Clinical Fellow programme is incredibly flexible. Working with colleagues locally, regionally, and nationally - at the very heart and highest levels of NHS Wales and Welsh Government - we are able to offer our MM/QI Fellows a programme of experience and project work that is both tailor-made and truly unique. 12-month posts commencing in time for the start of the academic year include funded enrolment onto a suitable Post-Graduate Certificate course (or first year of a distance-learning MSc). For posts commencing mid-year, we will endeavour to find suitable short course(s) to attend.

Opportunities unique to Bangor Since we created the concept of Clinical fellow posts incorporating “playtime”, other hospitals have copied the concept. We don’t mind – we know we have fantastic posts on offer, and we have some elements that nowhere else in the UK can offer. Totally unique to Ysbyty Gwynedd ED, Clinical Fellows are allowed to access the Bangor Mountain Medicine Database, which is the biggest of its kind in the world (nearly 1400 cases since 2004) and proving its worth as a goldmine for extracting material for conference abstracts! See www.scribd.com/BangorED for a taster. Those who help to maintain the Mountain Medicine Database may get a chance to add a national speaking engagement to their CV: we share them out! Visit www.mountainmedicine.co.uk to find out more. For Clinical Fellows with a PHEM interest, our relationship with local SAR colleagues mean that we have incredible access to SAR, Mountain Rescue teams, and HART team training facilities. And for everyone, we have the experience of Rural Emergency Medicine: a unique and rewarding aspect of UK EM that city training alone cannot prepare you for.

Prepared by Dr Linda Dykes, Consultant in EM – [email protected]

3

YG ED Clinical Fellow in EM with PHEM, MedEd or MMQI

Job Description Nov 2016 v1.0

Who are these posts designed for? These posts were originally designed for post-ACCS trainees wanting a “year out” prior to Higher Specialist Training. We typically have some post-ACCS EM Fellows on OOPE, some postACCS-anaesthetics/AM after CT3, and a few who are only able to squeeze in a six-month post (though note that minimum 10 months EM experience is required posts less than 12 months’ duration). We have also started to attract post-residency European EM specialists who want to experience EM in the UK (where the specialty is more established), before returning home to consultant posts. ACEM have previously approved our post for an Australasian EM trainee. The jobs are created around a template of a 13-session, full-time posts including 2 sessions a week PHEM, Medical Education or MM/QI (averaged over year, so 44 days per 12 months after AL/SL week taken into account). Applicants wishing to work less than full time are most welcome and very easily accommodated, with a pro-rata reduction in PHEM/MedEd/QIMM in job plans of 12 sessions or fewer. Our Clinical Fellow posts are not recognised UK training posts. This is deliberate: we know many EM trainees would like a year free from endless tick-box WPBAs (although the mandatory annual appraisal sadly does entail some eportfolio-like activity) and want to delay their CCT. We treat our Clinical Fellows very much like our StRs: post-holders have a named, enthusiastic educational supervisor (whose job plan provides sufficient time to look after supervisees) and are supported in undertaking a wide range of CV-enhancing activities. Most Fellows do, in fact, keep their e-portfolio entries going, and two have successfully applied for their year with us to be a mixture of OOPE and OOPT (although they do have to do 6/12-worth worth of WPBAs). In addition to this Job Description, there is very comprehensive information section on our website: www.mountainmedicine.co.uk which potential applicants are strongly advised to visit. Our website also includes lots of information about our ED & living in North West Wales. • •

•

•

• • •

Applicants must have competed UK ACCS (3 years) or be able to demonstrate equivalent competencies in EM, AM, ICM and anaesthetics. About 2/3rds of our Clinical Fellows are EM trainees, however, Anaesthetic or Acute Medicine trainees with at least 6 months prior EM experience are very welcome. If you need a 6-month SHO-tier EM post to become eligible, talk to us – we are sometimes able to offer a “Gateway Post” (usually 6/12 SHO-tier followed by 12/12 Clinical Fellow). Non-EM trainees are restricted to 12-month posts, whereas those who have completed ACCS EM and hold MRCEM (or who have at least 10-12 months EM experience by another route) may apply for posts anywhere from 6 to 12 months in duration. Some of our Clinical Fellows are taking a year out after CT/ST3 (or are returning from time abroad post-ACCS) but increasingly, most are on OOPE from EM training, after ST3 or ST4. If you are considering coming to us on OOPE, please talk to your Training Programme Director before applying: many deaneries insist on 6-months notice for OOPE applications, and some do not allow OOPE before completion of ST4. This recruitment round and Job Description is specifically for posts with starting dates between & including August 2017 and August 2018. All Fellows to date who came for 6 months have either stayed longer, or wanted to but had to go back to their NTN: it is difficult to get the full experience in only 6 months. Option to extend longer than 12 months, subject to spaces & satisfactory performance.

Prepared by Dr Linda Dykes, Consultant in EM – [email protected]

4

YG ED Clinical Fellow in EM with PHEM, MedEd or MMQI

Job Description Nov 2016 v1.0

The wildcard option: your chance to spend 4/12 in Community COTE What & why? Complex elderly medical patients are already a major part of EM workload in the UK, and over the next 25 years the number of over 80s is going to treble. All of us need to get better at Care of the Elderly, and yet our current EM training path via ACCS typically include little or no COTE: most post-MMC Emergency Physicians are lucky if they’ve had 4 months as an F1 or F2 (and pre-MMC EPs are little better!) but most have had no specific COTE training since med school. Hence, we are excited to offer a unique option to enhance your year in Bangor: four (or more) months doing Community COTE on the Isle of Anglesey, as part of the Mon Enhanced Care (MEC) team, a 5-day “Hospital at Home” service seeing patients in their own homes who either are ideally suitable for home treatment, have refused to go to hospital, for whom remaining at home is the agreed ceiling of care, or who require such frequent visiting and medication fiddling that their would be unfeasibly time-consuming for their hard-pressed GP. It’s a different world to the ED (one of our consultants, Clinical Fellow Programme Director Linda Dykes is doing at on secondment at the moment, see http://bit.ly/2c1H7dw ) but the patients are exactly the same as those that arrive in ED, and learning how to assess and manage them in situ (albeit with the assistance of point of care U&Es!) is both challenging, fascinating and eye-opening. The MEC team has a 3-tier system for clinicians. At the top is the Consultant in COTE who is available for advice daily, conducts a twice–weekly Board Round and undertakes domiciliary visits if required. He’s fantastic and extremely supportive. Next are the “decision making clinicians” – currently, a hugely experienced ANP and two part-time GPs (one of whom is our consultant, who’s dual qualified). Then there are “eyes and ears” clinicians, who aren’t expected to make major treatment decisions independently, but gradually build up in capability from being the ANP’s sidekick to seeing patients independently and conjouring a management plan with the support of either the COTE consultant or one of the decision-makers. We’d expect a typical post-ACCS Clinical Fellow to spend a good part of the 4 months in the “eyes and ears” role (plus orientation days with OT, physio, heart failure team etc) before transitioning up to a supported decision-making role. The job plan for a full-time 4-month COTE secondment could be your choice of either a 10session-a-week, Monday-Friday post all within office hours (ish) including two sessions a week of your chosen playtime (if PHEM, we would expect you to concentrate your WAST shifts on Anglesey during your time with MEC, as we are planning to start taking referrals from WAST crews) or - in order to maintain the same pay as when in the ED - a 13-session job plan to include some night/weekend shifts in the ED. Annual leave would be taken pro-rata within the secondment, as would your choice of playtime. LTFT job plans easily accommodated. The Community COTE option is brand new for our 2017/18. We would very much like to find three Fellows who each want to do 4 months in COTE, not least because we have limited posts available for August 2017 (we have several post-holders running Feb 17-Feb 18, plus some deferred starts from last year’s recruitment) and if we have three volunteers for Community COTE, we have squeeze in another whole person! We would be looking to capitalise on the PR value of any Fellows wishing to undertake COTE, and there is definitely publication potential too. To discuss further, please contact Linda. Prepared by Dr Linda Dykes, Consultant in EM – [email protected]

5

YG ED Clinical Fellow in EM with PHEM, MedEd or MMQI

Job Description Nov 2016 v1.0

Our Emergency Department The service Our Emergency Department at Ysbyty Gwynedd (in Bangor) provides a comprehensive 24-hour service for all emergencies. Led by a dynamic team of consultants, all of whom have completed a modern UK training programme in Emergency Medicine culminating in passing the FRCEM by examination, Bangor ED has an international reputation for nurturing the talent of ED doctors in training. We see around 50,000 new attendances per year, including emergencies from all specialties, and new Fellows usually comment that are surprised by the breadth and quality of the ED casemix. Our proximity to Snowdonia and the popularity of outdoor pursuits and hazardous sports in the area mean that we see a disproportionately large number of major and minor trauma cases: we are famous for our mountain trauma (almost 40 trauma calls each year from mountain fallers) and we also see sporting, motorbike, farm, watersport and equestrian-related trauma, as well as the usual RTC-related trauma and occasional drowning victims. However, penetrating trauma is extremely rare and assault-related trauma uncommon. We work as a Major Trauma Unit, and are part of the West Midlands Trauma Network (except paediatric trauma, for which our Paediatric MTC is Alder Hey in Liverpool) and work very hard to constantly refine our trauma response. Some daytime major trauma cases bypass Bangor and go directly from scene to our MTC in Stoke via EMRTS aircraft, but we still handle all major trauma in bad weather/poor visibility/low cloud (which is much of the time: there is a mountain range between Bangor and Stoke!), after 7pm, and if EMRTS is busy elsewhere. The ED is supported by a full range of inpatient services, including paediatrics and O&G, although some specialties are networked across North Wales e.g. vascular, maxillofacial surgery, and out–of-hours ophthalmology. Our Helicopter Landing Site is just behind the building and a high proportion of our sick patients arrive by either Helimed or SAR helicopter (now provided by the MCA in the Bristow S92). We currently have limited access to PPCI for STEMI (via Glan Clywd hospital, 35 miles East, and not 24/7) and so both paramedics and the ED thrombolyse STEMI patients. Stroke thrombolysis runs 24/7, but is undertaken by the medics/stroke physicians. The GP Out Of Hours service is co-located with the ED, and we have a close relationship with them: our triage nurses can direct ED attenders straight to GP OOH when appropriate. Our longterm goal is to further integrate the services to provide a “one stop emergency care shop” in the future. We have our own 5-bedded Observation Ward, and our middle grades are involved with the running of this facility, and an Acute Frailty unit is due to open in the hospital in winter 2016/7. Plans are well underway for a complete redevelopment and expansion of the Emergency Department at Ysbyty Gwynedd, which is much needed! Once building starts, this will be an 18month project, so applicants for these posts may be joining us whilst we are living in the midst of a building site, but it is a very exciting time for the ED.

Prepared by Dr Linda Dykes, Consultant in EM – [email protected]

6

YG ED Clinical Fellow in EM with PHEM, MedEd or MMQI

Job Description Nov 2016 v1.0

The staff The Emergency Department medical staffing currently comprises: • • • •

• • • •

5 x consultants (plus a locum covering sessions dropped by those LTFT in the ED) 2 x Associate Specialists, who take part on the consultant/senior on-call rota 1 x Wales Deanery EM ST5 (LTFT) 1 x EM ST4 on OOPT from Yorkshire Feb 2017-Feb 2018. We could accept another EM ST4-6 on OOPT from Feb 2018, but you need to apply as if for a Clinical Fellow post to compete for a slot, and on 100% OOPT there’s no playtime except the SPA session. 1 x Wales Deanery EM CT/ST3 10 x Clinical Fellows (rising to 15 over the next few months) although some are LTFT 8 x SHO-tier posts (a mixture of F2 doctors, ACCS and GP trainees) and one Academic F2, and until Feb 2018 we also have three additional “F3” doctors. In addition, our well-established Emergency Nurse Practitioner service handles most of our Minor Injuries workload 7/7, we have our own Specialist Physiotherapist, and we are training Advanced Nurse Practitioners to work in the Majors area.

The Clinical Fellow posts are on the middle-grade tier and work under the direction of the Consultants and Associate Specialists and are involved in the immediate care of acutely ill and injured patients of all ages, acuities, and presenting conditions. All current middle grades and seniors either have, or are working towards, CEM Level 1 accreditation in ED ultrasound and the appointee must be willing to train in ED point-of-care ultrasound (POCUS) if not already undertaking this activity. What to expect: the culture of our ED Bangor ED is a small and friendly department. We all live and work in the same community. Our ability to function professionally depends on excellent relationships with specialty colleagues – and if we are ill or injured, we often have to treat each other. This brings a unique dynamic to the ED that is very different to many city emergency departments: we are politely assertive about the role of Emergency Medicine within the hospital, but aggressive behaviour towards other specialties is unacceptable. Whilst there is plenty of room for a full range of personalities, the negative & disengaged behaviour that is culturally acceptable in some large hospitals does not go down well here. Thankfully, most new doctors settle here really well and thoroughly enjoy working in our ED, which means it is a much happier place to work in than many other UK departments! What to expect: why our Clinical Fellows have fantastic CVs when they leave us Our Clinical Fellows are generally dynamic individuals, many of whom want to take a break from the sausage-machine demands of deanery training posts, but who are keen to develop professionally during their time in Bangor. We do expect a lot of our Clinical Fellows, but we endeavour to put a lot back in return, and the feedback from previous post-holders has been exceptional: 95% would recommend the posts. Several former Fellows are poised to return to us as consultants, and all of our Clinical Fellows

Prepared by Dr Linda Dykes, Consultant in EM – [email protected]

7

YG ED Clinical Fellow in EM with PHEM, MedEd or MMQI

Job Description Nov 2016 v1.0

who have so far applied to re-enter Higher Specialist Training following their time in Bangor have done so uneventfully. Additionally, all those who have so far applied for PHEM subspecialty training have been offered a place. All Clinical Fellows must be willing (with appropriate senior support) to participate in the teaching and supervision of the SHO-equivalent junior doctors, ENPs, paramedics and medical students. There is an active audit programme, weekly junior doctors’ teaching, and a weekly middle-grade teaching plus journal club (run by the SpR/StR and Clinical Fellows). A DipIMC Exam Prep Group starts once entries to the exam are confirmed. We produce nationallyacclaimed conference reports when we have been to CPD events (Fellows are expected to participate!) and occasional ED newsletters highlighting patient safety and governance issues. You can see some of our material at www.scribd.com/BangorED The Clinical Fellow team are also responsible for co-ordinating the monthly ED M&M meetings (you get two juniors to help you!) and developing our fledgling ED Simulation programme. It has also become a tradition for the Fellows to run CPD days for local EMS colleagues, which is also an excellent way to build your skills and confidence presenting to large groups. Participation in research projects is encouraged: this need only be low-key (it doesn’t need to be scary!) but Clinical Fellows are usually at a career stage where CV development is essential, and it’s much easier to do these things during a “year out” rather than in ST5/6 at the same time as wrestling with exams. We have an almost-100% record of our Clinical Fellows having at least one new entry in the “Publications” section of their CV from their time in Bangor: we are the leading unit in Wales for presentations at College of Emergency Medicine academic conferences, with multiple free papers, moderated poster and poster presentations at every CEM conference since 2006. All staff are expected to attend courses relevant to their practice and continuing medical education – the funded study leave allocation is 10 days per year, but some of the 44 days of activity time can also be used to attend CPD activities (although not necessarily paid for by the hospital!). Clinical Fellows are required to engage in Educational Supervision meetings with their nominated supervisor – our Learning Contracts include our commitment to provide constructive feedback to support personal and professional development, set goals and support projects, and we expect our Clinical Fellows to demonstrate their commitment in return. Plus, like all doctors outside the training grades, Clinical Fellows must participate in an annual appraisal, which is also required to maintain your progress towards GMC revalidation. Ysbyty Gwynedd ED is home to the Bangor Mountain Medicine Project, a partnership between the ED and local Search & Rescue providers (HMCG SAR helicopter crews, Mountain Rescue). As well as maintaining a database of every mountain casualty brought to the ED by SAR providers, the Mountain Medicine project hosts hugely popular medical student placements, and runs occasional conferences for our pre-hospital and SAR colleagues. As part of daily life in the ED, all our Clinical Fellows are expected (with appropriate guidance and support) to co-supervise medical students on attachment to the ED, as well as visiting prehospital personnel such as WAST paramedics and SAR winchmen. Of course, our MedEd Fellows take this process one step further and will use some of their MedEd days to perfect the art of shop-floor teaching.

Prepared by Dr Linda Dykes, Consultant in EM – [email protected]

8

YG ED Clinical Fellow in EM with PHEM, MedEd or MMQI

Job Description Nov 2016 v1.0

If this all sounds like a lot of work, you’re right, but it is shared out between a team of 12+ people, supported by enthusiastic consultants who have dedicated time to look after the Clinical Fellow scheme. Plus, every Clinical Fellow has a 4-hour session for these Supporting Professional Activities each week (i.e. totalling the equivalent of 22 days each year after AL/SL) that is paid but not timetabled, so can be undertaken flexibly.

The Posts: duration, rota & pay The advertised post(s) are fixed-term appointments of 6-12 months (see Person Specification for stricter eligibility for 6-month posts) with starting dates from August 2017 up to and including August 2018. Many post-holders opt to extend their posts and stay with us longer, which is an option available subject to satisfactory performance and space being available. The basis of the Clinical Fellow posts is that the post-holders will be released from the ED for an average of 2 sessions per week (totalling 44 days in the 12-month period = 2 sessions/one day per week, less 6 weeks of AL and 2 weeks of SL) to undertake activities relevant to PHEM/MedEd/MMQI (see above). This will sometimes be on a block basis. Applicants for the PHEM posts should note that WAST shifts are longer than ED shifts: postholders may choose to count each WAST shift (12 hours) as 1.5 ED shifts. However, most postholders prefer to maximise their PHEM experience and accept that hours in excess of 8 per (PHEM) shift are either unremunerated or come from the SPA allocation. Some post-holders choose to use a few of their PHEM/MedEd/MMQI days in ITU or the Operating Department to ensure that their skills do not decay – basically, the 2 sessions/week of “activity time” may be used to undertake any activity that facilitates the individual’s professional development. The post holder will be responsible to the Clinical Fellow Programme Director (Dr Linda Dykes) and their Educational Supervisor (currently Dr Linda Dykes, Dr Pete Williams or Dr Helen Salter) plus the other Emergency Medicine Consultants. Precise duties will be determined by a weekly rota, but the post holder may be offered or asked to do extra shifts occasionally according to the needs of the department. Pay The pay scale for the post is based upon the Specialty Doctor scale of £36,807.00 to £68,638 for basic 10-session contract, but gross pay for those on the standard 13-session job plan is at least 30% more than this. The current rota is based upon 12 sessions per week (including 2 sessions of chosen activity) plus one (non-timetabled) SPA/admin/CPD session, therefore attracting remuneration of 13 sessions per week. We can easily accommodate job plans of fewer than 13 sessions: “playtime” is reduced pro-rata for job plans of 12 or fewer sessions (although those on 10 sessions or more play a full part in the night & weekend rota as this is still counted as full-time) and we can sometimes allow extended periods of unpaid leave mid-year: two of our current Fellows are taking advantage of this, one to spend the ski season in the Alps and the other to do a trauma elective in South Africa. Obviously, this is dependant upon staffing levels at the time, not everyone can go at the same time! The usual jargon applies: the exact point of scale is determined upon verification of previous NHS service. The post is subject to the Wales NHS Hospital Medical and Dental Staff terms & conditions of service.

Prepared by Dr Linda Dykes, Consultant in EM – [email protected]

9

YG ED Clinical Fellow in EM with PHEM, MedEd or MMQI

Job Description Nov 2016 v1.0

Rota Our Clinical Fellows and ST4-6s share a full-shift middle grade rota, with our EM ST3 contributing to those shifts that are suitable for ST3 or ST4+/Clinical Fellow. In August 2016 we introduced an annualised rota, devised and run by Dr Rich Griffiths, who is currently a locum consultant with us after being a Clinical Fellow in 2012/13 and an ST6 on OOPT for the final six months of his training. Our annualised middle grade rota is about as far away from the horrors of a rolling rota with fixed annual leave as you can imagine, but it is complicated for those only accustomed to banded junior doctor rotas. Here’s how it works: If everyone on the rota does exactly the same number of each type of shift (i.e. without any annualisation) then, assuming a full-time job plan of 13 sessions (10 clinical, 2 activity, 1 SPA) the following would happen: •

•

Night shift frequency = inversely proportional to the number of doctors. The absolutely maximum night frequency is 1:8, and we aim for no more frequent than 1:10. Our 2016/17 Fellows have just voted to stay on a 1:10 nightshift frequency (instead of lowering to 1:14/15 as more people arrive) to reduce pressure on their junior colleagues whose night shifts are much more frequent. Weekend frequency = between 3:7 and 3:8 or mathematical equivalent. We’d love to reduce the weekend frequency, but removing the need for top-up weekend locums is how we’ve paid for expanding the number of posts.

How does an annualised rota work? Because we use the SAS doctor pay-scale (calculated in sessions, with a weekday daytime session bring 4 hours and evening, weekend and night shifts sessions 3 hours) we can offer an annualised rota, in line with the RCEM recommendations for sustainable working. It means your shifts can start to fit around your life, instead of vice versa. Not all shifts are not created equal… Over a 12-month post, imagine that a standard full-time 13-session Clinical Fellow has (e.g.) 440 sessions rostered to the ED shop floor. But whereas a standard 8-hour day shift is 2 sessions, a 10-hour night or weekend shift is 3.33, with weekday evening shifts are in between. This means: • •

If you work more proportionately more night or weekend shifts, you could work fewer shifts overall and enjoy more days off (which can then be added to your AL). If you work proportionately fewer nights or weekends, you’ll have more weekday daytime shifts, but work a higher number of shifts (but not more sessions) overall.

The full benefit of annualising is only seen if, within the rota participants, there are a range of preferred shift patterns – if everyone wants the same, there’s no benefit. That is a risk with a whole bunch of “typical” Clinical Fellows (usually around 30, rarely with kids). However, it’s usually not too difficult to at least find someone who doesn’t mind night shifts but wants to reduce weekend frequency (e.g. spouse/partner lives outside of North Wales) and someone who doesn’t mind working a higher weekend frequency in return for more weekday days off (e.g. mountain bunny who wants to get out into the hills when there are fewer tourists!).

Prepared by Dr Linda Dykes, Consultant in EM – [email protected]

10

YG ED Clinical Fellow in EM with PHEM, MedEd or MMQI

Job Description Nov 2016 v1.0

To fully enjoy the many benefits of an annualised rota system, a collegiate approach to rota planning is essential, with civilised & open communication, and give and take on all sides. Remaining engaged is essential – we use private Facebook Group for communications and all participants have to check social media regularly. We sort out the Christmas & New Year rota by gathering all Clinical Fellows into a room (those who can’t attend appoint a proxy to represent them) and reaching a consensus everyone is happy with. Of course, if a majority of appointees decided they prefer a traditional, inflexible rolling rota, we can switch back, but we really wouldn’t recommend doing so!

Further details of the options available Option 1 – Pre-hospital Emergency Medicine (PHEM) Many applicants to our PHEM posts are at least considering a career incorporating PHEM, and make use of the post as preparation for a future application to undertake PHEM sub-speciality training by building up their PHEM-logbook prior to sitting the DipIMC. However, we also welcome applicants whose interest lies in gaining a deeper understanding of how unscheduled care services in a rural area fit together, as well as doctors seeking a fun and productive “year out” between EM ST3 and ST4 with a “taster” of PHEM, plus experience of EM outside the city teaching-hospital setting. We are happy to accept PHEM beginners. As well as work with Welsh Ambulance Service Trust (WAST), our excellent relations with local Search & Rescue providers (SAR, RNLI, MRT) often enables us to offer activities that provide a unique insight to these specialised areas of PHEM work. The main PHEM activity undertaken will be practical, on-the-job training with experienced WAST paramedics, on ambulances, Rapid Response cars and the Welsh Air Ambulance (H61) based at Caernarfon airport. H61 will be coming under the governance arrangements of EMRTS sometime in the next few months, but (apart from requiring a second honorary contract in addition to the WAST one) we do not anticipate major changes in Fellows’ access to Helimed shifts. Do be aware, however, that helicopter shifts are subject to weight limits, and comprise an absolute maximum of 50% of PHEM shifts. This maximum can be difficult to achieve now we have so many Fellows flying with H61, and is mathematically impossible unless you opt to do some Helimed shifts at weekends. These will not count towards your 3:8 weekend frequency, but of course you’d take your weekday rostered PHEM day off in lieu. We also arrange opportunities tailored to individual needs and interests, with previous examples including: • • • • • • •

Visits to ambulance control (at least one shift there is compulsory) Observer day with the Emergency Medical Retrieval & Transfer Service (EMRTS) aircraft flying on the Welsh Air Ambulance aircraft based in Welshpool Observing/assisting with the training of SAR helicopter technicians and paramedics Extrication and scene safety training Participation in (+/- involvement in the planning of) major incident exercises Training with relevant Primary Care (e.g. GP Out of Hours & District Nurses) Observing/participating in HART team training (confined space, rope access & water rescue).

Prepared by Dr Linda Dykes, Consultant in EM – [email protected]

11

YG ED Clinical Fellow in EM with PHEM, MedEd or MMQI • • • • •

Job Description Nov 2016 v1.0

Training in forensic awareness at scene Monthly regional pre-hospital simulation training (attendance is expected if not on shift in the ED or on AL) Attendance at Helimed & EMRTS Clinical Governance days Visits to RNLI station & coastguard base Assisting with mountain rescue training by playing casualty for scenarios

In addition, the ED consultants facilitate networking to enable the Clinical Fellow to gain additional experience – both paid and unpaid – in their own time. For example, sporting event medical cover and event medicine cover. Some Clinical Fellows also join the local BASICS scheme, the North Wales Emergency Doctor Service (NWEDS). The goal of the PHEM experience is to produce doctors who are comfortable utilising their existing skills in the pre-hospital setting; who understand how UK paramedics work and how the unscheduled care system fits together in a rural area; who are welcomed as valuable additional WAST teams members; who know how to work safely in and around helicopters; and who have been exposed to the wide range and acuity of rural UK PHEM cases. The range of PHEM cases seen by our Clinical Fellows is much broader than in most UK physician-supported PHEM systems, but with the trade-off that the proportion of very highacuity cases seen will be less. However, the whole point of the posts is that they are much more than “just” a Helimed job. Post-holders will be expected to maintain a logbook of PHEM cases they have seen: those contemplating a career incorporating PHEM are expected to sit the Diploma in Immediate Medical Care of the Faculty of Pre-Hospital Care of the RCSEd as soon as they are eligible. A DipIMC preparation group starts early each year in readiness for the summer diet of the exam. Please note: applicants for the PHEM posts who still have a GMC’s “Approved Practice Setting” requirement must be in good standing with the GMC and the Trust as the BCUHB Medical Director’s permission is required to allow work outside of the APS setting of the hospital. Courses/qualifications Our 12-month posts include a fully-funded pre-hospital course such as PHTLS, or ATACC. Holders of posts under 12 months’ in duration can use study leave undertake any of these courses, but we do not guarantee funding it.

Prepared by Dr Linda Dykes, Consultant in EM – [email protected]

12

YG ED Clinical Fellow in EM with PHEM, MedEd or MMQI

Job Description Nov 2016 v1.0

Option 2 – Medical Education MedEd is the new “Must Have” for all hospital doctors, as Educational Supervisors are now required by the GMC & Deaneries to provide evidence of formal training as medical educators. You could wait until you hold your CCT before trying to get to grips with this at the same time as wrestling with your first consultant post – or you could come to us for a year and spread your MedEd wings in our Clinical Fellow MedEd post, whilst also enjoying a year of rural EM & living so close to the outdoor playgrounds of Snowdonia and Anglesey. We can offer a variety of learners for you to work with. In the ED, there are medical students, Physician Associate students and student nurses as well as our junior doctors, all requiring both shop floor teaching and small-group tutorials. Inside the hospital (but outside the ED) our middle grades are always in demand to support the F1 and specialty teaching programmes. Outside the hospital, we work with ORMS (a civilian paramedic training provider, whose HCPCrecognised pre-registration paramedic course is optimised for SAR paramedics) to provide teaching practice for our Clinical Fellows, who can become involved with paramedic training under the watchful eye of qualified educationalists, with written feedback. We also host paramedics and SAR winchmen of all levels of experience in the ED, and there are usually a couple of nurses or paramedics undertaking their MSc in Advanced Clinical Practice, all of whom require a clinical mentor/teacher whilst on placement in the ED. If you are an instructor for ALS/APLS/ATLS, you will be welcomed with open arms by our Resuscitation Training Department. If you’re not – and want to be – we can brief you what the faculty are looking for in candidates of these courses when “instructor potential” candidates are identified. The Clinical Fellow Programme Director has a PGCertMedEd, and we also seek out other guest teaching/lecturing opportunities for Clinical Fellows, in order to provide a varied teaching portfolio. Simulation Ysbyty Gwynedd has a very well equipped Clinical Skills Lab including a good simulation suite. Although the ED in situ simulation programme is still in its infancy (we are only in our second year of having dedicated MedEd Fellows) the undergraduate Simulation Programme is extremely well established. Training in running simulation is available, so our MedEd Fellows will continue the process of establishing simulation as integral to the EM teaching programme. Courses/qualifications 12-month posts commencing in time for the start of the academic year include funded enrolment onto Post-Graduate Certificate in Medical Education course, either at Bangor University (which includes some face-to-face taught sessions) or the Cardiff University distance learning course. For posts commencing mid-year, and 6-month posts, we will endeavour to find suitable short courses to attend to produce a solid portfolio of MedEd-related CPD.

Prepared by Dr Linda Dykes, Consultant in EM – [email protected]

13

YG ED Clinical Fellow in EM with PHEM, MedEd or MMQI

Job Description Nov 2016 v1.0

Option 3 –Medical Management/Quality Improvement (MM/QI) Possibly the most flexible of all our Clinical Fellow posts, the MM/QI post activity time is totally tailored to the post-holders’ interests. We have been pledged support by a wide range of medical, managerial and political leaders both locally and regionally within BCUHB, and nationally at the highest levels of both the NHS in Wales and in the Welsh Government. Post-holders are able to explore and gain experience in whichever areas hold most personal appeal, be that mainly QI, mainly medical management/politics, or a mixture of both. Quality Improvement – theory and practice We are lucky to work closely with an incredibly talented colleague, Dr Chris Subbe, a highprofile consultant in Acute, Respiratory and Critical Care Medicine who runs a successful QI Fellowship within his own team and who is keen to support ours – the obvious target for a project being something that crosses the EM/AM interface. As a medical registrar in 2000, Chris identified delayed recognition of critical illness as a key patient safety issue. His group published the first peer reviewed paper on a Modified Early Warning Score (MEWS), the first interventional trial using MEWS and a range of further peer reviewed publications in this field (http://www.ncbi.nlm.nih.gov/pubmed/?term=Subbe). He was a member of the group at the Royal College of Physicians recommending a National Early Warning Score, and clinical champion for the early adoption throughout the Welsh Deanery. He has undergone Quality Improvement training to Silver Level, and won two grants by the Health Foundation for quality improvement projects to enhance safety in acute care, the most recent one in a joint bid with the Helen Hamlyn Centre for Design at the Royal College of Art. Chris is actively involved in training of students and junior doctors in quality improvement techniques (but says he is “still struggling with twitter – but try @csubbe”!) In Chris’s own words: “I became interested in QI for obvious reasons: we all stand around the nursing station and moan about this and that, and why “that doesn't work”. And get frustrated. And feel we waste time. And that the patient is getting short-changed. And then I realised that you can actually change most of these things. And somebody somewhere already has. But you would need to know how to find better ways, how to show to colleagues that they work, and you have to convince them that it is worth a trial. At that time I met a fabulous colleague from our Service Improvement Department, Julie. She knew a lot. I started reading. And then we started to change how we worked. We introduced Early Warning Scores on one ward. Then throughout the hospital. Now they are standard in the UK. And in Ireland. And in Holland ....” If making things better for patients floats your boat, then our MM/QI Fellowship offers you the opportunity to work with this inspirational clinician – a true friend of our ED - and learn how to devise and run a project that will make a difference, with support every step of the way.

Prepared by Dr Linda Dykes, Consultant in EM – [email protected]

14

YG ED Clinical Fellow in EM with PHEM, MedEd or MMQI

Job Description Nov 2016 v1.0

Medical Management – local/regional Medical management is so much more than the in-tray exercise in the FRCEM. A solid understanding of the many layers of activity that go on to keep a hospital running can be very useful when, as a consultant, you need something from the hospital. From finances to committees, performance to personnel, we have cajoled a range of colleagues in management at all levels (from our own managers locally to members of the Health Board Executive team) to take a Fellow along with them, a bit like a doctor on work experience. Furthermore, the recently-announced changes to the FRCEM mean that this is a great opportunity to start building your management portfolio. It isn’t clear yet whether projects undertaken outside of training posts can be included, but most doctors who move posts take their good ideas with them, so there’s plenty of scope to do something in Bangor and then re-do it somewhere else with ease! If this applies to you, have a chat with your TPD and see how much of your management portfolio /QI project they’d accept from a year on OOPE. Medical politics – regional/national The hospital and Health Board’s interaction with the wider NHS and outside world is a source of mystery to many doctors, but gaining an understanding of the wider picture will be of great benefit as your career progresses. We have lined up a range of top-level politically active individuals (both inside and outside the NHS) to spend time with our MMQI Fellows and help them gain a fuller understanding of how the Welsh NHS fits together. This includes politicians with health-related briefs in the highest levels of the Welsh Government. Courses/qualifications 12-month posts bring with them funding to enable the post-holder to enrol on a suitable postgraduate course most relevant to their area of interest e.g. PGCert in Health & Social Care Leadership, or in Risk Management, or, to undertake a range of relevant one-day courses.

Prepared by Dr Linda Dykes, Consultant in EM – [email protected]

15

YG ED Clinical Fellow in EM with PHEM, MedEd or MMQI

Job Description Nov 2016 v1.0

Ysbyty Gwynedd Hospital Ysbyty Gwynedd was opened in 1984. The usual services of a District General Hospital are provided and include an Emergency Department, General Medicine, Care of the Elderly Medicine, Haematology & Oncology, Intensive & Coronary Care, General Surgery, Urology, Gynaecology & Obstetrics, Trauma & Orthopaedics, Radiology, Ophthalmology, ENT, Paediatric Medicine and Maxillofacial Surgery. There is a comprehensive Pathology Service, three CT scanners and MRI. Good facilities are available in the modern Postgraduate Medical Department with a relatively new and well-stocked Library. The Health Board and Bangor/Llandudno District: Gwynedd Hospital (Ysbyty Gwynedd), Bangor, serves the Counties of Gwynedd and Anglesey, and is the main District General Hospital with 468 beds, situated in the University town of Bangor. It has a comprehensive range of diagnostic and treatment facilities and all the general and acute specialties are represented serving a population of approximately 250,000. Ysbyty Gwynedd delivers clinical teaching to medical students from Cardiff and Swansea university in their 3rd, 4th and 5th years, and currently takes upwards of 50 medical students per rotation – which provides plenty of opportunity for doctors of all grades to involve themselves in teaching. The North Wales Clinical School (NWCS) also provides a structure within which teaching with other health professionals can take place, and NWCS has 3 dedicated teaching rooms, an assessment suite, common room, extended library and Clinical Skills Lab. The Betsi Cadwaladr University Health Board (previously North West Wales NHS Trust) - which is responsible for Ysbyty Gwynedd - has worked in partnership on this project with Bangor University, Glyndwr University and the Cardiff University School of Medicine.

Bangor - The City & university Bangor is located on the mainland side of the Menai Straits, in the far North West tip of Wales, UK, sandwiched between the mountains of Snowdonia and the Isle of Anglesey (which is where Wills and Kate used to live when Prince William was one of our local RAF SAR pilots!). It is a University and Cathedral City. Bangor University is a thriving institution, and the hospital has close links with both the School of Medical Sciences and the School of Healthcare Sciences. There is a dedicated Trials Support Unit, and we are able to access their friendly statisticians when required! The A55 dual carriageway links give easy access to the national motorway network and Manchester International Airport. It takes about an hour to drive to Chester or the M6, and excellent high-speed rail services ensure that all parts of the country are within easy reach: you can be in London in just over 3 hours. Ireland is also very easy to reach by ferry: the port of Holyhead is 20 miles away, and you can do Dublin as a day trip. It is also possible to fly between Anglesey to Cardiff, which is useful, because it is a bit of a pain to drive (though very scenic in good weather!), and the train also takes four hours.

Prepared by Dr Linda Dykes, Consultant in EM – [email protected]

16

YG ED Clinical Fellow in EM with PHEM, MedEd or MMQI

Job Description Nov 2016 v1.0

Lifestyle & Leisure activities – see www.mountainmedicine.co.uk Gwynedd and Anglesey are perfectly situated for anyone enjoying outdoor pursuits: Bangor is sandwiched between the beautiful mountains of Snowdonia National Park, and the Menai Straits looking across to Anglesey. World-class hill-walking, climbing, abseiling and scrambling venues are only a few minutes drive from the hospital in one direction, with watersports venues and beautiful beaches a few minutes drive in the other. Many hospital staff participate in the multitude of sporting activities available here: sailing, wind-surfing, canoeing, water-skiing, kite-surfing, and diving. Back on land, keeping horses is relatively economical here compared to many parts of the UK and dry ski slopes at Llandudno and Capel Curig ensure that skiing is possible all year around. There’s even Britain’s first artificial surfing beach at Surf Snowdonia! There is an abundance of golf courses, together with town & village clubs for football, rugby, cricket and tennis etc. all of which are very popular and receiving enthusiastic support. Gwynedd and Anglesey’s coastline, mountains, historic sites (there are a lot of castles here!) and settlements give it a truly unique character. The diversity of Welsh culture is an important feature of life in the area: many locals speak Welsh and the area is very much bilingual. However, the working language of the health system in Wales is English, and many doctors at Ysbyty Gwynedd can’t actually speak Welsh (although many have learning Welsh somewhere on their “to do” list and some have even got round to it) - but everyone picks up a few words. Our Clinical Fellows have established a track record of building themselves into a very closeknit unit, and regularly participate in the pub quiz on Tuesday evenings in Felinheli, the marina village 5 minutes from the hospital where most of them choose to live. They aren’t very good at the pub quiz, but it’s a great pub! The Ysbyty Gwynedd doctors in general are a sociable bunch, whatever the grade, and it is quite normal for ED doctors to be included in invitations to group sailing trips, hill walks and cycle rides. Or, for the less outdoor-inclined, supper clubs, gin clubs, board-game nights and cinema expeditions. We think it is a good sign that many of our Clinical Fellows don’t want to leave after their original posts comes to an end: we generally struggle to get them to leave and about a third have stayed on longer in various guises, from becoming our Wales Deanery ST4 to switching from the PHEM programme to Medical Education, and some of our early Fellows are now lined up to apply for consultant posts here. We’re always happy to keep Fellows for longer, assuming good performance (and an available slot!). Our website contains comprehensive information on life in North West Wales, from life’s essentials (yes, we do have BT infinity Broadband) to luxuries (we have a Waitrose in Menai Bridge, about a mile from the hospital) and, of course, the outdoor activities on offer. If you’d like to suss out the rental property market, try looking at properties in Felinheli, Menai Bridge or Bangor… or Llanberis if you’re a real mountain bunny! Property prices are very reasonable so rental rates are affordable – about £550-600 for a flat or £700-900 for a familysized house where 2 or 3 could share. We know of some lovely rental houses that are usually handed from one set of Clinical Fellows to the next!

Prepared by Dr Linda Dykes, Consultant in EM – [email protected]

17

YG ED Clinical Fellow in EM with PHEM, MedEd or MMQI

Job Description Nov 2016 v1.0

Conditions of Service • •

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These posts are subject to the Wales NHS Hospital Medical and Dental Staff terms and conditions of service. Unfortunately, these posts are not eligible for relocation expenses. The post-holders will be expected to be members of an appropriate medical indemnity organisation (e.g. MPS, MDU – usually cheaper if you hold an NTN but are on OOPE) and Clinical Fellows in PHEM posts must also hold their own personal accident insurance whilst working on ambulance vehicles and undertaking pre-hospital activities. This is most easily and economically arranged by joining the UK Intensive Care Society (£105/year). Single or married accommodation can sometimes be provided on a temporary basis or during the successful candidates’ search for more permanent accommodation. In the unlikely event of having to revert to non-resident on-call from 2am, these are classed as non-resident posts, and the appointee must reside within range to fulfil non-resident on-call commitments. PHEM post-holders will require an Honorary Contract with Welsh Ambulance Service Trust (WAST): this is subject to their CV being approved by the WAST Medical Director. We anticipate that these will soon be an additional Honorary Contract requirement when H61 is brought under the EMRTS governance chain. The Betsi Cadwaladr University Health Board is an Equal Opportunities Employer.

Application Procedure •

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The applicant must be a fully registered medical practitioner with a licence to practise, hold the MRCEM (or equivalent, e.g. Primary FRCA, MRCP) with a minimum of four years regular hospital experience in training posts at SHO-grade or equivalent (i.e. minimum of five years post graduation), including at least 6 months experience in Emergency Medicine and the other ACCS specialties. Applicants for the PHEM posts must be able to meet the higher occupational health standards of the Welsh Ambulance Service +/- EMRTS (in particular, there are weight limits for doctors flying with Helimed, and pregnancy immediately precludes front-line PHEM work). You will need access to a car to undertake the full range of PHEM activities on offer. EM trainees who have passed MRCEM and completed ACCS ST/CT3 will meet the required experience levels for the posts, as will post-ACCS Anaesthetic and AM trainees who have done a “CT3” year, but please see the Person Specification for further details of eligibility requirements. Please check the Person Specification carefully before applying We strongly encourage all potential applicants to contact us for a chat and, if possible, to visit: to discuss the post further, please contact either Dr Linda Dykes (Consultant in EM & Clinical Fellow Programme Director), Dr Helen Salter, Dr Rich Griffiths (best for rota queries/explanations) or Dr Pete Williams, Emergency Medicine Consultants via our secretary on 01248 384003, or email [email protected] We can also put you in touch with current and previous post-holders who are happy to discuss the job with you, warts and all, and we also encourage potential applicants to visit the department informally – if you join our team for a year, we want you to be happy here. Application is by visiting NHS Jobs UK, website www.jobs.nhs.uk and following the instructions for on-line applications. If you are intending to take time out of your NTN on OOPE, please discuss your plans with your Training Programme Director as soon as possible. If you are interested in coming to us as an EM ST4-6 on OOPT (no activity time sadly, but all the other advantages!) from Feb 2018 when we next have capacity for an extra Higher Specialist Trainee, please talk to us ASAP: in order to guarantee you a slot we would need to apply & be interviewed alongside the potential Clinical Fellows.

Prepared by Dr Linda Dykes, Consultant in EM – [email protected]

18

YG ED Clinical Fellow in EM with PHEM, MedEd or MMQI

Job Description Nov 2016 v1.0

General Requirements This post is subject to the Terms and Conditions of employment of the Betsi Cadwaladr University Health Board. Competence You are responsible for limiting your actions to those that you feel competent to undertake. If you have any doubts about your competence during the course of your duties you should immediately speak to your Line Manager/Supervisor. Registered Health Professional All employees of the Health Board who are required to register with a professional body, to enable them to practice within their profession, are required to comply with their Code of Conduct and requirements of their professional registration. Supervision Where the appropriate professional organisation details a requirement in relation to supervision, it is the responsibility of the post holder to ensure compliance with this requirement. If you are in any doubt about the existence of such a requirement speak to your Manager. Risk Management It is a standard element of the role and responsibility of all staff of the Health Board that they fulfil a proactive role towards the management of risk in all of their actions. This entails the risk assessment of all situations, the taking of appropriate actions and reporting of all incidents, near misses and hazards. Health and Safety Requirements All employees of the Health Board have a statutory duty of care for their own personal safety and that of others who may be affected by their acts or omissions. Employees are required to co-operate with management to enable the Organisation to meet its own legal duties and to report any hazardous situations or defective equipment. Flexibility Statement The content of this Job Description represents an outline of the post only and is therefore not a final list of duties and responsibilities. The Job Description is therefore intended to be flexible and is subject to review and amendment in the light of changing circumstances, following consultation with the post holder. Confidentiality All employees of the Health Board are required to maintain the confidentiality of members of the public and members of staff in accordance with Health Board policies. Record Keeping All employees are responsible for ensuring Departmental and Health Board Records are created and maintained in accordance with the Health Board Policy.

Prepared by Dr Linda Dykes, Consultant in EM – [email protected]

19

YG ED Clinical Fellow in EM with PHEM, MedEd or MMQI

Job Description Nov 2016 v1.0

Appendix: our New Zealand exchange partner For candidates seeking a longer time out of training, there may be the possibility of rotating to the ED in Palmerston North, 87 miles North of Wellington (North Island, New Zealand), following the Bangor post. The Palmerston North ED Clinical Director, Dr Helen Cosgrove, spent her sabbatical within us in Summer 2014: her department is very successful, and several of the EM consultants are UK-trained FCEM +ve and they are very experienced at supporting British doctors in their first NZ posts. Bangor ED Clinical Fellows wishing to rotate to her department in New Zealand may be eligible for a streamlined appointment process, subject to satisfactory performance whilst in our ED in Ysbyty Gwynedd. Appointment to the NZ post would, of course, still be subject to New Zealand immigration visa & Medical Registration requirements, which are outside our control. Doctors who have not worked at middle-grade level in NZ before are sometimes required by the MCNZ to do the first three months as an SHO. NZ starting dates do not synchronise with our UK August/Feb - one of the reasons why we often have Clinical fellows starting with us in February after returning from Australia and NZ! - but if you’re interested in the NZ option, please email [email protected] or [email protected] and we can put you in touch with Dr Helen Cosgrove to enquire about post availability in her ED. We can consider “split posts” – come to Bangor for 5 months, go to NZ for at least 6 months, and complete the remainder of your year in Bangor on your return.



Prepared by Dr Linda Dykes, Consultant in EM – [email protected]

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