Training

MAYDAY HEALTHCARE NHS TRUST
SUBSPECIALTY TRAINEE IN UROGYNAECOLOGY
JOB DESCRIPTION
MARCH 2006

SUBSPECIALTY TRAINEE IN UROGYNAECOLOGY

Applications are invited for the above training programme at Mayday Healthcare Trust. The post will commence on 1st December 2006. Applicants must hold GMC registration. The post is open to trainees who have completed at least 4 years of a Specialist Registrar training programme in Obstetrics and Gynaecology (passed RITA C- 4th year) and hold a National Training Number (NTN). This is a two-three year post depending on research exemption and previous experience.

The subspecialty training programme will be supervised by Miss Ranee Thakar and Mr Abdul Sultan. The training programme and timetable have been structured according to RCOG requirements to allow time for clinical and operative training and time for research. The successful candidate will be required to undertake research leading to abstracts, which will be presented at national and international meetings relating to urogynaecology and leading to publication in peer reviewed journals. The successful candidate would be expected to teach nurses, as well as undergraduate medical students and doctors. The candidate will be encouraged to submit a thesis relating to urogynaecology for a higher degree. In addition to the weekly timetable the candidate will be required to participate in the on-call rota.

UROGYNAECOLOGY SUBSPECIALTY TRAINING FELLOW

Background

Medical and other staff contributing to Subspecialty Training in Urogynaecology

Name	Qualifications	Speciality
R Thakar	MD, MRCOG	Urogynaecology
A Sultan	MD, FRCOG	Urogynaecology
R Addison	RN, BSc	Continence Nurse Consultant

DIRECTORS OF TRAINING PROGRAMME

Miss Ranee Thakar MD, MRCOG
Mr Abdul Sultan MD, FRCOG

Mayday University Hospital is a large district hospital with two consultant urogynaecologists in post. The trust has developed a purpose built continence department (The Lancaster Suite) as a focus for continence services within Croydon. This is led by Ray Addison who is a nurse consultant in continence care. In addition, there are one urodynamic nurse specialist, one colorectal nurse specialist and six continence nurse advisors who work in an integrated primary and secondary care service.

The Croydon Continence Care team won the 2005 Hospital Doctor Award. The excellent set-up helps to provide a service for referral and transfer of patients with urogynaecological problems, with close collaboration with other gynaecologist within and outside the centre. The unit places strong emphasis on a multidisciplinary approach to female pelvic floor dysfunction and there are close links between the department and affiliated specialties within and outside the trust including colorectal, Urology, Geriatrics, Orthopaedics and renal medicine. Within the Trust, there is close collaboration and cross-referral of patients with the two consultant urologists (Mr Garry Das and Mr Raju), two consultant colorectal surgeons (Mr Muti Abulafi and Mr Ian Swift) and a consultant neurologist (Dr Fred Schon). To facilitate this service, Miss Ranee Thakar runs a monthly complex urogynaecology clinic in the Lancaster Suite with Mr Ray Addison. Two Pelvic Floor Clinics and two combined theatre lists are held every month by two teams (1) Mr Abdul Sultan and Mr Muti Abulafi and (2) Miss Ranee Thakar and Mr Ian Swift). A perineal clinic is held weekly in which patients with postpartum pelvic floor problems are seen and third degree tears are followed up. This clinic attracts tertiary referrals for obstetric pelvic floor disorders, endoanal scans and manometry. There are four dedicated weekly clinics in which the majority are urogynaecology patients. In addition there is a weekly nurse led triage clinic. The candidate will be expected to facilitate and attend these clinics.

There is a well equipped urodynamic and anorectal laboratory. There are five nurse led and one consultant led urodynamic sessions weekly. In addition to the perineal clinic two endoanal scan clinics are held every month by Mr Abdul Sultan. The candidate will be required to participate in these sessions including performing investigations, interpreting results and institute appropriate treatment under supervision.

The candidate will participate in two in-patient urogynaecology lists each week. Surgical management will be undertaken under the supervision of the two consultant urogynaecologists. Other duties will include pre-operative assessment and postoperative care. The unit has an ongoing audit programme in addition to that of The British Society of Urogynaecology for surgical outcomes and the trainee will oversee this.

A number of educational courses are held every year and the trainee will be expected to contribute to them. At present, these include 5 hands-on third degree tear repair courses, one endoanal scan course, one episiotomy and perineal tear course for midwives and a number of courses for nurses which are organised by Ray Addison ( bowel dysfunction in continence care, clinical practice in continence care, health promotion in continence care, children's continence course, digital rectal examination course, bladder retraining, catheterisation, bladder ultrasound course, digital vaginal examination course and a course for community nurses on pelvic floor dysfunction).

Both consultants have a strong research background and currently there are a number of research projects being carried out. The trainee will be encouraged to actively take part in research with a view to producing an MD thesis, publications and presentations at relevant forums. However, the training programme is tailored to suite the needs of the individual and will be either 2 years (research exempt) or 3 years if the applicant has not undertaken appropriate research.

Structured training will include a monthly journal club, a weekly teaching ward round and a monthly urodynamic meeting. Informal training such as attending other meetings of urogynaecological interest. is encouraged.

The successful candidate will be expected to be involved in an active research programme. The job plan is flexible to allow sufficient time to undertake research and attend other specialty sessions over 2-3 year period in order to fulfill the criteria laid down by the RCOG for subspecialty accreditation in urogynaecology.

	Monday	Tuesday	Wednesday	Thursday	Friday
AM	Allied speciality	Theatre	Research	Urogynae Clinc	Perineal clinic
PM	Allied speciality	Theatre	Urodynamics	Urogynae Clinic	Triage clinic/CPD

1 pelvic floor clinic is held monthly instead of the urogynaecology clinic.
2 theatre sessions a month will be with the colorectal surgeons

The above weekly rota is flexible to allow the trainee to attend other sessions- urology, colorectal, elderly care medicine, community advisory centre and visit other centres.

Department of Obstetrics and Gynaecology

Obstetrics and Gynaecology has 50 obstetrics beds and 27 gynaecological beds. In addition, there are day care beds for gynaecology patients. The maternity unit has 12 delivery rooms and a designated theatre suite, including two operating theatres and recovery area.

There are excellent in-house radiology, CT scanning and ultrasound facilities.

The unit is staffed by seven Consultants,seven Specialist Registrars (excluding this post), and eight SHOs. A list of the Consultant staff is set out below with their specialist interest and responsibilities:

Mr Michael Booker FRCOG Special interest in Infertility

Miss Britt Clausson, FRCOG Special interest in Colposcopy

Miss Rosol Hamid, FRCOG Special interest in Feto-Maternal medicine

Mr Emmanuel Ofuasia, MRCP, MRCOG Special interest in Minimal Access Surgery and Early Pregnancy Unit

Mr Abdul Sultan, MD, FRCOG Special interest in Urogynaecology

Miss Ranee Thakar, MD, MRCOG Special interest in Urogynaecology

Mr Greg Ward, FRCOG, FRACOG Special interest in High Risk Obstetrics

Arrangements can be made to discuss the post with Miss Ranee Thakar by contacting her secretary on 0208 401 3154

Terms & Conditions of Service and Trust Policy

The Appointment will be held with Mayday Healthcare NHS Trust.

The appointment is covered by the terms and conditions of service for Hospital Medical and Dental Staff.

The Job Description is a reflection of current service needs and may be reviewed and amended, in consultation with the post holder, in the light of future changes or development.

The successful candidate will have a continuing responsibility for the care of patients in his/her charge. He/she will undertake the administrative duties associated with the care of his/her patients.

Medical and dental staff will be required to assist management and its agents during investigations into claims alleging medical negligence and, where requested, to provide related factual statements.

Within the terms of DHSS Circular HC (88) 9 - Protection of Children - applicants are required when applying for this post to disclose any records of convictions, bind-over orders of cautions.

The Trust is committed to providing safe and effective care for patients. To ensure this, there is an agreed procedure for medical staff that enables them to report quickly and confidentially concerns about the conduct, performance or health of medical colleagues (Chief Medical Officer, December 1996). All medical staff practising in the Trust should ensure that they are familiar with the procedure and apply it.

Registration

It is a condition of your appointment to be registered with the General Medical Council and to maintain this registration

It is your responsibility to present certificates to the Medical HR Department on an annual basis. Failure to maintain registration could lead to disciplinary action being taken against you.

Indemnity

The Trust will cover all medical staff for NHS work under NHS Indemnity. Mayday Healthcare NHS Trust is required to encourage medical and dental staff to ensure that they have adequate defence cover for any work that does not fall within the scope of the Indemnity Scheme (HSG (96) 48 refers).

Confidentiality

All personal matters relating to patients' diagnosis and treatment and personal information relating to members of staff are strictly confidential and under no circumstances are such information to be divulged to unauthorised person(s). Breach of this condition will result in disciplinary action including dismissal. A breach of confidentiality may also result in a civil action for damages.

Criminal Records Bureau

All Trust staff are subject to a Police check and are required to complete and return the Disclosure application form, together with the necessary documentation as proof of identity and address.

Rehabilitation of offenders

All Medical and Dental posts are exempt from the provisions of Section 4(2) of the Rehabilitation of Offenders Act 1974(Exceptions) Order 1975. Applicants are, therefore, not entitled to withhold information about convictions which for other purposes are 'spent' under the provisions of the Act. Failure to disclose such convictions could, in the event of employment, result in dismissal or disciplinary action by the Trust. Any information given will be completely confidential and will be considered only in relation to the particular post.

Appraisal

All trust staff must participate fully in the appraisal process.

Performance

Continuation of your appointment under this Agreement is subject to satisfactory performance. Your performance and progress in relation to agreed standards will be reviewed at regular intervals with your Consultant. Unsatisfactory performance could be considered as grounds for action under the Trust's Disciplinary Procedures.

Occupational Health

A full examination will not normally be required but the successful candidate will be required to complete a health questionnaire and will need to produce evidence of a satisfactory chest x-ray within the last year.

Hepatitis 'B' Screening and Immunisation

Posts are offered on the understanding that the applicant will comply with local requirements regarding immunisations.

Applicants will be asked to supply written evidence to the Occupational Health Department of degree of immunity to Hepatitis B. If not immunised, the result of a test that indicates freedom from carrier state will be required and immunisation should then be commenced.

Applicants should be aware of the guidance to HIV infected health care workers from the Department of Health and the GMC/GDC.

'IT' Requirements for All Medical Staff

It is a condition of employment that all medical staff comply with the Trust's IT policy in respect of secure use and safeguarding confidentiality.

It is a condition of employment that the post holder:

• Attends and satisfactorily completes training on Trust's clinical IT systems as they relate to the medical care and management of patients
• Conforms to the Trust's IT security policy, which includes:
  • Safeguarding the confidentiality of his/her password
  • Not allowing the use of his/her password by anyone else
  • Logging off promptly at the end of each task
  • Not using other people's passwords
  • Not misusing the Internet facilities available through the Trust's IT system
  • Safeguarding patient confidentiality
• The Trust will require all medical staff to hold the European Community Computer 'Driving Licence' as soon as this becomes a requirement for continued registration with the General Medical Council.
• The Trust will provide adequate IT training. The Trust monitors the use of its IT facilities, passwords, e-mail and Internet traffic. Failure to comply with the Trust's IT security policy will be taken seriously and may result in formal disciplinary action and has resulted in dismissal for severe offences.

Removal Expenses

Candidates must indicate at interview if they are considering putting forward an application for removal expenses. Application in writing must be made within three months of appointment. Reasonable removal expenses will be paid, subject to a maximum, that may be varied in exceptional circumstances.

Annual Leave

Notification must be made six weeks in advance to the Medical HR and relevant departments that will require this information in order not to disrupt the delivery of the service.

Study Leave

Application must be made six weeks prior to the leave and the guidelines are available from the Postgraduate Medical Centre.

Sickness

If you are absent due to sickness, notification to the Medical HR department is essential together with other key areas; failure to do this will result in nil pay. A self-certificate must be sent from the 1st day of sickness covering you to the 7th day. A medical certificate is required from the 8th day onwards covering the period until you return to work. Without this sickness benefit cannot be paid. Long-term sickness will require you to be seen by Occupational Health prior to return to work.

Equal Opportunities

The Trust is committed to the concept of Equal Opportunities, which is detailed in the organisation's Equality and Diversity Procedure. You are required to fulfil your responsibilities under this Policy and to ensure that no individual receives less favourable treatment on the grounds of their gender, sexual orientation, martial status, disability, religion, creed, colour, race, ethnic, national origin, HIV status, age, social background, trade union membership or non-membership and is not placed at a disadvantage by requirements or conditions which cannot be shown to be justifiable.

Institutional Racism

Mayday has made a serious commitment to tackling Institutional Racism and the post holder would be expected to participate fully in this.

Health & Safety

Employees are required to be aware of health and safety legislation and Trust policy and should take responsibility for ensuring this is adhered to. You have a responsibility to follow the incident reporting system, which will ensure that the Trust can manage risks to patients, visitors and staff.

Whistleblowing Policy

Mayday Healthcare is committed to the highest standards of quality, probity, openness and accountability. We are committed to tackle any issues of abuse of serious malpractice.

As part of that commitment, we encourage employees with serious concerns about any aspect of our work or practices of fellow employees to come forward and express those concerns to someone who can, if necessary do something about

Contract

Whilst the duties of the NHS appointment will be primarily at the hospital(s) stated, the appointment will be made to the Mayday Healthcare NHS Trust and there will be a commitment to attend occasionally at any other hospital or clinic in the Trust, as may be necessary from time to time.

The successful candidate should apply in line with Terms and Conditions of Service Guidelines for consideration of their starting salary.

Emergency Cover

The Junior Doctor accepts that he/she will also perform duties in occasional emergencies and unforeseen circumstances at the request of the Duty Consultant, in conjunction where practicable with her/her colleagues, both senior and junior.

It has been agreed between the professions and the DHSS while junior staff accept that they will perform such duties, it stresses that additional commitments arising under this sub-section are exceptional and in particular that junior staff should not be required to undertake work on this kind for prolonged periods on a regular basis.

General Information

The main site is Mayday University Hospital, which dates back to 1885. This is a 700-bed District General Hospital with a 24 hour Accident & Emergency. The Trust also includes Purley War Memorial Hospital (constructed in 1918 with later additions). Purley currently has 35 inpatient beds for elderly people, but these beds will move to the Mayday site once the Jubilee Wing is completed in 2004. Purley Hospital will be rebuilt to provide an expanded role for diagnostics and outpatients. The Trust also runs a Minor Injuries Unit in a health centre at New Addington (afternoon and evening, 7 days a week) and a Sickle Cell and Thalassaemia Centre in Whitehorse Road, Croydon. There is an independently run out of hours GP and minor injuries service on site, which receives referrals from Mayday's Accident & Emergency. NHS Direct is on site.

The Trust mainly serves the London Borough of Croydon. This is London's largest borough in terms of population, currently standing at 340,000 people and growing. Croydon is a multi-cultural borough with approaching 26% of its population categorised as black and ethnic. The main hospital is in the North of the borough and at the last count our workforce included 37% black and ethnic minority staff.

Partners

From 1 April 2002 the main Health Commissioner is now Croydon Primary Care Trust (PCT). This consists of three localities that cover the North, Central and South areas of Croydon. On the 1 April 2002 South West London Strategic Health Authority was formed, covering Croydon to Kingston and Richmond. The Mental Health Trust, which serves Croydon, is the South London & Maudsley, which covers also Lambeth, Southwark and Lewisham.

The Trust has over 2600 employees and a turnover of over £140 million per year. The main hospital is a 19-acre site and the land and buildings are valued at over £50 million.

Mayday has been building its managerial performance year on year. In the last seven years Mayday has maintained its financial balance every year, invested in its estate, delivered government targets for waiting lists, and improved relationships. The Trust continues to pride itself on the good relationships between clinicians and management and its open non-hierarchical culture.

Impressions of Mayday

Just stating the facts does not convey the feel of Mayday. Visitors tell us that it feels a very busy place (and consequently sought after for junior doctor training), a very friendly place (in a particularly non hierarchical way) but initially confusing because of the mix of building styles and ages ranging from 1885 to 2003.

Following our clinical governance review in July 2001, the Commission for Health Improvement also commented that their perception was that Mayday was a very friendly place to work.

Service Profile

The main groups of services and our current assessment of their standing are as follows.

Accident and Emergency

An exceptionally busy service in a building which has recently been extended to accommodate the current number of attendances (100,000 a year) and to co-locate Croydon's out of hours GP Service. Medical staffing comprises two consultants plus one consultant physician on a pilot basis. This is an area of critical focus at present to meet the national targets. There is no EAU currently but agreement has been received to proceed.

Diagnostics

The pathology laboratories were upgraded in 1998/1999. Cytology has now received CPA Accreditation, which is a major achievement looking at some of the big name hospitals that have failed to do this. Haematology has also been accredited and we await visits to the other disciplines. Radiology is relatively well equipped, having a recent spiral CT scanner, MRI in partnership with the private sector and new x-ray equipment. We also recently constructed an endoscopy suite (funded out of waiting list money) and replaced cardiac catheterisation equipment (funded from charitable appeal). There is a rapid assessment chest pain clinic.

Outpatients

The main department was built in 1995, and contains a large suite of generic consulting rooms. There are also other outpatient departments around the site, notably ophthalmology, chest, paediatrics, trauma and orthopaedics, and dermatology. We perform well on standards in relation to waiting times in the clinic and at about the national average for 'do not attends' We have been successful in achieving a reduction in over 26 and 13 week waiters, despite a consistent rise in demand for our outpatient services.

Elective Inpatient/Day Cases

We have a very high rate of day surgery (over 14%) in three Day Surgery theatres. Construction was started in 2001 on a new ward block including 306 beds and Day Surgery. Both inpatient and day case surgery waiting lists have shown reductions from April 1997 to date, and good performance was seen in the last business year.

Medicine and Elderly Care

The medical and elderly beds are in the current Victorian wing of the hospital. All of these will move to the Jubilee Wing in 2004. Elderly care services received a Charter mark in February 2000. There is a dedicated stroke unit and a dedicated ortho/geriatric ward. The GUM/HIV services are relatively new and have a growing reputation.

Family Care

The Croydon PCT policy of bringing work back to Mayday has led to an increase in births in Mayday, which now has one of the largest numbers of births in London (over 4200). We also have a neonatal intensive care unit and an enviable range of facilities in refurbished wards.

NHS Direct

Mayday was chosen as the site of NHS Direct for South West London, which began in December 1999, and is the lead (employing) body for this service which serves 1.3 million people stretching in the west from Kingston through Richmond, Merton, Sutton and Wandsworth to Croydon.

Recent achievements

In the last few years Mayday hospital has:

• Developed a purpose designed well woman clinic providing mammography, ultrasound and colposcopy on one site.
• Installed new cardiac catheterisation laboratory.
• Installed an air vacuum transport system between the wards, pathology and pharmacy departments.
• Opened a dedicated pre-operative assessment unit.
• Maintained all surgical waiting lists within targets.
• A new staff gymnasium.
• A completely refurbished pathology laboratory.
• Opened a new state of the art MRI.
• Installed a new spiral CT.
• Opened a dedicated Endoscopy unit.
• Opened a new purpose built Satellite Dialysis Unit in April 2000.

A £22m new ward block (Jubilee Wing) is currently under construction. This would enable the closure of all the Victorian Nightingale wards on the site. Expected completion is Summer 2004.

Development of the Trust's Services

Mayday hospital is, by any measure, a very large District General Hospital with a secure population base. We enjoy good working relationships with our host purchaser, Croydon PCT, which accounts for approximately 90% of our income. We are currently working together in developing and strategic direction for acute services in Croydon. The hospital has been designated as a cancer unit for the main cancers in most specialties. Recent developments funded by Croydon include colorectal, GU Medicine and HIV/AIDS, rehabilitation, ortho-geriatric, satellite renal dialysis unit and HDU. We see the population base to which we provide services expanding in line with our capacity. Following the ending of the internal market, clinical collaboration is being encouraged across the South West London area. We will extend the very significant progress already made in sub-specialisation to the full range of specialities and continue to press the frontiers of day surgery.

CROYDON

The Surrounding Area

The London Borough of Croydon is the largest of the London boroughs and the tenth largest in the UK with a population of 320,000. It is one of the outer London Boroughs and is coterminous with the Croydon Primary Care Trust, sharing boundaries with Lewisham, Bromley, Sutton and Caterham and Tandridge. The London Borough of Croydon is the largest of the London boroughs and the tenth largest in the UK with a population of 320,000. It is one of the outer London Boroughs and is coterminous with the Croydon Primary Care Trust, sharing boundaries with Lewisham, Bromley, Sutton and Caterham and Tandridge. There are still however, numerous features recalling its prosperity in earlier times. The Archbishop's Palace (now a girls school) was occupied by the Archbishops of Canterbury until the 18th century. The oldest shop in the town can be seen in the south end, a 16th to 17th century building with over hanging upper storey. The Wrencote in the high street is a fine example of an 18th century town house. Other places of interest include the 16th century Whitgift Hospital (an almshouse). A Flemish style 19th century Town hall and the parish church of St. John the Baptist, rebuilt in 1867 - after a fire - by Sir Gilbert Scott, in the original 15th century style

Travel

The Croydon area is very well connected for travel by rail and provides regular access to places within the local Croydon area and many fast trains to central London (Victoria and London Bridge) and Thameslink. These services operate round the clock which makes access to London west end particularly easy. From East Croydon Station there are good services to Gatwick Airport, Brighton, Sussex, Hampshire and Dorset.

The first tram service in London for many years (Tram link) was opened in 2001 and connects Croydon with Wimbledon, New Addington, and Beckenham.

By road, there is quick and easy access to the M23 and M25 motorways, Gatwick Airport being reached in less than half an hour and Heathrow in approximately 50 minutes.

Recreation and Leisure

Croydon has a selection of indoor and outdoor recreation facilities. These include golf courses, leisure and fitness centres, tennis, swimming and sports clubs. Crystal Palace Sports Centre lies close to Croydon.

Within easy range of Croydon are numerous country parks and gardens including Beddington Park, Boxhill and South Norwood Country Park. Brands Hatch motor racing circuit is within a 40 minutes drive.

Croydon Clock Tower houses a central library, life times - a local museum, and exhibition gallery and the David Lean cinema which shows art house films. Theatres within Croydon include the Ashcroft Theatre and Warehouse Theatre. The Fairfield Halls offers venues for classical music and other varied shows.

Housing

Within the 10 miles/30 minute radius of Mayday University Hospital all types of housing are available from central London through to village areas within Surrey. Contact Medical HR department for further information.

Pre-school facilities

The Trust has an on site nursery with priority given to hard to recruit staff. There are also many local nurseries and childminders. Contact Medical HR department for further information.

Education

Excellent state and independent schools for both boys and girls are available in the housing areas mentioned above.

In addition, excellent adult education is available at a number of venues.

POST OF SUBSPECIALIST TRAINEE IN UROGYNAECOLOGY PERSON SPECIFICATION

	Essential	Desirable	Method of Assessment
Qualifications/Training	MRCOG Part 2	Experience and interest in research in urogynaecology	Application form CV Interview
Experience and skills	Must have completed at least four years as an SPR in Obstetrics and Gynaecology and hold an NTN/VTN		Application form CV Interview References
Research	Basic urodynamics and surgical experience in the management of uterovaginal prolapse and incontinence.	MD/PhD	Application form CV Interview
Special aptitudes/abilities eg: initiative, leadership, ability to work on own or with others	Scientific research in urogynaecology and/or childbirth trauma		Interview References
Motivation and disposition	Ability to work in a team-orientated environment Ability to cooperate with colleagues on research projects	Hard working	Interview References
Personal Qualities	Non temperamental disposition. Motivated to keep the discipline and department in the forefront.	Friendly	Interview