HSE Consultant Gastroenterology Hepatology Medicine in Munster Region - Republic of Ireland on a fixed term / permanent basis; working for our client via Workplace Doctors

*** Must have IMC (Specialist Division) Registration (Irish Medical Council) - Essential
*** Location: Republic of Ireland – Munster Region (Clare, Cork, Kerry, Limerick, Tipperary, Waterford)
***Speciality: Medicine: Gastroenterology Hepatology Physician

*** Role: Consultant (6+ years post graduate experience)

*** Duration: 12 months (FREE visa & work permit + relocation package offered)

*** Start date: ASAP

***IELTS Score of 7.0 Overall (minimum) – Essential

***Exact location details provided on application

*** Pay rate: €217,235 to €261,051 Euro’s (dependent on experience) basic salary (allowances paid extra)

Irish Teaching Hospitals and Medical Universities receive great international acclaim & recognition throughout the world, doctors with experience and training in Ireland typically enjoy great success in terms of professional career development & job satisfaction.

Overview

CONSULTANT GASTROENTEROLOGIST with an Interest in HEPATOLOGY (10 PAs) the following carefully considered, well-balanced and flexible job plan is proposed.

·       Ward Cover 7-Day Working (1 in 6 weeks, 8.67 weeks per year, no outpatient sessions)

·       Outpatient Duties 4-Day Week (5 in 6 weeks, 33.3 weeks per year, leave taken during off ward period)

·       24 HR Upper GI Bleeding Out of Hours Rota (minimum 1:6, currently 1:8, 1PA plus )

·       NO Acute Medicine On Call commitment

·       Total Direct Clinical Care (DCC): 7.5 PA

·       Supporting Professional Activities (SPA): 2.5 PAs ( 1.5 SPA can be taken flexibly )

·       Option to increase Clinical or Management PAs (by discussion, max 12 PA total)

·       Innovations to improve local services will be supported (e.g. BSCP, EUS etc)

·       A research interest can be supported by discussion and mutual agreement.

We are looking to appoint keen, well-trained Gastroenterologists to complement our clients friendly, supportive and highly capable Department with opportunities to subspecialise and develop services of special interest. In particular, opportunities are available to develop Endoscopy (including BCSP/ERCP/EUS) and Hepatology, although ALL speciality interests will be welcomed and considered. There is also an opportunity to take on additional clinical, management and developmental PAs by discussion.

The Medical Department has recently restructured with the appointment of Acute Physicians who now cover the Acute Medical Take, supported by the Care of the Elderly/Stroke and Respiratory teams.

The newly appointed Gastroenterologists will have NO Acute Medicine on call commitment, but will contribute to the established Out of Hours Upper GI Bleed Endoscopy rota (minimum 1:6), supported by on-call endoscopy nurses. In addition, 7-day working will be supported by a time-limited 4-hour Saturday & Sunday morning Ward Round covering the Gastroenterology team’s inpatients and acute Gastroenterology referrals (1:6 weekends).

Please note that full IMC registration and license to practice is an essential for this role. If you do not currently have IMC registration, but you are in the process of applying, please use the supporting information section of the application form to provide an update about the status of your IMC application.

Candidates without IMC registration at the time of shortlisting will not be considered- as per hospital requirements.

Additional Information

You will be able to take advantage of the excellent Consultant contract for the Republic of Ireland. The basic salary range for this post is euros €217,235 to €261,051 Euro’s per annum plus a further euro 26,672 per annum available in Commitment Awards.

Department of Gastroenterology

The highly capable Gastroenterology team currently consists of 4 Consultant Gastroenterologists, a Nurse Consultant Endoscopist, 4 Clinical Nurse Specialists and 2 ward-based Advanced Nurse practitioners. In addition, there are 2 Gastroenterology Specialist Registrars, 3 Junior doctors (CMT/SHO) and a Physician Associate supporting the ward team. There is an UGI Cancer Nurse specialist, Gastroenterology dietitian and pharmacist.

A well-balanced team-working pattern has been developed to maximise the capacity of the in-patient and outpatient service and the Endoscopy department. The in-patient ward work will be shared on a rotational basis (1:6) within the team. The department are a progressive department and welcome innovative developments.

There are well established and collaborative links with Upper GI / HPB surgery (within the region) and Colorectal surgery with both upper and lower GI multi-disciplinary team meetings occurring weekly. In addition, an Inflammatory Bowel Disease MDT has also recently been established.

The department has developed the roles of our Clinical Nurse Specialists (CNS) and Advanced Nurse Practitioners (ANPs) who together run Nurse-led, consultant-supervised abnormal LFT/ hepatology, viral hepatitis, IDA and IBD clinics, including an IBD helpline, paracentesis and PEG service with substantial autonomy.

Other specialty interests include diagnostic & therapeutic endoscopy, capsule endoscopy, bowel cancer screening (including Bowel Scope), viral hepatitis (with links to the Munster Viral  Hepatitis MDT), inflammatory bowel disease, GI physiology (including state-of-the-art High Resolution Impedence Oesophageal Manometry and pH Impedance studies) and capsule endoscopy.

The Hospital is served by an excellent range of investigative and treatment facilities including recently refurbished and modernised Pathology Laboratories, fully digitalized Radiology department (including 2 CT and MRI scanners), Nuclear Medicine and Neurophysiology Departments. Our GI Radiology service is now sub-specialised offering:

·       CT colonography

·       CT / MR Enterography

·       MRCP

·       Barium Studies

·       SEHCAT scans

·       T-HIDA scans

·       NM Gastric Emptying

·       Liver Biopsies

The Department is progressive and up to date. Recent innovations include the addition of the Primary Care Pathway to the long-established Faecal Calprotectin Pathway. Once established, the Department will have a fully independent specialty diagnostic capability.

Endoscopy Department

There is a purpose-built JAG-accredited endoscopy unit in the Hospital with two endoscopy rooms (with XRay screening facilities) and adjacent patient assessment / recovery areas. Both endoscopy rooms are fully equipped with Olympus scope guides and NBI imaging, CO2 insufflation / irrigation devices and a full range of therapeutic Endoscopic equipment. There is an established capsule endoscopy service.

Available therapeutic interventions include a full range of GI bleeding interventions (adrenaline and thrombin injection, heater probe / APC, banding and haemospray), as well as ERCP, Oesophageal and Colonic Stenting, Advanced Polypectomy, EMR/ESD, PEG etc.

The Unit has developed its service in line with the Patient Centred approach from the National Endoscopy team, scoring highly on the Global Rating scale and keeping up to date with all HSE recommendations. Monthly Business & Operational meetings are held to discuss governance issues and progress developments in a productive manner.

Specific Duties

·       To provide a high quality service in Gastroenterology (and General Internal Medicine inpatients) to the patients of Munster and the surrounding area, using evidence-based guidelines and clinical governance structures.

·       To contribute to multi-disciplinary team working.

·       To advise clinical colleagues on matters within his/her sphere of expertise;

·       To offer advice / support / education to medical, nursing, managerial and other staff on appropriate matters.

·       To carry out medical teaching, examination and accreditation duties as required.

·       To participate in the formal appraisal of junior medical staff in accordance with guidelines from the Royal College of Physicians and the Regional Postgraduate Deanery.

·       To contribute to postgraduate and continuing medical education activity including Continuing Professional Development.

·       To contribute to the training of nurses, paramedical, scientific and technical staff.

·       To participate in medical audit on a regular basis and develop relevant audit projects.

·       To provide information for service development and management purposes to support job planning, service planning etc.

·       To contribute to the management process within the hospital through participation in planning, project or liaison groups as appropriate. In particular the post holder would be involved in Specialty and Service Unit business meetings.

·       To support the Clinical Directors and Service Unit Director with appropriate advice with regard to the development of Gastroenterology and Medical services at HSE Hospital.

·       To work within the framework of policies and procedures relevant to Medical and Dental staff.

Teaching Commitments

·       regular commitments to ward based teaching of undergraduates.

·       participation in the lecture programmes for 2^nd and 4^th & 5^th year medical students.

·       teaching of other groups as required including other specialty juniors and specialist nurses.

Job Plan

A formal job plan will be agreed between the appointee, the Operational Medical Director and Lead Medicine Consultant, on behalf of the Trust’s Medical Director, based on the provisional timetable. This will be signed by the Chief Executive and will be effective from the commencement date of the appointment.

It will be reviewed at 3 months & thereafter annually or at any time, but no less than 3 months after a previous review, as requested by the appointee, Operational Medical Director or Clinical Lead & adjusted accordingly to the agreement of both parties.

The job plan will initially be offered as 10 PAs, although there are opportunities to increase the number of PAs to 11 or 12 by discussion and mutual agreement. The 10 PAs will comprise follows:

·       Direct Clinical Care 7.5 PAs (to include GI Bleed on call at 1 PA plus standard availability supplement)

·       Supporting Professional Activities 2.5 PAs (1.5 SPA may be worked flexibility, 1 PA on site)

·       Optional sessions of specialist clinics or endoscopy up to 12 PAs subject to discussion.

·       A research interest can be supported

The overall PA calculation is complex (table available for review before contract is signed) as “WARD COVER (on ward)” weeks require cover 8.67/52 weeks per year as they are shared equally on a 1:6 basis (52/6 = 8.67 weeks). Department policy is that Annual Leave and Study Leave should be avoided when ON the ward (or swapped internally) to ensure equitable and effective ward cover.

ON Wards (1:6) - The proposed Consultant Gastroenterology service provides Consultant ward rounds or targeted board-rounds each day Mon- Friday with additional Nutritional Support Team ward rounds Tues and Thursdays. In addition, same day referrals are undertaken in liaison with the Acute Physician teams on the Clinical Assessment Unit (CAU) to provide early senior decision making for Gastroenterology patients. The WARD COVER commitment will be shared equally on a 1:6 basis allowing 5:6 weeks OFF the ward to focus on Endoscopy and out-patient clinics (see representative job plan below). ON Ward intensity (PA calculations) offers a 4 day working week when OFF wards.

Once the full complement of specialty and acute medical consultants (6 per specialty) are recruited, the Gastroenterology specialty inpatient caseload is predicted to cover only 16 inpatient beds

The Ward Cover consultant is also tasked with providing e-Advice & Guidance and triaging GP e-referrals.

OFF Wards (5:6) – Outpatient Specialty Clinics or Endoscopy lists are delivered for the remaining weeks of the year when “OFF ward” (i.e. 33.3 weeks/yr, excluding annual leave (i.e. 52-8.667-10 = 33.3 weeks/yr). Typical clinic: New Patient slot 30 minutes, Follow-Up patient slot 20 minutes. A consultant with an interest in Hepatology will be offered the option of either Hepatology Clinics (or a mixture of Hepatology and Endoscopy) by mutual agreement.

Upper and Lower GI Cancer MDT meetings and associate clinical paperwork attracts 1 PA per week.

Supporting Professional Activity constitutes 2.5 SPA per week. Departmental policy is that 1 SPA must be delivered on site, with 1.5 SPAs worked flexibly.

OUT of HOURS work - The Gastroenterologists will have NO Acute Medicine on call commitment. The Acute Physicians supported by the Geriatric/Stroke and Respiratory consultants will undertake all Acute Medical Take. The post-holders are expected to take part in the 24hr Out of Hours Upper GI Bleed rota (minimum 1:6, currently and anticipated 1:8) offering emergency GI bleed endoscopy according to national standards (attracts 1 PA plus 5%)

A consultant with an interest in Hepatology will be offered the option of either Hepatology Clinics (or a mixture of Hepatology and Endoscopy) by mutual agreement.

Standard Duties and responsibilities

a) To participate in development of and undertake all duties and functions pertinent to the Consultant’s area of competence, as set out within the Clinical Directorate Service Plan  and in line with policies as specified by the Employer.

b) To ensure that duties and functions are undertaken in a manner that minimises delays for patients and possible disruption of services.

c) To work within the framework of the hospital / agency’s service plan and/or levels of service (volume, types etc.) as determined by the Employer. Service planning for individual clinical services will be progressed through the Clinical Directorate structure or other arrangements as apply.

d) To co-operate with the expeditious implementation of the Disciplinary Procedure 

e) To formally review the execution of the Clinical Directorate Service Plan with the Clinical Director / Employer periodically. The Clinical Directorate Service Plan shall be reviewed periodically at the request of the Consultant or Clinical Director / Employer. The Consultant may initially seek internal review of the determinations of the Clinical Director regarding the Service Plan.

f) To participate in the development and operation of the Clinical Directorate structure and in such management or representative structures as are in place or being developed. The Consultant shall receive training and support to enable him/her to participate fully in such structures.

g) To provide, as appropriate, consultation in the Consultant’s area of designated expertise in respect of patients of other Consultants at their request.

h) To ensure in consultation with the Clinical Director that appropriate medical cover is available at all times having due regard to the implementation of the European Working Time Directive as it relates to doctors in training.

i) To supervise and be responsible for diagnosis, treatment and care provided by non-Consultant Hospital Doctors (NCHDs) treating patients under the Consultant’s care.

j) To participate as a right and obligation in selection processes for non-Consultant Hospital Doctors and other staff as appropriate. The Employer will provide training as required. The Employer shall ensure that a Consultant representative of the relevant specialty / sub-specialty is involved in the selection process. 

k) To participate in clinical audit and proactive risk management and facilitate production of all data/information required for same in accordance with regulatory, statutory and corporate policies and procedures.

l) To participate in and facilitate production of all data/information required to validate delivery of duties and functions and inform planning and management of service delivery

Essential Requirements

This post is open to doctors who hold Registration as a Specialist in the Specialist Division of the Registrar of Medical Practitioners maintained by the Medical Council in Ireland in the specialty of Medicine: Hepatology

Office Accommodation

The post holder will undertake administrative work associated with their clinical and other professional duties.  Adequate time and facilities for clinical administration, including appropriate office space, secretarial support and access to a personal computer, software & internet access, will be available.

Service Provision and Cover during Absences

The consultant has a continuing responsibility for the care of patients in his/her charge and for the proper functioning of the service allowing for appropriate delegation for the training of his/her staff.

He/she must be available by telephone and able to attend the hospital in a timely fashion when on-call (40 minutes journey time).

Consultant staff must ensure that services are covered during his/her planned absences. Where fixed commitments need to be cancelled during planned absences appropriate notice (8 weeks) must be given. Absences must be co-ordinated with other consultant staff in the specialty to ensure senior cover is always available.

Management Responsibility

All Consultants are required to attend the monthly Directorate Meetings. Post holders will be expected to share in administrative duties allocated by mutual agreement within the Directorate. As part of the Consultant Team, the consultant  will offer mentoring support and lead the existing clinical team through; joint clinics, one-to-one support, individual case management and complex cases, identifying development needs and suggesting CPD (Continuous Professional Development) opportunities and responding to clinical enquiries via e-mail and telephone.

If you are interested in working in growing your career and increasing your income, then talk to our healthcare team today. If you can fill the above requirements, we will give you the following benefits:

*** Visa & Work Permit for FREE!

*** Guidance, Training & Career Development

*** Dedicated & Supportive team- Consultant available when you need.

*** Excellent Basic Pay, Overtime paid for extra hours
***Assistance provided with relocation

We look forward to helping you progress your career and find you the ideal position.

Doctors Guide to working in the Republic of Ireland – Click here

The hospital welcomes all applications irrespective of age, disability, gender, sexual orientation, race or religion- essentially the applicant must meet the criteria mentioned above

Call us today on +44 (0) 1234 889213 to discuss this vacancy or email your CV to info@workplacedoctors.co.uk  or apply online today (see below).

***Please note due to the high number of applications, we do answer every application in turn.***