Republic of Ireland HSE Consultant Rheumatologist Rheumatology Medicine in Connacht Region 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 – Connacht Region (Galway, Leitrim, Mayo, Roscommon, Sligo, Donegal)
***Speciality: Medicine: Rheumatology Rheumatologist

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

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

*** 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

The appointees will join the well-established department of six existing full time consultants in Rheumatology. The successful candidates will complement the consultant capacity to enable an effective and seamless service for rheumatology patients, in the in-patient and out-patient settings. The successful candidates will also help drive forwards the department’s vision of early inflammatory arthritis management. Any sub-speciality interest of relevance to a DGH Rheumatology department will be welcomed, particularly in Bone Health and Connective Tissue Disease management, as is an enthusiasm for teaching, audit and research.

A Needs Based Care (NBC) model is to be introduced across the Medicine Division where timely allocation is predicated on a patient’s clinical need and not on age. Early allocation of patients to a speciality team according to their clinical need, improved continuity of care across seven days, with minimal handovers and an identified single responsible consultant is associated with safer practice, improved clinical outcomes and higher levels of patient and workforce satisfaction

Weekly work commitments will be within the European directives on working hours and will also be influenced by the Royal College of Physicians recommendations, the new consultant contract and specified in the Job Plan. The senior rheumatologists in the department will act as the mentors for the new consultants, along with the other consultants in their absence. However, the department enjoys a very close working relationship and all clinical issues are openly discussed at formal and informal meetings.

The allocation of programmed activities will be based on 8.5 for direct clinical care and 1.5 for supporting professional activities. The detailed job plans will be agreed in consultation with the Clinical Director and the Consultants in the Department, with the approval of the Medical Director and Chief Executive or his/ her representative.

The job plans will be a prospective agreement that sets out a consultant’s duties, responsibilities and objectives for the coming year. It will cover all aspects of a consultant’s professional practice including clinical work, teaching, research, education and managerial responsibilities. It will provide a clear schedule of commitments, both internal and external.

In addition, it will provide personal objectives, including details of links to wider service objectives, and details of the support required by the consultant to fulfil the job plan and the objectives. The pattern of work may change in the future to meet local changing needs and annual review meetings will take place in line with the new Consultant Contract, job planning and appraisal arrangements.

Specific Duties

Consultant Rheumatologist

The principal rheumatology commitment of these posts will be five general rheumatology clinics per week. Details of the clinic provision are given in section 4.4. Patient numbers are 8 follow-up and 2 new in the general clinics, and three new and three follow-ups in the Early Arthritis Clinic utilising ultrasound. Currently the clinics have SpR and Clinical Nurse Specialist clinics running alongside. There is no requirement for formal Educational Supervision of an SpR, but if this duty become available, it will be assessed at the 3 month review and the allocation of an additional 0.25 PAs/trainee will be awarded. Clinics are 3.5 hours/1PA to include additional administration time which may be taken outside of the clinic environment. If it is apparent that additional patient administration time is required, this will be assessed and funded from this meeting. Additional PAs above 10 are reviewed yearly at the job planning meeting.

The post holders will work with the other Consultants to provide speciality rheumatology advice and support to patients within the Trust. They will attend the weekly multidisciplinary departmental meetings and weekly X-ray meetings, and will be expected to help support and train the SpRs and other junior medical staff in rheumatology/general medicine, and the Clinical Nurse Specialists

Where possible, the post-holders will be encouraged to develop a research interest, compatible with the background of the department and its facilities. Audit will be a mandatory part of the role.

The Rheumatology Directorate has close links with local General Practitioners and there is an active teaching program for them, and also for all grades of doctors within the Trust. The post holders will be encouraged to continue teaching and training at all levels.

Acute and General Medicine

As with the other general medical specialities in the Trust, Rheumatology has a commitment to the acute medical take and management of general medical in-patients. The Directorate of Medicine has currently organised the on-call commitments into two rotas (A and B rota). This has enabled the Directorate to provide Consultant Physician input to the acute medical take from mid-morning until 22.00, seven days a week.

The General Medical responsibility of these posts, is to provide ward-based care for one of the general medical wards and other patients admitted under the team, in outlier wards. This in-patient duty is shared with another consultant physician in the team. Currently there are 4 other consultant physicians in the team (consultants in rheumatology and diabetes/ endocrinology) to share this General Medical ward-based care duty for the team’s designated base ward. This will increase to eight Consultants aligned with further recruitment to support the introduction of the Needs Based Care model.

Currently the Acute Medical responsibility of these posts is to participate in the ‘B’ rota, which is a 1:13 rota. The ‘B’ rota consultant provide out of hours general medical cover (up to 78 years of age) together with the physicians of the Department for Medicine for the Elderly (over 78 years- the ‘C rota’). Both these groups undertake the traditional weekday morning and weekend post-take round of patients admitted overnight on a 1:13 rota. Together, the ‘B’ and ‘C’ rota physicians are also available to be called back into the hospital out of hours to deal with clinical problems. This commitment will be reviewed as the Needs Based Care model becomes more established.

The ‘A’ rota complements the ‘B’ and ‘C’ rota whereby the A rota consultant has medical responsibility for an acute EAU session (the consultant review of acute patients) from 11.00~22.00, Monday, Tuesday (off Wednesday and Thursday) and then a separate block of 10.00~22.00 Friday to Sunday (off the following Monday and Tuesday) and 11.00~22.00 Wednesday and Thursday (off Friday) once every 12 weeks.

The acute and general medicine rotas will be subject to review as Needs Based Care implementation progresses.

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: Rheumatology Surgery 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.

A 10 PA week divides into a minimum of 8.5 PAs for clinical activity and a minimum 1.5 PAs for Supporting Professional Activity (SPA) in agreement with the Clinical and Divisional Directors. The Academy of Medical Royal Colleges estimates that 1.5 SPAs per week is the minimum time required for a consultant to meet the needs for CPD for revalidation purposes. CPD activities encompass clinical, personal, professional and academic activities. If required and agreed additional SPA time above 1.5 should be linked to organisational objectives, such as, research, clinical management or medical education roles. The Job plan allocation for Clinical Activity and SPA will be reviewed three months after appointment. A diary exercise will provide evidence of activities. Thereafter review will be annual.

In addition to the fixed clinical sessions necessary to provide continuous cover in the clinical area, flexible sessions that include time for teaching, administration, management and clinical governance will be discussed and agreed.

The Trust may wish to contract for up to a further 2 PAs to support the provision of extended clinical cover and other supporting professional activities. This will be discussed with the appointees.

Example Outline Timetable - (Subject to change)

The principle commitment of this 10 PA post is to provide an average of 4 rheumatology clinics per week with the associated administration (total 6 PAs). The General Internal Medicine (GIM) in-patient commitment will rotate in blocks of 4 weeks, to be shared with other consultant colleagues in the directorate. Elective outpatient work commitment in Rheumatology will be adjusted accordingly during blocks of GIM.

Weekend working is provided for during the GIM block. Additional duties currently include ward referrals and providing clinical support for the wider Rheumatology MDT team, are shared flexibly and equitably with other consultant colleagues in the directorate. A reduction in PAs for ‘off ward weeks’ will compensate for weekend working.

The pattern will be subject to change, in order to fit in with the requirements of the emerging Needs Based Care project in the provision of Acute/ General Internal Medicine as well as availability of out-patient clinic accommodation.

Example timetable during elective weeks (weeks 1- 3)

Example timetable during GIM block (week 4)

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

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.

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 General Medicine: Rheumatology

Office Accommodation

Office accommodation will be provided for the appointee with secretarial support

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

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

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

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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.***