|
Palliative Medicine Sub-Speciality Training at ST3+ |
|
SPECIALIST REGISTRAR IN
PALLIATIVE MEDICINE
JOB DESCRIPTION
Leicestershire & Rutland Hospice
Cransley Hospice, Kettering
Cynthia Spencer House, Northampton
University Hospitals Leicester
Kettering General Hospital
Northampton General Hospital
ST3 – ST7 TRAINING PROGRAMME
PALLIATIVE MEDICINE JOB DESCRIPTION
The
post is a rotation between Leicestershire & Rutland Hospice (LOROS),
Kettering General Hospital & Cransley Hospice, University Hospitals
Leicester and Northampton General Hospital and Cynthia Spencer House,
Northampton
GENERAL DESCRIPTION OF TRAINING
PROGRAMME
This
four year programme consists of six posts of approximately eight months’
duration providing a comprehensive training in palliative medicine. The training is provided in neighbouring
counties and gives a variety of experience in both NHS and voluntary specialist
palliative care settings. All the
services in the programme have been in existence for some time and therefore
give the opportunity of working with other members of established multidisciplinary
teams. The scheme provides trainees with
opportunities for clinical experience and training in palliative medicine in a
wide variety of settings, in cancer multidisciplinary teams and clinics and in
non-malignant disease.
There
will be an educational supervisor for the trainee in each post and clinical
supervision is also provided by other consultants working in the service. Regular appraisals, personal learning plan
development, educational reviews and assessments will be carried out throughout
the programme.
There
are monthly educational meetings of all the registrars on the programme and
quarterly educational meetings with other trainees in the “Trent Region”, ie.
from Leicester, Sheffield and Nottingham and Derby.
The
exact order of the rotation will depend upon the timing of entry and leaving of
registrars on the scheme. As trainees
move through the rotation, they will be given increasing responsibility in
clinical situations, with consultant supervision. Experience in management will be available in
later posts and teaching opportunities will be available in all posts, but with
an increased emphasis in the senior posts.
Entry
to the scheme will be at ST3 level.
The
six posts in the rotation are:-
|
|
|
|
|
1&6 |
Leicestershire & Rutland Hospice (LOROS) |
Inpatient care Outpatients Community palliative care Hospice at Home Lymphoedema Day Centre |
|
2 |
Kettering General
Hospital & Cransley Hospice |
Hospital palliative care teams Outpatients, inpatients Motor Neurone Disease clinics Non-malignant palliative care Community palliative care |
|
3 |
Leicester Royal
Infirmary |
Hospital palliative care Oncology clinics Cancer MDTs |
|
4 |
Leicester General
Hospital Glenfield General
Hospital |
Hospital palliative care teams Cancer MDTs Outpatient clinics |
|
5 |
Northampton General
Hospital & Cynthia Spencer House |
Hospital palliative care team Oncology clinics Palliative care Inpatients |
MEDICAL STAFF
Consultant
Staff
Leicester - Dr Cooke, Dr Faull, Dr Feathers
Dr
Rudd, Dr Waterhouse
Northamptonshire - Dr
Grant
Dr
Tallon, Dr Willows (Associate Specialist) [Northampton]
Dr
Shah [Kettering
]
Other
Medical Staff
Leicester - SHO x3
Kettering - Dr Kerr (Staff Grade)
Dr
Streeter (Clinical Assistant) SHO
Northampton - Dr Bird (Clinical Assistant)
SHO
TRAINING OBJECTIVES
The
purpose of the first three posts is to give the appointee a good basic
knowledge of palliative medicine and oncology.
The detailed objectives for each post will be planned with the trainee
at the beginning of the post and depend upon previous experience.
SENIOR CLINICAL POSTS
These
aim to complete the training in clinical topics relating to palliative medicine
and to develop the management and leadership skills required for a consultant
post.
The
trainee will therefore have greater clinical responsibility while continuing to
receive consultant supervision.
Again,
detailed objectives will be set with the trainee at the beginning of each post
and opportunities will be given to have more experience with cancer
multidisciplinary teams to complete the range of experience commenced earlier.
Management
experience will not only include attendance of at least one management course,
but also shadowing consultants involved in management and attending management
meetings.
In
these posts, the trainee will also be given the opportunity to develop and use
their teaching skills and will be encouraged to attend a recognised course on
teaching.
DESCRIPTION OF PALLIATIVE CARE
UNITS / HOSPITALS
The
LNR Cancer Network
This
consists of two cancer centres, Leicester and Northampton, and one cancer unit,
Kettering General Hospital. There is a
co-existing palliative care network.
Leicester
i. Leicestershire & Rutland Hospice
(LOROS)
This
is a 31-bedded voluntary hospice serving a population of approximately one
million. A day unit operates from
another site. The unit provides care, in
the main for patients with cancer and Motor Neurone Disease. LOROS offers a wide range of specialist
palliative care services including inpatient unit, daily outpatients, home care
team, hospice at home, volunteer family support service, complementary therapies,
counselling service and lymphoedema service.
The day centre offers 15 places, three days per week.
In
addition to the specific areas outlined above, LOROS acts as a general resource
for advice, knowledge and support for health professionals, patients and carers
on all aspects of palliative care.
Medical
Staff
Visiting
Consultant Anaesthetist (1-2 sessions)
Visiting
Oncologist
Visiting
Consultant Psychiatrist
SpR
SHO
x3
Education
& Training
There
is an active multidisciplinary education programme for both undergraduate,
postgraduates, nurses and allied health professionals. An education co-ordinator has recently been
appointed. Medical students undertake
clinical placements and are supervised by the ward SpR.
Principal
meetings at LOROS:-
·
Multidisciplinary
case conference x2/week
·
Weekly
lunchtime doctors’ meeting
·
Monthly
clinical governance meeting involving audit
·
Monthly SpR
teaching afternoon
Duties
·
Oversee
medical management of inpatients
·
Supervise SHOs
·
Follow-up of
discharged patients in outpatients
·
Regular
clinical supervision to community nurse specialists in palliative care
·
Medical
opinions for lymphoedema team
·
Medical
support to Hospice at Home team
·
Co-ordinate
medical student teaching
·
Participate in
audit and clinical governance programme
·
Participate in
on-call rota
Opportunities
·
Domiciliary
visits as needed
·
Working in an
established MDT
·
Extending
their teaching role - undergraduate/postgraduate/PAMs/nurses
·
Some management
opportunities
·
Specialist
pain anaesthetist visits twice weekly
·
Liaison
Psychiatry
ii. University Hospitals Leicester
Leicester Royal Infirmary
This
is the largest hospital in Leicester (1110 beds) and the site of the casualty
department. Main specialities include
oncology, upper and lower GI surgery, paediatrics, head & neck surgery,
maxillofacial surgery, obstetrics & gynaecology, medicine, dermatology,
orthopaedics and ophthalmology.
Oncology
Department
This
is on a new purpose-built site opened in 1997.
There are three medical oncologists, six clinical oncology consultants
and one associate specialist. The
academic department is headed by Professor WP Steward. There are weekly MDTs in all the major cancer
sites requiring palliative care input.
LRI
Palliative Care Team
This
comprises five WTE Macmillan nurses and one consultant (0.5 WTE). The team provides care and support for
patients mainly with advanced cancer as well as running an active educational
programme. There are weekly MDTs and
good liaison with all specialist teams.
Duties
·
Involved in
all aspects of the specialist palliative care service
·
Supervise
clinical care of specialist nurses
·
Contribute to
educational programmes
·
Participate in
oncology MDT
·
Fortnightly outpatients
at LOROS Day Centre
·
Attend
teaching at LOROS
·
Participate in
LOROS on-call rota
·
Liaison
psychiatry / psycho-oncology service
Opportunities
·
Attend
oncology clinics
·
Close working
relationships with all cancer site teams.
Particular opportunities here in:-
head and neck
cancer / gynae-oncology / haematology / sarcoma
·
Specialist
cancer pain service
Leicester
General Hospital
Leicester General Hospital (LGH) has 450 beds. It is the
site for urology, renal, upper and lower GI and hepatobiliary, general medicine
and obstetric & gynaecological services.
LGH Palliative Care Team
This comprises three WTE Macmillan nurses and one consultant
(0.5 WTE). The team provides care and
support for patients mainly with advanced cancer as well as running an active
educational programme. There are weekly
MDTs and good liaison with all specialist teams.
Glenfield
General Hospital
Glenfield General Hospital (GGH) has 350 beds. It is the site for breast services, upper and
lower GI surgery, lung and cardiothoracic services.
GGH Palliative Care Team
This comprises three WTE Macmillan nurses and one consultant
(0.5 WTE). The team provides care and
support for patients mainly with advanced cancer and in particular work closely
with the lung cancer team, as well as running an active educational
programme. There are weekly MDTs and
good liaison with all specialist teams.
Duties
·
The specialist
registrar will be involved with all the clinical aspects of the palliative care
service
·
The SpR will
supervise the clinical care of specialist nurses
·
Contribute to
educational programmes
·
Participate in
oncology MDTs
·
Undertake
fortnightly outpatient clinic at day centre
·
Attend
teaching at LOROS and participate in on call rota
Opportunities
LGH:
·
Develop
existing relationships with all cancer site teams especially:-
§
Urology
§
Hepatobiliary
surgery
§
Tertiary renal
service with developing links to palliative care
GGH:
·
There are close
relationships to the lung cancer team leading to excellent experience in
management of lung cancer complications, eg. pleural effusions
·
Tertiary
cardio-thoracic centre with increasing links to palliative medicine
iii. Kettering
Cransley Hospice
This
is a purpose-built 9 bedded specialist NHS hospice covering a population of
260,000. The unit provides care to
patients with any terminal disease, the majority of patients have cancer, Motor
Neurone Disease, multiple sclerosis and respiratory or cardiac failure.
There
is a well-established multidisciplinary team. There are regular outpatient
clinics, including a Motor Neurone Disease clinic and lymphoedema service.
Medical
Staff
Consultant in Palliative Medicine (0.6 WTE) based at
Cransley & Northampton
SpR
Staff Grade
Clinical Assistant
Kettering General Hospital
Kettering
General Hospital (KGH) has 600 beds serving a population of 260,000. It is a cancer unit with a day case cancer
treatment unit and inpatient haematology beds.
Palliative
Care Team
Three
Macmillan nurses, a specialist lung cancer nurse and palliative care consultant
(WTE 0.2) are based at KGH. They see
patients with palliative care needs across the hospital, offering advice and
support. They also partake in an active
educational programme.
Duties
of the Post
·
When at
Cransley Hospice, to be responsible, with the SHO or staff grade, for the
day-to-day care of inpatients
·
Work with the
palliative care support team at Kettering General Hospital
·
Participate in
regular weekly medical meetings
·
Participate in
on-call rota
·
Supervision of
junior staff and other medical staff on secondment to the unit
·
Provide advice
on symptom control as needed to community staff at the educational meetings
(Cransley & Kettering)
Opportunities
·
Own outpatient
clinic session at Cransley (dependent on experience)
·
Experience of
MND including the MND clinic
·
Learn about
the medical and social aspects of bereavement and the organisational aspects of
running a bereavement service
·
Medical
student teaching
·
Haematology
experience
Northampton
Cynthia Spencer Hospice
This
is a 16 bedded specialist NHS hospice serving a population of 360,000. A day hospice operates from the same
site. Patients are admitted with cancer,
Motor Neurone Disease, multiple sclerosis and respiratory or cardiac
failure. There is a full
multi-disciplinary team and lymphoedema service.
Medical
Staff
Consultant in Palliative Medicine (0.8 WTE) + 0.6 WTE mainly
working at Northampton General
Associate Specialist (0.8 WTE)
SpR
SHO
Clinical Assistant 0.5 WTE
Northampton General Hospital
Northampton
General Hospital (NGH) has 600 beds and is a general hospital with all
specialities as well being a cancer centre.
The palliative care team has good working relationships with the
oncologists and haematologists.
Palliative
Care Team
A
consultant in palliative medicine (0.6 WTE), three Macmillan nurses and a
specialist lung cancer nurse are based at NGH.
They see patients with palliative care needs across the hospital,
offering advice and support. They also
partake in an active educational programme.
Duties
– Cynthia Spencer Hospice, Northampton
·
Responsible
for day-to-day management of inpatients
·
Outpatient
session
·
Medical
support for the day hospice
·
Participate in
weekly medical meetings
·
Participate in
on-call rota
Opportunities
·
MND (as KGH)
·
Teaching
medical students
·
Domiciliary
visits with community Macmillan nurses
·
Management
experience
Duties
– Northampton General Hospital
·
Involved in all
aspects of the specialist palliative care service
·
Supervise
clinical care of specialist nurses
·
Contribute to
educational programmes
·
Participate in
oncology MDT
·
Liaison
psychiatry / psycho-oncology service
Opportunities
·
Very close
working with the cancer centre
·
Haematology
experience
·
Developing
teaching programme
·
Specialist
pain clinics
·
Service
development opportunities
RESEARCH
There
is no designated block for research but if trainees wish to do a research
project, they should discuss this with their educational supervisor and lead
for research.
Last
updated: January 22, 2007