JOB DESCRIPTION

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					Health & Social Services
Medical Staffing
Gloucester Street
St Helier
JE1 3QS
Medical Staffing - Telephone: 01534 445405




                  HEALTH & SOCIAL SERVICES

                   DIRECTORATE OF SURGERY


                               JOB DESCRIPTION

                       ASSOCIATE SPECIALIST IN
                    OBSTETRICS AND GYNAECOLOGY


                           RELATIONSHIPS:

                           MR N A MACLACHLAN FRCOG, CONSULTANT
                           OBSTETRICIAN AND GYNAECOLOGIST

                           DR FIONA NELSON, MRCOG, MPHIL, DFFP, CONSULTANT
                           OBSTETRICIAN AND GYNAECOLOGIST

                           MR J B DAY FRCOG, FRCS, CONSULTANT OBSTETRICIAN
                           AND GYNAECOLOGIST currently covered by:

                           MR P J SULLIVAN, LOCUM CONSULTANT OBSTETRICIAN
                           AND GYNAECOLOGIST

                           ONE ASSOCIATE SPECIALIST (THIS POST)

                           FIVE STAFF GRADE DOCTORS

                           THREE StR GP TRAINEES

                           2 F2’S

                           ONE TRUST GRADE SHO
Introduction

Jersey, the largest of the Channel Islands, is situated in the Bay of Mont St Michel, fourteen
miles west of the Cherbourg Peninsula and is a self-governing dependency of the British
Crown.

The Island is about nine miles from east to west and five miles from north to south (at its
maximum), with an area of 45 square miles. The population is approximately 87,000, which
rises considerably during the summer season, and banking, tourism and agriculture supply
the bulk of its revenue. There are few industrial undertakings.

Close links are maintained with the Wessex Health Region and other major centres in the
UK and consultants in areas such as oncology, neurology and cardiology visit the Island on a
regular basis.

The gynaecological theatres have the most up-to-date laparoscopic equipment and full
range of gynaecological procedures are carried out on the island. The staffing of the
department comprises of the following:

Health and Social Services

The Jersey Health and Social Services Department is independent from the UK National
Health Service and is the political responsibility of the Health and Social Services Ministry,
consisting of an elected Minster and Assistant Minster who serve as part of the Island’s
Government system. The States of Jersey Health and Social Services Department is
directed by a Chief Executive, Mr Mike Pollard, supported by the Senior Management Team.
Funded by the States of Jersey from taxation revenue, the Department of Health and Social
Services has a statutory requirement to provide free health care in respect of Hospital
Services, Community, Public and Environmental Health.

This service provides the care for the Island of Jersey, there are 3 clinical Directorates
providing healthcare:

      Surgery
      Medicine
      Mental Health

The Gynaecology Service

The Gynaecology service carries out approximately 2,000 operations a year, and there are
over 350 emergency cases a year admitted through the Gynaecology Ward. 38% of all
operations are carried out in the award winning Day Surgery Unit that has recently been
expanded. A nurse-led pre-admission service operates in the Day Surgery and main
Gynaecology area. Each year there are over 6,000 referrals to the Outpatient Department,
and there are over 1,000 inpatients admitted to the ward in a year. The Gynaecology Ward
(Rayner Ward) has 10 inpatient beds, and attached to the ward is the Gynaecology
Outpatient Department. Nursing staff rotate between the ward and the Outpatient area
providing continuity of care. There is a fully equipped colposcopy unit, and an ultrasound
scanner in the Outpatient Department. There is a separate Assisted Reproductive Unit on
Le Quesne Ward, directed by Mr MacLachlan, run by a Sister in Assisted Reproduction, a
Staff Grade and receptionist. A satellite Assisted Reproductive service has been set up
between Jersey and Bourn Hall in Cambridge for egg recovery and embryo transfer.



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The Gynaecology Department carries out a considerable amount of laparoscopic surgery
under the direction of Mr. John Day who is a MATTU preceptor (currently being covered by
Mr Peter Sullivan). Laparoscopic equipment is available in both Day Surgery and Main
Theatre. About half of the hysterectomies are carried out vaginally or laparoscopically
assisted. There is a Uro-gynaecology service available which carries out urodynamic
assessments, and there is an active uro-therapy physiotherapy department. There are
dedicated counselling services for all areas within the department.

Colposcopy training and colposcopic practice is supported within the department.

Gynaecology Oncology is co-ordinated by Mr. John Day (currently covered by Mr Peter
Sullivan), and Visiting Specialists from the UK hold chemotherapy and radiotherapy Clinics.

The termination of pregnancy service is led by Dr Fiona Nelson.
The termination laws in Jersey differ from those of the U.K. with termination being permitted
up to the end of the 12th week of pregnancy, unless there are fetal anomalies, where TOP is
allowed up until 24 weeks. Dr Nelson also provides psychosexual counselling and is
involved with developing the sexual health strategy for Jersey.

The Obstetric service

There are approximately 1,000 births per annum. There is a high quality well equipped
Labour Ward suite with intrapartum monitoring and blood gas analysis available. There is a
designated Operating Theatre on Labour Ward and twenty four hour anaesthetic cover, with
approximately 34 % epidural rate. There is a complete mix of obstetric cases with the Unit
having to deal with high-risk obstetrics as well as low risk because of the geographical
isolation of the island. There are three Consultant Ante Natal Clinics per week. . Most of the
low risk antenatal care is shared care between General Practitioners and the hospital
Midwives. Each Consultant has an antenatal clinic each week for higher risk cases. Every
ante natal patient is offered a booking scan and Nuchal translucency serum screening for
aneuploidy. The Maternity Ultrasound Department is recognised by the RCR/RCOG for
training in Advanced Obstetric Ultrasound, and there have been a number of successful
trainees who have gone through the Unit. There is a telemedicine link with Guys/St Thomas
fetal medicine and cardiology department. The obstetric outcome is audited using the Protos
maternity system and the Obstetric Ultrasound Department uses the fetal medicine package
- Viewpoint fetal database). All fetal abnormalities are recorded and the Unit is involved with
the Wessex Ante Natal Detection register, (WANDA). All obstetric outcomes are monitored
and the department participates in the Confidential Enquiry into Stillbirths and Deaths in
Infancy. There is twenty-four hour anaesthetic cover with an approximately 34% epidural
rate.

The Post

This full time post comprises 11 sessions per week, plus extra sessions based on the on-call
rota at night.

The appointee is expected to participate in the Registrar on-call rota at night (1:6), but on-
call and day-time sessions will be flexible so that they reflect service needs at the discretion
of the Clinical Director. He/she will be on duty with an StR/F2 and should remain close to the
Hospital when on call. (Resident on call).

The postholder should be experienced in all aspects of Labour ward management and
operative deliveries.

General gynaecology experience at Registrar, Staff Grade or equivalent level is essential.

The successful candidate may be required to hold sessions as part of the Satellite Assisted
Conception service. Clinics are held for preparing couples for the Assisted Conception

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programme in accordance with the HFEA. There are scanning sessions every morning on
ARU and experience in scanning in an infertility setting would be advantageous.

There are 4 Colposcopy clinics each week and it would be desirable if the successful
candidate was accredited in Colposcopy.

An early pregnancy clinic is held Mon – Fri mornings and experience in early pregnancy
scanning is desirable.

The Post Holder will manage the Middle Grade Rota, ensuring that there is no reliance on
external locum cover, except in emergency unavoidable situations. They will also plan the
rotation of the middle grades through the consultant teams on a 4 monthly basis.

The post holder will rotate through the Middle Grade Rota in the same way as the other
Middle Grade Doctors, but will also co-ordinate and organise this process.

Ensure the Continuous Professional Development of the post holder and of the other Middle
Grade doctors.

The post holder will have an active role in clinical governance and risk management. This will
involve participation in the development and updating of departmental protocols.

Teaching/Audit

The postholder will be expected to play a role in the provision of teaching and the general
training of the junior medical staff within the Division. Increased emphasis is placed upon
medical audit and the postholder will also play a crucial role in co-ordinating these activities.

Post Graduate Education

The States of Jersey Health and Social Services Department places a high priority on further
training.

The Hospital has a well equipped library with all the main journals. In addition there is a
MEDLINE CD ROM computer link system so that many more journals may be accessed.
The internet is available in the library.

The Department holds perinatal mortality/morbidity and gynaecology/pathology meetings
once a month. Every Friday afternoon the department holds an education session for all
members of staff.

There are monthly audit/teaching days.
There are weekly clinical incident reporting meetings in Obstetrics.
There are regular perinatal mortality/morbidity meetings with the Paediatricians.
There are monthly gynaecology MDT and Risk Management meetings
There is PG teaching every Friday afternoon.

There is a purpose-built Post Graduate Centre providing six seminar rooms as well as the
Halliwell Lecture Theatre. The Theatre has recently been re-equipped and provides tiered
seating with dual and single slide projection, videos and computer data presentation facilities
for up to ninety five people.

The Hospital is a recognised ATLS and ALS training centre and enjoys close clinical and
expanding academic links with Southampton and other major mainland teaching hospitals.
Medical staff are treated as honorary members of the Wessex and South West Regional
Associations.




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There is a well stocked Medical Library with an experienced full-time Librarian in charge.
Literature search facilities are available.

Study Leave Allowances and Training

The study leave allowance is up to thirty days in a three year period. All applications for
study leave must be approved by the Consultant. Course fees and travel expenses are paid.
All travel is arranged by the Staff Travel Officer.

Locum cover may be provided for extended periods of study leave. For shorter periods
arrangements must be made with colleagues to ensure cover of your duties and the on-call
rota. It is essential that the secretaries and Medical Staffing are notified of these
arrangements before the study leave can be approved.

Annual Leave

Associate Specialist doctors are entitled to thirty days annual leave per annum.

Holidays must be arranged so as not to coincide with the absence of the consultant or other
members of the on call team.. Leave should be taken in complete weeks running from
Sunday to Sunday. Six weeks notice is required if locum cover is requested

Forms for the application of annual leave are obtainable from Medical Staffing and must be
fully completed, notifying the name of the colleague who will cover the duties and sanctioned
by the Directorate Manager - Surgery before they can receive final authorisation from the
Consultant. Annual leave is not normally granted during the first four, or last two, weeks of
the contractual period.

Salary

The salary is in accordance with NHS scales, currently assessed for eleven sessions per
week. The postholder will receive payment for additional sessions to take into account
flexibility and participation in a rota that provides prospective cover as well as for
participation in a one in six on-call rota, shared with the Staff Grade doctors,




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