THE HILLINGDON HOSPITALS NHS FOUNDATION TRUST

Trust SHO’s Medicine (4 posts)

(Diabetes and Endocrinology/Cardiology/Care of the Elderly and General Medicine)

Start date Feb 2019 for 6 - 12 months

(Earlier appointment possible)

The Hillingdon Hospital Trust is a District General Hospital in West London. The hospital
serves the borough of Hillingdon (population >300,000). The London Borough of Hillingdon is
contiguous with the Hillingdon Primary Care Trust and Clinical Commissioning Group. It
incorporates Heathrow Airport and has a spectrum of ethnicity and deprivation consistent with
its location. The Trust gained foundation status in April 2011 and comprises of Hillingdon
Hospital situated in the south of the Borough, which supports acute services, paediatric and
maternity services. Mount Vernon Hospital, to the North of the borough, delivers out-patient
services, elective surgery, elective Endoscopy and some older peoples services. Mount
Vernon also hosts the North and East Hertfordshire Cancer Centre which our patients use.
Besides a busy Accident and Emergency and urgent care department (110,000 attendances
per year), The Hillingdon Hospital admits 56,000 patients, has separate emergency surgery
and trauma rotas, a level 3 intensive care unit, stroke unit, a coronary care unit, medical and
surgical day care units and a specialist neurorehabilitation unit.

There is an active Education Centre with close links to Brunel University. It is associated with
Imperial College Medical School and is part of their undergraduate teaching programme.

These posts have become available due to the Deanery being unable to fill training posts.
However as the posts are filled locally, they will not be recognised for training. These posts
would suit junior doctors with prior NHS experience who wish to gain further experience in a
busy, friendly District General Hospital, at SHO or Senior SHO level, particularly those
wishing to pursue Endocrinology, Cardiology or Care of the Elderly specialty training. Prior
experience of working in the NHS is mandatory for this post.

1. The Post

THIS IS NOT A DEANERY RECOGNISED TRAINING POST

The postholder will spend 6 months within the Diabetes and Endocrinology/Cardiology/Care
of the Elderly firms, with responsibility for acute admissions to the team and care of ward
patients. The post-holder is expected to be part of the on-call medical rota which includes
evenings, nights and weekends. The posts will be available in February 2019, however
suitable candidates wishing to start earlier, will be accommodated within the Team/ Division.
The posts are extendable to 12 months, subject to satisfactory performance and service
requirements.

Location of duties: Hillingdon Hospital

Minimum criteria: FY2 level competency in general medicine with previous NHS
hospital experience. BLS certified.

Desirable: Desire to gain experience in Diabetes and Endocrinology/

Cardiology/ Care of the Elderly/ General Medicine at SHO or Senior
SHO level. ALS Certified. MRCP.

Education: The post holder will be expected to participate and attend specialty
teaching, general medical grand rounds, clinical governance
meetings and X-ray meetings.

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 The postholder will be encouraged to participate in teaching and in
Quality improvement projects including audit and service
development.

2. Diabetes and Endocrinology Department

The department is staffed by 4 Consultants, 2 Diabetes and Endocrinology Registrars, 1

Renal Registrar, 1 part-time Foundation doctor (F2) and 2 full-time Foundation doctors (F1).

We run Diabetes clinics to assess new or newly referred diabetic patients, type 1 and
complex type 2 diabetes mellitus, teenagers (16-19 years old) and young people (19-25 years
old) with diabetes, diabetic women planning pregnancy, antenatal diabetes, diabetic kidney
disease, diabetic foot problems including a Multi-disciplinary Foot Clinic, diabetic dietetic
clinics including weight management. The Unit is an accredited Type 1 diabetes education
(DAFNE) provider and runs an established insulin pump (continuous subcutaneous insulin
infusion, CSII) service.

The Endocrinology clinics are designed for patients with a wide range of hormone and
metabolic problems. The Unit offers a nurse-led endocrine testing service for specialized
hormone blood investigations.

Churchill ward is our 20 bedded base ward. The inpatients include general medical patients,
renal patients and a broad range of specialty patients including patients with Diabetic keto
acidosis, Diabetic foot ulcers and complex diabetic patients. There is daily Consultant ward
rounds and hence consistent Consultant supervision and support. The weekly X-Ray
meetings provide an opportunity to discuss imaging of inpatients and outpatient podiatry
patients seen in the Department and in the Community. The post holder has an opportunity to
attend a weekly clinic where new patients with both diabetes and various endocrinological
conditions can be assessed and presented to the supervising Consultant.

We strongly encourage and support doctors with an interest in Diabetes and Endocrinology to
take up projects within the department to help further their career development.

3. Cardiology Department

The Cardiology Department at THH provides in-patient care for all patients admitted with
acute Cardiac disease and provides general Cardiac out-patient clinics at both the Hillingdon
Hospital and Mount Vernon Hospital sites. There are currently 2.6wte Cardiologists at THH.
Dr Simon Dubrey is based at THH; Dr Georgios Karagiannis is present 4 days at THH and 1
day of transplant medicine at Harefield Hospital; Dr Gareth Rosser (4 days at THH/1 at
Harefield doing interventional cardiology), several other Harefield Cardiology Consultants
have weekly clinics at THH, Dr V Panoulas (main interests in coronary intervention and TAVI),
Dr W Hussain and Dr T Saluke (Electrophysiologists) and Dr Anthony Barron (Interest in
imaging). There is 1 Cardiology SpR on the North West London rotation, 2 ST2s, 2 FY1s and
a Cardiology Physician Associate.

There is a daily Consultant-led Ward round of all cardiology inpatients, which incorporates
seeing new patients from the previous day’s medical take with cardiac problems. Currently
the Consultants work as a Team, providing cover to the wards on different days, depending
on their outside commitments.

Each week the department runs 3 Rapid Access Chest Pain clinics, 6 General Cardiology
clinics, one heart failure clinic and a Virtual clinic. In 2016/17 3502 new patients and 6500
follow ups were seen. The Echo department is accredited by the British Society of Echo and
offers transthoracic and transoesophageal echo. There is a weekly Consultant-led echo
departmental meeting to review interesting and challenging cases. There is no catheter lab on
site, but we have very strong links to Harefield Hospital to provide primary angioplasty (since

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2004), acute angiography for patients with acute coronary syndromes, and
pacing/EP/devices.

The department offers direct access echocardiograms, 24hr holter and blood pressure
monitors to local GPs and each of these requires a concomitant report to be sent.
There is a Specialist heart failure clinic led by Lisa Casey (Heart Failure nurse). Molly Teoh
(Senior Cardiac Specialist Nurse) runs post ACS discharge clinics, arrhythmias clinics and a
nurse-led cardioversion service.

4. Care of the Elderly

The Department currently has 12 Geriatricians with a complement of SpRs, Core and
Foundation Year trainees and Trust Grade doctors. The department has an excellent track
record in service development and improvement and the post holder would be encouraged
and supported to be involved in projects.

The service is integrated with General Medicine but provides a specialist inpatient service for
people over 80 or younger on a needs related basis. There are 4 onsite care of the elderly
wards including 2 30 bedded acute Care of the Elderly wards, Grange and Hayes Ward, a 24
bedded rehabilitation ward, Beaconsfield East, and a 10 bedded Acute Frailty Unit There is a
24 bed Stroke Assessment Unit which receives repatriations from the Hyperacute Stroke Unit
at Northwick Park Hospital. Mount Vernon and Hillingdon both have day hospitals where
outpatients are held. We also provide the Consultant supervision for the Hawthorn
Intermediate Care Unit which is a 22 bedded rehabilitation unit co-located on the Hillingdon
Site.

We run daily Rapid Access Clinics for the Elderly with additional General clinics throughout
the week. We also run dedicated Falls, TIA and Stroke clinics and there will be opportunity for
the post holder to attend clinics where possible.

5. Acute Medicine

Patients referred through A&E and GP expected are assessed and admitted through the
brand new, purpose built Acute Medical Unit with approximately 45-70 patients assessed
each 24hour period. The unit is staffed by 4 consultants who are responsible for running the
on call from 7 am until 7 pm, Monday to Friday. The on-call team comprises a medical SPR
with two middle grade trainees (CT1/CT2/ST1/F2) and one F1.
There are twice daily handover meetings and a hospital at night scheme.

6. Department structure – medical staffing and other staff

This Post falls within the Directorate of Medicine. The Directorate comprises of 3 separate
streams – Department of Medicine, Care of the Elderly and Rehabilitation, and Directorate of
Emergency Care.

Divisional Director Dr. Michele Cruwys

Deputy Divisional Director for Emergency Care Dr Fiona Wisniaki
Specialty Clinical Leads for medical division: Dr Louise McCusker – Elderly Medicine
Dr Evangelos Vasileaides – Non-acute
specialties
Dr Bob Grover – Acute Medicine
Specialties
Dr Milena Kostic – Emergency Medicine
Management structure:
Assistant Director of Operations: Miss Rachel Tustin
Assistant Director of Nursing Services : Mrs. Audrey Malik
Senior Business manager: Mr. Michael White

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Consultant Physicians

Acute Medicine Dr S Goel, Dr S Narayanaswamy, Dr S Salehi, Dr C Rasanu,

Dr Jariwala (locum)
Cardiology Dr S Dubrey, Dr G Karagiannis, Dr G Rosser
Care of the Elderly Dr J Vowles, Dr S Barnes, Dr E McCusker, Dr E Vasileiadis,
Dr A De Souza, Dr E Baldwin, Dr A Lam, Dr N Jethwa, S
Khan (P/T)
Diabetes & Endocrinology Dr R Baburaj, Dr C Mitchell, Dr B Krishnan
Gastroenterology Dr B Grover, Dr S Lean, Dr A Postgate, Dr Y Siaw, Dr A
Rajendran and locum
Respiratory Medicine Dr P Wills, Dr Haselden, Dr S Kon
Dermatology Dr S George, Dr F Ravat, Dr D Shah, Dr S Murali, Dr M Joshi
Haematology Dr R Kaczmarski, Dr K Patel, Dr M Sohal, Dr T Sugai
Neurology Dr Y Tai, Dr S Viegas, Dr S Gregoire
Palliative medicine Dr Y Saunders, Dr J Potter, Dr J Leithead
Radiotherapy/Oncology Dr M Harrison, Dr A Guppy, Dr C Westbury, Prof J Maher, Dr
C Lemon, Dr G Rustin
Renal medicine Dr P Hill, Dr S Goel
Rehabilitation Dr A Nair
Sexual Health Dr B Holden, Dr L Rubinstein
Rheumatology Dr S Woodham, Dr A Bhatia
Stroke Dr A Parry, Dr E Vasileiadis, Dr B Aweid

7. Trust CARES Values

The Trust has defined its culture as one that puts compassionate care, safety and quality at
the heart of everything we do. Our CARES values stand for:

Communication Recognising the importance of listening and communicating in practice.

Striving to understand others’ needs, responding with care, compassion
Attitude
and professionalism.
Taking responsibility for consistently delivering excellence and being
Responsibility
open in all that we do.
Equity Recognising that people are different and value everyone equally.
Safety Viewing patient, staff and visitor safety as a priority.

TERMS AND CONDITIONS OF SERVICE

The Hillingdon Hospital Trust holds the contract for this post.

The post-holder is covered by the National Terms and Conditions of Service –

The whole-time salary scale applicable to this post is £30,302 - £40,090, London Weighting
Allowance of £2,162 per annum is payable. An Additional supplement will be paid for out-of-
hours/ on-call work.

The successful candidate will be required to have and maintain full registration with the
General Medical Council.

Your attention is drawn to the confidential nature of information collected within the NHS. The
unauthorized use of disclosure of patient or other personal information is a dismissible
offence and, in the case of computerized information, could result in a prosecution for an
offence or action for civil damages under the Data Protection Act 1998. It should be noted
that contracts of employment for Consultant staff are the subject of discussion at national
level and any changes will be incorporated into your contract.

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A satisfactory medical examination is a condition of employment for medical and dental staff
in the NHS. The successful candidate may therefore be required to undergo such an
examination unless a satisfactory one has been carried out within the last twelve months.

ARRANGEMENTS FOR ANNUAL AND STUDY LEAVE

The appointee will be expected to make their own arrangements regarding annual leave and
study leave cover, liaising with the other doctors as appropriate. Six weeks notice is required
and consultant agreement / form signature for leave.

REHABILITATION OF OFFENDERS ACT 1974

As the nature of work you will be undertaking during your appointment involves direct contact
with people who are receiving a health service, we have been obliged to ask you to complete
a disclosure form (at enhanced level), which will be processed by the Criminal Records
Bureau. We require you to disclose any convictions, cautions, reprimands and warnings you
may have under the conditions of the above order. You are not entitled to withhold such
information about convictions which otherwise might be ‘spent’. Failure to disclose such
convictions could result in the termination of your appointment.

The post is subject to a Criminal Records Disclosure Check at enhanced level. The
appointed candidate will be required to complete the NHS Pre-, and Post-Appointment
Declaration form as outlined in HSC2002/008.

SAFEGUARDING

The Hillingdon Hospital NHS Trust is committed to and has a duty to make arrangements to
safeguard and promote the welfare of children, young people and vulnerable adults (Children
Act, 1989 and 2004; Safeguarding Vulnerable Groups Act, 2006). Staff groups will have
different training needs to fulfil their duties, depending on their degree of contact with children,
young people and vulnerable adults and on their level of responsibility. Each employee has a
responsibility to cooperate with their manager in attending the relevant training and to adhere
to safeguarding legislation, local policy and processes.

To this effect all new job descriptions will contain the above statement.

For exiting staff the above commitment will apply and staff will be expected to comply with
this. If you are unsure whether you require further training or if it is relevant for your area,
please speak to your manager.

HEALTH AND SAFETY

It is the duty of every employee while at work not to intentionally or recklessly interfere with
anything provided in pursuance of statutory provision.

It is the duty of everyone while at work to take reasonable care of the Health and Safety of
themselves and other persons who may be affected by acts or omissions at work.

It is the duty of every employee while at work to co-operate with the employer in ensuring that
all statutory and other requirements are complied with.

INFECTION CONTROL

It is the responsibility of all staff to recognize their role in maintaining a safe environment for
patients, visitors and staff to minimize the risk of avoidable healthcare associated infection.
Employees are responsible for ensuring that they are fully aware of the Trust’s Infection
Prevention and Control policies and the post holder will undertake infection control training on
an annual basis.

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HEPATITIS B

The successful candidate will be required to provide documentary evidence of natural or

acquired immunity to Hepatitis B, before taking up employment. Where this is not possible,
the post holder will be required to demonstrate by recent (within the last year) evidence of
serology showing the absence of Hepatitis B surface antigen. These provisions are to meet
the requirement of the Department of Health’s instructions to Trusts (HSG(93)40).

EQUAL OPPORTUNITIES

The post holder is required at all times to carry out responsibilities with due regard to the
Trust’s Equal Opportunities Policy and to ensure that staff receive equal treatment throughout
their employment with the Trust.

RISK MANAGEMENT

All staff has a responsibility to report all clinical and non-clinical accidents or incidents
promptly and when requested to, co-operate with any investigation undertaken.

CONFLICT OF INTERESTS

You may not, without the consent of the Trust, engage in any outside employment and in
accordance with the Trust’s Conflict of Interest Policy you must declare to your manager all
private interests, which could result in personal gain as a consequence of your employment
position within the Trust. Interests that might appear to be in conflict should also be
disclosed.

In addition, the NHS Code of Conduct and Standards of Business Conduct for NHS staff
(HSG93/5) require you to declare all situations, where you or a close relative or associate has
a controlling interest in business (such as a private company, public organization or other
NHS voluntary organization), or in an activity which may compete for any NHS contracts to
supply goods or services to the Trust. You must therefore register such interests with the
Trust whether on employment or subsequently whenever such interest arises. You should
not engage in such interests without the written consent of the Trust, which will not be
unreasonably withheld. It is your responsibility to ensure that you are not placed in a
position, which may give rise to conflict between your private patients' interest and your NHS
duties.

CODE OF CONDUCT FOR PROFESSIONAL GROUPS

All staff are required to work in accordance with their professional group's code of conduct
(e.g. NMC, GMC, DOH, Code of Conduct for Senior Manager).

For further information/ discussion, please contact Dr Catherine Mitchell, Consultant in

Diabetes and Endocrinology, Dr Bob Grover, Consultant Gastroenterologist and
Hepatologist, bob.grover@nhs.net

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