SANDWELL AND WEST BIRMINGHAM HOSPITALS NHS TRUST

Research Fellow-General and Colorectal Surgery

JOB DESCRIPTION
Introduction

We are seeking to appoint to the post of Clinical Research Fellow a candidate

undertaking clinical research leading to a higher degree (MD or PhD). It is expected that
the appointee would have a research project already agreed and registered with an
appropriate sponsor/academic department.

The post would be designed to ensure maintenance and continued development of

clinical skills during time in research by providing support to the department of surgery on-
call rota. This is currently 1 in 13 and includes SAU shifts and CEPOD theatre shifts and
nights. There is no expectation of additional elective clinical commitments but there may
be scope to provide this by agreement with the clinical lead.

Candidates will carry out clinical duties at junior or senior SpR level, depending upon
previous clinical experience, working with the full support and under the direct supervision
of a consultant surgeon at all times. ISCP support in terms of educational and clinical
supervisor provisions well as WBA support will be provided.

You must possess a basic medical qualification (MBBS or equivalent) and must be fully
registered with the GMC. You need to have passed the MRCS and have a minimum of 2
years post foundation training experience or equivalent, with 12 months post foundation
experience in general surgery. Trainees who have secured a National Training Number
and who wish to engage in a period of formal research and can organize this as an 'out of
programme experience' with their Training Programme Directors, are also welcome to
apply for these posts. Previous registrar level experience is not essential, but would be
desirable.

Sandwell and West Birmingham Hospitals NHS Trust

About the Trust

Great care can change everything. Like you, everyone here at Sandwell and West
Birmingham Hospitals NHS Trust wants to be a part of truly brilliant, integrated care. And
just like you, we’re ambitious about what we do. We’re always seeking ways to do more
and be better for our patients.

Bring your dedication and determination here, and you’ll be surprised by just how great
your career can be. We like to think we offer you the best of both worlds. We’re a

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welcoming and friendly place that’s devoted to our community. But our plans and ideas for
the future - yours and ours - are huge.

First, let us tell you what we’re building on. It’s a firm foundation, of which we’re very
proud.

We are an integrated care organisation with an outstanding reputation for teaching,

education, research and innovation. Our 7,200 staff are here for 530,000 local people
when they need us.

City Hospital in Birmingham is home to the Birmingham and Midland Eye Centre, the Pan-
Birmingham Gynae-Cancer Centre and our Sickle Cell and Thalassaemia Centre. It’s also
the regional base for the National Poisons Information Service.

At Sandwell General Hospital in West Bromwich, you’ll find inpatient, paediatrics, most
general surgery and our stroke specialist centre.

At the Trust, we also have significant academic departments in cardiology, rheumatology,

ophthalmology and neurology. There is now a new Research centre in Sandwell Hospital.

We have intermediate care hubs at Rowley Regis and at Leasowes in Smethwick, which
is also the base for our Birth Centre.

Our community teams throughout Sandwell provide integrated services for children in
schools, GP practices and at home. They also offer both general and specialist home care
for adults in hospices and nursing homes.

In line with our 2020 vision, we will open the brand new Midland Metropolitan Hospital in
2022 - the perfect demonstration of our vision for the future. And we are investing in far
more than buildings.

We are dedicated to investing in you. It matters to us that you enjoy the training, support
and opportunities you need to fulfil your total potential and build the career you really
want.

To make that happen, we’ve trebled our training budget. We’ve developed new career
path frameworks and new ways to recognise your achievements.

Because you’re part of our family, we want the best for you.

Our newest hospital

A community of half a million is eagerly anticipating the brand new Midland Metropolitan
Hospital. It will be worth the wait. Its opening will be the beginning of a fresh chapter in
our ambitious journey to be the nation’s leading provider of integrated care.

As well as being the closest adult hospital to Birmingham’s busy city centre, Midland
Metropolitan Hospital will offer dedicated maternity and children’s services. Crucially, it will
bring together teams who provide acute, emergency care, in line with the views expressed
in our public consultation.

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This exciting new building has been designed with room to grow. What’s more, we are
retaining buildings and wards at Sandwell Hospital for future development.

The majority of out-patient and day-case surgery services will still be provided at Sandwell
Hospital, the City Hospital site and Rowley Regis. City Hospital will house three key
facilities - The Birmingham Treatment Centre providing outpatient, day case and
diagnostic services. The Birmingham and Midland Eye Centre, and the Sheldon Block will
provide intermediate care services. The Sandwell site will house the Sandwell Treatment
Centre, intermediate care beds, and a new 24-hour urgent care centre. All of this mean
that our communities will benefit from truly excellent facilities in the years ahead.

In 2016-17, nearly 6,000 women gave birth with our help. 526,945 people attended
outpatient clinics. There were 199,437 patient attendances plus 33,265 attendances seen
under GP triage at our emergency departments with over 38,994 people admitted for a
hospital stay.

We undertook 45,950 day case procedures, whilst more than 650,000 patients were seen
by community staff.

Each year we publish a quality account to outline to local people how our services
compare to our aims and to others.

The latest data shows that:

Harm-free care: We achieved 95.4 per cent coverage for VTE assessment in 2016/17.

Safe stays: Our overall readmission rate within 30-days of discharge from April 2016 to
February 2017 was 7.2 per cent.

Sandwell and West Birmingham Department of General Surgery

Over the past several years the general surgical department have reconfigured its
services and all inpatients activity now takes place on the Sandwell site. Within general
surgery, endoscopy, daycase/short-stay surgery and out-patients take place on both City
and Sandwell sites with some outpatient activity at the Rowley Regis site.

In November 2015 the City site SAU closed and an enlarged SAU opened on the
Sandwell site. City Hospital retains medical services and some surgical specialties
including urology, ENT, gynaecology and the regional gynaecology-oncology unit, as well
as an emergency department, although this has been changed from a trauma unit to a
local emergency hospital with transfer of trauma to either Sandwell or the major trauma
unit at the University Hospital Birmingham. Both sites have an ITU and acute medical
admissions unit.

To support this re-organisation systems and pathways have been put in place to divert all
emergency GP referrals and ambulance admissions with abdominal pain to Sandwell and
transport City ED referrals to Sandwell SAU for assessment as required. In exceptional
circumstances emergency general surgical treatment will take place at City Hospital.

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The department has 61 beds over 2 wards (Lyndon 2 ward and Priory 2 ward). In
addition, there is also a 20-bedded Day Surgical Unit/Admissions Unit and associated
daycase theatres, and the use of beds in the Intensive Therapy Unit and Paediatric
Wards. A newly expanded 8 bedded higher dependency (Level 1) area (SMU) provides
care to higher-risk post-operative and emergency patients and is co-located on the higher
acuity Priory 2 ward.

Elective Activity

All elective inpatient activity takes place at Sandwell, with day case, out-patients and
endoscopy taking place on both sites. There are two inpatient wards with a total of 61
beds co-located on the same floor as the surgical assessment unit. We currently have 23
theatre sessions split between inpatient and day case, the majority being based at
Sandwell. Outpatient and endoscopy sessions also take place each day.

The department delivers a range of general and specialist activity. The colorectal team
provide colorectal cancer surgery and IBD surgery which is performed predominantly
laparoscopically (and to include trans-anal TME surgery and single-port surgery) and has
a large functional bowel practice in addition to general coloproctology. The general/upper
GI team deliver a wide range of general surgical activity as well as specialist laparoscopic
upper GI services such as anti-reflux surgery, hiatal hernia surgery, bile duct exploration,
splenectomy and hernia surgery.

The department contributes to the trust endoscopy activity, both upper and lower GI.

Emergency Activity

As described above the vast majority of emergency activity takes place at Sandwell, with
only a small number of unstable patients being treated at the City site.

To facilitate this we currently have 2 consultants on call each day between 08.00 and
18.00 with no other commitments. One is based at Sandwell and is responsible for seeing
all emergency inpatients each day including weekends, the other provides cover for the
CEPOD theatre in the morning and any inpatient referrals from City Hospital. Overnight
there is a single consultant covering cross site.

There is a CEPOD theatre staffed 24/7 with allocated consultant anaesthetic sessions
08.00-18.00. There is a separate trauma list every day meaning that general surgery has
priority access to the emergency theatre.

The Surgical Assessment Unit (SAU) is comprised of a 24 bed/trollied ward and an

adjoining ambulatory assessment area – the Surgical Emergency Assessment Unit
(SEAU). An emergency daily “hot clinic” is run through the SEAU for review of ambulatory
primary care or ED referrals with dedicated ultrasound slots to reduce overnight stay and
facilitate rapid access to diagnostics for emergency patients.

Departmental Staffing

Consultants

General and Upper GI Team

Mr Dham Mobarak Upper GI Surgery

Mr Yogesh Kumar Upper GI Surgery
Mr Abdul Sillah Upper GI Surgery
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Mr Edward Harper Upper GI Surgery
Mr Mohammed Hanif (Locum) General Surgery
Mr Rajnish Mankotia (Locum) General Surgery

Colorectal Team

Mr Howard Joy
Mr Vijay Thumbe
Miss Kathryn Gill
Mr Misra Budhoo
Mr Andy Torrance (Clinical lead)
Mr Rajeev Peravali
Mr Chris Thompson
Mr Anil George

Doctors in Training (Current)

5 Specialist Registrars (NTN)

4 Clinical fellows (JSD Higher)
2 Clinical Research fellows (Middle grade level – contributing to on-call rota
only)
1 Breast fellow (based at City hospital but contributing to on-call rota)
1 CT1
3 Trust SHO/JSD
1 FY2

THE POST

The post will be based within the directorate of Surgery at Sandwell General Hospital. The post
holder will work a 1:13 full-shift system including prospective cover for annual and study leave.

The Clinical research fellow is not expected to contribute to elective duties in this post. There is
scope to provide training through the JAG/JETS Endoscopy training programme depending on
desire/experience.

On-call duties include emergencies referred from practitioners and the hospital Accident &
Emergency Department and cover for the dedicated 24/7 CEPOD emergency theatre. Two
Registrars are on-call during daytime hours (08:00-20:30) with one predominantly supporting and
co-ordinating CEPOD emergency theatre and one providing cover to the SAU ward and SEAU
clinic. A further Registrar is then on-call on-site at Sandwell hospital overnight. The team is
further supported when on-call by an FY2/CT grade doctor, 2 FY1 grade doctors in the daytime, a
further FY1 during twilight hours and another 2 FY1s overnight.

The above duties are subject to the post holder’s acceptance that, at the request of the
appropriate Consultant, in consultation where practicable with his/her colleagues both senior and
junior other duties may be required in occasional emergencies and unforeseen circumstances. It
has been agreed between the professions and the department that while juniors accept they will
perform such duties, the Secretary of State stresses that additional commitments arising under
this sub-section are exceptional and in particular that juniors should not be required to undertake
work of this kind for prolonged periods or on a regular basis.

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Main terms and conditions of service

 The successful candidates will be required to undergo a pre-employment medical

examination by the Occupational Health Department and police checks undertaken by
the Disclosure and Barring Service.

 You will also be expected to provide evidence of immunity against ‘Hepatitis B’.

 The salary for the post will be on MT04 Medical and Dental Staff pay grade.

 The annual leave for this post is 28 days per annum (pro rata) plus bank holidays,
increasing to 33 days after completion of the appropriate service. Annual leave is
granted with the approval of the supervising Consultant. Leave is not fixed in the rota.

 It is the responsibility of all Medical Staff to ensure that they are appropriately
registered with the General Medical Council. If registration lapses employment may
result is suspension/termination. You are also advised to be a paid-up member of a
recognised Medical Defence Society.

 An offer of appointment for an overseas doctor (Non-EEC) can only be offered to a

doctor who has the correct visa status in this country. A fixed term training visa will not
be issued for this unrecognised post.

 All employees are expected to comply with appropriate Trust Health and Safety
policies.

 The Trust has prohibited smoking for staff and patients within all its buildings and
grounds.

Clinical Guidelines
Relevant clinical guidelines are available on the Trust intranet.

Additional Duties
The junior doctor accepts that he/she will also perform additional duties in occasional
emergencies and unforeseen circumstances at the request of the appropriate consultant,
in consultation where practicable with their colleagues, both senior and junior. It has been
agreed between the professions and the Department that, while juniors accept that they
will perform such duties, the Secretary of State stresses that additional duties arising
under this sub-section are exceptional and in particular that juniors should not be required
to undertake work of this kind for prolonged periods or on a regular basis.

Clinical Governance
Everyone is expected to participate in Clinical Governance. Clinical audit is an
established facet of the hospital. The appointee is required to participate actively.
Regular clinical governance half days are held where all elective activity is cancelled.

Safeguarding – Children/Young People and Vulnerable Adults

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Every employee has a responsibility to ensure the safeguarding of children and
vulnerable adults at all times and must report any concerns immediately as made clear in
the Trust's Safeguarding Policies.

Infection Control

The Trust is committed to reducing the risk of health care acquired infection. Accordingly it
is essential that you adhere to all Trust infection control policies, procedures and
protocols (to include hand decontamination, correct use of PPE (Personal Protective
Equipment) and care and management of patients with communicable infections). You
are required to report any breaches/concerns promptly using the Trust's incident reporting
system.

Accommodation
Single accommodation is subject to availability.
Canteen facilities are available on both sites.

Confidentiality:

The post holder must maintain confidentiality of information relating to patients, staff and
other Health Service business.

Use of Information Technology:

To undertake duties and development related to computerised information management to

meet the changing needs and priorities of the Trust, as determined by your manager and
in accordance with the grade of the post

Health and Safety:

Employees must be aware of the responsibilities placed on them under the Health and
Safety at Work Act (1974) and the Manual Handling Operations Regulations (1992). This
ensures that the agreed safety procedures are carried out to maintain a safe environment
for employees, patients and visitors to the Trust. These instructions will be widely
available and displayed throughout the working environment.

Induction:

Attendance at Trust induction is a condition of employment.

Risk Management:

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

Equal Opportunities:

The Trust has a clear commitment to its equal opportunities policy and it is the duty of
every employee to comply with the detail and spirit of the policy.

Conflict of Interest:

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The Trust is responsible for ensuring that the service provided for patients in its care meet
the highest standard. Equally it is responsible for ensuring that staff do not abuse their
official position for personal gain or to benefit their family or friends. The Trust’s Standing
Orders require any officer to declare any interest, direct or indirect with contracts involving
the Trust. Staff are not allowed to further their private interests in the course of their NHS
duties.

The above duties and responsibilities are intended to represent current priorities and are
not meant to be a conclusive list. The post holder may from time to time be asked to
undertake other reasonable duties. Any changes will be made in discussion with the post
holder in the light of service needs.

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 SANDWELL AND WEST BIRMINGHAM HOSPITALS NHS TRUST

PERSON SPECIFICATION

Clinical Research Fellow-General Surgery-1 Post

CRITERIA FOR ESSENTIAL REQUIREMENTS DESIRABLE/

SELECTION (A clear definition for the necessary ADDITIONAL REQUIREMENTS
(Justifiable as criteria) (Where available, elements that
necessary for safe contribute to
and effective improved/immediate
performance) performance in the job)
Qualifications: Primary medical qualification
(MBBS/MBChB) or equivalent.
MRCS.

Clinical Experience Minimum of 24 months post FY2 Previous middle grade

experience or equivalent. experience.
12 months post FY2 experience in Experience in NHS working
general surgery or equivalent. environment.
An understanding of the current
NHS environment.
Professional and Ability to work well with colleagues
Multi-disciplinary and within a team.
team working:
Clinical Experience and evidence of Audit projects undertaken every
Effectiveness conducting clinical audit. 6-12 months.
Previous research experience.
Personal Attributes Energy and enthusiasm and the
ability to work under pressure.
Caring attitude to patients.
An ability to organise and prioritise
work effectively.
Ability to communicate effectively
with colleagues, patients, relatives,
GPs, nurses, other staff and
agencies.
Commitment to continuing Medical
Education and Professional
Development.
Driving licence or the ability to
return to the hospital independently
when on call.
Other Registered MD/PhD project
Requirements:
Full GMC Registration with a
Licence to Practice.
Appropriate Immigration Status.