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Respiratory Consultant Start the next chapter of your life and influence the next chapter of our Islands health care. Jersey is a unique place to live and work and being a consultant in Jersey is different, join a progressive health service with brand new facilities. As a crown dependency, we are an Island nation which includes our own Health Care Service and a more favourable financial position: • Salary: £119,667 – £177,400, • Maximum personal tax rate of 22%, • Government of Jersey Pension with no annual tax cap, • Opportunity to carry out private practice Our health service is on the move with construction of a brand-new hospital starting this year. The level of care that you can give here is far more extensive. With further investment into modern healthcare facilities, we work to ensure that our consultants can provide the best patient care possible. Our consultants have the time to make a difference to our patients, providing end-to-end patient care throughout their pathway giving consideration to their medical requirements in its entirety. And as with many aspects of Island life, our Healthcare system is familiar enough for comfort but offers variances that mean our Consultants and patients have a different experience. A small Island community, we have one main hospital that acts as a hub with a small number of offsite facilities and the geography of our Island means there is a shorter commute for you. Find out more about relocating to Jersey ___ Job summary: The Consultant Physician, specialist in Respiratory Medicine is a replacement post, the successful applicant will join an expanding team of currently eight Consultant Physicians to provide a comprehensive service in Respiratory Medicine and provide support to general medical in-patients. The appointee must have a CCT/CESR in Respiratory Medicine and General Medicine and be able to offer a diagnostic bronchoscopy service and expert opinion in respiratory medicine. They should also have a strong background in acute unselected medicine on-call. They must have management and administrative experience and be prepared to audit and manage audit within the Medical Services Care Group. The appointee will have inpatient ward commitments as the named treating Consultant, dependant on the ward allocated inpatient workload will consist of between 13-18 patients. The appointee will provide Consultant supervision of the inpatient medical team consisting of 1x middle grade, 1x clinical fellow & 1x foundation year doctor. The appointee will also provide respiratory medicine input to other wards where requested through the specialist referral process. The successful candidate should be adaptable, flexible and innovative in order to meet the ongoing challenges within the service. A mentor shall be provided on arrival from a named acute medicine Consultant in addition to a dedicated appraiser. The post holder will be expected to take part in management and audit activities and represent the service at Hospital meetings, as agreed with colleagues. The post holder will be expected to be fully involved in a ‘Risk Management” programme and support the Governance agenda. On Call Rota The appointee will take part in the General Medicine on-call rota of one in eight however this will be in line with the development of the service provision according to the Medical Services Medical Model where the successful appointee may focus on respiratory medicine provision for the island of Jersey. During the on-call the Consultant will cover all medical inpatients in the event of deterioration or medical emergencies. For weekday on-call a post take ward round is undertaken at 5pm, the following morning the on-call Consultant is only required to post-take patients who are not on the Emergency Assessment Unit. During weekends and bank holidays the Consultant will undertake post take ward rounds and discharge ward rounds in line the medical model at 8am & 5pm. Weekday on-calls operate 8am-8am the following day. Weekend on-calls operate from 8am on Friday to 8am Monday. The Specialty The legacy of cheap tobacco in the past has resulted in a high incidence of smoking related illnesses. The Southwest Cancer Registry indicates that Jersey has an incidence of lung cancer 30% above the average for the U.K. There are an equivalently high number of patients with COPD. In 2019 Respiratory Medicine had 740 outpatient referrals and 49 bronchoscopy procedures were undertaken. The average weekly referral to the respiratory service is as follows: 2019 = 17 per week 2020 = 14 per week 2021 to date = 15 per week The Consultant establishment for Respiratory Medicine is as follows: Vacant, Consultant in Respiratory & General Medicine (2 posts) The Clinical Investigation Unit (Manager Andrew Norman, who is a Senior qualified Respiratory Physiologist) provides a comprehensive range of services for patients with respiratory illnesses incorporating: 1. Full lung function testing using body plethysmography, 2. Sleep studies and provision of CPAP, 3. LTOT and nebulizer services, 4. A dedicated ‘drop in’ Asthma clinic, 5. Histamine/Methacholine challenge testing The respiratory services are supported by a comprehensive radiological department offering CT and MRI. One of the Consultant radiologists, Dr Salman Zaman, have a special interest in respiratory disease offering expert opinion and biopsy services. The Radiology Department provides CT, MRI, ultrasound, mammography and general X-Ray services. An on-call service is provided for CT, ultrasound and general x-ray. The Radiology Department has undergone extensive development and renovation in the last few years. A new GE PACS/HSS CRIS system (with access from home) went live in 2010. A new GE 750 Dual source 64 slice CT (inc CT Fluoro) was commissioned in October 2010. A Phillips 1.5T Intera MRI was commissioned in 2007. 4 new General rooms with either CR or DR were commissioned with the new PACS in 2010. There is a new Phillips screening/interventional suite with a C arm and remote control and a dedicated US machine for biopsy/drainage. We comply with the guidelines on ultrasound guided chest drain insertion and expect the successful candidate to continue this service. When the Consultant is not available, the Radiology department performs ultrasound of the chest to guide drain insertion. We have presented the successful introduction of this service at the National Emergency Medicine conference. There are 2 new Phillips IU22 Ultrasound machines (2009/10) in the main department. The department recently became ISAS accredited. Community outreach service supported by 1 full time and two part time respiratory specialist nurses who are providing care to patients with asthma/COPD. 1 T.B specialist nurse and 1 lung cancer nurse, continue to support patients in the community and support early discharge. The respiratory department works closely with the Consultant Microbiologist in the Management and Control of TB and HIV. Lung cancer surgery is performed in Southampton General Hospital. The Thoracic Surgeon, Dr Martin Chamberlain, visits four times each year. Surgery is provided to NSF guidelines. The hospital participated in the NLCA (National lung cancer audit) and our performance ranks among the best performing centres nationally. PET-CT scans are performed at Southampton, and we have an electronic link for sharing x-ray and CT images. Weekly lung cancer meetings are held are attended by the following: Consultant Radiologists (Salman Zaman), One Consultant Histopathologist Miklos Perenyi or Bruce Lyons), Consultant Respiratory Physician (this post), Consultant Medical Oncologist (Mohammad Butt) Nicola Bailache Associate Specialist Palliative Care, MDT coordinator who helps organising the meeting and keep records. There are 3 Consultant General Histopathologists (as above) providing general histology and cytopathology, and there is full laboratory back up for immunohistochemistry. There is access to specialist referral centres for molecular and gene analysis of tumours. We have close links with Southampton to coordinate the management of interstitial lung disease and severe Asthma; the successful applicant will have the opportunity to develop further tertiary links. The respiratory service is supported by the ambulatory care service located and supported by the acute medicine physicians delivering ultrasound guided pleural procedures including pleural aspirations, ambulatory drainage and pleurex drains. An Endoscopy unit is based at Jersey General Hospital consisting of two procedure rooms, the Respiratory Medicine service has dedicated bronchoscopy sessions within this unit. Respiratory Medicine has access to the Medical Day Unit providing day case treatments Monday – Friday consisting of 5 treatment couches. The island has a dedicated chemotherapy unit with clinical oncologist & medical oncologist support on island. Palliative care facilities are provided by a charitably funded body called Jersey Hospice Care and operates from an independent facility called Clarkson House. Jersey Hospice Care provides in-patient beds for respite services both hospital discharges and in the community. An Associate Specialist in Palliative Care with nursing support has recently been appointed with responsibility and funding split between the Hospice and Hospital. The respiratory service in Jersey has a close links with Southampton to coordinate the manage interstitial lung disease.

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