Specialty Doctor/Senior Clinical Fellow in NEONATOLOGY

(Middle grade, ST4 to 8 equivalent)

JOB DESCRIPTION

Responsible to: Consultant Neonatologists

Accountable to: Clinical Director / Lead Neonatologist

Base Hospital: Singleton Hospital, Swansea

1. Introduction

Swansea Bay University Health Board:

Swansea Bay University Health Board was named on 1 st April 2019 following a boundary
change to the former Abertawe Bro Morgannwg University Health Board and the transfer of
the Bridgend locality into Cwm Taf Morgannwg Health Board.

The Health Board provides services to around 400,000 people, primarily serving the
populations of Neath, Port Talbot, and Swansea and their respective communities. In
addition, the Health Board provides a large range of regional and sub-regional services,
including Renal Medicine, Cardiology, Cardiac Surgery, Forensic Mental Health and
Learning Disability Services, Haemophilia and Autologous Bone Marrow Transplantation,
Pancreatic surgery and Burns and Plastics.

The Health Board has three major hospitals: Morriston and Singleton Hospitals in Swansea
and Neath/Port Talbot Hospital.

Morriston Hospital:

Morriston Hospital is one of two teaching hospitals in the West Division of the HB and
currently has 850 beds. The range of specialist services provided at Morriston Hospital
now includes Renal Medicine, Paediatrics, Neurology and Spinal surgery, Oral and
Maxillofacial Surgery, the Welsh Centre for Burns and Plastic Surgery and the second

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 Tertiary Cardiac Centre in Wales. Rheumatology and Palliative Medicine are also provided
to a wide catchment area. These services are supported by critical care facilities, which
include a General ITU, ICU, Cardiac ITU, Burns ITU and two HDU’s as well as a full range
of high quality diagnostic and therapeutic services. The District General Hospital
component encompasses a Coronary Care Unit, several General Medical sub specialties, a
well-developed Trauma and Orthopaedic service & a range of General Surgical specialties.
Morriston Hospital is also the site of the major Accident and Emergency Department for
Swansea with its accessibility to the South West Wales population, and is designated as a
Major Trauma Centre with heliport.

Singleton Hospital:
Singleton Hospital is the other teaching Hospital in the West Division of the HB with 300
beds. Sited approximately 8-miles from Morriston, it is adjacent to the campus of University
College of Swansea.
Inpatient facilities for Clinical Haematology including Autologous Stem Cell transplantation
and the sub regional Haemophilia Centre are based here. Additional services include
General Medicine Care of the Elderly, Ear Nose and Throat, Ophthalmology, Obstetrics,
Gynaecology, Dermatology, and a High dependency Unit. The sub-regional departments of
Medical Physics and Neonatal Medicine are also based here.
Singleton Hospital Houses the South West Wales regional Cancer Centre (see below).
Close contact is maintained with the appropriate departments within the University and
there is direct access to the University Computing Centre. The Pathology Department
includes the Public Health Wales labratory. The Department of Medical Photography and
an excellent medical library are on site.

Neath Port Talbot Hospital:

The state-of-the-art Neath Port Talbot Hospital has 270 beds and has a full range of
outpatient, diagnostic, rehabilitation and day services. The hospital also has a freestanding
mental health unit. Outpatient Haematology services are provided in one of the purpose
built outpatient suites and are fully supported. There are also day case facilities for blood
transfusion and minor bedside diagnostic procedures.

2. Description of Department

The Singleton Neonatal Intensive Care Unit (NICU) provides a specialist regional neonatal
service for South West Wales, an area with a birth rate of around 10,000 per annum. The
South West Wales Region covers a large geographical area from Aberystwyth to Bridgend,
with a population of around 1,000,000 people. The unit attracts many high risk in-utero
transfers not just from this area but from other parts of Wales and the UK. It is a Wales
deanery approved training unit. Currently there are 7 fully funded intensive care cots, 6 high
dependency cots and 10 special care cots although the unit often works well over its funded
capacity and there are plans for further expansion. A dedicated transitional care unit is
currently under construction, and this will enable further expansion of capacity over the next
1 to 2 years. In 2018, there were 514 admissions, and 1719 days of intensive care, 2199

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days of high dependency care and 3224 days of special care were provided on the unit.
The unit provides the full range of medical neonatal care from 23 weeks gestation and
above including fully up to date modes of ventilation and inhaled nitric oxide. We care for
over 100 babies born at less than 1500 grams per year. The unit also provides facilities for
cerebral function monitoring and therapeutic total body cooling when required. The unit is
one of the few NICUs in the UK to have the predictive heart rate characteristics monitoring
to detect early illness (HeRO).The unit contributes one week in every three to the Welsh
Neonatal Transport Service (CHANTS).

We nurture a very pleasant working environment and passionate about providing the
highest standard of care. The unit has excellent benchmarked outcomes and is recognised
for high quality innovative practices including programmes on antibiotic stewardship, family
integrated care, neurodevelopmental follow up programmes and predictive monitoring. The
unit was the recipient of the 2017 NHS Wales Award for ‘Improving Quality Together’
methodology of quality improvement. The unit benchmarks very well for all neonatal
outcomes on the Vermont Oxford Network and The National Neonatal Audit Programme.
The unit was invited to showcase their innovative practices in the ‘Neonatal care around the
world’ plenary session in the 2016 Annual VON Conference in Chicago.

Singleton has been one of the top rated neonatal units in the UK for educational supervision
in the recent GMC Trainee Surveys. The unit provides clinical placements for medical
students and physician associates from Swansea Graduate Entry Medical School, one of
the top rated medical schools in the UK as per the recent ‘Complete University Guide’.
The unit has a dedicated team to run weekly multidisciplinary high-fidelity simulation
training. The department runs a number of national training courses including the highly
acclaimed ‘Wales Neonatal Ventilation Course’ and an annual international perinatal
conference – the Swansea Perinatal Symposium (SWAPS). Singleton is a UK
Resuscitation Council Neonatal Life Support Course Centre and we run courses in
simulation training and courses on the use of Ultrasound in neonatal practice. We also lead
the organisation of the WIGNET Conference, the only dedicated RCPCH approved training
day for International Medical Graduates (IMG) in Wales. The department offers structured
neurodevelopmental follow up services for high-risk preterm infants and other specialist
services such as chronic lung disease, cardiac and cleft lip and palate services. We are
also co- located with the community paediatric department and child development centre,
which provides a range of neurodisability services and specialist clinics. The department
has an excellent record of accomplishment of participating in multicentre trials and local
research projects.

Consultant Staff:

Dr Sujoy Banerjee (Lead Clinician Neonatal services)

Dr Lucy Georgiou
Dr Amit Kandhari
Dr Vasiliki Makri
Dr Maha Mansour
Dr Geraint Morris (Clinical Director Children’s services)
Dr Jean Matthes (Honorary Consultant)
Dr Sree Nittur
Dr Arun Ramachandran (RCPCH MTI programme champion for Wales)
Dr Carol Sullivan

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 Dr Joanna Webb

3. The post

The post is available immediately for two years duration pending satisfactory progress.

This post will allow experience and training in all the tertiary treatment modalities available
on the unit, including therapeutic total body cooling, high frequency oscillatory ventilation
and nitric oxide therapy. The post offers opportunities to gain experience in
echocardiography or neurodevelopmental assessment depending on the preference of the
applicant, as well as simulation training, cranial ultrasound scanning neonatal transport and
teaching.

The postholder will take part in the middle grade (tier 2) rota, though if the candidate has no
prior UK experience, the postholder will start on the tier 1 rota (ST3 level) for at least 1 to 3
months to allow adaptation to UK working practices. On successful demonstration of
suitable competencies, the postholder will then progress to the second tier rota (ST 4-6
level). All post holders will be encouraged to document educational supervision and
progress on the RCPCH E-portfolio, and will be allocated a Consultant Educational
Supervisor. Regular supervision meetings will be expected every 3 months for the first year
and every 6 months after that. The post holder can develop a personal development plan
with their supervisor.

Both tier 1 and tier 2 rotas are currently 1:8, and are staffed by a combination of career
grade doctors, trainees, advanced neonatal nurse practitioners (ANNPs) and consultants
with resident duties. The rotas may be changed depending on the number of staff working
in the department, but this will not be done without the agreement of the participants if the
change takes place after the date of appointment.

All new post holders will be given a comprehensive induction programme. All
mandatory training identified by the Health Board should be completed. In addition to the
provision of service for the NICU the post holder will be expected to take part in some of the
following teaching and training opportunities.

a) The departmental weekly teaching program (Thursday afternoon)

b) The Tuesday ‘Grand Round’
c) The Wednesday ‘High Fidelity Simulation Training’
d) The remainder to be delivered flexibly with in the week to allow training and attendance
in outpatient clinic activity. Should the post holder wish, these can be used by him/her
to undergo specific training in neurodevelopmental assessment or echocardiography.
e) Clinical governance meetings

MRCPCH examination:

Unless they have passed already, post holders will be encouraged to undertake the MRCPCH
examination Trainees in Wales and Swansea Bay University Health Board have an excellent track
record of success in the membership examinations. Singleton hospital has a well-equipped library
with out of hours access and very helpful library staff who will be able to help as much as possible
to obtain reading materials even if not immediately available in the library. Local training to
undertake clinical parts of the examination is available in Swansea and at Morriston Hospital which

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is where the acute paediatric service is provided.

Diploma in United Kingdom Medical Practice (DipUKMP)

Overseas candidates may wish to undertake this qualification provided by RCPCH & Liverpool
University of Tropical Medicine. The Singleton NICU would be able to support you to do this

Cranial Ultrasound (CUSS) training:

The post holder will be expected to develop skills in undertaking routine CUSS. Training will be
provided.

Echocardiography Training

The unit has an excellent level of expertise in echocardiography, with three of the consultants
having undergone echocardiography training, and one highly experienced senior cardiorespiratory
technician who is fully trained in paediatric echocardiography. A number of middle grade doctors
on the unit have undergone this training successfully and have developed a specialist interest in
echocardiography. We have a dedicated networked ultrasound machine, which can transmit
images by telemedicine to distant centres. We are well supported by the tertiary paediatric cardiac
service at Cardiff, with whom we have excellent working relations.

The post holder will be given opportunity to learn echocardiography and will be encouraged to
avail himself/herself of the following learning opportunities:

 Attendance on formal echocardiography courses

 Regular echocardiography practice on the neonatal unit
 Regular attendance at cardiology clinics run by Drs Nittur, Morris and Mansour.
 Review of echocardiograms performed by the post holder by Drs Nittur/
Morris/Mansour.
 Maintenance of a logbook for ECHO training is recommended. Please liaise with
Dr.S. Nittur early in your training if you have an interest in Paediatric Cardiology.

Neurodevelopmental Assessment

Singleton has had a well-developed and structured neurodevelopmental follow up programme for
high-risk preterm and other at-risk infants for well over a decade. A number of consultants are
trained in undertaking structured neurodevelopmental assessments including Bayley 3 and
General Movement Assessments (Prechtl). The programme is well supported by a team consisting
of a paediatric physiotherapist, neonatal occupational therapist and outreach community nurses.
The long term outcome data are collated in our annual report. The post holder would be supported
to attend the following learning opportunities:

 Attendance on formal neurodevelopment assessment courses

 Regular attendance at neurodevelopment follow up clinics run by Dr’s
Banerjee/Webb/ Georgiou/Makri to develop competency in structured
neurodevelopmental assessment
 Develop insight and management skills to establish and manage a structured
neurodevelopment service.
 Please liaise with Dr. J. Webb early in your training if you have an interest in

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 neurodisability or palliative care.

Neonatal Transport (CHANTS)

Singleton NICU provides neonatal transport services as part of the All Wales Neonatal Transport
Services (CHANTS). This is a specialized Consultant delivered service. If this is a particular area
of interest, the successful applicant could undertake transport experience and training along with
the Consultant as a pre agreed activity.

Teaching and training

The unit has a very good reputation for teaching and training, and the post holder will not only
benefit from being a recipient of this but may also wish to develop his/her own teaching skills.
Excellent experience is offered in both undergraduate and postgraduate teaching. At
undergraduate level the unit has close links with Swansea University Medical School, which is one
of the fastest growing medical schools in the UK. There are ample opportunities for taking part in
formal teaching sessions under the guidance of experienced tutors. The unit has a well-
established programme of simulation training using the latest high fidelity manikins and the post
holder would be able to assist in the delivery of this training should he/she wish to do so.This post
is covered by the National Health Service Terms & Conditions of Service – Specialty Doctor
(Wales). Details of these may be obtained from the Medical HR Department.

You will be required to participate in the 2nd tier (middle grade) shift system for medical staff which
includes out of hours duties. The rota operates as a 1:8 full shift system with annual leave built in.
Advanced neonatal nurse practitioners (ANNPs), consultants providing resident duties and Wales
deanery trainees all contribute to the rota as well as clinical fellows. Ten consultant neonatologists
support the unit and we have excellent links with other specialist consultants such as
ophthalmologists, plastic surgeons, cleft surgeons, orthopaedic surgeons and consultants with
expertise in paediatric gastroenterology and paediatric neurology. The unit is well known for its
friendly and supportive atmosphere and the excellent teaching and training provided.

You will be entitled to Study Leave in line with the Health Board’s Study Leave policy.

4. Other Duties

You will provide a clinical service in conjunction with your colleagues, under the direction of the
Consultant Neonatologists, which will include the responsibility for the prevention, diagnosis and
treatment of illness.

You will be required to adhere to the principles of good medical practice laid down in the guidance
of ‘Good Medical Practice’ issued by the General Medical Council.

You will be provided with access to ample IT facilities. There is a dedicated doctor’s office with
networked workstations as well as networked computers at each cot side in the intensive care and
high dependency areas. The use of the Badgernet database is required for daily data entry and
generation of summaries. Training will be provided in these areas.

You will be expected to deputise for absent colleagues and in exceptional unforeseen
circumstances may have to perform additional duties to ensure the safe running of the

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department. Where such duties take place outside your normal contracted duties, you will receive
either an equivalent off duty period or will be remunerated appropriately.

You will be required to participate in the LHB’s risk management process and in clinical audit and
other clinical governance activities within the department, the directorate and the Trust.
Adherence to Caldicot Principles is mandatory.

You will be required to participate in the LHB’s Appraisal Scheme in conjunction with your
Supervising Consultant, to identify training and development needs. You will be allocated an
Educational Supervisor and be expected to participate in personal and professional development
to fulfill Royal College CME requirements.
You will provide advice to clinicians in hospital and primary care, originating either from telephone
calls or ward referrals.

You will be responsible for undertaking the administrative duties associated with the care of
patients and the administration of the department. This will include overseeing the rotas at first and
second on call and participating in the teaching and training of new medical staff.

You will be required to participate and contribute to Clinical Audit in line with the Trust’s policy.

The Ionising Radiation (Medical Exposure) Regulations 2000 impose a legal responsibility on
Trusts for all staff who refer patients for medical radiation exposure such as diagnostic x-rays to
supply sufficient data to enable those considering the request to decide whether the procedure is
justified.

In exceptional circumstances it may also be necessary to undertake duties at other locations with
the LHB.

Subject to the terms and conditions of service, the post holder will be expected to observe policies
and procedures of the LHB drawn up in consultation with the professions, where they involve
clinical matters.

There must be no conflict of interest between NHS work and private work.

For services provided which are subject to the payment of an additional fee, work undertaken
during employment will not attract the additional fee. If a fee is paid this must be passed to the
LHB. There are circumstances which allow the additional fee to be retained by an individual and
as a general principle this is for work done in his/her own time, or during annual or unpaid leave.
More information regarding this is provided within the Terms and Conditions of Service which are
available from the Medical HR Department. However it is advisable to discuss with your
Directorate/Department if wishing to carry out any work that would be subject to an additional fee
and can form part of the job planning process.

5. DISCLOSURE OF CRIMINAL BACKGROUND OF THOSE WITH ACCESS TO PATIENTS

It is the policy of this LHB that, in accordance with the appropriate legislation, pre-employment
Disclosure Checks are undertaken on all newly appointed Doctors and Dentists. The Disclosure
and Barring Service is authorised to disclose, in confidence to the LHB, details of any criminal
record, including unspent and spent convictions, cautions, reprimands and final warnings.

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Applicants being considered for this post must provide this information on the application form
before they can be considered.

Any information disclosed will be treated in the strictest confidence and all circumstances will be
taken into account before any decision is reached. The successful applicant will be required to
complete a DBS Disclosure Check application form and to provide the appropriate documentation.
Applicants should be aware that a refusal to comply with this procedure may prevent further
consideration for the post.
The nature of the work of this post is exempt from the provisions of Section 4(2) of the
Rehabilitation of Offenders Act 1974 (Exemption Order 1975). Applicants are, therefore, not
entitled to withhold information about convictions under the Act and, in the event of employment
any failure to disclose such convictions could result in dismissal or disciplinary action by the LHB.
Any information given will be completely confidential and will be considered only in relation to an
application for positions to which the Order applies.

6. Visiting the Department

It is anticipated that you may wish to visit the hospital, in this case, please contact:

Clinical Director Child Health:

Dr Geraint Morris
Consultant Neonatologist.
Telephone 01792 285047

Clinical Lead Neonatology:

Dr Sujoy Banerjee
Consultant Neonatologist.
Telephone 01792 285047

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7. General

 Performance Reviews/Performance Obligation: The post holder will be expected to

participate in the LHB’s appraisal and job planning process to ensure continued professional
development.

 Job Limitations: At no time should you work outside your defined level of competence.
If you have concerns regarding this, please discuss immediately with your Manager /
Supervisor / Consultant. All staff have a responsibility to inform those supervising their duties
if they are not competent to perform a duty.

 Confidentiality: In line with the Data Protection Act 1998, the post holder will be
expected to maintain confidentiality in relation to personal and patient information, as outlined
in the contract of employment. The post holder may access information only on a need to
know basis in the direct discharge of duties and divulge information only in the proper course
of duties.

 Health & Safety: The post holder is required to co-operate with the LHB to ensure health
and safety duties and requirements are complied with. It is the post holder’s personal
responsibility to conform to procedures, rules and codes of practice; and to use properly and
conscientiously all safety equipment, devices, protective clothing and equipment, which is
fitted or made available, and to attend training courses as required. All staff have a
responsibility to access Occupational Health and other support in times of need and advice.

 Risk Management: The LHB is committed to protecting its staff, patients, assets and
reputation through an effective risk management process. The post holder will be required to
comply with the Trust’s Health and Safety Policy and actively participate in this process,
having responsibility for managing risks and reporting exceptions.

 Job Description: This job description is not inflexible but is an outline and account of the
main duties. Any changes will be discussed fully with the post holder in advance. The job
description will be reviewed periodically to take into account changes and developments in
service requirements.

 For Clinical Staff Only: All clinical staff are required to comply, at all times, with the
relevant codes of practice and other requirements of the appropriate professional
organisations e.g. BMA, RCN, CPSM etc. It is your responsibility to ensure that you are both
familiar with and adhere to these requirements.

All Clinical Staff will be advised during their induction of the arrangements available for them
to access advice and support both during and outside normal working hours.

Relocation Expenses and Salary:

You will be offered relocation expenses for taking up this post.
The post holder will have the choice of specialty doctor or senior clinical fellow terms and
conditions. Specialty doctors are paid in sessions and undertake job planning in a similar way
to consultants and other career grade staff. Senior clinical fellows are paid a salary according
to the junior doctors banding system based on hours of work

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