Consultant Neurologist

Contract Details

This is a joint appointment on a PUBLIC ONLY CONSULTANT CONTRACT 2023 basis under the Consultants’ Contract 2023 with a commitment of 18.5 hours per week to the Coombe Hospital (TCH) and 18.5 hours per week to Tallaght University Hospital (TUH).

The Consultant’s PUBLIC ONLY CONSULTANT CONTRACT 2023 provides for a normal working week of 37 hours. The Employee’s core working hours will be scheduled by the Employer to meet service needs and having regard to the principles, including rostering principles. The normal duties for the post as outlined in the documentation and agreed by the HSE will include inter alia:

The successful candidate duties will include the following:

• Will work in the Coombe Hospital as part of a multidisciplinary team under the direction of the Master/CEO and CCOO.
• Will work as part of the Neurology and Obstetrics & Gynaecology Divisions within the Hospital.
• Will possess the necessary skill-mix to address current deficiencies.
• Responsibility for organisation and development of Neurology services at TCH & TUH
• Responsibility for education, training and involvement in audit in relation to maternal medicine services.
• Responsibility for improving the access of women to Neurology Services.
• Involvement in Clinical Audit Committee and Ethics Committee as required.
• Will provide clinical leadership in MDT context - hand-over, ward-rounds, clinical risk & morbidity/mortality
• Conferences, teaching, training and audit.
• Ward Rounds
• On call services
• Multidisciplinary Skills and drill training, Risk Management and Quality Improvement strategies.
• Provide support for primary care services.
• Continuous Professional Development
• Will conduct ward rounds to enhance efficiency and safety[JH1] .
• Provision of out-patient Neurology care.
• Provision of in-patient Neurology care.
• Participation in the on-call rota TCH and TUH if applicable.

Background and Purpose of the Post

As per the Integrated Epilepsy and Maternity Model of Care, developed by the HSE’s NWIHP and HSE’s National Epilepsy Clinical Care Programme and signed off by the HSE’s CCO and the Department of Health, it is planned that each of the six tertiary maternity services within the state will have as part of its Maternal Health Department a designated consultant neurologist with a special interest in maternal health and a ANP with a special interest in epilepsy. These resources based in the relevant tertiary maternity site, are to be structured on a 50:50 basis between the maternity services and the relevant regional neurology hub. This will enable and support an integrated network of care across two specialist services. In 2024, the development of these resources are being prioritized in the following tertiary maternity services – The Rotunda Hospital, University Limerick Maternity Hospital and The Coombe

Hospital.

The role is 50:50 time commitment to Coombe and Tallaght University Hospitals providing care for Women with Epilepsy at the Coombe and affiliated regional Obstetric services, and Epilepsy care at Tallaght University Hospital to include a first seizure pathway and a longitudinal epilepsy care clinic.

The post-holder will also actively participate in multidisciplinary skills and drills training, risk management and quality improvement strategies and liaise and provide support for primary care services and their seamless integration with hospital-based services.

This post will significantly (a) improve access (b) reduce waiting times (c) reduce length of stay - due to involvement in decision-making re admissions and discharge planning and the expansion of Neurology and day case treatments (d) increase patient safety and quality of care. Increased efficiency will off-set the need for significant expansion in other services.

The HSE’s National Women and Infants Health Programme working with the National Epilepsy Clinical Care Programme has identified the absolute requirement for the implementation of an integrated model of care for the management of women with epilepsy (WWE) attending maternity services. A practice guide for the safe management of WWE attending maternity services was developed in 2018 under the governance of the National Epilepsy Clinical Care Programme. However to date the dedicated resources to safely deliver this care in the HSE Dublin & Midlands Region have not been readily available. Neurology services including the neurology regional hub in TUH are under significant pressure from the overall demands on their specialist service, resulting in tertiary maternity services like The Coombe Hospital struggling to access structured dedicated specialist medical resources and inputs that are aligned and protected for women attending their services. This presents a very real and significant clinical risk in the management and care of WWE attending maternity services, with this risk being further heightened in circumstances whereby the patient is no longer under the active care or clinical governance of a designated neurologist or neurology service. The need for a resourced and structured integrated model of care between specialist neurology/epilepsy services and tertiary maternity / women’s health services is further compounded when other key elements and issues are factored in including

· The pathway that women travel with epilepsy and how their life decisions regarding their reproductive and sexual health impact the management and their experience of epilepsy,

· The requirement of the HSE to respond in a robust and structured manner to requirements surrounding the safe prescribing and use of sodium valproate;

· The specific recommendations of the practice guide regarding WWE attending maternity services and the need for these recommendations to be implemented by the HSE so to enhance the safety of women attending maternity services; and

· The clinical care needs of women attending maternity and other women’s health services who present with neurological conditions – new or existing – other than epilepsy.

· The appointee will participate with colleagues within the Maternity Model of care for Women with Epilepsy to further the goals or PREVENT and establish a HSE supported Anti-Seizure Medicines Pregnancy Registry

This post is being developed to address two pressing needs (i) delivery high quality neurological care for women attending obstetric services at The Coombe Hospital and (ii) develop clinical neurology services at TUH with particular focus on improving care for people attending the epilepsy service.

Accountability

The principal duties and responsibilities associated with this proposed consultant post are as follows:

· To provide clinical leadership in the region regarding the development, co-ordination and management of common neurological diseases in pregnancy, particularly in relation to women with epilepsy attending maternity services in HSE Dublin and Midlands region.

· To work closely and collaboratively with consultant obstetric colleagues in the Maternal Health Department in the Coombe regarding the provision of coordinated care to women with epilepsy and other neurological conditions attending maternity services in the Coombe inclusive of joint high-risk clinics, out-patient consultation services and Coombe inpatients.

· To increase awareness and actively engage in the provision of education and training to other health care practitioners on women’s neurological clinical health issues particularly in the maternity health care setting. D)To work with the National Epilepsy Clinical Care Programme and the National Women and Infants Health Programme so as to enable and support the implementation of the HSE’s Integrated Epilepsy &Maternity Model of Care, participating as required in relevant national fora and professional networks.

· To support the implementation of HPRA VPA guidance and Pregnancy Awareness / PREVENT

Programme.

· To provide structured and clinical supervision and mentorship to appointed ANP resources in the area of epilepsy care in both hospitals.

· To support the Irish Epilepsy Pregnancy Register and the collation and review of key data and metrics.

· To establish and provide a first seizure clinic in TUH.

· To attend and support the longitudinal care epilepsy clinic in TUH.

· To participate in the existing on-call neurology service rota in TUH.

· To provide inpatient consultation services at the Coombe and TUH.

Standard Duties &Responsibilities

· To participate in the development and delivery of services and undertake all duties and functions pertinent to the Consultant’s area of competence in line with the POCC23 Consultant Contract.

· To ensure that duties and functions are undertaken in a manner that minimizes delays for patients and possible disruption of services.

· To work within the framework of the both hospitals’ service plans and levels of service (volumes, types etc) as determined by the respective hospitals and employer. Service planning for individual clinical services will be progressed though the respective Clinical Directorate structures or other arrangements as applicable.

· To participate in the development and operation of the respective Clinical Directorate structures and in such management or representative structures as are in place or being developed. The Consultant shall receive training and support to enable him/her to participate fully in such structures.

· To provide, as appropriate, consultation in the Consultant’s area of designated expertise in respect of patients of other Consultants at their request.

· To ensure in consultation with the respective Clinical Director that appropriate medical cover is available at all times having due regard to the implementation of the European Working Time Directive as it relates to doctors in training.

· To supervise and be responsible for diagnosis, treatment and care provided by non-Consultant Hospital Doctors (NCHDs) treating patients under the Consultant’s care.

· To participate as a right and obligation in selection processes for non-Consultant Hospital Doctors and other staff as appropriate. The Employer will provide training as required. The Employer shall ensure that a Consultant representative of the relevant specialty / sub-specialty is involved in the selection process.

· To ensure in consultation with the Clinical Director that appropriate medical cover is available at all times having due regard to the implementation of the European Working Time Directive as it relates to doctors in training.

· To participate in clinical audit and proactive risk management in both hospitals and facilitate production of all data/information required for same in accordance with regulatory, statutory and corporate policies and procedures.

· To participate in and facilitate production of all data/information required to validate delivery of duties and functions and inform planning and management of service delivery.

· To support and enable the delivery of evidence-based information, care and management to patients so as to optimize their health and well-being.

· To be actively involved in the clinical governance aspects of the respective departments in both the Coombe and TUH.

· To participate in multidisciplinary team meetings with relevant specialists across both sites.

· To ensure that written protocols and clinical guidelines are in place in both services as required and that these include and address recommended national and international guidelines and best practice;

· To utilize and support e-health options e.g. use of MN-CMS to monitor the care of women.

General Accountability

Working with Others

· Develops networks and works in partnership with patients/service users, carers and colleagues within and across systems to deliver and improve services.

· Builds and maintains relationships, listening, supporting others, gaining trust and showing understanding.

· Encourages contribution creating an environment where others have the opportunity to contribute.

· Works within teams to deliver and improve services.

Managing Services

· Contributes to the development of business and service plans to achieve service goals.

· Manages resources to ensure the delivery of safe and efficient services.

· Manages people by providing direction, reviewing performance, motivating others and promoting equality and diversity.

· Manages performance, holding themselves and others accountable for service outcomes.

Setting Direction

· Identify the contexts for change, demonstrating awareness of the political, social, technical, economic, organisational and professional environment.

· Applies knowledge and evidence, gathering information to produce an evidence-based challenge to systems and processes in order to identify opportunities for service improvement.

· Makes sound evidence-based decisions consistent with the values and priorities of the organisation and profession.

· Measures and evaluates outcomes taking corrective action where necessary and being accountable for decisions.

Improving Services

· Ensures patient safety by assessing and managing the risk to patients associated with service

· developments, balancing economic considerations with the need for patient safety.

· Critically evaluates services to identify where services can be improved, working individually or as part of a team.

· Encourages improvement and innovation, creating a climate of continuous service improvement.

· Facilitates transformation, actively contributing to change processes that lead to improved healthcare.

Demonstrating Personal Qualities

• Is aware of own values, principles and assumptions and is able to learn from experience.

• Organises and manages self while taking account of the needs and priorities of others.

• Learns through participating in continuing professional development and from experience and feedback. Acts with integrity, behaving in an open, honest and ethical manner.

Management & Administration

a) To work within the framework of the hospital's service plan and/or levels of service (volume, types etc.) as determined by the Employer. Service planning for individual clinical services will be progressed through the Clinical Directorate/ TCH structure or other arrangements as apply.

b) To participate in the development and operation of the Clinical Directorate/TCH structure and in such management or representative structures as are in place or being developed. The Consultant shall receive training and support to enable him/her to participate fully in such structures.

c) To formally review the execution of the Clinical Directorate Service Plan with the Clinical Director / Employer periodically. The Clinical Directorate Service Plan shall be reviewed periodically at the request of the Consultant or Clinical Director / Employer. The Consultant may initially seek internal review of the

determinations of the Clinical Director regarding the Service Plan.

d) To participate in and facilitate production of all data/information required to validate delivery of duties and functions and inform planning and management of service delivery.

e) To be responsible for the maintenance of appropriate liaison arrangements between his/her department in the hospitals and the patients normal medical attendants.

Human Resources

a) To co-operate with the expeditious implementation of the Disciplinary Procedure as per Consultants Public Only Contract 2023.

b) To ensure in consultation with the Master/Clinical Director that appropriate medical cover is available at all times having due regard to the implementation of the European Working Time Directive as it relates to doctors in training.

c) To participate as a right and obligation in selection processes for non-Consultant Hospital Doctors and other staff as appropriate. The Employer will provide training as required. The Employer shall ensure that a Consultant representative of the relevant specialty / sub-specialty is involved in the selection process.

Risk Management

a) To participate in clinical audit and proactive risk management and facilitate production of all data/information required for same in accordance with regulatory, statutory and corporate policies and procedures.

Financial

a) To assist in the preparation of annual estimates/budgets of expenditure for revenues for which he/she is responsible.

General

a) To reside convenient to TCH or such other place as may be approved by the TCH.

(b) To perform such other duties appropriate to the office as may be assigned by him/her by the TCH or other authorised officer.

b) The person appointed will hold office under the terms and conditions of the Public Only Contract 2023 for consultants employed in the public service which will determine that he/she will participate actively in the management of the hospitals, take cognisance of resource constraints and retain clinical autonomy while practising.

Other duties and responsibilities may be assigned to the appointed consultant by the Master/CEO and CCOO of TCH Hospital and the General Manager MRHP. The duties of the successful applicant may change in

The above Job Description is not intended to be a comprehensive list of all duties involved and consequently, the post holder may be required to perform other duties as appropriate to the post which may be assigned to him/her from time to time and to contribute to the development of the post while in office.

[JH1]Labour ward ward round isn't likely to be relevant to this post