SENIOR HOUSE OFFICER IN PAEDIATRICS
JOB DESCRIPTION
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INTRODUCTION
There are two posts both of six months each, one based at the Princess Royal Hospital, Telford and one based at
the Royal Shrewsbury Hospital. There are seven SHO posts within each of the paediatrics departments. All posts
are recognised by the West Midlands Deanery and the Royal College of Paediatrics and Child Health (RCPCH), and
are suitable for MRCPCH or General Practice. Previous paediatric experience is not essential for this post.
THE PRINCESS ROYAL HOSPITAL
THE DEPARTMENT
The Children’s Department offers care for children and babies from the area. Neonatal intensive care is provided at
Shrewsbury and a new GP maternity unit has recently been opened at Princess Royal.
The Telford Children’s Department comprises
24 in-patient beds,
the Telford Children’s Centre (our Development Clinic)
Children’s Out-patient Department
There are 4 Consultant Paediatricians:
Dr Hinde has an interest in diabetes
Dr Vrahimis has an interest in paediatric respiratory medicine and cardiology
Dr Abdu has an interest in paediatric gastroenterology. He is presently the College Tutor.
Dr McCrea has an interest in endocrinology
The Consultant Paediatricians operate a ‘Consultant of the Week’ system providing continuity of care and
supervision for the children’s ward.
In addition there is Community Paediatrics and a Children's Development Unit.
Dr Vaid & Dr Ganesh provide Community Paediatrics for Wrekin and East Telford.
The middle grade staffing consists of six Staff Grade Paediatricians.
There are 7 Senior House Officers 1:7 residential full shift 48 hour rota with prospective cover. Each week of the
rota has different set duties including a week of night duty, a week of clinic duty and a week which has been left free
from fixed commitments in order to provide cover for absent colleagues (but not night duty, which must be swapped).
The on call responsibility begins at 9am and ends at 9.30 pm with the night SHO covering the 9 pm to 9.30 am on
call duty. Other shifts include Ward duty and protected teaching. Although there is no on call room for use during
the shift, the Medical Common Room has been equipped for use during break times.
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RESPONSIBILITIES OF THE POST
The post offered is for a period of six months and has a full-time workload. The supervision of the Senior House
Officers is shared between all Consultants.
The Unit is run on the basis that each Senior House Officer remains responsible for his/her admissions throughout
the period of their hospital stay, including the maintenance of the ward notes and any communications required on
each child. This ensures continuity of patient care. In addition, Senior House Officers may be called upon to
organise the day care of children for investigations on an out-patient basis.
Opportunity will be given to attend out-patient clinics whenever ward duties permit and Senior House Officers are
required to attend some new patient clinics and participate in them. All patients seen in these clinics will also be
seen by a Consultant.
The on call rota requires prospective cover for annual leave and study leave. The rota meets the Manpower
requirements for the reduction of Junior Doctors Hours and the job is recognised by the Post Graduate Dean for
training and for hours. The post is also recognised by the Royal College of General Practitioners. In exceptional
circumstances the Senior House Officer may be asked to cover other departments of the hospital.
The Senior House Officer is not expected to work in the Accident & Emergency Department, but will commonly be
called there by the staff working in the department in order to review or admit paediatric cases.
These duties are only a guideline and it must be clearly understood that they may be subject to change from time to
time, according to the needs of the department as a whole. In exceptional circumstances the Senior House Officer
may be asked to cover other departments in the hospital.
TEACHING
An initial 3 day cross-county induction programme in conjunction with Royal Shrewsbury Hospital provides a good
basis for advanced life support training and is compulsory.
Senior House Officer are actively encouraged to study for and sit the DCH & Part I RCPCH examination. There are
teaching meetings based at ward level on a regular basis and one half day per week protected teaching time is
provided either at Princess Royal Hospital or Royal Shrewsbury. Study leave may be granted (at the discretion of
the Paediatric division) for approved courses in preparation for higher qualifications.
Opportunities are also offered to the Senior House Officers to spend some time in the Children’s Development Unit
and also in community children’s clinics should they require it. Attending combined audit meetings and presentations
with neighbouring hospitals is encouraged. Neonatal experience is provided at The Royal Shrewsbury Hospital
where Senior House Officer may attend the neo-natal unit for teaching and to perform routine neo-natal
examinations.
The post provides a broad general training in Paediatrics and is also ideal for GP trainees pursuing their own training
scheme. Study Leave will be provided for appropriate courses in conformity with regional and national policy. Each
Senior House Officer will be given one full half day off per week. This will be a morning off two weeks out of three
and an afternoon off in the third week. In addition, it is generally possible for a Senior House Officer to finish early
following a night on-call.
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Aims of the Training
The Paediatric SHO will be exposed to a wide variety of paediatric conditions, and will learn how to approach and
manage these.
 Early in this placement he/she will be able to assess and start treatment on the seriously ill child according
to the APLS guidelines.
 This will include exposure to venous access and canulation,
o fluid therapy,
o pain management,
o and lumbar puncture.
 Every Tuesday, each SHO in turn will have the opportunity to present to the department a clinical case by
Powerpoint.
 Weekly meetings will teach SHOs how to liaise with Community Nurses and Health Visitors.
 There is ample opportunity to attend Paediatric out-patient clinics, both specialist and general.
 The Paediatric SHO will need to deal with anxious parents, and will be obliged to optimise communication
skills.
 There will also be opportunity to observe developmental assessments at the Telford Children’s Centre.
The Senior House Officer is expected to attend and participate in weekly X-ray meetings, Topic Teaching sessions
and Audit Meetings. There are Clinical Governance meetings every three months. There are three formal appraisal
sessions during the six-month post. The SHO will be given encouragement and advice regarding his/her career
progression and in the preparation of research projects and the submission of papers for publication. We have a
good record for placing SHOs into career posts.
There is an active Post Graduate Medical Centre with a library, a 12 terminal internet/computer room, seminar rooms
and a lecture theatre. The library holds over 10,000 books and 70 current journal titles. It has a CD-Rom facility for
literature searches (MEDLINE, CINAHL and Cochrane), National Research Register and an interactive computer
graphics anatomy package (which is recommended for preparation for FRCS exams). Facilities for Slide
Preparation are also available through the library. When undertaking research, you are required to follow the Trust's
procedure in line with the Research Governance Framework.
SPECIFIC CONDITIONS OF SERVICE
Annual and study leave is co-ordinated within the department. The SHOs are expected to work as a team and
therefore should arrange their annual/study leave to avoid disruption to the department. There are cross cover
arrangements in place and therefore only one SHO should be on leave at any one time. Annual leave and study
leave is not usually granted in the first or the last two weeks of the post. 2.5 weeks annual leave must be requested
by the end of the first fortnight of duty and taken within the 6-month period. A minimum of 6 weeks notice must be
given. Leave must be booked and agreed with the co-ordinating Consultant – Dr F Hinde.
Occasional emergencies and unforeseen circumstances occur, and Senior House Officers may be asked to assist in covering
the Hospital.
The successful applicant will be expected to work with professional colleagues and managers in the efficient running
of hospital services. The clinical policies and guidelines, standing orders and financial instructions of the Princess
Royal Hospital are to be followed, as are its Health and Safety Policies.
Other conditions of service are as listed under "Main Conditions of Service" below.
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THE ROYAL SHREWSBURY HOSPITAL
THE CHILDREN’S UNIT
The Paediatric ward is located within the Maternity Department. There is an integrated Medical and Surgical ward of
27 beds including 7 cubicles and a 3 bed day assessment area. There are approximately 3,000 admissions and
1600 children attend the day assessment area annually. There is a designated Outpatients area adjacent to the
ward where nearly 5,300 children are seen per annum. There are specialist clinics such as Cystic Fibrosis Clinic,
Respiratory Clinic, Oncology Clinic, Diabetic Clinic, Epilepsy Clinic, UTI Clinic, Paediatric Metabolic Clinic,
Neurodevelopmental Clinic, Neonatal Follow-up Clinic and Neurology Clinic. In addition, there are joint clinics with
visiting specialists for Paediatric Surgery, Cardiology, Renal, Endocrine, Gastro-enterology and Genetics.
There are separate paediatric day surgical and ENT/Ophthalmology wards.
The Consultant Paediatricians operate a ‘Consultant of the Week’ system providing continuity of care and
supervision for the Children’s Ward.
THE MATERNITY & NEONATAL UNIT
The Royal Shrewsbury Hospital Maternity Unit on the RSH North site has a modern and recently upgraded 11 room
labour suite and theatre with two antenatal/postnatal wards. There is an integrated General Practitioner Unit.
Because of the large rural catchment population there are peripheral General Practitioner Units at Telford,
Bridgnorth, Oswestry and Ludlow in Shropshire and Welshpool, Newtown and Knighton in Powys. Because of
rigorous patient selection there are very few neonatal problems from the General Practitioner Units. Two Consultant
Obstetricians have a special interest in Fetal Medicine.
The Neonatal Unit is adjacent to the labour suite and comprises 22 cots. Six cots are intensive care/high
dependency. The Unit has full back-up including its own ultrasound machine, blood gas analyser, intensive care
transport incubator and EBME technician. High frequency ventilation and nitric oxide therapy are available. The
nursery staff are well trained with a high proportion of the senior staff having completed the Neonatal 405 course.
Six Advanced neonatal nurse practitioners are in post and there is a Community Neonatal Nursing Service. There
are 2 mother and baby flats attached to the Neonatal Unit and a six bedded transitional care unit attached to one of
the postnatal wards.
Babies requiring neonatal surgery or cardiology are transferred to Liverpool or Birmingham with follow-up clinics in
Shrewsbury with the regional consultants. There are approximately 500 admissions to the neonatal unit each year
with 120 babies ventilated and 1600 intensive care days. The unit is served by four consultant neonatologists.
There are regular visits by a consultant ophthalmologist and a consultant radiologist. The Consultant Neonatologists
operate a ‘Consultant of the Week’ system providing continuity of care and educational supervision.
THE DEPARTMENT
There are 4 full-time Consultant Paediatricians based at the hospital department and 3 Consultants based
predominantly in the Community 1 or the nearby Robert Jones and Agnes Hunt Hospital, Oswestry 2:
Dr J E H Brice
Dr C E Cramp
Dr M Rees
Dr N Ayub
Dr R C M Quinlivan
Dr M Smith
Dr J B Watt
General Paediatrics (Respiratory and Oncology)
General Paediatrics (Epilepsy and Diabetes)
General Paediatrics (Respiratory & CF)
General Paediatrics (Gastroenterology)
General Paediatrics (Neuromuscular) 2
Consultant Paediatric Neurologist 2
Community (Neurodevelopmental) 1
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There are 3 Consultant Neonatologists.
Dr R J Welch
Dr S Deshpande
Dr W Tyler
Dr A Moore
Neonatal (Neonatal Neurology)
Neonatal (Metabolic), College Tutor
Neonatal (Feto-maternal)
Neonatal
The middle grade staffing consists of 1 Associate Specialist, 2 Staff Grade Paediatricians, 6 Core Specialist
Registrars (3 General Paediatrics, 2 Neonatology and 1 Community) and a middle/finisher SpR (Community and
Neurodisability).
The first on-call cover for the Children’s Ward is provided by 4 Senior House officers (2 career Paediatricians and 2
VTS trainees), 2 F2 and a F1 trainee in a full-shift rota. Three SHOs and 6 neonatal nurse practitioners, provide
separate first on call cover for the Neonatal Service, and cover
the neonatal unit, resuscitation calls to labour ward and the examination and care of babies on the postnatal wards,
including transitional care. These staff members combine to form a full shift on-call arrangement (Band 2B).
THE RESPONSIBILITY OF THE POST
The appointment is for 6 months with full-time workload and responsibility in General Paediatrics.
The SHOs are under the clinical direction of and managerially responsible to the Consultant Paediatricians. Staff
are encouraged to follow a special interest with active participation in teaching and audit. Each junior doctor has a
designated Consultant supervisor and there is a well established system of regular appraisal and assessment.
TEACHING & AUDIT
The posts are recognised for general professional training by the Royal College of Paediatrics and Child Health
(RCPCH), and are suitable for MRCPCH. The department prides itself on its commitment to teaching and training.
There is a Wednesday afternoon Consultant-delivered protected SHO teaching program (separate for General
Paediatrics and Neonatology) lasting 3 hours/week. It includes common paediatric and neonatal topics in conformity
with the RCPCH syllabus, in addition to Child Health Surveillance modules. Additionally, there is a North-West sector
SHO teaching programme held every 4th Wednesday at Stafford.
The active academic programme additionally includes regular Monday and Thursday lunch-time meetings consisting
of clinical presentations, Grand Rounds, journal club, paediatric guidelines meeting as well as a fortnightly X-ray
meeting. There is a monthly district clinical or audit meeting, monthly perinatal mortality meeting and twice monthly
feto-maternal meetings. Medical students from Birmingham, Manchester/Keele, Imperial College London and
Guy’s/St Thomas’s Hospital, London, have regular clinical attachments.
A new multidisciplinary Shropshire Education & Conference Centre (SECC) provides state of the art postgraduate
educational facilities, including lecture theatres, seminar rooms, IT suite, practical skills laboratory, library and
catering service.for medical staff in both the hospital and community. Regular teaching meetings are held here and
educational programmed for each medical speciality are available.
The postgraduate centre deals with study leave application, approval and authorisation for reimbursement.
Information on courses, membership and fellowship examination can be provided. Study leave will be approved in
conformity with regional and national policy. For further information please contact the Centre Manager on ext 2501.
There are opportunities for research, mainly clinical, but the emphasis is on obtaining good general clinical
experience in a busy department.
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MAIN CONDITIONS OF SERVICE
a)
The appointment is full time and the terms and conditions of service are set out in the Terms and Conditions
of Service of Medical and Dental Staff (England and Wales) and the General Medical Council Conditions of
Service as amended from time to time.
b)
Contracted Hours
The contracted hours attaching to this post are:
Standard Working Week
40
You will receive, in addition to your base salary a supplement at the rate of 50% of your base salary for
duty contracted at Band 1a at PRH and Band 2b at RSH. (including prospective cover)
Peripheral allowance is not applicable to this post.
c)
Absence from the Hospital site for ANY reason must be reported to the Medical Staffing Officer by 10 am.
Failure to do this will result in the time in question being unpaid.
d)
The successful candidate will be subject to a Criminal Records Bureau Disclosure. No prospective member
of staff will be permitted to commence employment until the results of the disclosure have been received
and discussed with the appointing officer.
e)
The successful candidate will not be permitted to commence employment until a full medical examination has
been completed with a satisfactory result or the Occupational Health Physician has satisfied himself that a full
examination is not necessary. The completion of a satisfactory health questionnaire is a condition of
appointment. Immunisation against Hepatitis B is essential.
f)
Possession of a recognised medical qualification and limited/full registration with the General Medical Council
is a condition of appointment. The post holder is advised to be a member of recognised medical defence
society or suitably insured.
g)
If appointed, you should attend Health & Safety at Work training and have read and be conversant with the
recommendations (available on Wards and through the Health & Safety Officer).
h)
Emergencies And Unforeseen Circumstances
It is a responsibility of the Consultant to determine whether a particular situation can be described as an
emergency. In such circumstances you may be asked to work additional hours or to change the hours you
have been allocated.
i)
Residential Accommodation
The Hospital has residential accommodation for medical staff including limited provision of married
accommodation.
This post is not compulsorily resident but a practitioner who resides in hospital accommodation voluntarily
shall pay a rental or lodging charge, which may be deducted from his/her remuneration. Where the post
holder does so elect, every attempt will be made to suit his/her needs within the total accommodation
available.
All Hospital staff, whether on-duty or off-duty shall pay for meals and other refreshments they take in the
hospital.
Non Resident post holders will be required to reside within easy travelling distance of the hospital (no more
than 15 minutes by car).
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SHROPSHIRE AND THE LOCAL HOSPITALS
Shropshire is the largest inland county. It is a predominantly rural area and an attractive place to live. The two main
towns are Telford and Shrewsbury. The population of the county is now 450,000 and is increasing due to the
development of Telford - one of the fastest growing towns in the UK. The distribution of the population gives a wide
mixture of social environments ranging from deprived urban to isolated rural communities.
The Shrewsbury and Telford Hospital NHS Trust is the main hospital in Shropshire. It comprises two district general
hospitals, the Princess Royal Hospital (PRH) at Telford and the Royal Shrewsbury Hospital (RSH). The PRH serves
Telford and East Shropshire while RSH serves the western part of the county and part of Wales. The population is
between 250-260,000 of which some 45,000 are under 16 years of age.
Telford New Town has stimulated the development of new industries in the area. The population of Telford is
between 250-260,000 of which some 45,000 are under 16 years of age. The Princess Royal Hospital is a busy,
friendly, modern district general hospital located on a green-field site in the former park land of the Apley Castle
estate. It has 370 beds and was purpose-built to the Department of Health’s nucleus design in August 1989. The
hospital has all the main specialities and offers doctors in training a challenging and friendly environment in which to
develop their careers.
The Trust has links with the Orthopaedic Hospital in Oswestry (North West of District) which includes an active
Rheumatology department, a spinal injury unit, spinal surgery and a multidisciplinary muscular dystrophy clinic and
with tertiary centres in Birmingham and Stoke on Trent.
At Shrewsbury the main hospital is the Royal Shrewsbury Hospital. RSH has approximately 526 beds including the
Consultant Maternity Unit. It is a friendly hospital with different departments enjoying good relationships with each
other. In addition to the Shropshire County catchment population the Hospital provides all District General Hospital
services for the Powys Local Health Board (registered population of 132,000) with the exception of elective
orthopaedic services.
The Consultant Maternity Unit is based at the RSH with a GP unit at PRH. There are approximately 4,800 deliveries
in the District and catchment area. Also within the Shrewsbury campus is Shelton Hospital which is part of
Shropshire’s Community and Mental Health NHS Trust. The Trust Websites are: www.prh-telford.org.uk and
www.nhs-shropshire.com
THE PRINCESS ROYAL HOSPITAL:
The Hospital provides the following services:
Accident & Emergency
Anaesthesiology and Intensive Care
General Medicine
Medical Admissions Unit
Care of the Elderly
Rehabilitation
Neurology
Cardiology & Coronary Care Unit
Endocrinology
Gastroenterology
Respiratory Medicine
Rheumatology
Radiology
Paediatrics
G.P.Maternity Unit
Pain Clinic
General Surgery, including
Breast, Vascular, Upper G I Surgery
Urology
Surgical Intermediate Care Unit (4 bed)
Trauma & Orthopaedics
Intensive Therapy/High Dependency combined Unit (fluid 9 bed capacity)
There is a purpose built Day Surgery unit which offers:
ENT
Ophthalmology
Gynaecology
Urology
Community Dental Unit
A purpose built Endoscopy suite.
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The Clinical Consultant Staff comprises:
13 Physicians
6 General Surgeons
5 Orthopaedic Surgeons
4 Paediatricians
10 Anaesthetists
2 Consultants in A&E Medicine
General and Orthopaedic Surgery is served by five theatres - two with laminar flow ultra clean air. In addition, there
are three dedicated theatres for Day Surgery. There is a purpose built Fracture and Orthopaedic Clinic.
Imaging Department
There are six Radiologists. The imaging department has recently introduced a digital X-ray system (PACS - Picture
Archiving and Communications Systems) throughout the hospital and is the first Trust in the West Midlands region to
do so. It enables films to be in more than one place at once, allowing instant access to images in all clinical areas
both for in and outpatients and the sending of images and reports to our sister DGH, the Royal Shrewsbury Hospital
and the a community hospital at Bridgnorth.
The department provides a full service including screening rooms, ultrasound, nuclear imaging facilities,
mammography, Spiral CT and MRI.
Pathology - A full range of Pathology Services is provided on site and within the Shropshire District. Advice is
available from on-site Consultants in haematology, microbiology and chemical pathology.
Other departments - There are also Pharmacy, Physiotherapy, Occupational Therapy, Speech Therapy, Audiometry
and Orthotic departments. The Outpatients Department covers all acute specialities.
THE ROYAL SHREWSBURY HOSPITAL
The Royal Shrewsbury Hospital is currently split into two separate sites (North and South) divided by the main road.
The South site will close in 2003/04 and relocate to the North site with developments in two phases. The first phase
has already been completed, namely the Shropshire Education & Conference Centre which is a major development
and one of the best in the country. The second phase is the construction of a new Gastroenterology and Endoscopy
Unit, Day/Surgery Unit, a purpose-built 32-bedded Admissions Unit with acute medical and rehabilitation beds. An
MRI scanner will be integrated into the new build.
The Royal Shrewsbury Hospital NHS Trust comprises the following:
Royal Shrewsbury Hospital North
Acute
(including Eye, Ear & Throat)
Royal Shrewsbury Hospital South
Acute
Royal Shrewsbury Hospital Maternity
Maternity
RSH also has a General Paediatric Unit.
Inpatients
The Royal Shrewsbury Hospitals have inpatient facilities for
General Surgical,
Medical,
Paediatric,
Heamatology,
Oncology,
Orthopaedic,
Radiotherapy,
Dental,
Obstetric/Gynaecological,
ENT
Ophthalmology
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305 beds
86 beds
143 Cons bed
22 SCBU cots
11 labour rooms
There are also facilities for Out-Patient treatment for all of the various specialties and a day surgery unit.
Other facilities include
Child Assessment Unit,
Programmed Investigation Unit,
Cancer Unit,
Gastroenterology Unit,
Coronary Care Unit,
Intensive Therapy Unit,
Renal Unit,
Elderly Care Day Hospital and Stroke Unit.
There are also nine major and two Day Surgery operating theatres and a Department of Physical medicine and support
services by the Radiology and Pathology Departments available.
LOCAL FACILITIES AND ACCOMMODATION
Princess Royal Hospital is approximately 2 miles north of Wellington, and less than 2 miles north of Junction 6 on the
M54. There is good access to the Shropshire countryside from Telford, including the Ironbridge Gorge www.virtualshropshire.co.uk/ironbridge-gorge-museum, Wenlock Edge and the Wrekin. There are many well sign-posted
country walks and cycle paths in the area. Shrewsbury is easily accessible both by road and by train (the last train
back is 23.25). Intercity trains link to London and Birmingham and the M54 provides quick access to the national
motorway network with Birmingham, the West Midlands and Merseyside within 45 to 90 minutes drive. Historic
Ludlow and the Welsh mountains (including Snowdonia) and the coast are all within easy reach.
Telford has an excellent shopping centre including a 10 screen multiplex cinema. Most sports are well catered for
including golf, squash, athletics, indoor and lawn tennis, ice-skating, shooting, fishing and horse-riding. There is an
artificial ski slope, swimming pools and a racquet centre (discounts available) including tennis, squash, and
badminton. On the Long Mynd hills near Shrewsbury gliding and hang-gliding is available. Wales is easily reached
and offers mountaineering, sailing, surfing and windsurfing.
Cultural pursuits are easy to follow. The centre of Birmingham is less than an hour away and provides first-class
music, ballet, opera, theatre and art galleries. Shrewsbury has a popular music hall offering arts and entertainment
www.musichall.co.uk, the world famous Shrewsbury Flower Show is held each August in the Quarry Park beside the
river and the other well known local even is the West Mid Show which is held in its own show ground outside the
town. Between Shrewsbury and the modern town of Telford are the impressive remains of the second largest
Roman city in Britain – “Viroconium” www.english-heritage.org.uk and Shropshire’s vineyard at Wroxeter.
www.wroxetervineyard.co.uk. Further Shropshire information can be found on www.shropshireonline.gov.uk and
www.shropshiretourism.info
There is a very friendly and enthusiastic Doctors Mess organised by the Junior Doctor’s Mess’ Committee, Social
events, parties, outings etc. are regularly arranged. Free drug lunches are held on a weekly basis. The Mess itself is
comfortably furnished and equipped with a large television, Sky television, multi CD player stereo, pool table, barbecue
and coffee facilities, along with a choice of daily newspapers, and table football. A coffee maker, microwave oven and
toaster are provided in the kitchen along with regular with milk, coffee, tea bread and soup. There are laundry facilities
and a vending machine with chilled cans. Pigeon holes for mail are in the post room within the main hospital. There is
an onsite Fitness Centre due to re-open January 2004 which will be available to all members of staff.
Single on site accommodation is available consisting of single rooms with shared kitchen and bathroom. Married off
site accommodation may also be available which is situated on relatively new housing estates close to the hospital.
A wide range of attractive housing is available in and around Telford offering town or village life. High quality state
and private schools are available.
FURTHER INFORMATION
Candidates who wish to discuss the post and visit the department are advised to contact the Consultant's
Secretaries on 01952 641222 at Princess Royal Hospital and 01743 261000 at Royal Shrewsbury Hospital.
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