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Detailed job description and main responsibilities

This post will take on general neurology clinical commitments at the Chelsea & Westminster Hospital as well as contribute to the regional neurosciences unit based at Charing Cross Hospital with a specialist clinic there.

A provisional timetable denoting the allocation of fixed/non-fixed commitments is for Direct Clinical Care (DCC) 8.0 and supporting professional activities (SPA) 2.0. The job plan will be subject to change in the future, subject to the needs of the service and in consultation with the post-holder. The illustrative weekly commitment is shown on page 21 & 22.

The post will initially attract 2.0 SPAs.�� These are provided for personal CME/CPD, mandatory training, appraisal and revalidation, and medical student teaching. At the first annual job plan review, the SPA allocation will be reviewed in line with Trust Policy.��

Specific SPA objectives and outcomes will be agreed with the Service Lead within 3 months of appointment. Additional SPA e.g. a more significant teaching commitment, clinical or educational supervision etc, if agreed will be accommodated through job planning.

Clinics are set up using the ABN template of 30mins for a new patient and 15mins for a follow up in the general clinics with the recommended reductions when a trainee is present to supervise.

Inpatient numbers at any one time vary with Nell Gwynne ward having 20 stroke and 4 neurology beds with some flexibility according to sub-speciality need.

In-patient/ward referrals are very variable but there has been an undoubted upward trend, reflecting the increased activity in the Acute Assessment Unit and A&E attendances. On average there are 5-6 referrals per day seen by the senior clinical fellow and reviewed by the consultant of the day/next ward round depending on urgency.

A degree of flexibility on cross cover will be expected to cover for inpatient work such as ward rounds and deal with any unexpected clinical matters that arise relating to colleague(s) leave. This is programmed in the job plan but may require early start/later finishes elsewhere in the week. Similarly there will be consideration of time off in lieu.

It is expected that the post holder will engage in specific management tasks and contribute to monthly departmental meetings and hospital committees in agreement with the Service Director and the Directorate management.

The on call commitment is via the Regional General Neurology rota based at Charing Cross Hospital which is currently approx. 1 in 20 weeks non-resident on call and paid at the appropriate intensity supplement and includes post take/ referral ward rounds.

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The Stroke Component at Charing Cross:

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Background to the post

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The post attracts applicants with sound experience and training in Stroke Medicine to join the Imperial Stroke Centre team to support existing colleagues in this busy service. The successful applicant will be within the Division of Medicine and will be expected to participate in the management of the hyper acute and acute stroke service in accordance with national and international clinical guidelines and will rotate through these parts of the service. The appointee will work closely and in partnership with the rest of Medicine and with Neurosciences. They will be expected to contribute to the existing stroke research effort at Imperial. Clinical teaching, at undergraduate and post-graduate level, will be an important aspect.

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The work of the department

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The Stroke Service on the Charing Cross site provides 24 hours per day, 7 days per week support and hyper acute care for all acute stroke patients (and mimics) and those with “high-risk” TIAs, including those requiring neurovascular intervention. We provide thrombolysis as well as thrombectomy for appropriate patients. The thrombectomy service has been expanded to provide 24 hour cover. The Hyper acute Stroke unit (HASU) has 23 beds and there is an adjacent 22-bedded Acute Stroke unit for early assessments and rehabilitation.

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The Stroke Service offers a same-day full investigation service for “high risk “TIA patients Monday to Sunday, with the weekend and after-hours service available. The Imperial clinical director for stroke and neurosciences sits on the Pan-London Stroke Strategic Clinical leadership group. Imperial are actively engaged with the London commissioners in expanding and improving existing community rehabilitation.

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Training and research are central to our mission. We have now trained many accredited stroke physicians. We take a leading role within the North West London Academic Health Science Network (AHSC) and have Hyperacute Stroke Research Centre (HASU) status. We hold a weekly Academic meeting where Research Study accrual numbers are reviewed and new studies presented and discussed. Thrombolysis and thrombectomy cases are carefully monitored and selected cases discussed in detail in our monthly separate Thrombolysis & Thrombectomy mortality and morbidity meetings.

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Our Stroke Clinical Specialist Nurses lead on nursing aspects of stroke thrombolysis. All of our nurses receive specific training in hyper acute stroke care on a regular basis. Specialist stroke therapists are available every weekday, with a weekend review service. We have access to neuro-rehabilitation in a variety of settings, with the Charing Cross Neuro-Rehabilitation Unit (CNRU) on site.

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Stroke services at Imperial College Healthcare are very well supported by Imaging and Therapies. We have access to weekend MRI. We hold weekly Stroke Neuro-imaging meeting where cases and further investigations are fully discussed.

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There is a monthly Stroke Quality Board and a Management meeting where performance is reviewed. Senior multi-professional attendance at these ensures a cohesive management structure and robust governance. There is weekly teaching and training for all grades of staff and a commitment to medical student teaching.

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Imperial College Healthcare NHS Trust shows a strong commitment to appraisal and revalidation, and aims to be a national exemplar to this end. Support is provided for all employees by the Trust's professional development officer, with regular updates and support provided at each stage of the revalidation process.