Consultant Respiratory Paediatrician

Job overview

This post replaces an existing post already established in Paediatric respiratory services but can be tailored to a candidates special interests.  We are looking for an enthusiastic colleague to join our service and to complement the current team of three friendly and cohesive consultants. The post is offered as a locum for 12 months in the first instance with the aim to become substantive.

The post holder will contribute to the general respiratory and asthma service and be encouraged to develop specific areas of interest in line with their experience and the needs of the department..

The respiratory team currently run weekly respiratory and asthma clinics and a number of other joint clinics with other specialities. There are regular clinics for children with difficult asthma, bronchiectasis and those on long-term respiratory support. There are monthly joint clinics with ENT, the neonatal team, haematology and the neuro-disability team.  The team also supports PICU, NICU, haematology & oncology (in conjunction with the Royal Marsden Hospital), fetal medicine, paediatric surgery and infectious diseases.

Main duties of the job

The aim of this post is to contribute to the increasing ambulatory and inpatient capacity of the service at St Georges and further develop the service and its research profile. The post holder will receive referrals from other consultants and specialties, from PICU and NICU, and from General Practice. These will be seen as either inpatients or outpatients as appropriate. Patients may be local or from outside the region. There is a 1:4 attending rota for respiratory ward cover with out of hours telephone support. There postholder would not contribute to the general paediatric service.  The post holder would be fully responsible for the management of respiratory patients within their expertise and in conjunction with other members of the team and the wider MDT. We operate several joint clinics with other specialties including ENT, foetal and neonatal medicine, neurodisability and immunology. We have a growing cohort of children with complex respiratory disorders including those; on invasive and non-invasive long term respiratory support; congenital and interstitial lung diseases and those with chronic suppurative lung disease.

Detailed job description and main responsibilities

The aim of this post is to contribute to the increasing ambulatory and inpatient capacity of the respiratory service at St Georges and further develop the service and its research profile. We also aim to provide linked outreach clinics. The post holder will receive referrals from other consultants and specialties, from PICU and NICU, and from General Practice. These will be seen as either inpatients or outpatients as appropriate. Patients may be local or from outside the region. The post holder would be fully responsible for the management of such patients. The postholder would be expected to take an active role in the investigation of oncology patients with respiratory disorders in conjunction with the oncology and PID services. Similarly, joint care of those with sickle cell.  We have a growing cohort of children on invasive and non-invasive long term respiratory support and there are plans to develop a respiratory led transitional care unit.

There is a comprehensive diagnostic service with excellent support from four paediatric radiologists with state of the art facilities for MRI, CT and Ultrasound.

The respiratory service is supported by a dedicated paediatric physiology service with facilities for spirometry, plethysmography and gas exchange and exhaled nitric oxide. The physiologists also run sleep studies including respiratory semi-polysomnography (no EEG) and oxy-capnography, predominantly as domiciliary studies.

The post holder should be competent in performing flexible bronchoscopy for children in the PICU or in theatre. There are close links with ENT for managing children with tracheotomies and those who require rigid bronchoscopy.

At present children requiring chest drains are managed in conjunction with the paediatric surgeons. The surgical team, led by Mr Bruce Okoye also offer VATS for management of congenital lung abnormalities, complex effusions and lung biopsy.

On average the post holder will perform 2-3 clinics per week except when on ward duty when the clinic load will be reduced.

• Mr. Hamid Daya and Mr Prince Modayil (ENT surgeons) managing children with complex airways and tracheostomies – Dr Kappos & This post
• Dr Sandeep Shetty (Consultant Neonatologist) for infants with chronic lung disease of prematurity and other congenital lung problems – Dr Kappos.
• Dr Irene Hadjikoumi (Consultant in Neurodisability) for children with complex neurodisability and pulmonary issues – Dr Chavasse.
• Dr Konstantinos Karampatsas (Consultant in Immunology and Infectious Diseases) for children with immune deficiencies (6 monthly)- This Post
• Prof Asma Khalil (Fetal Medicine) – Counselling of parents expecting a child with a congenital lung lesion – This post
• Dr Rubina Malik (Consultant in Haematology) to offer respiratory care for children with sickle cell disease – Dr Kavaliunaite
• Dr Sachelle Ruickbie (Consultant Respiratory Physician) – Asthma Transition Clinic – Dr Kavaliunaite
• Tadworth Children’s Trust (Variable) – This post

Ward Duties

The postholder will share ward attending for children admitted to hospital with respiratory conditions with the other three respiratory consultants (Respiratory Consultant of the week - RCoW) on a 1:4 basis. They will be available to consult on children admitted under the general paediatric team or any of the other specialties. The respiratory team will review all children who are admitted with asthma to ensure adequate management and appropriate follow-up to drive up standards of asthma care. The RCoW will have time dedicated to attend the wards on a daily basis. At present we operate a system of a week on duty at a time transferring care on a Monday. They will also be available for telephone advice service out of hours (category B on call).

The RCoW will attend the PICU ward round on a weekly basis to discuss children with chronic respiratory issues as well as interval visits as requested by the PICU consultants. They will have time to undertake urgent bronchoscopies on PICU according to need.

The RCoW will attend a joint neonatal MDT respiratory meeting with the attending neonatal service to review infants with severe chronic lung disease of prematurity, congenital conditions affecting the lungs those admitted with possible cystic fibrosis. Children discharged home in oxygen will be followed up in the neonatal respiratory joint clinic.

There is a weekly MDT meeting for the whole respiratory team to discuss relevant patients. There is a weekly academic meeting for academic presentation, discussion and service development. It is anticipated that there will be a monthly sleep physiology meeting. There is also a weekly MDT radiology meeting.

Bronchoscopy

There is a monthly theatre list available for elective flexible bronchoscopy under general anaesthesia. There is the facility to undertake CT scans under the same GA if needed. There is facility to perform pH studies. There is also a daily paediatric CEPOD list for more urgent bronchoscopies. Patients referred from PICU needing bronchoscopy can be performed on the unit.

There will be the development of joint protocols, governance, radiology sessions, research and audit projects. The team will continue to develop regional and national links. The aim is to provide outreach clinics in the region and maintain links with other specialist units in London. The post holder will be encouraged to participate in National and International groups, audit and research.

Research & Teaching

St. George’s University of London has identified paediatrics and paediatric infectious diseases as key areas for research and so would welcome candidates with a research interest that complements the clinical interests of the department. Research will be encouraged. The postholder is also encouraged to be involved in teaching undergraduate medical students.