Medical Training Initiative Post [Paediatric Neurology] · Medical Training Initiative Post...

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Cardiff and Vale University Health Board

2020

Medical Training Initiative Post [Paediatric Neurology] Job Description Lead clinician: Dr Frances Gibbon

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Hospital: Noah’s Ark Children’s Hospital for Wales

Directorate: Acute Child Health

Grade: ST4-8

This is a 24-month post offered under the Medical Training Initiative scheme (MTI) run by the Royal College of Paediatrics and Child Health. The post starts with 6 months in General Paediatrics of which the first 3 months at ST3 level (SHO). This is because our experience and feedback from many previous MTIs strongly emphasises that starting in General Paediatrics is an essential first step in settling into our Children’s Hospital. This is followed by 18 months at ST4-8 level in tertiary level Paediatric Neurology. Please note the post has been quality assured by the MTI team at the RCPCH.

Hours Per Week: 48 Salary Scale: Specialty Registrar salary scale MN37 with a 2B (50%) banding supplement for out of hours work.

Key Working Relationships:

Paediatric Neurology is part of the Paediatric Neuroscience service delivered by the Children’s Hospital for Wales. This service provides paediatric neurology, neurosurgery, neuro-rehabilitation, neuro-oncology, neurophysiology and neuroradiology and referrals are received from all the South and West Wales Health Boards. The paediatric neurology team provides shared medical care for all paediatric neurosurgical patients. The team also works closely with colleagues across all medical specialties, PICU and NICU. The paediatric neurology team consists currently of: 3 consultants 2 epilepsy nurse specialists (job-share) 1 full time paediatric neurosurgery nurse specialist 2 middle grades 1 SHO Consultants in Paediatric Neurology

Dr Frances Gibbon Paediatric Consultant Neurologist Dr Johann Te Water Naude Paediatric Consultant Neurologist Dr Anurag Saxena Paediatric Consultant Neurologist The 3 consultants have subspecialty interests including epilepsy, ketogenic diet, adolescent epilepsy and VNS clinics, neuromuscular disorders, neuro-rehabilitation, neuro-oncology, white matter disorders and outreach clinics are held in neighbouring Health Boards. Dr Gibbon is assistant secretary of the British Paediatric Neurology Association (BPNA). Dr Te Water Naude is honorary secretary of the Welsh Paediatric Society. Anurag? We have regular meetings with the multidisciplinary therapy team and a recently established neuro-rehabilitation service including physio, occupational, speech and language therapy, psychology, dietetics and others. We have close links with Clinical Genetics and regular neurogenetics meetings. We also work closely with Adult Neurosciences with a range of joint

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clinics and opportunities to participate in the adult neuroscience meetings. The Unit has national approval for training in tertiary Paediatric Neurology (CSAC). Clinical Training Responsibilities

• Ward rounds and ward duties (2 large medical wards and shared care for the neurosurgical patients on the surgical ward).

• Neurological input to the care of children on paediatric HDU, PICU and NICU.

• Outpatient clinics

• Attendance at multidisciplinary meetings

• Co-ordination of investigations for children on the weekly GA list for MRI, including liaison with special biochemistry and performance of lumbar punctures.

Programme Description: This 2-year MTI fellowship is offered in conjunction with the Royal College of Paediatrics and Child Health MTI programme. Induction All MTI candidates will receive a comprehensive induction programme to familiarise them with the functioning of the hospital, the Trust’s procedures and issues of clinical governance. In addition, there is a specific induction to the department of Paediatric Neurology which will cover all aspects of working within the department. The Programme All MTI candidates will start training in General Paediatrics at ST3 level for the first 3 months, stepping up to ST4-8 (middle grade) level for the next 3 months. This is to allow acclimatisation with practice in the UK. The expectation is that the trainee will satisfy level 1 & 2 acute competencies for General Paediatrics in this period. In the final 18 months of training candidates will be expected to complete level 3 competencies within Neurology as discussed with their educational supervisor. Consultant supervision and advice is available at all times. Subject to performance, we will consider facilitating for your last 6 months a secondment or transfer to another unit to acquire specific competencies of your interest, e.g. Community Paediatrics (management of neurodevelopmental disorders) or epilepsy surgery. Training, Education, E portfolio and ARCP MTI fellows working in Cardiff and Vale UHB will be to fully engage in our educational program and learning opportunities in the same way as our Deanery trainees. Please note it is mandatory for all MTI fellows to maintain an RCPCH e-portfolio record of their training from start of the programme.

Assessment of competencies will be through e-portfolio and an annual in house review of curriculum progress (“ARCP”). A certificate stating the periods of training and competencies acquired is provided on completion of the programme. In addition fellows are required to have an annual appraisal, as are all health board employees. Departmental Education The range of educational opportunities available within the Department includes weekly Tuesday and Friday morning teaching ward rounds, neuroradiology and neurosurgery MDTs. Fellows are also expected to take part in acute scenario simulation training, to complete all mandatory training, including Safeguarding Level 3, and to attend the weekly teaching on Monday, Tuesday, Thursday and Friday lunchtime organised within Acute Child Health with the last Friday of the month dedicated to guidelines. They will be released to attend their

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share of the twice monthly all day Wednesday teaching sessions organised by the Wales Deanery. Fellows are also invited to attend our MRCPCH exam practice teaching sessions. Outpatient Clinics These are considered an important part of the service and fellows will have the opportunity to be involved in this. The exact configuration of the timetable will be negotiated as part of the development of the individual learning plan with the Educational Supervisor. Clinics are run every working day of the week. Working Pattern & Duty Roster The fellows take part in a full-shift pattern of working to cover the out of hours service. Shift patterns include cycles of nights and long days (13hour shifts) and short days (08:30-16:30). Our rotas are New Deal and EWTD compliant and deliver the RCPCH curriculum. Educational Supervision All MTIs are allocated an Educational Supervisor who will be one of the Consultants they are working with. A personal training plan will be developed at the beginning of the post to suit the individual’s training needs. Progress will be monitored by regular appraisal. Research & Audit MTI Fellows will have the opportunity to contribute to clinical trials. Audit and Quality Improvement activities are expected and supported. The Liverpool Diploma (LSTM) is not mandatory but will be supported. Local Tutor support

The Children’s Hospital employs a large number of doctors from across the world. In addition to two local tutors for Deanery Trainees, Child Health therefore has a designated local tutor overseeing the learning and career development needs of all fellows who are not part of the Wales Deanery, including all MTIs. Code of Conduct

The completion of a satisfactory health declaration questionnaire and screening is a condition of the appointment. The post holder must comply with the UK Health Department guidance on "Protecting Health Care Workers and Patients from Hepatitis B" (PSM (93)12) as implemented by the UHB.

b) Because of the nature of the work of this post it is exempt from the provision of

Section 4 (2) of the Rehabilitation of the Offenders Act 1974 (Exemption Order 1975). Applicants are therefore not entitled to withhold information about convictions of the Act. In the event of employment, failure to disclose such convictions could result in dismissal or disciplinary action. Any information given will be completely confidential and will be, considered only in relation to an application to which the order applies.'

c) The UHB will require the successful candidate to have and maintain full

registration with a licence to practise with the General Medical Council throughout the duration of this contract.

d) You are normally covered by the NHS Hospital and Community Health Services

indemnity against claims of medical negligence. However, in certain circumstances (e.g. in service for which you receive a separate fee or in an emergency situation outside of work) you may not be covered by the indemnity. The Health Departments, therefore, strongly advise that you maintain membership of your medical defence organisation.

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Accommodation There is single accommodation you can book on the hospital campus. You will need to pay this yourself. Importantly, there is no double or family accommodation.

Relocation Expenses

The Child Health Directorate does not pay relocation expenses. Study Leave: 30 days per annum, is incorporated in to the rota. This post does attract a £600 per annum study leave budget (equal to the budget of Deanery trainees).

Time off for study leave is incorporated into the rota and may be granted for education purposes to attend courses at the discretion of the Clinical Director, provided the clinical service is covered and must be planned well in advance. At least six weeks’ notice is required. A Study Leave Approval Form must be completed and authorised by the Consultant and Clinical Director. Annual Leave MTI fellows are entitled to 5 weeks annual leave per annum (rising to 6 weeks per annum upon reaching the third incremental point of the MN37 pay scale). Annual leave is incorporated into the rota and swaps may be arranged.

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Appendix – description of Cardiff and Vale UHB and services within the Children’s Hospital

CARDIFF AND VALE UNIVERSITY HEALTH BOARD

BACKGROUND Cardiff and Vale University Local Health Board was established on 1st October 2009 and is one of the largest in the UK, providing health services for over 500,000 people living in Cardiff and the Vale of Glamorgan. We also serve a wider population of 2.5 million people across South and Mid Wales for specialties such as paediatric intensive care, specialist children’s services, renal dialysis, cardiac services, neurology, and medical genetics. We are also responsible for the delivery of NHS primary care services in Cardiff and the Vale of Glamorgan, including general practitioners, community pharmacists, dentists and optometrists. Cardiff and Vale University Health Board’s nine hospitals are; Barry Hospital, Cardiff Royal Infirmary West Wing, Children’s Hospital for Wales, University Hospital Llandough, Rookwood Hospital, St. David’s Hospital, University Dental Hospital, University Hospital of Wales, and Whitchurch Hospital. We are a teaching health board with close links to Cardiff University. The University boasts a high profile teaching, research and development role within the UK and abroad. Together we are training the next generation of medical professionals.

THE HOSPITAL(s) University Hospital of Wales In 1971, UHW was officially opened and rapidly established itself as one of the foremost teaching hospitals in the UK and the flagship of Wales.

Cardiff and Vale UHB is one of the largest health organisations in the United Kingdom with over 900 beds and a budget of well over £1 billion. The hospital provides for the fullest integration of a 924-bed hospital and medical school in one complex. Three blocks running north south with 6 subsidiary 'link' blocks comprise the main complex. The main building is 10 storeys high, with numerous peripheral developments. Each week the hospital sees around 5,000 outpatients, 500 inpatients and 200 day cases. The Main operating theatre suite is one of the largest in Great Britain with 10 theatres and 12,000 cases per year. Emergency services are located within state of the art accommodation on the University Hospital of Wales site. It is an extremely busy department with approximately 100,000 attendances per year. Children’s Hospital for Wales The Children’s hospital has a dual remit to provide secondary care the local population of Cardiff and the Vale of Glamorgan and almost all tertiary services through the South Wales Network. This is an exciting time of expansion for all paediatric services in Cardiff, with the UHB having recently opened the final phases of the Children’s Hospital for Wales which has enabled the consolidation of all paediatric specialities into a dedicated facility with five theatres, Paediatric Critical Care Unit (PHDU& PICU), Medical and Surgical Wards, a separate Paediatric Oncology ward and clinic area and parents accommodation, a teenage cancer unit, a large outpatient suite, designated Paediatric Radiology, Audiology, and an admission and assessment unit.

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Further paediatric outpatient services are provided at Llandough Hospital and community paediatric services are offered at both Llandough and St David’s Hospital. Unscheduled paediatric care currently has two points of entry into the Children’s Hospital, with GP referrals to the Children’s assessment Unit located in the Children’s Hospital (8000 children per year) and self-referrals to the paediatric section of the Emergency Department (35,000 children per year). Paediatrics and ED sit under separate directorates but work closely together, with the ultimate aim of the development of a single point of entry. Child Health offers the following wide range of services, notably, General Paediatrics, Community Paediatrics, Paediatric Emergency Medicine, and tertiary Neonatology, Cardiology, Respiratory, Gastroenterology, Nephrology, Neurology, Endocrinology, Metabolic Medicine, Palliative Care, Paediatric Oncology, Critical Care. Paediatric Surgery, Trauma and Orthopaedics, Spinal Surgery, Neurosurgery, Urology, ENT and Ophthalmology. Clinical Director Acute CH Dr Rim Al-samsam Clinical Director Community CH Dr Sian Moynihan Assistant Clinical Director Quality and Safety: Dr Rajesh Krishnan Assistant Clinical Director Junior Workforce: Dr Siske Struik CARDIFF UNIVERSITY Cardiff University’s School of Medicine is based on the site and consequently the hospital is regarded as the major teaching hospital within Wales. With one or two exceptions the NHS service side is interlinked with professorial departments and both the NHS and School elements are heavily involved in research and development and have gained eminent reputations both nationally and internationally. The University Department of Child Health is the academic limb to paediatric clinical services and has its main base at University Hospital of Wales led by Professor Sailesh Kotecha. The University has been successful in attracting external funding from a wide range of bodies in the public and private sectors and performed exceptionally well in the recent Research Assessment Exercise and Teaching Quality Assessment. Active research areas include acute general paediatrics, endocrinology, gastroenterology and nutrition, neonatal medicine, determinants of infant mortality, paediatric respiratory and neonatal lung disease. Research interests of the Department of Community Child Health include The Welsh Child Protection Systematic Review Group www.core-inf.cf.ac.uk, primary research programme into the diagnosis of child abuse, accident prevention, domestic violence, vulnerable groups, and special needs of disadvantaged children. THE POSTS (Generic Information) Workload / Rota Arrangements / Example Timetable

• Normal working days are Mon-Fri for 8 hours. In addition you will do evening shifts, night shifts (in blocks of Mon-Thurs or Fri-Sun) and weekends (generically named ‘out of hours’ shifts).

• General Paediatrics and Subspecialties have a low night shift frequency of overall 1 in 11, enabling more daytime training, notably protected clinic time. The NICU and PICU rotas are separate and to reflect the nature of the work (and thus training) these have a 1 in 8 nights frequency, in line with Deanery policy.

• All rotas allow up to 15 days study leave each 6 months.

• The evening and weekend paediatric medical team, covering General Paediatrics and the Subspecialties, consists of 2 middle grades, 3-4 SHOs and a nurse practitioner. The night team consists of 2 middle grades and 2 SHOs. For SHOs this means there is always middle grade support on site. PICU has one middle grade on site overnight. The NICU rota has one middle grade and 1-2 SHOs on site overnight.

http://www.core-inf.cf.ac.uk/

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• The rotas are full shift and attract 2B banding (50% supplement). They are New Deal and European Working Time Directive compliant (ie 48 hour working weeks) and have an excellent reputation.

Non Clinical Training Responsibilities You will take part in the departmental cycles of clinical governance activities (e.g. bimonthly safety and quality meetings) and will be supported in and expected to complete a relevant audit or clinical governance project each 6-12 months. You will have opportunity and be expected to contribute to our rolling programme of ward based-teaching of medical students, paediatric trainees and allied professionals. Further Training Opportunities / Courses Available The department has a rolling generic teaching programme with at least 1 hour most days. For example General Paediatrics offers: Mondays: 1pm - 2pm microbiology and radiology meeting Tuesday: 1pm - 2pm SHO teaching Wednesdays: 8am - 8.30am journal club and 1pm - 2pm hospital ‘grand round’ Fridays: 1pm - 2pm unit teaching (case/topic presentations with literature review) Each specialty also has its weekly MDT/teaching meeting and other specific educational activities. And more:

• Frequent simulation teaching including unannounced dummy runs.

• Bimonthly 1/2 day safety and quality meetings (clinical governance)

• Active teaching programmes for South Wales ST1-3, ST4-5 and ST6-8 trainees with ~bimonthly regional study days.

• Intense MRCPCH exam support to South-Wales trainees with for example 3 weeks of daily teaching sessions (free) leading up to clinical exams.

• A wide range of in house (mostly free or low cost) courses are available, notably in child protection, simulation training for emergency scenarios and a range of clinical subspecialty study days,

• Courses in good clinical practice (research governance for clinicians, free) and in teaching methods.

• Courses and Modules in all aspects of clinical governance, such as service development, quality improvement.

• Personal development courses in clinical leadership and related generic skill You will be assigned an educational supervisor and supervision will follow the same pattern as for Wales trainees, with at least 3 meetings (1:1) in 6 months, using the ePortfolio.

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DESCRIPTION OF THE DEPARTMENTS 1. GENERAL PAEDIATRICS The General Paediatrics department has grown steadily over the last 10 years. We now have a core group of nine Consultant General Paediatricians (7.2 whole time equivalent in total), 5 Associate Specialists, 6 Nurse Practioners, 8 Registrars and 15 SHOs (of which 6 paediatric trainees, 5 GP trainees and 4 Foundation trainees). We are based within the Children’s Hospital for Wales, which is an integral part of the University Hospital. We deliver the full scope of secondary care paediatrics to our large local population and also have a supporting and coordinating role in the multidisciplinary care of many complex tertiary patients. We are a dynamic team and work closely with the subspecialties and with our large nursing team, pharmacy and a range of therapists (physio, occupational, speech and language, psychology, play therapist, dietetics and others). We are a frontrunner with regards to service model innovations. For example this year won bursaries for two Welsh Clinical Leadership fellows who are now working with us respectively on overhauling our interface with primary care (electronic referrals, personalised links with GPs etc) and on improving holistic coordination of care for young people with chronic and complex health needs. We have strong academic links and participate frequently in studies. As part of a large Paediatric post-graduate training centre in a University setting, the General Paediatrics team has a very substantial commitment to teaching and training. Indeed one of our consultants is local program director for the Children’s Hospital. The Wales Deanery has professionalised educational supervision in line with current GMC and RCPCH requirements. All general paediatric consultants are registered educational supervisors, delivering training to a large number of trainees at Foundation, GP and ST1-8 level and a substantial number of international trainees, notably through the RCPCH Medical Training Initiative. We have a full teaching calendar including an intensive MRCPCH bedside teaching program. The School of Paediatrics at the Wales Deanery has excellent exam pass rates and came out top in the GMC training survey for 2016 We also have an active and growing clinical research program currently focussing on acutely unwell children, infections, pneumonia, asthma and bronchiolitis and large-scale operational research NIHR funded study examining paediatric early warning systems (The PUMA study). We are proud to have Dr Colin Powell in our team, who also is Reader in General Paediatrics and deputy Dean for Research for the Medical School at Cardiff University and has a large international general paediatric research portfolio. Several other team members have strong academic grounding and varying on-going involvement. A Paediatric Clinical Research facility has recently been established and so there is support for establishing and running studies. Furthermore, we contribute to a pro-active resuscitation working party whose remits are both clinical (streamlining practice) and training, and who provide not just APLS courses but also extensive in house small group or individual simulation training tailored to the individual needs of undergraduates and post graduates. In short, we are a well-connected, highly dynamic and supportive team, committed to forming a strong and forward thinking general paediatric core at the heart of a specialised children’s hospital. Consultants in General Paediatrics Dr Martin Edwards General Paediatrics, Child Health Epidemiology, lead Dr Jennifer Evans General Paediatrics, Infection & Immunology Dr Siske Struik General Paediatrics, Infection and Immunology; ACD Dr David Tuthill General Paediatrics, Nutrition and Allergy, Pharmacology Dr Paul Davis General Paediatrics and Community Paediatrics Dr Gillian Body General Paediatrics, Medical Education / Unscheduled Care, Local

Deanery Programme Director Dr Ambika Shetty General Paediatrics and Diabetes

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Dr Jenny Stevens General Paediatrics, Infection Dr Ron Loh General Paediatrics, Epilepsy and Neurology Dr Daniel Rigler General Paediatrics, Respiratory Medicine and CF Local Program Director Paediatrics

Clinical Training Responsibilities Ward rounds and ward duties (2 large wards and medical support to tertiary services including surgery) Assessment and management of acute GP and A&E referrals and emergencies, child protection cases and outpatient clinics.

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2. PAEDIATRIC ONCOLOGY/HAEMATOLOGY Paediatric Oncology/Haematology is a highly specialised tertiary service and offers unique training opportunities for General Paediatricians, those training with an interest in related sub-specialities and those aiming for consultant roles in shared care Paediatric Oncology. Working within Paediatric Oncology/Haematology provides the opportunity to develop several skills:

• Working with children and families who are facing serious and potentially life-limiting illnesses

• Caring for acutely sick patients including HDU-level patients on the ward. Managing those with multisystem failure, complex fluid balance issues, acute sepsis, infection in the immune-suppressed child

• Developing communication skills eg. breaking bad news and dealing with medically stressful situations

• Working within well-functioning multidisciplinary teams which deal with the diagnosis, clinical management, psychosocial and late effects of cancer in children

• Understanding the varied presentations of childhood cancer and how often cancer mimics common diseases in childhood

• Developing skills and an understanding of the management of cancer in children

• Experience of clinical research trials (the majority of children with cancer participate in clinical trials) and this is part of routine working within the Unit

The Paediatric Haematology Unit at the Children’s Hospital for Wales is the only centre in Wales delivering tertiary Paediatric Haematology, caring for patients with complex benign and malignant blood disorders in children. This also includes referrals from the Newborn Screening Programme for sickle cell patients and patients with coagulation disorders. There is a wide variety of patients managed ranging from haemoglobinopathies to inherited bone marrow failure syndromes and HLH. Many Cardiff trainees have gone on to develop a special interest in Paediatric Oncology/Haematology as a Shared Care Consultant. Others have used the experience to enhance their understanding of the care of these patients in a wider context (eg. Endocrinology, PICU, Neurology). For trainees wishing to undertake a career as Specialists in Paediatric Oncology/ Haematology, Cardiff offers comprehensive training. This includes:

• Fully integrated specialist training in Paediatric Oncology and malignant Haematology

• Designated Teenage Cancer Unit

• Experience in paediatric Radiotherapy

• Experience in paediatric brain tumours, including Neurosurgery

• Experience in Paediatric Oncology Shared care services

• Specialist paediatric bone tumour clinics

• Clinical trials

• Comprehensive palliative care service

• High dose chemotherapy with stem cell rescue Consultants in Paediatric Haematology / Oncology Dr Cathy Morley-Jacob Consultant Paediatric Oncologist, lead Dr Meriel Jenney Clinical Lead for Cancer Services for the C&V UHB Dr Indu Thakur Consultant Paediatric Haematologist and Audit Lead Dr Phil Connor Consultant Paediatric Haematologist / Research and Development Lead Dr Maddi Adams Consultant Paediatric Oncologist Dr Lena Uzonova Consultant Paediatric OncologisT For further information or any queries, please contact Dr Cathy Morley-Jacob, Consultant Paediatric Oncologist (cathy.morley-jacob @wales.nhs.uk).

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3. COMMUNITY PAEDIATRICS The community child health team is a health based multidisciplinary team that works with children living in Cardiff and the Vale of Glamorgan. The team delivers both Universal and targeted services that address the needs of a range of children including:

• Children with Complex needs/ Palliative Care needs and disability including sensory impairments

• Children who need support to access education and learning opportunities

• Children in need of Safeguarding( Child Protection) and Children in Special Circumstances

• Children with emotional and behavioural disorders and Neurodevelopmental concerns such as learning disability, ADHD and Autism

• Children with variations of development e.g. dyspraxia and temporary impairments of function e.g. bladder and bowel continence and constipation

They work within the multidisciplinary team with a wide range of community services, including physiotherapy, occupational therapy, speech and language therapy, psychology, play therapist, dietetics and work closely with hospital based services. In close collaboration with social services and police, the community team (and where required hospital counterparts) play an important role in safeguarding (child protection), including assessment and management of sexual abuse. The Community Paediatric team consists of 9 consultants, a number of associate specialists, 4 registrars and 1 SHO. Community Child Health services are consultant led and locality-based, divided into North Cardiff, South Cardiff and the Vale of Glamorgan. Consultants in Community Paediatrics Dr Sian Moynihan Consultant Community Paediatrician Dr Cath Norton Consultant Community Paediatrician Dr Alison Mott Consultant Community Paediatrician Dr Paul Davis Consultant Community Paediatrician Dr Alison Kemp Consultant Community Paediatrician / Professor of Child Health Dr Katina Kontos Consultant Community Paediatrician Dr Nia John Consultant Community Paediatrician Dr Bethan Williams Consultant Community Paediatrician Dr Nicole Pickerd Consultant Community Paediatrician Dr Catrin Simpson Consultant Community Paediatrician Dr Kate Skone Consultant Community Paediatrician Contact for more information: [email protected] Learning and development opportunities are available within the above domains of community child health and will be developed according to the strengths and skills of individual successful applicants. Key areas of skill development which can be supported include:

• Adoption and Fostering

• Safeguarding

• Sexual Abuse examination as part of a regional Sexual Assault Referral Centre SARC

• Expert Court Skills and Fabricated and Induced illness

• National lead centre in Neurodevelopmental assessment of Autism and ADHD Diagnosis

• Paediatric Audiology

• Complex Needs and Neurodisability

• Educational Medicine Supervision will follow the same pattern as for Wales trainees, with at least 3 meetings (1:1) in 6 months and using the ePortfolio system.

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Additional information regarding sub-speciality attachments: Adoption and Fostering The Adoption and Fostering process in Britain is supported by National Regulations and Law that place medical responsibility on Health Boards to ensure that the health of children entering the Fostering and Adoption system are optimally advocated and cared for. Dr Carolyn Sampeys is a National adviser to BAAF and National Public Health Service Designated Doctor for Adoption and Fostering. The trainee will have opportunity in understanding the Cardiff and Vale Health Board Adoption service ,Medical advice on adopters, reports, presentation at Panel, Adoption medicals, compilation of Adoption Medical reports, Attendance at Adoption Panels in Cardiff and vale, Counselling of prospective adopters, Post adoption support. Knowledge of Cardiff and Vale Health Board Fostering service), including Children First Team and specialist nurses, Medical advice on foster carers, kinship carers, (Pathway independent fostering agency carers), reports, presentation at Local Authority Panel, Attendance at Fostering Panels in Cardiff and Vale. Safeguarding Common safeguarding standards exist to guide child protection practice in Wales, along with a framework for referral, assessment, decision-making & planning as outlined in the All Wales Child Protection Procedures. These emphasise the importance of agencies working together and include specific protocols, for example on Child Sexual Exploitation. This attachment will provide extensive exposure to facilitate safeguarding competences. Required competences will be achieved through regular weekly safeguarding medical assessments with development of report writing for social services and medico-legal process. There is monthly peer review learning and discussion of cases with mentoring and support at all times. Level 1, 2,and 3 training opportunities are regularly available. Since 2002, CORE INFO Based at Cardiff University developed an internationally recognized methodology for systematically reviewing the world literature with regard to child abuse and neglect. The focus, to date, has been on the recognition and investigation of suspected abuse / maltreatment, providing current and accessible literature, whilst also recommending a research agenda for those working within the field. Professor Alison Kemp is lead for this team. Local expertise also includes Expert witness skills and Fabricated and Induced illness assessment and diagnosis. Cardiff Sexual Assault Referral Centre SARC Cardiff SARC is a regional centre for the assessment of child sexual abuse across south Wales. The Cardiff SARC is going to be the regional hub in south east Wales, and continue to see children out of hours from across South Wales. The opportunities for training in the paediatric forensic assessment of child sexual abuse will therefore be increased. Further developments are planned with clinics in female genital mutilation. The trainee will have opportunities to undertake these sensitive examinations under close supervision, including use of the colposcope, interpretation of clinical signs and report writing. As part of their safeguarding duties trainees will be regularly allocated onto the Sexual Assault Referral Centre rota, closely supervised by a Lead Consultant. This will involve seeing children involved in historical and acute sexual abuse cases. Doctor Alison Mott is Designated Doctor for Safeguarding for Public Health Wales and Clinical lead for SARC in Cardiff Neurodevelopment assessment of Autism and ADHD Diagnosis Diagnosis of Autism and ADHD constitutes a significant part of community paediatric skills. National standards and guidance are now in place ensuring a systematic and timely process for assessment of these neurodevelopment disorders. The trainee will learn standardised National assessment processes as recommended by NICE and learn assessment and diagnostic skills in identifying and treating ADHD and Autism in childhood and Adolescence. There will be weekly clinics, following NICE Standards for diagnosis and use of validated assessment tools. School observations and discussion at multi-professional peer review meetings for diagnostic concerns and standard setting. Current there is a

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national programme to drive unified assessment process across Wales which is ongoing work for the next two years. There will be opportunity to be involved in the national standard development. Joint working with CAMHS and the Neurodevelopmental core team is central to this area of work. Paediatric Audiology The lead clinician for Community Paediatric Audiology is Dr Amanda Roberts.The Community audiology service works with the hospital based service to provide appropriate clinical hearing assessment pathways for all babies and children. Babies < 9 months or children with identified hearing loss and using hearing aids or children with complex developmental and health needs are assessed within the hospital Audiovestibular medicine clinics. There are close links with Paediatric Audiovestibular Medicine, Paediatric ENT and Cardiff Cochlear Implant Programme. Dr Roberts is the medical lead for the newborn hearing screening programme in Cardiff and Vale supporting screening and early assessment of babies referred from screening. Babies identified with hearing loss are offered aetiological investigation and multidisciplinary support including specialist teaching and speech and language therapy. Paediatric Audiovestibular Medicine experience and competencies can be supported within this placement. Complex Needs and Neurodisability Cardiff and the vale has excellent training opportunities in neurodisability and complex needs. There are two large special schools with regular consultant clinics, as well as the opportunity to carry out supervised clinics in other special schools. Within the service is access to genetics, neurology, orthopaedics, gastroenterology, palliative care, CAMHS, audiology and ophthalmology as well as many allied health professionals. We work strongly as part of a multidisciplinary team and there are many opportunities to attend and chair meetings to plan the care of children with complex needs. We work in collaboration with education and the specialist teachers and therapists to make multiprofessional assessments. Within Cardiff and the Vale is also Ty Hafan, which provides paediatric hospice services to the whole of South Wales. Academic Child Health Opportunities are available for a Clinical Fellow attachment to the University of Cardiff and Community Child Health to undertake the following options:

• Become member of research team (Within Division Population Medicine , Cardiff University)

• Take a lead (under supervision) in a research study in field of

• Chronic neuro-disability

• Child protection

• Injury prevention

• Clinical decision rule development and validation

• Child hood burns prevention

• The interface of health and social care for children

• Wider child health field within the Division of Population Medicine (HealthwiseWales) Types of Research Method Development

• Systematic review

• Large data set analysis

• Intervention studies

• Use of basic statistical packages (with supervision)

• Epidemiology

• Research governance ( ethics and R and D applications)

• Research protocol development Dissemination

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• Learn to write abstracts

• National conference presentations

• Writing academic manuscripts

• Submitting manuscript for publication and response to peer review 5. PAEDIATRIC NEUROLOGY Paediatric neurology is part of the Paediatric Neuroscience service delivered by the CHfW. This service provides paediatric neurology, neurosurgery, neuro-rehabilitation, neuro-oncology, neurophysiology and neuroradiology and referrals are received from all the South and West Wales Health Boards. We work closely with other colleagues in the paediatric service including subspecialties, PICU and NICU. We work particularly closely with the paediatric neurosurgery service and provide shared medical care for all paediatric neurosurgical patients. We have regular meetings with the multidisciplinary therapy team and a recently established neuro-rehabilitation service including physio, occupational, speech and language therapy, psychology, dietetics and others. We have close links with Clinical Genetics and regular neurogenetics meetings. We also work closely with Adult Neurosciences with a range of joint clinics and opportunities to participate in the adult neuroscience meetings. The paediatric neurology team consists currently of: 4 consultants 2 epilepsy nurse specialists (jobshare) 1 full time paediatric neurosurgery nurse specialist 2 middle grades 1 SHO The Unit has national approval for training in tertiary Paediatric Neurology (CSAC). Consultants in Paediatric Neurology Dr Frances Gibbon Paediatric Consultant Neurologist Dr Johann Te Water Naude Paediatric Consultant Neurologist Dr Anurag Saxena Paediatric Consultant Neurologist Supervisor: Dr Frances Gibbon The 3 consultants have subspecialty interests including epilepsy (including ketogenic diet, adolescent epilepsy and VNS clinics), neuromuscular disorders, neuro-rehabilitation neuro-oncology, white matter disorders and outreach clinics are held in neighbouring Health Boards). Dr Gibbon is assistant secretary of the British Paediatric Neurology Association (BPNA) and Dr Louise Hartley is director of the Distance Learning Program of the BPNA. Dr Te Water Naude is honorary secretary of the Welsh Paediatric Society. Clinical Training Responsibilities

• Ward rounds and ward duties (2 large medical wards and shared care for the neurosurgical patients on the surgical ward).

• Neurological input to the care of children on paediatric HDU, PICU and NICU.

• Outpatient clinics

• Attendance at multidisciplinary meetings

• Co-ordination of investigations for children on the weekly GA list for MRI, including liaison with special biochemistry and performance of lumbar punctures.

6 PAEDIATRIC INTENSIVE CARE

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The lead centre for Paediatric Intensive Care for South Wales was commissioned in September 1999, at the University Hospital of Wales by the Specialised Health Service Commission for Wales (SHSCW). With the opening of the new Children’s hospital in 2015, the high dependency unit and the critical care unit were integrated in to the paediatric critical care unit commissioned for 6 intensive care beds and 4 high dependency beds. Children from all the paediatric sub-specialties are cared for with those requiring cardiac surgery transferred on to Bristol or Birmingham. Paediatric critical care provides a specialised environment in which critically ill and injured children receive level 2 and 3 support. The PICU and the HDU support the paediatric general medical and specialty services with in the hospital. The patients include children with respiratory, cardiac, surgical, neurological, trauma, sepsis and metabolic problems. The PICU in Cardiff is able to offer children full supportive treatment, with the exception of ECMO and regularly provides a high level of care including HFOV, inotropic support and CVVH, with the facility to use nitric oxide. Even though children requiring cardiac surgery are referred to either Bristol of Birmingham, there are patients with cardiac conditions with inter-current illnesses managed in the PICU in Cardiff. Your responsibilities include assessment and management of critically unwell children as part of the initial admission of the patient to the PCCU as well as the daily presentation at handover. Middle grades are expected to perform practical procedures including basic airway management in an emergency, peripheral and central venous access. There is support from the in house anaesthetic team available 24 hours a day and 7 days a week. Even though it is not expected that all middle grades would be performing procedures such as intubation, central venous access and chest drains, any trainee who is interested to learn these skills is encouraged to do so in a in a safe and controlled environment. Good record keeping including up to date investigation results for all patients is an important aspect of work in PCCU. Candidates will be expected to be able to communicate with the team as well the patient’s family. It is not unusual that trainees find the work in PCCU a steep learning curve, but they find that they are well supported as the service is Consultant led with at least 3 Consultant led ward rounds per day when all patients are assessed and management plans provided. The West and Wales Acute Transport service for Children (WATCh) is a standalone critical care transport service, which is based in Bristol and covers the geographic areas of south west of England and south Wales. WATCh is commissioned to provide advice, stabilisation and transfer services in the care of critically unwell children referred from peripheral hospitals. The service works in partnership with the regional paediatric intensive care units in Bristol and Cardiff. Although most of the transfers are by road in dedicated ambulances, there is a potential for air transfer by helicopter. The staff comprise of call handlers, ambulance crew, transport nurses and doctors. The doctors include transport fellows and consultants. The fellow job is suitable for paediatricians, anaesthetists or intensivists who are looking for experience in critical care transport of children. In addition to the knowledge and skills involved in critical care transport, fellows can learn the logistics involved in road as well as air transport. There will be opportunities to participate in education programmes as WATCh has an active outreach programme. There is an initial period when all fellows are supervised until they attain all competencies and then are given the opportunity to do unsupervised transfers. Further information: www.watch.nhs.uk Out of hours duties are full shift and shared on a 1 in 8 basis, as per the Deanery requirements for PICU posts. Consultants in Paediatric Intensive Care Dr Michelle Jardine Paediatric Intensivist Lead (shared appointment with WATCH service) Dr Malcolm Gajraj Paediatric Intensivist / Dean for Quality at Cardiff Post Graduate Deanery Dr Helen Fardy Paediatric Intensivist / Paeds Head of School at Cardiff Post Graduate Deanery Dr Rim Al-samsam Paediatric Intensivist / Clinical Director for Acute Child Health Dr Siva Oruganti Paediatric Intensivist / Rota Lead Dr Allan Wardhaugh Paediatric Intensivist / Assistant Medical Director for Communication at CVUHB Dr Richard Skone Paediatric Intensivist (shared appointment with Paeds Anaesthetics & WATCH)

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Contact person for more information: [email protected] 7. EMERGENCY MEDICINE The Emergency Unit at UHW is the only one in Cardiff and serves a nominal catchment population of well over 400,000. By virtue of the various regional and supra-regional specialties, however, patients tend to be attracted from across a much wider area. There is a dedicated paediatric emergency department that operates 24 hours a day, seven days a week and is situated adjacent to the adult ED. We currently see over 30,000 children per year. With a planned reconfiguration of acute services across South Wales, it is also anticipated that UHW will become a major trauma centre within five years. Excitingly, plans for a single point of entry system for all acute paediatric presentations are also underway with a view to a new purpose-built, separately staffed emergency department. We have a strong experienced nursing team from a variety of backgrounds, including Emergency Nurse Practitioners, and are fortunate to be the only ED in Wales with a designated play specialist. The department has strong links with the adult department, in-patient specialties and Children’s Hospital, providing further learning opportunities within the Trust. As the front door to the hospital, we see a wide variety of presentations and this post contributes invaluable experience of:

• Paediatric major trauma

• Resuscitation and stabilisation of critically ill and injured children/neonates

• Experience with sedation, including nitrous oxide and ketamine for procedures

• Minor injury management, including fractures/joint dislocations, common ENT complaints, wound closure, acute eye problems, burns and maxillofacial injuries

• Plastering experience

• Safeguarding of children

In addition to shop-floor experience, there is the opportunity to participate in:

• Fracture clinic

• Weekly ED review clinic (minor injuries)

• Hand clinic

• Burns clinics (based at Morriston)

• Sessions with Radiology for x-ray interpretation There is an expectation to be involved in local and national audit, clinical guideline and service development. With the recent appointment of a University Professor in Emergency Medicine, participation in local and national research will be undertaken. There is an active teaching programme with daily lunchtime teaching slots, a weekly designated junior doctor education programme with internal and external speakers and the ability to attend the General Paediatric teaching, including journal club and grand round. Within the department, there is the opportunity for management experience with monthly Quality & Safety and Morbidity & Mortality meetings in addition to the handling, under supervision, of critical incidents, complaint handling, lead roles and project management. We have recently been approved as a training site for GRID sub-specialty paediatric emergency medicine for those who decide to pursue it as a career choice and for emergency medicine trainees, requiring some pure paediatric experience. This joint working enriches the care delivered within the department and makes for a well-rounded training post within the paediatric specialty. Consultants Paediatric Emergency Medicine Dr Zoe Roberts, lead Dr Sara Edwards Dr Jeff Morgan

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Dr Hannah Murch Dr Nikola Creasey Contact person for more information: [email protected] Clinical Training Responsibilities Daytime work is based in the Paediatric Emergency Unit (duties and opportunities as above). Out of hours work can be based either at the Emergency Unit also, or at the Children’s Hospital for Wales. 8. PAEDIATRIC CARDIOLOGY The Children’s Heart Unit in Cardiff provides a comprehensive cardiology service for children in South and West Wales. A team of four consultants provides a right environment that supports teaching, training, audit and research. Trainees leaving the unit are competent in basic echocardiography and will be confident in approaching a child with heart disease. Consultants in Paediatric Cardiology Dr Dirk Wilson Lead Consultant Paediatric Cardiologist Dr Victor Ofoe Consultant Paediatric Cardiologist Dr Orhan Uzun Consultant Paediatric Cardiologist Dr Alan Pateman Consultant Paediatric Cardiologist Contact for more information: [email protected] Clinical Training Responsibilities Ward rounds and ward duties, including the assessment and management of acute referrals and in house consultations. 9. PAEDIATRIC RESPIRATORY MEDICINE The Department of Paediatric Respiratory Medicine at Noah’s Ark Children’s Hospital for Wales in Cardiff provides a comprehensive tertiary respiratory service for all children in South Wales.

• South Wales regional Cystic Fibrosis Centre with shared care network

• South Wales Cardio-respiratory sleep service (home study and in-patient work)

• South Wales difficult asthma service

• Non-invasive respiratory support service (CPAP and BiPAP)

• Respiratory support for neuromuscular patients with specialist physiotherapy

• Management of emphysema and other complicated respiratory infections

• Investigation and management of all complicated respiratory illness

• Respiratory support to codependent tertiary services including ITU, NICU, HDU, neuromuscular, neurology, ENT, oncology, cardiology, spinal, anesthetics, and surgical services.

Respiratory medicine is at the nucleus of acute paediatrics, and training in specialist paediatric respiratory medicine will benefit all trainees who wish to pursue a career in acute paediatrics. The patients seen by the paediatric respiratory team include many complicated patients with multiple co-morbidites and working with the team will expose trainees to the complex issues and difficult decisions that they will face as general pediatricians when confronted with the more complicated patient. They will be exposed to many cross discipline discussions including well established multi-professional timetabled meetings with ENT, cardiology, Immunology, general paediatrics, and radiology. You will be exposed to the use of NIV, both as a means of home ventilation in vulnerable patients, and

mailto:[email protected]


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also in the management of acute respiratory deterioration, which is an increasingly important skill for the general paediatrican with an HDU interest. You will be taught how to site long lines and chest drains where appropriate. You will be given responsibility and be expected to use your initiative. You will be exposed and involved in a comprehensive governance programme which includes monthly MDT protocol meetings, monthly audit meetings, respiratory M&M meetings as well as weekly teaching sessions. You will be exposed to an active clinical and basic science research programme. Previous trainees have presented at regional, national and international meetings. The paediatric respiratory service in Cardiff is an accredited GRID training centre and usually has a senior GRID trainee in position. The GRID trainee rotation is shared with Bristol. The consultants in Cardiff have strong relationships with national colleagues in paediatric respiratory medicine. The paediatric respiratory service has a dedicated website: www.uhwchildren.com/respiratory. Consultants in Paediatric Respiratory Dr Julian Forton Lead Consultant in Respiratory Paediatrics & Cystic Fibrosis Prof Iolo Doull Consultant in Respiratory Paediatrics & Cystic Fibrosis Dr Lena Thia Consultant in Respiratory Paediatrics & Cystic Fibrosis Contact for more information: [email protected] Clinical Training Responsibilities All Clinical SpR responsibilities can be found at: http://www.uhwchildren.com/respiratory/?page_id=137

10. PAEDIATRIC GASTROENTEROLOGY The team comprises of two full time consultants, one SPR and a nurse specialist, who work closely with the subspecialties and general paediatric teams. Consultants in Paediatric Gastroenterology Dr Ieuan Davies Consultant Paediatric Gastroenterologist For more information contact : [email protected] Clinical Training Responsibilities Ward rounds and duties, outpatient clinics (gastroenterology and hepatology), endoscopy lists (supervised), and specialist nutrition (TPN). 11. PAEDIATRIC NEPHROLOGY The team currently consists of 4 consultants, 1 SPR and 1 SHO. The department supports paediatric nephrology services for the whole of South and Mid Wales and provides haemodialysis, peritoneal dialysis and post transplant follow up. The haemodialysis unit is supported by 5 nurses with dialysis happening four days a week. We work closely with other hospitals in Wales and with other subspecialties within the hospital. We run chronic kidney disease clinics and general nephrology clinics. There is plenty opportunity to learn about tertiary nephrology and undertake biopsies under supervision. Consultants in Paediatric Nephrology Dr Raj Krishnan Lead Consultant Paediatric Nephrologist Dr Graham Smith Consultant Paediatric Nephrologist

http://www.uhwchildren.com/respiratory


http://www.uhwchildren.com/respiratory/?page_id=137

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Dr Shivram Hegde Consultant Paediatric Nephrologist Dr Judith van der Voort Consultant Paediatric Nephrologist For more information contact: [email protected] Clinical Training Responsibilities

• Ward rounds and associated duties, under consultant supervision.

• Cover outpatient clinics and haemodialysis unit

• Attend multidisciplinary and professional meetings

• Attend biopsy and radiology meetings

• Undertake consult service

• Undertake biopsies under supervision

• Teaching medical students and SHOs 12 PALLIATIVE CARE The clinical network for Palliative Care is based in Cardiff and Swansea, and extends across the whole of Wales. The majority of the Welsh population lives in the South and the trainee will not usually be expected to travel to North Wales. There are three consultants (Dr Richard Hain, Dr Jo Griffiths and Dr Megumi Baba) comprising a core tertiary team that provides an all-Wales specialist service in paediatric palliative care and works closely alongside specialist palliative care nurses from each of the Health Boards in Wales and at Ty Hafan children's hospice. A paediatrician with a special interest takes the medical lead for palliative care in each region, again working closely with the palliative care nurses and providing a tier of secondary level expertise (APPM level III). There are six paediatric oncology outreach nurses across Wales who provide palliative care nursing expertise to children with cancer. There is input into the team from social work and chaplaincy services where possible Consultants in Paediatric Palliative Care Dr Richard Hain Lead Paediatric Palliative Care Consultant Dr Megumi Baba Paediatric Palliative Care Consultant Dr Jo Griffiths Paediatric Palliative Care Consultant For more information contact: [email protected] Clinical Training Responsibilities During office hours, the SpR will have middle-grade responsibilities in paediatric palliative medicine:

• Inpatient Palliative Care based at the Children’s Hospital for Wales, Cardiff and/or Morriston Hospital, Swansea

• Medical support, including home visits, for oncology and palliative care community outreach teams caring for children at home

• Specialist palliative medicine to Children’s Hospice (Ty Hafan) one half day per week

• Liaison with regional secondary care teams (including clinics and joint visits where necessary)

• Liaison with primary care teams (including visits where necessary)

• Outpatient symptom control clinics at various locations across South and West Wales

• Special school clinics in Cardiff and/or Swansea Training offers graduated responsibility, with an expectation that at the beginning of training all patients will be discussed with the clinical supervisor but that as the programme progresses this will give way to increasingly independent clinical working, supported always by good team communications.



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13 PAEDIATRIC ENDOCRINOLOGY The Paediatric Endocrine Department provides a service for children with a variety of growth and endocrine (hormone) disorders including short and tall stature, abnormalities of puberty, hypopituitarism, thyroid, parathyroid, adrenal and gonadal disorders. It is based within the Department of Child Health and provides for children both locally and across south and mid Wales. Specific services include:

• General growth and endocrine outpatient service.

• Dedicated clinics for children with growth disorders associated with previous cancer therapy, renal (kidney) disease and gastrointestinal disorders.

• Dedicated clinics for adolescent gynaecology (reproductive system) and for children undergoing transition to the adult service.

• Specialist service for children with metabolic bone disease.

• Shared care of patients from other centres across south and mid Wales.

• Outreach clinics in Bridgend, Neath, Swansea, Carmarthen, Haverfordwest, Aberystwyth, Aberdare, Wrexham and Newport.

• Day case endocrine testing.

• Inpatient facility for complex investigation.

• Training for patients starting growth hormone. Consultants in Paediatric Endocrinology Dr Justin Warner Lead Consultant in Paediatric Endocrinology Dr Ambika Shetty Consultant in General Paediatrics and Diabetes Professor John Gregory Professor of Paediatric Endocrinology For more information contact: [email protected] For more information contact: [email protected] 14 TERTIARY NEONATOLOGY The NICU at UHW provides specialised tertiary neonatal services (largely intensive or high dependency) for the whole population of South Wales with a small number of referrals from England. Along side this, secondary level intensive and high and low dependency care for Cardiff and other local residents are provided (about one in ten deliveries need this level of care). These services are similar to those provided in the other South Wales sub-regional neonatal units. The tertiary referrals include :-

• The extremely preterm and extremely low birth weight (including multiple pregnancies relating to Cardiff and other Assisted Reproduction services)

• Congenital malformations requiring multi-speciality assessment and/or neonatal surgery (often referred via the UHW Fetal Medicine service)

• Infants with neonatal complications requiring specific medical or surgical management. Examples of the latter are NEC, post haemorrhagic hydrocephalus, subglottic stenosis, organ failure – renal or hepatic, cardiac problems congenital or prematurity related, inborn errors of metabolism and specific specialised medical support such as HFOV or NO therapy.

Specialised services to the newborn include:

• Paediatric Cardiology

• Paediatric Neurology/Neurosurgery

• Paediatric surgery

• Clinical Genetics

• Paediatric Nephrology


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• Paediatric Urology

• Metabolic Medicine

• Children’s ENT

• Speech and Language Therapy

• Paediatric Gastroenterology This is the only unit in Wales capable of providing all these specialised tertiary services although North Wales looks to Liverpool, Manchester and occasionally Birmingham for tertiary neonatal support. About 500 infants are admitted to UHW per year and over 6000 days of intensive care/high dependency care were delivered in 2007. There is an increasing complexity of case-mix and improvements in survival over time. Approximately 60% of the unit’s admissions are regarded as tertiary referrals and much more than half the unit’s workload relates to these patients due to the richer case mix, higher dependency and often, longer length of stay.

The UHW unit currently comprises 8 Intensive Care cots, 10 High Dependency cots and 10 Special Care cots, with an additional double cubicle facility.

UHW also contributes on a rotational basis with Singleton and the Royal Gwent hospitals to CHANTS, the South Wales Neonatal Transport service, for which there is a dedicated consultant-led team. The clinical work entails day to day running of the neonatal unit at junior ST level on a full shift. This full shift involves duties in intensive care, high dependency, special care and post-natal wards as well as cover of delivery suite and night shifts. Consultant in Neonatology

Professor Sailesh Kotecha Clinical Professor / Consultant Neonatal Paediatrician Dr Patrick Cartlidge Senior Lecturer/ Honorary Consultant Neonatal Paediatrician Dr Cora Doherty Consultant Neonatal Paediatrician Dr Jennifer Calvert Consultant Neonatal Paediatrician Dr Rachel Hayward Consultant Neonatal Paediatrician, SHO rota lead Dr Amar Assokumar Consultant Neonatal Paediatrician, middle grade rota lead Dr Alok Sharma Consultant Neonatal Paediatrician Dr Angela Hayward Consultant Neonatal Paediatrician Dr Mallinath Chakraborty Consultant Neonatal Paediatrician Dr Ian Morris Consultant Neonatal Paediatrician, College Tutor Dr Elisa Smith Consultant Neonatal Paediatrician

For more information contact: [email protected] 15 PAEDIATRIC SURGERY The Paediatric Surgical team provides a large tertiary service for children from across South Wales. The team provides paediatric surgical middle grade training. Consultants in Paediatric Surgery Mrs Aruna Abhyankar Consultant Paediatric Surgeon and Urologist Mr Kim Hutton Consultant Paediatric Surgeon and Urologist Mr Raj Surana Consultant Paediatric Surgeon Mr Prabhu Sekaran Consultant Paediatric Surgeon Mr Oliver Jackson Consultant Paediatric Surgeon Mr Eniola Folaranmi Consultant Paediatric Surgeon Clinical Training Responsibilities For daytime work the SHO reports to the surgical middle grades and their team, which also includes advanced nurse practitioners. The work consists of surgical ward rounds and ward duties, assessment and management of acute surgical referrals, in house consultations and theatre assistance. Out of hours, the SHO works under the paediatric medical registrar covering all paediatric subspecialties. For more information contact: [email protected]


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