Careers at the

National Spinal Injuries Centre

Picture(s)

Stoke Mandeville Hospital

September 2017

Careers at the National Spinal Injuries Centre

WELCOME Hello! We’re delighted that you’re interested in working at the National Spinal Injuries Centre at Stoke Mandeville Hospital. We offer rewarding and interesting roles across the whole multi-disciplinary team here, with plenty of opportunities for personal and professional development. We also strongly support career development, with many of our staff going on to become successful managers and specialists in their field. The National Spinal Injuries Centre, which started work in 1944, is a unique place for you to develop your career. By being with us in this world-famous Centre for the treatment and rehabilitation of patients with spinal cord injury, we’re confident that you’ll gain valuable knowledge, insights and skills, which will help you throughout your career. In the following pages you’ll see lots of information about what it’s like to work with us, together with inspiring accounts from our staff about their experience here. We trust that you will find what we have to offer attractive and that you’ll consider the Centre as a place in which you could develop your career and truly thrive. To request more information about working at the National Spinal Injuries Centre, just e-mail NSIC.Careers@buckshealthcare.nhs.uk Jeanette Tebbutt Stuart Coalwood Divisional Chief Nurse (Specialist Services) General Manager (NSIC)

Staff in the NHS The NHS employs more than 1.5 million people! It is one the five largest employers in the world (the others are the US Department of Defence, McDonalds, Walmart and the Chinese People’s Liberation Army). In 2015, in hospital and community healthcare services and General Practices (local family doctors), the NHS employed: As well as qualified healthcare professionals, the NHS also employs a large number of support staff, who provide vital help to our clinical and technical staff.

THE NATIONAL HEALTH SERVICE Our History, Core Principles, Population The UK National Health Service started life in 1948, and was born from the ideal that good healthcare should be available to all people, regardless of income. The three main principles guiding us are: • to meet the needs of everyone • to be free at the point of

delivery • to be based on clinical need,

not ability to pay. These principles are one of the main reasons our staff are proud to work for the NHS, and why we are also admired around the world. Except for some charges, such as prescriptions, optical services, and dental services, the NHS remains free at the point of use for all UK residents. The population of the UK is more than 64.6 million people, with 54.3 million people in England alone, so it is a huge undertaking. However, in comparison with some of the world’s most developed nations (such as Germany, France and the United States) the NHS has been rated as the best healthcare system in terms of efficiency, effective care, safe care, co-ordinated care and patient-centred care. At Buckinghamshire Healthcare we’re proud to be part of the National Health Service.

Funding and Structure Funding for the NHS comes directly from taxation, and the overall NHS budget in 2015/16 was around £116.4 billion. 60% of this budget is put in the hands of groups of general practitioners (local family doctors known as ‘GPs’) who work together in ‘clinical commissioning groups’ (CCGs) to purchase healthcare for the people in their local communities. A body called ‘NHS England’ funds GPs, dentists, and opticians for the work they do, and there are also a range of specialist commissioning groups, including the organisation that purchases care for people with spinal cord injury.

Staff Profession

315,000 qualified nursing staff and health visitors

150,000 doctors

147,000 qualified scientific, therapeutic and technical staff

31,000 managers

25,500 midwives

23,000 general practice nurses

19,000 qualified ambulance staff

The Trust is a strongly values-based organisation. In 2014 over 700 people, including front-line staff and patients, were involved in defining exactly what it means to work for the Trust, and how this needs to be encompassed in our daily work with our colleagues, and in serving our patients. The end result was the Trust’s CARE values, and needless to say we strive to live by these values every day at the National Spinal Injuries Centre. THE BHT WAY We’re an ambitious organisation. Our mission is to provide safe and compassionate care, every time – we want to be one of the safest healthcare systems in the UK, and to be an organisation where our values are there for all to see. Our three main strategic priorities are: • Quality – we want to offer the highest

quality care, whether that’s in patients’ homes, the community, or in one of our hospitals

• People – we want to be a truly great place to work, where our people have the right skills and values to deliver excellence in care - we want to attract and retain the very best people we can

• Money – we want to be financially sustainable and to make the best use of our buildings and be at the forefront of innovation and technology.

BUCKINGHAMSHIRE HEALTHCARE NHS TRUST Buckinghamshire Healthcare provides acute, community and specialist healthcare services to patients across the county of Buckinghamshire, and neighbouring areas. Patients at the National Spinal Injuries Centre may come from further afield, but generally live in the south of England. Overall the Trust has around 6,000 highly-trained, qualified doctors, nurses, midwives, health visitors, therapists, healthcare scientists and other support staff caring for more than half a million patients every year. Our patients are at the heart of everything that we do, and our aim is to provide safe and compassionate care, every time. Our focus is on providing right care, right place, right time, first time and everything we do is aimed at delivering high-quality care when and where our patients need it. We are proud of the nationally recognised services that we provide. As you will read here, Stoke Mandeville Hospital is home to the internationally recognised National Spinal Injuries Centre; our stroke service is one of the best in the region and we are a regional centre for burn care, plastic surgery and dermatology. However we are not complacent and we continue to strive for success – building on our performance to improve our services for our patients and our community.

THE NATIONAL SPINAL INJURIES CENTRE Our history The National Spinal Injuries Centre (‘NSIC’) is the oldest, and one of the largest spinal injuries centres in the world. It was founded by neurologist Professor Sir Ludwig Guttmann at Stoke Mandeville Hospital, in 1944, to treat servicemen who had sustained spinal cord injuries in World War 2. Before 1944, the majority of people with a spinal cord injury died from complications within a year of injury. In 1948, Professor Guttmann began using sport as a vital component in rehabilitation programmes and on 29 July organised a competition for 16 paralysed men and women to coincide with the opening ceremony of the 1948 Olympic Games in London. The Stoke Mandeville Games for wheelchair athletes is widely seen as the moment when the Paralympic movement was born. Professor Guttmann received a knighthood in recognition of his contribution to the Paralympics. NSIC staff continue Professor Guttmann’s revolutionary work to this day. The experience gained in treating and preventing complications, together with an increase in injuries caused by road traffic accidents, led to a rapid expansion of the centre from an initial 26 beds to 118 beds in the main part of the hospital. In 1980, severe weather conditions caused structural damage to some of the wards at Stoke Mandeville and the centre's future looked in doubt. An ambitious fundraising campaign to create a purpose built spinal cord injuries centre was launched. Within three years, with the generosity of the public, £10m was raised and the new facilities opened in 1983.

Statute of ‘Poppa’ Guttmann outside the Spinal Unit

Our Mission The NSIC assists people with limitations secondary to spinal cord injury or paralysis, of all ages, to achieve realistic goals and to reach their highest feasible level of function by providing a comprehensive, specialised, interdisciplinary rehabilitation service across their lifespan. This provides them with the skills, knowledge and information to return to their role in society and lead healthy and fulfilling lives.

The National Spinal Injuries Centre – What We Do Today We provide specialised, coordinated, medical and rehabilitation care which is outcome focused and patient centred, serving the unique needs of people with spinal cord injury. The service is needs based and not age discriminatory. There is a total of 118 beds for people with spinal cord injury, 62 of these are for active rehabilitation, and there is a dedicated young person’s rehabilitation unit of 9 beds for spinal cord injured young people. The remaining beds are for acute admissions or people who are medically unstable and secondary elective admissions.

Our Vision The NSIC strives to champion and respond to the needs of all people with spinal cord injury, who need rehabilitation throughout childhood, adolescence and transition into adult spinal services. We are committed to working with charitable and statutory organisations to promote a continuum of rehabilitative care through the delivery of high quality spinal rehabilitation services, education, and integrative sports and arts programmes. Research and post graduate education has an existing and developing role in ensuring the NSIC is at the forefront of knowledge.

WORKING AT THE NATIONAL SPINAL INJURIES CENTRE We’re a multi-disciplinary team of over 400 people, from across a broad range of healthcare professions and occupations. This includes medical and nursing staff who have chosen to specialise in the field of spinal cord injury, to highly skilled therapists who have developed expertise in supporting the rehabilitation of people with spinal cord injury. Our registered healthcare professionals are supported by a committed team of support staff, including a large and dedicated group of healthcare assistants, staff who provide support within our physiotherapy and occupational therapy services, and not forgetting a highly skilled group of managers and administrators. All are featured in the pages that follow.

THE BENEFITS OF WORKING FOR US At the National Spinal Injuries Centre we want to employ the very best people to deliver the best patient care we can. We want you to be proud to work for us, and as you’ll see in the pages which follow, this is very often the case. We’re committed to providing you with rewarding and stimulating careers, with access to on-going training and development opportunities to support you to take your careers where you want. The NSIC has a reputation for teaching and training excellence and fosters an environment where lifelong learning creates innovation and flexibility in the way we deliver care to our patients. Whatever your job, you’ll have opportunities to learn and develop along the way. In keeping with the ethos of the Trust, we want our staff to become actively involved in making our services even better. We continually strive to talk to staff, listen to them and involve them in our plans, using their diversity, experience and unique knowledge to tell us what needs to happen. We know that our dedicated staff our are biggest asset and we want to protect and nurture them. Recognising the contributions and achievements of our staff is important. As well as celebrating long service there are a range of staff award schemes, both locally within the Centre, and in the wider Trust.

MEET OUR STAFF! Probably the best way to understand what it’s like to work at the National Spinal Injuries Centre is to hear from staff themselves. We also provide information about ‘getting started’ in each of the main professions.

SARA EDMUNDSON – PHYSIOTHERAPIST “When I was at school I thought I wanted to study medicine and actually got a place at medical school. During my final year at school, I carried out some voluntary work at Stoke Mandeville Hospital spent some time assisting physiotherapists and found this was what I really enjoyed. So I applied and trained as a physiotherapist at Brunel University. I got my first job after qualifying at Stoke Mandeville in 2004 and I’ve been here ever since. In my first job at Stoke Mandeville I was on a junior rotation scheme across the hospital, and this included the NSIC. I enjoyed my time here so much that I was keen to stay, so I was really pleased to secure a permanent job as a senior physiotherapist. I had the opportunity to rotate across specialist areas such as seating clinic, the acute ward, paediatrics, aquatic physiotherapy, splinting and sports. Since then I’ve progressed to a more senior level and I’m currently working in the NSIC’s Out-Patient Department in a job share – my department and the Trust are good at offering flexible working. One aspect that I really enjoy about working in the NSIC is being part of the patient’s whole journey. This starts soon after their injury and we see people progress, whether it’s to being able to transfer, sit up in a wheelchair, stand, everyone is different – it’s inspiring. Our gymnasium at the NSIC is open plan so it’s great to see patients supporting and encouraging each other. The same applies to staff – the physiotherapists in the gym see each other working and learn from each other. Another great thing about being a physiotherapist at the NSIC is that you get to use the full range of your skills, which isn’t always the case in other areas. Here this includes respiratory work, musculo-skeletal, neurology, postural assessment, aquatic physiotherapy.

I was fortunate to go on an acupuncture course and have been able to put these skills into practice. I’ve had lots of opportunities to develop since I started working here.

I completed a three year part time Master’s degree in 2015, which was supported by the Centre, I’ve been involved with some really interesting service development initiatives including research into fitness in spinal cord injury and have been on lots of other training courses. I’ve also had the opportunity to deliver pilates classes here, which is a particular interest of mine. For me a typical day might start with handovers or meetings about patients on the ward – I cover St Patrick, which is our re-admissions ward. Then I may spend time stretching people who are on bed rest, or helping people to get up. Most days I need to liaise with the wheelchair service, and write letters to GPs, and these days I see patients who come back to the centre to be seen in Out-Patients. I often need to refer patients to other services, and there’s always notes to update and other colleagues to liaise with. I like to spend time in the gym when I can. I’ve enjoyed the opportunity of leading Consultant ward rounds. All in all it’s a supportive place to work, and great to work with a really strong multi-disciplinary team.”

GETTING STARTED To work as a physiotherapist, you must be registered with the Health and Care Professions Council (HCPC). To register with the HCPC, you first need to successfully complete an approved degree (BSc) in physiotherapy. Courses are available across the UK. Full time degrees take three years. Part time degrees vary from four to six years. There are also two-year accelerated MSc courses available to people who already have a BSc degree in a relevant subject.

PHYSIOTHERAPY AND OCCUPATIONAL THERAPY ASSISTANTS Supporting the work of our Physiotherapists and Occupational Therapists at the NSIC is a team of Assistants who are highly skilled and knowledgeable in their own right, and who do vital work with patients.

REBECCA TANNER – PHYSIOTHERAPY ASSISTANT “In my younger days I worked as a carer in a private spinal unit – the Royal Buckinghamshire Hospital in Aylesbury. I also worked privately as a personal assistant to spinal cord injured patients in London. I really enjoyed working in the care field – there were such nice aspects of the job. You have the feeling that you’re with the patients on their journey almost from day one, and it was great to see patients progress and grow. You’re really seeing people begin their lives again in a different way, and it was amazing to be with them. I then made quite a big career change and worked in recruitment in the construction industry for several years, which was really different, of course. After having a baby I was a full-time mum for a while, and when I was ready to go back to work I saw an advertisement for the role here at Stoke Mandeville and didn’t hesitate to apply. I was lucky enough to be successful, and also to be able to work the hours that suited me – my new manager was really supportive in this way. I’ve been at the NSIC for over two years now as a Physiotherapy Assistant. I’m mainly involved in the daily running of the gym. This includes setting up the equipment each morning, making sure it’s clean and meets infection control standards. As part of my role I run circuits, so that patients can develop upper arm strength. I also set up the electrode machines which stimulate patients’ leg and arm muscles. I put people on leg bikes, help them with weight training, and on the treadmill and cross-trainer – any duties that aren’t part of the Physiotherapists’ role. Obviously it can be incredibly difficult for people after their injury, but as an upbeat person I’ve found that I can build really positive relationships with patients. Although there’s always some sadness, I’ve seen so many patients grow, and become excited and positive about the next phase of their lives.

They leave here really well equipped and ready to be as independent as possible. It’s a special thing to be involved with. Actually patients do tend to speak to the Physiotherapy Assistants about their concerns, and it’s nice to be able to give them some guidance about the resources and processes that will help them. I’d recommend working within my field to anyone. I enjoyed being a carer, but in my current role we tend to get the really nice parts of working with patients. It’s also a brilliant team, really upbeat, and people are so supportive of each other. We’re also genuinely trusted to help the Physiotherapists. Overall – well it’s my job to be helpful and to make patients feel as good as possible, to make them feel that they’re the most important – which they are, of course.”

GETTING STARTED Although there are no set entry requirements for physiotherapy or occupational therapy (OT) assistants, we generally expect good numeracy and literacy, and some experience or qualifications in health or social care. It’s definitely an advantage to have to have some work experience, ideally in health or social care, either paid employment or as a volunteer. Physiotherapy and OT assistants need to be good listeners, calm and understanding and happy to talk to and work with groups. Great communication skills are a must.

Other roles include Medical Records Clerk, Support Secretaries, Administrators (Outpatients, Outreach, and Multi-Disciplinary Education), and we also have a team of Ward Clerks, who make sure that administrative processes on our six in-patient wards run smoothly. They’re all an absolutely vital part of the team here. All of our administrative roles make a real difference to patient care, and that’s why I think our staff find them so rewarding. It’s incredibly satisfying when a patient gets in touch to thank you for what you’ve done, and the knowledge that you’ve helped clinicians to do their jobs effectively makes working here really worthwhile, I think. As the senior manager for our administrative functions, my role is to make sure that staff are supported, developed, and have opportunities to develop their careers as much as possible. In my time here I’ve seen a number of staff progress to more senior roles, and of course we’re part of a much larger hospital and healthcare Trust, so experience within NSIC can and does lead to some great opportunities. My own role also takes in governance, budget management, HR, the co-ordination of medical rotas, and medical education. There’s never a dull moment, and I’m delighted to recommend the NSIC as a great place to work for people who are interested in general and administrative management”.

MANAGERIAL AND ADMINISTRATIVE CAREERS AIMÉE PORTER-SMITH – OPERATIONAL MANAGER Although the NSIC is known around the world for the excellence of its clinical care for people with spinal cord injury, behind the scenes there’s a dedicated group of managers and administrators making it possible for clinicians to do their jobs. Here, Aimée Porter-Smith, NSIC’s Operations Manager talks about her role and the vital administrative function she manages. “I have a varied background in commercial and retail management which prepared me really well for life as an NHS Manager. My first NHS role was as a Service Delivery Manager in HIV and Sexual Health in Central London, and I also led a large project to integrate health services across general practice and hospital care, which also equipped me well for my role here at the NSIC. I joined in 2011 and haven’t looked back. I’m responsible for managing the administrative function in the Centre. We have a really varied set of roles here, with 16 staff in all – a group of very committed and skilful staff who help the Centre run efficiently, day-to-day. Our Information Team, which includes Data Co-ordinators, an Information Analyst and an Information Manager perform the vital role of gathering and collating information about the work we do here with patients. This ensures that we can demonstrate that we’re meeting our contractual commitments and that we receive the right level income from commissioners. We also have a Receptionist and Booking team, responsible for making sure that patients come to the right place, at the right time, to see the right clinicians. These staff also co-ordinate patients’ transport needs, which is especially important to get right in the context of the patient group we serve. Our busy group of Consultant and junior medical staff are supported by a team of Medical Secretaries, skilled in co-ordinating diaries, medical terminology and typing. The ability to multi-task is a must for this group of staff, who again play a vital role in administering our clinical workload.

GETTING STARTED - For any administrative role you’ll

need a good standard of literacy and numeracy, usually GCSEs (or equivalent) in English and maths. IT skills and qualifications are always useful too as so many of our systems are IT-based now. You’ll be using your skills in time management, organisation and communication in any of our administrative roles.

I would recommend nursing. There are a vast quantity of opportunities within nursing, whether it be specialization, travelling, working abroad, working within the military. The NHS has a great pension scheme and we seem to have more holiday than any other profession! We work Long Day shifts so only work 3 or 4 days a week! A career in spinal cord injuries is quite frankly very fast paced and physical. It is the busiest environment I have ever experienced as a nurse, but the hard work is rewarded by the outcomes for our patients - we see them at their lowest ebb, we see them ready to be reintegrated into the community following months of intense rehab, preparing them in the best possible way to minimize a “revolving door” of discharges and readmissions. There are many career opportunities within the NSIC, with foundation degrees, spinal course, MSPP, even trips to supplier HQ’s such as Coloplast HQ in Denmark, so we can use our experience in potentially designing new equipment. NSIC has very close knit teams who are committed to the cause. We strive to train, mentor, and become friends with new employees in making them feel comfortable in their surroundings and to become a confident and highly efficient practitioner for hopefully, many years to come!”

DEAN STRATFULL – NURSE & DEPUTY WARD MANAGER “Initially I never aspired to become a nurse, it was never in my thoughts growing up. I started as a mechanical engineering apprentice which I began to dislike, I wished to have a more secure career and one I could advance in continually. My mother, who is a nurse within the NSIC, suggested that I apply to become a Healthcare Assistant, in 2005. Having never even considered healthcare as a career, it was certainly very daunting, and at the tender age of 18, I did a lot of growing up, very quickly! So I started as a healthcare assistant, where I remained for five years. In those five years I completed an NVQ which allowed me to access a Senior HCA role in spinal rehab. I was gratefully offered a secondment to commence my nurse training in 2010 at Bedfordshire University. This was when I knew I had a job for life, I had really found my feet within such a specialized area of nursing, and could see myself working here for many years in the future. In 2013 I completed my training, and although I had initially planned to pursue a career in plastic surgery, I opted to continue my development in spinal injuries rehabilitation, and to stay within the unit who put such faith in my career progression. I completed the MSPP in 2014 which allows me to mentor students, and I am the educational link nurse of the ward. I completed the spinal course in 2017, this heightened my knowledge and background of spinal cord injury, also enhancing my CV so I was able to apply for a Band 6, Deputy Ward Manager role in 2017, in which I remain. The favorite aspect of my job is REHAB Nursing! Rehab is so important, we are empowering our patients to be functionally independent or verbally independent, it is so satisfying seeing them become comfortable towards the end of their rehab and ready to face the future following months of such hard work in some of the most daunting and challenging environments following such a devastating injury. It’s always such a wonderful feeling seeing a patient return to the unit looking so well and them screaming out your name down the corridor just to say hello!

GETTING STARTED IN NURSING Like Dean, a great way to get started could be to gain some experience as a Healthcare Assistant – to see if you enjoy the healthcare environment and caring for patients. Academic entry requirements for an adult nursing degree are set by individual universities. Typically you will need a minimum of five GCSEs at grade C or above (possibly in English language or literature and a science subject), plus two A levels or equivalent level 3 qualifications. Some universities may ask for three A levels or equivalent. You should check with each university directly before applying to see if your qualifications meet their entry standard.

MARIVEN BRIE – STAFF NURSE One of the great strengths of NSIC’s nursing workforce is its incredible diversity – the Centre employs nurses and healthcare assistants from 28 different nations, which means that we benefit from a huge wealth of talent. Our nurses are constantly inspired by each other, and in many cases that’s because they’ve gone to great lengths to work here. Here, Staff Nurse Mariven Brie talks about her journey to the NSIC and what she enjoys about her work. “I originally wanted to be a doctor, but at home in the Philippines I decided to train as a nurse first, and then decide whether to go on to do medical training. I did a four year nursing degree, followed by my Licensure examination, and then worked in a range of settings including medical and surgical wards, and maternity units – I’m also a licensed Midwife in the Philippines. I came to the UK in 2008 and worked in a care home while I did what was necessary to become a registered nurse in the UK. This involved taking an NVQ in Care, the International English Language Test (IELTS) and then my adaptation programme through City University. It was a lot of hard work but I finally got onto the Nursing and Midwifery Council Register in 2012. In 2013 I moved to Aylesbury to be with my husband (he works at NSIC too!) and after working in a care home locally I applied for a nursing post on St George ward, one of our three rehabilitation wards for adults. I really enjoyed the work there, but after a couple of years decided I would try another speciality at Stoke Mandeville. I moved to one of the hospital’s surgical wards and learnt a huge amount, but I really missed my patients in NSIC, and realised that my heart was in spinal injuries nursing. Naturally I missed the happy patients, but even the grumpy ones – I enjoy a challenge. I also realised that I got great support from my managers in NSIC, and after six months away I couldn’t wait to come back. Now I’m a staff nurse on St Joseph ward. It’s a very welcoming environment. I was lucky enough to work under a really experienced Ward Manager, and three exceptional Deputy Sisters, who taught me a lot – they were so knowledgeable and keen to share their knowledge with me. It’s a busy ward, but manageable. I’m responsible for making sure that all of our patients are up and ready on time for their therapy and other appointments, and I also do some of the teaching of patients and their relatives, and I really enjoy that. We’re really getting people ready for their lives outside the Centre, making sure they know exactly what to do and look out for after they’ve left us. As part of that I attend goal planning meetings as part of the multi-disciplinary team, and those meetings are a really important part of our patients’ rehabilitation. I’d recommend a nursing career in spinal cord injury to anyone – it’s where I want to stay and develop my career now.”

NURSING OPPORTUNITIES AT THE NSIC As well as opportunities on our three adult rehabilitation wards, where Dean and Mariven work, we also offer nursing posts on our two acute wards, where we care for patients post-surgery, and patients who are newly injured and transferred from an acute trauma centre. Work on our acute wards includes respiratory support including invasive ventilation. NSIC also has a dedicated ward for children and young people with a spinal cord injury, the only such unit in the country. So we’re also keen to hear from registered children’s nurses. For more information e-mail NSIC.Careers@buckshealthcare.nhs.uk

RALPH DIZON – HEALTHCARE ASSISTANT Supporting the work of our registered nursing workforce is an 80-strong team of Healthcare Assistants (sometimes known as ‘HCAs’). As a valued member of this staff group, Ralph Dizon works alongside our nurses to meet the needs of our patients at the various stages of their rehabilitation. He talks here about his journey to the NSIC and what he likes about his work here. “My family is from the Philippines, but I was born and brought up in Milan, Italy. After school I studied aircraft mechanics and got a degree, but it was really difficult to find work in that particular field in Italy. My sister is a nurse and came to the UK about a year before me. She worked on St Patrick ward, one of NSIC’s acute wards, and told me how much she liked it, and what a good experience she was having. I came over to join her and soon went to a Trust recruitment open day and got the job as Healthcare Assistant. I work mainly on St Joseph ward, and I really like it – it’s a good team here, and when I started I had really good support from the Deputy Ward Managers. I like what I do here – there’s a lot of contact with patients, and time to speak to them and get to know them. St Joseph is the pre-discharge ward, so patients are mostly self-caring, and they’re happy that they’ll be going home soon. My role is to help prepare them and face the reality of being outside the unit. In my normal daily routine I attend to patients’ needs including washing and dressing, and I also take them to their appointments around the unit. I give them information about bladder and bowel care, helping them with techniques that they’ll find useful after they go home.

I’m often asked to go and help out on one of the other wards here, which I don’t mind. It’s good to learn how to do things in the more acute areas, where patients sometimes need a lot more support. In the end it will help me to have such varied experience, because I’m interested in training as a nurse later on. There’s a career pathway here. I’ve done an NVQ 3 with Aylesbury College, and I’m planning to go further and take a Foundation Degree. I recommend working as a Healthcare Assistant in the spinal unit. I’ve worked in other parts of the hospital on the staff bank, but all in all I much prefer my job here, I think it’s the patients here that make it so enjoyable”.

GETTING STARTED AND CAREER PROSPECTS To become an Healthcare Assistant, previous experience in a health or social care setting is helpful, but definitely not essential. Much more important is an aptitude for the work – a caring nature, a willingness to care for people in challenging circumstances, great communication skills, and the ability to promote patients’ independence. We’ve established a career pathway for Healthcare Assistants. After taking competencies in more complex tasks you’ll be able to work as a Senior Healthcare Assistant. Then, as Ralph highlights, there are also opportunities to take a two-year Foundation Degree, after which you’ll be able to practice as a Nursing Assistant Practitioner and able to perform many of the same tasks as our nursing staff. The Trust sponsors staff for nurse training wherever possible. To find out more contact us at: NSIC.Careers@buckshealthcare.nhs.uk

GETTING STARTED IN CLINICAL PSYCHOLOGY You’ll need a BSc or BA honours degree in psychology to become a Graduate Member of the British Psychological Society, which allows you to apply for post-graduate courses in clinical psychology. Before you do that, and like Rebecca, you may well want to get some work experience. The number of students applying for psychology courses has risen dramatically in the last few years, which has resulted in higher grades being required to get accepted. A or A/S-level psychology is not required for entry onto degree courses, but many students find that it provides them with insight into the subject and helps them decide if they want do a psychology degree After your psychology degree, you'll need to undertake postgraduate professional training to become a clinical psychologist. You must then register with the Health and Care Professions Council HCPC, which allows you to practice in the NHS.

REBECCA EATON – ASSISTANT PSYCHOLOGIST "I've been working at the National Spinal Injuries Centre for six months now, and really enjoy it here. After school I undertook a Psychology degree, and then got a post at York Hospital as a Clinical Trials Assistant, working on research projects for the National Institute for Health Research. This was a really good introduction to the world of research, something that's a big part of my role here at the NSIC. Following that, I worked as an Honorary Assistant Psychologist at the Princess Royal Spinal Injuries Centre in Sheffield as part of my placement for my Health Psychology masters, where I conducted research on mood and adjustment in patients with spinal cord injury during rehabilitation. My experience in Sheffield also showed me what rewarding careers are available in the field of spinal cord injury. Every day is different in my role here at the National Spinal Injuries Centre, and I really like that. I do a lot of research-based work, including reviews of academic literature, writing research articles and formulating research proposals. There's also quite a lot of statistical analysis, which I enjoy. My role also involves administering patients' Needs Assessment Checklists, a system that was developed here at Stoke Mandeville to highlight what a patient's current knowledge is and establish what they need to learn during their rehabilitation with us. The checklist is a really helpful tool which places the patient as centre of rehabilitation and focuses a patient's goal planning process. They help the multi-disciplinary team to focus on what's really important for patients.

I'm also a Key Worker for a patient myself, and that's been a great experience for me - my patient has really engaged well with the process, and that makes it a pleasure to work with him. Within my role as a keyworker, I can advocate for the patient which is an important aspect for me and my role within the team. My colleagues in the Clinical Psychology team are really supportive. I am currently in the process of applying for the Clinical Psychology doctorate, which will enable me to become a Clinical Psychologist. I've received so much support with my applications - the team is just incredibly knowledgeable. Within my role, I feel I can raise any concerns or worries and know that I'm going to be supported. The support I receive from the psychology department is offered to other disciplines facing challenges. Overall, well I genuinely love it here and recommend the NSIC as a place to work. There's a genuine multi-disciplinary team work ethic here with all professions in the team being well respected, supported and listened to."

SARAH TIMMS – OCCUPATIONAL THERAPIST Occupational Therapy (‘OT’) is a really vital part of patients’ rehabilitation at the National Spinal Injuries Centre. From managing the upper limb through positioning and splinting, to supporting people to practice their activities of daily living and powered wheelchair skills, so that they can go on home leave and be discharged as independent as possible, our dedicated Occupational Therapists are at the centre of the multi-disciplinary team at the NSIC. Here, Sarah Timms talks about why she became an OT and what she loves about her job. “After taking a degree in Psychology I realised that I needed to get some experience of working in the NHS, and became an Occupational Therapy Support Worker. I enjoyed it so much that I decided to train as an OT! I took a two year Master’s programme at London Southbank University, soon followed by my first qualified role, a rotation in mental health, which I really enjoyed, and where I received great support with my development, enabling me to progress from a band 5 to band 6 practitioner. I then moved employer and spent two years working within a Community Learning Disabilities service, where I was able to use my previous mental health knowledge and develop my skills further, particularly in physical health skills, before coming to Bucks Healthcare. I started in the Trust at Wycombe Hospital, working on a neurology rotation, and then had the opportunity to take a six month secondment at the NSIC, which I loved and luckily for me became a permanent job. What’s really satisfying about working here is the amount of patient contact I have, and the sheer variety of roles I carry out. It’s really helped me to hone my OT skills, from seating and posture management to powered wheelchair set-up, to upper limb assessment and treatment modalities, alongside supporting patients with increasing their independence with activities of daily living. I enjoy seeing patients through the whole rehabilitation pathway, and this means there’s time to build quality relationships, which I value very much. Since coming here I’ve also had opportunities to get involved with research, through Stoke Mandeville Spinal Research, which is an area of practice that I have been keen to get into since qualifying.

Additionally as the NSIC is quite well-resourced there are also lots of opportunities to be at the forefront of new technology, and to use equipment with patients that might not be available in other NHS settings. A typical day for me would start at 08.30 with either a short team meeting or some making a community referral. Then I may have a washing and dressing practice, followed by an upper limb restorative therapy group session. In the afternoon I’d typically attend a multi-disciplinary goal planning meeting where we focus on particular goals for the admission. I may then splint a patient’s upper limb for positioning or a functional activity such as feeding. Sometimes I’ll support a patient to get ready for life outside the Centre, perhaps by helping them to fill in a Blue Badge form. The end of the day invariably ends note-writing, report writing and catching up with my emails. Overall I really like being based within a hospital environment, and working as part of a multi-disciplinary team at the NSIC. It’s a lovely team here, everyone is easy to get on with.”

GETTING STARTED IN OCCUPATIONAL THERAPY To practise as an occupational therapist, you must be registered with the Health and Care Professions Council (HCPC). To register with the HCPC, you first need to successfully complete an approved degree in occupational therapy. This is usually a BSc (Hons). Courses take three or four years full-time. If you already have a relevant degree and healthcare experience, you can take a postgraduate Diploma or Masters in occupational therapy. These courses usually take two years. Like Sarah, you may well want to get some work experience in healthcare before embarking on a programme of study.

MEDICAL CAREERS AT THE NATIONAL SPINAL INJURIES CENTRE As you’d expect, the National Spinal Injuries Centre has a highly skilled group of specialist medical staff working hard to treat patients after their spinal cord injury, and then supporting patients in their ongoing rehabilitation in the months and years ahead. The medical team is led by five Consultants in Spinal Injury Medicine, but they’re supported by a team of doctors who are at various stages of their medical careers, with many on the path to become Consultants themselves one day. Here, two of the Centre’s middle grade doctors explain what they enjoy about working here. Dr Anitha Naidoo is a Specialty Doctor at the National Spinal Injuries Centre. She came here after training and then working for many years in a range of different specialities in South Africa. This was her first job in the UK, and she has now been at the Centre for over 10 years. As such Anitha now has a wealth of knowledge and skill in the field of spinal cord injury. So what keeps Anitha here? “I love my job and I love seeing my patients. It’s really inspiring to work as part of the multi-disciplinary team here. I really enjoy the fact that we provide lifelong care to our patients, can manage their care holistically, and can work in such an integrated way within one speciality. We’re exposed to such a wide variety of issues, it means that you can gain a huge amount of specialist knowledge. There are also a lot of opportunities to do research, which I like, and also opportunities to teach and participate in education programmes, as well as conferences”. Dr Jamie Lewis - Registrar Jamie trained in the UK, but had his first experience of spinal cord injury in New Zealand, where he was travelling for two years. He liked the work and was aware of NSIC’s global reputation, so was delighted to obtain a post here after he returned to the UK. What does Jamie like about working at the NSIC? “I really like the fact that we have long-term interactions with patients, and the patients are fantastic to work with. These are brave, strong-willed people who are incredibly inspiring to be with. For a doctor it’s great to have the balance between general medicine, and more specialist work. The speciality is slightly under the radar, but I recommend working as a doctor here hands down. I have patients across all of the wards here, and see people at different stages of the rehabilitation process. I also do work in the Out-Patient clinic more and more , seeing people over the long term, and I enjoy that”. Jamie also has some advice for budding medical students. “It’s really competitive to get into medical school, and my advice is to do something to stand out. Whether it’s outstanding academic achievement, having a really interesting reason to study medicine, or perhaps doing some unusual work experience which shows your passion, make sure you stand out”

MEDICAL CAREERS – GETTING STARTED Medical training is in three stages: medical school / university, foundation training, and then speciality training. A range of qualifications may be acceptable for entry into medical school, but each medical school sets its own requirements, so check before making any applications. The Health Careers course finder (see page 19) will help you search for the medical schools/universities approved to run degree courses in medicine. We’d be delighted to hear from doctors who are in their foundation training and interested in discussing a career in spinal cord injury medicine. Contact us at NSIC.Careers@buckshealthcare.nhs.uk

The role is varied and complex at times. Often negotiation skills are needed, as sometimes the Case Manager sits between what is best for patients as well as working to the requirements of the community and unit to be as effective as possible. It’s very rewarding when a patient is discharged after a long admission and they go home with the support around them and feel they can start the next part of their journey, to be part of that is often really special”.

TRACY JOLIFFE – CASE MANAGER “I work as Case Manager in the NSIC. Having previously worked as a nurse, as deputy ward manager on St Joseph ward and right across the unit including on the acute wards, I felt I could bring a certain skill set to the role of Case Manager. The main role of the case manager is to assist the patient along with the MDT to achieve a safe and timely discharge from hospital. The majority of the patients we meet will have had life changing injuries and this will have implications for where they will be discharged and how they will be cared for after discharge. As Case Manager we aim to support, advocate and liaise where necessary. The Case Manager liaises with all relevant and appropriate teams in the community to make referrals and to request assessment to establish how and who will provide the care when a patient is discharged. This also involves a degree of coordinating the team around the patient in completing assessment paperwork, and providing reports and evidence of the patient’s needs, as well as involvement in discharge planning meetings. This may be Social services, continuing healthcare, care agencies, neuro navigators. Case Managers also work with the patient in identifying a suitable place for discharge. This may be at home but it may also be necessary to apply for re- housing in a suitable property and ongoing liaison with the patient’s housing officer. It may also involve working with commissioners or the Continuing Healthcare teams in identifying suitable interim options for discharge. The Case Manager is the link between external services that can assist our patients, such as legal services, Department of Work & Pensions as well as some charitable services. We also communicate with commissioners, keeping them updated of admission, proposed discharge dates and any potential for delays. We work alongside the whole multi-disciplinary team here as well as other professionals that maybe involved in the patient’s care such as dieticians, and speech and language therapists.

BECOMING A CASE MANAGER Case Managers generally need to have a clinical or social work background and be a registered professional. Experience of working within a multi-disciplinary team within a residential or rehabilitation setting, and working with people with complex needs is really important. A record of work with external agencies such as social services, continuing healthcare teams and housing departments is also required. Awareness of assessment processes is helpful, and needless to say, excellent communication skills are a must.

OTHER STAFF GROUPS AT THE NATIONAL SPINAL INJURIES CENTRE Pharmacy – Lisa Pazik, Lead Pharmacist “I work closely with patients, medical staff, nursing staff, GP’s and the multidisciplinary team advising on, and providing the medicines being used on the spinal unit. I work closely with another pharmacist and our spinal medicine management technician. I’ve worked in many different roles throughout my career but enjoy the challenges provided by the specialist nature of our patients. It means I need to draw on all of my previous experience to ensure patients get the very best from the medicines they are prescribed. I also provide education and training to staff and patients on medicines in spinal cord injury. We help patients to regain independence by providing medicines when they go home for short periods of leave. We’ve recently introduced a scheme on one of our wards that enables patients to have control of their medicines rather than wait for medicine rounds. This has been very well received by those who have participated in the scheme. I feel privileged to be able to be part of the spinal unit and the team of professionals working here.” Dietetics – Samford Wong, Lead Dietitian Samford leads a small team specialised in providing dietary advice to patients who have suffered Spinal Cord Injury (SCI) and may still be acutely recovering from the trauma or are stable and undergoing rehabilitation. Their nutrition needs are quite different. Samford and his team provide education to patient and training to nursing staff and doctors joining the NSIC. The NSIC Dietetics service has a long and on-going interest in research on the management of malnutrition and associated problems in SCI patients. His team has explored the role of probiotics in preventing bowel problems, the role of nutrition intervention in preventing nutrition related complications including pressure ulcers, osteoporosis and the management of obesity following SCI. Samford currently leading the ECLISP study, a multi-centre study to investigate the effectiveness of probiotic in preventing diarrhoea associated with antibiotic and Clostridium difficile infection in SCI patients. Since the NSIC Dietetic service established in 2011, the team has produced 20 peer-reviewed journal articles, and Samford has also co-authored 6 sets of clinical guidelines. He also chaired the weight management guideline for SCI individuals for the Multidisciplinary Association for Spinal Cord Injury Profession in the UK which is due to publish in November 2017. Speech and Language Therapy – Sarah Rossor and Sharon Leigh, Highly Specialised SPLTs The role of the Speech and Language Therapist on the Spinal Unit is mainly in swallowing and communication difficulties. Swallowing difficulties can often occur for patients with a cervical spine injury. This may be due to changes in sensation in the throat, swelling, having a tracheostomy or being on ventilation support. Some patients may have undergone anterior neck surgery which may affect the swallow. Usually over time, the swallow function recovers to allow oral diet to commence but often long-term difficulties remain with some diet modification required. Our main aim is to reduce the risk of chest infections as a result of food or fluid going down the wrong way. This is known as Aspiration Pneumonia. Rehabilitation exercises may be given and we work closely with our physiotherapy colleagues to assess at the optimum time during their tracheostomy/ventilation weaning process. It may be necessary to complete objective assessments such as a Videofluoroscopy (an x-ray of the swallow) or Fibreoptic Endoscopic Evaluation of Swallowing (FEES). Communication difficulties can often be related to ventilation support or tracheostomy placement. Associated upper limb weakness can mean a patient cannot point to a communication chart or press a call bell. A voice difficulty can resolve following tracheostomy removal. If there are on-going difficulties with the voice, an ENT review would be required and from there a series voice strengthening exercises would be given. Depending on the communication difficulty, a wipe board may help or eye gaze technology may help. Working on the Spinal Injury Unit as a Speech and Language Therapist is an extremely rewarding career and provides a complex/stimulating environment to work within. Housekeepers Last but certainly not least, NSIC has a dedicated team of Housekeepers, who work on our six in-patient wards, making sure – as their job title suggests – that their ward’s housekeeping needs are met and domestic matters are kept in good order. This involves liaising with the domestic services provider (Sodexho) on various issues including cleaning, patients’ meals, and supplies – so that ward staff have access to everything they need, at all times. Housekeepers are at the very centre of our wards’ daily activities.

FURTHER INFORMATION AND USEFUL LINKS Where to find our job vacancies As part of Buckinghamshire Healthcare NHS Trust, the NSIC advertises all of its job vacancies in two places: The Trust website: http://jobs.buckshealthcare.nhs.uk/ and click on the relevant staff group. The national NHS Jobs website: www.jobs.nhs.uk/ On both sites you’ll be able to open an account, making it easy for you to submit applications as and when you see suitable vacancies Help with career planning There’s something for everyone in the NHS, whether you’re still at school and thinking about your options, or already working in health. Many of us need help to manage our careers at some point in our life, and some really good help is available on the national “Health Careers” website: www.healthcareers.nhs.uk/career-planning On this site you'll find tools, tips and exercises for how you can help yourself take the next step in your career progression. Finding a course Health Careers have also developed a great “course-finder”. Use this to find undergraduate and postgraduate courses which lead to clinical careers in health. Most of the courses lead to eligibility to apply for statutory professional registration. www.healthcareers.nhs.uk/i-am/looking-course Further information about careers at the National Spinal Injuries Centre If you’d like more information about job and career opportunities at the NSIC, you can e-mail your query to our dedicated NSIC Careers service at NSIC.Careers@buckshealthcare.nhs.uk Volunteering A good way to gain experience of working in healthcare is to volunteer. NSIC has a dedicated group of volunteers, and there are many other opportunities in the wider healthcare Trust. Contact the Voluntary Services Team on 01296 316 676 or voluntary.services@buckshealthcare.nhs.uk. Refer-A-Friend – We’ll say thank you with £250! We want to attract the very best talent to our organisation, and you may be able to help us - and help yourself in the process. After you have started working for us, if you let us know that you have recommended to one of your friends that they apply for a job here, you will receive a voucher for £250 to use in John Lewis if they are successful. All you have to do is e-mail referafriend@buckshealthcare.nhs.uk before your friend applies for a job. In your e-mail tell us the name of the friend you have recommended. Your friend must also mention on their application form that you recommended them. You can do this as many times as you like! Keep up-to-date about the National Spinal Injuries Centre To keep up-to-date about developments at the NSIC, including events and inspiring stories of our patients’ rehabilitation, keep an eye on the NSIC’s website, NSIC on-line http://main.nsic-online.org.uk/

For more information about NSIC and the Trust, please visit: http://main.nsic-online.org.uk/ https://www.facebook.com/BucksHealthcare https://twitter.com/BucksHealthcare http://www.buckshealthcare.nhs.uk/NSIC%20Home/spinal http://jobs.buckshealthcare.nhs.uk/ or e-mail us at NSIC.Careers@buckshealthcare.nhs.uk

September 2017