The Princess Alexandra Hospital NHS Trust
The Princess Alexandra Hospital NHS Trust was established on 1 April 1995 and enjoys the patronage HRH Princess Alexandra GCVO. The trust provides acute hospital services to the population of West Essex and East Hertfordshire. Most patients are from Harlow, Epping Forest, Uttlesford, East Hertfordshire and Broxbourne Districts, giving a catchment population of 448,787.
The services are currently located on three sites: -
- The PrincessAlexandra Hospital - in Harlow, Essex, the main site
- St. Margaret's Hospital Epping, Essex - Outpatients and diagnostic services
- Herts and Essex Hospital, Bishop's Stortford, Hertfordshire
The trust has 451 beds (including a 5 bed intensive care unit and a 5 bed HDU and 8 inpatients theatres). Day stay facilities are provided in the purpose built Alexandra Day unit, which was opened in 1995. This unit has 2 modern operating theatres and 2 endoscopy suites. The maternity unit delivers approximately 2,500 babies a year. Magnetic Resonance Imaging (MRI) is undertaken in the Andrew Bryce Smith unit, which was opened in 1994.
The sites at Bishop's Stortford and Epping have been redeveloped as modern community hospitals. The Trust will continue to provide diagnostic, outpatient and minor day procedures at these sites. Outpatient services are currently provided on four sites including a clinic in Hoddesdon. Elderly continuing care, mental health, learning difficulties, professional therapeutic and other community services are provided by North Essex Mental Health trust and the other local Primary Care Trusts. St. Margaret's Hospital, Epping is managed by the Epping Forest Primary care Trust and Herts & Essex Hospital, Bishops Stortford, by the Royston, Buntingford and Bishop Stortford Primary Care Trust. The Princess Alexandra Hospital Trust leases facilities on both these sites.
About the Princess Alexandra Hospital
The hospital was first opened in 1965. It is situated within easy walking distance of Harlow Town Centre with good approach roads and is within easy reach of the M11. The following services are provided:-
- Child Health services including Child Development Centre
- Medicine for the elderly
- General medicine
- Cardiology and coronary care
- General surgery
- Urology
- Trauma and Orthopaedics
- Plastic Surgery
- Obstetrics and Gynaecology
- Ophthalmology
- ENT
- Maxillo-facial surgery
- Orthodontics
- Intensive and high dependency care
- Accident and emergency
- Radiology including CT & MRI
- Plus a full range of diagnostic and support services
The North Essex Mental Health Trust provides Mental Health services on the Princess Alexandra site.
Post Graduate Facilities
The Education Centre serves clinical staff from both Trusts in the 19th Century Parndon Hall, which is in the grounds of The Princess Alexandra Hospital. Facilities include a library, 24 hour study room, lecture theatre and clinical skills room. There are comprehensive postgraduate teaching programs including MRCP Conferences, journal clubs, grand ward rounds and GP meetings. The Trust has a number of teaching hospitals links, particularly the Royal London Hospital Trust, University College and the London School of Medicine and takes part in Medical students teaching and postgraduate rotations. Existing links with Addenbrookes's Hospital are being further developed.
Capacity & Structure
The West Essex (Harlow) GP Specialist Training Programme is approved by the Health Education East of England (HEEoE) GP School.
The training area incorporates Bishops Stortford to the north, Epping, Loughton and Buckhurst Hill in the south, Ongar in the south east, and Harlow in the centre. We are strategically positioned between Cambridge and London; with easy access by motorways M11 & M25 by air from Stansted Airport.
The ST1 and ST2 hospital speciality posts are based in Princess Alexandra Hospital, Harlow, and in the community. These include some Innovative Training Posts (ITP) where two sessions a week are in general practice.
The available posts comprise:
- Accident & Emergency (6)
- EAU (2)
- Elderly Care Medicine (4)
- Respiratory / Diabetes Medicine (2)
- Obstetric & Gynaecology (6)
- Paediatrics (6)
- Psychiatry (5)
- Ophthalmology (1)
- ENT (3)
- Urology (1)
- Orthopaedics (1)
- Gastroenterology (1)
- Dermatology/ Rheumatology ITP (1)
- Womens' Health/ Family Planning ITP (1)
- Palliative care medicine ITP (1)
- Frailty Care (ITP) (1)
giving a wide variety of selection and exposure. The programme also caters for Flexible training in General Practice. Whilst we do not offer part-time training posts during the hospital placements, applicants wishing to work a 50:50 job share arrangement are welcome.
The programme facilitates active, adult, problem based learning processes and encourages Trainee presentations, teaching and small group workshops. Communication skills and training in team working are promoted to the highest level. Regular practice examinations including clinical examinations, consultations/ communications and OSCEs are conducted to achieve high level pass rates in MRCGP, DCH & DRCOG examinations. We also support additional training in Minor Surgery/ Dermatology, Endoscopy, Ultrasonography, Women's Health. The residential course held each year facilitates a close relationship among Trainees and Trainers.
The General Practice Trainer network is active and enthusiastic; both full and associate trainers meet regularly at Trainers' Workshops to maintain and build on our high level of training.
Our most recent GP School assessment visit generated a very positive report with high levels of satisfaction reported by learners
A&E Department & EAU
The primary role of the Accident and Emergency Department is to provide emergency care of the acutely ill and injured patients arriving at the Hospital. Emergency care is also provided within the Accident and Emergency Department by the medical nursing staff for those patients referred by their General Practitioners. A secondary role of the A&E Service is to provide the initial care and when appropriate follow up care of the less seriously ill and injured presenting without referral to the hospital. The A&E Department sees approximately 55,000 new patients per annum and a total of 70,000 patients attend the department. There are three Consultant posts, 2 Staff Grades, 1 Specialist Registrar and 8 Senior House Officers.
The ENT Department consists of the following medical staff, 2 Consultants, 2 Associate Specialists and 2 Senior House Officers.
ENT Out of Hours is carried out at Broomfield Hospital in Chelmsford.
General/Elderly Medicine
The department offers experience in acute General Medicine, Care of the Elderly and other specialist medicine services. There is an age related admissions policy with patients above the age of 80 admitted under the team for care of the elderly. There are seven Consultants in the Medical Directorate Team with interests in Chest Medicine, Cardiology, Diabetes and Gastroenterology. Other specialities within the Medical Directorate are Neurology, Sexual Health, Rheumatology, Dermatology ,Haematology and Oncology and these are the responsibilities of a further 12 Consultants. The Care of the Elderly Team consists of four Consultants. The department as a whole has 5 Specialist Registrars, 1 Senior SHO, 13 Senior House Officers and 6 PRHOs.
Obstetrics & Gynaecology
The department consists of the following medical staff, four Consultants, two Trust Doctors, four Specialist Registrars, and six SHOs.
Maternity and gynaecology services have maintained an 'outstanding' rating, particularly for care
Ophthalmology
The department consists of 3 Consultants, 2 Clinical Assistants, 1 Senior Clinical Medical Officer, 2 Clinical Medical Officers, I Registrar and 2 SHOs. There is access to 17 adult beds, 6 day stay trolleys and paediatrics. There are Outpatient Clinics at PrincessAlexandraHospital, St. Margaret's Hospital and Herts & EssexHospital. There are 8 inpatient/day case theatre sessions available to Ophthalmology.
Orthopaedics
The department consists of the following medical staff, 6 Consultants, 4 Specialist Registrars, 1 Research Registrar, 1 Registrar and 6 SHOs. The Orthopaedic department within the Trust is regionally renowned for providing an excellent standard of surgery. The established special interests of the Orthopaedic Surgeons are as follows; Knee and Trauma Surgery, Hip and Knee Surgery, Hand and Upper Limb Surgery, Spinal Surgery, Non Union Surgery and Limb Reconstruction and Paediatric Surgery. It is anticipated that there will soon be an additional post specialising in Shoulder Surgery.
Paediatrics
Dolphin Ward has beds for Paediatric Medicine, general surgery, trauma and orthopaedic surgery. Children admitted for surgery come under the joint care of the Paediatricians and Surgeons with the former taking the responsibility for medical management. A high standard of secondary care is delivered from both in-patient and outpatient services. There are several visiting clinics from regional specialists. The Neonatal Intensive Care Unit is a designated level II unit. There are four intensive care cots and 12 special care cots. A Consultant Neonatologist leads the service in the district supported by three other Consultant Paediatricians with an interest in newborn. The unit has been commended by the Kings Fund Organisation Audit. The Paediatricians work in close liaison with the Obstetricians. Child and Adolescent Psychiatry is provided by North East Essex Mental Health Trust. Beds are provided at LongviewHospital, Colchester.
Urology Department
The department has 1 Consultant Urologist, 1 Specialist Registrar, and 1 Staff Grade and 2 Senior House Officers.
ITP Palliative Care
Place of work: ST Clare Hospice, Hastingwood, Harlow & The Limes Medical Centre Epping
Job Summary:
- To gain experience in all aspects of palliative care.
- To work with other members of the multi professional team within the hospice to provide the highest possible standard of holistic care for patients and their families and friends.
- To give advice to other hospice staff and external health care professionals about the management of patients in their car
- By the end of the post the trainee should be competent in:
- Recognising and managing physical aspects of patient care The holistic management of common symptoms Pharmacological palliation Psychosocial aspects of care of patient and carers Multi-professional team work Recognising the bereavement process Communication skills Recognising ethical dilemmas
Educational
- GPST should attend any relevant study days both internal and external to the Hospice with the agreement
- It is expected that the GPST attends the VTS programme on Tuesday afternoons.
- The GPST will be expected to undertake an Audit Project and consider the relevance of audit to Palliative Care and clinical Governance.
- Be encouraged to develop and undertake a research project exploring Palliative care issues relevant to Primary Care.
There is an excellent Post Graduate Centre on the Princess Alexandra Hospital site with 24ht Library access and study room.
Key working Relationships
Hospice medical teams, director of Nursing & Patient Services and Nursing staff, Family Support Manager & team, Hospital and Community Clinical Nurse Specialist.
ITP Women’s Health
Department: Families and Women’s Services (FAWS)
Report to: Dr Kamila El-Farra
Place of Work: Princess Alexandra Hospital Department of Women’s Health & Ongar Health Centre
Job Summary: To gain experience in all aspects of Women’s Health including Sexual Health, Family Planning, Gynaecology and Young Peoples Services.
Educational
- There will be an induction period of 2-3 weeks where the GPST will sit in on clinics with the consultant in FAWS, DOSH, YPIC, & Family Planning. Thereafter it will be expected that the GPST will undertake clinics on their own but with onsite supervisor from the key professional as above.
- There will be an option of attending and infertility clinic in order to gain some understanding in the management, counselling and techniques used within assisted contraception.
- There will be an option to attend O&G teaching sessions.
- It is expected that the GPST attends the VTS programme on Tuesday afternoons.
- The GPST will be expected to undertake an Audit Project and consider the relevance of audit to FAWS
- There is an excellent Post Graduate Centre on the Princess Alexandra Hospital site with 24ht Library access and study room.
Key Responsibilities/Tasks:
Clinical
DOSH
To provide screening for and treatment of sexually transmitted infections including HIV.
To provide contraceptive advice and supplies as required.
Educate clients in the prevention of sexually transmitted infarctions and refer on to Health Adviser as necessary.
Family Planning
To provide a comprehensive contraceptive service, ensuring that individual patients are assessed and counselled and their contraception prescribed and closely monitored.
Promote preconception care.
Give suitable advice about pre-menstrual syndrome including therapy when necessary.
Educate and advise and refer menopausal patients where necessary.
Refer if necessary for termination of pregnancy.
Gynaecology Emergency Room
To see and assess early pregnancy complications.
To assess and manage patients referred with pelvic pain, pelvic infections and vaginal bleeding.
To refer to the DOSH as necessary.
Gynaecology Clinics
Under the supervision of the consultant Gynaecologist, to see, assess and decide on management of patients referred by GP’s with a variety of Gynaecological problems.
To become proficient in a number of simple gynaecological techniques, including the insertion and removal of ring pessaries, endometrial biopsy, cervical smears and taking genital swabs, the removal of cervical polyps.
Young people’s Information Centre
To give advice, support and clinical intervention where appropriate to all clients accessing the Young Peoples Information centre (YPIC) for health needs.
To address the health needs of young people with particular preference to sexual health and contraceptive advice.
To refer clients where necessary for termination of pregnancy, midwifery access and ultra sound scans.
Administrative
To keep accurate, legible written records which are dated and signed to ensure prompt written communication with other health care professionals including GP’s, DOSH, FAWS, and family planning as appropriate.
To maintain a neat and tidy appearance.
On Call
There will be no On Calls from FAWS, Family planning, YIPC or DOSH.
It is expected that the GPST will do OHH within his or her General Practice as arranged with their GP trainer.
Confidentiality
Attention is drawn to the issue of confidentiality. All information relating to patents, families, friends and members of staff must not under any circumstance be divulged to an unauthorised person. Breaches of confidence will result in disciplinary action and may result in dismissal.
Other
This job description sets out key tasks and responsibilities. It is not intended to be comprehensive and it is essential that it should be regarded with a degree of flexibility so that the changing needs of our patients and staff can be met.
It is a condition of employment that the GPST shall have a current registration with the GMC and a recognised Defence Union.
It is the responsibility of the GPST to take reasonable care not to endanger themselves or anyone else on the premises by an act of omission.
The GPST must adhere to the Trust Fire Policy
The Trust has a Policy of No Smoking which restrictions apply to patients, staff and visitors alike.
ITP Post South Street Surgery & Rheumatology/ Dermatology & Minor Surgery
RHEUMATOLOGY COMPONENT
Rheumatologically symptoms are the commonest reason to seek advice in the Primary Care. General Practitioners are the first port of call for arthralgia’s, myalgia’s, rashes and regional pain syndromes. Early diagnosis and intervention in Rheumatological Diseases is critical (delay in treatment of inflammatory arthritis’s can result in irreversible erosive changes). Equally prompt recognition/referral to Specialist is obligatory in conditions such as suspected vasculitis or temporal arteritis. Exposure to Rheumatology in a Specialist setting with a Primary Care perspective, therefore, could be of immense value. The GP VTS Rheumatology post at The Princess Alexandra Hospital, Harlow, will provide a unique opportunity for the trainee GP's to learn practical diagnostic and treatment skills in the speciality.
CURRICULUM:
Supervised Training in:
GENERAL:
History and clinical examination of a patient with musculoskeletal disorder
Selection and interpretation of appropriate laboratory tests (including ESR, CRP, CK, RF, ANA, dsDNA, ENA and Serum Electrophoresis).
Knowledge of the place of imaging (X-rays, MRI and DEXA scan).
Core theoretical knowledge of the rheumatic disease
Journal Review (twice during the post)
Rheumatological Emergencies
SPECIAL SKILLS
Aspiration and/or injection of Shoulder, Knee and Wrist (inc carpal tunnel) joints.
Soft Tissue Injections: tennis/golfer's elbow; trigger finger; trochanteric bursitis; plantar fascitis
Counselling and communication skills with respect to chronic disease and its overall impact on life
DMARD'S (Disease Modifying Anti Rheumatic Drugs) Treatment and monitoring issues
Consultant: Dr Sarah Farrow
DERMATOLOGY COMPONENT
SHO will be able to gain experience in general dermatology and Dermatology Minor Surgery in these Clinics.
AIMS AND OBJECTIVES OF DERMATOLOGY TRAINING
1. To learn the essentials of dermatological diagnosis and to recognise the dermatoses which require urgent referral and hospital dermatology intervention.
2. To become proficient in the use of cryotherapy and curettage and cautery.
3. To become proficient in techniques of punch biopsy, incisional ellipse biopsy and excision biopsy.
4. To be familiar with all types of topical treatment.
5. To become skilled in the management of common dermatoses such as
Acne vulgaris,
Atopic dermatitis,
Contact dermatitis
Psoriasis and to recognise cases which require hospital specialist management.
6. To become proficient in diagnosing skin cancers and distinguishing them from common benign tumours.
7. To appreciate the role of specialist nurses in the management of skin diseases.
8. To become familiar with
Infections and
Infestations of the skin and their treatment.
9. To acquire skills in the collection of specimens from the skin for
Mycology,
Virology,
Bacteriology and Cytology.
Consultants: Dr Wolpert & Dr Verdolini