Position Details
Position Title Provisional Fellow
Position Number 14940
Employment Status Full Time - Exempt
Applications Close 31/07/2017
Local Health District Hunter New England Local Health District
Facility John Hunter Hospital
Specialty Neurology
Sub Specialty None
Award Public Hospital Medical Officers (State) Award
Classification Resident Medical Officer
Main Purpose of Position Clinical service support for the day to day operation of the RRTIA clinic, this involves a daily morning clinic Monday to Friday.

Oversight of the day to day running of the acute stroke unit and providing care for all acute stroke patients admitted under neurology.

Provide clinical service support in the day to day operations of the acute stroke unit.

Provide clinical service support to the acute stroke thrombolysis and endovascular reperfusion therapy team including telestroke support for the LHD primary stroke centres in Taree, Tamworth and Armidale.
Lead the acute stroke unit audit program with support from the acute stroke team
Provide support to the acute stroke research team across the portfolio of acute stroke research projects

Applicants should have extensive training and experience in neurology and stroke, deemed to be at the level of an advanced trainee in neurology.

Position Requirements
Conduct the daily RRTIA clinic supported by the staff specialist Neurologists and the stroke case manager. Some of these clinics will involve use of telemedicine to smaller regional hospitals or to patients in GP rooms or their own home.

Provide day to day clinical operational support for the running of the acute stroke unit.

Provide day to day clinical operational support to the acute stroke team including the selection of patients, for and the delivery of thrombolysis.

Provide after-hours roster support according to the stroke thrombolysis team.
Participate in the acute stroke on-call roster as first on call when deemed appropriate by the Director of Acute Stroke Services.

Provide supervised support to the senior neurology roster if required.
Conduct the monthly acute stroke audit and collect key data items for the national stroke audit and standards program

Provide active involvement in acute stroke research projects as deemed necessary by the Director of Acute Stroke Services.

Involvement in undergraduate and postgraduate teaching programs in stroke and neurology.

Convene the weekly neurology clinical meeting and quarterly stroke morbidity and mortality meetings.
Local Background & Environment Hunter New England Local Health District (HNE Health) is one of the largest health districts in New South Wales, covering a geographic area of almost 130,000 kilometres across the Hunter, New England and Lower Mid North Coast regions. HNE Health is responsible for the funding, organisation and delivery of public health services from Morisset in the south, to Tenterfield and Toomelah in the north, and as far west as Pilliga and Mungindi.
To effectively manage its vast range of hospital and community health services, HNE Health is divided into geographical clusters and acute hospital networks:
• Greater Newcastle Cluster includes John Hunter Hospital (including John Hunter Children’s Hospital and the Royal Newcastle Centre), Belmont Hospital, Calvary Mater Newcastle and facilities at Waratah, New Lambton, Newcastle, Wallsend, Windale, Toronto, Nelson Bay, Raymond Terrace and Morisset.
• Upper Hunter Cluster includes facilities at Muswellbrook, Denman, Scone, Murrurundi, Merriwa, Quirindi, Walhollow, Werris Creek, Premer and Tambar Springs.
• Lower Hunter Cluster includes Maitland Hospital and facilities at Cessnock, Kurri Kurri, Singleton, Dungog, East Maitland, Rutherford, Woodberry and Beresfield.
• Lower Mid North Coast Cluster includes Manning Hospital and facilities at Taree, Forster, Bulahdelah, Gloucester, Wingham, Hawks Nest/Tea Gardens, Harrington and Stroud.
• Peel Cluster includes Tamworth hospital and facilities at Gunnedah, Manilla, Walcha, Barraba and Nundle.
• Tablelands Cluster includes Armidale Hospital and facilities at Glen Innes, Guyra, Emmaville, Tenterfield and Uralla.
• McIntyre Cluster includes facilities at Inverell, Tingha, Warialda, Ashford, Bundarra and Bingara.
• Mehi Cluster includes facilities at Moree, Narrabri, Boggabri, Mungindi, Boggabilla, Toomelah, Wee Waa, Gwabegar and Pilliga.
HNE Health services are supported by district-wide Clinical Networks and Streams, which link health professionals together to work collaboratively, improve service delivery and ensure equitable provision of high quality, clinically effective care.
Hunter New England Health:
• Provides care for a population of more than 844,000 people (8 per cent of the population of NSW)
• Has approximately 15,500 staff
• Has 1400 medical officers
• Has 1600 volunteers
• Provides health services to 20 per cent of the state’s Aboriginal population
• Spans 26 Local Government Areas
• Spends $1.7 billion per annum
• Has a head office in Newcastle and a regional office in Tamworth
• Is unique, in that it is the only local health district with a major metropolitan centre (Newcastle/Lake Macquarie), as well as a mix of several large regional centres and many smaller rural centres and remote communities within its borders.
Data Financial year 2010/11
Separations 199,767
Average available beds 3, 435 (inc. nursing home beds)
1. Figures exclude delivery, emergency, recovery and theatre trolleys, and hospital in the home (HITH) beds-for information about trolleys and HITH beds please refer to the excel spread sheet on the Performance Gateway
2. HNE Health also has 5 beds at Hunter Rehabilitation (Newcastle East)
Occupied bed days 890,150
Non-inpatient occasions of service 3,353,953
Live Births 9,050
Emergency attendances 337,406 (Source: Business Objects)
Attended: 10 July 2012
Source (for all except Emergency attendances): HNE Health at: http://performancegateway.hne.health.nsw.gov.au/Activity.aspx
Key Internal and External Relationships Key Internal Relationships:
• Clinical streams
• Multidisciplinary teams
• Consumers/Carer’s
• Other Clinical Divisions
• Hospital Administration

Key External Relationships:
• Consumers/Carer’s
• GPs
• Community
• Police and Ambulance
Supervision Arrangements Supervision of the Doctor in normal hours of work:

• The Doctor will receive full direct supervision and support from the more senior resident staff and the specialist doctors within the departments through which they rotate. As such daily supervision is available at all times and at any time.
• The Doctor will benefit from the additional supervision of the Clinical Superintendent, and the Director of Prevocational Training and Development within the hospital, the Director of Basic Physician Training, and the Director of Advanced Physician Training.
• Additional supervision is available from members of the relevant clinical department.

Supervision of the Doctor after hours:
• The Doctor will have the immediate supervision of the medical officer on duty. As an advanced trainee the doctor will also be responsible for other Resident Medical Officers working after hours
• The Doctor will be able to call the Consultant on call for support and supervision after hours
Challenges/Problem Solving Maintaining the same day/next day patient access provision in the RRTIA clinic.

Providing emergency acute stroke care including prompt delivery of care to all stroke patients.

Balancing busy clinical workload with research and teaching priorities.

Working as part of a multidisciplinary team and collaborating with staff in Neurology, Administration Radiology and Allied health.

Provision of after-hours work as required by the acute stroke roster.
Decision Making
The clinical Fellow will be responsible for;

Initial assessments of patients referred to the RRTIA clinic and development of a provisional management plan for review and discussion with supervising senior staff. These clinics can be telemedicine clinics.

Supervision of junior medical staff around significant patient care issues directly related to the RRTA clinic, acute stroke unit care or stroke thrombolysis/endovascular therapy, such as: accurate diagnosis, selection of treatment options, patient and family discussion and education.

Direct liaison and advice to General Practitioners referred to the RRTIA clinic.

Support of the stroke case manager in their role of patients triage to the RRTIA clinic.

Assessment of patients for suitability for thrombolysis and endovascular reperfusion therapy plus the delivery of thrombolysis. The delivery of thrombolysis may be via telemedicine and the triage for endovascular therapy may also need to be performed via telemedicine.

All aspects of stroke patient management including the need for transfer of patients form peripheral centre to the JHH Comprehensive Stroke Centre, requirement for interventional therapies, acute secondary prevention and suitability for rehabilitation.
Communication Insuring high quality communication with all stake holders including attending senior medical officers in peripheral hospitals, patients, families and GPs.

Communicate with specialty teams and services informing the Director of Acute Stroke Services of any clinical research problems or unresolved issues.

Communicate effectively with all members of the multidisciplinary team.
Performance Monitoring - For medical officers with conditional registration, supervision reports for the NSW Medical Board will be completed at 3, 6 and 12 months as defined by the NSWMB guidelines.
- End of term reports for fully registered trainees will be completed
Additional Information
Additional Documents no addditional documents have been provided

Organisation Chart Org_chart 2016.pdf
Job Demands Checklist Click Here to View
Selection Criteria 1: MBBS or equivalent, current general registration with the Medical Board of Australia.

2: Demonstrated training and experience in Neurology and Stroke to a standard deemed equivalent to advanced trainee level or higher, also deemed acceptable by the supervising neurologists at John Hunter Hospital.

3: Demonstrated ability to safely and effectively deliver acute stroke and TIA care.

4: Demonstrated experience in clinical research and audit as evidence by publication and presentation output.

5: Demonstrated experience in undergraduate and postgraduate education.

6: Demonstrated good oral and written communication skills.

7: Current drivers licence.
Contact Details Dr Neil Spratt
02 49855593