DCT

ORAL AND
MAXILLO FACIAL
SURGERY
 Profile of Taunton & Somerset NHS Foundation Trust

Musgrove Park Hospital

Anaesthetics General Medicine Obstetrics and Gynaecology

Major Accident Centre General &Vascular SurgeryOphthalmology
Care of the Elderly Genito Urinary Medicine Orthodontics
Clinical Genetics Head Injuries Unit Orthopaedics and Trauma
Community Child Health Intensive Care Unit Paediatrics and Neonatal Unit
Coronary Care Unit Maxillo Facial Surgery Parkside Private Wing
Dermatology Neurology Pathology
Diagnostic Imaging Clinical Genetics Urology
Ear Nose and Throat

Musgrove Park Hospital is the main DGH for the county and serves a population of
approximately 340,000. It has 700 beds and access to full diagnostic imaging
facilities, including MR and helical CT scanning, duplex ultrasound, digital subtraction
and coronary angiography.

The DGH has undergone considerable re-development. The Queens Building,

opened in 1987, contains Accident and Emergency, Trauma and Orthopaedics and
Ophthalmology. The Duchess Building, opened in 1995, provides all general medical,
acute and rehabilitation care of the elderly services, an outpatients department, day
hospital facilities and other departments such as Diagnostic Imaging, Pharmacy and
paramedical support services. The inpatient facility for medicine comprises an Acute
Admissions and Assessment Unit, 6 general medical wards, 2 rehabilitation wards, a
9 bed Coronary Care unit with an integral cardiac catheter laboratory and access to a
7 bed ICU and 4 bed HDU. Dene Barton House, a 16 bed off-site intermediate care
facility, opened recently. Phase 1 of the Admission and Assessment unit has already
opened and Phase 2 of this development, with increased access to specialist advice
at an early stage of the assessment/admission process, will progress with the
planned additional Consultant expansion.

Other services provided on the DGH site include an excellent Postgraduate Medical
Centre (see below), a Public Health Laboratory providing services to Somerset and a
Young Chronic Disabled Unit, which is being developed to provide a county wide
head injuries specialist service managed by the Consultant in Disability Medicine.

Dene Barton House

16 beds Nurse led intermediate care facility.

Profile of Somerset

Somerset is a large rural county with a population of about 544,000, spread through
several small towns and many villages and hamlets. Its many varied attractions
include Exmoor National Park and a forty-mile stretch of coastline from the sandy
beaches of Burnham on sea at one end, past Blue Anchor Bay and Minehead to
the wooded cliff-lined shore of Porlock and beyond. The River Parrett, which runs
through Bridgwater, serves the famous Somerset levels of Wedmore and Sedgmoor,
which are home to a flora and fauna increasingly lost elsewhere in the country. These
flatlands are surrounded by ranges of hills from the Mendips in the north to the
Blackdowns and the Quantocks, and in the west the heights of Exmoor.

The county town of Taunton has a population of 64,000. The M5 motorway passes
north to south, past Bridgwater and Taunton and provides a focus for considerable
development. Taunton is the administrative centre and market town for much of
Somerset. Farming, service and unobtrusive light industry provide the economic
base. Communications are easy with the M5 located on the edge of town and there
are direct railway links to London and the Midlands. The journey to London takes 1
hour 40 minutes and 2 hours by rail.

The North Devon and Cornwall coast is between 1and 2 hours drive. Sailing, surfing,
caving, diving, hangliding, fishing, windsurfing and horse riding are all catered for
locally. There are many excellent routed country walks throughout the county with
easy access to the Quantock Hills, Exmoor and Dartmoor.
 TAUNTON AND SOMERSET NHS FOUNDATION TRUST

DENTAL CORE TRAINEE ORAL & MAXILLO FACIAL SURGERY

1 PROFILE OF TAUNTON & SOMERSET NHS FOUNDATION TRUST

The Musgrove Park Hospital, with 650 beds, has full investigative facilities including CT
scanning, Duplex ultrasound, digital subtraction angiography, coronary angiography
and MRI scanning. General surgery, ENT, Maxillofacial, gynaecology and urological
surgery is carried out in a suite of four theatres with adjacent auxiliary theatre,
endoscopy suite, ten-bed recovery and seven-bed ITU. There is also a twin theatre
orthopaedic unit, twin eye theatres and maternity theatre.

The DGH has undergone phased re-development based on the nucleus design. The
first stage of the re-development, Queen's Building, opened in 1987 and contains
Accident and Emergency, trauma and orthopaedics, ophthalmology.

The Duchess Building was opened in early 1995. It provides general medical, acute
and rehabilitation geriatric services, an outpatients department, day hospital facilities
and other departments such as diagnostic imaging, pharmacy and various paramedical
support service. It has enabled a substantial part of the existing DGH to be closed and
demolished.

Other departments within the DGH have also been upgraded, eg, Pathology (1986),
Maternity (1988), Operating Theatre and Recovery (1988), ITU/CCU (1989), Paediatric
Unit (1991). A 13 bedded, 2 consulting room private wing (Parkside) was opened in
1990. An additional ophthalmic operating theatre and a new dedicated twin theatre
endoscopy suite have both been opened during 1995.

A dedicated day case surgery unit on the DGH site was opened in July 1994. This unit
comprises two operating theatres and 24 beds.

The Jubilee Building, the most recent development was opened in 2014. With three
new wards with individual bedrooms it has a concourse that connects the Queens
building with the old hospital and the Postgraduate Academy. It also has a new food
store and a coffee shop.

There is a very active Haematology Unit. It is an approved centre for new drug
evaluation at both phase 2 and 3 stages of development and is the administrative
centre for the South of England Trials Group. Bone marrow transplantation and stem
cell transplants are carried out in the leukaemia unit. Basic research is also carried out
with particular emphasis on the molecular biology of lymphoma and CLL in respect of
new drug evaluation in the treatment of these conditions. The unit is also closely
associated with the EORTC and the Karolinska Hospital in Stockholm.

Other services provided on the DGH site include an excellent Postgraduate Medical
Centre, recently rebuilt and enlarged, a Public Health Laboratory providing services to
Somerset and a Young Chronic Disabled unit which is being developed to provide a
county wide head injuries specialist service managed by a Consultant in Disability
Medicine.
The phased re-development of the Musgrove Park Hospital is an integral part of the
Trust's strategy for redeveloping acute services. Phase III of the re-development,
which is part of the DGH site control plan, will provide replacement surgical facilities,
beds and operating theatres.

The community hospitals form a link between the GP services, the community nursing
services and the resident population of Somerset. The Trust's strategy is that each
community hospital should be a focus for health care in a locality serving a population
of approximately 50,000, and providing:- in-patient beds, mainly for rehabilitation but
also terminal care; pre-convalescence; sub-acute medical care; care for the profoundly
physically disabled; a day hospital; a base for community nursing services including
augmented home care; outpatients clinics; physiotherapy; medical aids; a
psychogeriatric and day hospital unit; respite care; and a casualty service where
appropriate. Respite and terminal care complements the specialist service provided at
the DGH and at St Margaret's Hospice in Taunton.

2 SERVICES PROVIDED BY THE TRUST

Each year the DGH deals with 56,000 emergency department attendances,41,000
patients admitted as emergencies, 3,400 babies delivered in the Maternity Unit and
315,500 outpatient attendances.

3 HOSPITALS IN THE TAUNTON & SOMERSET NHS FOUNDATION TRUST

3.1 Musgrove Park Hospital

Anaesthetics
Major Accident Centre
Care of the Elderly
Clinical Genetics
Community Child Health
Coronary Care Unit
Dermatology
Diagnostic Imaging
Ear Nose and Throat

General Medicine
General & Vascular Surgery
Genito Urinary Medicine
Head Injuries Unit
Intensive Care Unit
Maxillo Facial Surgery
Neurology
Clinical Genetics

Obstetrics & Gynaecology

Ophthalmology
Orthodontics
Orthopaedics and Trauma
Paediatrics & Neonatal Unit
Parkside Private Wing
Pathology
Urology
3.2 Bridgwater General Hospital
30 inpatient beds Nurse-led Minor Injuries Unit. Outpatient clinics

3.3 Williton Hospital

20 inpatient beds - GP and Consultant (mostly Care of the Elderly with 2 palliative
care beds). Day Hospital.

3.4 Minehead & West Somerset Hospital

19 inpatient beds - GP and Consultant (mainly orthopaedic and general surgery pre-
convalescent). 8 bedded theatre suite and ambulatory care beds. Outpatient clinics
for all specialties. Minor Injuries Unit. Outpatient physiotherapy and occupational
therapy. X-Ray service and Day Hospital.

3.5 Chard & District Hospital

20 inpatient beds - GP and Consultant (Care of the Elderly). Outpatient clinic for
most specialties. Physiotherapy and GP Casualty. Day Hospital.

3.6 Wellington & District Hospital

11 inpatient beds - GP. Some general outpatient clinics. GP Casualty. Outpatient
physiotherapy.

3.7 Burnham On Sea War Memorial Hospital

22 inpatient beds - GP. General outpatient clinics in most specialties. Outpatient
physiotherapy and GP Casualty. Day Hospital.

4.1 Department Staff

Oral and Maxillofacial Surgery

Consultants:
Mr M Blanco-Guzman
Mr G D Merrick
Mr J Page
Mr A Al-Rikabi

Associate Specialists: Mrs H Mitchell

Specialty Doctor: Miss D Jones

Mr N Patel

Orthodontics

Consultant Mr C N Mitchell
Miss H Griffiths
Restorative Dentistry

Consultant Mr M Jerreat
Mrs C Drysdale

4.2 The Post

This post is intended to run for six months in the first instance. (Extension for a further
six months may be possible if mutually agreeable). A copy of the work programme is
included with the job description and it will be seen that the newest member of the team
will spend more time undertaking clerking work and supervised operating whilst they
familiarise themselves with the department and the hospital. DCTs participate in a one-
in-five on-call rota and there is an emphasis on pre-operative assessment clinics to
reduce the amount of time junior staff spend out of normal working hours in carrying out
clerical duties. This also enhances the quality of treatment received by patients and
allows junior staff greater time for study when not on-call.

The posts are based at Musgrove Park Hospital, Taunton, the main District General
Hospital. A wide range of oral and maxillofacial surgery is carried out by the Unit and
includes dento-alveolar surgery, surgery for non melanoma skin cancer of the head
and neck, salivary gland surgery, orthognathic surgery, surgery for head and neck
cancer, TM joint surgery and the use of osseo-integrated implants.
In addition the on-call commitment will enable postholders to see and treat a wide
range of maxillofacial trauma. There is no Neurosurgery Unit in Somerset but there is a
good working relationship with the Department of Neurosurgery at Frenchay Hospital,
Bristol. Both Taunton and Yeovil Hospitals have CT and MRI scanners to enable the
accurate diagnosis of severe head injuries where appropriate and there is also a
modern MRI Unit in West Somerset.

The Department has new purpose-built premises which have been specifically
designed to allow an increase in out-patient minor oral surgery under local anaesthetic.
In-patients are admitted to a 22-bedded ward shared flexibly with ENT and Ophthalmic
surgery. There are eight operating lists per week in Taunton which occur either in the
dedicated ENT/Maxillofacial Theatre or Day Surgery Centre. A further three day-case
lists are held each week in Yeovil Hospital.

There is a full support service of DSAs, secretaries and clerical staff at both Taunton
and Yeovil Hospitals. There is also an onsite maxillofacial technicians laboratory
which provides the technical services needed by the Department for trauma and
orthognathic surgery.

The DCTs will work closely with the Consultants and the Specialty Doctors/ Associate
Specialists. The fact that at the moment there are no Specialist Trainees in OMFS in
the unit, gives a good opportunity to DCTs to have more active involvement in the
treatments we offer. In addition the DCTs are expected to co-operate with consultants
and junior staff in other specialties over the management of patients with overlapping
interests, eg haemophilia. The Accident and Emergency services also expect the co-
operation of DCTs in the management of patients with dental, oral or maxillofacial
emergencies.

Out-patients are referred by both General Dental and Medical Practitioners and there
are regular combined clinics for oncology and orthognathic cases. The Community
Dental Service provides a service for routine extractions and conservation under
general anaesthetic with dedicated lists in the Day Surgery Unit.

These posts are designed to suit applicants who already have some postgraduate
experience, preferably in a residential post, but they are also suitable for the post-VT /
DF1 graduates. Each post will provide a good basic training in oral and maxillofacial
surgery which would be valuable either as a basis for a career in hospital service or
general practice.

The Taunton and Somerset Trust is firmly committed to medical audit and a
computerised data collection. When on call, junior doctors are occasionally required to
provide out of hours cover for Parkside, the private patient unit.

5 MAIN CONDITIONS OF SERVICE

(a) The post is covered by the Whitley Council Terms and Conditions of Service.

(b) The post is full-time. (Non-Resident on-call, you are required to be within 30
minutes of the hospital, whilst on call).

(c) The banding for this post will be confirmed at interview.

(d) Accommodation

(i) Accommodation can be provided if requested.

(ii) The post is deemed to be non-resident on call.

(iii) A small number of self contained two/three bedroomed houses are available to
rent, subject to availability. If you are interested in this accommodation, please
contact the Accommodation Officer in the Personnel Department.

(f) Holidays

Six weeks notice of annual or study leave is required. All leave to be approved
to ensure appropriate cover and compliance with hours restrictions.

Five weeks per annum plus two days and one day in lieu of each Bank Holiday
worked falling within the period.

Cover for absence is provided internally, no external locums are sought.

(g) Study Leave

Study Leave can be arranged, but the merits of any request will need to be
assessed as only limited funds are available to provide such leave and there is
not an automatic entitlement to such leave. Discussions with the Educational
Supervisor and Postgraduate Academy are required prior to any study leave
being arranged. Adequate arrangements will need to be made to cover study
leave.

(h) Staff Occupational Health

The successful candidate is required to complete Staff Occupational Health

Service forms and obtain clearance before employment may start.

(i) Hepatitis B

The successful candidate will be required to provide documentary evidence of

natural or acquired immunity to hepatitis B. Where this is not possible, the
postholder will be required to demonstrate by recent (within the last year)
evidence of serology showing the absence of hepatitis B surface antigen.
These provisions are to meet the requirements of the Department of Health's
instructions to Trusts (HSG(93)40).

6 OTHER INFORMATION

6.1 Postgraduate Training

There is a postgraduate library at Taunton which holds a good spread of

relevant journals. Basic textbooks are also available and some further textbooks
are available within the Department. Regular meetings are held in the
Postgraduate Centre on Wednesdays on all topics of medical interest and junior
staff are encouraged to attend.

The department has an Educational Supervisor who is responsible for the

overseeing the appraisal and education of the DCTs. There is a programme of
educational meetings/ sessions which occur on a regular basis.

6.2 Research and Development Support Unit

Since September 1994 a Research and Development Support Unit (RaDSU)

based at the Taunton and Somerset Hospital, has been providing support and
advice to all health care staff with research interests. Briefly, the unit can give
support to individual research projects in the following areas :-

providing ideas for R & D studies

 providing access to related research material
advising on research methodologies
drafting protocols
drafting questionnaires and study forms
providing advice on how to approach the Ethics Committee
securing funds for research
advising on conduct of study
providing help with data analysis and interpretation
providing advice on report writing
providing advice on publishing papers

From a more general perspective, Ra DSU can also provide support for training
relevant to R&D, for example, advising where to obtain funding, and organising
presentations of research findings.

6.3 Profile of Somerset

Somerset is a large rural county with a population of about 530,000, spread

through several small towns and many villages and hamlets. Its many and
varied attractions include the Exmoor National Park and a forty mile stretch of
coastline from the sandy beaches of Burnham-on-Sea at one end, past Blue
Anchor Bay and Minehead to the wooded cliff-lined shore of Porlock and
beyond. The River Parrett which runs through Bridgwater serves the famous
Somerset levels of Wedmore and Sedgemoor, which are home to a flora and
fauna increasingly destroyed elsewhere in the country. These flats are
surrounded by ranges of hills from the Mendips in the north to the Blackdowns
and the Quantocks, and in the west the heights of Exmoor.

The county town of Taunton with a population of 40,000 is expanding fast. The
M5 motorway passes north to south, past Bridgwater and Taunton and is
providing a focus for considerable development.

Taunton is the administrative centre and market town for much of Somerset.
Service and unobtrusive light industry provide the economic base.
Communications are easy with the M5 on the edge of town and there are direct
railway links to London and the Midlands. The journey to London takes
approximately 2 hours by rail. For a town of its size, Taunton has excellent
educational and recreational facilities and a thriving cultural calendar.

Recreational facilities include rugby, football, cricket, hockey, squash,

badminton, tennis, fencing, snooker, bowls, etc. There are a number of
municipal and private swimming pools and golf courses. Sailing, caving, diving,
hang-gliding, fishing, windsurfing and horse riding are all catered for locally and
there are many excellent routed country walks throughout the county.
Contractual Terms and Conditions

Audit

Participation in audit is encouraged- with full help from the department.

Clinical Governance

The clinical governance process is well established at all levels in the Trust. Each
directorate has a multidisciplinary Clinical Governance Group that meets regularly
and monitors and co-ordinates quality improvement activities.

Nature of Contract

This is a full-time post

Salary

The salary for this post is taken from the scale for DCTs as detailed in the Whitley
council Medical and Dental Staff handbook.

Starting salary will be determined in accordance with paragraphs 121 to 133 of the
Whitley Council Medical and Dental Staff handbook. Where incremental credit is
given for previous service, this will be subject to confirmation of such service.

DEFINITIONS

Duty is all time spent at work or being available to carry out tasks for the employer,
even if you are resting.

Work is all time spent actually working

Performing clinical duties including administrative tasks and time spent giving
advice on the telephone.
Substantial gaps between tasks should be recorded as rest.
Waiting to perform a clinical duty, for example a doctor waiting for the operating
theatre to be prepared should count this waiting time as work, a doctor notified of
a need to return to the hospital or unit but not immediately should count this
waiting time as rest.
Formal teaching/educational sessions including those held at lunch times.
 Natural breaks, which are very short.

Rest is all scheduled and unscheduled time spent not working (as defined above), for
example time spent at the doctors mess/rest area, sleeping, watching TV, reading
books etc

Staff Health Clearance & Exposure Prone Procedures

The successful candidate is required to complete Staff Occupational Health Service

forms and obtain clearance before employment may start.

The successful candidate will be required to provide documentary evidence of natural

or acquired immunity to hepatitis B. Where this is not possible, the postholder will be
required to demonstrate by recent (within the last year) evidence of serology showing
the absence of hepatitis B surface antigen. These provisions are to meet the
requirements of the Department of Healths Instructions to Trusts (HSG(93)40)

No employee will be permitted to undertake any Exposure Prone Procedures (EEP)

until Occupational Health confirmation has been obtained.

Criminal Record (Disclosure) Checks

The Trust aims to promote equality of opportunity for all with the right mix talents,
skills and potential and welcomes applications from diverse candidates. Criminal
records will be taken into account for recruitment purposes only when the conviction
is relevant.

As the Trust meets the requirements in respect of exempted questions under the
Rehabilitation of Offenders Act 1974, you are required to disclose details of any
cautions, reprimands or final warnings as well as convictions. Failure to disclose such
information at the time of application may result in dismissal

Accommodation
This post is non-resident on-call, a rest room can be provided if required. Please
contact the Porters Lodge on X 2626.

Annual Leave and Associated Rules

The annual leave entitlement is five weeks and two days per annum.

Bank Holidays

A doctor who is on-call on the night leading into a Bank Holiday (and is therefore
working between 12 midnight and the morning of the Bank Holiday) will be entitled to
a lieu day; as will a doctor whose on-call starts on the actual Bank Holiday.

Study Leave

Health and Safety Statement

It is the responsibility of all staff to be aware of their duties under the Health and
Safety at Work Act under specific local or departmental Health and Safety Policies.

Data Protection Statement

Any matters of a confidential nature, including particular information relating to

patients, their treatment and diagnosis, individual staff records, details of contract
prices and terms must under no circumstances be divulged or made available to any
unauthorised person(s). It is the responsibility of all staff to be aware of their
obligations in respect of the Data Protection Act 1998.

Postgraduate Medical Centre and Library

There is an active Postgraduate Medical Centre with three full-time administrative
staff and a busy Doctors dining room which acts as a focus for contact between
doctors at all levels and in all disciplines. Within the Postgraduate Centre there is a
well-stocked library with a full-time librarian and the usual audio visual aids and
complete research facilities. These include computer facilities for Medline searches
and Internet.

Two medical photographers are available for help in the preparation of material for
lectures and publications. There are weekly meetings for both hospital staff and
general practitioners.
 PERSON SPECIFICATION

ESSENTIAL DESIRABLE
Qualifications Full Registration with General
Dental Council or General
Medical Council
Relevant 1 -2 year post graduation
experience clinical experience
Clinical skills Experience of minor
dentoalveolar surgery
Audit skills Involvement in audit and
presented findings
Academic Part A MFDS or Part A
achievements MRCS
Personal skills Team Worker
Career intentions