Paediatric Emergency Medicine (PEM)

Sub-Specialty Training Posts 1

Recruitment Timetable

Apply from 20 February 2018
Closing date 8 March 2018
Interview dates 24 April 2018.

 Paediatric Emergency Medicine

Sub-Specialty Training Post in Paediatric Emergency medicine (to include PICU and general paediatrics) ST5-7

Applications are invited for sub-specialty training posts in Paediatric Emergency Medicine at ST5-7 level, based at Bristol Royal Hospital for Children at University Hospitals Bristol NHS Foundation Trust.

This post is due to commence in August 2018 for a duration of 12 months.

This post would be expected to rotate between Emergency medicine (6/12), PICU (3/12) and general paediatrics (3/12). The post is approved for subspecialty training in Paediatric Emergency Medicine.

This post does not come with a NTN therefore candidates who are applying from a training programme must be able to bring their NTN with them. We understand that approval for subspecialty training in Paediatric Emergency Medicine may be granted post CCT and therefore we would welcome applications from candidates who hold a CCT in Emergency Medicine. Educational support, including a study budget, will be provided to the successful candidate.

The Postgraduate Dean confirms that placement has the required educational and Dean’s approval. The post holder should be registered with the GMC.

Please note that in order to be eligible for subspecialty recognition the applicant must fulfil the essential criteria set by the college. Applicants not fulfilling these criteria but fulfilling the essential criteria for the post will be considered. These applicants should note that in this case subspecialty recognition cannot be approved retrospectively.

Candidates should discuss their intention to apply for this sub-specialty post with their Head of School and Training Programme before making an application.

If you require assistance with your application please email or telephone the candidate support line 01454 252610 between 8.30am and 4.00pm



University Hospitals Bristol NHS Foundation Trust

Bristol Royal Hospital for Children

Senior training post in Paediatric Emergency Medicine (including PICU and general paediatrics) at Bristol Children’s Hospital


1. The Post

This training post will be available for 12 months and will provide excellent training in Paediatric Emergency Medicine. The post would suit a senior trainee seeking accreditation in the subspecialty of Paediatric Emergency Medicine.

The post provides an ideal opportunity for the successful candidate to work in a busy inner city university foundation trust, coupled with the benefits of working in the South West tertiary paediatric referral hospital and major trauma centre.

The post is aimed at those individuals particularly interested in gaining subspecialty recognition in paediatric emergency medicine. The post does not come with a national training number and therefore those individuals currently on a training program must be able to bring their NTN with them. The post is recognised for training in PEM and we understand that recognition may be awarded post CCT for those who undertake this training. We would anticipate the post holder should be ST5 or above and either hold a national training number or have a CCT in emergency medicine, however other candidates from either an emergency or paediatric background will be considered on merit.


The post holder will primarily be based in the paediatric emergency department, however in order to fulfil the requirements of subspecialty recognition the post holder  will spend 3 months based on PICU, 6 months based in the paediatric emergency department and 3 months based on secondment to general paediatrics and paediatric specialties.. These placements will be divided into 3 month blocks and may occur in any order.


2. The Department of Paediatric Emergency Medicine


The Paediatric Emergency department sees a whole range of conditions both medical, surgical and trauma in children aged between 0 – 16 years. In 2017 the department saw 41,000 new patients of which ~20% were admitted. The Emergency Department observation unit admitted ~5500 patients.  The department is a designated paediatric major trauma centre. 

The department serves our local inner city population as well as receiving patients from other local hospitals for specialist emergency care. The Emergency Department assesses and treats all GP medically referred patients.The clinical facilities have recently been refurbished to a high standard and have allowed an increase in the capacity of the department.  The observation area is adjacent to the ED, comprises an 8 bedded unit and is the sole responsibility of the Emergency Department.

The paediatric ED is co-located with the adult ED for UHBFT but with physical separation of the waiting and clinical areas. The junior staffing is separate between the adult and paediatric EDs but there is cross departmental working by some consultant staff.


3. The Work of the Department


a. Senior Staff

            Dr Lisa Goldsworthy                  Consultant in Paediatric Emergency Medicine

            Dr Anne Frampton                    Consultant inAdult and Paediatric Emergency Medicine

            Dr Giles Haythornthwaite          Consultant in Paediatric Emergency Medicine

            Dr Will Christian                       Consultant in Paediatric Emergency Medicine

            Dr Nick Sargant                        Consultant in Paediatric Emergency Medicine (Clinical Lead)

            Dr Mark Lyttle                          Consultant in Paediatric Emergency Medicine

            Dr Paul Reavley                        Consultant in Adult and Paediatric Emergency Medicine

            Dr Rob Stafford                        Consultant in Adult and Paediatric Emergency Medicine

            Dr Rebecca Thorpe                   Consultant in Adult and Paediatric Emergency Medicine

            Dr Sam Milsom                         Consultant in Adult and Paediatric Emergency Medicine

            Dr Rachel Sunley                       Consultant in Paediatric Emergency Medicine

            Dr Dan Magnus                         Consultant in Paediatric Emergency Medicine

            Becky Ace                                Lead Sister in Paediatric Emergency Medicine

            Sue Humphries                          Matron for Paediatric Emergency Medicine


We have a mix of junior medical staff working in the department, including paediatric emergency medicine grid trainees, senior emergency medicine trainees undertaking paediatric emergency medicine sub-specialty training (this post), CT3s in emergency medicine, GPST1 and GPST2s, ST1 and ST2s in paediatrics and F2s.


This allows for 24 hour middle grade cover.  There is a consultant providing direct supervision to the department from 0800-0000hrs 7 days a week. 

b. Nursing Staff

Medical and nursing staff work together as one team within the department. This nter-professional ethos is actively encouraged.

The current nursing establishment is:



Band   7 posts (including ENPs)


Band   6 posts


Band   5 posts


Band   2 posts



  • Experienced nurses within the      department provide a 24 hour triage system
  • There is a dedicated Emergency      Nurse Practitioner service
  • A plaster technician and      physiotherapist are also available


4. The Bristol Royal Hospital for Children


The Royal Hospital for Children was founded in 1866 and is the second oldest Children’s Hospital in the country.  It is housed in a purpose-built building in the centre of Bristol next to the Bristol Royal Infirmary, the Medical School and main university complex.  It forms part of the University Hospitals Bristol NHS Foundation Trust.

It provides the main inpatient and outpatient service for central and southern Bristol, and is the site of the regional and supra-regional services in paediatric oncology, bone marrow transplantation, cardiology, cardiac surgery, paediatric surgery, intensive care, neurology, neurosurgery, burns and plastics, gastroenterology, endocrinology, respiratory medicine and clinical physiology.  The hospital is the designated regional paediatric major trauma centre for the south-west.  This is a fully consultant led service.

The Institute of Child Health, University of Bristol, is situated on the same site as the Children’s Hospital. Within the Directorate system of the UH Bristol, the full range of children’s secondary healthcare is contained in a single Directorate of Women’s & Children’s Services (Head of Division, Bryony Strachan; Divisional Manager, Ian Barrington).


5. Library and Education facilities


The UHBFT Education Centre, opened in August 2001, is situated opposite the Bristol Royal Infirmary and the Children’s Hospital.  It accommodates several Trust departments, including Postgraduate Medical Education, the Clinical Skills Centre, Resuscitation Services and the Learning Resources Centre, as well as the Bristol Medical Simulation Centre and the Institute of Child Health. The Education Centre also offers a range of training facilities for both formal lectures and group work.

The Bristol University Medical Library is 10 minutes walk from the BRI / BRHC precinct.

6.  Bristol Simulation Centre

The Simulation Centre is located directly across the road from the Bristol paediatric Emergency Department. We have close links with the Simulation Centre, where we organise regional teaching / training days for emergency medicine trainees, and other courses for emergency department staff.  Dr Dan Magnus, one of the paediatric emergency medicine consultants is programme director for the centre.


7. Duties and Responsibilities

The successful candidate will join a team of senior medical and nursing staff committed to providing excellent emergency services to the children of Bristol and the south-west. The common aim will be to deliver the highest quality of emergency care to patients whilst developing the department in all aspects of emergency clinical service, training and research. Close teamwork between senior medical, nursing and management staff is an essential requirement of this appointment.


a. Clinical

The appointee will be responsible for:

The reception, resuscitation, diagnosis and emergency treatment of patients presenting to the paediatric Emergency Department.

The department completes a ‘fit to ward’ protocol review of all tertiary patients before they are admitted to the relevant speciality ward (excluding PICU patients). However any patient who requires resuscitation (from whatever source) will have their treatment initiated in the Emergency Department

There is close liaison with PICU / paediatric specialist teams in the Children’s Hospital. Patients referred to Specialist Units within the hospital are the responsibility of that specialist team, who will see the patient in the Emergency Department and arrange appropriate care. However, medical and nursing staff in the ED are responsible for any emergency care necessary. This shared care is seamless and collaborative.

Responsibility will be given for the clinical supervision of the junior staff working within the Department, as well as the organisation and delegation of clinical work. 

An Emergency Consultant will be in charge of the Emergency Department in the event of a major incident. However, prior to their arrival a doctor of the middle grade tier will provide this role.

Emergency admissions to medical, surgical or trauma beds within the hospital will be the responsibility of the appropriate physician or surgeon on-call for that day

The appointee will share responsibility with his/her Emergency Medicine colleagues for patients admitted to an ED Observation Area.

All patients with fractures who require follow-up are referred to the orthopaedic department.


b. Teaching

Protected consultant lead teaching is provided each week. Currently this is 1-3pm on Tuesday afternoons and includes regular simulation. The topics addressed cover all aspects of paediatric emergency care.


c. Managerial

Whenever possible clinical practice will be standardised and evidence based. Protocols for referral and admission will be agreed with the inpatient teams, but the aim will be to develop uniform policies wherever possible.

The successful applicant will assist in the management of rosters etc by agreement.  He/she will also help maintain focus to achieve patient flow through the department.


d. Clinical Governance, audit and research

Clinical audit is established at the UHBFT. The appointee will share responsibility for clinical governance. They will participate in the active monthly subject and review process and attend interdisciplinary clinical governance meetings.  The paediatric emergency department is committed to undertaking research into aspects of paediatric emergency medicine.  The successful candidate will be expected to partake in research projects whilst working in the department.


8. Conditions of Appointment:


  1. The appointment will be subject to the Terms and Conditions of Service of Hospital Medical and Dental Staff (England and Wales) as amended from time to time with the exception of paragraphs 20(e) Hours protection, paragraph 21 Pay protection and paragraphs 251& 252 Study Leave, where local procedures are in place.
  2. Whole time appointment: The practitioners hours of duty shall be the standard working of 40 tandard hours.
  3. The basic salary is the NHS salary scale for equivalent to Speciality Registrars (2017)
  4. The successful applicant 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 instruction to Trusts (HSG(93)40).
  5. The postholder must be a fully subscribed member of the General Medical Council.
  6. Study Leave will be at the discretion of the department and Directorate of Children’s Services.
  7. Holidays are not rostered at present but cover is prospective and adequate notice must be given of     requests (minimum 6 weeks) which will be accommodated where ever possible but with consideration for the requests of all and the needs of the service. Locum cover is not provided for Annual leave.  




9. Protection of Children:

Disclosure of Criminal Background of those with Access to Children

The person appointed to this post will have substantial access to children as defined in the joint circular No HC(88)9, HOC8/88 and WHC(88)10. Applicants are therefore advised that shortlisted candidates will be asked to complete a form disclosing any convictions, bind-over orders or cautions, and to give permission in writing for a police check to be carried out. Refusal to do so could prevent further consideration of the application. Attention is drawn to the provisions of the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 as amended by the Rehabilitation of Offenders Act 1974 (Exceptions) (Amendment) Order 1986 which allows convictions that are spent to be disclosed for this purpose by the Police and to be taken in to account in deciding whether to engage an applicant. Candidates are assured that the completed form will be treated with strict confidentiality and will not be disclosed to the Appointment Committee until the successful candidate has been selected. A police check will only be requested in respect of the candidate recommended for appointment. All forms completed and returned by other candidates will be destroyed when the final selection of the candidate to be recommended for the appointment has been made.


10.General Information


a. Job descriptions

All job descriptions are subject to review.  Job holders are expected to be flexible and be prepared to carry out any similar or related duties which do not fall within the work outlined.  Any review will be undertaken by the line manager, in consultation with the post holder.


b. Health and safety

Under the provisions contained in the Health and Safety at Work Act 1974, it is the duty of every employee to:

  • take reasonable care of themselves and for others at work
  • to co-operate with the Trust as far as is necessary to enable them to carry out their legal duty
  • not to intentionally or recklessly interfere with anything provided including personal protective equipment for Health and Safety or welfare at work.

c. Senior Management (including Clinical Directors and General Managers)

Senior Management is responsible for the implementation throughout the Trust of suitable arrangements to ensure the health, safety and welfare of all employees at work and the health and safety of other persons who may be affected by their activities.

Where health and safety matters cannot be resolved at Senior Management level the appropriate Executive Director must be notified.


d. Line Managers

Each manager is responsible for the health and safety management of all activities, areas and staff under their control.  This includes responsibility for ensuring risk assessments are completed and implementation of suitable and sufficient control measures put in place.

Health and safety issues are dealt with at the lowest level of management practicable.

Where health and safety matters cannot be resolved at a particular management level the appropriate Senior Manager must be notified.


e. Clinical governance

Clinical Governance is the framework through which this Trust is accountable for continuously improving the quality of its services and safeguarding the high standards of care.  It does so by creating and maintaining an environment in which excellence in clinical care will flourish.


Every member of staff must work within this framework as specified in his/her individual job description.  If you have concerns on any clinical governance matters these should be raised with your line manager, professional adviser, or a more senior member of management.  Your attention is also drawn to the Trust guidance on Raising Concerns about Provision of Patient Care.


f. The Working Time Regulations 1998

You are required to comply with Trust policy on implementation of the Working Time Regulations, including declaration of hours worked and breaks taken, completing written records if required, and reporting any instances where your pattern of working hours may constitute a health and safety risk to yourself, patients, the public an other Trust employees. You have the right not to be subjected to any unlawful detriment by reporting any concerns under the Regulations.


g. Additional Work

You are required to disclose any additional workyou undertake or are planning to undertake for another employer.  The Trust will permit you to undertake this additional work providing the Trust is satisfied that this does not conflict with the interests of the organisation, performance of your normal duties or with the requirements of the Working Time Regulations.


11. Arrangements for applicants visiting the Hospital and meeting members of staff

Prospective candidates are welcome to contact Dr Nick Sargant (Clinical Lead) or Dr Sam Milsom (PEM Lead for Severn School of Emergency Medicine) on 0117 3428187 for further information.