CONSULTANT general Physician
WITH AN INTEREST IN Respiratory Medicine (2 Posts)
Clyde Sector
INFORMATION PACK
REF: 49661D
CLOSING DATE: 5TH JANUARY 2018
SUMMARY INFORMATION RELATING TO THIS POSITION
POST: CONSULTANT IN RESPIRATORY MEDICINE (2 POSTS)
BASE: CLYDE SECTOR
Applications are invited for the above posts based at Inverclyde Royal Hospital. These posts represent an exciting opportunity to strengthen and develop our Respiratory Service across the Clyde Sector whilst providing clinical excellence and senior clinical leadership. The successful candidates will be encouraged and supported to expand the Service in the direction of their chosen specialist field, e.g. Interstitial Lung Disease/Pleural Service.
It is expected that the successful applicants will have a high clinical profile with the drive and initiative to achieve and sustain the highest standards of medical care for the local population.
The appointed candidates will work within the Emergency Care and Medical Services Directorate as part of the Clyde Sector which is currently planning how future services may look and be delivered in the medium to long term. Consultant staff have been integral in developing these plans.
The posts will offer nine direct clinical care sessions in Respiratory and General Medicine with one SPA and will involve participation in the general medical on-call rota. The successful candidates will be joining a dynamic team of Consultant Physicians who have recently redesigned the receiving medical process which has significantly improved patient safety and flow on both sites. In addition they will join the existing Clyde respiratory service that currently has 7 Consultants. Respiratory outpatients will be seen at Inverclyde Royal Hospital.
MRCP UK or equivalent qualification is essential and you must have full GMC registration with the GMC and a licence to practice. Those trained in the UK should have evidence of higher Specialist Training leading to a CCT in Respiratory and Acute General Medicine or eligibility for specialist registration (CESR) or be within six months of confirmed entry at the date of interview. Non UK applicants must demonstrate equivalent training
The post holder will be required to maintain and develop the respiratory service and work with colleagues to progress service delivery for patients across Clyde.
Informal enquiries to:Dr Dave Sharma, Consultant in Respiratory Medicine via email () or telephone (01475 505248) or Dr Louise Osbourne, Lead Consultant via email (louiseosborne.net) or telephone (01475 50450)
Consultant in Respiratory Medicine (2 Posts)
Clyde Sector
General Information
Inverclyde Royal Hospital is a modern district general hospital in Greenock, and serves the Inverclyde District (Greenock, Gourock, Wemyss Bay and Port Glasgow), parts of North Ayrshire, Isles of Bute and Cumbrae, and the Cowal Peninsula, with a total population of approximately 130,000. The hospital has 239 acute beds and was opened in 1979. A variety of major specialties are represented within the hospital including a PFI-funded Medicine for the Elderly Unit comprising of around 90-bedded in Larkfield (on campus) and an acute stroke unit with 17 beds. There is also an 8 bed Physically Disabled Rehabilitation Unit in the Larkfield Unit
There are close clinical links with the strong community infrastructure and with the other acute hospitals within Clyde Division; the Vale of Leven, Alexandria and Royal Alexandra Hospital, Paisley and the hospitals / university hospitals in the North and South of Glasgow.
Greenock is situated 30 minutes from Glasgow, amid superb coastal and mountain scenery with excellent transport links. The area offers excellent residential accommodation and first class state and private schools.
The district has excellent recreational activities including fabulous sports facilities, sports-centres, indoor and open air pools, playing fields and is particularly fortunate with outstanding golf courses and opportunities for sailing. The area also has a modern shopping centre, and is within easy rail, bus and motorway links to Glasgow and Edinburgh.
The Royal Alexandra Hospital (RAH) is situated in Paisley and provides acute health care services to Renfrew District (pop 205,000). The Hospital is a 968 bed modern District General Hospital (DGH) which opened in 1986 and is one of the largest and busiest teaching DGHs in Scotland. In addition, the hospital is currently the base for provision of surgical, orthopaedic and also the majority of maternity services to the population north of the Clyde served by the Vale of Leven Hospital.
The hospital provides a wide range of District General Hospital specialties with excellent support facilities. The hospital has a first class modern radiology department and services. All departments participate in undergraduate teaching and there is an active postgraduate educational programme. The hospital enjoys an enviable reputation for undergraduate teaching and is highly popular with training grades. There is also a good medical library service.
The Medical Unit
The Medical Unit at Inverclyde Royal Hospital consists of a 30 bedded Acute Medical Receiving Unit and three general medical wards totaling 116 beds. In addition, there is an 11 bedded Coronary Care Unit and 4 bedded HDU and 3 bedded ITU. The Renal Unit opened in 2000 and expanded to 12 haemodialysis stations in 2007. There is also a Haematology and Oncology Day Bed Unit. The Medical Unit provides an acute service in general medicine with clinics in Diabetes & Endocrinology, Gastroenterology, Cardiology, Rheumatology, Respiratory Medicine and Haematology and visiting consultant clinics in Nephrology and Neurology.
The Medical Unit at the Royal Alexandra Hospital has 209 beds. This includes an 18 bedded Coronary Care / Chest Pain Unit, a 30 bedded medical receiving ward and Medical Assessment Unit and evolving ambulatory care pathway. The medical unit provides an acute service in general medicine with clinics in general medicine, diabetes and endocrinology, gastroenterology, cardiology, asthma, respiratory medicine and haematology.
Consultant Staffing
In addition to the current post, there are fourteen consultant physicians based at IRH with special interests as noted.
- Dr Helen PapaconstantinouCardiology
- Dr Omar HasanCardiology
- Dr Andrew McCullochCardiology
- Dr Angela Wright/ Vacancy Respiratory
- Vacancy Respiratory
- Dr Dave Sharma Respiratory
- Dr Chris Jones Diabetes and Endocrinology
- Dr Louise Osborne Diabetes and Endocrinology
- Dr Mohamed Azharuddin Diabetes and Endocrinolgy
- Dr Abdalla Hassan Gastroenterology
- Dr Mohammed Hamed Gastroenterology
- Professor David MarshallRheumatology
- Dr Lisa Hutton Rheumatology
- Dr Nma Campbell Rheumatology
- Dr Laura ConnellRheumatology
- Dr Paul LawsonGeriatric Medicine
- Dr Fiona JohnstonGeriatric Medicine
- Dr Javed AkhtarGeriatric & Stroke Medicine
Coronary Care is covered Monday to Friday by the Consultant Cardiology team and by the on-call Physicians at weekends, with support from the Golden Jubilee National Hospital (GJNH) for primary coronary angioplasty and out of hours pacing.
Consultant Dermatologists, Dr C Fitzsimmons, Dr I Hay, Dr Milligan and Dr May, run a busy Dermatology Ambulatory Care Treatment Centre with their own dermatology middle-grade staff.
Dr C Geddes and Dr M Woo Consultant Nephrologists based at the Western General Infirmary (WIG) visit the Renal Unit twice weekly and run a renal clinic from within the unit with one Associate Specialist in support. Consultant Neurologists Dr Jack and Dr Selvarajah also provide weekly support to the hospital.
Based at RAH there are currently 28 Consultant Physicians with special interests as detailed below:
Dr Iain FindlayCardiology
Dr Stuart HoodCardiology
Dr Clare MurphyCardiology
Dr Eileen PeatCardiology
Dr Alastair CormackCardiology
Dr Keith RobertsonCardiology
Prof Martin McIntyreDiabetes and Endocrinology
Dr Clare HarrowDiabetes and Endocrinology
Dr Neil McGowanDiabetes and Endocrinology
Dr Chris SmithDiabetes and Endocrinology
Dr Graham NaismithGastroenterology
Dr Riz HamidGastroenterology
Dr Mathis HeydtmannGastroenterology
Dr Selina LamontGastroenterology
Dr Zia Mustafa Gastroenterology
Dr Laura Clark Gastroenterology
Dr Beth ReedGastroenterology
Dr Natasha McDonaldGastroenterology
Dr Lindsey McClure Respiratory Medicine
Dr Jane GravilRespiratory Medicine
Dr Douglas GrieveRespiratory Medicine
Dr Yi LingRespiratory Medicine
Dr Matthew Embley Respiratory Medicine
Dr Iain KeithAcute Care Physician
Dr Chris FosterAcute Care Physician
Dr Gautam RayAcute Care Physician
Dr Hannah Simpson Acute Care Physician
Dr Abigail GunnAcute Care Physician
Dr Martin Perry Rheumatologist
Dr Taha AkhterRheumatologist
Junior Medical Staff
Junior staff are provided by Scotland Deanery, West Region training programmes, across all grades and a combination of staff grade doctors and clinical fellows.
RAH Middle Grade Doctors 29
RAH Foundation 1 and 2 doctors 27
IRH Middle Grade Doctors 14
IRH Foundation Doctors 12
There are Specialist Nurses in Diabetes, Respiratory Medicine, Cardiac Rehabilitation, Cardiac Failure, Haemato-Oncology, D.V.T and Chest Pain management and Inflammatory Bowel Disease across Clyde.
Acute Medical Services
Acute Receiving/Specialty Medicine
Both Doctors and Nurses in medicine work very closely and priority is placed very firmly on patient safety. This can be evidenced by ward and hospital huddles, safety briefings, the implementation of the deteriorating patient and sepsis 6 work streams.
The clinical teams are led by a dynamic, enthusiastic and supportive Consultant team, lead nurse and clinical service manager where improvements and developments to patient care are encouraged and facilitated. Each Consultant is encouraged to lead on an area of work where clinical leadership is necessary e.g. case note audits, SPSP, deteriorating patient, AWI etc.
At IRH Acute medical admissions are admitted to ward J North (30 beds), which is staffed by one of the consultants on a rotating basis. The on-call physician will commence receiving at 1300hrs and remain on the ward until 2000hrs. On-call continues from home and the Consultant is once again based in the ward from 0900hrs – 1400hrs. Patients are then triaged to the appropriate specialty wards if not for early discharge. There are three general medical wards, G North (30 beds), G South (34 beds), J South (22 beds) which receive patients form the Acute Medical Receiving Ward. These wards are supported by the different specialty consultant staff and their teams of junior doctors.
At RAH, GP referred medical patients are triaged from the Emergency Department to the Medical Assessment Unit at Royal Alexandra Hospital Monday to Sunday 8am to 10pm. All patients are reviewed by a senior doctor of whom 50% are subsequently discharged home. Patients requiring admission can be admitted to the relevant specialty bed direct from MAU. A re-design of front door assessment is currently underway on the RAH site in order to provide early specialist review and support ambulatory pathways of care.
Acute medical admissions are admitted to the Acute Medical Unit (ward 2) at the RAH, which is staffed by one of the consultants on a rotating ‘Physician of the Week’ basis Monday morning to Friday lunchtime and an Acute Care Physician. Patients are then triaged to the appropriate specialty wards if not for early discharge. Separate rotas are in place to cover weekend acute and continuing care.
Coronary Care Unit
Patients with acute myocardial infarction, acute coronary syndromes, arrhythmias or congestive cardiac failure are admitted to the Coronary Care Unit. Staffed during the day by one of the cardiologists on a rotational basis, and supported by junior medical staff. Cardiology services are supported by the Golden Jubilee National Hospital which provides primary percutaneous coronary intervention service and out of hours temporary cardiac pacing from Glasgow.
Junior Doctors Out-of-Hours
A Hospital at Night and Weekend service commenced in August 2006, and medical staff covering the out of hours period are required to lead and participate in this team, as well as attending the hand over. A hospital handover takes place every night led by the senior medical Doctor.
Medicine for the Elderly
Medicine for the Elderly is part of the Rehabilitation and Assessment Directorate, however many of its activities are combined with Adult Medicine. In particular, the out of hours cover is provided by junior doctors from Medicine for the Elderly and Adult Medicine.
Respiratory Services
Respiratory Services within Clyde provide outpatient services in Inverclyde Royal, the Royal Alexandra and Vale of Leven Hospitals.
There are dedicated clinics for lung cancer, asthma, sleep, pulmonary fibrosis and COPD / general respiratory.Bronchoscopy clinics are carried out at IRH and RAH.
Medical Staff
The advertised posts are to join the existing medical team that consist of three Consultants at IRH and 5 Consultants at RAH. One of our posts is to fill a vacant post and the second post is as a result of service development/redesign. Consultants are supported by two middle grade junior doctors and ward based cover provided by anFY1 doctor. The Middle Grade Doctors provide ward cover and clinic cover.
This Consultant team is supported by Specialist Nurses hwohave played a pivotal role in the development of the respiratory service over recent years including and are a dynamic resource to Consultants, doctors, nurses and patients. They lead and are involved in the following
- Education of patients, carers and healthcare professionals in all aspects of respiratory illnesses.
- Admission avoidance
- Early supported discharge
- Long term oxygen therapy assessments
- Flight assessments
- Supporting staff, patients and carers with the NIV service
- Pulmonary rehabilitation
- Tele-health
- General outpatient respiratory clinics
- Advice Line for patients and Healthcare Professionals
Other Specialist Staff
The department is supported by a pulmonary function service and physiotherapy staff.
In addition there is also a dedicated team of administrative and clerical staff who support service delivery and patient care.
Clinics
There are a range of out-patients clinics operating across Clyde.
Within Inverclyde Royal Hospital the Respiratory Physicians have a share of the acute medical beds. These are centred on the Ward J North, the acute receiving ward and ward G South (15 beds shared between two consultants). There are comprehensive HDU and ITU services with a strong anaesthetic support team available for patients who may require escalation of care.
Management Arrangements
Emergency Care and Medical Specialties at Inverclyde Royal Hospital is part of the Emergency Care and Medical Specialties Directorate, Greater Glasgow and Clyde wide. Emergency Care and Medical Specialties within Inverclyde Royal Hospital consists of Accident and Emergency and General Medicine.
The Consultant Physicians, Geriatricians, Haematologists and Dermatologists combine to form the Division of Medicine. The consultant appointed will be expected to participate fully in the work of the Division and Directorate.
The management of the directorate is as follows:
Marie Farrell – Director Clyde Sector
Dr Chris Jones - Chief of Medicine Clyde Sector
Dr Lisa Hutton - Clinical Director for Emergency Care and Medical Services,
Clyde
Dr Louise Osbourne, Lead Consultant for Medical Services, Inverclyde Royal Hospital, Dr Jane Gravil, Lead Consultant for Medical Services based at the Royal Alexandra Hospital.
Mrs Jacqueline Nicol - General Manager, Emergency Care and Medical Services Clyde supported by Mrs Debbie Hardie and Mr Gerry Wright, Clinical Service Managers.
The management team consist of progressive and innovative individuals, keen to support Consultants and clinical staff to develop services and contribute to improvements in patient care.
Summary of the Post
Respiratory
The posts of Consultant Physician with a specialist interest in respiratory medicine will provide a consultant-led, accessible respiratory service. The post holder will perform 3 respiratory clinics per week; (combined new and return) and will be supported to develop sub specialty interests.
It is envisaged that the successful appointees will support the development of services across Clyde in the future and may wish to hold clinics on multiple sites depending on service need.
The post holder will take responsibility for the in hours care of respiratory and general medical patients. Out of hours cover being provided by the physician on-call. The department is involved in both undergraduate and postgraduate teaching and the consultants appointed will be expected to contribute to this.
Acute Medicine
The successful candidate will be expected to provide a full range of consultant services as agreed with colleagues including in-patient management of patients admitted to the Medical Wards and also Coronary Care Unit out of normal working hours.
Each consultant is on-call for emergency admissions from 1300hrs to 1400hrs the following day at Inverclyde Royal Hospital. This is a fixed rotation and is planned for twelve months in advance. The numbers of patients admitted as medical emergencies is approximately 25 patients per day rising to around 35 if particularly busy.
Suggested Timetable
A work programme for the week will be negotiated and agreed with the successful candidates. The core working week will be based on 9.0 PA’s of Direct Clinical Care (DCC) duties and 1.0 PA of SPA time. This includes on-call commitment that attracts a 3% supplement that is included in the final pension.
The successful candidates will have respiratory sub-specialty interests supported if relevant to the long term plans of the respiratory Service and the Department of Medicine.
Suggested job plan
This job plan is negotiable and will be agreed between the successful applicant and the Clinical Director. NHS Greater Glasgow & Clyde initially allocates all full time consultants 10 PAs made up of 9 PAs in Direct Clinical Care (DCC) and one core Supporting Professional Activities (SPA) for CPD, audit, clinical governance, appraisal, revalidation, job planning, internal routine communication and management meetings. The precise allocation of SPA time and associate objectives will be agreed with the successful applicant and will be reviewed at annual job planning.
The job plan will be tailored to the successful candidate’s interests and the following should be taken as a guide.
Duty /PAs
In patient work and administration / 4Out patient work and administration / 4
SPA / 1
Out of Hours On Call / 1
TOTAL / 10
AM / Day / PM
Ward round / Monday / Clinic
Admin / Tuesday / Clinic
Ward round / Wednesday / SPA
Clinic (alternate weeks) / Thursday / Admin
Bronchoscopy / Friday / Clinic
On Call Duties
The appointees will be expected to take a share with the existing Consultant Physicians of the general medical workload in terms of out of hours cover.