RURAL GENERAL HOSPITAL
CONSULTANT
GENERAL SURGEON
1. THE WESTERN ISLES
The Western Isles lie approximately 30 miles off the West Coast of Scotland and consist of many small islands in the Outer Hebrides. The main ones being Lewis, Harris, the Uists and Barra with a total population of 26,500. They are easily accessible by ferry from Ullapool, Skye and Oban and by air from Ullapool which runs in conjunction with the ferry timetables and links with rail services from Inverness.
Stornoway is the administrative “capital” of the Western Isles. It has a population of approximately 8,000 and has all the facilities one would expect to find in a town of this size. There are many primary schools on the islands as well as secondary schools. They are all provided through the Lews Castle Technical College which is part of the University of the Highlands & Islands. Degree courses are available at the College.
2. WESTERN ISLES HOSPITAL
The Western Isles Hospital is a general rural hospital serving the Outer Hebrides area. The hospital was opened in 1992, is modern and well equipped. The main bug hospital is in Stornoway with 96 beds covering specialities in General Medicine, General Surgery, Orthopaedics and Trauma, Obstetrics & Gynaecology, Psychiatry, Paediatrics and Radiology.
The Hospital has an up-to-date laboratory service covering the main disciplines of haematology, microbiology and clinical chemistry with ready access to more specialized investigations at Raigmore laboratories and other specialized laboratories in Scotland.
The Radiology Department is well equipped for routine radiology, CT scanning, ultrasound and Doppler studies.
Locally based consultant services
· General Medicine
· General Surgery
· Orthopaedics
· Anaesthesia
· Paediatrics
· Obstetrics & Gynaecology
· Psychiatry
· Radiology
· Dental Services
Visiting Consultant Services
· Respiratory Medicine
· Rheumatology
· Dermatology
· Oncology
· Neurology
· Ophthalmology
· Renal Medicine
· Otolaryngology
· Urology
· Child & Adolescent Mental Health
Tertiary referrals
The main referral centres are in Inverness and Glasgow, but hospitals in Edinburgh and other hospitals in Scotland are used when necessary in accordance with established referral management system.
3. DEPARTMENT OF GENERAL SURGERY
Local Surgical services based in Western Isles Hospital include general surgery, orthopaedics and gynaecology. The general surgical service is provided for the population of the Western Isles which meets both elective and emergency needs.
Visiting surgeons from Inverness (NHS Highland) provide ENT, ophthalmology and Urology services.
The locally based surgeons provide a general surgical service which includes: gastrointestinal endoscopy, laparoscopic cholecystectomy, large bowel disease and basic urology. Some major general surgery and surgery in patients with severe concomitant medical disease is transferred to larger surgical units on the mainland.
The main base is the Western Isles Hospital in Stornoway but outpatient clinics and outreach services are also provided in the Uist and Barra Hospital in Benbecula. There will be GI endoscopy sessions in Uist and Barra Hospital in Benbecula from January 2015. The responsibility for these outreach services is shared amongst the three surgeons.
There are no surgical in-patient facilities within St Brendans Hospital, Barra.
The organisation of surgical services within NHS Western Isles is kept under regular review in response to population health needs, national targets and guarantees. Close working with other surgical specialties and input to the overall modernisation programme for the hospital will be among the areas that successful candidates will contribute to.
Workload
General Surgery deals with around 1,000 inpatients and 900 day cases per year. There are 1 – 4 (average 1.5) emergency admissions per day. The bed occupancy runs at 70 – 75%.
There are approximately 1,300 new outpatients per year and some 2,000 ‘return’ patients. Our outpatient waiting times are shorter than the national average and we continue to meet the TTG for inpatients.
Timetable
The General Surgical Unit provides the following services:
In-patient care relating to emergency and elective patients with 18 in-patient beds, 2 High Dependency Area beds and a 12 bed day care unit.
Ward rounds
Monday, Tuesday, Thursday and Friday 0830 onwards (usually 0915 -0930)
Wednesday teaching ward round combined with unit business meeting 0930 – 1030
Weekends (on call consultant) 0900/0930 onwards.
Consultant availability for patient problems throughout the day with particular requirement to see sick patients in HDU, wards and A&E departments and see in- hospital referrals.
Operating Theatre sessions
Operating theatre capacity and utilisation is kept under regular review and reflects the most efficient and effective response to patient needs.
General Anaesthetic - Monday, Thursday and alternate Fridays (at present used for GI endoscopy) 0930 - 1600
Local anaesthetic – Minor Operations Thursday 1400 - 1600
Endoscopy
Monday and Thursday (at present alternate Fridays) 0930 – 1400
Out patients
Parallel morning and afternoon clinics on Tuesday Scheduled 0930 – 1300 and Wednesday 1400 – 1630
Urology
Every three months Consultant urologists from Raigmore Hospital in Inverness come to the Western Isles Hospital for outpatient clinics and perform operating sessions over a two day period. These sessions are within the surgical schedule.
There is a monthly visiting oncology service from Raigmore. A video link paediatric surgical consultation takes place with the Royal Hospital for Sick Children in Glasgow once per month.
The General Surgical Consultants have educational, training and supervisory responsibilities for one Foundation Year 1 House Officer, one Core Surgical trainee, one GPST trainee (Mixed Surgical Specialities) – 5 weeks every 4 months, phase IV Aberdeen University undergraduate students for 20 weeks/year, one Phase V Edinburgh University undergraduate student, other undergraduates as and when clinical attachees as required
A videolink gastrointestinal malignancy multi disciplinary team meeting trakes place every Friday. It involves Surgeons, Oncologists, Physicians, Histopathologists and Radiologists from Raigmore Hospital in Inverness, the Belford Hospital in Fort William and the Caithness General Hospital in Wick.
Uist and Barra Hospital (UBH)
On alternate Thursdays there is an Outpatient Clinic at UBH. This requires a day trip by air. From January there will be a requirement to perform endoscopies at UBH. Therefore the frequency of attendance will increase to twice monthly.
A job plan will be agreed and renewed annually with the consultant to incorporate the above mentioned service commitments and to reflect patient/service demands.
Undergraduate/Postgraduate Training
Medical students from the Universities of Aberdeen and Edinburgh, other UK and EU Universities and commonwealth countries are regularly attached to the department throughout the year. The post holder will be expected to contribute in teaching medical students and in training junior staff.
The Western Isles Hospital has an active and enthusiastic undergraduate and postgraduate training programme.
The medical department runs a regular weekly lunchtime (Tuesday) meeting.
The post holder will have a computer in his/her office with access to appropriate clinical and other systems.
Research
The Board encourages and where possible gives assistance to the pursuit of research by consultant staff.
Rehabilitation Services
There is a modern physiotherapy, occupational therapy and speech therapy department. These departments also provide services in the community.
Diagnostic services
The Laboratory in the Western Isles Hospital provides haematology, blood transfusion, biochemistry and microbiology services. Raigmore Hospital, Inverness provides consultant haematological and histopathological services.
The Radiology Department is modern with fully digitized imaging, ultrasound, Doppler scanning and a 64-slice CT scanner. The department is fully integrated with PACS.
Outpatient Facilities
There are excellent outpatient facilities within the hospital. Visiting consultants from Inverness and Glasgow (see above) support various subspecialties.
Main Conditions of Services
1 The post is subject to the Terms and Conditions of Services for Hospital Medical and Dental Staff (Scotland), as amended from time to time.
2 Subject to agreement of a satisfactory job plan the Contract will be for 10 (8:2) Programmed Activities per week. The Health Board may offer up to 2 extra programmed activities according to diaried on-call activity. The salary will attract an 8% availability allowance.
3 Residence – the successful applicant will be required to reside within 10 road miles of the Western Isles Hospital.
4 Where relocation assistance has been agreed, the Board’s Policy on Removal and Associated Expenses will apply and further details will be provided as and when required.
5 For pre-employment health assessment purposes, as part of the Board’s Occupational Health Service, the successful applicant will be required to complete a health questionnaire. This will be treated in strict confidence. The successful applicant will be required to undergo a medical examination.
6 Active participation in SPSP with effective implementation of local and/or nationally agreed systems of care/care bundles.
7 Compliance with all approved Board policies and procedures
8 Annually revised and agreed job plan. The Job Plan will essentially be driven by the evolving and changing needs of the patients and services.
9 Theatre sessions may be required across the 7 days of the week in order to meet the TTG and the needs of patients
Study and Training
Study leave entitlement is a maximum of 30 days including off duty days within the leave period, in any period of three years, in relation to leave with pay and expenses in the UK. Priority will be given to CME.
Rehabilitation of Offenders
Because of the nature of this work, the post is exempt from the provisions of Section 4(2) of the Rehabilitation of Offenders Act 1974 (exemptions) Order 1975. You are therefore not entitled to withhold information about convictions, which for other purposes are “spent” under the provisions of the Act, and any failure to disclose such convictions could result in disciplinary action by the Board. Any information given will be kept in strict confidence, and used only in relation to the position to which the order applies.
Visiting Arrangements
Prospective applicants are encouraged to visit the hospital and to meet the Consultants. Informal enquiries to: Dr Angus McKellar (01851 708050) or email:
PERSON SPECIFICATION
FACTOR / ESSENTIAL / DESIRABLE /1. ATTAINMENTS: e.g. education, qualifications or training / Primary medical degree FRCS or equivalent
On Specialist Register or within 6 months of CCT / Higher degree by examination or thesis
2. KNOWLEDGE: e.g. procedures, techniques, legislation, new technology / Capable of independent practice in all aspects of general surgery.
Some experience in colonoscopy. / Expertise in the management of anal canal disease and faecal incontinence
Experience of diagnostic urology (cystoscopy)
Completed JAG recognised training re colonoscopy
3. WORK EXPERIENCE: e.g. level, knowledge acquired as a result of training/education, responsibilities / To have worked in broad based general surgery at a senior level / Management experience
4. SKILLS: e.g. secretarial, manual, mechanical, computer, supervisory, management, specialised / Ability to take on responsibility for educational and clinical supervision of a Foundation year 1 doctor, a Core Specialist Trainee and a General Practice Specialist Trainee.
Teaching and supervision of undergraduate medical students.
Audit / Attended appropriate SCOTS courses
Computer literacy
Knowledge of wider aspects of remote and rural health care.
5. DISPOSITION: e.g. decisiveness, stress tolerance, initiative, judgement, persistence, dependability / Able to work as a member of a team
6. INTERESTS: e.g. intellectual, physical, social, artistic
7. OTHER: e.g. health, appearance, manner, car driver, special demands of post, e.g. to work unsocial hours/on-call/areas covered / Good health record, smart appearance, car driver, able to work unsocial hours and on-call
In the event that an otherwise appointable candidate does not have one of the essential criteria and this skill may be acquired through a period of further training, consideration may be given to offering a “proleptic appointment”.
December 2014
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