Dumfries and Galloway

Contents

Page

The Post2

The Department of Anaesthetics2/3

-Education, Research and Audit4

-Description of Programmed Activities and On-Call Commitments4/5

Dumfries and Galloway Region6

NHS Dumfries & Galloway7

-Structure7

-NHSD&G Corporate Aims7

-Staff7

-Services8

-Dumfries and Galloway Royal Infirmary8

-DGRI Education Centre 9

-DGRI Future Re-development 9

-Galloway Community Hospital10

-Midpark Hospital10

-Cottage Hospitals10/11

Qualifications11

Terms & Conditions of Service11/12/13

Enquiry Arrangements13

Selection Criteria14

Relocation 15

Dumfries and Galloway Royal Infirmary

CONSULTANT ANAESTHETIST

THE POST

This is a replacement post for a colleague who is retiring in the near future. The successful candidate will join a team which comprises 15 Consultants, 6 Specialty Doctors and 5 trainees.

THE DEPARTMENT OF ANAESTHETICS

The Anaesthetic Department is based at Dumfries and Galloway Royal Infirmary, the district general hospital for the Dumfries and Galloway Region.

There is a modern 6 theatre operating department suite with recovery area and an adjacent endoscopy/day case suite with 20 trolley spaces and two endoscopy rooms. In addition there is an ophthalmology operating theatre adjacent to the ophthalmology ward and an obstetric operating theatre in the Birthing Suite. Equipment in Theatres is of a high standard with all anaesthetic machines equipped with electronic flowmeters/end tidal control; BIS and videolaryngoscopes in each theatre;fibreoptic bronchoscopes,oesophageal Doppler andultrasound facilities for regional anaesthesia readily available.

The Intensive Care Unit is staffed for four level 3 patients and is well equipped, currently with Evita ventilators, Philips monitoring and Oesophageal Doppler, PICCO and echocardiography available. Multi-modality renal support is used. The Intensive Care Unit runs a closed model and is staffed by 6 Consultant Anaesthetists with an interest in Critical Care on a ‘week at a time’ daytime rota. The unit actively participates in audit and multi centre research.There is a separate 4 bed Surgical High Dependency Unit and an 8 bed Medical High Dependency/Coronary Care Unit which are currently run as an open model with support from Anaesthesia and Intensive Care when requested. There is full Medical Physics back-up, day and night for all departments.

There is a well established Specialist Nurse led Acute Pain Service with Consultant Anaesthetist support.

The regional Emergency Department is supported by the Department of Anaesthesia and Intensive Care in resuscitation and stabilisation of patients in the Emergency Department and on occasions is responsible for transport of critically ill patients to tertiary centres, particularly for neurosurgical and cardiothoracic intervention.

The multidisciplinary chronic pain service is led by two consultant anaesthetists with interest in chronic pain, with out-patient clinics and dedicated theatre sessions to perform interventions. There are links with the acute pain and palliative care services,General Practitioners and the voluntary sector.

In addition, the Department supports the following facilities:

1. Cresswell Maternity Wing, which provides a specialist Obstetric and Neonatal Service for south-west Scotland, with around 1,400 deliveries per year. The resident anaesthetist is always trained in obstetric anaesthesia. A labour epidural service and remifentanil PCA are offered. There are two Consultant sessions for elective cases on Tuesday and Thursday mornings.

1. ECT. This is now provided in the day surgery unit following the move of psychiatric services to the new MidparkHospital.

1. Galloway Community Hospital, which has a separate anaesthetic rota staffed by the two Galloway Community Hospital consultants, (one post currently vacant) supported by a visiting specialty doctor. Weekend and night locum sessionsare available if individuals from the Department wish to support this.

1. Ophthalmology. A fully equipped operating theatre is used in the ophthalmology ward for local anaesthesia and occasional general anaesthetic cases.

The Anaesthetic Department establishment at present is as follows:

Consultants:Special Interest:

Dr D R Ball (w/t)TIVA, Airway Skills

Dr D Christie (w/t)ICU, Deteriorating Patient

Dr V Edwards (w/t)Emergency Surgery, Rota

Dr D Macnair (w/t) Obstetrics

Dr J Muthiah (w/t) Chronic Pain, Orthopaedics

Dr J Neil(w/t)Obstetrics, Blood Transfusion

Dr W Peel (w/t)ICU, Vascular Surgery, ECT,

Dr V Perkins (w/t)Pre-operative Assessment,

Dr J S Rutherford (w/t)ICU, Vascular Surgery, Acute Pain, Paediatric Anaesthesia, APLS Course Director, Non technical skills

Dr L Verner (p/t)Regional Anaesthesia, Orthopaedics

Dr D Williams (w/t)ICU, Vascular Surgery, Specialty Lead Clinicianfor ICU, ALS Course Director

Dr S Wilson (w/t)ICU, Airway lead

Dr W Wrathall (w/t)ICU,Vascular Surgery, ALERT Course Co-ordinator, Clinical Director of Anaesthesia & Intensive Care

Dr H Goonesekera(w/t)Chronic Pain

Dr R J Spicer (p/t)...... GCHInter-hospital Transfer, Asthma, Day Surgery

Vacant post (locums) GCH

Specialty Doctors:

Dr D Ballingall (wt/)

Dr K Shahzad(w/t)

Dr C Fernando (w/t)

Dr M Lawrence (w/t)

Dr N Roux (w/t)Commenced March 2015

Dr J DeutschCommencing April 2015

Dr J Carruthers (p/t)Locum appointment

Dr D Coyle (p/t)…..GCHProvides 1 in 4 weekend on-call

Trainees:

• Five CT1,2 doctors, recognised by the College for basic specialist training, on the West of Scotland training rotation

• One ST3, for six months per year

Education, Research and Audit

The Department holds weekly Intensive Care lunch-time meetings and monthly half-day “Continuing Education and Professional Development” sessions. There is a tutorial programme and a series of lectures to theatre nursing staff.

The Department is accredited for basic level training in Intensive Care Medicine and is currently being assessed for intermediate level training in Intensive Care Medicine

The Department is heavily involved in Critical Care and Resuscitation teaching with ALERT, IMPACT, APLS, ALS, SCOTTIE courses, all being run in the Education Centre and Resuscitation Training Centre. SIM-MAN and HAL mannequins are used in much of the teaching

Future Developments

Members of the Department of Anaesthesia and Intensive Care have been heavily involved in the design of the new General Hospital (see below) scheduled to open in 2018. The design incorporates an 8 theatre operating suite and a 16 bed Critical Care unit combining existing ICU and HDU facilities.

Supporting Professional Activities

A minimum of one SPA is included in the indicative job plan, amounting to 168 hours per annum which shall normally be sufficient to reflect activities such as revalidation, appraisal, personal audit, and professional development (occurring outwith the 30 days of study leave entitlement in any three year period). Time permitting, it may also cover minimal teaching, training and non-clinical administration. Any additional SPA allocation will require to be evidenced as being mutually beneficial and required by the department. Adjustment to the programme to incorporate additional SPA will require other activities to be reviewed to accommodate any increase as necessary. It will be requested that SPAs are delivered at the normal place of work, unless there are mutual advantages to it being performed elsewhere. The exact timing and location of SPAs, and flexibility around these, will be agreed during the 1:1 meeting with the Clinical Director/Associate Medical Director and included in the prospective job plan.

The Department of Anaesthesia and NHS Dumfries and Galloway value the development of non-clinical interests and, as these roles expand, additional time may be allocated.

An interest and additional training in Intensive Care Medicine is desirable for this post and will be accommodated by a place on the 7 person ICU rota covering a week of days at a time.

The department has a flexible approach to clinical sessions and it is hoped that the successful candidate will work with the same flexibility as the existing consultants.

Job Plan

1 week in 6: ICU 08.00-18.00 Mon – Fri with no night time on call.

5 weeks in 6:

(This weekly plan is an example of a possible job plan: other sessions may be available and subspecialty interests will be accommodated if possible.)

1 SPA to be taken flexibly during the week.

2 PAs are allocated to out of hours clinical work generated by the 1:6.5 on call rota (see below).This calculation is supported by consultant diary evidence.

A clinical session is allocated 5 hours, or 1.25 PA, to allow for pre and post-operative clinical input and admin time associated with clinics. A typical morning session therefore is from 08.00-13.00 and afternoon session 13.00-18.00.

Up to 10 days of funded external study leave per year is allocated. In addition Professional Leave for additional external duties may be available at the discretion of the Medical Director for Acute Services.

A hierarchical on call system operates; a resident CT/ST or Specialty Doctor is first on-call (always obstetric anaesthesia competent), Consultants are second and third on-call, one of which always has an ICU interest. At present, the Consultants work 1:13 2nd on-call and 1:13 3rd on call, making the overall on call rota 1:6.5 with prospective cover. The on call is non-resident.

The on call nights rotate through the week so no one consultant has a fixed on call night. Following a night second on call, no clinical commitments are allocated for the following day. Following anight third on call with aCT trainee, no clinical commitments are allocated for the morning session.

The on call case mix covers all sub-specialties including Obstetrics, Paediatrics, Intensive Care and resuscitation and transport for tertiary care for specialties not locally available eg Cardiothoracic and Neurosurgery.

Compulsory resident overnight duties are not part of current job plan, however future re-designs may be necessary to accommodate changes in working practices and it may be necessary to negotiate consultant resident out of hoursduties. This is not,howeverthe current model of future service provision.

The department is accommodated in an open plan office with each consultant having a desk space and networked PC, fully supported by the IT department with access to PACS, lab browser, patient records, pre-assessment clinic records, theatre management system, dictation facilities, NHS.net and clinical support including e-library. The Health Board is moving towards a fully electronic patient record. Department administration is provided by one full-time and one part-time secretary.

QUALIFICATIONS

All candidates are required to be on the GMC Specialist Register and hold a License to Practise.

The candidate will hold any of the following: a CCT or be within 6 months of obtaining the certificate, CESR (CP), CESR (Article 14) or will be an established consultant.

TERMS AND CONDITIONS OF SERVICE

The terms & conditions of service offered are those determined by the Consultant Contract 2008 Scotland(as amended from time to time).

This is a permanent position.

Salary scale

£76,001 - £102,465 (basic, whole-time equivalent).

New entrants to the NHS or the consultant grade will normally commence on the minimum point of the salary scale (dependant on qualifications and experience) with 3% availability allowance for on-call.

Hours of duty

The hours of duty are 40 per week.

Superannuation

You have the option to join the NHS Superannuation Scheme, to participate in the State Earnings Related Pension Scheme or to take out a Personal Pension. Employee’s contributions to the NHS Scheme are Tiered based on your earnings and the employers contribution equates to 13.5 % of salary. Employees in the NHS Scheme are “Contracted-out” of the State Earnings Related Pension Scheme and pay a lower rate of National Insurance contributions. Employees who choose to participate in the State Earnings Related Pension Scheme pay the higher rate of National Insurance contribution. A Stakeholder Pension is also available. A Personal Pension is a private arrangement agreed with the pension provider that will be an organisation such as a Bank, Building Society or Insurance Company.

Removal expenses

Assistance with relocation and associated expenses may be given and can be discussed prior to appointment. A quick reference of entitlements is attached for you.

Expenses for candidates attending for interview / visit

Candidates who are required to attend an interview will be given assistance with appropriate travelling expenses. Re imbursement shall not normally be made to employees who withdraw their application or refuse an offer without good reason.

Disclosure Scotland / PVG

This post is considered to be in the category of “Regulated Work” and therefore requires a Disclosure Scotland Protection of Vulnerable Groups Scheme (PVG) Membership which currently costs £59.00. The cost of the PVG Membership will be paid by NHS Dumfries & Galloway.

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Right to work in the UK

NHS Dumfries & Galloway has a legal obligation toensure that it’s employees, both EEA and non EEA nationals, are legally entitled to work in the United Kingdom. Before any person can commence employment within NHS D&G they will need to provide documentation to prove that they are eligible to work in the UK. Non EEA nationals will be required to show evidence that either Entry Clearance or Leave to Remain in the UK has been granted for the work which they are applying to do. Where an individual is subject to immigration control under not circumstances will they be allowed to commence until the right to work in the UK has been verified. ALL applicants regardless of nationality must complete and return the Confirmation of Eligibility to Work in the UK Statement with their completed application form. You will be required provide appropriate documentation prior to any appointment being made.

Rehabilitation of Offenders Act

The rehabilitation of Offenders act 1974 allows people who have been convicted of certain criminal offences to regard their convictions as “spent” after the lapse of a period of years. However, due to the nature of work for which you are applying this post is exempt from the provisions of Section 4 of the Rehabilitation of Offenders Act 1974 by virtue of the Rehabilitation of Offenders Act 1974 (Exceptions Orders 1975 and 1986). Therefore, applicants are required to disclose information about convictions which for other purposes are “spent” under the provision of the act in the event of employment, failure to disclose such convictions could result in dismissal or disciplinary action by NHS Dumfries & Galloway. Any information given will be completely confidential.

Disabled Applicants

A disability or health problems does not preclude full consideration for the job and applications from people with disabilities are welcome. All information will be treated as confidential. NHS Dumfries & Galloway guarantees to interview all applicants with disabilities who meet the minimum criteria for the post. You will note on our application form that we ask for relevant information with regard to your disability. This is simply to ensure that we can assist you, if you are called for interview, to have every opportunity to present your application in full. We may call you to discuss your needs in more detail if you are selected for interview.

Notice

The employment is subject to three months’ notice on either side, subject to appeal against dismissal.

Medical negligence

In terms of NHS Circular 1989 (PCS) 32 dealing with Medical Negligence the Health Board does not require you to subscribe to a Medical Defence Organisation. Health Board indemnity will cover only Health Board responsibilities. It may, however, be in your interest to subscribe to a defence organisation in order to ensure you are covered for any work, which does not fall within the scope of the indemnity scheme.

Accommodation

The post is non-resident, but temporary single accommodation may be available for a fixed period.

DUMFRIES AND GALLOWAY REGION

The population of Dumfries and Galloway is 148,000, within a large geographical area of about 2,500 square miles. Dumfries and Galloway stretches from Langholm in the East to Stranraer in the West, and from Kirkconnel in the North down to the SolwayCoast. There are a number of community hospitals in various towns throughout the region, and an intermediate unit – GallowayCommunityHospital(withmedical and maternity in-patient beds) in Stranraer.

Dumfries has a population of approx. 48,000 and is situated in the eastern half of the region.The River Nith runs through the town to the Solway coast and the city of Carlisle is approximately 45 minutes drive from Dumfries. Glasgow is within 1½ hours, Edinburgh and Newcastle within 2 hours, and Manchester and Liverpool within 2½ hours driving time from Dumfries.

Dumfries and Galloway offers the very best of Scottish countryside...... from rugged cliffs and sandy beaches to forests, hills and rolling farmland. You’re spoilt for choice in the range of activities on offer, with watersports, fishing, birdwatching, golf, mountain-biking or cycling along the network of rural roads . . . and much more. The Southern Upland Way runs for 212 miles from Portpatrick in the west to Cockburnspath in the eastern Scottish Borders, through some of Scotland’s wildest country.

There are many attractions, rangingfrom the University Town of Dumfries, Scotland’s National Booktown Wigtown, Artists’ Town Kirkcudbright, CastleDouglasFoodTown to the historic monuments, castles and abbeys, beautiful gardens, fascinating museums throughout the region. The local Council is committed to investing in education, with high achieving schools that earn top marks in HM Inspector of Education Reports. Children are encouraged to develop their talents and interests, with first-class opportunities in music, arts and sports. High quality sport and leisure facilities are available throughout the region. Property offers exceptionally good value.

NHS DUMFRIES & GALLOWAY

NHS Dumfries & Galloway became operational on 1st April 2003 when the two Trusts (Acute & Maternity and Primary Care) were dissolved and one NHS organisation was created, incorporating all NHS services along with the Health Board.

Structure

The NHS Board has its headquarters on the Crichton site in Dumfries. Comprising executive and non-executive Directors, its key responsibility is to ensure delivery of our Local Delivery Plan and Single Outcome Agreement with Council.

NHSD&G Corporate Aims

Our Purpose:

• To deliver excellent care that is safe, effective, efficient and reliable.
• To reduce health inequalities across Dumfries and Galloway.

Achieved by:

• Creating a momentum for improvement by engaging the enthusiasm of staff to achieve excellence.

Our Outcomes: