Intensive Care Medicine

CONSULTANT

INTENSIVE CARE MEDICINE

glasgow royal infirmary

INFORMATION PACK

REF: 42474D

cLOSING DATE: nOON ON 23rd may 2016

You should be appropriately experienced and qualified in the specialty, fully registered with the GMC and have a licence to practice. Those trained in the UK should have evidence of higher specialist training leading to CCT or eligibility for specialist registration (CESR) or be within 6 months of confirmed entry from date of Interview. Non UK applicants must demonstrate equivalent training.

We wish to appoint a Consultant colleague to join the Critical Care team at Glasgow Royal Infirmary. The successful candidate will join a cohesive, friendly group of ICU consultants. The group is committed to excellence in all aspects of intensive care medicine, and to ongoing quality improvement.

The critical care unit is a mixed 20 bedded area, with 12 nominal level 3 beds and 8 level 2 beds. There are currently 12 consultants who provide blocks of intensive care, as well as services to their base specialty. These blocks come in units of 4 days (Monday – Thursday) and 3 days (Friday – Sunday), and can be run together. At present, on call is provided on 1:12 first on and 1:12 second on.

There is a consultant and one trainee for each 10 beds. There may also be senior trainees in intensive care medicine or from the medical specialties. We provide tertiary care for burns, pancreatic diseases, complex upper GI surgery, sarcoma surgery and gynaecological cancer.

We have an active research programme in conjunction with the University department of Anaesthesia, Pain and Critical Care, as well as regular audits. The consultant body has varied interests and expertise including health improvement, trauma, education, ventilation and respiratory disease, ethics, diagnostic error and academic critical care.

The job plan outside critical care is negotiable, depending on the background of the successful candidate. It may also be possible to undertake some sessions in academic critical care.

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 major focus of clinical care is to provide treatment for critically ill patients in the Royal Infirmary, from admission to the hospital until discharge. We aim to aggressively manage deteriorating patients within and out with the critical care unit to avoid deterioration; provide first class, evidence based interventions for every patient who requires our services; and to follow up our patients to prevent relapse.

In addition, we run an award winning multidisciplinary follow up clinic.

Candidates will also provide sessions to their base specialty, depending on their skills and the requirements of the service.

As consultants, we have a responsibility to ensure our service runs efficiently in the interests of patients; that we communicate effectively with our colleagues from all disciplines; that we provide education and training for our multidisciplinary team. Candidates will be expected to contribute fully to these activities.

There is a corporate induction programme for all new employees. A tailored local induction will be undertaken with peer support and with interdisciplinary involvement. As a new consultant you would be afforded the opportunity to be assigned a clinical mentor to meet your requirements.

NHS Greater Glasgow and Clyde is one of the largest National Health Service providers and employers in the UK. In partnership with local authorities we are responsible for the health needs of a population of 1.2 million people, almost a quarter of the entire Scottish population; Glasgow itself has a population of nearly 600,000.The geographical area covered by NHS Greater Glasgow and Clyde is diverse; it coversboth urban and rurallocations in the Glasgow and Clyde area.

With an annual budget of one billion pounds this is a particularly exciting time to be joining Greater Glasgow’s Health Service. Over the next decade there is planned investment of more than £750 million, the largest single investment programme in the history of Scotland’s NHS – giving the North and South Glasgow Hospitals accommodation for 21st Century health care.

Our Hospital Modernisation programme is a £750 million strategy that has seen the transformation of acute services across the city including the replacement of out-dated Victorian buildings and the creation of one- stop/rapid diagnosis and treatment models for the vast majority of patients. This will greatly improve the experiences of patients, and staff working environments. Significant investment in acute hospital services means radical changes to Greater Glasgow and Clyde’s healthcare. Reorganisation of services has changed the profile of hospital configuration since June last year within Glasgowto create centres of excellence for surgical, medical and emergency care.

NHS Greater Glasgow and Clyde hosts the largest group of adult acute hospitals in Scotland – offering many opportunities to ensure job satisfaction and career development. We enjoy close links with Glasgow’s three universities, and make a significant contribution to teaching at both undergraduate and postgraduate teaching. Research also enjoys a high profile within the organisation.

Core adult acute care is currently delivered from four sites within Glasgow. Gartnavel General Hospital delivers acute care in the west-end of the city, In the north-east of the city acute care is delivered from Stobhill Hospital (Minor Injuries Unit and Acute Care and Diagnostics Hospital), and Glasgow Royal Infirmary. The Victoria Ambulatory Care Hospital serves the south-east and the Queen Elizabeth University Hospital (QEUH) in the south-west of the city. Paediatric care is delieverd from the new Royal Hospital for Children adjacent to the QEUH.

Glasgow Royal Infirmary, in the east of the city, provides a wide range of district general hospital, regional, supra-regional and national acute clinical services. Since 2010 an ongoing program of works has been underway to ensure the Royal Infirmary will be fully equipped to serve as the main inpatient hospital for the north and east of the NHSGGC area.

Research also has a high profile within the organisation. The New Lister Building, (formerly known as the University Tower) at Glasgow Royal Infirmary, opened in January 2014 following a £15 million refurbishment. The state of the art equipment, facilities and decor transformed the building for the staff and patients and also includes two floors for the University of Glasgow.

The new Lister Laboratory is named after Joseph Lister who is famous for his ground breaking work in the prevention of wound infection. He worked at GRI between 1861 and 1869 and his work during this time with carbolic acid change the face of surgical procedures making it much safer for patients. In 1911 the pathological institute at GRI was renamed the Lister Laboratory in his honour and since then has continued his pioneering work.

The GRI Site includes, the original hospital building, The Queen Elizabeth building, The Princess Royal Maternity, the Jubilee Building and clinical services from some floors within the Walton Building. Providing a full range of emergency and elective medical and surgical services, the GRI campus hosts a number of specialist services including the Regional Plastics and Burns Unit, hosts complex Upper Gi and Pancreatic Surgical services, Orthopaedic Oncology, Gyn-Oncology surgical services; a range of complex colorectal services are provided including care for Sarcoma management and intestinal failure patients. With renowned services for Gastroenterology and Hepatology, Interventional Radiology, the medical, surgical and radiology services complement each other working closely also with Older People Services to provide comprehensive care for all elements of patient pathways.

The £100 million state of the art Ambulatory Care Hospital (ACH) was opened at Stobhill in 2009 and is one of the largest hospitals in Scotland covering 4 floors with an area the size of 30,000 square metres – the equivalent of five football pitches. It supports the treatment of around 400,000 patients each year and provides a wide range of outpatient, diagnostic and day surgery services. The ACH also has 12 short stay surgical beds with weekday overnight medical cover enabling clinicians to extend the range of surgical procedures offered within the new hospital. Stobhill site also provides 4 Endoscopy rooms in a bespoke unit. It is recognised as one of the most modern and well-equipped hospitals in the country.

The Critical Care Unit is a 20 bedded mixed level 2 and level 3 unit. We admit approximately 1100 patients per year, and provide tertiary care for burns and pancreatic disease.

We have good outcomes (as evidenced by our SMR) despite treating a population with the highest deprivation scores in Scotland. We are proud to provide first class intensive care for our patient group, who have often been disadvantaged in every other way.

There are two consultants on call for the unit each daytime and one after 8pm. A third consultant is available for referrals in the mornings. We have at least two critical care trainees on 24h per day, and expect support from an FY1, senior intensive care trainees and medical trainees during weekdays.

Our trainee feedback is excellent and a recent exercise also found very positive feedback for the consultants from the trainees. As well as providing excellent care to our patients, we aim to provide first class training, in a supportive environment, for all our staff.

We plan to train and employ ACCPs in the near future, and are currently in advanced discussions about the details of this exercise.

In Glasgow, we have a cohesive city wide critical care community. We meet regularly to discuss difficult cases and provide education, both in the West of Scotland Intensive Care Society and the Pan Glasgow Clinical Governance meetings.

EQUIPMENT AND SUPPORTING SERVICES

We have immediate access to all supporting services within the hospital.

We have a dedicated echocardiography machine, as well as ultrasound machines. We have 6 dialysis machines, including two which offer all modes of renal replacement therapy. We have a nitric oxide delivery system.

There are 3 CT scanners within the hospital, an interventional radiology suite and an endoscopy suite.

We have excellent relations with all our user groups, and receive outstanding support from our consultant colleagues in all specialties.

UNIVERSITY LINKS

There are close links between ICU at Glasgow Royal infirmary and the Academic Unit of Anaesthesia, Pain and Critical Care at the University of Glasgow. The Academic Unit is in the refurbished New Lister Building, adjacent to the ICU which has state of the art research and teaching facilities. The Academic unit¹s main research is critical care. Several of the clinical academics have an interest in critical care. Professor John Kinsella is the Professor and Dr Tara Quasim is a Senior Lecturer. There is also a Clinical Lecturer, Post Doctoral Research Fellow and research / teaching fellows. In addition, Dr Charlotte Gilhooly has academic teaching sessions. The research interests include ICU rehabilitation, liver disease, burns, sedation, measuring critical illness severity and long term outcomes and computing. Expertise in statistics, big data and modelling are available. The unit publishes and presents widely and has extensive grant funding. Recent awards include grants from The Health Foundation, Chief Scientist Office, Scottish Government, the MRC, the BMA and Cancer Research UK. The Academic Unit also run a highly successful intercalated BSc in Critical Care for undergraduate medical students.

Name

Dr Martin Hughes, Clinical Director, North Sector

Currently President of the Scottish Intensive Care Society, and immediate past chair of the Training and Education group of the Society. He is Editor of ‘Advanced Respiratory Critical Care’ published by Oxford University Press. He has written 18 book chapters and lectures widely on ventilation and respiratory disease, clinical decision making and coma.

Consultant members of the Department:

Consultants in Critical Care Medicine:

Dr Alex Puxty. Interests include sepsis, echocardiography (FICE mentor) and the right heart.On GRI trauma committee, Scottish critical care trials group and BSc mentor.

Dr Malcolm Booth. Chair of West of Scotland Research Ethics Committee, immediate past chair of ethics committee of the European Society of Anesthesiology. Lead for infection surveillance/control. Organises students attachments including electives.Continues to be involved in research despite full time clinical role.

Dr Audrey Chalmers. As well as her role as consultant in critical care, Dr Chalmers is heavily involved in the Christian Medical Fellowship, which provides support for doctors of all faiths and none, and sends medical teams around the world at short notice to help with humanitarian crises.

Dr J Cuthill. FICM faculty tutor and ALS instructor. Honorary Clinical lecturer Glasgow University. Sports medicine expertise – medical team lead for triathalon at Commonwealth Games; faculty on SportPromote and research interests in ultra endurance exercise, hyponatraemia and activity at work.

Dr Malcolm Daniel. NHS GGC North Sector Medical Quality Improvement lead and SICSAG lead. Institute for Healthcare Improvement fellow 2010-11.Keeps the ICU focussed on "learning how to do the common things uncommonly well".

Dr Lindsay Donaldson. Interests include acute and chronic liver disease withincritical care.

Deputy Director of Medical Educationin Glasgow and the lead for online induction and quality assurance in medical education.

Dr Charlotte Gilhooly. Audit lead for National Managed Clinical Network for Burns, lead for electronic patient record, heavily involved in undergraduate and postgraduate education

Professor John Kinsella. Head of the Academic Unit of Anaesthesia, Pain and Critical Care at the University of Glasgow and Lead clinician for the National Managed Clinical Network for Burns (COBIS). He is also Chair of the Scottish Intercollegiate Guideline Network (SIGN). He leads a large grant funded research program which publishes and presents widely.

Dr Barbara Miles Interests include healthcare quality improvement percutaneous tracheostomy, mobilisation, delirium, long term outcomes, ERAS and organ donation. Lead clinician for anaesthesia.

Dr Carol Murdoch. Longstanding interest and involvement in training in intensive care medicine - lead RA for ICM for Scotland. Subspecialty interest within ICM is echocardiography - FICE mentor the organiser/director of the Glasgow FICE courses.

Dr Kathryn Puxty. Interests include big data analysis - currently examining outcomes in ICU cancer patients whilst undertaking a MD. Other interests include teaching, echo and lung ultrasound. Co-lead for the GRI safe ventilation QI project. CLOD.

Dr Tara Quasim. Senior lecturer with an interest in ICU rehabilitation and long term outcomes after ICU. Runs an award winning follow up clinic (InS:PIRE) which is about to be rolled out to selected other sites in Scotland. Other interests include delirium and cognitive impairment. Set up our Patient and Family Advisory Council.