Locum Consultant Cardiologist with an Interest in Cardiac Transplant Medicine

SHOW/2285

Opportunities in Cardiothoracic Anaesthesia and Fellowship– Cardiothoracic Anaesthesia and Critical Care

Fixed Term – 1 year period

Closing date 6th June 2016

The National Waiting Times Centre Board welcomes your enquiry in connection with the above post. Please find enclosed an information pack.

Should you wish to submit an application for the above post, please ensure you do so in advance of the closing date. Late applications will not be forwarded for short listing.

Should you contact the recruitment team to discuss any queries regarding your application it is advisable that you retain the job reference number as you will be asked to quote this when you call. Please note that we no longer acknowledge receipt of applications and therefore you will not receive any further communication until after the post has been shortlisted.

In the meantime, I wish you success with your application and should you require any further information or wish to check the progress of your application please do not hesitate to contact the recruitment team on the contact telephone number shown above.

Yours sincerely

SANDRA HILL Recruitment Assistant NATIONAL WAITING TIMES CENTRE BOARD

INFORMATION PACK FOR THE POST OF

Opportunities in Cardiothoracic Anaesthesia and Fellowship– Cardiothoracic Anaesthesia and Critical Care

Fixed Term – 1 year period

REFERENCE NUMBER: SHOW/2285

CLOSING DATE: 6th June 2016

2 NATIONAL WAITING TIMES CENTRE BOARD

GENERAL INFORMATION FOR CANDIDATES

 This information package has been compiled to provide prospective candidates with details of the post and background information about The National Waiting Times Centre Board.

 The contents of this package are as follows:- o Job Description/person specification o Terms and Conditions of Service o Application Form o Equal Opportunities Monitoring Form o Information on Agenda for Change

 The Equal Opportunities Monitoring form is required for monitoring purposes only and will not be made available to the interview panel during any part of the recruitment process.

 Please note, to ensure that we adhere to our current policy on Equal Opportunities; CV’s received with Application Forms will be destroyed prior to Application forms being passed for Short listing.

 NWTC operates a NO SMOKING Policy on all Premises and Grounds.

 All offers of employment will be subject to the receipt of satisfactory References, Occupational Health screening and Disclosure Scotland clearance.

 Please send your completed application to:-

Recruitment Team, HR Department Golden Jubilee National Hospital Agamemnon Street Clydebank G81 4DY

 When returning your completed application and any associated enclosures by Royal Mail you must ensure that the correct postage cost is paid. We have been informed by the Post Office that they are retaining those which have been underpaid. This has resulted in completed applications not being returned until after the closing date, and not being included for short listing.

 The short listing process will take place shortly after the closing date.

 As a Disability Symbol user we recognise the contribution that all individuals can make to the organisation regardless of their abilities. As part of our ongoing commitment to extending employment opportunities all applicants who are disabled and who meet the minimum criteria expressed in the person specification will be guaranteed an interview.

 The organisation has introduced a set of shared values. These values will be measured during the Competency Based Interview. The values are:

o We will treat everyone with dignity and respect o We will take responsibility to do our jobs well o We will demonstrate our commitment to quality o We will work effectively with others in teams o We will display a “can do” attitude at every opportunity

3 GOLDEN JUBILEE NATIONAL HOSPITAL

TERMS AND CONDITIONS OF SERVICE

1. Terms and Conditions of Service

The terms and conditions applicable to this post are those of all NHS Employees.

2. 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 amount to 5% to 10.9% of salary (depending on rate of Pensionable Pay) and the employers’ contribution equates to 14% 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.

3. Salary

Clinical Fellow

4. Grade

Clinical Fellow

5. Annual Leave

The annual leave entitlement in a full year commencing 1st April to 31st March is 27 days, rising to 29 days after 5 years’ service and 33 days after 10 years’ service. There are 8 Statutory and Public Holidays in each leave year. (Pro rata where applicable)

6. Hours of Duty 40.00

7. Tenure of Employment

Fixed Term for 12 month period

8. Asylum and Immigration Act 1996

Under the Asylum and Immigration Act 1996, we are required to carry out checks to ensure that all prospective employees are entitled to live and work in the United Kingdom. You will therefore be asked to provide appropriate documentation prior to any appointment being made.

4 NHS National Waiting Times Centre Benefits

NHS Superannuation scheme: All staff are eligible to join this scheme from date of commencement. Employee contributions vary from 5% to 13.3% depending on annual pensionable pay. Benefits include a lump sum and pension when you retire, life assurance of 2 years’ pay while you are working, pension and allowances for your spouse and children in the event of death, and benefits for ill-health retirement. Members of the scheme receive tax relief on contributions and Lower National Insurance contributions.

Annual leave entitlement (including public holidays): 35 days annual leave on appointment 37 days annual leave after 5 years 41 days annual leave after 10 years

Free car parking

Continuing professional development opportunities

Discounts at the associated Beardmore Hotel

Leisure Club membership – Get fit and healthy at the Beardmore Leisure Club for only £28 per month.

Childcare vouchers – If you are a working parent with children under the age of 16 you could save up to £1,196 per parent, per annum on the cost of childcare.

For more information about the benefits and discounts available to NHS staff, visit www.nhsdiscounts.com

5 Golden Jubilee National Hospital

Job Description

Fellowship in Cardiothoracic Anaesthesia and Critical Care

6 National Waiting Times Centre NHS Board

Job Description

1. Job Identification

Job Title Fellowship Cardiothoracic Anaesthesia and Critical Care

Responsible to: Operational & Strategic Clinical Lead

Accountable to: Associate Medical Director -Surgical Division

Department(s): Department of Anaesthesia

2 Introduction.

The Golden Jubilee Hospital is a state of the art tertiary referral centre on the banks of the River Clyde in close proximity to Glasgow International Airport and within 30 minutes of the centre of Glasgow by road and rail links

The hospital was originally built as a private hospital in 1995 and is now the National Waiting Time Centre which is a special health board of NHS Scotland. The Golden Jubilee National Hospital has 300 beds overall with all wards having single or two bedded rooms with ensuite facilities. The estate is one of a high specification and has the invaluable asset of a hotel and conference centre as an integral unit alongside the hospital. All facilities are managed by the National Waiting Times Centre Board The main clinical services provided are Heart and Lung Specialties, elective major Orthopaedics, General Surgery, Plastic Surgery, Bariatric Surgery, Endoscopy and Diagnostic Imaging.

The West of Scotland Heart and Lung Centre

The Centre was created in March 2008 at the Golden Jubilee Hospital, bringing Interventional Cardiology and Cardiothoracic services previously provided by Greater Glasgow and Clyde and Lanarkshire onto our Specialist Tertiary Centre at the Golden Jubilee National Hospital. The interventional cardiology service which includes primary PCI is among the busiest in the UK. The Centre also provides the regional electrophysiology service for the West of Scotland. In addition to these regional specialist services the GJNH is the site for the co-location of three services funded by the National Services Division of National Services Scotland (accountable for commissioning specialist services provided on a national basis on behalf of the Scottish Executive). These include the Scottish Adult Congenital Cardiac Service (SACCS), the Scottish Advanced Heart Failure Service (SAHFS) and the Scottish Pulmonary Vascular Unit (SPVU). The 7 SAHFS provides cardiac transplantation and mechanical support services for the treatment of advanced heart failure to the Scottish population. With this array of specialist cardiopulmonary services for a catchment population of 2.2 million, the GJNH is one of the largest heart and lung centres in Europe. The Heart and Lung Centre also benefits from MRI and CT imaging facilities with capabilities for CT angiography and a brand new 64 slice CT.

Orthopaedic Surgery

The orthopaedic service works across five laminar flow theatres in a modern theatre suite, delivering over 25% of all hip and knee replacements for the NHS in Scotland, and approximately 50% per cent of those by West of Scotland hospitals. The service has just undergone successive expansions in recent years and has recently completed phase six of this process. One of the great successes within the Orthopaedic program is the ‘CALEDonian’ Technique (Clinical Attitudes Leading to Early Discharge). This is a multi-disciplinary approach to peri-operative care aimed at promoting Enhanced Recovery and facilitating early discharge – the programme has reduced the length of hospital stay following joint replacement to an average of 2 to 3 days. There is also a growing activity of Orthopaedic day cases, predominantly foot and ankle surgery and this has followed the appointment of a Specialist Orthopaedic surgeon. Overall, the department has recently increased the rate of day of surgery admissions for joint replacements. This has been facilitated in part by providing Consultant Anaesthetic sessions in the preoperative assessment clinic. Despite the fact that the GJNH has no defined geographical 'catchment area' (by virtue of being a national hospital), day of surgery admissions are possible in some patients by allowing overnight stay prior to surgery in the adjacent Beardmore hotel.

General and Plastic Surgery

There is a program of both elective General Surgery (approx 600 cases per annum) and elective Plastic Surgery (approx 800 cases per annum) These cases are predominantly daycase, short stay procedures with minimal complexity anticipated (either surgical or patient- related). All of the surgeons providing this service are visiting.

Thoracic Surgery

Thoracic Surgery in the West of Scotland is provided solely at the West of Scotland Heart & Lung Centre at the Golden Jubilee National Hospital. Three full-time Thoracic Surgeons and two mixed practice Cardiothoracic surgeons undertake the full range of thoracic surgical procedures including a small component of oesophageal surgery. The unit is committed to the principle of enhanced recovery and has recently developed programmes of VATS lobectomy and thymectomy. There is one thoracic ward which manages the majority of patients. In addition there is a new surgical day unit for same day admission and day surgical procedures. Two thoracic operating rooms are available, both of them equipped to a high standard with

8 fluoroscopy, laser and video thoracoscopy. Although the High Dependency Units are mixed cardiothoracic, one HDU receives the majority of the thoracic patients. All surgeons deal with referrals in a flexible manner, but lung cancer referrals tend to based on the geographical patterns defined by the MDTs (see below). Cardiothoracic trauma is not uncommon in the West of Scotland and all Cardiothoracic surgeons are expected to provide emergency cover for the management of chest trauma. The APS team provide input into the pain management of postoperative thoracic surgical patients and cases are reviewed on the daily APS 'ward round'.

Acute Pain Service (APS) The hospital has a long established and well resourced Acute Pain Service that is part of the Department of Anaesthesia and Perioperative Medicine. This service is Consultant led and supported by four specialist APS nurses. The APS adopts a proactive team approach in delivering an individualised patient-centred service which is primarily aimed at supporting the various enhanced recovery initiatives across the hospital and minimising the effect of pain as a factor limiting the rate of recovery from surgery. The APS team are responsible for developing and delivering education programs across the hospital to the various multidisciplinary teams in relation to pain management. The management of pain within GJNH is highly protocolised in order to provide both efficacy and safety in pain management. The development of policies and protocols is the responsibility of the Consultant APS Lead and the APS Nursing team in partnership with other stakeholders throughout the hospital and changes are made through the APS steering group which meets quarterly. The APS is continuously involved in Audit and Research and maintains a comprehensive database. This is subject to regular review and helps to inspire innovation and directs changes towards improvements to clinical practice in the continuous evolution of the CALEDonian technique and Thoracic enhanced recovery programs

Management Structure

The NHS National Waiting Times Centre is a Special Health Board of Scotland which reports directly to the Scottish Government. Within the hospital there two divisions of which Anaesthesia, ICU and Theatres are part of the Surgical Specialties Division.

Management team:

Operational and Strategic Clinical Lead - Cardiothoracic anaesthesia and critical care. Dr Jacqueline Church Associate Medical Director, Surgical Specialties Dr Alistair Macfie Head of Operations, Surgical Specialties Mrs Lynn Graham Head of Nursing (Acting) Mrs Theresa Cairns Theatre Manager Mrs Karen Boylan 9 Operations Manager Mrs Claire MacArthur Surgical Services Manager Mrs Elaine McIntosh

Medical leadership in department structure

DIRECTOR OF DIRECTOR OF MD BUSINESS SERVICES NURSING

HEAD OF AMD HEAD OF OPERATIONS NURSING

OPERATIONS & GOVERNANCE LEAD STRATEGIC LEAD

CONSULTANT

3. Work of the Department

The Department of Anaesthesia, during a period of development and expansion since becoming part of the NHS in 2004, established itself as a major centre of excellence in anaesthesia,

10 intensive care and pain medicine. The department has an international reputation in pain management. Consultant Anaesthetists provide support for Outpatient pre-admission clinics. We have an active research programme that attracts a steady stream of clinical research fellows to the department. The main areas of interest are:  PK/PD of intravenous anaesthesia  Monitoring depth of anaesthesia  Patient controlled sedation using propofol  Perioperative risk stratification  Acute lung Injury after thoracic surgery  Regional anaesthesia for lower limb surgery The acute pain service was established in 1996 to provide co-ordinated post-operative pain management for all patients of the Golden Jubilee National Hospital. This is run by the Anaesthetic department under the leadership of a Consultant Anaesthetist within a multidisciplinary team with nurses. The service also includes the use of regional anaesthetic and analgesic techniques, patient controlled analgesia systems and a co-ordinated approach in the use of multimodal analgesia.

The hospital has a modern operating theatre department which consists of 15 operating theatres to facilitate with the following distribution of specialties:

 Cardiac ( 4)  Thoracic ( 2 )  Orthopaedic ( 4 )  General, and plastic surgery ( 3 )  There is also a separate day facility providing Ophthalmic and Endoscopy activity. The operating theatres provide a 24-hour on-call service with morning lists commencing at 08.00.

The anaesthetic department provides an intra-operative trans-oesophageal echocardiography service to cardiac surgery and has TOE machines based in each cardiac theatre and intensive care. Several of the anaesthetic consultants are accredited in TOE. There are two intensive care units with a total of 22 physical beds (currently 20 staffed) and there are 16 high dependency beds in two separate units. In addition to providing care to cardiac surgical patients, the critical care unit also manages patients critically ill with heart failure and patients undergoing heart transplant and mechanical circulatory support under the Scottish National Advanced Heart Failure Service and it supports the regional primary

11 angioplasty service.

We serve patients undergoing complex adult congenital surgery within the Scottish Adult Congenital Service. We have links with Glasgow and surrounding obstetric services to provide peri-partum care for women with severe congenital heart disease or heart failure. The critical care service also treats occasional patients who have undergone orthopaedic or general surgical procedures in the hospital. Techniques used in the intensive care include renal replacement therapy, intra-aortic balloon pump counter pulsation, ventricular assist device support, invasive and non-invasive ventilation, pulmonary artery catheterisation, and Tran oesophageal echocardiography. There is dedicated prospective sessional daytime cover from the team of 10 consultant anaesthetic intensivsists and a dedicated out of hours rota (see below).

The National Services ward (including the Scottish National Advanced Heart Failure Service) currently occupies an adjacent 8-bedded high dependency area.

Conference, Research and Education facilities

Research, Development and Innovation are very important components of the activity at the Golden Jubilee National Hospital supported by a steering group and dedicated manager. Contract (commercial) research is encouraged and staff use income generated from this source to maintain research support staff such as Clinical Research Fellows and Research Nurses.

Education The GJNH has an anaesthetic college tutor appointed by the Royal College of Anaesthesia who has responsibility for anaesthetic educational supervision. The Fellow will have a named educational supervisor. The appointee would be expected to attend educational CME meetings which occur once a month on Friday afternoons. There is also a programme of regular weekly cardiothoracic tutorials. Other educational opportunities include the Heart Failure meeting on Friday mornings.

Governance and Risk management

The Board has a comprehensive programme that covers both clinical and research governance domains and all medical staff are expected to uphold clinical and non-clinical policies and be exemplar role models for all other medical and non-medical staff. Patient safety underpins clinical practice and initiatives following the guidance of the SPSP and

12 subsequent programmes apply to all staff. Medical staff are required to undergo annual appraisal, meeting the requirements that will be required for revalidation purposes. The Medical Director is the Responsible Officer for all medical staff who work principally at the Golden Jubilee National Hospital.

4. Duties of the post / Proposed Job Plan

This one year post will include working as the cardiothoracic anaesthetic fellow in cardiothoracic theatres and the cardiac intensive care unit. The fellow will undertake training in cardiothoracic anaesthesia and critical care alongside the rotational anaesthetic trainees from the West of Scotland deanery. The post holder will take part in the cardiothoracic anaesthetic on call rota for cardiac intensive care. This rota currently has ten doctors: six rotational ST anaesthetic trainees, two anaesthetic lecturer posts supervised by Professor Kinsella of Glasgow University and an associate specialist. The fellow will supervised by consultants of the anaesthetic department. The fellow will receive training in cardiothoracic anaesthesia including intra-operative trans-oesophageal echocardiography.

There are excellent teaching opportunities within the department. Each week the junior staff have 1 hour of protected teaching time on a Tuesday afternoon which covers the cardiothoracic curriculum in a consultant led tutorial format. There is a monthly multidisciplinary M&M afternoon on the first Friday of the month (3 hours). On the third Friday afternoon there is the anaesthetic department CME (3 hours). On Friday mornings, an advanced heart failure MDT is held to discuss the selection and management of Transplant and VAD patients.

Training Objectives:  To reach a standard of cardiothoracic anesthesia to allow independent practice without immediate supervision  To gain accreditation within the year in trans-oesophageal echocardiography which involves the collection of 125 TOE cases and preparation of examples and passing the BSE/ACTA TOE Exam.  To gain experience in cardiothoracic critical care.

Workload Flexibility

18 consultant anaesthetists undertake cardiothoracic anaesthesia and ITU duties. 8 consultants cover anaesthesia for the other surgical specialties and a small number work in both groups.

The details of the workload shall be arranged within the Department of Anaesthesia and may be altered to accommodate the changing demands placed upon the department. The cardiothoracic anaesthetic fellow shall be expected to share responsibility in providing clinical

13 workload for the department with a degree of flexibility in a planned fashion. There may be occasions when short notice for a change of duty will be provided on account of sudden unexpected absence of a colleague.

Indicative Job Plan

This is a hybrid rota with commitments to:  Cardiothoracic theatre is scheduled from 8am to 6pm.  On call rota for 10 doctors for critical care 8am to 9pm, 9pm to 9am

Total hours = 48 hours / week

Submission and review of job plan

Job plans are reviewed on an annual basis on behalf of the Medical Director who will have Executive responsibility. Changes will be discussed and agreed with the post holder in line with service needs and objectives set for the cardiothoracic anaesthetic fellow. ICU and On-call Arrangements

The ICU is staffed by 10 anaesthetic training doctors on a full shift system. They are mostly attached to the West of Scotland anaesthetic training programme. The Hospital does not have a general emergency receiving unit, but will directly readmit patients with complications that have arisen from treatment at the Golden Jubilee National Hospital. Emergency Cardiology and Cardiothoracic patients are received directly 24/7 apart from those who are admitted to trauma units.

There are currently 3 Consultant Anaesthetic on-call rotas: ICU CT Theatres Non CT & Acute pain

The successful candidate will have access to secretarial support, office accommodation and access to a personal computer. The appointee will be expected to work flexibly on the basis of the needs of the Anaesthetic service.

5. Terms & Conditions of Service

 The post is subject to pre employment checks such as Disclosure Scotland, Occupational Health, Visa clearance (where applicable) and satisfactory references.  You are required to be registered with the General Medical Council/General Dental Council throughout the duration of your employment and to comply with and abide by the relevant code of professional practice, as appropriate. 14  Salary scale: National Salary Scales per annum for a speciality doctor.  The appointee will be expected to follow the local and national employment and personnel policies and procedures.  All medical and dental staff employed by the Centre are expected to comply with the agreed health and safety policies.

JOB DESCRIPTION AGREEMENT

Job Holder’s Signature: Date:

Print name: Date:

Head of Department Signature: Date

Intending applicants are welcome to visit the Department and to discuss the post in detail by arrangement. In the first instance please contact:

Mrs Lynn Graham Dr. Jacqueline Church Head of Operations Operational/Strategic Clinical Lead Golden Jubilee National Hospital Golden Jubilee National Hospital Agamemnon Street Agamemnon Street Clydebank Clydebank G81 4DY G81 4DY Tel: 0141 9515937 Tel: 0141 951 5607 Email: Lynn.graham @gjnh.scot.nhs.uk Email: [email protected]

7. Applications

Completed applications to be returned to:

Mrs Sandra Hill Recruitment Section Human Resources Department Golden Jubilee National Hospital Agamemnon Street Clydebank G81 4DY

15 16 Person Specification –Fellowship – Cardiothoracic Anaesthesia and Critical Care Essential Essential (Evidence Desirable (Short list) gathered at Interview) Qualifications/Traini 1. MBCHB or 1.Post CCT ng equivalent

2. FRCA or equivalent.

Experience 3. A minimum of 3 6. Demonstrate years full time post understanding of graduate training importance of experience in audit and research anaesthesia / critical care (or its equivalent gained on a part time or flexible basis experience.

4. Minimum of 6 months Intensive care experience.

Skills/Knowledge 7. Excellent 2.Have some formal knowledge of training in teaching written and spoken methods English

8. Evidence of excellent communication & team working skills. Additional job 9. Have 3.Evidence of requirements appropriate involvement in e.g. car driver, knowledge base clinical audit unsocial hours and ability to apply sound clinical judgement to problems.

Any other additional 5. Full registration information with GMC with licence to practice