Golden Jubilee National Hospital Surgical Specialties Directorate

Golden Jubilee National Hospital

Surgical Specialties Directorate

Job Description and Particulars Relating to the Post of Locum Consultant Anaesthetist 1. Job Identification Job Title: Locum Consultant Anaesthetist

Responsible to: Operational/Strategic Lead and the Associate Medical Director

Accountable to: Chief Executive

Department(s): Department of Anaesthesia and Peri-Operative Medicine

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. Direct overnight sleeper rail service to Euston, London is available via the local station 5 minutes from the hospital.

The Golden Jubilee National Hospital is effectively situated a short distance west of Glasgow City and is minutes away from the countryside of the West of Scotland and Loch Lomond. Glasgow and the immediate surroundings have a population of around 580,000. It is Scotland’s largest city and commercial capital. The city has a renowned vibrant cultural life, with municipal art galleries and museums, first class sports and leisure facilities, a wide range of theatres and restaurants, excellent shopping and is only 45 miles from Edinburgh.

The hospital was originally built as a private hospital in 1995 and is now fully part of NHS Scotland. Together with the Beardmore Hotel and Conference Centre it forms the National Waiting Times Centre special Health Board. It 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. This has provided a very pleasing and attractive working environment for staff and a desirable patient experience. 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 , Plastic and Bariatric Surgery, as well as Endoscopy and Diagnostic Imaging.

The West of Scotland Heart and Lung Centre

The Centre was created in March 2008 at the Golden Jubilee National Hospital, bringing Interventional Cardiology and Cardiothoracic services previously provided by Greater Glasgow and Clyde and Lanarkshire onto our Specialist Tertiary Centre. 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, incl. Transplantation and mechanical assist service) and the Scottish Pulmonary Vascular Unit (SPVU). 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.

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 dedicated thoracic ward (level 4 west) which manages the majority of patients, but the two other cardiothoracic wards are also used. Two thoracic operating rooms are available, both of them equipped to a high standard with 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.

Orthopaedic Service

The orthopaedic service works across four laminar flow theatres with a 5th Theatre newly commissioned delivering over 22% of all hip and knee replacements for the NHS in Scotland, and approximately 50% per cent of those by West of Scotland hospitals. One of the great successes within the Orthopaedic Department is the ‘Caledonian’ Technique. This is a multi-disciplinary approach to peri-operative care aimed at Enhanced Recovery and early discharge – the programme has reduced the length of hospital stay following joint replacement to an average of 4 days. There is also a growing activity of Orthopaedic day cases, predominantly lower limb and foot surgery. Overall, the department has also increased the rate of same day admission for joint replacements.

Acute Pain Service (APS)

The hospital runs an established Acute Pain Service that is part of the Department of Anaesthesia and Perioperative Medicine. This service is Consultant led and supported by three specialist nurses. The APS is the focal point for managing all sorts of local anaesthetic infusions, is involved in the Caledonian Enhanced Recovery program and provides consulting services for the management of any complex pain problems across the hospital. The APS is continuously involved in Audit and Research based on a comprehensive database. The APS steering group is responsible for training and policies and protocols that are related to their remit.

Management Structure

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

Management team:

Associate Medical Director, Surgical Specialties Dr. Alistair MacFie Head of Operations, Surgical Specialties Mrs Lynn Graham Operations Manager Mrs C MacArthur Head of Nursing Mrs Anne Marie Cavanagh Theatre Manager Mrs Karen Boylan

DIRECTOR OF DIRECTOR OF MD BUSINESS SERVICES NURSING

HEAD OF AMD HEAD OF OPERATIONS NURSING

OPERATIONS & GOVERNANCE LEAD STRATEGIC LEAD

CONSULTANT

Medical leadership in department structure

3. Work of the Department The Department of Anaesthesia and Perioperative Medicine, has established itself as a major centre of excellence in anaesthesia, intensive care and pain medicine. The current medical staff comprises of 22 resident and 4 visiting consultants, one specialty doctor, two PA (A) s and two research fellows (Glasgow University).

The department has an international reputation in pain management and Regional Anaesthesia, attracting visiting anaesthetists from all over the world. Consultant Anaesthetists also provide support for Outpatient pre-admission clinics. The department also runs a hospital wide service for long-term venous access (PICC and Hickman lines).

There is additional support from two full-time PAA’s (Physician Anaesthetic Assistants) for theatre work and in pre-assessment. We have an active research programme that attracts a steady stream of clinical research fellows to the department.

The main areas of interest are:  Pharmacology and PK/PD of intravenous anaesthesia  Brain function monitoring and effects of anaesthesia  Multi-modal analgesia  Regional Anaesthesia and Enhanced Recovery  Mechanism of lung injury  Coagulation and blood transfusion

The hospital has a modern operating theatre department which consists of 16 operating theatres to facilitate with the following distribution of specialties:

 Cardiac ( 4 )  Thoracic ( 2 )  Orthopaedic ( 5 )  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.  There is a special arrangement to accommodate unexpected over-runs

There are two intensive care units with a total of 22 physical beds (currently 21 staffed) and there are 16 high dependency beds in two separate units. Apart from post-operative cardiac and thoracic surgical patients, the unit manages patients critically ill with heart failure and patients undergoing heart transplant under the Scottish National Advanced Heart Failure Service and it supports the regional primary angioplasty service. There is a mechanical circulatory support programme and there is a contingency for complex orthopaedic and general surgical patients in critical care.

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. 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 transoesphageal echocardiography.

There is dedicated prospective sessional daytime cover from the team of 10 consultant anaesthetic intensivists and a dedicated out of hours rota. The National Services ward (including the Scottish National Advanced Heart Failure Service) currently occupies an adjacent 8-bedded high dependency area.

There is an excellent 24/7laboratory service providing Clinical Chemistry, Haematology, Blood Transfusion (utilising electronic cross-matching) and Microbiology.

The pharmacy department provides a medicine management service to an increasing number of clinical areas and there is a comprehensive rehabilitation department including physiotherapy, occupational therapy, speech therapy, chiropody, podiatry, acupuncture and laser treatments. The radiology department is well equipped with a full range of up to date diagnostic imaging equipment including MRI, 64 slice CT, Ultrasound, Fluoroscopy and Bone Densitometry.

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. Academic research is also encouraged and the new appointment will be strongly encouraged to take an active role in this activity. The appointee will also be expected to work with other national and UK collaborative projects that are relevant to position. A number of consultants undertake significant research and academic work. The Board is committed to the development of innovative clinical programmes. The new Beardmore Health Sciences Centre (BHSC) opened in May 2011. The Centre will contain a dedicated Clinical Research Facility for managing patients recruited to clinical trials.

There are four consulting rooms; one is set up for echocardiography, one for an exercise tolerance suite and two rooms for general consulting and volunteer studies. The rest of the BHSC is made up of a small prep room, a nurse’s station and a patient waiting area. The facility is adjacent to the main auditorium of the conference centre providing excellent opportunities to develop teaching techniques and learning. Improved audiovisual links to theatre have recently been established. The Beardmore Hotel and the integral conference centre attached to the Golden Jubilee Hospital is a unique arrangement in the UK and will enable important national and ‘focus’ international meetings to share learning in the UK and beyond.

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 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.

Appointment of recognised Medical Appraisers, and staff education The Board is committed to developing a strong educational ethos within the department and the new appointee will be expected to provide education and support to medical and non-medical staff members and develop the key educational skills to be an effective clinical supervisor. Supporting relevant programmes will be a requirement for the new appointment. 4. Duties of the Post /Proposed Job Plan The successful candidate would be expected to provide the following;  9 direct clinical care PA’s (DCC)  1 SPA, to include non-clinical administration, and fulfilling the requirements for enhanced appraisal and revalidation, including participation in departmental clinical governance, quality improvement and audit programmes. In addition to the core job plan EPA’s (Extra Programme Activities), may be negotiated and agreed through job-planning. These may be direct clinical care sessions or to provide time to undertake other specific duties in line with corporate and departmental objectives (e.g. teaching and educational supervision, service improvement, research, committee work etc).

Indicative Job Plan This job plan is focused on supporting the expansion of the orthopaedic activity and the Consultant led Pre-assessment clinic.

Day DCC Activity PA’s General/Plastics and Pre-Assessment 2.5 0800-1800 (alternating weeks) 2.7 Orthopaedic Theatre 0800-1800 5 Wednesday 0900 -1300 1300 -1700 2.7 Orthopaedic Theatre 0800-1800 5

Friday

Sub Total 8

Day Flexible Activities PA’s SPA 1 Unpredictabl 1:8 rota with e OOH prospective cover 1 (on call) Subtotal 2 Grand Total 10

The tabled job plan is an indicative programme that will be revised 3 months after commencement by Directorate Management Team. All attributes are based on flexible cover of the rota when required.

Submission and review of job plan Job plans are reviewed on an annual basis by the Medical Director or his deputy. Changes will be discussed and agreed with the post holder in line with service needs and objectives set for the consultant.

On-call Arrangements The successful candidate will have access to secretarial support, and a hot desk with access to a personal computer. The appointee will be expected to work flexibly on the basis of the needs of the Anaesthetic service.

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 1:10 CT Theatres/Cath lab 1:8 Non CT & Acute Pain 1:8

This post holder will be expected to participate in the Non CT & Acute Pain on call service.

Prospective cover of colleague for annual and study leave is a requirement of the post.

There is 24/7 emergency General Surgery provided by consultants with their principle employment for adjacent health boards. They also undertake elective surgery (day or 24 hour stay procedures).

5. Terms & Conditions of Service  National terms and conditions of service (Consultants (Scotland) 2004) cover the post.  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 throughout the duration of your employment and to comply with and abide by the relevant code of professional practice, as appropriate. It is also required to familiarise and comply with local clinical policies and protocols.  The appointee will be expected to work with local managers and professional colleagues in the efficient running of services. The appointee will be expected to follow the local and national employment and personnel policies and procedures.  All medical staff employed by the Centre is expected to comply with the agreed health and safety policies.  The successful candidate(s) will normally be required to live within 45 minutes drive of GJNH.  The Terms and Conditions of Service state that the “removal expenses shall be reimbursed and grants paid only when the employing authority is satisfied that the removal of the practitioners home is required and the arrangements proposed are reasonable”. Therefore, successful candidates are advised not to enter into contractual arrangements for the removal of their home until such a time as the formal approval of the Centre is confirmed in writing.  Annual appraisal and job planning is a requirement for all permanent medical staff.

JOB DESCRIPTION AGREEMENT

Job Holder’s Signature: Date:

Print name: Date:

Head of Department Signature: Date:

6. Further information and arrangements to visit

Intending applicants are welcome to visit the Department and to discuss the post in detail by arrangement with Mrs. L. Graham, Head of Operations Surgical Specialties, Tel 0141 951 5519 or Prof. S. Schraag, Operational and Strategic Lead, Tel 0141 951 5609 at the Golden Jubilee National Hospital, Clydebank.

In the first instance please contact:

Dr Alistair Macfie, Assistant Medical Director Golden Jubilee National Hospital Agamemnon Street Clydebank G81 4DY Tel: 0141 951 5298 Email: [email protected]

Prof. Stefan Schraag, Operational and Strategic Lead Non Cardiac Specialties Golden Jubilee National Hospital Agamemnon Street Clydebank G81 4DY Tel: 0141 951 5609 Email: [email protected]

7. Applications

Applications should contain:

 Comprehensive CV  Two reference contacts  Covering letter indicating and describing the application  Copies of training certificate  Copy of GMC certificate  Evidence of further qualifications

Completed applications to be returned to:

Miss Paula Wood Recruitment Section Human Resources Department Golden Jubilee National Hospital Beardmore Street Clydebank G81 4HX

National Waiting Times Centre NHS Board Recruitment Person Specification - Locum Consultant Anaesthetist

Essential Desirable How or wher e to be judge d

1. Qualifications

MBChB or Equiv. Higher research degree Application

FRCA or Equiv. Evidence of mandatory Application training e.g. resuscitation, On GMC specialist register or hand hygiene and fire Application eligible to be within 6 months training. Application

Application/Interview 2. Training / Experience Recent experience of Extensive training in working within the NHS Anaesthesia including Uk provider Application/Interview regional anaesthesia Application/Interview Experience in intravenous anaesthesia (TCI) Application/Interview

Application/Interview Specialist training in loco . -regional anaesthesia

European Society of Regional Anaesthesia (ESRA) diploma

3. Skills/Knowledge Experience in ultrasound Effective MDT working for regional anaesthesia Interview Excellent team working skills Application/Interview

IT skills including use of Application/Interview clinical systems.

4. Understanding of the Interview objectives of the NWTC Board Clinical Strategy 5. Teaching & Education

To provide clinical supervision Ability to become an Application/Interview of postgraduate training educational supervisor doctors “Training the trainers” Application/Interview Teaching undergraduates and qualification. other health professionals

6. Clinical Audit & Risk Management

Demonstrate recent Application/Interview experience of clinical audit and evidence based practice Application/Interview Key principles of Clinical Governance and Data Protection Application/Interview

Understanding of risk management and patient safety initiatives 7. Research and innovation Peer-reviewed Application/Interview Previous and current active publications in recognised interest in research with journals reflecting peri- evidence of publications operative medicine Interview Previous contributions to innovative service developments 8. Understanding of GMC Requirements

Knowledge of ‘good medical Interview practice’ Knowledge of appraisal/revalidation process Interview

Understanding of the GMC and its new roles Interview 9. Leadership/Management Previous management Interview Demonstrate leadership and Clinical Leadership potential roles Application/Interview

Management qualification or leadership training e.g. Application/Interview MBA