CONSULTANT ANAESTHETIST Candidate Information Pack

June 2021

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NHS Shetland Pack Contents

To assist you with your application for the post of Consultant Anaesthetist, NHS Shetland, this pack will provide useful information about the post, about NHS Shetland and about the region more generally.

Section 1 Welcome from Kirsty Brightwell, Medical Director Page 3

Section 2 Working for NHS Shetland Page 4

Section 3 Advert Page 9

Section 4 Job Description Page 10

Section 5 Organisation and Departmental Information Page 13

Section 6 Main Duties and Responsibilities Page 17

Section 7 Person Specification Page 19

Section 8 Terms and Conditions of Service Page 22

Section 9 General Information for Candidates Page 26

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NHS Shetland Section 1 Welcome Dear Candidate,

Thank you for your interest in our Consultant Anaesthetist vacancy based at The Gilbert Bain Rural General Hospital, Shetland.

We are looking to work with individuals who understand the needs of small, generalist teams working with the challenges of distance and weather to together provide high quality, person-centred services to the population of Shetland. We understand that having a flexible approach to contracts and supporting people to maintain skills and other interests can create mutually beneficial ways of working.

Currently NHS Shetland is recruiting permanent posts in General Practice, Surgery, Medicine and Anaesthetics to create teams in each speciality. This will strengthen current arrangements which are partially dependent on long term locums. We aim to appoint the right individuals to our posts and to achieve this are flexible in the contracts we are prepared to offer to the right candidates.

Being remote is also an opportunity and Shetlanders are resourceful and community-spirited. There is a tradition of working together and partnership working with the Scottish Ambulance Service, Primary Care, the local authority and third sector organisations is well-established. Our patients are benefitting from the innovations in IT with more remote consulting locally and with Grampian.

The Gilbert Bain Hospital is one of the oldest in Scotland and we are in the process of planning for a new health hub. We have been working with the public and our partners to consider what a building for the next 50 plus years should provide. You will be involved in how we start to meet the changing requirements of our population in preparation to a move to a new site. The balance of diagnostics and definitive care and how we work with our tertiary care centre and ambulance service colleagues are conversations you will help shape.

In the meantime our teams provide adult and paediatric surgery both routine and emergency. You would be instrumental to the management and stabilisation of surgical and trauma emergencies. Being a small team means that colleagues will support each other in emergency situations. For the surgeons this particularly means playing a role in Gynaecology and Obstetrics to support single- handed colleagues. You will also need to build networks of support to maintain and improve the quality of care for the diversity of presentations that you will face.

We extend a warm welcome to you from Shetland and would love to explore with you how we could support a mutually beneficial relationship to bring you challenge and enjoyment. You can email me at [email protected] to organise a discussion about your next steps.

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NHS Shetland Section 2

Working for NHS Shetland

Who are we?

NHS Shetland provides primary and secondary care for the Shetland Islands.

The NHS Board determines strategy, allocates resources and provides governance across the health system working in partnership with the Integration Joint Board for Community Health and Adult Social Care services.

About NHS Shetland

NHS Shetland is the most northerly Health Service in the country and a unique setting in which to provide healthcare services. We are, of course, a small organisation, with around 700 staff looking after the health needs of some 23,000 people spread across 15 islands. However, what we lack in size, we more than make up for by way of the tight-knit, highly professional ethos that characterises every aspect of our operations. Local hospital services are provided from the Gilbert Bain Hospital in Lerwick. In addition, visiting consultants from NHS Grampian provide out-patient clinics as well as in-patient and day- case surgery to supplement the service provided by our locally-based Consultants in General Medicine, General Surgery, Anaesthetics and Psychiatry. There are 10 health centres spread across Shetland, with GPs, Advanced Nurse Practitioners, District Nurses and Practice Nurses providing primary health care. We have a progressive agenda within Shetland and work in partnership, not only with other local stakeholders but with the NHS in Scotland as a whole, and NHS Grampian in particular along with health boards in the North region.

Your job should you care to join us – is to provide surgical services to, and strive to improve the overall health of, the population of this most delightful part of the British Isles. As well as the Gilbert Bain Hospital there are Local Community Services, which are provided via GPs and Community Nurses , Dentists, Pharmacists, Allied Health Professionals and Social Care workers working from one of our ten Health Centres/ or Care Homes and other locations including mobile units and schools. All in all, you’ll find a superb degree of professionalism allied to a practical, resolute approach to the challenges of providing healthcare in a northern island setting.

Working at NHS Shetland

What’s it like to work in the Health Service in Shetland? Well, the remote and rural nature of our service brings its own challenges, however you can be assured that appropriate facilities and equipment are as good as any you’ll get on the mainland. Moreover, the friendliness and professionalism of your new colleagues will help you to quickly find your feet and feel at home in your new surroundings.

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NHS Shetland

Living in Shetland

We cheerfully admit that Shetland is not for everyone – if you want to go on the underground train to a West End Theatre then we’re going to disappoint you – but for those looking for a rural lifestyle and an indisputably higher quality of life then we should be on right at the top of your list.

It is a land of many contrasts - rugged hills and flower-strewn meadows; large new houses and traditional crofts; ultramodern ships and small boats which can trace their ancestry back to Viking times. Islands which are distinctly Norse in character yet part of Scotland’s islands with a fascinating heritage and a timeless quality.

Watch myriads of seabirds over an ultramarine sea or the breathtaking loveliness of a reflected sunset. Listen to the sigh of the waves or the weird “drumming” of the snipe at dusk. Smell the heady fragrance of massed wildflowers or the evocative tang of peat smoke.

What we can offer you

Working with NHS Shetland offers a variety of opportunities and benefits:

• Access to the NHS pension scheme • Financial and peer assistance relocating to Shetland • NHS Shetland is an equal opportunities employer and promotes work-life balance and family-friendly policies • A beautiful setting to live and work and to take time out after a busy day or week • Access to a transport network offering easy travel links to the rest of the UK and Europe, as well as international options

Teaching and Training Opportunities & Research Continuing education and professional development (CEPD)

The Board recognises this to be a crucial aspect of the appointment as part of its provision of high-quality health care and responsibility for clinical governance. CEPD is undertaken not only in line with individual Personal Development Plans but also as part of departmental service development.

A medical library has been recently established and is rapidly evolving under the guidance of senior medical and nursing staff. Internet access, the e-library and an on-line retrieval system is available locally. Arrangements exist for access to the extensive medical library at Aberdeen Royal Infirmary for research and study purposes not catered for in Shetland.

CEPD programmes are encouraged and take full advantage of study leave opportunities. Requests are considered flexibly to allow for the difficulties of off-island travel. The Board is at the forefront of videoconference use as an innovative tool to support remote learning. In recognition of the potential difficulties of professional isolation the Board also looks

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NHS Shetland favourably on short secondments to other units, especially if designed to update clinical skills or to further develop clinical networks.

Clinical audit is regarded as an integral part of the CEPD package: some assistance and guidance in performing clinical audit is available from the Clinical and Governance Team. Regular inter-departmental meetings are being developed to capitalise on local expertise and to enhance cross-fertilisation of knowledge, and videoconferencing is used to access Deanery and Royal College Programmes. Inter-disciplinary ward ‘mortality and morbidity’/governance meetings are currently scheduled every two weeks.

Regular service-wide multi-disciplinary clinical governance activities are in place.

Outside the hospital the local Postgraduate Education Adviser organises an active postgraduate training programme for doctors in both primary and secondary care and all are encouraged to participate. In addition mainland experts are invited at intervals to lecture both to this group and to local symposia.

Whilst small we do provide teaching and training opportunities for junior doctors.

We enjoy close links with the University of Aberdeen (http://www.abdn.ac.uk) whose Medical School is renowned for preparing its medical students to become doctors.

Our vision, values and strategic aims

We strive to provide high quality, safe, effective and person centred healthcare, continually improving clinical outcomes for patients who use our services and for our population as a whole.

To achieve this, we are committed to ever-closer integrated working with patients and our other partners in healthcare and to embedding a culture of continuous improvement to ensure that:

We have identified five strategic objectives to ensure we can deliver safe, effective and person-centred health and social care: 1. To improve and protect the health of the people of Shetland 2. To provide quality, effective and safe services, delivered in the most appropriate setting for the patient 3. To redesign services where appropriate, in partnership, to ensure a modern sustainable local health service 4. To provide best value for resources and deliver financial balance 5. To ensure sufficient organisational capacity, capability and resilience

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NHS Shetland

Vision

To deliver sustainable high quality, local health and care services, that are suited to the needs of the population; to make best use of our community strength, community spirit and involvement; for people to make healthy lifestyle choices, and use their knowledge and own capacity to look after themselves and each other.

Values

Person centred – in the partnerships between patients, their families and those delivering healthcare services we respect individual needs and values and demonstrate care and compassion, continuity, clear communication and shared decision-making.

Safe – avoiding injury or harm, in an environment that is clean and safe.

Effective – the most appropriate treatments, interventions, support and services provided to everyone who will benefit.

Efficient – making best use of available resources, and the eradication of wasteful or harmful variation.

Equitable – taking account of and valuing diversity, promoting equality, fairness.

Timely - linked to effective: services in the right place at the right time, reducing waiting times wherever possible.

Sustainable – using resources responsibility, to continue to provide services locally.

Ambitious – always striving to be better for our patients, staff and service

Geography 60º North

The islands of Shetland lie scattered like the pieces of an elongated puzzle some 93 miles (150 km.) north of the Scottish Mainland. The capital, Lerwick is 211 miles (340 km.) from the Scottish port of Aberdeen and only about 18 miles (29 km) more than this from Bergen in Norway and Torshavn in the Faroe Islands.

The 60-degree line of latitude lies across the South Mainland of Shetland, passing through the small island of Mousa with its famous broch. There are over 100 islands ranging in size from the large island of Mainland (351 square miles/909 square kilometres) to the numerous small skerries and islets along the coast.

The distance from Sumburgh Head, the most southerly tip of Mainland, to Hermaness at the most northerly tip of Unst, is about 70 miles (113 km). North of Unst lies Muckle Flugga with its lighthouse perched 192ft. (59m) above sea level; the most northerly inhabited island in the British Isles.

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NHS Shetland

Fair Isle is 24 miles (39 km) south-west of Sumburgh Head and lies mid-way between Shetland and Orkney. Foula, off the West Mainland, is about 18 miles (29 km) west of Walls.

Travelling to Shetland

Shetland lies at the crossroads of the North Sea and the North Atlantic, virtually equidistant from Aberdeen, Bergen in Norway and the Faroe Islands, and there are frequent, efficient air and sea services through Aberdeen.

Most major airports and cities in the UK have scheduled flights to Shetland through Aberdeen (50 minute flight), Edinburgh (1hour 20minutes) and Glasgow (1hour 30 minutes). Northlink Ferries currently operate car ferries seven days a week direct from Aberdeen to Shetland on Mondays, Wednesdays and Fridays (via Orkney on Tuesdays, Thursdays, Saturdays and Sundays) in comfortable, well-appointed vessels. There are also connections to Scrabster in Caithness (via Orkney).

The ferry journey from Aberdeen to Shetland takes between 12-14 hours, leaving Aberdeen at 1900 hours direct (1700 via Orkney) and arriving in Shetland 0730 hours the following morning. The return journey similarly leaves Lerwick at 1900 hours direct (1730 via Orkney).

In the summer an air service connects Bergen with Sumburgh Airport.

Links The websites below provide useful information for living and working in Shetland: https://www.shetland.org/ http://www.shetland.gov.uk/

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NHS Shetland Section 3 CONSULTANT ANAESTHETIST Full time or Flexible Part Time Contract Salary Range £84,984 - £112,925 Per annum (pro rata if applicable) Plus: 8% On-call supplement, Distant Islands Allowance £1,971 per annum (pro rata) and relocation assistance up to £8,0001

NHS Shetland is the most northerly Health Service in Scotland and is a unique setting in which to develop your career. We are, of course, a small organisation, with circa 700 staff looking after the health needs of 23,000 people spread across 15 islands. However, what we lack in size, we more than make up for by way of highly integrated, person centred and multi-professional ethos that characterises every aspect of our operations.

We are looking to appoint part time or full time Consultant Anaesthetists to work for NHS Shetland at the Gilbert Bain Hospital, Lerwick. We are offering both the standard contract and a new format, which enables the post holder to work in Shetland, but also maintain continuing education and professional development (CEPD) and specialist interests within a tertiary centre or overseas. We are offering either a full time post (WTE 1.0) with a standard contract or part time posts with a contract for 39 weeks per year (WTE 0.75). For the part time post, the Consultant will have a job plan which requires them to work in Shetland up to 26 weeks per year, on a rota providing blocks of cover 4 weeks at a time (which equates to approximately four weeks in every nine weeks), but other patterns of working would be considered in line with service need.

A further 6 weeks will be paid to enable the Consultant to maintain their clinical skills and special interests (e.g. accessing CEPD, pursuing research interests etc). NHS Grampian is our nearest tertiary centre but the Consultant will be able to establish an honorary contract with another suitable Health Board or Trust as appropriate to meet their needs.

On call is part of the service and has a 1:4 prospective commitment. This model is already in place and you will be joining a stable team that is familiar with this pattern of rotational working.

The Anaesthetic Department provides comprehensive general anaesthetic and critical care services. In addition, because of the remote nature of Shetland there is the necessity on occasion for anaesthetists to provide an enhanced trauma resuscitation service, to provide expertise in the resuscitation and stabilisation of neonates and paediatric patients, and to reap the reward of being able to adapt core anaesthetic skills to suit unpredictable and potentially challenging clinical scenarios arising outside the traditional theatre-based environment.

For more information and informal enquires contact Dr Catriona Barr, Consultant Anaesthetist via email [email protected]

Closing Date: 1st August 2021 Interview Date: 12th August 2021

For further details and to apply, please click on the following link: https://apply.jobs.scot.nhs.uk/vacancies.aspx?chkDivision=173

1 Only applicable for staff relocating to Shetland

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NHS Shetland

Section 4

JOB DESCRIPTION

Job Title: Consultant Anaesthetist

Department: Anaesthesia

Model of service delivery and contract types available

We are offering either a full time post (WTE 1.0) with a standard contract or part time posts with a contract for 39 weeks per year (WTE 0.75). For the part time post, the Consultant will have a job plan which requires them to work in Shetland up to 26 weeks per year, on a rota providing blocks of cover 42 weeks at a time (which equates to approximately four weeks in every nine weeks), but other patterns of working would be considered in line with service need.

On call is part of the service and has a 1:4 prospective commitment. This model is already in place and you will be joining a stable team that is familiar with this pattern of rotational working.

Section 7 sets out the different contract types.

Post Summary:

The anaesthetic team in Shetland have to manage a broad range of anaesthetic and critical care challenges and from a service delivery point of view need to remain ready to cover all areas. Therefore the ability to utilise or develop a subspecialty interest with respect to service delivery is available and encouraged. Examples of subspecialty interests that would be considered are pain medicine, trauma obstetric anaesthesia and paediatric anaesthesia.

2 Longer blocks or variation in pattern of working can be negotiated

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NHS Shetland NHS Shetland wishes to be open and flexible in order to accommodate the needs of any applicant wishing to maintain skills. Therefore, we would consider applicants wishing to split their time between Shetland and a mainland hospital or other medical employment e.g. Retrieval medicine

Anaesthetic department function and workload

The Department provides comprehensive general anaesthetic and critical care services. Adult, level 2 critical care services are provided locally and we stabilise and care for level 3 patients prior to their retrieval and transfer to the mainland by the ScotSTAR retrieval team. Retrieval services cover adult, paediatric and neonates.

In keeping with the nature of the workload, each anaesthetist is expected to have a broad range of anaesthetic skills encompassing generalist, paediatric, obstetric and critical care fields. Case load is such that each anaesthetist has to plan their continuing professional development carefully to ensure that essential skills are maintained.

This may be achieved through remote learning, periods spent working away from Shetland and networking with the wider regional and national teams. NHS Shetland is committed to the anaesthetic team retaining existing skills and developing new ones, while ensuring that the clinical workload remains covered.

There is a Chronic Pain Clinic which has approximately 750 patient contacts a year, an anaesthetist with existing skills to contribute to this workload would be welcome to apply- currently the service is provided by locum staff.

There is a good working relationship between the department and colleagues at Aberdeen Royal Infirmary and each anaesthetist would be eligible to apply for Honorary Consultant status with Grampian Health Board which is valuable for the purposes of regular periods of secondment for professional development and skills refreshment.

Departmental workload includes sessional commitments to elective and emergency anaesthesia, pain services, anaesthetic pre-assessment and High Dependency as in the departmental weekly service plan shown below. Sessions would be apportioned on an equal footing to each consultant according to their own interests, their job and development plans, the requirements of the service and the resources available

Successful applicants would work on a one in four rota with prospective cover and must be available to attend the hospital within 20 minutes of being called, therefore where you reside will be a key consideration. While the workload is less intense than in a mainland hospital on call commitment, the anaesthetists do attend the hospital regularly out of hours and when involved in the stabilisation of a level 3 patient will be resident in the hospital for 6 or more hours, depending on weather, retrieval team availability and other factors.

Non- Clinical workload The anaesthetic department is central to the work of the hospital and is represented on a number of hospital committees, for example the Resuscitation Committee, the Ambulance Liaison Group, the Consultants Group and the Medical Education Governance Group. Anaesthetic team meetings are held regularly with the anaesthetic nurses, and theatre team, and the Anaesthetic department also runs hospital wide clinical governance meetings alongside the surgical, medical,

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NHS Shetland primary care and mental health teams. Practice development work in pre-operative assessment, vascular access, the use of ultrasound in elective and emergency care is currently ongoing and new appointees can contribute to this and other areas of interest. Managing the function of the team including the rota will also be expected as part of the role.

Example of possible Job Plan: Mon Tue Wed Thu Fri Sat Sun AM 8am- List List On Call SPA On Call One in Four One in Four 12 noon /High Dependency Unit/Pre-operative Assessments PM List List On Call List On Call One in Four One in Four 12 noon- /High Dependency 4pm Unit/Pre-operative Assessments OC On Call One in Four One in Four 4pm-8am + 2PA for out of hours

The above is an example of a weekly rota. Full time consultants in post currently work 8 DPA’s + 2 SPA’s, plus 2 EPA’s for out of hour’s commitment

There needs to be flexibility in such a small hospital and team. Team work is of great importance in Shetland, and in the interests of good patient care and support of the team, consultant anaesthetists may need to vary their work pattern, for example doing clinical work while on SPA time and vice versa.

In addition, you may still be required to remain on the Island at the weekend even if you are not on call. We try to ensure that there are at least two anaesthetists on the island at all times in order to support each other with difficult clinical situations.

The job plan and work schedule will set out agreed arrangements for how work is organised, when it is performed, and how programmed activities are divided between Direct Clinical Care and Supporting Professional Activities. The job plan is subject to mutual agreement and will initially be reviewed by the Medical Director three months after commencement of employment. In accordance with Section 3 of the Terms and Conditions of Service, the job plan will be reviewed at least annually thereafter.

All posts are offered according to the Terms & Conditions of the 2003 Consultant Contract (Scotland) including all subsequent modifications to this. In addition where the above T&Cs do not make any provision the provisions of the General Whitley Council Terms & Conditions shall apply. The posts are subject to the provisions of the European Working Time Directive. The posts require the successful applicant to be registered with the GMC with a license to practice and to be on the specialist register by the time of taking up the post. The successful applicants will be allocated an appraiser and will be expected to participate in annual appraisal and job planning and to revalidate as required by the GMC.

Annual leave and study leave are as per the above T&Cs. Office accommodation and equipment is provided along with secretarial support.

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NHS Shetland For Consultants opting for a rotational post, the work pattern will be the same as the example above but will be worked in rotational blocks e.g. four weeks in every nine weeks. There will also be a short handover period to allow handover of caseload between each rotation.

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NHS Shetland Section 5

Organisation and Departmental Information

Introduction

The appointee will provide a comprehensive anaesthetic service to Shetland Health Board and the people of Shetland. The post is located at Gilbert Bain Hospital, Lerwick and you will be responsible to the Chief Executive via the Medical Director, a senior clinician.

Gilbert Bain Hospital

The Gilbert Bain Hospital, Lerwick, is the only acute general hospital on Shetland and it serves both the population of approximately 23,000 within the Shetland Health Board area and 4000 offshore workers in the fishing and oil industries. The hospital is a 3-storey building, opened in 1961, with an extension opened in 1991 and a modern Outpatient department completed in 2008.

The bed complement is: Ward 1 Surgical in-patients 20 Surgical HDU 2 Day Surgery 6 Ward 3 Medical 22 Maternity 6

The Accident and Emergency Department serves not only the islands but also acts as a front- line station for personnel on marine vessels and offshore installations. A full range of medical and surgical conditions is treated, from minor injuries to major trauma requiring resuscitation, stabilisation and aero-medical evacuation to mainland Scotland. It is permanently staffed and has two fully equipped resuscitation bays, a plaster room and three individual cubicles. . Medical cover is provided in-hours by junior medical and surgical staff, with support from a middle grade doctor in surgery, a number of Emergency Nurse Practitioners and a cohort of very experienced nursing staff. At night, cover is provided by a junior doctor supported by the nursing team with medical, surgical and anaesthetic consultants available from home.

Ward 1 is an acute surgical receiving unit with 20 acute beds and 2 High Dependency Unit beds. Emergency and elective surgical patients of all specialities are cared for here, along with paediatric surgical patients, palliative care patients, and patients with emergency orthopaedic complaints. Medical cover is provided by the 3 surgical consultants, a middle grade doctor and junior medical staff. The Board is at the early stages of incorporating advanced nurse practitioners into this team. A group of nurses have received training in remote and rural critical care and provide cover for the high dependence unit. On the HDU we are able to provide invasive monitoring and single organ support, including high flow nasal cannula oxygen, and short-term non-invasive and invasive ventilation. The unit is open to both medical and surgical patients. Depending on resources level 3 patients may be cared for in the HDU, in the Resus room, or in the recovery ward. The number of HDU patients is variable and increasing because of repatriation of some major surgery from Grampian, increasingly complex and elderly medical patients and changes in senior medical staffing.

The Day Surgery Unit provides 6 day-case trolleys for elective surgery and endoscopy and four beds for day case medical care for example iron transfusions, immunotherapy. Although currently

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NHS Shetland in separate locations these beds will soon be amalgamated in a major redevelopment which will culminate in a new 12 bed ambulatory care complex.

The Theatre Suite is spacious, modern and well equipped. It includes two operating theatres with adjoining anaesthetic rooms, a Recovery Unit and communal rest-room facilities for nursing and medical staff. Anaesthetic and monitoring equipment is of high standard and wherever possible is standardised throughout the Suite, the A&E and the HDU. The in-house surgeons undertake most elective and emergency procedures, and visiting surgeons provide regular opportunities to practice anaesthetic techniques for gynaecological, ENT, ophthalmic, and maxillofacial / dental surgery. Endoscopy is performed in theatre and the anaesthetic team provide sedation for this service. There are five qualified anaesthetic nurses who, as well as providing excellent support in theatre also participate fully in the management of critically ill adults, children and neonates.

Pre-operative assessment is carried out by highly trained nursing staff supported by the consultant anaesthetists using protocols based on NICE guidance and shared with NHS Grampian. The anaesthetists provide over the phone or in person advice regularly for the pre-operative nursing staff and have a close relationship with them. The anaesthetic nurses also perform pre-operative assessment for Shetland patients having surgery in Grampian and in the Golden Jubilee Hospital in Glasgow.

The Maternity Department is small but spacious (approximately 170 deliveries per year; 6 beds). Care is heavily triaged by the midwifery team. Ladies with anticipated difficulties are transferred to Aberdeen Maternity Hospital for delivery. Anaesthetic involvement includes ante-partum advice in potentially high risk pregnancies, anaesthesia for elective and emergency caesarean sections; it also includes resuscitation services to both mother and baby should the occasion arise. Recent changes have taken place for intra-partum care and we now have a Consultant Obstetrician on the Island at all times. The Obstetric service is currently provided Consultants who rotate every 4 weeks. They support ante-natal and peri-partum care and assist the general surgeons with Caesarean sections.

Services for children are designed to be appropriate for a non-specialist unit. We have recently appointed a Consultant Community Paediatrician which will not change the emergency care requirements. There are regular paediatric lists for dental surgery and some operating for general minor/intermediate surface surgery, together with the regular paediatric component of ENT. The anaesthetic team in Shetland are supported to provide anaesthesia for elective minor surgery in fit children down to the age of one year old. A paediatric surgeon visits the island four times a year and operates on suitable children locally at these visits.

In a surgical emergency involving a child, management depends on available skills and the practicability of timely transfer, and on occasion major emergency surgery in a child will be needed, on island.

In recognition of their specialist skills anaesthetists are asked to advise and contribute to specialist areas of medical paediatric care, in support of and in partnership with the consultant physicians. A nation-wide retrieval team exists for the transfer of critically ill children, but the anaesthetic department is pivotally involved in the initial resuscitation, stabilisation and local management of such patients.

In addition to undertaking pre-operative assessments, the Outpatient Department houses visiting specialist services providing expert support for ENT, ophthalmic, gynaecological, oral maxillofacial

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NHS Shetland surgery and dental services. A variety of tele-health services are also in place e.g. orthopaedics as the Health Board strives to repatriate services to Gilbert Bain Hospital. Specialist Nurses are in place supporting long term conditions and a variety of Link Nurses are in place to support other aspects of care such as Breast cancer and Inflammatory Bowel Disease.

The medical unit is based on Ward 3, is a 22 bedded medical ward with adjoining consultant and medical secretarial offices. Nursing staff are flexible and expected to help manage the genuinely unselected admissions on the unit.

Clinical Support Services are in line with those expected of a Rural District General Hospital (DGH). These include a full range of laboratory services, including laboratory biochemistry, haematology/bloodbank and microbiology. There are three portable ultrasound scanners available for clinician use within the hospital.

There is a CT scanner and in hours diagnostic ultrasound. A number of invasive radiological investigations are performed locally on a regular basis under the supervision of a visiting radiologist. Digital CR/PACS is in place which allows viewing of an electronic image anywhere in the hospital. Images are sent digitally to NHS Grampian for reporting. The community in Shetland is currently fundraising for an MRI scanner.

Gilbert Bain Hospital offers a wealth of opportunities to teach junior medical and nursing staff, helicopter and land ambulance paramedics, and a steady stream of medical students on elective. In addition there are two cohorts of Aberdeen medical students in Shetland throughout the academic year and St Andrews medical students in the summer. Consultants are encouraged to maintain GMC trainer status at appraisal and to apply for honorary lecturer status in Aberdeen School of Medicine. Consultant anaesthetists contribute to locally run ALS, ILS and PLS courses. A well-equipped new clinical skills training area with clinical simulation equipment and several training rooms is now available within the hospital.

An experienced medical secretary with extensive local knowledge provides secretarial assistance to the whole consultant team for anaesthetics. Her main responsibilities are the organisation of elective caseload relating to chronic pain services.

Standard office facilities include a personal laptop PC with IT support including Internet access, e- mail and electronic shared diary facilities. Communication devices such as a smart phone and bleep will be provided.

The hospital medical staff establishment:

Anaesthesia: 4.0 WTE Consultant Anaesthetists

Surgery: 4.0 WTE Consultant Surgeons 1.0 WTE Speciality Doctor: 1.0 WTE Trainee Advanced Nurse Practitioner (from August 2019)

Obstetrics & Gynaecology 2.3 WTE Consultant Obstetrician/gynaecologists (Job Share between 3)

General Medicine: 4.0 WTE Consultant Physicians (1 Job share between 2 part time Consultants)

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NHS Shetland

Psychiatry: 2 Consultant Psychiatrists (1 Job share between 2 part time Consultants)

Paediatrics: 1 Consultant Community Paediatrician (part time)

Junior Doctors 11 junior doctors: a mix of FY1, FY2, Clinical Development Fellows, LAS, LAT, working across Medicine, Surgery and Accident and Emergency.

In addition there are further senior medical staff:

The Medical Director, Associate Medical Director (Acute), Consultant in Public Health Medicine, Dental Director, Associate Medical Director (Primary Care)

Management Structure

NHS Shetland is a unified Island Board and the Board is responsible for both primary and secondary care services and is accountable directly to the Scottish Government Health Directorate. Formal professional representation at Board level is through the Medical Director, and the chair of the Area Clinical Forum (ACF). An Executive Management Team (EMT) provides strategic and organisational direction to both hospital and community care. Primary Care is integrated into the overall structure via the Integrated Joint Board (IJB). The jointly appointed (NHS and Council) Director of Community Health and Social Care is the joint officer for integrated community health and social care services. The Director of Nursing & Acute Services is the Chief Officer responsible for the Acute and Specialist Care Directorate.

Board philosophy is to involve and work closely with senior clinicians regarding major aspects of health care management and strategy.

Consultant professional interests are focused into a Consultants Group with the additional representation on the Executive Management Team and the Board through the Medical Director. The Area Medical Committee (AMC), of which all consultants are automatically members, is represented on the Area Clinical Forum by the chair of the AMC. The Chair of the Area Clinical Forum attends Board Meetings.

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NHS Shetland Section 6

Main Duties and Responsibilities

Posts are based on full time, 10 Programmed Activities (i.e. 8+2) and the possibility to negotiate up to 2 further EPAs (i.e. 10+2) with the Medical Director subject to job plan. Applicants interested in part-time/job share roles would have the terms pro rata.

Location:

 Gilbert Bain Hospital

Provide high quality care to patients:

 Maintain GMC specialist registration and hold a licence to practice  Develop and maintain the competencies required to carry out the duties of the post  Ensure patients are involved in decisions about their care and respond to their views  Where possible to collaborate with academic and clinical colleagues  To provide high quality teaching to medical undergraduates and members of other health care professions as required by the Director of Medical Education.  Responsibility for provision to the Health Board, with consultant colleagues, of a full range of anaesthetic services and the proper functioning of the anaesthetic department.

 Out-of-hours responsibilities on a 1:4 rota with prospective cover for emergency anaesthesia and critical care (see above). Cover of consultant colleagues for periods of absence will be required (in accordance with section 4 of the Consultant Grade (Scotland) Terms and Conditions of Service).

 In order to maintain adequate staffing levels, leave must be taken carefully and in consultation with colleagues to ensure that there are at least three consultant anaesthetists available during the week and two available on the island at the weekend.

Medical Staff Management:

 To work with colleagues to ensure junior doctors’ hours are compliant in line with European Working Time Directive and New Deal.  To participate in the recruitment of junior medical staff, and other health professionals as and when required.  To participate in team objective setting as part of the annual job planning process.

Governance:

 Participate in clinical audit, incident reporting and analysis and to ensure resulting actions are implemented.  Ensure clinical guidelines and protocols are adhered to by doctors in training and updated on a regular basis.

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NHS Shetland  Keep fully informed about best practice in the specialty areas and ensure implications for practice changes are discussed with the Medical Director.  Role model good practice for infection control to all members of the multidisciplinary team.  A requirement to participate in medical audit and other aspects of clinical governance, continuing medical education, appraisal and revalidation procedures.  Subject to the provisions of Terms and Conditions of Service, a requirement to observe the Board’s agreed Policies and Procedures, drawn up in consultation with the profession on clinical matters, and to follow the standing orders and financial instructions of the Shetland NHS Board; in particular, in formally managing employees of the Board, there is the requirement to follow the local and national employment and personnel policies and procedures.  A requirement to comply with Board Health and Safety policies.

Strategy and Business Planning:

 To participate in the clinical and non-clinical objective setting process for the directorate

Leadership and Team Working:

 To work collaboratively with all members of the team  To resolve conflict and difficult situations through negotiation and discussion, involving appropriate parties  Adhere to NHS Shetland and departmental guidelines on leave including reporting absence  Adhere to NHS Shetland values  Work with local managers and professional colleagues in the efficient running of services, and to manage local waiting lists, times and other service delivery targets and guarantees in order to ensure the quality delivery of services.  Share with consultant colleagues in the medical contribution to management.  Respond positively to appropriate requests for assistance wherever possible in the event of a major incident or other event where anaesthetic or professional expertise is felt to be advantageous.

Contact information

Interested applicants are most welcome and are encouraged to contact the relevant department for additional information and to discuss the specifics of the post. Please contact Dr Kirsty Brightwell (Medical Director) by email: [email protected] Or via phone 01595 743060 You are most welcome to contact a substantive post holder who currently works for NHS Shetland Dr Catriona Barr Email: [email protected]

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NHS Shetland Section. 7 PERSON SPECIFICATION

REQUIREMENTS ESSENTIAL DESIRABLE

Values and Commitment to being: Evidence of commitment to Priorities Patient centred networking at local/regional and A supportive member and lead of a team national levels Flexible and conscientious Evidence of commitment to Prioritise: systematic, high quality, Safety multidisciplinary learning and Quality Improvement teaching Lifelong learning including Appraisal and Revalidation A sustainable work-life balance Qualifications GMC Registered medical practitioner APLS, ALS, ATLS provider or and Training instructor status or willingness to FRCA or equivalent undertake this training in a timely Be on, or eligible for inclusion on, within 6 way. months of interview the GMC Specialist GMC recognised trainer Register for Anaesthesia with a licence to practice. Educational/clinical supervisor and able to sign off trainees on the (For successful applicants planning to RCoA lifelong learning platform. follow the CSER process a locum Additional post-graduate appointment would be made for a qualifications, e.g. MD/PhD/MSc or maximum of one year to allow the process sub-specialty training in obstetric to be completed) anaesthesia or pain medicine

Recent generalist experience at consultant Critical care/transfer experience Experience level in Anaesthetics including acute on- and/or demonstrable ability and call. willingness to upskill in Experience of critical care at senior trainee stabilisation/critical care of the or consultant level including on-call. unwell neonate, child and adult.

Subspecialty experience in a relevant discipline e.g. paediatric, obstetric, remote and rural Anaesthesia, critical care, transfer medicine or chronic pain.

Previous experience of working at senior level within the NHS

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NHS Shetland

Circumstances There will be rostered out of hours work. of Job However due to geographic location and demands on the single on-call anaesthetist this may necessitate supporting them outwith rostered hours.

In daytime hours there will be the requirement to flex between SPA activity and clinical work depending on the variable workload for the anaesthetic team.

Applicants will therefore need to demonstrate willingness to work flexibly.

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NHS Shetland

HOW TO APPLY AND TO ARRANGE INFORMAL VISITS External Applicants: i.e. if you are NOT currently an NHS Shetland employee or registered on our Bank, you must apply via the following website link:- https://apply.jobs.scot.nhs.uk/vacancies.aspx?chkDivision=173 ………………………………………………………………………………

If you require assistance with your application, please contact the HR office on 01595 743694.

More information about living and working in Shetland (including transport links to mainland Scotland) can be found on the Visit Shetland website on www.shetland.org Thank you for your interest. The Board hope that you will agree with them that the challenges and rewards of this position and life and work in Shetland are worth exploring further and we look forward to receiving your application.

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NHS Shetland Section 8 TERMS & CONDITIONS OF SERVICE – Section 7a: Terms and Conditions of Employment (Substantive contract) Type of Contract Substantive Grade and Consultant Salary £84,984 - £112,925 per annum pro rata based on seniority Plus eligibility to the following allowances: Supplement for on call work in Shetland per Consultant contract Ts and Cs Distant Islands Allowance of £1,971 per annum Hours of Work 40

Notice Period Employment is subject to three months’ notice on either side, subject to appeal against dismissal. Superannuation New entrants to NHS Shetland who are aged sixteen but under seventy five will be enrolled automatically into membership of the NHS Pension Scheme. Should you choose to "opt out" arrangements can be made to do this via: www.sppa.gov.uk

General You will be expected to work with local managers and professional colleagues in Provisions the efficient running of services and will share with Consultant colleagues in the medical contribution to management. Subject to the provision of the Terms and Conditions, you are expected to observe the organisation’s agreed policies and procedures and to follow the standing orders and financial instruction of NHS Shetland, in particular, where you manage employees of the organisation, you will be expected to follow the local and national employment and personnel policies and procedures. You will be expected to make sure that there are adequate arrangements for hospital staff involved in the care of your patients to be able to contact you when necessary.

Relocation Relocation assistance is provided up to £8,000. Expenses

Expenses of Candidates who are requested to attend an interview will be given assistance with Candidates for appropriate travelling expenses. Re-imbursement shall not normally be made to appointment employees who withdraw their application, refuse an offer of appointment. Non NHS employees are not normally awarded travel expenses.

Tobacco Policy NHS Shetland operates a No Smoking Policy in all premises and grounds.

Disclosure This post is considered to be in the category of “Regulated Work” and therefore Scotland requires a Disclosure Scotland Protection of Vulnerable Groups Scheme (PVG)

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NHS Shetland

Rehabilitation of The rehabilitation of Offenders act 1974 allows people who have been Offenders Act 1974 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 Shetland. Any information given will be completely confidential.

Medical In terms of NHS Circular 1989 (PCS) 32 dealing with Medical Negligence Negligence the Health Board indemnity will cover only Health Board responsibilities. Paragraph 63 of the General Medical Council's Good Medical Practice requires you to have adequate insurance or indemnity cover. You may wish to consider taking out additional medical indemnity e.g. with a Medical Defence Organisation to ensure that you have indemnity for the whole of your practice.

Principal Base of Gilbert Bain Hospital Work

Social Media You are required to adhere to NHS Shetland’s Social Media policy, which Policy highlights the importance of confidentiality, professionalism and acceptable behaviours when using social media. It sets out the organisation’s expectations to safeguard staff in their use of social media.

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NHS Shetland

Terms and Conditions of Employment (rotational contract)

Type of Contract Substantive Grade and Consultant Salary £84,984 - £112,925 per annum pro rata based on seniority. Plus eligibility to the following allowances: Supplement for on call work in Shetland per Consultant contracts and Distant Islands Allowance of £1,971 per annum Hours of Work 40 Notice Employment is subject to three months’ notice on either side, subject to appeal against dismissal.

Annual Leave 6 weeks per annum (pro rata for part time) e.g. pro rata proportion of 0.75 wte Public Holidays 10 statutory public holidays each year (pro rata for part time) e.g. pro rata proportion of 0.75 wte Other Leave Details of other types of leave including study leave, sick leave and special leave can be found in Section 7 of the Terms and Conditions of Service for Consultant Grade (Scotland). e.g. for part time Consultants, 6 weeks CPD, 1 week study leave plus 32.5 days AL/PH and any other leave combined which must be taken at times when not due on rotation.

Leave during 4 week rotation in Shetland will be by exception, on a time back basis where necessary to meet demands of the service. Superannuation New entrants to NHS Shetland who are aged sixteen but under seventy five will be enrolled automatically into membership of the NHS Pension Scheme. Should you choose to "opt out" arrangements can be made to do this via: www.sppa.gov.uk General You will be expected to work with local managers and professional colleagues Provisions in the efficient running of services and will share with Consultant colleagues in the medical contribution to management. Subject to the provision of the Terms and Conditions, you are expected to observe the organisation’s agreed policies and procedures and to follow the standing orders and financial instruction of NHS Shetland, in particular, where you manage employees of the organisation, you will be expected to follow the local and national employment and personnel policies and procedures. You will be expected to make sure that there are adequate arrangements for hospital staff involved in the care of your patients to be able to contact you when necessary. Relocation Relocation assistance is provided up to £8,000 (for full time contract holders Expenses only). Free accommodation3 will be provided for Consultants who take part time contracts and Shetland is not their permanent residence.

Expenses of Candidates who are requested to attend an interview will be given assistance Candidates for with appropriate travelling expenses. Re-imbursement will not normally be made

3 The free accommodation pertains to the time when the Consultant is working in Shetland covering the roster (i.e. up to 26 weeks or whatever the negotiated number of weeks are in the contract) to provide direct patient care.

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NHS Shetland appointment to employees who withdraw their application or refuse an offer of appointment

Tobacco Policy NHS Shetland operates a No Smoking Policy in all premises and grounds.

Disclosure This post is considered to be in the category of “Regulated Work” and therefore Scotland requires a Disclosure Scotland Protection of Vulnerable Groups Scheme (PVG)

Confirmation of NHS Shetland has a legal obligation to ensure that it’s employees, both EEA and Eligibility to non EEA nationals, are legally entitled to work in the United Kingdom. Before work in the UK any person can commence employment within NHS Shetland 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 for which they are applying. Where an individual is subject to immigration control under no circumstances will they be allowed to commence until right to work in the UK has been verified. Rehabilitation of The rehabilitation of Offenders act 1974 allows people who have been convicted Offenders Act of certain criminal offences to regard their convictions as “spent” after the lapse 1974 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 Shetland. Any information given will be completely confidential. Medical In terms of NHS Circular 1989 (PCS) 32 dealing with medical negligence the Negligence Health Board indemnity will cover only Health Board responsibilities. Paragraph 63 of the General Medical Council's Good Medical Practice requires you to have adequate insurance or indemnity cover. You may wish to consider taking out additional medical indemnity e.g. with a Medical Defence Organisation to ensure that you have indemnity for the whole of your practice. Notice Employment is subject to three months’ notice on either side, subject to appeal against dismissal. Principal Base Gilbert Bain Hospital of Work Social Media You are required to adhere to NHS Shetland’s Social Media policy, which Policy highlights the importance of confidentiality, professionalism and acceptable behaviours when using social media. It sets out the organisation’s expectations to safeguard staff in their use of social media.

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NHS Shetland

Section 9

General Information for Candidates

Data Protection Act 1988

Please note that any personal information obtained from you throughout the recruitment process will be collected, stored and used in line with the Data Protection Act 1998. Information will be available to the recruiting manager and to Human Resources staff.

Counter Fraud

NHS Shetland is under a duty to protect the public funds it administers, and to this end will use the information you have provided on your application form for the prevention and detection of fraud. It will also share this information with other bodies responsible for auditing or administering public funds for these purposes. More detail on this responsibility is on NHS Shetland intranet (Counter- Fraud and Theft page) and further information is available at http://www.audit- scotland.gov.uk/work/nfi.php.

References

All jobs are only offered following receipt of two satisfactory written references. At least one reference must be from your current/most recent employer or your course tutor if you are currently a student. If you have not been employed or have been out of employment for a considerable period of time, you may give the name of someone who knows you well enough to confirm information given and to comment on your ability to do the job.

Disclosure Scotland

Where a Disclosure or Protection of Vulnerable Groups Check is deemed necessary for a post, the successful candidate will be required to undergo an appropriate check. Further details on the Recruitment of Ex-Offenders are available from the recruitment centre.

Work Visa

If you require a Work Visa, please seek further guidance on current immigration rules, which can be found on the Home Office website www.ind.homeoffice.gov.uk

Job Interview Guarantee Scheme

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 job description will be guaranteed an interview.

Overseas Registration and Qualifications

NHS Shetland will check you have the necessary professional registration and qualifications for this role. You will need to provide an official translation of qualifications notarized by a solicitor of

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NHS Shetland your overseas qualifications to be checked by the recruiting panel. Please ensure that this is available before applying for the post.

Workforce Equality Monitoring

NHS Shetland is committed to supporting and promoting dignity at work by creating an inclusive working environment. We believe that all staff should be able to fulfill their potential in a workplace free from discrimination and harassment where diverse skills, perspectives and backgrounds are valued.

In order to measure and monitor our performance as an equal opportunities employer, it is important that we collect, store and analyse data about staff. Personal, confidential information will be collected and used to help us to understand the make-up of our workforce that will enable us to make comparisons locally, regionally and nationally.

Equal Opportunities Policy Statement

NHS Shetland considers that it has an important role to play as a major employer and provider of services in Shetland and accepts its obligations both legal and moral by stating commitment to the promotion of equal opportunities and elimination of discrimination.

Our Equal Opportunities in Employment policy can be viewed at:

http://www.shb.scot.nhs.uk/board/policies/hr-recruitment.pdf http://www.shb.scot.nhs.uk/board/equality.asp

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NHS Shetland

NHS Shetland Upper Floor Montfield Burgh Road Lerwick ZE1 0LA Telephone: (01595) 743060

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