NHS Ayrshire & Arran

CONSULTANT ANAESTHETIST (with interest in Intensive Care Medicine) University Hospital

VACANCY

Consultant in Anaesthesia 40 hours per week £80,653 (GBP) to £107,170 (GBP) per annum Tenure: Permanent

Applications are invited for the position of Consultant Anaesthetist (with an interest in Intensive Care Medicine) based at University Hospital, Ayr.

The post is within the Ayr Directorate of Anaesthesia, within an area-wide Anaesthetic Service which has a complement of 39 Consultant Anaesthetists. The Service serves a population of 375,000 with specialities located at University Hospital Ayr (in Ayr) and University Hospital (in ). There are currently 15 Consultant Anaesthetists based at Ayr and 24 at Crosshouse.

This post is based at University Hospital, Ayr. As with all appointments to NHS Ayrshire & Arran this appointment may require the appointee to work sessions across Ayrshire.

The successful applicant will be joining the Department of Anaesthesia at University Hospital Ayr, which currently has 15 Consultants, 2 Associate Specialists, 4 Specialty Grade Doctor and 5 Trainee Anaesthetists. The post holders will have the opportunity to develop sub-specialty interests to complement the existing expertise and interests of the department. The Department would welcome applications from individuals with an special interest in Intensive Care Medicine.

University Hospital, Ayr is a relatively new General Hospital which opened in 1991. In addition to a wide range of laboratory and investigative facilities, it provides acute and elective care in Orthopaedics and Trauma, General and Vascular Surgery, Ophthalmology and Urology. The Medical Department provides care in all aspects of General Medicine, Cardiology and Oncology. There are a total of 343 beds.

University Hospital Ayr is easily accessed by road, with the recently upgraded M77 providing rapid access to Glasgow (40 minutes from University Hospital Ayr). Rail services also link Ayr to Glasgow and other surrounding towns, and Airport is a 15 minute drive. University Hospital Ayr provides ample, free car parking facilities.

The Terms and Conditions of service are those determined by the Consultant Contract and the post is offered on a 10 programmed activity basis. Although the post is offered on a full-time basis, applicants wishing to work part-time would be considered.

Applicants must have full GMC registration, a licence to practise and be eligible for inclusion in the GMC Specialist Register.

Those trained in the UK should have evidence of higher specialist training leading to a CCT in Anaesthetics or eligibility for specialist registration (CESR) or be within 6 months of confirmed entry from the date of interview.

For further information or to apply for this exciting role, please contact the NHS International Recruitment Service:

Telephone: +44141 278 2712 Email: [email protected] Web: www.international.scot.nhs.uk

GLOSSARY

AHP Allied Health Profession CAMHS Child and Adolescent Mental Health Service CAPA Choice and Partnership Approach CBT Cognitive Behavioural Therapy CCT Certificate of Completion of Training CESR Certificate of Eligibility for Specialist Registration CPD Continuing Professional Development DCC Direct Clinical Care EEA European Economic Area FBT Family Based Treatment GIRFEC Getting it Right for Every Child GMC General Medical Council HR Human Resources HSCP Health and Social Care Partnership LD Learning Disabilities NHS National Health Service OOH Out of Hours PA Programmed Activity PVG Protection of Vulnerable Groups RMN Registered Mental Nurse SCA Scottish Centre for Autism SPA Supporting Professional Activity UK United Kingdom WTE Whole Time Equivalent

JOB DESCRIPTION

NHS Ayrshire & Arran Consultant Anaesthetist (with interest in Intensive Care Medicine)

Facilities Critical Care in Ayrshire There are currently 2 Intensive Care Units within Ayrshire in University Hospital Crosshouse and in the University Hospital Ayr.

The Intensive Care Unit in University Hospital Ayr is currently funded for 4 beds with 5 serviced bed spaces. The Renal Service is based at Crosshouse and both ICUs can provide Continuous Renal Replacement Therapy.

High Dependency Unit has 4 beds for medical and surgical patients and is collocated with the ICU. Both units are staffed by the same nursing team. There are plans to expand the HDU to 10 beds.

ICU has a dedicated echo machine with 2 FICE mentors in the department.

Full Haemodynamic monitoring is provided including CO monitoring.

Theatre Facilities The Theatre suite, expanded 3 times since 1991, now consists of 6 main theatres, 2 with laminar flow, an Interventional theatre, 3 Day Surgery Theatres and 2 Outpatient procedure rooms. The nearby Endoscopy suite has 3 fully equipped Endoscopy rooms. The 4-bedded ITU is immediately adjacent to the theatres.

A dedicated Emergency Theatre is available throughout the week and over the weekend for 24 hours a day. It is shared between all surgical specialties with Orthopaedics & Trauma having weekday morning priority.

On certain weekend days, depending on trainee experience, it is covered by a dedicated consultant working a session in the morning and continuing as the service demands with time allowed against flexible sessions or recouped in other ways. (see below under On-call arrangements)

NHS Ayrshire and Arran continues to invest in the purchase of up to date theatre equipment and has a well established programme for the ongoing replacement of existing equipment.

No. of Facilities The Ayr Hospital Main Theatres (five with laminar flow) 6 plus an interventional theatre Day Surgery Theatres 3 DSU Treatment Room 2 Endoscopy Procedure Rooms 3

Beds The following table provides a breakdown of the bed complement within University Hospital Ayr:

Surgical Specialty University Hospital Ayr General Surgery 24 Vascular Surgery 24 Orthopaedic 38 Ophthalmology Admitted to surgical ward if necessary Urology 23 ENT / Maxillofacial Surgery - Plastic Surgery 0 Oncology 12 High Dependency 4 (in addition there are 4 medical high care beds and post operative care rooms within the surgical ward) ITU 4

University Hospital Ayr has opened a Combined Assessment Unit in June 2017. This is a 29 single bedded area for medical and surgical patients. There is also an initial assessment area and an ambulatory care unit.

Imaging An extensive range of imaging facilities are available including spiral CT with 3D reconstruction, MRI, MRA, radio-isotope facilities and digital subtraction angiography.

The Emergency Department University Hospital Ayr provides full Emergency facilities through the Emergency Department. The Unit is currently staffed by teams of consultants in Emergency Medicine, supported by Middle grade, trainee doctors and Emergency Nurse Practitioners. The University Hospital Ayr site has undergone extensive development of their front door services, with a Combined Assessment Unit opened in June 2017.

Education Centres Excellent post-graduate facilities are provided at within the MacDonald Education Centre based at the University Hospital Ayr. The centre has a full size lecture theatre, classrooms, a skills lab, IT training facilities, and a number of tutorial rooms.

The facilities are supported with modern audio visual and information technology, including teleconferencing facilities and incorporate an excellent up-to-date library with a resident librarian. We have an enthusiastic faculty of trained simulation facilitators from anaesthesia, general medicine, emergency medicine.

Medical Photography The Medical Illustrations Department can provide a full service at both hospitals for clinical photography, preparation of slides, PowerPoint etc, for lecture purposes.

Medical Staff Resources

University Hospital Ayr Consultants SAS grades Dr I N Taylor (this post) Dr S Livingstone Dr RE Jackson Dr R Vidon Dr A Ziarkowski, ICU Clinical Lead Dr K Scott Dr B Parrish Dr A Mazhar Dr R McRobert, Clinical Director Dr D Belch Dr N Alaouabda Dr K Kerr Dr D McLaughlan Dr J Mitchell

Dr J Todd Dr J Ramsay Dr K Walker Dr K Dick

Future Plans for the Speciality The challenges currently facing all specialties centre around making more efficient use of our valuable resources and reducing inefficient practices whilst improving safety and reducing waiting times. Theatre managers meet on a weekly basis to review activity and have made significant improvements in both efficiency and safety.

Key to improving these further is Pre-operative care and assessment. We have an established CPET testing facility and consultant-led pre-operative assessment clinics. In addition, we have Enhanced Recovery Programmes established in Orthopaedics and Colorectal Surgery and are expanding these to include Major Urology. The recent appointment of ER Specialist Nurses will help develop these services and facilitate an increase in same-day admission.

The department consistently receives excellent feedback for its CCPOM teaching programme and has links with Glasgow Medical School in the form of two Honorary Clinical Senior Lecturers within the department. There will be opportunities for successful candidates to contribute to departmental teaching and training and for developing a role as educational supervisors and trainee appraisers.

Indicative Job Plan/Programme of Activities Proposed Weekly Programme The proposed weekly programme is shown below. Activities with current fixed time commitments will be carried out as detailed in the work programme e.g. clinics. Other DCC and SPA activities are shown with indicative timings within the weekly programme and will be discussed with the appointee.

Notes on the Programme Patient Administration: This activity covers the management of individual patients including Out Patient administration, results reporting, letters/phone calls to patients, carers, GP’S and members of the wider multidisciplinary team involved in the patients care.

Ward Rounds: The time allocated is indicative and will be discussed with the appointee. Ward work will include teaching ward rounds as required.

Travel: Any travel allocation will be included within the Total Programmed Activities and will be determined by location at which Direct Clinical Care and Supporting Professional activities are carried out.

On call arrangements: The post will involve participation on a 1:15, 2nd on-call from home rota with prospective cover. There is also a transfer rota which provides additional cover for moving critically ill patients and also additional theatre cover at weekends.

Flexible sessions: Any flexible sessions will be worked during the period 08:30 – 21:00 to allow flexible cover of elective theatres during the day time, and to cover emergency work including emergency theatre in the evenings and weekend mornings. These will be agreed in advance depending on the requirements of the service.

Supporting Professional Activities: NHS Ayrshire and Arran recognise the important role Job Planning has in ensuring consultants are supported in delivering high quality, safe, sustainable clinical care to patients. It is therefore important to ensure there is an adequate balance between direct clinical care activities and activities which support both the personal and professional development of the consultant workforce and facilitates agreed contribution to activities including:  Under and post graduate teaching/training  Clinical Governance  Quality and Patient Safety  Research and Innovation  Service management and planning  Work with professional bodies

All consultants will initially have 1 SPA as a minimum to support job planning, appraisal and revalidation with 1 further SPA to support department audit, teaching and development. However the final balance of SPA and DCC activity will be agreed between the appointee and clinical manager prior to contracts being agreed.

There may be a requirement to vary the DCC outlined in the indicative timetable below when the final balance of DCC and SPA is subsequently agreed. There may also be opportunities to contract for Extra Programmed activities Opportunities subject to service requirements and in accordance with national terms and conditions of service.

If the post-holder will be responsible for the formal training and supervision of post- graduates and under-graduates, a suitable additional allocation of SPA time will be made in accordance with national guidance.

Job Plan Review New appointees will discuss the indicative job plan with the Clinical Director, prior to commencement and will at that time review the balance of activities where it is possible to agree a revision to the indicative plan in advance of commencement this will be acted upon. In any event however, there must be an interim Job Plan review conducted at 3 months post commencement to agree and finalise the Job Plan. The consultant at time of induction should ask for an interim review date to be scheduled. The agreed job plan will include all the consultant’s professional duties and commitments, including agreed Supporting Professional Activities. Thereafter Job Planning will be carried out annually as part of the Boards Job Planning process.

Private Practice: If the post-holder wishes to undertake any private practice, they are obliged to inform their employer at the time of appointment of their intentions to do so. This should be submitted in writing to the Clinical Director. The conduct of private practice will be in accordance with the Consultant Contract (Scotland) Terms and Conditions.

The post-holder shall be free to undertake private practice without approval provided such work is undertaken outside the time agreed in the job plan for programmed activities. (Refer Section 6 of the New Consultant Contract).

Post Details The post holder will be accountable to the Clinical Director based at University Hospital Ayr, who will agree the job plan.

He/she will be expected to work with local managers and professional colleagues in the efficient running of services and will share with Consultant colleagues in the medical contribution to management. Subject to the provisions of the Terms and Conditions of Service, he/she is expected to observe NHS Ayrshire and Arran’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 NHS Ayrshire & Arran.

In particular, where he/she formally manages employees of the organisation, the post holder will be expected to follow the Local and National Employment and Personnel Policies and Procedures.

He/she will be expected to make sure that there are adequate arrangements for hospital staff involved in the care of patients to be able to make contact with the post holder when necessary.

The post holder is required to comply with NHS Ayrshire and Arran’s Health and Safety Policies.

He/she will be responsible for the training and supervision of Junior Medical Staff who work with the post holder and will be expected to devote time to this activity on a regular basis. In addition, he/she will be expected to ensure that Junior Staff have access to advice and counselling. If appropriate, the post holder will be named in the Contracts of Doctors in training grades as the person responsible for overseeing their training, and as the initial source of advice to such Doctors on their career.

Resources The staff resources of the Directorate are listed elsewhere. The post holder will have access to such general administrative support as is required for the discharge of his/her duties and responsibilities.

This will include the provision of adequate secretarial and clerical support and the availability of accommodation, equipment etc.

The post holder will receive support from such other professional staff as are employed within the organisation and are deployed to his/her area of patient care.

Duties and Responsibilities The main duties and responsibilities of the post include:  Continuing responsibility for the care of patients in his/her care and for the proper functioning of the department.  Administrative duties associated with the care of hi/her patients.  Responsibility for continuing care of patients as scheduled in job plan / programmed activities.  Provision of cover for consultant colleagues during periods of annual and study leave.  Professional supervision and management of Junior Medical Staff.  Responsibilities for carrying out teaching, accreditation and examination duties as required, and for contributing to undergraduate and postgraduate medical education. The post holder will be expected to comply with College recommendations on Continuing Medical Education.  The post holder will be required to comply with NHS Ayrshire and Arran’s Policies on Clinical Governance.  The successful applicant will be encouraged to participate in research and to develop a subspecialty interest, subject to resources and local priorities.  Requirements to participate in medical audit and in continuing medical education.  Managerial, including budgetary, responsibilities (where appropriate).

Annual Appraisal & Job Planning You shall be required to participate in annual appraisal. Job planning is linked closely with, but is separate to, the agreed appraisal scheme for consultants. The job plan review will take into account the outcome of the appraisal discussion and reflect the agreed personal development plan.

Terms and Conditions

The Terms and Conditions of Service are those determined by the Terms and Conditions of the New Consultant Grade (Scotland) as amended from time to time. The distance that a consultant can reside from the principal base hospital, where travel time is seen as more important than mileage, is subject to the agreement of the Executive Medical Director, but it is usually anticipated that a journey that takes no more than 30 minutes for any emergency situation would be acceptable.

Further Information and Visiting Applicants wishing further information about the post are invited to contact Dr Rose McRobert, Clinical Director for Anaesthesia, Tel 01292 617025 (Secretary) or via Switchboard, with whom visiting arrangements can also be made.

Indicative Job plan timetable

AM PM

Monday Emergency Theatre (alt weeks) Emergency Theatre (alt weeks)

Tuesday SPA* SPA

Wednesday ICU ICU

Thursday Day Surgery Urology Pre op / SPA

Friday ICU ICU

*SPA – Supporting Professional Activities

There may be sessions available within sub specialties should the preferred candidate have an interest in delivering sessions in a specific specialty within their job plan. The above job plan is indicative however these posts are to enable the department to move to a model of weekly blocks of ICU cover.

PERSON SPECIFICATION

NHS Ayrshire & Arran

Consultant Anaesthetist (with interest in Intensive Care Medicine)

Attributes Essential Desirable Qualifications Fellowship of the Royal College of and training Anaesthetists (or equivalent)

Full Registration with the GMC and a licence to practice

Completion of Higher Training in Anaesthetics and inclusion on the GMC Specialist Register or within six months of CCT or CESR (Anaesthetics) at interview

Experience Knowledge & skills relevant to the management of Anaesthesia for Adults

Knowledge of and skills relevant to the management of elective and emergency anaesthesia for adults

Ability to communicate effectively with all levels of staff and patients

Ability to work efficiently and timeously

IT literacy

Team Work Effective team player

Development Evidence of audit and involvement in clinical improvement activities within anaesthesia or critical care

Teaching & Experience in teaching Proven ability to deliver Training high quality teaching Interest in and knowledge of advances in medical education and training

Research & Evidence of publications in Publications a Peer-reviewed Journal

Clinical Audit Evidence of previous audit activity Peer reviewed publications relating to Anaesthesia and presentations

Management Commitment to effective Proven ability to lead a and departmental management and clinical team Administration the organisation and management of a multidisciplinary team Proven management experience

Understanding of resource management and quality assurance

Proven organisational skills

Personal and Effective communicator and Knowledge of recent Interpersonal negotiator changes in the NHS in Skills Scotland Demonstrate effective team leadership A willingness to accept flexibility to meet the A willingness to develop special changing needs of the NHS interests which conform to the in Scotland needs of NHS Ayrshire and Arran

Ability to operate on a variety of different levels

The ability to work flexibly and constructively with a team of colleagues

TERMS AND CONDITIONS OF SERVICE

NHS Ayrshire & Arran

Consultant Anaesthetist (with interest in Intensive Care Medicine)

Type of contract Permanent

Grade and salary Consultant: £80,653 to £107,170 per annum (GBP) New Entrants to the NHS will normally commence on the minimum point of the salary scale (dependent on qualifications and experience). Salary is paid monthly by Bank Credit Transfer.

Hours of duty 40 hours per week (10 sessions per week)