JOB DESCRIPTION

1. JOB IDENTIFICATION Job Title: Salaried General Medical Practitioner Location: Orcades Practice – Branch

Responsible to: Isles Network of Care (INOC) Manager

Accountable to: Associate Medical Director - Community

Department: Primary Care

2. JOB PURPOSE To undertake a traditional General Practitioner role for an island community; with sufficient time and support to provide exemplary standards of care. The post holder will be one of three GPs providing services to the island of Hoy in rotation. The post holder will be resident on island during periods of working and will be central to providing a full range of general medical services to the population of Hoy. The GP rota will be planned by mutual agreement between the GPs working on Hoy and the INOC Practice Manager, supported by the Primary Care department.

The post holder will provide daytime general medical services five days a week and emergency cover during the out of hours period each night and over the weekends. There is a community nursing service five days a week. The GP and nurse support each other in the delivery of holistic care and the management of emergencies. When clinically appropriate the practitioner will be expected to utilise technology, such as videoconferencing, to help deliver care. Back up support on island is provided by a group of volunteer ambulance staff and the GP will contribute to ongoing training and support of the nursing and ambulance staff. Teaching and providing experience of remote clinical working to visiting students and qualified practitioners is also part of the post holder’s responsibilities.

In addition to clinical duties, the GP team on Hoy must take responsibility for, and be actively engaged in, the administrative and ongoing governance duties required within the practice. These responsibilities must be appropriately shared between, and consistently supported by, all practitioners.

Hoy Surgery is a branch of The Orcades Practice, a “virtual practice” consisting of six island branches working together to improve clinical care, practitioner support and efficiency. The post holder will contribute to the smooth running and continual improvement of Orcades; contributing to clinical governance, educational and administrative activities and developments within the practice.

Orcades Practice is in turn a key part of the Isles Network of Care (INOC), which includes an additional four island practices, each staffed by Nurse Practitioners attached to independent GMS practices on Mainland. The post holder will also contribute to professional activities within INOC.

Through their role in Orcades Practice and their contribution to INOC, the post holder will work with NHS Orkney to further develop and improve clinical services in Orkney and support the aim of NHS Orkney to become a centre of excellence for remote and rural healthcare delivery and training.

3. CONTEXT The Orcades Practice is composed of , Papa Westray, , , Sanday and Hoy. Each island is staffed by either a GP or Nurse Practitioner providing 24-hour medical cover. GP staffed islands also have Community Nurse cover. These separate island practices were brought together to

Island GP (Hoy) Job Description Charlie Siderfin April 2021 form the Orcades Practice in order to promote best practice, improve clinical and administrative efficiency and further develop peer support. The Isles Network of Care (INOC) is composed of the Orcades Practice plus the services on , , and . Flotta is a branch surgery of Practice, Rousay a branch of Practice. Shapinsay and North Ronaldsay are branches of Heilendi Practice. INOC joins these island practitioners together through weekly videoconferencing sessions designed to deliver clinical governance and mutual support whilst developing a unified system of care. High clinical standards, robust clinical governance, good continuity of care and co-operative team working are essential components of the network which helps ensure the very highest standards of care. Local reception staff provide administrative support to the practices. You will work collaboratively with all staff within INOC and Orcades, taking responsibility for appropriate clinical and administrative areas within the practice, as agreed together. Unified clinical and administrative systems provide increased ease and flexibility should staff need to work in other areas of the network.

4. ORGANISATIONAL POSITION

Head of Primary Care

Associate INOC Medical Director Manager - Community

Salaried GPs

ORCADES AND INOC STRUCTURE

Island GP (Hoy) Job Description Charlie Siderfin April 2021

5. DUTIES AND RESPONSIBILITIES KEY RESULT AREAS COMPETENCIES

Provision of General Medical Services • Undertake the prevention, diagnosis and treatment of • Broad general medical experience illness, disease, disorders and injury of patients. and skills development. • Ensure provision of continuing care, treatment and • Effective team working. onward referral of patients, where appropriate. • Awareness and understanding of the • Provide a broad range of general medical services GMS Contract. and enhanced services to the practice population. • Provide emergency, preventative and anticipatory care along with the effective management of chronic disease. • Provide nursing services with support and training from nursing colleagues. • Provide support to NHS Orkney dental practitioners in managing emergency dental cases on the islands. • Provide services in the surgery and, where appropriate, in the patient’s home. Undertake telephone triage, consultation and appropriate management of patients contacting the service by telephone. Utilise NHS Near Me video consultations, where appropriate. • Actively participate in the multidisciplinary primary care team and work in cooperation with nursing, allied health and social work professional colleagues to provide a seamless service. • Keep contemporaneous, accurate and legible records of all patient contacts and contribute to electronic data monitoring and audit as directed by NHS Orkney. • Prescribe and dispense to the patient population in line with NHS Orkney policies and national standards. • Support the achievement of the GMS contract. • Support colleagues in ensuring practice cover is available at all time. • Provide a key role in pre-hospital emergency care until evacuation.

Clinical Governance • Ensure services are provided to recognised • Maintaining up to date knowledge on professional standards e.g. GMC. changes to practice. • Ensure services are provided in accordance with • Interest in quality development recognised best practice guidelines and protocols e.g. • Collaborative working. SIGN. • Deliver and support the quality improvement activities of the GP Cluster. • Undertake clinical audit as part of routine daily practice. • Promote and encourage reflective practice and learning for Orcades and the Isles Network of Care e.g. significant event analysis. • Prescribe effectively and safely in keeping with the Orkney Formulary. • Participate in the review of protocols and documentation and undertake research. • Undertake Clinical Governance within the context of Orcades and the Isles Network of Care.

Island GP (Hoy) Job Description Charlie Siderfin April 2021

Practice and Service Development • Actively develop a team approach in conjunction with • Pro-active. the Isles staff and other members of the INOC to • Team player. progress patient care and practice activities. • Flexible. • Actively participate in network meetings (business • Well motivated. and clinical) and contribute to service development • Ability to deal with change. and quality improvement. • Ability to work unsupervised. • Build positive and constructive relationships within • Awareness of NHS strategy and the network and with the wider clinical population. future national & local plans for • Participate or lead in activities to promote team service development and delivery. learning/development. • Support and train the island voluntary responder / ambulance personnel.

Public Health • Awareness and understanding of • Work in collaboration with Public Health colleagues broad public health issues. to achieve specific agreed local objectives with a • Appreciation of key general practice particular emphasis on innovative health role in this agenda. improvement within the practice. • Maintain a focus on the health improvement agenda through all activities. • Provide support to the public health management of communicable disease and environmental exposure incidents.

Continuing Professional and Personal Development • Participate fully in the GP Appraisal process. • Pro active about life-long learning, • Take a pro-active, planned approach to continuing development and personal professional development, building on outcomes of achievement. GP Appraisal. • Maximise opportunities to develop expertise/clinical interest in relevant topic areas.

6. ASSIGNMENT AND REVIEW OF WORK • Work will be dictated by patient need and will be as appropriate. There will be a requirement to be on call over the 24 hour period. • Supervision of clinical activity will be undertaken by peer review by the Associate Medical Director – Community, or their deputy, as appropriate. The post holder will be expected to seek and develop opportunities for critical peer review in cooperation with other clinical colleagues as part of Orcades and the Isles Network of Care. • Annual appraisal will be undertaken through the NHS Orkney GP Appraisal Scheme, or in another appropriate NHS Board. Compliance will be the responsibility of the post holder. • The post holder will be expected to actively participate in job planning.

7. COMMUNICATION AND WORKING RELATIONSHIPS • The post holder will work closely with the extended primary care team. This includes administrative and managerial staff, community nurses and community psychiatric nurses, social work staff, practice nurses and other GP colleagues. • There is a close and interdependent working relationship with clinical colleagues at The Balfour and with visiting clinicians from other NHS boards. The post holder will be expected to develop their relationships with these colleagues and work as part of a cohesive and supportive team. In addition, a high level of communication and liaison is expected with allied health professionals and ancillary staff. • The nature of life in small communities demands a careful approach to confidentiality and appropriate professional behaviour at all times, whilst acknowledging the need to be a central part of the community.

Island GP (Hoy) Job Description Charlie Siderfin April 2021

8. MOST CHALLENGING PART OF THE JOB • Spending time living and working in small and close knit communities can be a challenge in terms of work/life balance. • Maintaining professional skills and competence whilst working in isolation can be difficult and opportunities to learn from and cooperate with peers must be utilised.

9. PHYSICAL, MENTAL, EMOTIONAL AND ENVIRONMENTAL DEMANDS OF THE JOB • Professional and social isolation. • Close working in small communities • Distance from areas of population and amenities • Occasionally unexpected relocation to cover other islands • Travel and working in a physically and geographically challenging environment.

Island GP (Hoy) Job Description Charlie Siderfin April 2021

PERSON SPECIFICATION

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