Job Title: Consultant Anaesthetists (4 posts) Location: Dr Gray’s , Elgin Ref No: PR009776 Closing Date: Tuesday, 3rd March 2020

CONSULTANT ANAESTHETIST

DR GRAY’S HOSPITAL, ELGIN

REF: PR009776

You are invited to apply for the position of Consultant Anaesthetist at Dr Gray’s Hospital, Elgin (4 vacant posts).

You will be joining an enthusiastic team of 6 consultants (expanding to 9 with these posts) dedicated to providing a high quality, consultant- based anaesthetic service.

This is an opportunity to live and work in Scotland’s smallest District General Hospital within the beautiful and friendly surroundings of Moray Speyside.

Informal enquiries and visits are welcome.

Dr Iain Macdonald Dr Brodyn Poulton Dr Andrej Andrasovsky Dr Marek Wolanski Dr Alastair Ross Dr Doug McKendrick

ABOUT DR GRAY’S HOSPITAL

Dr Gray’s Hospital opened The anaesthetic department provides an in January 1819. The new e lective and emergency anaesthetic service for hospital was built co- General Surgery, Orthopaedics and Trauma, located to the original Dr Obstetrics and Gynaecology, ENT , Gray’s and opened in Urology, Ophthalmology and Dental Surgery. 1995. Anaesthesia is provided for surgery in children over the age of two years. Dr Gray’s is Scotland’s smallest District General Hospital with 100 Anaesthetists also play a central role in the acute beds serving a catchment population of resuscitation and stabilisation of critically ill about 132,000 spread between Forres and patients, including children. Macduff along the coast, and inland as far as Huntly and Tomintoul. Our hub tertiary centre We have a combined medical and surgical High ( Royal Infirmary) is located 65 miles Dependency Unit with ten beds. HDU staffing to the east. and medical supervision are under current review. Intensive Care Unit facilities are located The hospital has approximately 35 consultants at Aberdeen Royal Infirmary and necessitate working in the acute sector. Anaesthesia transfer of critically ill patients by road (or provides a consultant-based service. Service occasionally air). review for anaesthesia is currently taking place. It is now recognised that a significant increase in Remote and rural anaesthesia: new flexible the number of anaesthetists at Dr Gray’s arrangements are being discussed. There may Hospital is required to allow for a modern work- be potential for an appointee to have job life balance and promote an environment which planned time outside the Dr Gray’s Hospital will attract and retain high quality colleagues. An environment within one of the remote NHS Grampian review committee is also Community in the Highlands and assessing options for the potential of an Islands. additional resident tier of Specialty Doctor and Medical Training Initiative anaesthetists.

North of Scotland Retrieval Service Departmental Interests In April 2019, ScotSTAR opened a new North We currently have consultants with interests of Scotland critical care team and transfer/ which include regional anaesthesia, difficult retrieval hub (Emergency Medical Retrieval airway skills (Dr Gray’s International Airway Service North). This is a development of the Course), pre-assessment and pre-hospital and newly founded Major Trauma Centre (MTC) retrieval . A newly built Clinical Skills based at Aberdeen Royal Infirmary. A team of Centre (Alexander Graham Bell Centre) co-run Anaesthetic, ED consultants and ITU with University of Highlands and Islands (UHI) consultants run this service. This provides exists less than 1 mile from the hospital at the retrieval services for critically ill patients at Dr local UHI College base. We are keen to Gray’s Hospital by the Aberdeen-based team. encourage and develop any interest which a Patients are stabilised by the Dr Gray’s team candidate may wish to pursue. prior to retrieval. There are occasions when EMRS is not available and transfer is then A full Pre-Admissions Assessment Service required to be carried out by an anaesthetist sees all patients before admission for elective from Dr Gray’s Hospital. surgery and there is a consultant-led clinic every weekday afternoon. The acute pain service has Flexible, part-time working and remote and a full-time clinical nurse specialist. Foundation rural practice. Year 1 doctors complete a four- week block in We encourage applications from candidates anaesthesia during their critical care block and who wish to work in a part-time, flexible or final-year medical students from Aberdeen annualised manner. We fully realise that life as University are attached to the department for 8 a modern consultant should not necessarily weeks at a time. require to adhere to a standard Job Plan. There are opportunities for any candidate to develop a An anaesthetic nurse training programme work programme outside NHS Grampian. follows the Scottish Portfolio of Core Competencies framework set up by NHS Education Scotland. Ambulance paramedics and paramedics from the local Coastguard Search and Rescue unit attend for airway training.

THE POST

Four whole time equivalent consultant anaesthetist posts are available. These are replacement posts. Annualised or part-time working is available and encouraged. Each WTE post comprises an average of 4.5 clinical sessions per week plus out of hours non resident on call duties. This is a 10 PA post, but due to the needs of the service there is potential for additional EPA’s to be offered subject to agreement. 2.5 SPAs are allocated to each consultant.

The on-call commitment is 1:3.6. (when all posts are recruited to). Out of hours call in for the first on-call consultant ranges between 30% to 50%. Two consultant anaesthetists are on-call in every 24-hour period. The first on-call anaesthetist has no clinical commitments the following day.

Service review (anaesthesia) is due to report initial findings by December 2019: our service is currently entirely consultant delivered with a high call-out frequency and intensity of work. A resident tier of non-consultant anaesthetists is thought to be required for the “modern District General model”, and plans to institute this are under investigation. This could result in a resident tier of Hospital Specialty, Medical Trainee Initiative and rotational trainee posts, supported by consultants. An alternative option (with no resident middle grade anaesthetists) would be for a team of 12 non-resident consultant anaesthetists which would ultimately reduce on-call to 1:4.8 after prospective cover.

No more than 3 out of 10 WTE consultant anaesthetists should be on annual leave or study leave at one time. All consultants work flexibly to provide cross-cover for colleagues who are on leave or on- call. Covering sessions in this manner allows cross cover of all the surgical specialties in the hospital. Study leave allowances are generous, and every effort is made to encourage consultants to pursue CME activities.

The appointee will be expected to play a role in the activities of the department and the hospital, including teaching, audit, departmental meetings, liaison with other departments and general administration.

Dr Gray’s Hospital is part of NHS Grampian. The department of anaesthesia in Elgin is part of the clinical directorate of anaesthesia in Grampian and maintains close links with the department in Aberdeen.