CLINICAL DEVELOPMENT FELLOWS IN

EMERGENCY MEDICINE

2018

NHS FIFE

ACUTE SERVICES DIVISION

Information for Candidates

CONTENTS

Page

Fife Region
Providers of Health Care in Fife
Summary of post / 3
3
4
Emergency Medicine, VictoriaHospital, Kirkcaldy / 4-5
Minor Injuries Unit, QueenMargaretHospital, Dunfermline / 5
Post Description
Emergency Department Staffing / 6
7
Non clinical aspects, Terms and Conditions of Service / 8
Applications / 9
Person specification
Appendix 1: Sample Junior Rota / 10
11
Appendix 2: Purchasers of Health Care in Fife / 12

Information for Candidates

FIFE REGION

The Region of Fife is bounded in the north by the Firth of Tay, in the east by the North Sea and in the south by the Firth of Forth. The Region spans an area of 130,700 hectares and has a population of 360,000. The population served by NHS Fife is currently around 280,000. There is a highly developed agricultural area in east and north-east Fife, and in the west there is an extensive cross-section of highly skilled and scientifically orientated industry. The largest towns are Dunfermline, Kirkcaldy and Glenrothes. The cathedral city of St Andrews is the seat of Scotland’s oldest and the UK’s second oldest university.

Fife is an area of considerable scenic and historical interest. The usual range of sporting facilities are available locally including golf, swimming, fishing, curling, soccer, rugby, cricket, sailing, motor sport and gliding. The Cairngorm Mountains are within easy reach providing access to skiing, mountaineering, orienteering, stalking and salmon fishing. Wide ranges of cultural activities are available in Fife, and in the cultural centres of Edinburgh and Glasgow. The main urban and leisure centres of central Scotland are within easy reach and there are excellent air, rail and motorway links to the rest of the UK. Edinburgh & Glasgow Airports are within easy reach by road.

PROVISION OF HEALTH CARE IN FIFE

Health care in Fife is provided by an Operating Division and three Community Health Partnerships:

Acute Services DivisionAcute services for Fife

Three Community Health PartnershipsCommunity, Learning Disability and Mental Health Services for Fife

EMERGENCY MEDICINE IN FIFE

VictoriaHospital, Kirkcaldy

Emergency Medicine in Fife

Acute care in Fife was centralised in January 2012 with the opening of the new phase of the Victoria Hospital, Kirkcaldy. The annual attendance is approximately 65 000 patients per year.

The department includes an 8 bay resuscitation area, a 9 bay majors area, a 6 bay minors area and 2 paediatric consulting rooms. There is a dedicated Procedures room and a 6 bedded Emergency Medicine Observation Unit which admits primarily toxicology and head injury patients. There is access to electronic pathology and radiology ordering. Departmental guidelines, protocols and rotas are on the departmental intranet web pages.

The Emergency Department has 24 hour senior doctor presence, with current shop floor consultant presence daily from 0800 to 2300. We have 4 GPwSI who deliver regular sessions in evenings and at weekends. There are daily ENP sessions to help with the minors flow.

There is a co-located GP OOH service in the evenings and at weekends, allowing redirection of appropriate patients. A formal redirection policy is in operation.

There is a 24 hour ENP-led Minor Injuries Unit Located at Queen Margaret Hospital in Dunfermline which is clinically supported by the senior doctors in the Emergency Department.

Facilities

Resuscitation Area

8 resuscitation bays, including a dedicated paediatric bay, with capability to accommodate 5 ventilated patients

All bays have full invasive monitoring capability

Facilities for CPAP/BiPAP

Mobile x-ray and processing

Dedicated Blood gas analyser

Telemedicine link for Stroke Thrombolysis out-of-hours

Majors/Immediate Care Area

9 monitored cubicles

Central staff base island with computer access to results and PACS x-rays

Procedures Room

1 one-bedded fully equipped procedures room used for procedural sedation and regional anaesthesia

Paediatrics

Paediatric waiting area separate from the main waiting area, with direct access into 2 dedicated paediatric consulting rooms

Minors

Staff base with computer access.

6 consulting bays and 3 rooms currently used for ENT, Eyes and O&G assessments.

Psychiatry Interview Room

A secure interview room with access to waiting area and emergency department

Emergency Medicine Observation Unit (EMOU)

6 bed observation unit solely for admission of patients under the care of the on-call emergency physician. This includes head injury observation, toxicology and post sedation observation and other conditions at the discretion of the on-call consultant. This clinical area is never used for the accommodation of patients awaiting admission under other specialties and there are strict admission criteria.

There is a multi-use office co-located with the ward with access to computers, which is also used for teaching sessions.

In addition there is consultant office space, senior nursing and doctors’ offices, secretarial accommodation and a relatives’ room.

In-patient specialty support on – site

On site support includes Anaesthetics and ICU, General Medicine (with Medical HDU), Cardiology and CCU, General Surgery (with Surgical HDU), Trauma and Orthopaedics, Maxillofacial Surgery, Paediatrics and Obstetrics & Gynaecology.

ENT is on site Monday 0800 to Friday 1700.

Emergency radiology is provided in a dedicated emergency diagnostic suite directly adjacent to the department. There is 24 hour access to CT scanning. MRI is available on site within office hours.

Emergency laboratory investigations are available 24 hours per day.

There is a stroke thrombolysis service which operates 24/7 either through on-site stroke or emergency physicians or telemedicine support from the regional hub.

QueenMargaretHospital (QMH), Dunfermline

A 24/7 ENP minor injuries unit runs in the former Emergency Department at the Queen Margaret Hospital, Dunfermline. Telephone support is provided by the consultant and middle grade staff at VHK.

THE POSTS

These now well established posts support the provision of high quality patient care within the Emergency Department. It is aimed at post Foundation Year trainees who wish to broaden their clinical experience and receive excellent training in the assessment and management of the undifferentiated patient.

These posts are for 1 year with a mutual review after the first 3 months. The first six months would be contracted at up to 48 hours per week. During this period, you will work for four months as an additional member of the junior tier not working more than 1:6 weekends. Night shifts will not exceed 4 nights in a 6 week cycle.You will be exposed to shop floor teaching focusing on prioritisation of workload, formulation of investigation and management plans. There will be scheduled time spent at Virtual Fracture Clinic vetting, knee clinic, and assisting on the observation ward with patient review under consultant supervision. There will be opportunities for additional experience in other specialties such as ophthalmology and ENT. It is expected that successful candidates with complete any outstanding life support courses not yet done (ie APLS/ATLS)

In addition, one month will be spent as a supernumerary trainee in anaesthesia (up to 40 hours per week) gaining skills in basic airway assessment and management. One month will be spent on the junior rota in Paediatrics (up to 40 hours per week) gaining and developing skills in assessment and management of paediatric patients including venepuncture and cannulation.

The second six months will involve working on the middle grade rota paired up with another clinical development fellow. This period will be contracted at maximum 48 hours per week, 8 hours per week for CPD. There will be the option to use these CPD sessions to allow a period of secondment to another specialty within NHS Fife.

Successful applicants will be encouraged to take part in departmental audit and in delivery of teaching sessions to junior colleagues and nursing staff with consultant support. They will be expected to maintain an e-portfolio and undertake regular appraisal. Each clinical fellow will be allocated a consultant educational supervisor to support their clinical and professional development.

Emergency Department Staffing

Consultants

There will be 9.85 WTE consultants providing shop floorcoverfrom 0800-2300 with overnight on-call.

Middle Grades

From August it is anticipated there will be a fully staffed six person middle grade rota providing 24 hour cover for the department.

There are 3 ST trainees from Lothian/SE Scotland rotation and 3 senior clinical fellows.

GP sessions

We have 4 GPwSI who do regular days and one weekend per month

Junior Doctors

6 FY2 and 6 GPSTs

Non Clinical Aspects of the Post

Teaching

There is an ongoing programme of departmental teaching sessions for the junior doctors (FY2 & GPST) which the successful applicant will be expected to attend during the first six months. They may be invited to deliver some of the content with consultant support and supervision during the second six months of the post. The department runs regular training days for nursing staff and there will be opportunities to contribute if wished.

Medical students from St AndrewsUniversity attend afternoon sessions on a Thursday for 2 semesters per year. The department also takes students from other Medical Schools for elective placements.

NHS Fife has an adult simulator which can be utilised for scenario based teaching and this is kept within the Emergency Department. We runmultidisciplinary scenario teaching sessions every 2 weeks in which the successful candidate will have the opportunity to participate. There will be scope to improve your teaching skills by developing scenarios to be used in the training program. There are SEFCE training sessions in Fife and you will be encouraged to participate in these via the TUBs system.

Continuing Medical Education

NHS Fife supports and will require the successful candidate to participate in continuing medical education (CME).

Research

Interest in research is welcomed and would be supported by consultant colleagues. The department has been involved in recent multi-centre trials.

Clinical Governance

NHS Fife is committed to maintaining a high quality of services to patients, with particular regard to patient safety, by continual development of practice in the light of research evidence and by audit based against relevant standards. There is a designated Audit Lead and active audit programme which includes participation in CEM audits. We hold a regular M&M meeting which you will be expected to contribute to.

TERMS AND CONDITIONS OF SERVICE

The post is covered by the specialty registrar conditions of service

APPLICATIONS

If you wish to apply for this post please email and you will be provided with the job pack and an application form for completion. You should ensure within the application form you include the names and email address’s of three referees, one of which should be your current or most recent employer.

CLOSING DATE: Friday 9th Marchat 5pm

CANDIDATES NOTIFICATION OF SHORTLISTING (BY EMAIL): Tuesday 13th March

INTERVIEW DATE: Monday 19th March*. * if there is a high volume of applicants there may be the need for an additional interview day on Tuesday 20st March

START DATE: August 1st 2018

Prospective applicants wishing to visit the department or desiring further information should contact:-

Dr Andrew Kinnon

Consultant Emergency Physician

VictoriaHospital

Hayfield Road

Kirkcaldy KY2 5AH

Tel: 01592 643355 ext 29782

E-mail:

Dr Julie Thomson

Consultant Emergency Physician

VictoriaHospital

Hayfield Road

Kirkcaldy KY2 5AH

Tel: 01592 643355 ext 20162

Email:

Junior Clinical Fellow in Emergency Medicine

PERSON SPECIFICATION

REQUIREMENTS / ESSENTIAL / DESIRABLE
Qualifications and Training /
  • MBChB or equivalent
  • Full registration with GMC and a Licence to Practice
  • Provider status in 1 of ATLS, APLS/EPLS or ALS
/
  • Provider status in more than 1 of ALS, ATLS, APLS/EPLS.

Clinical Skills and Experience /
  • 2 years of experience post qualification
  • Satisfactory completion of Foundation training or equivalent
  • Ability to prioritise workload
  • Ability to seek advice appropriately
/
  • Previous experience in Emergency Medicine
  • Experience in paediatrics, orthopaedics, General Practice
  • Understanding of principles of risk management

Audit /
  • Proven understanding of audit and how it relates to clinical practice.
/
  • Evidence of completion of appropriate audit.

Research /
  • Some knowledge of research principles
  • Commitment to evidence based medicine
/
  • Critical appraisal skills
  • Publication in peer reviewed journals

Teaching /
  • Enthusiasm and commitment to teaching junior medical staff and nursing staff, medical students
/
  • Previous clinical teaching experience

Communication Skills and Personal Attributes /
  • Able to work as part of a team with colleagues in own and other disciplines
  • Good skills in written and spoken English to allow effective communication with patients and colleagues
  • Able to organise time efficiently and effectively.
  • Good communication skills
  • Adaptable and open to new ideas.
  • Commitment to learning and developing new skills
/
  • Able to motivate colleagues
  • Sense of humour

Rota

The first six months will roughly follow the pattern of the junior tier rota. Shifts will be flexed to accommodate training for the successful candidates and also to provide staffing if other tiers are not filled. Appointees will not be expected to work unsupported as a middle grade in the first six months of the post.

We are flexible for those wishing to work less than full time who require a particular work pattern, but there will be a requirement for out-of hours and weekend working.
Appendix 2:PROVISION OF HEALTH CARE IN FIFE

NHS Fife

At present NHS Fife provides approximately 95% of all health care in Fife.

NHS Fife Headquarters

NHS Fife Headquarters is situated at Hayfield House, Victoria Hospital. Strategic planning is an area function performed by the Board’s headquarters staff. The Director of Public Health is Dr Margaret Hannah.

Public Health

The primary task of the Department of Public Health is the analysis of problems of health and health care in Fife and the planning of measures to promote health, prevent ill-health and provide health care. The aim of the department is the maintenance and improvement of the health of the community. Public Health Specialists advise the Director of Public Health on specified clinical areas including Acute Services, Mental Health, Care of the Elderly, Physical Handicap, Child Health, Well-Woman & Family Planning, Communicable Disease Control, and Environmental Health.

Health Education

The Department of Health Education supports all health educators in the community, including medical staff, and runs the Board’s Resource Centre and Library.

Primary Care

The Department of Primary Care is responsible for administration of all Primary Care Services.

NHS Fife Emergency Medicine1Feb 2018