Consultant General Physician with an Interest in Rheumatology

consultant general physician with an interest in rheumatology

inverclyderoyalhospital

Information pack

reF: 31410d

Closing Date:noon27th December 2013

SUMMARY INFORMATION

Post: consultant general physician with an interest in rheumatology

Base:InverclydeRoyalHospital

This post will join the existing team of four Consultants across Clyde. The post is for a Consultant General Physician with an interest in Rheumatology based In Inverclyde Royal Hospital, Greenock with clinical activities in RoyalAlexandraHospital, Paisley.

The post holder will be required to participate in acute medical receivingand provide care for inpatients at InverclydeRoyalHospital

Rheumatology outpatients will be seen at InverclydeRoyalHospital and RoyalAlexandraHospital, Paisley as part of the Clyde Rheumatology Service

Greenock is situated 45 minutes from Glasgow, amid superb coastal and mountain scenery with excellent transport links. The area offers excellent residential accommodation and first class state and private schools.

InverclydeRoyalHospitalhas a team of eleven Consultant Physicians, one Specialist Doctor, fourteen Middle Grade Doctors (GP trainees, Core Medical trainees and Higher Medical trainees) and twelve Foundation Year 1 Doctors. Foundation Year 2 doctors staff the Department of Medicine for the Elderly in the Larkfield Unit and contribute to GIM on call rota.

The post holder will be required to maintain and develop the rheumatology service and work with colleagues to progress service delivery for patients across Clyde.

MRCP UK or equivalent qualification is essential and you must have full registration with the GMC and a licence to practice. Those trained in the UK should have evidence of higher Specialist Training leading to a CCT in Rheumatology and General Acute Medicine or eligibility for specialist registration (CESR) or be within six months of confirmed entry at the date of interview. Non UK applicants must demonstrate equivalent training

NHS Greater Glasgow & Clyde

Emergency Care and Medical Services – Clyde Sector

CONSULTANT GENERAL PHYSICIAN WITH AN INTEREST IN RHEUMATOLOGY

Particulars of the post of Consultant General Physician with an interest in Rheumatology based at InverclydeRoyalHospital, Greenock, Inverclyde, Scotland

1. General Information

InverclydeRoyalHospital is a modern district general hospital in Greenock, and serves the Inverclyde District (Greenock, Gourock, WemyssBay and Port Glasgow), parts of North Ayrshire, Isles of Bute and Cumbrae, and the CowalPeninsula, with a total population of approximately 130,000. The hospital has 239 acute beds and was opened in 1979. Most major specialties are represented within the hospital including a PFI-funded Medicine for the Elderly Unit comprising of around 90-bedded in Larkfield (on campus) and a 15 bedded Acute Stroke Unit. There is also an 8 bed Physically Disabled Rehabilitation Unit in the Larkfield Unit

There are close clinical links with the strong community infrastructure and with the other acute hospitals within Clyde; the Vale of Leven, Alexandria and RoyalAlexandraHospital, Paisley and the hospitals / university hospitals across NHS Greater Glasgow and Clyde.

The district has excellent facilities at hand including good sports centres, playing fields, golf and sailing. The area has a modern shopping centre, a new custom-built swimming pool, open air swimming pool, leisure centre and ice rink and is within easy rail, bus and motorway links to Glasgow and Edinburgh.

Greenock is situated 40 minutes from Glasgow, amid superb coastal and mountain scenery with excellent transport links. The area offers excellent residential accommodation and first class state and private schools.

2. The Medical Unit

The Medical Unit consists of a 30 bedded Acute Medical Receiving Unit and three general medical wards totaling 105 beds. In addition, there is an 11 bedded Coronary Care Unit and 4 bedded HDU and 3 bedded ITU. The Renal Unit opened in 2000 and expanded to 12 haemodialysis stations in 2007. There is also a Haematology and Oncology Day Bed Unit. The Medical Unit provides an acute service in general medicine with clinics in Diabetes & Endocrinology, Gastroenterology, Cardiology, Rheumatology, Respiratory Medicine and Haematology and visiting consultant clinics in Nephrology and Neurology

3. Workload of Adult Medicine

General Medicine / 2012/2013
Elective Inpatient Admission / 160
Emergency Inpatients / 9,943
Day Cases / 195

4. Consultant Staffing

In addition to the current post, there are fourteen consultant physicians with special interests as noted.

Dr Helen PapaconstantinouCardiology
Dr Brian Murphy Cardiology
Dr Andrew McCullochCardiology
Dr Nicola Deans Respiratory
Dr Dave Sharma Respiratory
Dr Chris JonesDiabetes and Endocrinology
Professor Martin McIntyreDiabetes and Endocrinology
Dr Abdulla Hussan Gastroenterology
Dr Mohammed Hamed Gastroenterology
Professor David MarshallRheumatology
Dr Lisa HuttonRheumatology
New Post - this post Rheumatology
Dr Paul LawsonGeriatric Medicine
Dr Fiona JohnstonGeriatric Medicine
Dr Javed AkhtarGeriatric & Stroke Medicine

The Medicine for the Elderly Department contribute to the Department of Medicine at Consultant and middle-grade level. Consultant Geriatricians contribute fully to the on-call medical rota, as detailed below:

Monday - Friday - Medical on-call rota 1:11

Saturday - Sunday - Medical on-call rota 1:12

Coronary Care is covered Monday to Friday by the Consultant Cardiologist team and by the on-call Physicians at weekends, with support from the Golden Jubilee National Hospital (GJNH) for primary coronary angioplasty and out of hours pacing.

Consultant Dermatologists, Dr C Fitzsimmons, Dr I Hay, Dr Milligan and Dr May, run a busy Dermatology Ambulatory Care Treatment Centre with their own dermatology middle-grade staff.

Dr C Geddes and Dr Mark Consultant Nephrologists, based at the Western General Infirmary (WIG) visit the Renal Unit twice weekly and run a Renal clinic from within the unit with one Associate Specialist in support.

Consultant Neurologists Dr Jack and Dr Selvarajah also provide weekly support to the hospital.

Junior Medical Staff

Middle Grade Doctors- 14
Foundation Year 1- 12
Foundation Year 2 - 6

6.Non Training Grade Doctors

Specialty Doctors

(Rheumatology & Gastroenterology) - 2

7. Acute Medical Services

7.1 Acute Receiving Ward

Acute medical admissions are admitted to ward J North (30 beds), which is staffed by one of the consultants on a rotating ‘Physician of the Week’ basis Monday morning to Friday lunchtime, then by another of the consultants for the weekend. Patients are then triaged to the appropriate specialty wards if not for early discharge. Plans are being developed to enhance acute receiving with extra consultant support and acute medical physician input.

7.2 General Medical Wards

There are three general medical wards, G North (30 beds), G South (34 beds), J South (22 beds) which receive patients form the Acute Medical Receiving Ward, J North (30 beds). These wards are supported by the different specialty consultant staff and their teams of junior doctors.

7.3 Coronary Care Unit

Patients with acute myocardial infarction, acute coronary syndromes, arrhythmias or congestive cardiac failure are admitted to the 11 bedded Coronary Care Unit. Staffed during the day by one of the cardiologists on a rotational basis, and supported by junior medical staff. Cardiology services are supported by the Golden Jubilee National Hospital which provides primary percutaneous coronary intervention service and out of hours temporary cardiac pacing from Glasgow.

7.4 Junior Doctors Out-of-Hours

A Hospital at Night and Weekend service commenced in August 2006, and medical staff covering the out of hours period are required to lead and participate in this team, as well as attending the hand over. This is now well established and further development will aim to enhance out of hours patient care and safety.

7.5 Medicine for the Elderly

Medicine for the Elderly is part of the Rehabilitation and Assessment Directorate, however many of its activities are combined with Adult Medicine. In particular, the out of hours cover is provided by junior doctors from Medicine for the Elderly and Adult Medicine.

There are three wards within the Medicine for the Elderly Unit and DayHospital are located next to the main hospital, while the Stroke ward is located within the main hospital building.

8. Rheumatology Services

Rheumatology Services within Clyde provide outpatient services in Inverclyde Royal, the Royal Alexandra and Vale of Leven Hospitals.

There are dedicated clinics for Ankylosing Spondylitis, Psoriatic Arthritis, Connective Tissue Disease, and Osteoporosis.

Biological Therapies and Joint Injection Clinics are provided in the Rheumatology Day Care Units. Outpatient physiotherapy (including hydrotherapy) and occupational therapy is provided in Inverclyde Royal and the RoyalAlexandraHospitals.

There are plans to develop a bespoke Rheumatology Outpatient and Day Unit Centre (with Diabetes Team) on Level C with facilities for clinics, infusions, musculoskeletal ultrasound, education and teaching.

Plans are progressing with colleagues in the Western Isles to develop outreach services supported by the Consultants in Clyde. This would include a weekly all day outpatient clinic on a rotational basis and if agreed, the successful candidate would be expected to contribute to this development following job plan review. Existing service support available to the Rheumatology in the Western Isles is excellent and includes AHP and specialist nursing input. Telemedicine links would also be pivotal to this development.

Plans are also progressing regarding the development of an academic base within Clyde and discussions with GlasgowUniversity are ongoing in this regard. The Cellma database which has been in use across Clyde for a number of years now underpins this development.

Whilst sub-specialty interests will be accommodated where possible, there is a particular need to develop the musculoskeletal ultrasound service. High quality equipment for this service is available at both Inverclyde Royal and RoyalAlexandraHospitals.

The service offered has developed over the years and current activity is detailed below.

8.1 Medical Staff

The advertised post is to join the existing medical team of four Consultants. Rheumatology services at InverclydeRoyalHospital are supported by two middle grade junior doctor and ward based cover by an FY1 doctor. The Junior Doctors provide ward cover and clinic cover.

8.2 Rheumatology / Osteoporosis Clinical Nurse Specialists

Team Leader Ellen Forde1 wte
Clinical Nurse Specialist Amanda McAnally 1 wte
Clinical Nurse Specialist Ruth Harrington 1 wte
Clinical Nurse Specialist Sandra Hanlon1wte
Clinical Support Worker Agnes Provan 1wte

This team play a pivotal role in the running of the rheumatology service over recent years including:

Education of patients, carers and healthcare professionals in all aspects of rheumatology
Infusion service within the Rheumatology Day Bed Unit.
Commencement of patients on sub – cutaneous therapies
General outpatient rheumatology clinics
Advice Line for patients and Healthcare Professionals

8.3 Other Specialist Staff

The department is supported by a full time Specialty Doctor in Rheumatology, Dr Jan Bunemann and is a teaching centre for Higher Specialty Trainees in Rheumatology on the West of Scotland programme.

This service is also supported by an Extended Role Physiotherapist Fiona Collins and a dedicated Occupational Therapy team.

In addition there is also a dedicated team of administrative and clerical staff who support service delivery and patient care.

8.4 Clinics

There are a range of outpatients clinics operating across Clyde.

The tables below details outpatient activity data for 2012 / 13 for rheumatology services across Clyde:

Site / New attendances / New
DNA / Total / Return attendances / Return
DNA / Total
RAH / 763 / 84 / 847 / 1849 / 248 / 2097
VOL / 347 / 35 / 382 / 617 / 80 / 697
IRH / 811 / 112 / 923 / 2260 / 315 / 2575

Within InverclydeRoyalHospital the Rheumatology beds are located on G North. There are comprehensive HDU and ITU services with a strong anaesthetic support team.

9. Management Arrangements

Emergency Care and Medical Specialties at InverclydeRoyalHospital is part of the Emergency Care and Medical Specialties Directorate, NHS Greater Glasgow and Clyde.

Prof. Martin McIntyre is the Clinical Director for Emergency Care and Medical Specialties, Clyde, Dr Stuart Hood Lead Clinician for Royal Alexandra and Vale of Leven Hospitals and Dr Chris Jones, Lead Clinician, InverclydeRoyalHospital.

Ms Anne Harkness, is the Director of Emergency Care and Medical Specialties across Greater Glasgow and Clyde, Dr David Raeside the Associate Medical Director and Mrs Joyce Brown, Head of Nursing.

10. Summary of the Post

10.1 Duties of the Post

Rheumatology

The post holder will provide a consultant-led, easily accessible rheumatology service. The post holder will perform 3 – 4 clinics per week; rheumatology clinics (combined new and return) with support for sub specialty interests. The post holder will be required to contribute to outpatient service provision in the RoyalAlexandraHospital, Paisley.

The post holder will take responsibility for the daytime care of rheumatology and general medical, out of hours cover being provided by the physician on-call. The department is involved in undergraduate and postgraduate teaching.

Acute Medicine

The successful candidate will be expected to provide a full range of consultant services as agreed with colleagues including in-patient management of patients admitted to the Medical Wards and also Coronary Care Unit out of normal working hours.

Each consultant is on-call for emergency admissions either Monday – Thursday or Friday – Sunday periods. This is a fixed rotation and is planned for twelve months in advance. During the week of on-call the number of emergency patients between 9.00am – 9.00pm is seasonal, and can vary with between 15 to 30 per day, with an average of 25 patients being admitted per day.

In view of the increasing complexity of acute receiving, plans are actively being developed with senior management and as part of the ongoing review to redevelop acute receiving across Clyde.

With the appointment of the new post holders the on-call rota will be approximately 1:11 for weekdays and 1:12 for weekends.

10.2 Suggested Timetable

A work programme for the week will be negotiated and agreed with the successful candidates. The core working week will be based on 8.0 PA’s of Direct Clinical Care (DCC) duties and 1.0 PA of SPA time and 1.0 PA for out of hours commitments.

The successful candidates will have sub- specialty interests supported, as long as they are relevant to the wider aims of the Rheumatology Service and the Department of Medicine.

10.3 Suggested job plan

The job plan will be tailored to the successful candidate’s interests and the following should be taken as guidance. A detailed job plan will in be agreed with the Clinical Director and thereafter this will be subject to periodic review and adjustment if necessary.

Duty /

PAs

Inpatient/Daycase Work / 3
Admin / 1
Out patient work / 4
SPA / 1
Out of Hours On Call / 1
TOTAL / 10

The job plan is subject to review as a minimum once a year by the post holder and the Clinical Director.

10.4 On Call Duties

The appointees will be expected to take a share with the existing Consultant Physicians of the general medical workload in terms of out of hours cover. Currently each consultant cancels other duties and is ‘Physician of the Week’.

11. Postgraduate and Undergraduate Training

The unit has a postgraduate tutor programme, which includes a weekly meeting, monthly journal club and SHO tutorial sessions. There are weekly hospital postgraduate meetings during term time. Dr Manfred Staber, Consultant Anaesthetist, is the Post Graduate Tutor. The Medical Unit teaches a large number of medical students from GlasgowUniversity. As part of the new curriculum teaching of one to five years is becoming established.

InverclydeRoyalHospital has an excellent Postgraduate Centre immediately adjacent to the main building. This provides both excellent library facilities and the latest computer and technological supports for research and study. There is one large lecture theatre (seating 80) and 4 smaller seminar rooms.

There is an active postgraduate forum within InverclydeRoyalHospital with weekly medical division clinical lunchtime meetings, at which the Department of Medicine regularly present. Each month there is a half day educational/clinical governance rolling programme involving all departments.

12. Further information

For further information and arrangements to visit the Department, please contact:

Professor David Marshall

Consultant Physician with special interest in Rheumatology

InverclydeRoyalHospital

Larkfield Road

Greenock

PA16 OXN

Tel:01475 504982 (secretary)

E mail: or

Dr Chris Jones

Consultant Physician and Lead Clinician

InverclydeRoyalHospital

Larkfield Road

Greenock

PA16 OXN

Tel:01475 504501

E mail:

TERMS AND CONDITIONS OF SERVICE

The conditions of service are those laid down and amended from time to time by the hospital, Medical & Dental Whitley Council.

PERSON SPECIFICATION

ESSENTIAL / DESIRABLE
QUALIFICATIONS /

Entry on GMC Specialist Register or within 6 months of receipt of CCT at time of interview.
Full GMC and Licence to practise.

MRCP or equivalent.

CLINICAL EXPERIENCE /

Clinical training and experience equivalent to that required for gaining UK CCT in General Internal Medicine and Rhematology.
Ability to offer expert clinical opinion on a range of gastrointestinal problems.
Ability to take full and independent responsibility for clinical care of patients.

Sub-specialty interest.

MANAGEMENT AND ADMINISTRATIVE EXPERIENCE /

Ability to advise on the efficient and smooth running of the GI service.
Ability to organise and manage ward patients, outpatient priorities and endoscopy lists.
Experience of audit management.
Ability and willingness to work within NHS GG&C and NHS Scotland performance framework and access targets.

Attendance at management course for clinicians.

TEACHING EXPERIENCE /

Experience of supervising medical trainees.
Ability to teach clinical skills.

Experience of MMC assessment tools.

OTHER ATTRIBUTES /

Ability to work in a team.
Good interpersonal skills.
Caring attitude to patients.
Ability to communicate effectively with patients, relatives, GPs, nursing staff and other relevant parties.
Commitment to the requirements of clinical governance.

TERMS AND CONDITIONS OF SERVICE