CONSULTANT IN MEDICINE FOR THE ELDERLY (GERIATRIC ORTHOPAEDIC REHABILITATION)
gARTNAVELGENERALHOSPITAL
Information pack
reF: 32269d
Closing Date:25th april 2014
SUMMARY INFORMATION
Post: CONSULTANT IN MEDICINE FOR THE ELDERLY (GERIATRIC ORTHOPAEDIC REHABILITATION)
Base:GARTNAVELGENERALHOSPITAL
This is an exciting opportunity to join a team of Consultants providing a comprehensive Medicine for the Elderly service across the North West of the city. You will be responsible for both inpatient and outpatient care, including assessment and rehabilitation
There will be significant service reorganisation of clinical services in South and West Glasgow leading up to the planned opening of the New South Glasgow Hospital in 2015. The successful applicant will have the opportunity to contribute to service development and redesign.
You should be appropriately experienced and qualified in the specialty, fully registered with the GMC and have a licence to practice. Those trained in the UK should have evidence of higher specialist training leading to CCT or eligibility for specialist registration (CESR) or be within 6 months of confirmed entry from date of Interview. Non UK applicants must demonstrate equivalent training.
ACUTE SERVICES DIVISION
Rehabilitation & Assessment Directorate
GARTNAVELGENERALHOSPITAL
INFORMATION PACK
FOR THE POST OF
CONSULTANT IN MEDICINE FOR THE ELDERLY
- GLASGOW – A GREAT PLACE TO LIVE AND WORK
Greater Glasgow and ClydeValley are among the world’s most thrilling and beautiful destinations.
There is a wealth of attractions to discover, the UK’s finest Victorian architecture to astound you, and internationally acclaimed museums and galleries to inspire you, as well as Glasgow’s own unique atmosphere to soak up.
Be entertained in one of Europe’s top cultural capitals by its year-long calendar of festivals and special events and enjoy outstanding shopping, superb bars and restaurants all located within a stone’s throw of some of the country’s finest parks and gardens.
The area also stands at the gateway to some of Scotland’s most spectacular scenery, with Loch Lomond and the Trossachs only 40 minutes away.
We are easily accessible by air rail and road so getting here could not be easier.
- THE HOSPITAL MODERNISATION PROGRAMME THE SERVICES OF TOMORROW
Health services in Glasgow are on the verge of dramatic and exciting change, brought about by the recently approved Hospital Modernisation Programme. This ten-year £700 million strategy will see the transformation of acute services across the city including the replacement of out-dated buildings and the creation of one- stop/rapid diagnosis and treatment models for the vast majority of patients.
Core adult acute care is currently delivered from six sites within Glasgow. The Western Infirmary and Gartnavel General Hospital operate in tandem delivering acute care in the west-end of the city. In the north-east of the city acute care is delivered from Glasgow Royal Infirmary. The Victoria Infirmary serves the south-east and the Southern General Hospital the south-west of the city. Services for children are provided centrally from the RoyalHospital for Sick Children, Yorkhill. Full adult Accident and Emergency services are provided at the Western Infirmary, Glasgow Royal Infirmary, the Victoria Infirmary and the Southern General Hospital.
The Hospital Modernisation Programme will ensure that walk-in/walk-out hospital services are provided for the majority of patients. The pattern of service provision will shift to reflect moves towards ambulatory care. Currently 85% to 90% of patient encounters with acute hospital services are on a walk-in/walk-out same day basis. These include out-patient attendances, diagnostic tests, imaging procedures, and a range of day surgery procedures. In future, these services will be provided from ambulatory care centres designed to deliver the streamlined process of care, which patients want - to be seen quickly by the appropriate specialist, to undergo clinical investigation, and to receive treatment without delay.
The ambulatory care centres for the city are in 2 new purpose - built hospitals next to the current Victoria Infirmary and StobhillHospital These state-of-the-art facilities opened in 2009. They house the main out-patient centre and day surgery services for the city. In-patient services will be concentrated in a new £235 million south-side hospital to be built on the site of the current Southern General Hospital and a refurbished Glasgow Royal Infirmary. The new south side hospital is planned to open in 2015.
The children’s hospital will relocate from Yorkhill to a new £100 million building on the Southern General Hospital site over the next five years to sit alongside and be fully integrated with maternity and adult services.
The redesign and redevelopment of Glasgow’s acute services will address many of the pressures currently facing the hospital service. The new services will be provided in modern facilities rather than in 19th century buildings not designed for modern healthcare. The purpose-designed facilities will enable the one-stop/rapid diagnosis and treatment models required for the future. Continuity of service will improve with the elimination of the need for patients’ notes and results to be moved from building to building. Concentration of services will allow the requirements of junior doctors’ hours and issues arising from increasing sub-specialisation of medicine to be addressed through the creation of larger staff teams and sustainable rotas for both junior and senior staff.
The formation of larger clinical teams will make sure that programmes of work, including the need to cover emergencies without interfering with waiting list and ambulatory care sessions, can be planned effectively. The concentration of in-patient services on fewer sites will help strengthen specialist services and maximise the capacity of the service.
- GREATER GLASGOW AND CLYDE ACUTE SERVICES DIVISION
8 Hospitals
5,800 beds
£30m income
26,500 wte staff
The Acute Division brings together all acute services across the city and Clyde under a single management structure led by the Chief Operating Officer. The Division is made up of eight Directorates of clinical services each managed by a Director and clinical management team along with a Facilities Directorate.
These are:
Emergency Care and Medical Services
Surgery and Anaesthetics
Rehabilitation and Assessment
Diagnostics
Regional Services
Women’s and Children’s Services
Oral Health
Clyde
Facilities
In the Emergency Care and Medical Services, Surgery and Anaesthetics and Facilities directorates the General Managers combine a city wide role with a local sectoral role for one of three sectors in the city – north and east, west and south.
Emergency Care and Medical Services
The specialties included in this Directorate are:
Accident and Emergency services
Acute Medicine
Cardiology
Respiratory Medicine
Renal Medicine
Gastroenterology
Diabetes
Infectious Diseases
Rheumatology
Dermatology
This Directorate also includes management of the out-of-hours
GP service.
Acute medicine is managed by general managers on a sector basis with a lead strategic role for a citywide specialty.
Surgery and Anaesthetics
This Directorate includes:
General Surgery – including vascular and breast surgery
Orthopaedics / trauma
Anaesthetics – including critical care [with the exception of Coronary care]
Ophthalmology
Optometry
ENT Surgery
Audiology
Endoscopy
Urology
The smaller surgical specialties of ophthalmology, urology and ENT surgery have a single citywide general management structure. In each of the larger surgical specialties, in addition to a pan Glasgow structure, there will be sector-based general management.
Rehabilitation and Assessment Directorate
The Rehabilitation and Assessment Directorate brings together the management of services that have strong inter-relationships to related CHCPs.
The Directorate manages the following services:
Stroke
Movement Disorder Service
Falls Service
Orthogeriatric Liaison Service
Frail elderly
Palliative Care
Inpatient Physically Disabled
West of Scotland Mobility and Rehabilitation Centre (Westmarc)
Physiotherapy
Dietetics
Speech and Language Therapy
Rehabilitation
In addition, the Directorate will manage a range of community services including palliative care, a number of specialist community disability services, pain services, continence, services to care homes and falls prevention.
Regional Services
This Directorate includes:
Neuro-sciences [including all sub-specialties except neuro-
Radiology and neuropathology]
Specialist Oncology services [including haemato-oncology]
Plastic Surgery and Burns
Cardiothoracic Surgery
Renal Transplantation
Oral and surgery
Homeopathy
Diagnostics Directorate
This Directorate includes:
All Laboratory Medicine including Paediatrics
Diagnostic imaging [including Beatson radiological services and Paediatric Radiology]
Vascular and Interventional Radiology
Breast Screening services
Women and Children’s Services
This Directorate brings together maternity, gynaecology and children’s services.
The Directorate includes:
Obstetrics
Gynaecology
Neonatology
Paediatric Medicine
Paediatric Surgery
Paediatric Accident and Emergency
Paediatric Anaesthetics
Oral Health
This Directorate brings together adult acute, paediatric and community dental services in a single Directorate.
Facilities Directorate
This Directorate includes:
Site maintenance for both acute and CHCP facilities
Hotel services
Laundry
TSSU
Supplies
Transport
Catering
Telecommunications
Waste management
- VALUING OUR STAFF
The Division is committed to extending training and development opportunities to all staff and is actively developing multi-disciplinary training, extending the role of on-line learning, and recognition of the importance of developments in technology for both staff and patients.
We Offer:
Policies to help balance commitments at work and home and flexible familyfriendly working arrangements
Excellent training and development opportunities
Free and confidential staff counseling services
A central Glasgow location, with close access to motorway, rail and airport links
On-site library services
Subsidised staff restaurant facilities on each site
Access to NHS staff benefits/staff discounts
Access to discounted First Bus Travel
Active health promotion activities
Bike User Group
Good Public Transport links
Commitment to staff education and life-long learning/development opportunities
Excellent student support
Access to NHS Pension scheme
- Brief Description of the Rehabilitation and Assessment Directorate of the Acute Services Division
The Rehabilitation and Assessment Directorate (RAD) is one of nine Directorates within the NHS Glasgow and Clyde Acute Operating Division.
In operational terms the Directorate is responsible to the Chief Operating Officer of the Division and through her to the NHS Board. RAD directly manages a range of staff and services including frail elderly - assessment and rehabilitation, inpatient and community physical disability services, stroke services – acute and rehabilitation, and palliative care. The Directorate also manages all psychology, dietetic, speech and language therapy, orthotic, occupational therapy, physiotherapy and podiatry staff who work within adult services of the acute division. In addition it is responsible for the management of chaplaincy and spiritual care. A number of services provided in the community are also managed by the Directorate: These include the community falls service and the back pain service.
There are 1152 inpatient beds and 270 NHS continuing care partnership beds within the Directorate involving a budget of £100m and 2500 staff.
The integrated discharge teams are managed within the RAD. This includes responsibility for the Glasgow City Council social work staff and the Directorate has a key role in promoting safe discharge across the organisation as well as meeting the delayed discharge targets.
The RAD also has strategic responsibility for whole system planning, policy development and performance management for older people’s services, disability, palliative care and stroke. This is delivered through a network of local and Board-wide planning groups which both managers and clinicians attend. These groups work with colleagues in primary and social care to review and develop services.
- Brief Description of the Hospital
There will be significant service reorganisation of clinical services in South and West Glasgow leading up to the planned opening of the NewSouthGlasgowHospital in June 2015. The successful applicant, and consultant colleagues, will have the opportunity to contribute to DME service development and redesign. This will inevitably require ongoing review of individual consultant job plans
This post will be initially based in Gartnavel General Hospital (GGH) which is part of a split campus along with the Western Infirmary Glasgow (WIG). GGH is a busy teaching hospital with 456 beds and in tandem with the WIG, which has a further 400 beds, provides a wide range of district general hospital, regional, supraregional and national acute clinical services. The Acute Medical and Surgical receiving units are located in the WIG. The Acute Geriatric Assessment Unit together with general and specialty medical units including Rheumatology, Diabetes, Gastroenterology, Respiratory and Infectious Diseases, and specialty surgical units are located in Gartnavel GeneralHospital which is about 1.5 miles from the WIG. Both the WIG and GGH are situated in the West End of Glasgow. The Medicine for the Elderly service in the West of Glasgow is part of a unified service for North Glasgow. Stroke is split between the Western Infirmary (Acute Stroke Unit and TIA/Cerebrovascular Clinic) and Gartnavel GeneralHospital (Stroke Rehabilitation Unit).
The Acute Medical Assessment Unit (AMAU) in the Western Infirmary has been recently redesigned following an extensive upgrade. The ethos of the unit is to promote real time assessment, diagnosis and treatment of patients with acute medical needs. Physicians from the major specialties including Acute Medicine, Clinical Pharmacology and Therapeutics, Stroke, Diabetes and Endocrinology, Gastroenterology, Infectious Diseases, Renal, Respiratory and Rheumatology undertake medical receiving on a rotational basis based at the Western Infirmary. All acute medical patients are initially admitted via Accident and Emergency to the 30-bed AMAU at the Western Infirmary, and are later triaged to general medical or other specialist units within the Western Infirmary or Gartnavel General Hospital. Consultants in Medicine for the Elderly (supported by an Elderly Care Assessment Nurse) visit the AMAU daily to provide early access to Comprehensive geriatric Assessment.
7. The Work of the Department/Specialty
The Medicine for the Elderly Unit is based on several sites. The Acute Geriatric Assessment Unit is at Gartnavel General. The rehabilitation hospital (DrumchapelHospital) which is 3 miles to the West has inpatient beds (rehabilitation and NHS Continuing Care), a day hospital and out-patient clinic facilities. St Margaret’s Hospice in Clydebank has NHS Continuing care beds.
Interface with Medicine:
Emergency admissions are admitted to the Acute Medical Admissions Unit at the Western Infirmary Glasgow and triaged by Consultant and middle grade staff from the Acute Medical Receiving Unit if appropriate to the Acute Geriatric Assessment Unit.
Assessment & Rehabilitation:
A number of patients are admitted directly to the Assessment Unit, either from day hospital, out-patient clinic, other wards within the Hospital or at the request of a general practitioner. Patients in the WIG or Gartnavel General requiring rehabilitation, either general or specialist, are assessed either by Consultant, middle grade or specialist nursing staff prior to transfer to Drumchapel Hospital. DrumchapelHospital hosts 28 general rehabilitation beds and 28 geriatric orthopaedic rehabilitation beds.
Geriatric Orthopaedics
There is a well established Falls Service based in DrumchapelHospital. Patients are referred by the HomeFalls prevention Service, by their own General Practitioner and from other hospital clinics. Patients attend a Pre-screening clinic prior to their Falls clinic attendance on a Monday or Tuesday. Patients are assessed functionally at the Pre-screening clinic by the appropriate AHP and have a full medical assessment at the Falls Clinic. Each patient is then discussed at the Multi- Disciplinary Meeting that follows every Falls Clinic. Patients who attend the Falls Clinic have full access to all available clinical investigations.
There is an active Orthopaedic-Geriatric liaison service. The Acute Trauma ward is situated in the WIG. The Medicine for the Elderly department undertakes two Consultant led ward rounds and one Specialty Doctor ward round per week in the Trauma ward. Within DrumchapelHospital there are 28 dedicated orthogeriatric rehabilitation beds and patients are transferred to the beds following assessment by a senior member of the Medicine for the Elderly staff.
Community:
The Department of Medicine for the Elderly is involved at Consultant level with awell established community rehabilitation and supported discharge team which allows patient rehabilitation to be continued in the community. There are strong links with the 3 CHPs in our catchment area. In line with other services in NHSGGC the department is delivering a Rapid Access service based in the DayHospital to facilitate early access to Comprehensive Geriatric Assessment for frail older people in the community. The community rehabilitation team is involved in assessing patients for early supported discharge across a number of hospital settings including Acute Trauma and Orthopaedics, Medicine for the Elderly, General Medicine, Accident and Emergency, and G.P. Rapid Response.