consultant in paediatric gastroenterology
royalhospital for sick children
Information pack
reF: 28010d
CLOSING DATE NOON ON 5th april 2012
SUMMARY INFORMATION
Post: consultant in paediatric gastroenterology hepatology and nutrition (PGHN)
Base:royalhospital for sick children
The Women & Children’s Directorate (An Acute Operating Division of Greater Glasgow & Clyde, NHS Board) is a world leader in the care of child and maternal health services. Located in the West end of Glasgow, the RoyalHospital for Sick Children hosts many national and regional specialist services.
The Directorate also supports an extensive array of community child health services.
A New Children’s Hospital is due to open in 2014.
This new consultant post will be a replacement creating a team of 5 consultants within the department of PGHN.
This post has been created to maintain excellence in PGHN and to deliver the managed clinical network within the West of Scotland.
Candidates should be trained in general paediatrics and ideally will have spent at least 3 years in approved posts/programmes in PGHN.
Applicants must have full registration with the General Medical Council and a licence to practice medicine in the UK.
Those trained in the UK should have evidence of higher Specialist Training leading to CCT (or be within six months of confirmed entry from the date of interview) or have equivalent training and experience. Non-UK applicants must demonstrate equivalent training.
A split of 9:1 between direct clinical care PAs and supporting professional activities is now the advertised standard for all new consultant job plans in Scotland. The one SPA minimum will reflect activity such as appraisal, personal audit and professional development occurring outside study leave time. Once the candidate has been appointed more SPA time may be agreed for activities such as undergraduate and postgraduate medical training which takes place outside direct clinical care, as well as research and/or management. These activities must be specifically and clearly identified and be agreed with the candidate and desired by the department.
NHS Greater Glasgow & Clyde
Acute Division
Women and Children’s Directorate
Information Pack
for the post of
Consultant in Paediatric Gastroenterology,
RoyalHospital for Sick Children, Glasgow
CONSULTANT IN PAEDIATRIC GASTROENTEROLOGY
JOB DESCRIPTION
REF: 28010D
THE POST
This post is a replacement post and will maintain excellence in the clinical provision of paediatric gastroenterology, hepatology and nutrition (PGHN) within the West of Scotland.
Candidates should be trained in general paediatrics and have spent a minimum of three years in approved posts/programmes in paediatric gastroenterology, hepatology and nutrition. The appointee will share in the workload of the Paediatric Gastroenterology unit. Applicants should possess, or be within six months of receiving CCST/CCT in general paediatrics with sub-specialisation in gastroenterology, hepatology and nutrition.
Any Consultant who is unable for personal reasons to work full-time will be eligible to be considered for the post; if such a person is appointed, modification of the job content will be discussed on a personal basis with the Trust in consultation with consultant colleagues.
Section 1Children’s Services across NHS Greater Glasgow and Clyde
The post is based at the RoyalHospital for Sick Children, Yorkhill, Glasgow. The hospital was founded in 1883 and the present buildings opened in 1971. The hospital forms part of the NHS Greater Glasgow and Clyde Women and Children’s Directorate, Acute Division, which in addition to the RHSC includes the Queen Mothers Maternity Hospital. The RHSC is one of the largest children’s hospitals in the United Kingdom and the largest in Scotland. The Division provides secondary health care to a local population of 900,000, but tertiary paediatric services to the entire West of Scotland, population 3 million. Several national services are provided at Yorkhill, including Renal Transplantation, Paediatric Cardiac Surgery, Complex Airway, Bone Marrow Transplant, Erb’s Palsy and ECMO (Extracorporeal membrane oxygenation).
All paediatric medical and surgical subspecialties are represented, including general medical paediatrics, cardiology, neonatology, neurology, nephrology, respiratory, endocrinology, gastroenterology, immunology and infectious diseases, dermatology, haematology/oncology, rheumatology, metabolic medicine, audiology, ophthalmology, ENT surgery, orthopaedics and general paediatric and neonatal surgery. A selection of child and adolescent psychiatry facilities are located within the campus along with a recently opened Child Protection Unit. Neurosurgery services are in the process of integrating into the clinical groups at the RHSC. There is an Emergency Department at RHSC which sees 35,000 new patients annually. There is also a 16 bed Paediatric Intensive Care Unit and a 6 bed High Dependency Unit. An operating theatre complex was opened in 1998. It comprises seven operating theatres, a dedicated endoscopy room and a dental suite. The complex also includes a spacious Day Surgery Unit.
The diagnostic imaging facilities available on-site include MRI, CT, ultrasound and nuclear medicine, and a new fluoroscopic digital screening room. A Scotland-wide PACS for transmission of digital diagnostic imaging has been rolled out. Virtually all the hospitals in Glasgow, including Yorkhill are filmless. Laboratory provision includes a Department of Paediatric Pathology and the regional Department of Medical Genetics. There is on site clinical audit and research and development support to assist with departmental research projects.
Yorkhill is a major centre for research and education. The hospital provides the major Undergraduate Paediatric Teaching facility for the University of Glasgow and accommodates the University Departments of Child Health, Child and Family Psychiatry, Medical Genetics, Human Nutrition, Paediatric Pathology, Paediatric Biochemistry and Paediatric Surgery projects. There are also links with both Caledonian and StrathclydeUniversities. The Research and Development Department and the Department of Clinical Audit provide assistance with research projects. A Scottish Medicines for Children Network supports research projects adopted through Clinical Studies Groups of UK based Medicines for Children Research Networks.
In order to provide the city with child, maternal and adult services on a single site, a new children’s hospital is planned on the Southern General Hospital site, and is due to open in 2014.
Other Paediatric Services in Glasgow and Clyde
In addition to maternity services at QMH and the Southern General Hospital these are also delivered at the Princess Royal Maternity Hospital and RoyalAlexandraHospital, Paisley, all with neonatal facilities. There is also a Paediatric Ward in the RoyalAlexandraHospital.
Paediatric Neurosurgery is located in the Institute of Neurosciences at the Southern General Hospital. A redesign of current service provision in this area is work in progress.
Paediatric Radiotherapy (under general anaesthetic) is completed at the Beatson Oncology Centre (located at the Gartnavel campus).
There is an extensive range of specialist community based children’s services across NHS Greater Glasgow and Clyde. Managed within Community Health and Social Care partnerships, these services are integrated with Primary Care and Social Care Services. Well established clinical links across combined Acute and Community settings within the NHS Board are in place.
New Hospital Build / Service Re-organisation
In 2004 there was ministerial announcement for the development of a new children’s hospital to be built within the Greater Glasgow area, this build co-located within acute adult facilities. Within this new build on the Southern General site, re-provision of RHSC facilities will be provided alongside the neonatal and maternity service. Completion of this new tripartite clinical arrangement covering acute care of adult, children and maternity services was set at five years with an expected completion date of 2014.
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Section 2Paediatric Services
Clinical Leadership
PGHN is a key component of integrated hospital paediatric services within the Women and Children’s Directorate (of Acute Operating Division, NHS Greater Glasgow and Clyde)
- Dr Jim Beattie (Consultant in Paediatric Renal Medicine) is the Associate Medical Director for Women and Children’s Services
- Dr Graham Stewart, Consultant Paediatrician, Clinical Director Medical and Community Paediatrics
The clinical lead for PGHN in the West of Scotland is Dr Paraic McGrogan, Consultant Paediatric Gastroenterologist
There are a number of link clinicians supporting general and paediatric sub-speciality services.
The structure of clinical leadership is mirrored within surgical services.
National Service Contracts
The RoyalHospital for Sick Children hosts a number of paediatric national services. These national services are listed in box 1 below:
Box 1 / Paediatric National Services
UNIVERSITY OF GLASGOW LINKS
The Yorkhill academic campus is part of the Division of developmental medicine. The Professor has recently retired, and the post will shortly be re-appointed. The Department of Child Health was founded in 1924 and is located in the heart of the RoyalHospital for Sick Children. It is responsible for the teaching of paediatrics and child health to undergraduate students, and has major research programmes in Paediatric Gastroenterology and Nutrition, Paediatric Endocrinology, Paediatric Respiratory Disease, Epidemiology and Community Child. In addition to the academic, research and administrative staff, Honorary Clinical Senior Lecturers and Honorary Clinical Lecturers assist in undergraduate teaching and examining, and postgraduate training.
Child Health has close links with the other four University Sections on the Yorkhill site – Human Nutrition, medical genetics and surgical paediatrics. Together these academic departments are partners in the Division of Medicine, and collaborate with several NHS Departments with strong research programmes. Child Health shares laboratories with Human Nutrition, and has a special interest in the application of stable isotopes for biomedical research.
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Section 3 The work of the Department
The PGHN Department is one of the largest departments within the UK and offers tertiary service to a population of 3.1 million. PGHN care
The network facilitates the care of children and young people with PGHN diseases via local teams delivering care close to home with information and intervention being provided, as necessary, by specialist centre. Each consultant has responsibility for a different geographical area throughout the region in liaison with a local general paediatrician with an interest in PGHN medicine. They have a responsibility to facilitate care pathways and to ensure that the identified clinical health indicators are successfully achieved within their area. The consultants will undertake an outreach outpatient service to the DGH within their area.
The philosophy of the unit is to provide the highest level of care within a multi-disciplinary setting. One of the strengths of the department has been the development of extended roles for our Dietetic and Nurse Practitioners. An example of this has been the successful institution of a Dietetic-led coeliac Service. The new appointee will take a lead role in a key service area supported by consultant colleagues. The previous appointee undertook the lead role for the liver services. However, it should be noted that the designation of consultant roles within the Department is flexible and could be altered, based on the interests, experience and expertise of the new appointee.
The inpatient care of PGHN patients is primarily based on wards 3B and 4B with the daily average of 8 PGHN patients and ongoing shared care of many complex patients around the hospital. There is a strong working relationship with the paediatric GI surgeons with joint care being offered for short gut and intestinal failure patients on the neonatal unit and ward 3B. The PGHN team also undertakes nutritional support to general pediatrics and tertiary specialties such as the intensive care unit, oncology & cardiology departments. This support extends to formal nutritional ward rounds.Children admitted for diagnosis and management of complex PGHN conditions have access to the full range of diagnostic and therapeutic services including interventional radiology and rapid turnaround histopathology.
The department offers a full diagnostic and therapeutic endoscopy service in a dedicated endoscopy theatre. There is a small bowel investigative programme, providing a capsular endoscopy and enteroscopy service. There are 4 scheduled GA sessions for endoscopy each week and access to a 24/7 emergency theatre list. The consultants are expected to work in a flexible manner to ensure delivery departmental and corporate targets. Consultants are not allocated a fixed weekly list, enabling the appointee to pick up handed back lists within the team and support cover of theatre sessions across the 50 weeks of the year. Clinics and theatre sessions numbers are annualised in consultant job plans.
The outpatient work is primarily at a tertiary level, though triaging of GP referrals is undertaken to fast track suspected IBD and liver patients and individuals who require early endoscopy assessment. There are specialist clinics in inflammatory bowel disease, liver disease, viral hepatitis and home parenteral nutrition. All Consultants undertake a general tertiary clinic for new and follow up patients. In addition, virtual (telephone) clinics are currently being established to facilitate reporting of investigative results and to establish early management strategies. There are currently several transition clinics for inflammatory bowel disease and liver patients within the greater Glasgow region and the West of Scotland. The new appointee will participate in regional transition clinics. Glasgow has formal links with KingsCollege, London and St James Hospital, Leeds with shared care arrangements for liver transplant patients. Dr Alastair Baker and Dr Patricia McClean, consultant paediatric hepatologists, undertake joint all day clinics in Glasgow throughout the year.
There are approximately 60 new IBD patients annually with a current caseload of 280 patients. There are currently 10 HPN patients and 25 patients who have had liver transplantation.
The endoscopy annual workload includes approximately 500 upper GI endoscopies and 200 ileocolonoscopies as well as 30+ therapeutic procedures.
There is a formal out-of-hours provision for PGHN with all consultants undertaking a prospective 1 in 5 rota. Formal ward rounds are undertaken at the weekend and the consultant will be expected to return to review patients out of hours as clinically required.
Medical Staff:
PGHN Consultants
Dr Andrew Barclay, Consultant Paediatric Gastroenterologist
Dr Diana Flynn, Consultant Paediatric Gastroenterologist
Dr Paraic McGrogan, Consultant Paediatric Gastroenterologist , Clinical Lead for PGHN West of Scotland
Dr Richard Russell, Consultant Paediatric Gastroenterologist
New Appointment
Members of Multi-disciplinary Team
Elaine Buchanan, Clinical Specialist Dietitian and dietetic lead for PGHN West of Scotland,
Tracey Cardigan, Senior Dietician, Hazel Duncan, Senior Dietitian, and rotational post (grade 6)
Sister Vikki Garrick, IBD Clinical Nurse Specialist, Sister Lee Curtis, IBD Clinical Nurse Specialist
Sister Christina McGuckin, Parenteral Nutrition Clinical Nurse Specialist, Sister Isobel MacLeod, Enteral Nutrition Clinical Nurse Specialist
Sister Jenny Cowies, Hepatology Clinical Nurse Specialist
Sister Karen Sinclair Nurse Educator/Facilitator
Dr Janie Donnan, Dr Amy Thomson, Clinical Paediatric Psychologists
Karen Fraser, Data Manager
Non Consultant Career Grades & Trainees
In general there is one designated middle grade trainee and an FY2 post. Glasgow is accredited for 24 months by CSAC for tertiary PGHN training. All trainees provide cover on the general medical rota and as such are removed from the ward on a regular basis.
Consultant Staff in Allied Departments
Paediatric GI Surgery:
Mr Carl Davis, Mr Graham Haddock, Mr Atul Sabharwal, Mr Gregor Walker
Sister Avril Smith, Gastrostomy Nurse, Sister Yvonne Keane, Stoma Nurse
Paediatric Surgery:
Prof Robert Carachi, Mr Constantinos Hajivasilliou, Miss Nicola Brindley, Mr Stuart O’Toole, Mr Martyn Flett, Mr Salvatore Cascio, Mr Phil Hammond
Histopathology:
Dr Clair Evans, Dr Dawn Penman
Radiology:
Dr Andrew Watt, Dr Sanjay Maroo, Dr Greg Irwin, Dr Sandra Butler, Dr Harjeet Kaur, Dr Ruth Allen, Dr Emily Stenhouse
Other Associated Consultants
Dr Conor Doherty, Consultant Paediatric Immunologist in Infectious Diseases, Viral Hepatitis clinic
Dr Rosie Hague, Consultant Paediatric Immunologist in Infectious Diseases, Viral Hepatitis clinic
Dr Dan Gaya, Consultant Physician & Gastroenterologist, Glasgow Royal Infirmary, IBD Northside Transition Clinic
Dr Rob Boulton-Jones, Adult Physician & Gastroenterologist, VictoriaHospital, IBD Southside Transition Clinic South,
Dr Adrian Stanley, Adult Hepatologist, Glasgow Royal Infirmary, Hepatology Transition Clinic
Dr Ewan Forrest, Adult Hepatologist, Glasgow Royal Infirmary, Hepatology Transition Clinic
Dr Alastair Baker, Consultant Paediatric Hepatologist, shared Care Clinic with King’s College, London
Dr Patricia McClean, Consultant Paediatric Hepatologist, shared Care Clinic with Leeds General Infirmary
Support Facilities (Offices/Secretary):
A shared office, secretarial and IT support will be available. The department has a number of clinical databases. Internal hospital servers (HISS, Clinical Portal and PACS systems) provide an automatic download facility of chemical pathology, haematology, radiology and histopathology results.
Library and Education Facilities:
i) The Hospital has its own medical library on site with a full time librarian. Electronic journal access is facilitated in conjunction with NHS Glasgow e-library project and also through the University of Glasgow with whom the postholder will have honorary senior clinical lecturer status.
ii)The Glasgow University Library is ten minutes’ walk from Yorkhill operating division.
DUTIES AND RESPONSIBILITIES
a)Clinical
The post-holder will share responsibility with the current consultants for the provision of PGHN services to West of Scotland. The consultants provide 24 hour cover for the service, including support of all patients locally, a consultation service for other departments and telephone advice for the West of Scotland. This is provided by a ‘two week on service’ rota. During the weeks on service the consultant will have limited outpatient commitment (a rapid access clinic), though would be expected to see emergency referrals.