CONSULTANT IN PAEDIATRIC INHERITED METABOLIC MEDICINE
royal hospital for children, glasgow
INFORMATION PACK
REF: 43577D
cLOSING DATE: 19th August 2016
SUMMARY INFORMATION RELATING TO THIS POSITION
Post: CONSULTANT IN PAEDIATRIC INHERITED METABOLIC MEDICINE
Base:royal hospital for children, glasgow
We are seeking a Consultant in Paediatric Inherited Metabolic Medicine.
This provides an exciting opportunity to continue the development of an integrated service for children with Inherited Metabolic Disorders both within theRoyal Hospital for Children in Glasgow and across the whole of Scotland, through outreach and ongoing development of the National Managed Clinical Network for Inherited Metabolic Disorders (IMD Scotland). The successful applicant will become one of a team of three Consultants.
The successful applicant will be based at the new, state of the art, Royal Hospital for Children in Glasgow. The new hospital is co-located with the newly built Queen Elizabeth University Hospital, Maternity and Neonatal services, and extensive modern laboratory services including Paediatric and specialist metabolic Biochemistry, the Scottish Newborn Screening Laboratory and Clinical and laboratory Genetics.
We are keen to encourage the development of an individual candidate’s special clinical and research interests.
We have very close links with services for adults with Inherited Metabolic Disorders, and there may be opportunity to participate in these for a suitably qualified and interested applicant.
Candidates should be trained in general paediatrics and ideally will have completed a full three year GRID training programme in Paediatric Inherited Metabolic Medicine. Candidates with equivalent training and experience are invited to apply. All applicants must have full registration with the General Medical Council, a licence to practise and be eligible for inclusion in the GMC Specialist Register,or eligibility for specialist registration (CESR) or be within 6 months of confirmed entry from the date of interview. Non-UK applicants must demonstrate equivalent training.
Informal enquiries can be made by contacting Dr Peter Robinson () or Dr Alison Cozens ().
NHS Greater Glasgow & Clyde
Women and Children’s Directorate
Information Pack
for the post of
Consultant in Paediatric Inherited Metabolic Medicine
Royal Hospital for Children, Glasgow
REF:43577D
CONSULTANT IN PAEDIATRIC INHERITED METABOLIC MEDICINE
JOB DESCRIPTION
REF: 43577D
THE POST
This post is a replacement post to continue the development of an integrated service for children with Inherited Metabolic Disorders both within the Royal Hospital for Children in Glasgow and across the whole of Scotland, through outreach and ongoing development of the National Managed Clinical Network for Inherited Metabolic Disorders (IMD Scotland). The successful applicant will join two existing Consultants in Paediatric Inherited Metabolic Medicine.
The successful applicant will be based at the Royal Hospital for Children in Glasgow, but will be expected to provide outreach clinics throughout Scotland, and provide telephone advice to clinicians throughout Scotland on a 1 in 3 on call basis.
Candidates should be trained in general paediatrics and ideally will have completed a full three year GRID training programme in Paediatric Inherited Metabolic Medicine. Candidates with equivalent training and experience are invited to apply. All applicants must have full registration with the General Medical Council, a licence to practise and be eligible for inclusion in the GMC Specialist Register, or be within six months of confirmed entry at the date of interview.
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 directorate in consultation with consultant colleagues.
Children’s Services across NHS Greater Glasgow and Clyde
The post is based at the Royal Hospital for Children, South Glasgow (RHC).The hospital was founded in 1883 and the new building opened in June 2015. The hospital forms part of the NHS Greater Glasgow and Clyde Women and Children’s Directorate, Acute Division. The RHC 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, including Renal Transplantation, Paediatric Cardiac Surgery, Complex Airway, Bone Marrow Transplant, Erbs 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, neonatal surgery and neurosurgery. A selection of child and adolescent psychiatry facilities are located within the campus along with a recently opened Child Protection Unit. There is an Emergency Department at RHC which sees 45,000 new patients annually. There is also a 24 bed Paediatric Intensive Care Unit. There are eleven operating theatres, a dedicated endoscopy room and a dental suite. The complex also includes a spacious Day Surgery Unit.
There are extensive modern laboratory services including Paediatric and specialist metabolic Biochemistry, the Scottish Newborn Screening Laboratory and Clinical and laboratory Genetics.
The diagnostic imaging facilities available on-site include MRI, CT, ultrasound and nuclear medicine, and a fluoroscopic digital screening room. A Scotland-wide PACS for transmission of digital diagnostic imaging has been rolled out. Almost all hospitals in Scotland are filmless.
The Royal Hospital for Children 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. There are also links with both Caledonian and Strathclyde Universities. The Research and Development Department and the Department of Clinical Audit provide assistance with research projects. A Scottish Medicines for Children Network (SMCN) supports research projects adopted through Clinical Studies Groups of UK based Medicines for Children Research Networks.
Other Paediatric Services in Greater Glasgow and Clyde
Maternity services are delivered at the Southern General Hospital, the Princess Royal Maternity Hospital and Royal Alexandra Hospital, Paisley, all with neonatal facilities. There is also a Paediatric Ward in the Royal Alexandra Hospital.
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.
Paediatric Services
Clinical Leadership
The Paediatric Inherited Metabolic Disorders Service 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. Phil Davies is Clinical Director for specialist medical paediatric services. Dr Christine Gallacher is Clinical Director for general paediatrics.
THE JOB ITSELF
(a)Title:
Consultant in Paediatric Inherited Metabolic Medicine
(b)Relationships:
(i)Name of Health Board:
NHS Greater Glasgow & Clyde Acute Services Division
(ii)Names of Consultant members of the Department:
. Dr Peter H Robinson
Consultant in Paediatric Inherited Metabolic Medicine & Honorary Clinical Senior Lecturer
Dr Alison Cozens
Consultant in Paediatric Inherited Metabolic Medicine and Lead Clinician IMD Scotland National Managed Clinical Network for Inherited Metabolic Disorders
(iii)Number and Grades of other members of department:
S/N Susan McMahon Paediatric Metabolic Specialist Nurse
Mrs Barbara Cochrane Specialist Metabolic Dietitian (Children)
Ms Sarah Adam Specialist Metabolic Dietitian (Adults and Children)
Clinical Trainees
There is a designated middle grade trainee shared with the endocrinology and diabetes service. Glasgow is not currently accredited for tertiary training in Paediatric Inherited Metabolic Medicine. All trainees participate in the general medical on call rota.
Aims and Objectives of the Service for Paediatric Inherited Metabolic Medicine
From July 2015 the two existing PIMM Consultants in Scotland have combined forces so that we can build a national Scottish PIMM service, based in Glasgow, but structured to support inpatient and outpatient care across Scotland.NHS Scotland aims to provide specialist care as close to home as possible, and Consultants in the full range of Paediatric subspecialties are used to working very closely together across the regional Health Board boundaries to provide a consistently highstandard of specialist care across Scotland, through outreach and joint working.
We aim to provide comprehensive clinical diagnostic and management services for all children with inherited metabolic disorders in Scotland. Children living within Southwest Scotland are looked after directly by the team at RHC Glasgow; children living in Southeast Scotland are looked after directly by the team at RHSC Edinburgh. Both services are led by PIMM Consultants, together with experienced metabolic dietitians, and in Glasgow,an experienced specialist metabolic nurse.The current PIMM Consultants provide specialist support, in close collaboration with local Link Paediatricians, through telephone consultations and outreach clinics, for children living in the more remote and less populated parts of Scotland, including Tayside, Grampian and Highland regions.
We aim further to develop and consolidate joint working and robust referral pathways, mediated by the National Managed Clinical Network for Inherited Metabolic Disorders (IMD Scotland). This will provide improved access to specialist PIMM services for all children living in Scotland, and will be expected to continue significantly to improve long-term outcomes.
The service for children is very closely linked to services for adults with inherited metabolic disorders, and both current PIMM Consultants contribute significantly to those services. We are working closely with NHS Scotland National Specialist Services to develop plans for increasing service capacity for these adults, to create and develop sustainable services for adults and robust transition pathways.
Integration and consolidation of specialist services through IMD Scotland, based in RHC Glasgow, will allow us to develop research, training and teaching programmes in Inherited Metabolic Disorders in Scotland, building on the established links with Glasgow University.
Description of Service: Scotland
Children with inherited metabolic disorders require access to a wide range of health care practitioners, multi-disciplinary facilities, including those of other paediatric and neonatal sub-specialties, complex laboratory investigation facilities and highly specialist dietetic services.
A full range of specialist Paediatricand surgical services are necessary to support children with inherited metabolic disorders. Most of these are provided within the Royal Childrens’ Hospital in Glasgow, including, for example, neurology, respiratory, gastroenterology, renal, bone marrow transplant and cardiology services. Spinal surgery is based at the Royal Hospital for Sick Children in Edinburgh. The Scottish PICU service is provided jointly between Glasgow and Edinburgh with an associated jointly managed critical care transport service.For some inherited metabolic disorders (particularly hyperammonaemias), the Royal Hospital for Children provides a fully comprehensive service for Scotland with availability of both intensive care and renal dialysis facilities, including haemodialysis, haemofiltration and haemodiafiltration.
There is a neonatal intensive care unit onsite. Community, therapy, neurodisability and childrens’ mental health services are readily accessible. We have strong links with the Children’s Hospice Association of Scotland who have a Children’s Hospice in Kinross in the East, and another in Balloch, in the West. Advice and support are given by telephone or in person, as needed.
Diagnosis of inherited metabolic disorders requires access to specialist metabolic biochemistry services; there are fully accredited metabolic biochemistry laboratories in Glasgow (co-located with the Royal Hospital for Children) and Edinburgh. Medical and Clinical Biochemists from both laboratories participate actively in metbionet, and they have very close links with each other, and with biochemistry laboratories throughout Scotland, to provide expert advice, necessary monitoring, and timely access to specialist metabolic testing.
We have a very close working relationship with the Scottish Newborn Screening Laboratory, also based on the same site. Referrals for babies identified with PKU or MCAD deficiency are all made directly to the PIMM Consultants, ensuring adherence to robust referral pathways and timely diagnosis and treatment. The laboratory and IMD Scotland members are working closely with NHS Scotland to implement newborn screening for 4 additional inherited metabolic disorders in the near future.
Clinical Genetics services are essential; these are provided through four regionally based services in Scotland, all with GTN recognised laboratories.In Glasgow, these are also on the same site.
Description of Service: Royal Hospital for Children Glasgow
Children living in Greater Glasgow, much of South West Scotland, Central Scotland and Western Scotland attend outpatient services at the Royal Hospital for Children, Glasgow. Referrals may come from all over Scotland. Care is provided for children with the entire range of inherited metabolic disorders, including organic acidaemias, fatty acid oxidation defects, aminoacidopathies, lysosomal storage diseases, glycogenosis, mitochondrial diseases and many more rare disorders. We also provide a (rapidly expanding) nurse-led service for children identified from the Scottish cascade screening programme for familial hypercholesterolaemia.
Currently three multidisciplinary clinics for children are provided weekly: general metabolic, new patient, and PKU. There is a monthly transition clinic for young adults held jointly with a Consultant Chemical Pathologist, who also provides a service for adults with Inherited Metabolic Disorders in SW Scotland. At present, the PIMM Consultant also provides a weekly outpatient clinic for women of reproductive age during pregnancy, or planning pregnancy, supported by specialist dietetic, midwifery and obstetric staff. Some clinics are dietitian-led, aimed at group teaching rather than the traditional face to face consultation. There is a regular nurse-led clinic for children with familial hypercholesterolaemia.
Children requiring inpatient care are nursed on the specialist paediatric ward. Many of the ward nursing staff have years of experience looking after children with inherited metabolic disorders. There is an onsite Paediatric Accident and Emergency department and the General Paediatric service provide care for acute admissions and out-of-hours. Immediate access is available to Paediatric Intensive Care facilities (PICU) and the High Dependency Unit, as required. There is a nationwide retrieval service. Whilst in PICU, responsibility for day-to-day coordination of clinical care rests with the Paediatric ICU staff, but with close involvement of the specialty consultants. Some infants are similarly jointly managed in the Neonatal Intensive Care Unit. There are excellent close working relationships with these specialists and with the range of Paediatric medical and surgical sub-specialists, and specialist inpatient consultations are readily available. Children from all over Scotland may be admitted for specialist PIMM investigations, assessment and/or treatments which cannot be provided locally.
A day investigation unit (ambulatory care facility) is open Monday to Friday for outpatient investigations. Nursing support for complex metabolic investigations is provided by a Metabolic Clinical Nurse Specialist, with cross-over support provided by Clinical Nurse Specialists from the department of Paediatric Endocrinology, and also by trained designated general nursing staff. This unit also provides Enzyme Replacement Therapy for children with Lysosomal Storage diseases.
Description of Service: Royal Hospital for Sick Children Edinburgh
Currently inpatient and outpatient services for children with Inherited Metabolic Disorders in Southeast Scotland are provided by a single PIMM Consultant, supported by experienced metabolic dietitians, a metabolic laboratory service and medical, nursing and therapy staff from the general and specialist medical and surgical Paediatric teams. Two general metabolic clinics per week, monthly clinics for children with familial hypercholesterolaemia and monthly joint neurometabolic clinics are provided. It is planned that in future this service will be shared between all three PIMM Consultants, based in Glasgow. The PIMM Consultant also currently provides two clinics per month for adults at the Western General Hospital in Edinburgh.
Description of Service: Outreach
The two PIMM Consultants currently provide support to children with IMDs in the North and East of Scotland, through outreach clinics in Kirkcaldy, Dunfermline, Aberdeen, Dundee, Perth, Melrose and Inverness, and through 24 hour telephone advice for inpatients. This has been highly successful in improving both acute and long-term care, timely diagnosis and joint working with local Paediatricians. The National Managed Clinical Network for Inherited Metabolic Disorders (IMD Scotland) has been instrumental in facilitating these closer working relationships, and we plan to build on this success, and to extend outreach to other Health Boards, when we can.
The successful applicant will be expected to participate actively in the maintenance and development of outreach services.
Access to Service
We accept referrals from Consultant Paediatricians, General Practitioners, the Scottish Newborn Screening Laboratory, metabolic Biochemistry laboratories, Clinical Genetics, Maternity services and occasionally from other services. All new referrals are seen by Consultant staff.