Consultant Physician in Respiratory and General (INTERNAL) Medicine

consultant physician in respiratory and general (INTERNAL) medicine

glasgow royal infirmary

Information pack

reF: 32029d

Closing Date:noon14th march 2014

SUMMARY INFORMATION

Post: consultant physician in respiratory medicine

Base:glasgow royal infirmary

Applications are invited for the post of Consultant Physician in Respiratory and General (Internal) Medicine. The post will be based at Glasgow Royal Infirmary. Hospital

The successful candidate will integrate with existing consultant colleagues and provide clinical excellence in Respiratory Medicine within Glasgow Royal Infirmary/Stobhill ACH. The priority of this post will be to support lung cancer services.

This post will offer an opportunity for the successful candidate to be involved in the provision of a successful modern consultant led service.

All major specialties are represented within Glasgow Royal Infirmary currently there 52 Consultant Physicians with special interests in Acute Medicine, Cardiology, Diabetes & Endocrinology, Gastroenterology, Respiratory Medicine, Rheumatology and Elderly Care.

The post offers 9 direct clinical sessions in Respiratory Medicine. By negotiation with the Clinical Director there may be some flexibility in accommodating a reduced number of direct clinical sessions, a special interest and/or out-patient care. This post will require participation on the general medical on call rota.

Applicants must have full GMC registration and a licence to practice. Those trained in the UK should have evidence of higher Specialist Training leading to a CCT 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 GLASGOWANDCLYDE

GLASGOW ROYAL INFIRMARY

CONSULTANT PHYSICIAN RESPIRATORY AND GENERAL (INTERNAL) MEDICINE

BACKGROUND INFORMATION

NHS Greater Glasgow and Clyde (NHSGGC) is one of 14 regional NHS Boards in Scotland.The Board provides strategic leadership and performance management for the entire local NHS system in the Greater Glasgow and Clyde area and ensures that services are delivered effectively and efficiently. Responsible for the provision and management of the whole range of health services in this area including hospitals and General Practice, NHSGGC works alongside partnership organisations including Local Authorities and the voluntary sector. NHSGGC serves a population of 1.2 million and employs 44,000 staff – it is the largest NHS organisation in Scotland and one of the largest in the UK. If you want to know more about the NHS in Scotland then please visit

NHS Greater Glasgow and Clyde’s purpose is to:

“Deliver effective and high quality health services, to act to improve the health of our population and to do everything we can to address the wider social determinants of health which cause health inequalities”

Facts and Figures

• Serves a population of 1.2 million
• Employs over 38,000 staff
• More than 300 GP Surgeries (General Practitioners)
• 35 Hospitals of different types
• Dental Services in more than 270 locations
• Almost 180 Optician practices
• Over 50 Health Centres and Clinics
• More than 300 Pharmacies.

Area Covered

From Gourock to Easterhouse, Lennoxtown to Eaglesham, Alexandria to Bishopbriggs, NHSGGC serves the people of:

• Inverclyde,
• Renfrewshire,
• East Renfrewshire,
• Glasgow,
• East Dunbartonshire,
• West Dunbartonshire,
• and part of South Lanarkshire, including Rutherglen and Cambuslang.

Acute Services Division

The Acute Services Division is the largest group of adult acute hospitals in Scotland. It enjoys close links with Glasgow’s three universities and makes a significant contribution to teaching at both undergraduate and postgraduate level. Research also has a high profile within the organisation. Education facilities are provided at Glasgow Royal Infirmary and the new ambulatory care hospital at StobhillHospital. The service in North Glasgow presently employs more than 14,300 staff serving a core catchment population of 560,000.

Glasgow Royal Infirmary (GRI) & new StobhillAmbulatoryCareHospital (nSACH)

Glasgow Royal Infirmary is one of the major teaching complexes of the University of Glasgow. It provides the Emergency Medicine service for the North Eastern districts of Glasgow and has inpatient beds in general medicine and related specialities, medicine for the elderly, general surgery, orthopaedics, plastic surgery and obstetrics and gynaecology. There are also beds in intensive care, medical and surgical high dependency, and coronary care. Following the closure of StobhillHospital March 2011 all acute medical beds, with the exception of some long-stay care of the elderly beds, are on the GRI site. The new StobhillAmbulatoryCareHospital is a modern purpose built ACH providing a full range of out-patient and ambulatory care services including an ENP led Minor Injuries Unit (MIU). Radiology, Cardiology and Respiratory diagnostic services are provided both at GRI and nSACH.

Staff at GRI and nSACH are proud of the close inter-departmental links and co-operation. They are at the forefront of a progressive agenda in relation to clinical standards, managed clinical networks and patient focused service re-design. There are close clinical links with colleagues in the Community Health Care Partnership and other hospitals in NHS Greater Glasgow and Clyde, Glasgow, Strathclyde and GlasgowCaledonianUniversities. There is a dedicated hospital wide academic programme supported by a strong service educational commitment. GRI and nSACH are provided with dedicated education centres and IT support. Both have excellent reputations in supporting and nurturing its clinical staff and also have an excellent reputation for under and post graduate training. There are academic units in Anaesthetics, Cardiology, Human Nutrition, Medicine, Surgery, and Obstetrics and Gynaecology.

At GRI medical emergencies are admitted via an Acute Assessment Unit (AAU) run by acute physicians or viathe Emergency Department (ED) to an Acute Medicine Unit (AMU). This comprises 4 geographically defined ward areas covered by specific specialty teams – general medical, respiratory, gastroenterology and medicine for the elderly. Where bed availability permits, patients with specific conditions are triaged to the appropriate specialty team e.g. patients with respiratory disease to the respiratory area. Four consultant physicians representing each speciality group take part in acute receiving each day in the AMU with morning and evening ward rounds.

Acute admissions to medicine range from 45 to70 per day. Patients requiring a short stay are discharged from AMU. Those requiring longer stays are transferred ‘downstream’ to medical, care of elderly or cardiology beds. There are216 downstream medical beds split into specialty units/wards; Respiratory Medicine, Rheumatology, Gastroenterology, Diabetes and Endocrinology. Consultants from the department of medicine for the elderly (DOME) contribute to receiving duties, but also have 183 in-patient beds in a number of wards within Glasgow Royal Infirmary with additional rehabilitation beds at LightburnHospital and StobhillHospital. There is a separate Stroke Ward.

The Respiratory Department

Respiratory outpatient services are provided at nSACH and GRI,with inpatient beds at GRI.

Respiratory Team

Medical Team

The advertised post is to join the existing medical team who consist of Consultants in Respiratory Medicine. The service has the support of middle grade junior doctors and ward based cover by FY1/2 doctors. Middle grade doctors and sessional GPs provide support to out-patient clinics.

Consultants

Dr Mark Cotton - Consultant in Administrative Charge;(Respiratory Infections / Airways Disease)

Dr Christine Bucknall – Consultant (Complex Asthma / Airways Disease)

Dr George Chalmers - Consultant (Interstial Lung Disease / Vasculitis)

Dr Brian Choo-Kang – Consultant (Pleural Disease / Respiratory Infections)

Dr Eric Livingston – Consultant (Sleep)

Dr Robert Milroy - Consultant (Cancer)

Dr Joris Van der Horst – Consultant (Cancer / Interventional Bronchoscopy)

Dr Brian Neilly - Consultant (Nuclear Medicine)

Sessional General Practitioners

Dr John Farley

Dr Cameron Livingston

Respiratory Nurse Specialists

There are Respiratory Nurse Specialist (RNS) across GGC who specialise in various areas of Respiratory Nursing (Lung cancer, Asthma & COPD, Interstitial Lung disease, Breathing Support, Cystic Fibrosis and Pulmonary Vascular Disease)- 8.4 WTE in North East Glasgow. These RNS’s provide expert respiratory clinical skills to manage patients across both Secondary care and Primary care settings. The RNS's play a key role on improving the quality of care for respiratory patients by reducing unplanned hospital admissions, facilitating early discharge, offering care at home and improving patient self-management skills. There are well established links with the British Lung Foundation. Two TB nurses are based in the respiratory department.

Respiratory Physiotherapy

A specialist respiratory physiotherapist provides out patient services and supports in-patient physiotherapy with the assistance of the general physiotherapy service.

Respiratory Clinical Physiology

Respiratory physiology servicesare based at both Glasgow Royal Infirmary and the new StobhillAmbulatoryCareHospital. Therespiratory physiology and sleeplaboratories have the aim of providing an efficient, comprehensive clinical, therapeutic and pulmonary function assessment service for the diagnosis and rehabilitation of patients with respiratory and sleep related breathing disorders. The two laboratories provide a full range ofroutine pulmonary function tests (lung volumes by body plethysmography, spirometry, and single breath gas transfer assessment, response to bronchodilator and blood gas assessment by arterialised ear lobe capillary sampling). Specialist respiratory physiologyand sleep assessment arealso provided,in particular Progressive Cardiopulmonary Exercise Testing, Bronchial Provocation Testing, Respiratory Muscle assessment, Oxygen Assessment (LTOT, Ambulatory and Fitness to Fly) and Sleep diagnostic studies (Screening and Full Polysomnography). A full therapeutic service (CPAP/NIV) for patients with sleep related breathing disorders is also provided.The department currently has10 WTE Clinical Physiologists and 1WTE unqualified Support Worker providing the specialised services in sleepand exercise physiology.

Lung Cancer

The NE Respiratory service diagnoses about approximately 400 new lung cancer cases per year. The service is greatly supported by lung cancer nurse specialists, a consultant-led palliative care team visiting from the local hospice (whose Macmillan nurses also lend community support) and a consultant-led oncology team visiting from the West of Scotland Oncology Unit.. There is a weekly NE sector multi-disciplinary meeting, incorporating GRI, Stobhill and BeatsonOncologyHospitals, Golden Jubilee National Hospital (Thoracic Surgery) and the Southern General Hospital (Pathology Department). This is attended by a core group of respiratory physicians, thoracic surgeon, radiologists, oncologists, pathologists, lung cancer nurse specialists, and audit representation.

Investigation/Invasive Procedures

Bronchoscopy, is well developed, advanced and diagnostic procedures carried out within themodern purpose built Endoscopy suites at GRIand Stobhill. There are five bronchoscopy sessions each week approximately 700 bronchoscopic procedures carried per annum. Facillities include EBUS, approximately 150 procedures per annum, electro magnetic navigation, radiological screening, interventional bronchoscopy including cryotherapy and electrotherapy and stenting, Interventional radiology support stenting, specialist respiratory radiologists neck node FNA and CT-guided biopsy. In addition to this both GRI and Stobhill are supported by modern, well staffed radiology departments with access to Pleural Ultrasound, CT and MRI facilities.

Duties of Post:

Specialist interest and out-patient clinics.

It is expected that this appointment will contribute a specialist Respiratory Medicine interest to complement and expand the interests and expertise of the existing Consultants, which include interstitial lung disease, lung cancer, sleep services and complex asthma. This post may also provide the opportunity for the appointee to develop further experience and skills in an area of special interest on agreement with colleagues/management. The priority of this post will be to support lung cancer services.

Respiratory outpatient clinics are provided both at GRI and Stobhill. They include General Respiratory Medicine, Lung Cancer, ILD, Complex Asthma, Bronchiectasis, TB and Sleep clinics attended by consultants, specialty and middle grade doctors. The postholder’s outpatient clinics may be provided on both the GRI and Stobhill sites. There may be a requirement to participate in specialty MDT meetings.

Acute Medical Receiving (Glasgow Royal Infirmary) and In-patient work

The Respiratory Unit contributes a speciality component for medical receiving having 16acute respiratory beds in the receiving complex and continuing care of patients in downstream medical wards. The medical receiving is shared with all the major specialties except Renal and Cardiology. The rota is 1:8 approx, and includes morning and evening ward rounds in the receiving ward and in-patient speciality referrals from other units.

The respiratory medicine in-patient beds are situated in Wards 2, 6 and 7/16. These wards predominantly function as a specialist respiratory unit but may also be used for general medical patients (following acute receiving).

Teaching

The Unit has a major commitment to training junior staff and teaching medical students. During term-time the unit has third, fourth and final year students on the ward and there are frequently post-graduate students training for the MRCP examination. Teaching of practical procedures including pleural procedures and bronchoscopy to post graduates is a key component of the work of the unit The Unit runs a weekly clinical seminar in addition to participation in a range of MDT meetings in cancer, TB, ILD and mesothelioma, and participates regularly at grand rounds and postgraduate conferences.

Clinical Audit

The Respiratory Medicine Unit has been actively involved in audit programmes in several areas including Lung Cancer. The new appointee will be expected to have an active involvement in leading clinical audit.

Consultant Responsibilities

• As agreed with the Clinical Director in ECMS to provide (with consultant colleagues) a service in acute and respiratory medicine with responsibility for the prevention, diagnosis and management of illness and for the proper functioning of the service.

• To provide cover for consultant colleagues during annual and study leave or at such other times as agreed with the Clinical Director.

• To motivate staff within the service through leading by example and fostering good working relationships at all levels in line with the principles of the local Partnership Agreements.

• To participate fully in consultant appraisal and personal development planning activities.

• To ensure the efficient and effective use of Acute Services resources.

• To participate in the delivery of agreed national and local performance indicators e.g. Health, Economic Access Targets (HEAT).

• To participate in the Health Board and the Acute Division’s Clinical Governance framework and policies.

A split of 9:1 between direct clinical care PAs and supporting professional activities are 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. These activities must be specifically and clearly identified and be agreed with the candidate and desired by the department.

Proposed timetable

10 PA - Fixed sessions - 9 direct clinical care, 1 SPA

Flexibility for sessions to include timing of, will be necessary to take into consideration the changing service needs and absence of colleagues, such commitments will be incorporated into the post holder’s job plan. The final job plan will be agreed at or shortly after interview by agreement with the Clinical Director, General Manager and successful candidate.

Management Arrangements

General (Internal) Medicine and Acute Medicine are part of the Emergency Care and Medical Specialties Directorate, NHS Greater Glasgow and Clyde. Ms Anne Harkness, is the Director of Emergency Care and Medical Specialties across NHS Greater Glasgow and Clyde, and is supported by Dr David Raeside the Associate Medical Director and Mrs Joyce Brown, Head of Nursing.

At Glasgow Royal Infirmary the Clinical Director for Medicine is Dr Aidan Cahill, site specific management responsibility for Medicine at Glasgow Royal Infirmary and Stobhill Hospital is held by Ms Melanie McColgan, General Manager, NHS Greater Glasgow and Clyde, Ms Rosemary Brogan is the Clinical Services Manager for Medical Specialties and Cardiology and Mrs C Bell is the Clinical Services Manager for Acute Medical Receiving. Nursing leadership is provided by a number of Lead Nurses within all specialty areas.

Living & Working in Glasgow

Today Glasgow is a compact, vibrant and modern city. In fact Glasgow’s scale comes as a surprise to many people. It has the largest suburban rail network outside London and is second only to the UK Capital as a retail centre. There are good schools, excellent leisure facilities, beautiful golf courses and elegant accommodation across all price ranges. The night life and restaurants are renowned and its opera, theatres, art galleries and museums offer plenty of cultural stimulation. From Glasgow, it is only a short journey to many picturesque sites including Loch Lomond (45 minutes), the Argyll peninsula – or over the sea to Arran, Skye, Iona and Mull.

PERSON SPECIFICATION

CONSULTANT IN RESPIRATORY MEDICINE

REQUIREMENTS

ESSENTIAL

DESIRABLE

Qualifications and Training

ClinicalSpecialty Skills

Skills, knowledge and aptitude

Experience

Personal Skills