consultant physician in sleep and respiratory medicine
gartnavel general hospital/western infirmary
information pack
reF: 24878d
Closing Date:13th APRIL 2012
SUMMARY INFORMATION
Post:consultant physician in sleep and respiratory medicine
Base:gartnavel general hospital/western infirmary
Applications are invited for the post of Consultant Physician in Respiratory Medicine. This is a replacement post based at Gartnavel GeneralHospital and the Western Infirmary Glasgow with input into Respiratory Medicine, General Medicine and sleep medicine and home NIV.
The sleep service is located within the respiratory unit at Gartnavel GeneralHospital. Approximately 1000 new sleep/home NIV patients are referred annually to the service. The respiratory unit (40 beds) has 7 other consultants with major subspecialty interests in asthma, allergy, pulmonary vascular disease and cystic fibrosis.
The successful candidate will join a fully integrated respiratory and general medical clinical service which maintains strong academic and teaching links with the University of Glasgow.
The University will be asked to award an Honorary Clinical Senior Lectureship to the successful applicant.
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.
NHS GREATER GLASGOW AND CLYDE
JOB DESCRIPTION
Title of post: CONSULTANT PHYSICIAN IN SLEEP AND RESIRATORY MEDICINE
Base hospitals:GartnavelGeneralHospital & Western Infirmary Glasgow
Introduction
Living and Working in Glasgow
Today Glasgow is a compact, vibrant and modern city. In fact Glasgow’s scale comes as a surprise to some people. It has the largest suburban rail network outside London and is second only to the UK capital as a retail centre.
There are top-ranking schools, excellent leisure facilities, beautiful golf courses and elegant accommodation across all price ranges. The nightlife and restaurants are renowned and its opera, theatres, art galleries and museums offer plenty of cultural stimulation.
From Glasgow, the West of Scotland’s jewels are within easy reach. Loch Lomond is just 45 minutes drive, a little further to the Argyll peninsula – or over the sea to Arran, Skye, Iona and Mull.
Acute Services Division, NHS Greater Glasgow and Clyde
The Acute Division of NHS Greater Glasgow and Clyde is the largest group of adult acute hospitals in Scotland – offering many opportunities to ensure job satisfaction and career development.
We provide a wide range of services from community-based care through to the full range of general hospital services.
There is a significant amount of complex surgical work carried out, as we are home to a number of the country’s tertiary and national services including heart and renal transplantation and cardiothoracic surgery.
We enjoy close links with Glasgow’s three universities and make a significant contribution to teaching at both undergraduate and postgraduate level. Research also has a high profile within the organisation. We provide excellent facilities for students and their tutors in the state of the art, WolfsonMedicalSchool, based at GlasgowUniversity adjacent to the Western Infirmary site. Glasgow Royal Infirmary also provides excellent education facilities.
Employing more than 14,300 staff, we serve a core catchment population of 560,000. Our patients not only come from Greater Glasgow and Clyde but also, in some instances, from the whole of the West of Scotland and for our national services, from the whole of Scotland.
We have eight hospitals north of the River Clyde, all with teaching responsibilities: Glasgow Royal Infirmary (including Princess Royal Maternity Hospital), Western Infirmary, StobhillHospital, Gartnavel GeneralHospital, GlasgowDentalHospital and School, DrumchapelHospital, BlawarthillHospital and LightburnHospital. South of the river can be found the Southern General and Victoria Infirmary. In Paisley can be found the RoyalAlexandraHospital, while Greenock is home to InverclydeRoyalHospital and the Vale of Leven District General Hospital is situated in Alexandria.
With an annual budget of over one billion pounds this is a particularly exciting time to be joining NHS Greater Glasgow and Clyde. Over the next decade there is planned investment of more than £750 million, this is the largest single investment programme in the history of NHS Scotland – giving NHS Greater Glasgow and Clyde hospital accommodation for 21st Century health care.
NHS Greater Glasgow and Clyde plans to develop a new pattern of Accident & Emergency Services for Glasgow that will see:
- Specialist Accident & Emergency and Orthopaedic teams sited 24 hours a day at two centres of excellence – Glasgow Royal Infirmary and Southern General Hospital;
- New rapid access for GP emergency referrals; and
- Five Minor Injury Units staffed by nurse practitioners under the guidance of Accident & Emergency Consultants at Glasgow Royal Infirmary, Gartnavel General Hospital, Southern General Hospital and at the Ambulatory Care Hospitals to be built at Stobhill Hospital and the Victoria Infirmary.
By joining us now you will have the opportunity to be involved in the development and re-design of services enjoying a real chance to shape services for the future.
BRIEF DESCRIPTION OF WEST GLASGOW HOSPITALS
No of Beds:GartnavelGeneralHospital576 beds [40 respiratory beds]
The Western Infirmary545 beds
Functions
The WIG/GGH complex is one of the main teaching hospital complexes of the University of Glasgow. It provides the Accident & Emergency Service for the West of Glasgow. It provides all major specialties including Accident and Emergency, Intensive Care, Coronary Care, Oncology Centre, Renal Transplantation and Dialysis. The respiratory unit provides a comprehensive service for the diagnosis and management of all types of respiratory disease. Cardiothoracic surgery is provided in the nearby Golden Jubilee Hospital. The total population served is over 265,000. Patients are also referred for specialised respiratory investigation and treatment from other Health Boards. The West of Scotland Adult Anaphylaxis and Severe Allergy service; The West of Scotland Adult Cystic Fibrosis service the Scottish Pulmonary Vascular Unit are all established services within the respiratory unit based in various hospital sites throughout the north of the city.
WORK OF THE DEPARTMENT
General Respiratory Unit
Inpatients:
The respiratory unit has 40 beds available for general respiratory and sub-specialty admissions. Admissions from acute referrals from community and general medical take complement planned admissions from specialty clinics. Trained respiratory nurses over two wards are skilled in non-invasive ventilation, managing the acutely unwell respiratory patient and planned discharge of respiratory patients. The unit receives all types of respiratory cases continuously. There are approximately 2,000 discharges per year. In addition to all the techniques and skills expected in any teaching hospital respiratory unit, we have special expertise in the following areas: Inpatient facilities:
Sleep related disorders of breathing [This post]: A service to investigate and treat patients with disorders of breathing during sleep was started approximately 15 years ago and the Unit has seen a steady rise in referrals. Approximately 400 in-patients are investigated annually and also 400 patients at home.
Difficult Asthma [Dr Shepherd]: The unit has particular experience in the investigation and management of cases of difficult asthma. Combined with an internationally respected research unit, the clinical asthma service has experience of bronchial thermoplasty, omalizumab therapy and various ‘off-guideline’ managements such as subcutaneous terbutaline continuous infusion.
Allergy Services: [Dr Shepherd] The Regional Allergy service is the only Scottish Severe Allergy service and serves 1200 out-patients per year, offering venom and pollen desensitisation, anaesthetic allergy testing along with aero- and food allergy assessment. The successful applicant would contribute to this.
Pulmonary Vascular Disease (Scottish Pulmonary Vascular Unit) [Professor A Peacock and Dr M Johnson]: Patients with pulmonary hypertension are referred from all over Scotland. They are admitted to beds in the Respiratory Unit in Gartnavel and the Golden Jubilee Hospital where they undergo a series of investigations including cardiac catheterisation
Acute Nasal Ventilation [This post] NIV service is provided at Western Infirmary and Gartnavel General to treat infective exacerbations of COPD.
Interventional Bronchoscopy (EBUS, APC, PDT laser and stenting) [Dr S Bicknell, Dr Johnson, Dr Ross and Dr MacGregor]
Thoracoscopic Biopsy Techniques [Professor A Peacock, Dr S Bicknell and Dr MacGregor]
Cystic Fibrosis : [Drs Bicknell, MacGregor and Ross] West of Scotland Cystic Fibrosis Service covering est 240 adults with CF in West of Scotland.
Outpatients:
The unit is responsible for all aspects of the care of acute and non-acute patients referred to the respiratory outpatient department. Over 2,000 new patients and over 7,000 return patients are seen each year. Respiratory Clinics are held at Gartnavel GeneralHospital. There are specialised clinics dealing with specific areas: Sleep related disorders, Difficult asthma, allergy, cystic fibrosis, and pulmonary vascular disorders. The unit has expertise in the immunotherapy of allergic diseases such as bee or wasp venom reactions.
Respiratory Liaison Service:
TB nurse specialist (n=1): undertakes TB contact tracing, BCG vaccination, supervision of DOTs and domiciliary assessment. There are between 45 to 50 cases of pulmonary tuberculosis notified each year from the West Glasgow Area.
Respiratory liaison nurses (n=3): run the Asthma & COPD service including a Rapid Assessment Unit, supported discharge service and domiciliary service for patients with severe COPD (mainly on LOT).
Lung cancer liaison nurse (n=1): provides a lung cancer support service. Over 250 patients with confirmed lung cancer are treated annually and histological diagnosis obtained in 89% of patients
Cystic fibrosis nurse specialists (n=4): provide a service to the West of Scotland Adult Cystic Fibrosis Centre.
Pulmonary Vascular liaison nurses (n=2): provide a service to the Scottish Pulmonary Vascular Unit.
Bronchoscopy:
Four routine bronchoscopy sessions are undertaken each week with emergencies being accommodated at other times. The number of bronchoscopies (fibreoptic bronchoscopy/transbronchial biopsies) averages around 500 per year. The type of bronchoscopic procedures undertaken by the unit is as follows: fibreoptic bronchoscopy, transbronchial biopsy, EBUS transbronchial needle aspiration, autofluoresence brochoscopy, bronchoalveolar lavage, laser therapy, photodynamic therapy, endobronchial electrocautery, and bronchial stenting (in collaboration with radiology). The unit also performs medical thoracoscopy with facilities for up to two cases per week.
Respiratory Lung Function Laboratory:
The unit provides a specialised lung function service with laboratories situated at the Western Infirmary and Gartnavel General Hospital. The laboratory is administered by the consultant of the unit and is staffed by a complement of 6.7 whole time equivalent technical staff.
The types of test undertaken include measurement of spirometry, lung volumes, CO transfer factor, body plethysmograph, and specialised tests are also carried out i.e. histamine inhalation tests, occupational challenges, cardiopulmonary exercise testing and respiratory muscle strength assessment.
Educational programme:
The Respiratory Unit runs a weekly education programme including Seminars on Respiratory Medicine; General Respiratory Meeting: Multidisciplinary Lung Cancer Meeting; Radiology Meeting; Research Meetings.
Research and audit:
Clinical research, audit and innovation is integrated into the running of the respiratory services and supported by the clinical research facility based in the Western Infirmary, and the Division of immunology, inflammation and infection at GlasgowUniversity. It is anticipated that the successful candidate will contribute to the research of the group and will be encouraged to develop novel research.
Respiratory Unit Medical Staff:
No of Consultants
Dr S R BicknellDirector of the West of Scotland Adult Cystic Fibrosis Centre
and Consultant Physician in Respiratory and General Medicine
Asthma ConsultantTo be appointed. Consultant Physician in Respiratory Medicine and General Medicine
Professor A J Peacock Director of the Scottish Pulmonary Vascular Unit
Dr E RossConsultant Physician in Respiratory and General Medicine
Dr M JohnsonConsultant Physician in Respiratory and General Medicine
Dr G MacGregorConsultant Physician in Respiratory and General Medicine
Dr M ShepherdConsultant Physician in Respiratory and General Medicine
This postConsultant Physician in Respiratory Medicine and General Medicine
No of Associate Specialists 2 (Including 1 in asthma)
No of Grades of Supporting Staff2-3 ST3-5
1-2 ST1-2
2 FY2
3 FY1
No of Clinical Research Staff5
ACUTE MEDICINE
Acute medical receiving takes place within a 30 bedded acute medical admissions unit in the Western Infirmary. The junior medical staff work 12 hour shifts and are then off duty the following day. Under the present system the duty consultant physician conducts a ward round in the admissions unit at 6pm and at 8.00am the following morning and a second consultant physician provides continuity cover for patients within the receiving unit and a second acute medical ward. There are several protocolised nurse-led schemes and further developments are planned. There are currently around 30 acute medical admissions per 24 hours.
DUTIES AND RESPONSIBILITIES
Clinical
The post-holder will, together with consultant colleagues, be responsible for the provision of the general respiratory and the acute medical service. Weekly lung cancer MDT and radiology meeting are an important aspect of this post. The successful candidate will be responsible for a full sleep service which includes NHS inpatient polysomnography (PSG). Only GGH and Edinburgh Royal Infirmary offer NHS PSG service in Scotland. The responsibilities for the sleep service include an active outpatient weekly clinic, inpatient PSG and elective and emergency sleep/NIV admissions to the respiratory unit. This post includes responsibility for emergency referrals with unstable acute on chronic respiratory failure and includes NIV assessment/supervision in adult CF. A weekly case review is attended by nurses, physiologists and junior medical colleagues. A weekly reporting session is provided for home and inpatient sleep diagnostics and treatments.
Home Mechanical Ventilation service for neuromuscular disorders will be principally delivered at SGH, and chronic hypercapnic ventilatory failure from causes such as sleep breathing, adult CF and COPD requiring specialised home NIV skills will be delivered at GGH.
Supervision of Junior Staff
This post involves regular supervision of junior doctors with the aid of standard computerised resources.
Teaching & Administrative
The respiratory unit provides regular teaching commitment to undergraduates, postgraduates and nurses.
Research Opportunities
The Respiratory Unit has an active research programme with full-time medical and scientific staff carrying out research projects. Current research interests include asthma, cystic fibrosis, pulmonary vascular disease, sleep apnoea and COPD. The successful candidate may in the future be able to develop his or her own research programme. Academic respiratory medicine is a based within the Division of Immunity, Infection & Inflammation Director Professor FY Liew; 5* rated in last RAE.
Job Plan
Below is a representative timetable – details of timings can be negotiated
DAY / HOSPITAL/LOCATION / TYPE OF WORK / DCC / SPAMonday
9-1300
13-1700 / GGH / Alternate weeks bronchoscopy/
Administration
Sleep reporting
SPA / 2
2
2 / 2
Tuesday
9-1300
13-1700 / GGH/WIG
GGH / Resp ward rounds and sleep in-patient reviews plus GIM level 8 WIG for 8 weeks per year *
General Resp Clinic / 4
4
Wednesday
9-1300
PM OFF / GGH/WIG
PM OFF / Resp ward rounds and sleep in-patient reviews plus GIM level 8 WIG for 8 weeks per year * / 4
Thursday
9-1100
1100-1300
1300-1700 / GGH / Admin
SPA
Sleep/NIV clinic NIV meeting / 2
4 / 2
Friday
9-1300
13-1500 / GGH/WIG
GGH / Resp ward rounds and sleep in-patient reviews plus GIM level 8 WIG for 8 weeks per year *
Sleep clinic / 4
4
TOTAL AVERAGE HOURS PER WEEK / 36 / 4
*If taken over whole year
8 weeks cover of level 8 medicine is equivalent to 0.5 PA per week
Respiratory ward rounds not including weekends1 PA per week
In-patient sleep review1.5 PA per week
This totals 3 PAs or 12 hours as described above
Out of hours work
10 days on call
14 mornings second on call
1 in 7 Weekend Respiratory 1 PA
5 % availability supplement
A split of 9:1 between direct clinical care PAs and supporting professional activities is now standard for all new consultant job plans within NHSGG&C. 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.
PERSON SPECIFICATION
CONSULTANT RESPIRATORY MEDICINE
CONSULTANT INRESPIRATORY MEDICINE
REQUIREMENTS / ESSENTIAL
Requirements necessary for safe effective performance in the job / DESIRABLE
Where available, elements that contribute to improved, immediate performance in the job
Qualifications and Training / MRCP or equivalent
Applicants must have full GMC registration, a licence to practice and be eligible for inclusion in the GMC Specialist Register. 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 the date of interview. Non-UK applicants must demonstrate equivalent training. / MD/PhD
Clinical Specialty Skills / Demonstrates competence in the management of full range of respiratory and general medical presentations. / Experience in sleep-related disorders of breathing, including inpatient polysomnography.
Skills, knowledge and aptitude
(e.g. communication or organisations skills, proven work record) / Evidence of working in a multi-disciplinary team
Ability to organise and prioritise complex demands
Evidence of teaching and training skills for junior doctors
Effective communication skills / Management training
IT skills
Experience / Broad experience of respiratory medicine
Evidence of active involvement in relevant clinical audit
Sleep service experience / Evidence of participation in relevant research
Evidence of research publications
Evidence of innovative service developments
Personal Skills / Commitment to good team working and relationships
Ability to provide clinical leadership to the multidisciplinary team
Enthusiastic and ability to work under pressure
Supportive and tolerant
Caring attitude to patients
Special Requirements / Flexibility to respond to changing service needs
TERMS AND CONDITIONS OF SERVICE