NHS DUMFRIES & GALLOWAY
CONSULTANT PHYSICIAN WITH AN INTEREST IN
DIABETES AND ENDOCRINOLOGY
JOB DESCRIPTION
THE POST
This is a new post. The successful applicant will join a team that consists of 2 Consultants in Diabetes and Endocrinology, a Consultant Biochemist with an interest in diabetes and weight management, a Specialty Doctor in Diabetes and General Medicine, two (wte) Specialist Nurses, 3 Community Diabetes Specialist Nurses and 4 Specialist Dieticians and will be based at Dumfries and Galloway Royal Infirmary.
Over the last 10 years the diabetes service has undergone a period of substantial redesign and offers all aspects of modern diabetes care including delivery of the DAFNE and DESMOND structured education, a multidisciplinary ANC, multidisciplinary foot clinic, a combined renal/diabetes clinic, a CSII pump clinic and a transitional diabetes service. Diabetes care is delivered from a dedicated diabetes centre located on the Crichton Campus. There are peripheral clinics held in Stranraer both in person and using telemedicine. The successful applicant would also be expected to contribute to the general medicine on call rota (1 in 13.5).
DEPARTMENT OF DIABETES & ENDOCRINOLGY
The successful applicant will join the current two Consultant Physicians with an interest in Diabetes and Endocrinology and it is hoped that this additional resource will allow the local Diabetes Service to increase the provision of support to managing diabetes in a community setting. Dr. Fiona Green took up post in 2004 and has developed the lead role in the service as well as establishing the pump transitional service and the renal/diabetes clinic. Dr Ewan Bell joined the Board in 2005 as Consultant Clinical Biochemist and has a strong commitment to supporting the diabetes service as well as providing lipid and metabolic clinics in addition to his role in the biochemistry department. Dr Louise Clark joined the team in 2012 and has established a very active multidisciplinary the foot clinic.
There is a robust Managed Clinical Network for Diabetes that developed a strategy for delivering Diabetes care over the next five years. The network is well represented from both Acute and Primary Care, working in partnership to develop the service. The successful candidate will be expected to participate in the MCN.
The current Diabetic and Endocrine Service comprises of:
DIABETES
· There are a number of diabetes outpatient clinics carried out by a variety of staff at Dumfries and Galloway that are held in the diabetes centre based at Crichton Royal Hospital (on the same site as Dumfries and Galloway Royal Infirmary). The successful applicant will contribute to general diabetes clinics.
· A combined diabetic antenatal clinic runs weekly and a pre-pregnancy counselling service is integrated into this.
· A joint foot clinic involving a specialist diabetes podiatrist, Diabetes Specialist Nurse, Orthoptist, vascular surgeon and diabetologist runs on a weekly basis.
· Renal/diabetes clinics run twice monthly.
· Pump clinics run twice monthly.
· Dumfries was one of three pilot sites in Scotland to run the DAFNE programme and has been running the programme since 2005. These courses are now established and proving to be invaluable for our Patients with type 1 diabetes.
· Galloway Community Hospital (GCH) clinics – monthly Diabetes and Endocrinology clinics as well as weekly Diabetes telemedicine to GCH.
· All newly diagnosed type 2 patients in Dumfries and Galloway are offered the opportunity to attend the DESMOND education programme. Audit has shown this to improve glycaemic control.
· A monthly adolescent clinic with input from both the paediatric and adult services was established in 2004.
Current support for the diabetes service comprises: -
· Two wte experienced diabetic specialist nurses are currently in post in Dumfries Royal Infirmary. The nurses have experience in CSII therapy and all nurses are DAFNE trained.
· 3 LHP based diabetes Specialist nurse (with a nursing/educational background) are based in Dumfries & Nithsdale and Annandale & Eskdale. This post plays a pivotal role in bridging the primary / specialist care interface. These nurses have enhanced skills in achieving behaviour change and are skilled in a variety of psychological tools including motivational interviewing and CBT. These nurses are both DAFNE and DESMOND trained.
· Four diabetes dieticians (DAFNE, DESMOND trained and pump trained) aligned whole time to the service and participating in the regular DGRI based clinics.
· We have links to psychology and have weekly supervision meetings.
· Experienced podiatry help is available at the routine diabetes return clinic on Tuesday morning and at other times by request. Excellent links with region wide podiatry services with ability to provide regional specialist service – each LHCC has a senior 1 podiatrist with a high-risk liaison remit. The lead podiatrist inputs into the multidisciplinary foot clinic together with orthotics.
· A Comprehensive diabetes register using the SCI-Diabetes System has been implemented recently and there is separate diabetes secretarial support for the clinics. Current figures show that there are approximately 6100 individuals with Diabetes in Dumfries and Galloway and approximately 900 of them have type-1 diabetes.
· Dumfries and Galloway use a digital retinal screening programme as outlined in the Scottish Diabetes Framework and have the highest rate of screening in Scotland.
· A new diabetes centre was developed in Crichton Royal Hospital in 2005. This centre provides dedicated consultation and education facilities as well as an office base for the diabetes team.
There is a long-standing commitment in general practices throughout the region to provide diabetes care to their own patients. The impetus for that has, of course, been re-energised by the new GMS contract but prior region-wide audits showed good compliance with all the basic elements of good practice. It is hoped that this new post will allow an enhanced service for managing diabetes in a community setting to be developed
ENDOCRINOLOGY
Currently there are 4 endocrine clinics per week in Dumfries Royal infirmary. In conjunction with this, a nurse led endocrine testing service has been established. Radioiodine therapy is available for patients with thyrotoxicosis. Neurosurgery for pituitary disease is currently carried out in Edinburgh with links to Glasgow for adrenal surgery.
PERIPHERAL CLINIC COMITTMENTS
· Monthly all day clinics in GCH
· Telemedicine clinics weekly to GCH
· 6 weekly into ward at GCH combined with short clinic
We plan to increase our activity serving the West of the region by increasing clinic capacity and by providing closer links with GP surgeries utilising case management strategies.
THE DEPARTMENT OF MEDICINE
The Medical Unit provides acute hospital medical services to the population of South-West Scotland. The Division meets once weekly to discuss the challenges of the unit, which recently have included MMC and targets for acute medical admissions. The Consultant Physicians who participate in the emergency on-call rota are as follows:
Dr P Rafferty, Dr S Little Respiratory Medicine
Dr MJ McMahon Rheumatology
Dr G Jones Infectious Diseases
Dr F Green, Dr L Clark, Consultant (this post) Diabetes & Endocrinology
Dr S Saha, Dr A Wahab Gastroenterology
Dr IFC Hay, Dr R Holden & Dr Konstantinos Graikos Care of the Elderly
Dr S Finlay Acute Medicine
The following Consultant Physicians provide specialist services only:
Dr GW Tait, Dr A McKay, Dr H Ahmed, Dr S Esmail Cardiology
Dr L Yeo , Dr C Malone Dermatology
Dr O Dolezal Neurology
Dr A Stark, Dr R Thomas, Dr M Khan Haematology
Dr S Pickstock Palliative Care
Dr T Muniraju, Dr K Donaldson, Dr Rathnamalala (Locum) Renal Medicine
Dr A McKendrick Rehabilitation
Associate Specialists/Specialty Doctors:
1 x Cardiology
2 x Renal Medicine
2 x Care of the Elderly
2 x Rheumatology
2 x Rehabilitation
1 x Respiratory Medicine
1 x Gastroenterology
1 x Diabetes
1 x Infectious Diseases
1 x Dermatology
The Medical Unit is currently staffed by the following junior doctors:
2 x ST3
2 x CT2
3 x CT1
7 X GPSTs
4 X FY2
6 X FY1
Emergency Medical Care
There are 117 General Medical beds, 50 beds in Geriatrics/Rehabilitation and an 8-bedded Medical High Dependency Unit/Coronary Care Unit (distinct from the Surgical High Dependency Unit and Intensive Care Unit). The 10-bedded Stroke Unit is incorporated into ward 12. There is an 18-station haemodialysis unit for renal patients within the hospital.
Endocrine and general medicine outpatient clinics are held at the Royal Infirmary and in the Galloway Community Hospital, Stranraer. Diabetes clinics are delivered in the diabetes centre and in Stranraer.
The undergraduate teaching commitment is principally to Glasgow and Edinburgh University students during their final two years and to elective students from other Universities, with an increasing number of students applying to undertake Special Study modules. We attract postgraduate Clinical Attachments and have an active programme of teaching for SHOs preparing for MRCP examinations.
Education
There are weekly clinical meetings organised by the Department of Medicine on Wednesdays and a journal club on Fridays. Links with tertiary centres for continued professional development is encouraged.
A clinical timetable is attached to this job description detailing the commitments expected of the post holder. This will be subject to review on appointment of successful candidate.
QUALIFICATIONS
All candidates are required to be on the GMC Specialist Register.
The candidate will hold a CCT or be within 6 months of obtaining the certificate.
GENERAL PROVISIONS
Policies & Procedures
§ The successful candidates are required to work within the local management structure and co-operate with other professional colleagues to ensure the efficient running of the service and will take part, with other consultant colleagues in the medical contribution to management.
§ Subject to the provision of terms and conditions of service, the postholder is required to observe the organisation’s agreed Policies and Procedures, drawn up in consultation with the profession on clinical matters, and to follow the Standing Orders and Financial Instructions of the organisation.
§ The postholder is required to ensure that there are adequate arrangements in place for hospital staff involved in the care of patients for contacting him/her when necessary.
§ The postholders are required to comply with the Organisation’s and the Department’s Standing Operating Procedures including Health and Safety Policies.
§ The post-holder will be professionally accountable to the Clinical Director.
§ The post-holder will be managerially responsible to the General Manager.
Travel
Any travel allocation will be included within the Total Programmed Activities and will be determined by the location at which Direct Clinical Care and Supporting Professional activities are carried out.
Administration
This activity covers the management of individual patients including out patient administration, results reporting, letters/phone calls to patients, carers, GPs and members of the wider multidisciplinary team involved in the patients care.
Supporting Professional Activities
A minimum of one SPA is included in the indicative job plan, amounting to 168 hours per annum which shall normally be sufficient to reflect activities such as revalidation, appraisal, personal audit, and professional development (occurring outwith the 30 days of study leave entitlement in any three year period). Time permitting, it may also cover minimal teaching, training and non-clinical administration. Any additional SPA allocation will require to be evidenced as being mutually beneficial and required by the department. Adjustment to the programme to incorporate additional SPA will require other activities to be reviewed to accommodate any increase as necessary. It will be requested that SPAs are delivered at the normal place of work, unless there are mutual advantages to it being performed elsewhere. The exact timing and location of SPAs, and flexibility around these, will be agreed during the 1:1 meeting with the Clinical Director/Associate Medical Director and included in the prospective job plan.
Private Practice
If the postholder wishes to undertake any private practice, he/she is obliged to inform his/her employer at the time of appointment of his/her intention to do so. This should be submitted in writing to the Medical Director.
The postholder shall be free to undertake private practice without approval provided such work is undertaken outside the time agreed in the job plan for programmed activities and is in accordance with the national terms and conditions to service. (Refer Section 6 of the New Consultant Contract).
Annual Appraisal & Job Planning
You shall also be required to participate in annual appraisal. Job planning is linked closely with, but is separate to, the agreed appraisal scheme for consultants. The job plan review will take into account the outcome of the appraisal discussion and reflect the agreed personal development plan.
TERMS & CONDITIONS OF SERVICE
The terms & conditions of service offered are those determined by the Consultant Contract 2004 Scotland (as amended from time to time).
This is a permanent position.
Salary scale
£76,761 - £103,490 (depending on seniority point)
New entrants to the NHS or the consultant grade will normally commence on the minimum point of the salary scale (dependant on qualifications and experience).
Hours of duty
The hours of duty are 40 per week.
Superannuation
You will automatically be entered to the NHS Superannuation Scheme, in accordance with Auto Enrolment legislation. Full information regarding the pension scheme including information on auto enrolment is available from the SPPA website www.SPPA.gov.uk.
Removal expenses
Assistance with relocation and associated expenses may be given and can be discussed prior to appointment. A quick reference of entitlements is attached for you.
Expenses for candidates attending for interview / visit
Candidates who are required to attend an interview will be given assistance with appropriate travelling expenses. Re imbursement shall not normally be made to employees who withdraw their application or refuse an offer without good reason. Expenses will be paid from port of entry into the UK only.
Disclosure Scotland / PVG
This post is considered to be in the category of “Regulated Work” and therefore requires a Disclosure Scotland Protection of Vulnerable Groups Scheme (PVG) Membership which currently costs £59.00. The cost of the PVG Membership will be paid by NHS Dumfries & Galloway.
Right to work in the UK