Dumfries and Galloway

Dumfries and Galloway Royal Infirmary

Specialty Doctor in Anaesthetics and Intensive Care

THE POST

·  A full time substantive post is available

·  The post-holder will be an integral part of the clinical team.

·  Time will be allowed for suitable CPD according to the requirements of the individual, and the need to provide on-going service to patients.

·  Support will be given to the individual working towards external degrees and qualifications.

THE DEPARTMENT OF ANAESTHETICS

The Anaesthetic Department is based at Dumfries and Galloway Royal Infirmary. There is a modern 6 theatre operating department suite with recovery area and an adjacent endoscopy/day case suite with 20 trolley spaces, one day case theatre and two endoscopy rooms. Equipment in Theatre, ICU and SHDU is of a high standard. There is full Medical Physics back-up, day and night.

There is a four-bedded, well-equipped, Intensive Care Unit, a separate four-bedded Surgical High Dependency Unit and an eight bedded Medical High Dependency/Coronary Care Unit. The Intensive Care Unit runs a ‘semi closed’ model and is staffed by six consultant anaesthetists with an interest in Critical Care on a weekly daytime rota. The unit actively participates in audit and multi centre research.

There is a well established Specialist Nurse led Acute Pain Service with Consultant Anaesthetist support.

The chronic pain service is led by two consultant anaesthetists with interest in chronic pain, with out-patient clinics and dedicated theatre sessions to perform interventions. There are links with the acute pain and palliative care services, General Practitioners and the voluntary sector. The Anaesthetic Department strongly supports multidisciplinary working and has been working closely with management to establish a multidisciplinary pain team.

The regional Accident and Emergency Department is led by consultants in Emergency Medicine. The Anaesthetic Department assists in resuscitation and stabilisation of patients in the Emergency Department and on occasions is responsible for transport of critically ill patients to tertiary centres, particularly for neurosurgical and cardiothoracic intervention.

Many surgical specialties are supported including ENT, Ophthalmology, Vascular Surgery, Urology, Upper and Lower gastrointestinal surgery, gynaecology, obstetric, orthopaedic and maxillofacial surgery.

In addition, the Department supports the following facilities:

1.  Cresswell Maternity Wing, which provides a specialist Obstetric and Neonatal Service for south-west Scotland, with around 1,400 deliveries per year. There is a newly established labour epidural service and support given for Remifentanil PCA. There is an anaesthetist allocated for unscheduled obstetric anaesthesia each weekday morning and the department is staffed at other times to provide resident obstetric anaesthesia expertise at all times

There are two Consultant sessions for elective cases on Tuesday and Thursday mornings.

2.  ECT. This is now provided in the day surgery unit following the move of psychiatric services to the new Midpark Hospital.

3.  Galloway Community Hospital, which has a separate anaesthetic rota staffed by the two Galloway Community Hospital (GCH) consultants, supported by a visiting specialty doctor. There is informal voluntary rotation of DGRI consultants to GCH when the DGRI rota allows. Locum sessions are currently required to support this rota.

4.  Ophthalmology. A fully equipped operating theatre is used in the ophthalmology ward for occasional general anaesthetic cases.

The Anaesthetic Department establishment at present is as follows:

Consultants: Special Interest:

(Vacant post currently advertised) TIVA, Airway Skills

Dr D Christie (w/t) ICU, Deteriorating patient, vascular surgery

Dr V Edwards (w/t) Trauma and Emergency Surgery, Rota

Dr H Goonesekera (w/t) Chronic Pain, Vascular surgery

Dr D Macnair (w/t) Obstetrics

Dr J Muthiah (w/t) Chronic Pain, Orthopaedics

Dr J Neil (w/t) Obstetrics, Blood Transfusion

Dr W Peel (w/t) ICU, Vascular Surgery, ECT,

Dr V Perkins (w/t) Pre-operative Assessment, VTE prevention lead

Dr J S Rutherford (w/t) ICU, Vascular Surgery, Acute Pain, Paediatric Anaesthesia, APLS Course Director

Dr L Verner (0.5 WTE) Regional Anaesthesia, Orthopaedics

Dr D Williams (w/t) ICU, Vascular Surgery, Specialty Team Lead for ICU, ALS Course Director

Dr S Wilson (w/t) ICU, Airway lead, Vascular Surgery, IT

Dr W Wrathall (w/t) ICU, Vascular Surgery, Deteriorating Patient Lead, Clinical Director of Anaesthesia & Intensive Care

Dr R J Spicer (p/t)...... GCH Inter-hospital Transfer, Asthma, Day Surgery

Vacancy...... GCH Currently advertised

Specialty Doctors:

Dr D Ballingall (w/t)

Dr K Shahzad (w/t)

Dr C Fernando (w/t)

Vacancy (w/t) Locum Post currently advertised – 5 months

Dr J Deutsch (w/t)

Vacancy (w/t) This advertised position

Dr J Deutsch (w/t)

Dr J Carruthers (p/t) Locum appointment

Dr D Coyle (p/t)…..GCH Provides 1 in 4 weekend on-call

Trainees:

·  Five CT doctors, recognised by the College for basic specialist training, on the West of Scotland training rotation

Education, Research and Audit

The Department holds weekly Intensive Care lunch-time meetings and monthly half-day “Continuing Education and Professional Development” sessions. There is a tutorial programme and a series of lectures to theatre nursing staff.

The Department is heavily involved in Critical Care and Resuscitation teaching with ALERT, IMPACT, APLS, ALS, SCOTTIE courses, all being run in the Education Centre and Resuscitation Training Centre. SIM-MAN and HAL mannequins are used in much of the teaching. Dumfries is a regional centre for APLS, ALS, ALERT, IMPACT paramedic and undergraduate training and we are recognised for both basic and Higher Postgraduate Specialist Training.

Key Result Areas

·  Maintaining the high quality of clinical teaching for medical students that has existed in Dumfries & Galloway for some years, with the feed-back reports from students being used as an outcome measure.

·  Taking part in clinical audit, and all aspects of clinical governance as required by the Department.

·  Completing satisfactory CPD, and an appraisal process.

·  The Hospital has a Research Department, and the post-holder will be able to obtain support in the preparation and carrying out of research projects, a development which will be encouraged.

·  The postholder will be expected to work well with an extended multi-disciplinary team, ensuring good communications and co-operation with all members of the medical staff.

Job Plan

A job plan will be agreed with the successful candidate. Specialty interests may be accommodated. The job plan will be based on a 10 PA contract (1PA = 4hours) with a minimum of 1 SPA. Out of hours work is resident on a partial shift rota and out of hours commitment may vary from time to time. Currently the frequency of out of hours commitment equates to one in seven nights and weekends on the ‘first call’ rota. With successful recruitment to these positions some of the out of hours shifts will become resident 2nd call, supervising the work of the CT2 trainees. Whilst resident out of hours there are commitments to emergency surgery, resuscitation, critical care and emergency obstetric care at the adjacent Cresswell Maternity Wing. Daytime scheduled work averages 4.5 half day operating lists per week and may include day time duties to the intensive care unit. The successful candidate would be expected to work flexibly.

DUMFRIES AND GALLOWAY REGION

The population of Dumfries and Galloway is 148,000. Dumfries and Galloway covers an area of 2400 square miles stretching from Langholm in the East to Stranraer in the West, and from Kirkconnel in the North down to the Solway Coast. There are a number of community hospitals in various towns throughout the region, and an intermediate unit in Stranraer – Galloway Community Hospital (with medical and maternity in-patient beds).

Dumfries is a market town with a population of approx. 48,000 and is situated in the eastern half of this delightful rural region. The River Nith runs through the town to the Solway coast and the city of Carlisle is approximately 45 minutes drive from Dumfries. Glasgow is within 1½ hours, Edinburgh and Newcastle within 2 hours, and Manchester and Liverpool within 2½ hours driving time from Dumfries.

Dumfries and Galloway offers the very best of Scottish countryside; from rugged cliffs and sandy beaches to forests, hills and rolling plains. You’re spoilt for choice in the range of activities on offer, with watersports, fishing, birdwatching, golf, mountain-biking or cycling along the network of rural roads, and much more. The Southern Upland Way runs for 212 miles from Portpatrick in the west to Cockburnspath in the eastern Scottish Borders, through some of Scotland’s wildest country.

There are many attractions, ranging from the University Town of Dumfries, Scotland’s National Booktown Wigtown, Artists’ Town Kirkcudbright, Castle Douglas Food Town to the historic monuments, castles and abbeys, beautiful gardens, fascinating museums throughout the region. The local Council is committed to investing in education, with high achieving schools that earn top marks in HM Inspector of Education Reports. Children are encouraged to develop their talents and interests, with first-class opportunities in music, arts and sports. High quality sport and leisure facilities are available throughout the region. Property offers exceptionally good value, at very competitive prices.

·  Population – 147,780 (2001 census ie 3% of Scottish population)

Age

/

Population

/ % Total Population
> 65 years / 28,445 / 19.2%
> 75 years / 12,558 / 8.5%
> 85 years / 3,039 / 2.1%

The proportion of population over 65 years is the highest in Scotland and is set to rise further to 24.4% by 2016.

NHS DUMFRIES & GALLOWAY

NHS Dumfries & Galloway became operational on 1st April 2003 when the two Trusts (Acute & Maternity and Primary Care) were dissolved and one NHS organisation was created, incorporating all NHS services along with the Health Board. NHS Dumfries & Galloway has led the process of integration and is seen as the model for the rest of Scotland to follow. Continuing new investment has resulted from the system always having met all financial and waiting times targets.

Structure

The NHS Board has its headquarters on the Crichton site in Dumfries. Comprising executive and non-executive Directors, its key responsibility is to ensure delivery and development of the local Health & Community Care Plan. You can see a copy of the HCCP on - www.nhsdg.scot.nhs.uk.

Staff

NHS Dumfries & Galloway employs over 4300 staff from a range of different clinical and non-clinical backgrounds, made up of the following broad groupings:

Nursing 51% AHPs 2%

Administrative/Clerical 16% Scientific 1%

Ancillary 14% Pharmacy 1%

Medical 9% Maintenance 1%

Technical 4% Management 1%

Services

A wide range of services are provided from over 50 bases across the region. Many of these services are provided via one of four Local Health Partnerships (Annandale & Eskdale, Dumfries & Upper Nithsdale, Stewartry, Wigtown), whereas others, such as Mental Health, Child Health and Sexual Health, are provided as regional services. Most acute services are based at Dumfries and Galloway Royal Infirmary with a network of out-patient clinics held throughout the region and a range of acute services provided at the Galloway Community Hospital.

The map below highlights LHP areas and main service bases throughout the region.

Dumfries and Galloway Royal Infirmary

Dumfries and Galloway Royal Infirmary contains 368 staffed beds (+ 11 cots), and includes the Departments of:

·  Accident & Emergency

·  Anaesthetics

·  Cardiology

·  Care of the Elderly/Acute Rehabilitation

·  Dermatology

·  Diabetes/Endocrinology

·  ENT Surgery

·  Gastroenterology

·  General Medicine

·  General Surgery

·  Haematology

·  Infectious Diseases

·  Laboratory Services

·  Nephrology

·  Neurology

·  Obstetrics and Gynaecology

·  Ophthalmology

·  Oral and Maxillofacial Surgery

·  Orthodontics

·  Orthopaedic Surgery

·  Paediatrics

·  Palliative Care

·  Respiratory Medicine

·  Rheumatology

·  Radiology

·  Urology

The Operating Department, adjacent to the Day Surgery Unit (opened 2003), has six theatres (one allocated for emergency cases), two endoscopy suites and minor treatment room. The theatres have been recently upgraded. There is an Intensive Care Unit of four beds, a Surgical High Dependency Unit of four beds and a Medical High Dependency Unit of eight beds. There is a separate theatre in the Ophthalmology Day Case ward and an obstetric theatre in the adjacent Cresswell Maternity Unit

A new Renal Unit, providing 18 dialysis stations, opened in April 2006, replacing services previously provided in a former ward in DGRI.

DGRI Future Re-development

It is an exciting time in Dumfries and Galloway as a new District General Hospital is being built, due to open in 2018. Redesign of services at Dumfries & Galloway Royal Infirmary is currently underway. NHS D&G have been given the approval to start planning for a ‘new build’ hospital on a site on the western outskirts of the town. This new build will ensure NHS Dumfries & Galloway staff are able to continue to provide high quality clinical care to the population of Dumfries & Galloway in a modern environment. Full information on the DGRI Redevelopment Project can be found on the NHS Dumfries & Galloway website – www.nhsdg.scot.nhs.uk

Please click on the link below to experience a walk-through of our new state of the art hospital.

https://www.youtube.com/watch?v=425ePpuzzy4&feature=youtu.be

Dumfries and Galloway Royal Infirmary is the recognised Post-Graduate Medical Centre for south-west Scotland. The Education Centre at DGRI provides:

·  programme of weekly meetings, covering all specialties

·  induction programme for junior doctors

·  well-stocked library

·  internet access

·  superb audio-visual facilities

·  98-seat lecture theatre

Galloway Community Hospital

The Galloway Hospital is located in Stranraer, 75 miles from Dumfries. It contains an Emergency Department, 50 beds (rehabilitation-24, GP acute-20, maternity-4, palliative care-2), 4 renal places and an operating theatre. Services also provided at this hospital include Accident and Emergency, Anaesthetics, Laboratory and Radiology (including a CT scanner).

Midpark Hospital

A new Mental Health facilityhas opened in January 2012on a site adjacent to the Crichton Campus. Facilities provided at the new site include - a 15 Bed elderly ward; 16 bed dementia/organic illness ward; 6 bed IPCU; 34 Bed adult (2 wards – 17 bed each); Acute hub accommodation; 8 Bed rehab recovery; 8 Bed rehab long stay; and Rehab hub accommodation.

These facilities have an average annual admission rate of over 700 and approximately 7,000 out-patient attendances per year. They provide a full range of psychiatric services for patients of all ages in the Dumfries & Galloway region. The Emergency Department is supported by a Psychiatric Liaison Nurse.