CONSULTASNT IN RESPIRATORY MEDICINE

GLASGOW ROYAL INFIRMARY/STOBHILL ACH

INFORMATION PACK

REF: 51335d

cLOSING DATE: 4TH MAY 2018

SUMMARY INFORMATION RELATING TO THIS POSITION

Post: PART TIME consultant PHYSICIAN in respiratory and General medicine– REPLACEMENT POST – 9.5 PAs

Base:glasgow royal infirmary

Applications are invited for the post of Consultant Physician in Respiratory and General (Internal) Medicine. This is a replacement based at Glasgow Royal Infirmary.

The successful candidate will integrate with existing consultant colleagues and provide clinical excellence in Respiratory Medicine within Glasgow Royal Infirmary/Stobhill ACH.

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 58 Consultant Physicians with special interests in Acute Medicine, Cardiology, Diabetes & Endocrinology, Gastroenterology, Respiratory Medicine, Rheumatology and Elderly Care.

The post offers up to 9.5 PAs. 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 Practise. 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. Non UK applicants must demonstrate equivalent training.

NHS GREATER GLASGOW AND CLYDE

GLASGOW ROYAL INFIRMARY

PART TIME CONSULTANT PHYSICIAN RESPIRATORY AND GENERAL MEDICINE – REPLACEMENT POST

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 Stobhill Hospital. The service in North Glasgow presently employs more than 14,300 staff serving a core catchment population of 560,000.

Glasgow Royal Infirmary (GRI) & Stobhill Ambulatory Care Hospital (Stobhill ACH)

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 Stobhill Hospital 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 Stobhill Ambulatory Care Hospital 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 Stobhill ACH.

Staff at GRI and Stobhill ACH 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 Glasgow Caledonian Universities. There is a dedicated hospital wide academic programme supported by a strong service educational commitment. GRI and Stobhill ACH 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 via the Emergency Department (ED) to an Acute Medical Receiving Unit (AMRU). This comprises 4 geographically defined ward areas covered by specific specialty teams – general medical, respiratory, gastroenterology and medicine for the elderly. Acute Cardiology admissions are admitted to CCU or the Acute Cardiology Admission unit. There are 83 Acute Medical Specialty Receiving beds, 8 Coronary Care Beds, 8 Medical High Dependency Beds and 5 Hyper Acute Stroke beds. 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 to 70 per day. Patients requiring a short stay are discharged from AMU. Those requiring longer stays are transferred ‘downstream’ to medical specialty or care of elderly beds. There are 263 downstream medical beds split into specialty units/wards; Respiratory Medicine, Rheumatology, Gastroenterology, Cardiology, Diabetes and Endocrinology. Consultants from the department of medicine for the elderly (DME) 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 Lightburn Hospital and Stobhill Hospital. There is a separate Stroke Ward.

The Respiratory Department

Respiratory outpatient services are provided at Stobhill ACH 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 and CMT doctors. Middle grade doctors and sessional GPs provide support to out-patient clinics.

Consultants

Dr Hannah Bayes – Pathway Redesign/COPD

Dr George Chalmers (Lead Consultant) - Interstitial Lung Disease/Vasculitis

Dr Brian Choo-Kang – Pleural Disease/Respiratory Infections

Dr Mark Cotton - Respiratory Infections/Airways Disease

Dr Douglas Cowan - Asthma

Dr Stephen Crawley, Lung Cancer/COPD

Dr Eric Livingston – Sleep & Ventilation

Dr John Maclay – Lung Cancer/Interventional Bronchoscopy

Dr Brian Neilly - (Clinical Director for Medicine) Nuclear Medicine

Dr Joris van der Horst – Lung Cancer/Interventional Bronchoscopy

Dr Angela Wright – Interstitial Lung Disease

This post

Specialty Trainees

There are currently 4 ST trainees in Respiratory Medicine attached to the unit.

Sessional General Practitioners

Dr John Farley

Dr Cameron Livingston

Dr Gordon Macdonald

Respiratory Nurse Specialists

There are Respiratory Clinical Nurse Specialist (CNS) 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 CNS’ 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 services are based at both Glasgow Royal Infirmary and the new Stobhill Ambulatory Care Hospital. The respiratory physiology and sleep laboratories 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 has 10 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 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 Beatson Oncology Hospitals, 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.

The Respiratory Team runs a variety of sub-specialty clinics in Asthma, Bronchiectasis, Tuberculosis, Interstitial Lung Disease, Sleep and Ventilation, Lung Cancer, along with General Respiratory Clinics on both sites.

Investigation/Invasive Procedures

Bronchoscopy, is well developed, advanced and diagnostic procedures carried out within the modern purpose built Endoscopy suites at GRI and Stobhill. There are five bronchoscopy sessions each week approximately 700 bronchoscopic procedures carried per annum. Facillities include EBUS, approximately 300 procedures per annum, electro-magnetic navigation, radiological screening, interventional bronchoscopy including cryotherapy and electrotherapy and stenting. Interventional radiologists 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.

Respiratory outpatient clinics are provided both at GRI and Stobhill and the postholder’s outpatient clinics may be provided on both sites. There may be a requirement to participate in specialty MDT meetings. The post being replaced contributed to the Difficult Asthma clinic, and although there may be a requirement to continue that role at least initially, we are open to the development of other sub-specialties.

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

The Respiratory Unit contributes a speciality component for medical receiving having 16 acute respiratory beds in the receiving complex (Ward 50) 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 1:11, and includes morning and evening ward rounds in the receiving ward and in-patient speciality referrals from other units.

Respiratory medicine “down-stream” in-patient beds are situated in Wards 2, 6, 7/16 and ward 10. 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 is current policy of GGC Health Board for new posts, for this post the split is 8.5:1. 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.

Provisional timetable

9.5 PA – 8.5 direct clinical care, 1 SPA

AM / PM
Monday / Acute receiving/SPA (alt weeks) / Acute receiving/SPA (alt weeks)
Tuesday / Ward Round / OP clinic
Wednesday / DCC Admin
Thursday / OP Clinic
Friday / Asthma MDT/clinic / Board Round (0.5 PA)
Saturday/Sunday / Receiving/ward cover (11 week cycle) / Receiving/Ward cover (11 week cycle)

The provisional job plan reflects the post being replaced and the sessions available but if the successful candidate wishes, we will explore options to increase the allocation to 10 PA or more, subject to negotiation of additional workload and funding. The job plan above is provisional, and flexibility will be necessary with regard to the timing of sessions, changing service needs and any absence of colleagues. The final job plan will be agreed at or shortly after interview by agreement with the Clinical Director, General Manager and the 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.

At Glasgow Royal Infirmary the Clinical Director for Medicine is Dr Brian Neilly, site specific management responsibility for Medicine at Glasgow Royal Infirmary and Stobhill Hospital is held by Mr Russell Coulthard, General Manager, NHS Greater Glasgow and Clyde, Ms Rosemary Brogan is the Clinical Services Manager for Medical Specialties including Respiratory Medicine and Cardiology. Nursing leadership is provided by Lead Nurses within 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

ESSENTIAL / DESIRABLE
QUALIFICATIONS /
  • Applicants must have full GMC registration and a licence to Practise. 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. Non UK applicants must demonstrate equivalent training.
  • MRCP or equivalent.

CLINICAL EXPERIENCE /
  • Clinical training and experience equivalent to that required for gaining UK CCT.
  • Ability to offer expert clinical opinion on a range of clinical problems in acute medicine.
  • HDU experience
  • Interface with Accident and Emergency and Primary Care.
  • Ability to take full and independent responsibility for clinical care of patients.
/
  • Sub-specialty interest.

MANAGEMENT AND ADMINISTRATIVE EXPERIENCE /
  • Ability to advise on the efficient and smooth running of the acute medical service.
  • Ability to organise and manage ward patients and outpatient priorities.
  • Experience of audit management.
  • Ability and willingness to work within NHS GG&C and NHS Scotland performance framework and access targets.
/
  • Attendance at management course for clinicians.

TEACHING EXPERIENCE /
  • Experience of supervising medical trainees.
  • Ability to teach clinical skills.
/
  • Experience of MMC assessment tools.

OTHER ATTRIBUTES /
  • Ability to work in a team.
  • Good interpersonal skills.
  • Caring attitude to patients.
  • Ability to communicate effectively with patients, relatives, GPs, nursing staff and other relevant parties.
  • Commitment to the requirements of clinical governance.

TERMS AND CONDITIONS OF SERVICE