locum consultant in acute medicine
glasgow royal infirmary
Information pack
reF: 28825d
Closing Date:noon3rdmay 2013
SUMMARY INFORMATION
Post: locum consultant in acute medicine
Base:glasgow royal infirmary
Applications are invited for the post of Locum Consultant in Acute Medicine. The post will be based at Glasgow Royal Infirmary for 9 months in the first instance. The successful candidate will influence and lead the development of acute care within a unit recognized for its innovation and enthusiasm for change.
The successful candidate will integrate with three Consultants to develop the acute medicine service, whilst one of their colleagues is on maternity leave. This will offer a real opportunity for the successful candidate to be involved in the development of a successful modern consultant led service.
Within Glasgow Royal Infirmary there are currently 52 Consultant Physicians with special interests in Cardiology, Diabetes and Endocrinology, Respiratory Medicine, Gastroenterology, Rheumatology and Elderly Care.
The post requires coverage of a minimum of 9 clinical sessions in acute medicine. There may be some flexibility in accommodating a special interest negotiation with the Clinical Director.
This post does not require participation on the Medicine on call rota.
Applicants must have full GMC registration and a licence to practice.
NHS GREATER GLASGOWANDCLYDE
GLASGOW ROYAL INFIRMARY
LOCUM CONSULTANT ACUTE PHYSICIAN
BACKGROUND INFORMATION
Health Board
NHS Greater Glasgow and Clydeis the largest health board in Scotland and serves a population of 1.1 million people. There are 8 hospitals north of the River Clyde, all with teaching responsibilities: Glasgow Royal Infirmary (including Princess Royal Maternity Hospital), NewStobhillHospital, Western Infirmary, Gartnavel GeneralHospital, GlasgowDentalHospital and School, DrumchapelHospital, BlawarthillHospital and LightburnHospital. Three hospitals are situated in the south side of the city: Southern General Hospital, Victoria Infirmary and DykebarHospital. The acute Hospitals sites in Clyde are the RoyalAlexandraHospital, InverclydeHospital and the Vale of Leven Hospital.The Golden Jubilee National Hospital (GJNH) in Clydebank is the setting for the West of Scotland Heart and Lung Centre. The centre brings together, on a single site, cardiothoracic surgical services for the West of Scotland and is the dedicated unit for all interventional cardiology including primary PCI for NHS Greater Glasgow and Clyde and most surrounding Health Boards.
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. Excellent 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)
Glasgow Royal Infirmary is one of the major teaching complexes of the University of Glasgow. It provides the Accident and Emergency service for the North and Eastern districts of Glasgow and has inpatient beds in general medicine, medicine for the elderly, general surgery, orthopaedics, plastic surgery and obstetrics and gynaecology. There are also beds in intensive care, high dependency, and coronary care. Following the closure of Stobhill hospital at the end of March 2011 all medical beds, with the exception of some long-stay care of the elderly beds, are on the GRI site.
At GRI medical emergencies are admitted through an Acute Assessment Unit (AAU) or through Accident & Emergency (A&E) 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 will be triaged to the appropriate specialty team e.g. patient with GI bleed to gastroenterology area. 4 consultant physicians take part in acute receiving each day in the AMU with morning and evening ward rounds. There is a 40 bedded cardiology ward (ward 43) with 20 acute cardiology beds and a coronary care unit (CCU). Those needing admission for a primary cardiological problem go from AAU or A&E to the acute cardiology beds in ward 43 or CCU. The cardiologists also provide a daily consult service to patients needing review but in the AMU.
Acute admissions to medicine range from 45 to 70 per day. Patients requiring a short stay will be discharged from AMU/acute cardiology beds. Those requiring longer stays are transferred ‘downstream’ to medical wards (non acute cardiology bed in ward 43 for cardiological problem). These ‘downstream’ medical wards are split into specialty units. 4 specialty units have primary responsibility to general (internal) medicine, namely, Respiratory Medicine, Rheumatology, Gastroenterology and Diabetes and Endocrinology. Consultants from the department of medicine for the elderly (DOME) contribute to receiving duties, but also have a number of inpatient wards in Glasgow Royal Infirmary with additional beds at LightburnHospital and StobhillHospital. There is a separate Stroke Ward.
Acute Medicine
A 32 bedded AAU has been established next to the A & E Department. Patients referred by general practitioners are assessed in this unit before formal admission. There is also a short-stay facility. There are strong links with A&E, and a range of services supporting Acute Medicine, including imaging and laboratory services, an outpatient DVT service, and early supported discharge for COPD patients which was pioneered at GRI.
The AMU is based in wards 50-53, in the JubileeBuilding, which opened in 2001, and is located above the A&E. There are currently 70 in-patient beds, dealing with nearly 23,000 emergency medical admissions per year. These beds are divided into areas for general medicine, DOME, respiratory medicine, and gastroenterology. A range of disease-specific protocols are in use, in keeping with a modern AMU, and the unit has its own ultrasound machine for vascular access and screening for pleural or peritoneal aspiration. Non-invasive ventilation is available on the unit. A Medical High Dependency Unit (HDU) opened in July 2011. This unit has 6 operational beds.
GRI has traditionally been a training site for Acute Medicine specialty trainees and is able to offer a full range of training in keeping with guidelines. There is a weekly departmental meeting. The unit is staffed by a full complement of junior doctors (FY1, FY2, CMT, ACCS, GPST), Case Managers, Acute Medicine trainees and on-call medical Specialty trainees, and participates in Hospital at Night.
Consultant Staffing
There are four Consultants currently with day to day commitment to the activities of the AAU, AMU and HDU. Dr Ravi Jamdar, Dr Allan Cameron and Dr Christine Aiken work full time and Dr Pauline Grose works part time. This new post will be based at GRI and will be crucial in supporting colleagues already in post and allowing ongoing development of the service.
In addition to the acute physicians Professor Gerry McKay, consultant in Clinical Pharmacology/Acute Medicine has sessional commitments to the AMU (2 PAs).
As Lead Clinician for medicine at GRI Dr Cahill has clinical managerial responsibility for AAU and AMU reporting to the Clinical Director, Dr Robert Milroy.
MAIN DUTIES OF THE POST
Together with colleagues, the post holder will provide senior cover for the AAU, the AMU, and the Medical HDU at Glasgow Royal Infirmary, leading activity on the unit, in addition to the morning and evening receiving rounds which are led by the on-call Physicians. The post holder will be required to work one evening until 8pm and may be required to work weekends and other OOHs commitments.
In addition to assessment of new patients, ward work will include review of patients remaining on the AMU, and providing ongoing supervision of patients ready to be transferred or discharged, concentrating particularly on those who are unwell or unstable, and to ensure that appropriate patients are discharged home. The aim is to provide rapid senior review of patients admitted by junior medical staff, in order to promote timely investigation, management and discharge, and to enhance the educational opportunities by providing early feedback to the junior staff.
The acute medicine physicians have operational responsibility for the Medical HDU. The post holder will be involved in staffing and supervision of the Medical HDU along with acute medicine colleagues and in collaboration with other Physicians. There is an exciting opportunity for the post holder to be involved in the ongoing development of the Medical HDU.
An outpatient clinic session is specified, which can be developed in line with individual interests, and in keeping with the needs of the service. There are plans at an early stage to have an ambulatory service for outpatient investigations as a means of reducing the need for admission and the post holder may have the opportunity to be involved in the development of this service.
The post holder will participate in audit and medical specialty meetings, and undertake administrative dutiesfor which time will be made available within the job plan. The appointment is full-time and there will be some requirement for flexible hours in accordance with service needs as they develop.
Most medical specialities are offered within the hospital. The post holder will share responsibility for clinically supervising the trainees coming through the unit. Time for clinical administration (e.g. all communication from discharges from the AAU and AMU being co-ordinated from there) is included in the outline Job Plan. A regular review of the post holder’s job plan will be held to ensure that there is the correct balance between a satisfactory career pathway and service needs is maintained.
A split of 9:1 between direct clinical care PAs and supporting professional activities is 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. 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.
Proposed timetable
10 PA
Fixed sessions - 9 direct clinical care, 1 SPA
Mon / Tue / Wed / Thu / Friam / AMU / Clinical Administration / Teaching round/AMU / AAU / AMU
lunch / Unit meeting / HDU grand round / Grand round / Pharmacy meeting
pm / AMU / clinic / SPA / AAU / AMU
NB. Cover of the HDU is for the whole week, on a rotational basis.
Some flexibility in timing of sessions is necessary to take into account bank holidays and the absence of colleagues, but such commitments will be incorporated into the post holders job plan. In the above proposed timetable AMU activities includes periods supporting the AAU, periods supporting the activities on the AMU and managing patients in the Medical HDU, These three clinical areas will be covered prospectively on a Monday to Friday by the complement of acute physicians.
Management Arrangements
General (Internal) Medicine and Acute Medicine are part of the Emergency Care and Medical Specialties Directorate, NHS Greater Glasgow and Clyde. Mr Grant Archibald, is the Director of Emergency Care and Medical Specialties across NHS Greater Glasgow and Clyde, and is supported by Mr David Raeside the Associate Medical Director and Mrs Joyce Brown, Head of Nursing.
At Glasgow Royal Infirmary the Clinical Director for Medicine is Dr Robert Milroy, site specific management responsibility for Medicine at Glasgow Royal Infirmary is held by Mr Alan Hunter, General Manager, NHS Greater Glasgow and Clyde and Mrs Claire Bell is the Clinical Services Manager for A&E and Acute Medicine. Dr. Alistair Dorward (RAHPaisley) is the speciality advisor in Acute Medicine, NHS Greater Glasgow and Clyde.
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.
TERMS AND CONDITIONS OF SERVICE
The conditions of service are those laid down and amended from time to time by the Hospital and Medical & Dental Whitley Council.
TYPE OF CONTRACT / Fixed TermGRADE AND SALARY / Consultant
£74,504 £ 100,446 per annum (pro rata)
New Entrants to the NHS will normally commence on the minimum point of the salary scale, (dependent on qualifications and experience). Salary is paid monthly by Bank Credit Transfer.
HOURS OF DUTY / Full Time40.00
SUPERANNUATION / You have the option to join the NHS Superannuation Scheme, to participate in the State Earnings Related Pension Scheme or to take out a Personal Pension.Employee’s contributions to the NHS Scheme are Tiered based on your earnings and the employers contribution equates to 13.5 % of salary. Employees in the NHS Scheme are “Contracted-out” of the State Earnings Related Pension Scheme and pay a lower rate of National Insurance contributions. Employees who choose to participate in the State Earnings Related Pension Scheme pay the higher rate of National Insurance contribution. A Stakeholder Pension is also available. A Personal Pension is a private arrangement agreed with the pension provider that will be an organisation such as a Bank, Building Society or Insurance Company.
REMOVAL EXPENSES / Assistance with removal and associated expenses may be given and would be discussed and agreed prior to appointment.
EXPENSES OF CANDIDATES FOR APPOINTMENT / Candidates who are requested 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 of appointment.
TOBACCO POLICY / NHS Greater Glasgow and Clyde operate a No Smoking Policy in all premises and grounds.
DISCLOSURE SCOTLAND / 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.
CONFIRMATION OF ELIGIBILITY TO WORK IN THE UK / NHS Greater Glasgow and Clyde (NHSGGC) has a legal obligation to ensure that it’s employees, both EEA and non EEA nationals, are legally entitled to work in the United Kingdom. Before any person can commence employment within NHS GGC they will need to provide documentation to prove that they are eligible to work in the UK. Non EEA nationals will be required to show evidence that either Entry Clearance or Leave to Remain in the UK has been granted for the work which they are applying to do. Where an individual is subject to immigration control under not circumstances will they be allowed to commence until the right to work in the UK has been verified. ALL applicants regardless of nationality must complete and return the Confirmation of Eligibility to Work in the UK Statement with their completed application form. You will be required provide appropriate documentation prior to any appointment being made.
REHABILITATION OF OFFENDERS ACT 1974 / The rehabilitation of Offenders act 1974 allows people who have been convicted of certain criminal offences to regard their convictions as “spent” after the lapse of a period of years. However, due to the nature of work for which you are applying this post is exempt from the provisions of Section 4 of the Rehabilitation of Offenders Act 1974 by virtue of the Rehabilitation of Offenders Act 1974 (Exceptions Orders 1975 and 1986). Therefore, applicants are required to disclose information about convictions which for other purposes are “spent” under the provision of the act in the event of employment, failure to disclose such convictions could result in dismissal or disciplinary action by NHS Greater Glasgow and Clyde. Any information given will be completely confidential.
DISABLED APPLICANTS / A disability or health problems does not preclude full consideration for the job and applications from people with disabilities are welcome. All information will be treated as confidential. NHS Greater Glasgow and Clyde guarantees to interview all applicants with disabilities who meet the minimum criteria for the post. You will note on our application form that we ask for relevant information with regard to your disability. This is simply to ensure that we can assist you, if you are called for interview, to have every opportunity to present your application in full. We may call you to discuss your needs in more detail if you are selected for interview.
GENERAL / NHS Greater Glasgow and Clyde operates flexible staffing arrangements whereby all appointments are to a grade within a department. The duties of an officer may be varied from an initial set of duties to any other set, which are commensurate with the grade of the officer. The enhanced experience resulting from this is considered to be in the best interest of both NHS Greater Glasgow and Clyde and the individual.
EQUAL OPPORTUNITIES / The postholder will undertake their duties in strict accordance with NHS Greater Glasgow and Clyde’s Equal Opportunities Policy.
NOTICE / The employment is subject to three months’ notice on either side, subject to appeal against dismissal.
MEDICAL NEGLIGENCE / In terms of NHS Circular 1989 (PCS) 32 dealing with Medical Negligence the Health Board does not require you to subscribe to a Medical Defence Organisation. Health Board indemnity will cover only Health Board responsibilities. It may, however, be in your interest to subscribe to a defence organisation in order to ensure you are covered for any work, which does not fall within the scope of the indemnity scheme.
FURTHER INFORMATION