RURAL HOSPITAL DOCTOR
(2 Posts)
Ref: MD388g
As part of the recruitment process for this post,
we would strongly advise that prospective applicants visit the
GallowayCommunityHospital in Stranraer.
To arrange a visit you should contact
Alison Burns, General Manager on –
Tel: 01776 707755
or e-mail -
or Dr Adrienne Swan Clinical Lead Galloway Community Hospital
tel :01776707707 or email
Closing Date: 30th April 2015
JOB DESCRIPTION – RURAL HOSPTIAL PRACTITIONER
- JOB IDENTIFICATION
Department: GallowayHospital, Stranraer
Job Reference: MD388f
Hours of Work: 44 Hours per week (including day time and night work)
Remuneration: The basic starting salary is £83,266 per annum however
remuneration will averageapproximately £95,670 per annum
including premium payments for out of hours.
- JOB PURPOSE
The role is based in the GallowayHospital and will provide medical care to Accident and Emergency Services, RehabilitationWard and the Acute Ward. The A&E department deals with approximately 15,000 patients per year many with relatively minor conditions but occasionally severely ill or injured patients when rapid evacuation will be required. Supervision of the role in A&E is provided by A&E Consultants from Dumfries and Galloway Royal Infirmary. In the acute ward a range of in-patients are admitted where they can be managed without direct consultant involvement, complex investigations, or without the need for a surgical opinion. Support is provided by 2 Consultant Physician visits per week. There are twice weekly visits from a Surgical Consultant who is able to give advice. There are 2 Consultant Anaesthetists based in the Galloway.
The Rehabilitation Ward is mostly used for patients who are “stepping down” from acute admissions to the DistrictGeneralHospital: care is overseen by a consultant geriatrician who visits twice a week
The post holder may occasionally be required to provide medical support, in an emergency, to the midwife led Obstetric Unit, the nurse led Renal Dialysis Unit and nurse delivered Chemotherapy Service. In these settings no specialist knowledge of Obstetrics, Renal Dialysis or Chemotherapy will be expected: the standard required will be that of the ordinary doctor exercising due care.
The purpose of this role is to work with visiting consultants, permanent nursing staff and AHPs in providing the hospital with medical staff appropriately skilled to deal with a wide range of medical work encountered. In doing so you will assist in providing second tier of medical expertise in Wigtownshire for its population (30,000). This may involve airway management and transfer of critically ill patients. You will be expected to undertake training as required in particular to maintain ALS, ATLS, EPLS and also accreditation and annual medical updates. This will be assisted by regular rotation into consultant led units within Dumfries and Galloway Royal Infirmary particularly the A&E Department, Anaesthetic Department and the Acute Medicine.
- ORGANISATIONAL POSITION:
Working Relationships: - ……………………………………
Reports to: ______
Professionally accountable: NHS Board Medical Director
- SCOPE AND RANGE
Within the A&E Department experienced nursing staff including 2 emergency care practitioners will support the post holder in providing and A&E Service – treating minor and moderate illness and injury, admitting selective patients for intermediate care within the Acute Ward and resuscitation and transfer of more ill patients to Dumfries and Galloway Royal Infirmary by ambulance or particularly in severe trauma by contacting the Emergency Medical Retrieval Service in Paisley who will helicopter in a consultant led retrieval team to transfer the patient rapidly to Glasgow.
Close links are in place with Dumfries and Galloway Royal Infirmary and telephone advice or decision support can always be sought from experience middle grade and consultant staff in Dumfries and using the Pacs system, opinions can be provided on X-rays and CT Scans.
Admissions to the ward are covered by protocols with patients who might need a surgical intervention, extensive investigation or consultant level resuscitation and management transferred to Dumfries and Galloway Royal Infirmary. Cardiac Monitoring is available and low risk MIs are cared for after initial thrombolysis with transfer to Glasgow or Dumfries and Galloway Royal Infirmary if there is a failure of revascularization or challenging arrhythmia.
Consultant Physicians visit the hospital twice per week primarily to deliver out-patient consultations and also provide opinions on patients within the ward and informal teaching.
The hospital also is the base for the Primary Care Out of Hours Service which is situated within the A&E Department. During the Out of Hours periods and weekends it is expected that the Out of Hours Primary Care GP and the Hospital Doctor will work together sharing where appropriate the care of patients.
Currently there is a 24 -7 on-call Anaesthetist available.
Your hours of work will be 44 hours per week on a shift system. You will be expected to cover all aspects of the role including overnight work, daytime hospital work and weekend work,working in either the A&E Department or the wards depending on the rota. You will have advance notice of your part in the rotaand each member of the team will rotate through all aspects of the rota and there maybe additional shifts available for you to undertake and these will attract additional remuneration. GP trained doctors may also (if they wish) undertake shifts within the General Practice Out of Hours Service by separate arrangements via a web based session booking system.
You are entitled to 30 days annual leave and 10 public holidays (the rota may require that you work on a public holiday but time off in lieu will be available). You will be expected to undertake a 2 week attachment to A&E/Anaesthetics in Dumfries and Galloway Royal Infirmary prior to starting work and will in addition on a rota system have days within the A&E Department or Anaesthetics Departments to maintain skills. While it is anticipated that for GP trained doctors, the bulk of your professional development will be sessions and informal teaching sessions from visiting consultants, study leave (maximum 5 days per annum) can be approved by advanced notification to the General Manager .
Other doctors on specialist register will be supported to maintain their CPD and good standing with the appropriate Royal Colleges.
5. MAIN DUTUES/RESPONSIBILITIES
CLINICAL
Provide day to day cover at the hospital
- Accident and Emergency role dealing with a full range of trauma and minor injured. Involvement in follow up fracture clinics
- Intermediate care role involving admission and ongoing care of patients from A&E and the local GP community taking advice from appropriate specialities in Dumfries & Galloway Royal Infirmary
- Resuscitation, stabilisation and transfer of critically ill patients.
- Liaison with higher specialist units and the Scottish Ambulance Service to arrange all aspects of transfer of critically ill patients
- Maintain adequate medical records on all patients seen including the provision of discharge summaries following inpatient discharge.
- Operating in accordance with all locally agreed guidelines and protocols.
- Support and encourage RuralHospital
nursing staff, AHPs and ambulance staff
staff involved in the provision of care
- Function within a multi-disciplinary team
- Encourage an environment of team work
PERSONAL PROFESSIONAL DEVELOPMENT
- The post holder will be required as part of a contract to undertake annual appraisal which will be arranged locally
- Developing a Personal Development Plan to include skill areas of clinical expertise
- Adopt a personal life long learning culture
- Work and practice at all times in accordance with the GMC code of Professional Conduct.
- Actively demonstrates a positive approach to sustaining and developing personal and professional knowledge required to undertake own role.
- Complying with all Board policies particularly in respect of SEAs, complaint handling, maintaining adequate records and assisting in local audits.
- CCT holder in Acute Medicine, Emergency Medicine, Anaesthetics or General Practice.
- A&E skills and experience
- Resuscitation skills
- Airway management skills and experience
- ATLS, ALS or equivalent
- Excellent diagnostic skills
- In-patient management skills and experience
- Awareness of own limitations and those of the unit
- Planning and organising time including prioritisation of patient demands
- Management of risk
- Implementing listening and communication skills
- Diplomacy and trust building
- Literature updates
- Critical appraisal skills
- Awareness of national standards of care
- In depth knowledge of professional code of conduct
- Creative thinking
- Negotiation skills
- Motivational skills
- Dealing with complexity and contentious information
- Effective communication skills
- Ability to work across organisation boundaries
- SYSTEMS AND EQUIPMENT
- PC and Microsoft Office – Operational work
- Email system – Day to day communications
- Intranet/Internet – Source of reference material and NHS Dumfries and Galloway Protocols
- Laboratory and Imaging Computer interface for results of patient tests
- Computer based discharge letter system
- Numerous monitoring equipment used in the clinical area
- Resuscitation equipment and ventilator
- Near patient testing equipment
- AD-ASTRA on line Clinician which will need to be used to deal with NHS 24 triaged calls, car and driver and patient transport system
- DECISIONS AND JUDGEMENTS
- Rural Practitioner working mostly autonomously and with minimal supervision.
- Ability to recognise scope of personal abilities and clinical judgement.
- Ensure safety of practice at all times by liaison with other professionals and by adherence to national guidelines and standards.
- COMMUNICATIONS AND RELATIONSHIPS
- Responsible for partnership working, involving all staff at the earliest opportunity to influence change if required and provide most efficient, effective and safe service.
- Collaborate with a range of colleagues both locally and in higher specialist units in provision of patient care and in personal professional development
- Leadership and relationship building
- Effective communication skills
- Effective interpersonal skills
- Good negotiation skills
- Strategic thinking
- Influencing skills
- PHYSICAL DEMANDS OF THE JOB
- Ability to work in a sustained and focused manner
- Ability to make immediate decisions
- Ability to cope with stressful situations
- Resilience
- MOST CHALLENGING/DIFFICULT PART OF THE JOB
- Providing a very wide range of medical expertise in a challenging/isolated environment
- Updating clinical skills and continuing professional development
- Gaining respect and developing and maintaining effective working relationships with a range of colleagues, nurses and other Allied Health Professionals locally and regionally.
- Balancing your education and training demands with service demands, satisfying both with the resources available to you
- Determination and persistence in achieving successful team working where there may be competing priorities and agendas.
- Maintaining balance between competing demands in the job and between the job and other “life priorities”
- KNOWLEDGE, TRAINING AND EXPERIENCE REQUIRED TO DO THE JOB
- Current full General Medical Council registration
- Acute hospital inpatient experience
- Accident and Emergency experience
- Computer literate
- Expert communicator possessing influencing and negotiation skills
- Primary Care experience with involvement in Out of Hours work advantageous