NHS Lanarkshire – Information Pack
POSITION: Consultant Physician in Respiratory and General Medicine / /
Reference / MS/0216/11R2 / Quote on all correspondence
Grade / Consultant Physician in Respiratory and General Medicine
Location / University Hospital Monklands
Hours / PA’s / 10PAs per week (Part-time may be considered)
Salary Scale / £78,304 - £105,570
Closing Date / Monday 12th March 2018
Your Application / Thank you for expressing an interest in the above post within NHS Lanarkshire. Please find all the relevant information attached to begin the application process.
Should you require further information regarding this post you can contact the Medical Staffing team or make informal enquiries with the department using the contact details below.
To ensure we can process your application as easily as possible please complete all the information required within the Application Pack and email with your CV.
Contact Details / Telephone / 01698 377735
Email /
Application Process / To apply, please email your CV to the above, along with the attached completed Application Pack.

Additional Arrangements / Informal enquiries regarding this post will be welcomed by:-
Dr R Mackenzie / Chief of Medical Services / 01236 712305
Mrs A Fyfe / Director of Hospital Services / 01236 712305
Dr A Chapman / Clinical Director / 01236 712245
Dr S Baird / Respiratory Clinical Lead / 01236 712504
Date when the post is Vacant / The post is vacant immediately and a start date will be agreed with the successful candidate.
NHS Lanarkshire / For further information regarding NHS Lanarkshire and it’s hospitals, please visit our website:- www.medicaljobs.scot.nhs.uk
We are an Equal Opportunities Employer and Disability Confident Employer.
Integration of Health and Social Care Services
From the 1st of April 2016, two new legal bodies, North Lanarkshire Joint Integration Board (JIB) and South Lanarkshire Integration Joint Board (IJB) have responsibility for planning, commissioning and overseeing the delivery of community health and social care services. The Boards drawn from North and South Lanarkshire Councils, NHS Lanarkshire, professional health and care disciplines and third and independent sector organisations, will plan and commission local support and care services. These will be delivered primarily by the Councils and NHS Lanarkshire working together in teams in a new integrated way, to transform, re-design and improve the outcomes for the localities across North and South Lanarkshire.
The JIB and IJB are preparing Strategic Commissioning Plans to manage and integrate functions and drive a long-term programme of service transformation, re-design and improvement, particularly seeking to address local needs, change the culture, improve corporate systems and delivery processes while achieving a range of National Outcomes related to integration. The Plans will have to be affordable and will be effective in achieving an agreed level of performance. Throughout the planning process the JIB will respect our staff, our service users, our carers, our patients, our partners and those with whom we choose to contract.
Management Structure / The supporting operational and clinical management structures are focused on enhancing patient safety, quality improvement and local delivery at hospital level, with visibility of clinical leadership and support for individual professional accountability. Our Medical Managers will provide professional leadership to medical staff, ensuring that they are effectively developed, organised, integrated and managed to support the strategic aims of each Division and meet the needs of the patient.
Department of Medicine / Lanarkshire has a population of around 640,000 and is served by three acute Hospitals: Wishaw Hospital (Wishaw), Hairmyres Hospital (East Kilbride) and Monklands Hospital (Airdrie). The Department of Medicine at Monklands Hospital encompasses the specialties of Acute Medicine, Cardiology, Dermatology, Diabetes & Endocrinology, Gastroenterology, Infectious Diseases, Nephrology and Respiratory Medicine. It forms part of the Emergency and Medical Directorate, which also includes Emergency Medicine and Care of the Elderly.
Consultant Physicians’ inpatient responsibilities are arranged in specialty groupings and each medical specialty has a defined allocation of beds. This has allowed the development of specialist care in the wards. Dermatology, Infectious Diseases and Nephrology are concentrated services with all their inpatient beds at the Monklands site, while the other medical specialties have beds at all three sites. Haematology (part of a separate Directorate) inpatient provision is also concentrated at the Monklands site, with close links maintained between Haematology and the Department of Medicine.
There are visiting consultants in Neurology, Rheumatology and Oncology.
A Primary Coronary Intervention (PCI) service for Lanarkshire was established in October 2008, which means that patients with acute ST-elevation MI are transferred directly to the cardiac catheterization laboratory at Hairmyres Hospital rather than being admitted to CCU at Monklands.
The Medical Directorate is involved with undergraduate teaching in all years of the new curriculum at Glasgow University. The hospital is recognized for pre-registration and postgraduate training. There is an active postgraduate teaching programme including x-ray meeting, Journal Club and Hospital Grand Round Meetings. The hospital has a postgraduate lecture theatre, a number of seminar rooms and an excellent library.
General and Acute Medicine
Monklands Hospital admits just under 14,000 acute medical admissions per annum, with around half of these coming from Emergency Medicine and the other half constituting GP referrals.
The rota arrangements for Acute/ General Medicine at Monklands have recently been revised, moving to a ‘Physician of the Week’ model that is more closely aligned to the standards that have been developed by the Society for Acute Medicine (SAM).
The current Monday-Friday arrangements are that the ‘Physician of the Week’ (8AM – 4PM) provides enhanced front-door consultant continuity. S/he is supported in the assessment of new admissions by Acute Physician sessions (8AM – 8PM) and a ‘Physician of the Day’ on-call General Physician (2PM to 10PM). Care of the Elderly consultants also provide support for ERU.
We aim to discharge a large proportion of our referrals directly from the Ambulatory Emergency Care (AEC) and Acute Assessment areas following senior decision maker review, or within 48 hours of admission to the ERU ward. Patients requiring a longer stay in hospital are allocated a hospital inpatient bed on a specialty ward that is determined, as far as possible, by the patient’s clinical needs.
NHS Lanarkshire Board has approved funding for a substantial additional investment in Acute and/or General physicians, amounting to 6 new Consultant posts (phased recruitment). These appointments will allow us to expand our existing AEC service and to improve further our current ‘front door’ model
Medical HDU and Critical Care
There is a new 10-bedded Level 2/3 Intensive Care Unit at Monklands Hospital, run by Intensivists / Anaesthetists, but with ongoing consultant physician input into the care of relevant patients.
A medical High Dependency Unit (HDU) has also been established, currently comprising four Level 2 Critical Care beds and two Level 1 beds. This is co-located with the existing Monklands Coronary Care Unit (CCU) on Ward 18. The care of patients on medical HDU is primarily overseen by Acute Medicine. Excellent support is also provided by Intensivists / Anaesthetists, as well as by specialty-based General Physicians.
Respiratory Medicine / Medical Staffing:
The Respiratory Medicine service will be provided by four Consultant Physicians with support from a full-time Specialty Doctor Physician in Respiratory Medicine. ST3 trainees in Respiratory Medicine or ST3 trainees from other specialties rotate through Respiratory Medicine as part of their General Medicine training. There is an FY2 and two CMT trainees attached to the Respiratory Medicine. There is an FY1 trainee attached to the Respiratory ward.
Further expansion of the Respiratory medical workforce is anticipated in 2017. A business case for an additional (5th) Respiratory consultant has been submitted.
Specialist Nursing:
There are three Respiratory Nurse Specialists – one leading on Asthma, one on COPD, and one on Lung Cancer and they cross-cover their duties during periods of leave. There is also a part-time Associate Lung Cancer Nurse. There is a full-time Smoking Cessation Nurse Specialist.
Inpatients:
The Respiratory Physicians are based on Ward 17 (24 beds) which is the focus for inpatient respiratory care. The majority of acute admissions with respiratory illness are triaged from the Emergency Receiving Unit to Ward 17 and clinical responsibility transfers to the Respiratory Physicians. Elective respiratory admissions are to this ward. Nursing staff have undergone training in Respiratory Nursing, provide a nurse-led NIV service by protocol, and are trained to take arterial blood gas samples.
The ward has 4 BiPAP non-invasive ventilatory support machines and 4 TOSCA machines to allow monitoring of transcutaneous CO2. Tuberculosis patients are admitted to the infectious disease unit (Ward 2) and those patients from the Monklands catchment district are looked after by the Respiratory Team. Ward based chest ultrasound is also available in ward 17 to improve the safety of pleural procedures and there is a dedicated ultrasound machine housed in the ward for this purpose.
Outpatients:
There are out-patient clinics for general respiratory medicine, tuberculosis, airways disease, and lung cancer – with space for emergency new referrals each week. There is a fast-track lung cancer service with nurse assessment, dedicated CT slots and programmed investigation supported by a Lung Cancer Tracker. The new consultant appointment will allow redevelopment of the clinic profile and reduce overall waiting times. The development of subspecialty clinics and area specialty services in collaboration with colleagues at Wishaw and Hairmyres Hospitals will be discussed and encouraged.
Chemotherapy:
Chemotherapy for small cell and non-small cell lung cancer is given in the Haemato-oncology ward (in-patient and day case): this is undertaken by Medical Oncology. There are nurses trained in the administration of intravenous chemotherapy in that area.
Bronchoscopy and related procedures:
This is carried out in a purpose designed endoscopy suite with the support of endoscopy nursing staff. There is space for 8 day-cases. The endoscopy rooms are spacious and equipped with modern video facilities. There is an Nd-YAG laser for both endobronchial and gastroenterology use. Transbronchial lung biopsy is carried out under fluoroscopic screening in the Radiology Department. Monklands provides a regional EBUS service for Lanarkshire.
Medical Thoracoscopy:
This is carried out in the day surgery unit with the support of theatre nursing staff who are well versed in this procedure. There are 2 semi-rigid video thoracoscopes and this service takes referrals from across Lanarkshire. This service has enhanced the investigation of pleural disease within Lanarkshire.
Respiratory Investigation Centre:
The Centre comprises a comprehensive Respiratory Function Laboratory with 3 patient test rooms, a consulting room, an office for Respiratory Nurse Specialists, and the respiratory physiologists’ office. There is a patient waiting room with television and video for education purposes. The majority of the equipment is SensorMedics and includes 2 test stations for full lung function, whole body plethysmography, and facilities for histamine challenge and mannitol challenge.
Exercise tests are carried out in an air-conditioned exercise laboratory - both treadmill for exercise spirometry, and full progressive exercise testing equipment with cycle ergometer, metabolic cart, 12-lead ECG monitoring, oximetry, and transcutaneous blood gas monitoring. The equipment is linked by a file server to a reporting station. There is a blood gas analyser. There is a computerised analyser for overnight pulse oximetry studies. High quality sleep study diagnostic facilities (home-based Embletta) are available. Skin prick tests to assess atopic allergy are carried out. A nebuliser service and a Long Term Oxygen Treatment assessment service are run from the Centre. A flight assessment service is also available. The Centre is staffed by 4 Respiratory Physiologists. There is some secretarial support to the Laboratory.
Physiotherapy:
There is a full-time Senior Respiratory Physiotherapist. She delivers an inpatient service. She has an outpatient service including a clinic for hyperventilation/ breathing control problems. She runs the Pulmonary Rehabilitation Programme with the respiratory nurses.
Radiology:
The radiology support is excellent with two radiologists who have a specialist interest in Respiratory Medicine. A CT guided biopsy service and other interventional procedures including SVC stenting are available. Nuclear medicine is on-site and is comprehensive. There is a new MRI scanner on site. There is a weekly Respiratory Radiology meeting.
Thoracic Surgery:
Thoracic Surgery is undertaken at the Golden Jubilee National Hospital at Clydebank with all other West of Scotland cardiothoracic services.
Clinical Oncology:
2 Clinical Oncologists and 1 medical oncologist from the lung team at the Beatson Oncology Centre (Glasgow) visit one day per week for the Lanarkshire joint oncology lung cancer clinic and to run the on-site chemotherapy service for lung cancer patients. There is a weekly lung oncology MDT meeting to plan management of lung cancer patients. All radiotherapy is given at the Beatson Oncology Centre (12 miles distant).
The Post / NHS Lanarkshire is seeking to recruit a Consultant in Respiratory and General Medicine based at Monklands Hospital. The appointee to the post will joinDr L G McAlpine, Dr R Syyed and Dr S Baird in providing and developing specialist Respiratory Medicine services based at Monklands Hospital. The appointee will share responsibility for providing acute medical receiving with the other Physicians. The rota for acute receiving duties is based around a Physician of the Week model, supported by Acute Physician input and also a Physician of the Day.
Area services in Respiratory Medicine are being expanded and actively redeveloped. A business case for a 5th Respiratory Consultant at Monklands Hospital has been submitted to support this.
Specific clinical interests and an interest in research will be encouraged.
The precise details of the job plan will be dependent on the successful candidate’s subspecialty training and interests.
The job is offered as a full-time post on a 10 PA basis but applications will be considered from those wishing to work less than full-time. If full-time up to 2 EPA’s may be available to undertake additional outpatient and/or procedure sessions or management activity.
All new substantive Consultants are initially offered a minimum of 1 PA for SPA duties but this will be reviewed within 6 months (or earlier if required) of appointment and revised upwards if additional responsibilities have been undertaken. Additional SPA time (up to 2.5 PA’s in total) can be incorporated into the job plan depending on the time required to support the successful candidate’s professional activities and the needs of the service.