Older People and Stroke Service

consultant in

medicine for elderly

Older People and Stroke Service,

royalalexandrahospital

Information pack

ReF: 46172D

Closing Date:31st MARCH 2017

SUMMARY INFORMATION

Post: Consultant in MEDICINE FOR THE ELDERLY

Base:royalalexandraHOSPITAL

This is an exciting opportunity to join a team of Consultants providing Older People and Stroke services across the Renfrewshire and East Renfrewshire catchment areas. Based at the RoyalAlexandraHospitalyouwill work with 9 other Consultants to provide a comprehensive Older Peoples Service. This post will have a specific role in the management ofand support the development of a new needs-led service for Older Acute Medical Admissions. There is flexibility to accommodate the interests of applicants with opportunities for development.

For further information contact Dr Graeme Simpson, Clinical Director or Dr Janice Murtagh, Lead Clinician via the hospital switch board on 0141 887 9111

Applicants must have full GMC registration and a licence to Practice. 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.

ACUTE SERVICES DIVISION

Older People and Stroke Services

Clyde Sector

ROYALALEXANDRAHOSPITAL

PAISLEY

INFORMATION PACK

FOR THE POST OF

CONSULTANT IN MEDICINE FOR THE ELDERLY

1.General Information

The RoyalAlexandraHospital (RAH) is situated in Paisley and provides acute health care services to Renfrew District (pop 205,000). The Hospital is a 968 bed modern District General Hospital (DGH) which opened in 1986 and is one of the largest and busiest teaching DGHs in Scotland. In addition, the hospital is currently the base for provision of surgical, orthopaedic, ophthalmology, paediatric and also the majority of maternity services to the population north of the Clyde served by the Vale of Leven Hospital.

The hospital provides a wide range of DistrictGeneralHospital specialties with excellent support facilities. The hospital has a first class modern radiology department and services. All departments participate in undergraduate teaching and there is an active postgraduate educational programme. The hospital enjoys an enviable reputation for undergraduate teaching and is highly popular with training grades. There is also a good medical library service.

2.Older People and Stroke Service

The Older People and Stroke Service in the RoyalAlexandraHospital (RAH)delivers all its in-patient services on the hospital site. There are, however, close links with the Vale of Leven Service (VoL), particularly with an integrated stroke care pathway

Interface with General Medicine

Patient in the Acute Medical Unit (AMU) and Medical Assessment Unit (MAU) are screened Monday-Friday, using a Frailty Assessment tool, for determine suitability for transfer to the Older Adult Assessment Unit. There is also a daily visit to the AMU to review patients identified at the post-receiving round by General Physicians using agreed criteria. Direct transfers from there to Medicine for the Elderly beds takes place dependent upon bed availability.

Regular liaison visits to medical wards are undertaken to ensure appropriate patients are transferred to Medicine for the Elderly beds later in the course of admission.

Patients are admitted to RAH from the VoL service according to agreed criteria - generally the more medically unstable patients and all stroke patients (except those needing thrombolysis who go to the QueenElizabethUniversityHospital, Glasgow). If appropriate, they are transferred back to the VoL once stable for ongoing rehabilitation. Currently some Medicine for the Elderly patients admitted to RAH are not fit to return to VoL and are transferred to the Medicine for the Elderly service at RAH. The group of medical patients who remain in the VoL are cared for under the supervision of a ‘Physician of the week’ rotating from RAH. Medicine for the Elderly Consultants triage patients on a daily basis for transfer to their wards.

Stroke Service (patients of all ages)

Beds for stroke patients (approx 25) are part of a 30 bedded Medicine for the Elderly ward. Work is ongoing to ensure direct admissions from A&E and early transfer to the Stroke Unit. There are approximately 400 admissions to the stroke unit per year. Thrombolysis for patients from the RAH catchment area is delivered by the South Glasgow Stroke Service and patients repatriated thereafter.

Rapid access TIA clinics are undertaken, with the number of clinics required to achieve national performance targets recently being agreed following review.

There is a neurology liaison service in RoyalAlexandraHospital and InverclydeRoyalHospital and a new member of that team has a special interest in Stroke Medicine.

The Stroke service is represented on the Greater Glasgow & Clyde Stroke Managed Clinical Network.

Geriatric Orthopaedic Service

The orthogeriatic service is provided by 3 consultants, supported by a Staff Grade doctor. The team works to a target of reviewing patients within 72 hours of admission. There are both inpatient and community rehabilitation teams and links to care homes through the Gerontology Nurse Specialist with an interest in Orthogeriatrics.

There is a fast track service where patients with a Fractured Hip can be transferred directly to the Geriatric Orthopaedic Unit either in the Royal Alexandra hospital or Vale of Leven Hospital as appropriate according to certain criteria. There are also over 300 liaison visits per year. There is a weekly multidisciplinary team meeting in orthopaedics. The Older People and Stroke Service is strongly supported by Orthopaedics and has 22 dedicated beds in ward 3 which provide orthogeriatric rehabilitation

VoL trauma admissions are admitted to RAH and, when appropriate, older patients transferred directly back to Ward 15 in VoL for further orthogeriatric rehabilitation under the care of the Geriatrician.

Movement Disorders

The RAH service is provided by 2 consultants, supported by a one Parkinson’s Disease Nurse Specialist. There are 3 outpatient clinics per week and inpatients are cared for in ward 5 wherever possible/appropriate. The team provides liaison support to other specialties within the hospital and provides domiciliary visits, where possible, to our local nursing homes.

DayHospital

A 5 day services is provided, supported by a Specialty Doctor. The recent development of Community work and the introduction of rapid access clinic slots has been part of a review of the DayHospital service as an alternative to admission to hospital with comprehensive geriatric assessment being led by a Consultant Geriatrician.DayHospital also provides an IV zolendronate service and can support outpatient blood transfusion.

Outpatient Clinics

Specialist clinics are available, for Stroke, Movement Disorders and Falls.

Community Geriatric Medicine

Community Geriatric Medicine was established in 2006 under the auspices of the Joint Planning Group. Our Community Geriatrician provides weekly MDT meetings with the Community teams including the Gerontology Nurse Specialists, Rehab and Enablement Team, Rapid Response and Interface Pharmacy.

Bed Numbers

Ward 3 / 30 beds / GORU (22) & Assessment/Rehabilitation (8)
Ward 4 / 30 beds / Stroke + up to 5 geriatric patients
Ward 5 / 30 beds / Assessment/ Rehabilitation with Movement Disorders
Ward 6 / 12 beds / Older Adult Assessment Unit
Ward 7 / 30 beds / Assessment/ Rehabilitation
Ward 36 / 20 beds / NHS Complex care/Interim Care

Currently there at are 354 admissions to Wards 3 and 890admissions to 5 and 7 per year with an average length of stay of 13-14 days. The Older Adult Unit looks after 700-800 patients per year with average LOS of 3-4 days.

1. THE POST

Title: Consultant Physician in Medicine for the Elderly

(a)Relationships:

(I)Clyde sector

Director: Mrs M Farrell

Chief of Medicine Dr Chris Jones

General Manager Older People / Stroke Mr J Kennedy

Clinical Director Older People / Stroke Dr Graeme Simpson

Lead Clinician Older People Dr Janice Murtagh

(ii)Names of Consultant members of the Department:

Consultant: / Special Interest:
Dr J. McManus / Stroke / Heart Failure
Dr G. Simpson / Movement Disorder
Dr F. Boyce / Stroke
Dr S. Farid / Stroke
Dr L. McCracken / Older Adult Assessment Unit
Vacant post / Older Adult Assessment Unit and Complex Care
Dr J. Murtagh / Movement Disorder
Dr O. Lucie / Older Adult Assessment Unit and Community
Dr A.Macrae / Falls and orthogeriatric medicine
Dr D. Mack / Falls and orthogeriatric medicine
Dr K. Kanthi / Vale of Leven/GORU/Falls/Syncope

(iii)Support Grades

ease complete
Specialty Doctors 2 = 17 sessions
FY2 5
GPST 3
CMT 1

(b)Duties of the Post:

(i)The postholder will be expected to work with local managers and professional colleagues in the efficient running of the service. Subject to the provisions of the terms and conditions of Service, the postholder is expected to observe NHS Greater Glasgow and Clyde’s agreed policies and procedures, drawn up in consultation with the profession on clinical matters, and to follow the standing orders and financial instructions of the Health Board.

(ii)The postholder will be expected to ensure that there are adequate arrangements for hospital staff involved in the care of patients to be able to make contact with the postholder when necessary.

(iii)The postholder is required to comply with GG&C Health and Safety Policies.

(iii)Clinical

• The post is open to candidates who wish to contribute to the development of Older Peoples Services. The clinical duties described will depend upon final agreement of the job plan.
• Needs-led acute receiving for older people in the RoyalAlexandraHospital. Weekend cover to receiving is provided by the on-call Consultant 1:10This is on call for the service which includes input to medical receiving and covering the Rehabilitation and Assessment beds ( Stroke and Older People)
• Liaison and advice for appropriate older patients in medical and surgical wards.
• Care of assessment and rehabilitation patients in the Older Peoples beds
• General Older Peoples and Rapid Access Out-Patient Clinic
• ComplexHospital Care
• The Consultant will be expected to share cover for absent colleagues on annual or study leave by prior arrangement and short-term, unplanned sick leave

(iv)Supporting Professional Activities

• As part of supporting Professional activity, full involvement in the Clinical Governance programme of the Directorate

• Participation in Clinical Meetings and an audit programme

• The appointee will be expected to participate in annual appraisal

• Development of Older Peoples Services

With negotiation about total SPA time the following may be included:

• The Consultant will be responsible, in conjunction with colleagues, for the clinical and educational supervision of trainee medical staff.

• The Consultant would be expected to take part in the undergraduate

teaching for students from University of Glasgow

• The Consultant may be expected to contribute, by agreement with

Clinical Director, to internal and external Health Service committees

4. Proposed Weekly Programme

4.1Job Plan

The proposed indicative weekly programme is shown below. Activities with current fixed time commitments will be carried out as detailed in the work programme eg clinics. Other DCC and SPA activities are shown with indicative timings within the weekly programme and will be discussed with the appointee.

The job plan will be reviewed with the successful candidate no later than 3 months following appointment and where possible discussion may take place in advance of appointment. Job plan review thereafter will be no less frequent than annually.

The agreed job plan will include all the consultant’s professional duties and commitments, including agreed Supporting Professional Activity.

Opportunities may exist for Extra Programmed Activities to be undertaken subject to service requirements and in accordance with national terms and conditions of service.

JOB PLAN

Name: Specialty: Older People and Stroke Service

Principal Place of Work: RoyalAlexandraHospital

Contract: Full Time /Part time/ Honorary Programmed Activities: 10EPAs: N/A

Availability Supplement: None/Level 1/Level 2 (delete as appropriate) 3 %

Premium payment received:

Managerially Accountable to: Mr John Kennedy, General Manager, (Clyde) RAD

Professionally Responsible to: Dr Graeme Simpson, Clinical Director

a) Timetable of activities which have a specific location and time

DAY / HOSPITAL/LOCATION / TYPE OF WORK
Monday
From/To
am
0900-1200
pm
1300-1500
1500-1700 / General Assessment and Rehabilitation Ward round (15 patients)
MDT
Administration / DCC
DCC
DCC
Tuesday
From/To
am
0900-1300
pm
1300-1700 / Older Adult Unit
Acute Medical Unit Liaison
Older Adult Unit
OAAU MDT / DCC
DCC
DCC
DCC
Wednesday
From/To
am
0900-1100
pm
1300-1700 / Ward 36 Ward round (12 patients)
Medical/Surgical Liaison/OAAU cross-cover / DCC
DCC
Thursday
From/To
am
0900-1200
pm
1300-1500 / General Assessment and Rehabilitation Ward round (15 patients)
Administration / DCC
Administration
Friday
From/To
am
0900-1300
pm
1300-1700 / Outpatient Clinic
SPA / DCC
SPA
Saturday
From/To / RAH 1:10 / Acute Medical Unit Liaison
Review patients wards 3-7
Sunday
From/To / RAH 1:10 / Acute Medical Unit Liaison
Review patients wards 3-7

4.2 Notes on the Programme

Patient Administration. This activity covers the management of individual patients including Out Patient administration, results reporting, letters/phone calls to patients, carers, GP’S and members of the wider multidisciplinary team involved in the patients care. Office accommodation will be in the RoyalAlexandraHospital.

Ward Rounds: The time allocated is indicative and will be discussed with the appointee. Ward work will include teaching ward rounds as required.

Travel: Any travel allocation will be included within the Total Programmed Activities and will be determined by location at which Direct Clinical Care and Supporting Professional activities are carried out.

Supporting Professional Activities: This job plan is negotiable and will be agreed between the successful applicant and the Clinical Director. NHS Greater Glasgow & Clyde initially allocates all full time consultants 10 PAs made up of 9 PAs in Direct Clinical Care (DCC) and one core Supporting Professional Activities (SPA) for CPD, audit, clinical governance, appraisal, revalidation, job planning, internal routine communication and management meetings. The precise allocation of SPA time and associate objectives will be agreed with the successful applicant and will be reviewed at annual job planning. It will be requested that SPAs are delivered at the normal place of work, unless there are mutual advantages to it being performed elsewhere. The exact timing and location of SPAs, and flexibility around these, will be agreed during the 1:1 meeting with the Clinical Director and included in the prospective job plan.

1. On – Call Duties

The postholder will be part of the current Older People and Stroke Rota based at The Royal Alexandra Hospital. This rota is a 1:10. Availability supplement is 3%. Duties include review of new and unwell patients in wards 3 – 7 and liaison to AMU

A half programmed activity based on premium time per week has been included within the allocation of DCC to recognise the predictable and unpredictable hours of work associated with the provision of emergency cover.

1. Support Staff

There is secretarial support for consultant appointments

1. Postgraduate and Undergraduate Training

Both the Medicine for the Elderly and Medical units have a postgraduate programme which includes a weekly unit meeting, morbidity and mortality meetings and SHO tutorial sessions. There are weekly hospital postgraduate meetings during term time. Mr Andrew Renwick is the postgraduate tutor at RAH.

The Medical Units teach a number of medical students from GlasgowUniversity. As part of the new curriculum, teaching of years one to five is becoming established.

8.Further information

Candidates are strongly urged to make contact for further information and to arrange a visit to the department:

Please contact:

Dr G Simpson Clinical Director, Older People / Stroke (Sec 0141 314 6190)

Dr Janice Murtagh Lead Clinician, Older People, RAH (Sec 0141 314 6835)

Mr John Kennedy General Manager, Older People and Stroke Service (Sec01413146835)

1. DATE WHEN POST IS VACANT:March 2017

PERSON SPECIFICATION

ESSENTIAL / DESIRABLE
QUALIFICATIONS / Applicants should have full GMC registration, a licence to practise, MRCP or equivalent and eligibility for inclusion on the Specialist Register. Those trained in the UK should have evidence of higher specialist training in General Internal Medicine and Geriatric Medicine 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.
CLINICAL EXPERIENCE / Clinical training and experience equivalent to that required for gaining UK CCT in General Internal Medicine and Geriatric Medicine.
Ability to offer expert clinical opinion on a range of geriatric problems.
Ability to take full and independent responsibility for clinical care of patients. / Sub-specialty interest.
MANAGEMENT AND ADMINISTRATIVE EXPERIENCE / Demonstrate leadership qualities that will help them to support and develop the Older People’s 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.
Demonstrate an understanding of clinical governance as a concept, as well as the local priorities in this area. / Attendance at management course for clinicians.
TEACHING EXPERIENCE / Experience of supervising medical trainees.
Ability to teach clinical skills. / Experience of MMC assessment tools.
Qualification in clinical or educational supervision
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 colleagues within and outwith the department
Commitment to the requirements of clinical governance.

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 / Permanent
GRADE AND SALARY / Consultant
£ 77,529 - £104,525per 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 Time 40.00
SUPERANNUATION / New entrants to NHS Greater Glasgow and Clyde who are aged sixteen but under seventy five will be enrolled automatically into membership of the NHS Pension Scheme. Should you choose to "opt out" arrangements can be made to do this via:
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 no 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