sENIOR CLINICAL FELLOWS
Paediatric intensive care/specialties
royal hospital for Children
INFORMATION PACK
REF: 45177D
cLOSING DATE: 23rd DecEMBER 2016
www.nhsggc.org.uk/medicaljobs
SUMMARY INFORMATION RELATING TO THIS POSITION
POST: SENIOR CLINICAL FELLOW (MIDDLE-GRADE) IN PAEDIATRIC INTENSIVE CARE/SPECIALTIES
BASE: ROYAL HOSPITAL FOR CHILDREN, GLASGOW
Applications are invited for posts based in the Paediatric services within the Royal Hospital for Children (RHC), Glasgow from Feb/March 2017. We have a variety of opportunities available within different specialties within Paediatrics. These include posts in Oncology & Endocrinology or Paediatric Intensive Care Medicine. The RHC is a new built state of the art facility opened in 2015 which provides regional subspecialty services for the whole of the West of Scotland and some aspects of subspecialty services for the whole of Scotland.
Each of these posts provides interesting clinical experience suitable for trainees who already have some experience within Paediatrics. Appointees will be expected to work on our middle-grade rota. Applicants will also be considered for any other vacancies that arise prior to the interview date.
To practice medicine in the UK you need to hold both GMC registration and a license to practice.
NHS GREATER GLASGOW & CLYDE
WOMEN’S & CHILDREN’S DIVISION
Middle-grade Clinical Fellow in Paediatric Intensive Care/Specialties
Royal Hospital for Children, Glasgow
INFORMATION PACK
BRIEF DESCRIPTION OF HOSPITALS AND DEPARTMENTS
ROYAL HOSPITAL FOR CHILDREN (RHC)
The RHC is a comprehensive Children's Hospital serving the West of Scotland with a national and international reference function. It is a teaching hospital of the Faculty of Medicine of the University of Glasgow. It is a new build facility opened in June 2015 with state of the art facilities and co-located with a regional maternity unit and comprehensive adult services at the Queen Elizabeth University Hospital.
The RHC is the largest paediatric teaching hospital in Scotland. It provides care, not only for children resident within Greater Glasgow, but is also a tertiary referral centre for children from the West of Scotland and, in some sub-specialties, from the whole of Scotland.
The RHC is co-located with a regional maternity unit (including fetal medicine service) and NICU with 16 ICU cots, 14 HDU cots and 24 SCBU cots. All paediatric medical and surgical subspecialties are represented in RCH. The hospital provides the Scottish national ECMO service for paediatric and neonatal patients. It is the centre for all paediatric cardiac surgery and the majority of the Paediatric Intensive Care for Scotland.
The hospital is the base teaching hospital for postgraduate paediatric training in the West of Scotland. Paediatric training is provided in the following areas: Neonatology (level 3 units), Intensive Care, Cardiology, Haemato-oncology, Gastroenterology, Neurology, Respiratory Medicine, Rheumatology, Endocrinology & Diabetes, Nephrology and Infectious Disease/Immunology. General Paediatric training is provided between this hospital and the local district general hospitals (including Royal Alexandra Hospital).
The RHC provides the major Undergraduate Paediatric Teaching facility for the University of Glasgow.
The Royal Hospital for Children Paediatric Services
The RHC provides all the acute emergency and general paediatric service for the whole of Glasgow. There is an extremely busy Paediatric Emergency Department and General Paediatric receiving service, which between them provide a wealth of learning opportunities. Trainees working in general paediatrics undertake supervised work within the outpatient environment. The aim of our placements in general paediatrics is to progress trainees to a level of competence that enables them to function in a middle-grade role within general paediatrics in their next placement. Subspecialty placements also exist in the RCH within Gastroenterology, Neurology, Respiratory Medicine, Rheumatology, Endocrinology & Diabetes, Nephrology and Infectious Disease/Immunology. The placements within these departments are for more senior trainees with established middle-grade competency and include out-of-hour involvement in acute general paediatric with leadership of the Hospital at Night team. Daytime duties involve working with the subspecialty multidisciplinary teams to provide both in-patient and out-patient subspecialty services.
All junior doctors have nominated Educational supervisors and are encouraged to progress with their postgraduate exams. There are consultant-led exam preparation sessions held prior to each MCPCH clinical exam and there is a high pass rate for this exam locally.
The Royal Hospital for Children Neonatal Service
RHC houses the inpatient facilities of all the major paediatric subspecialties. This is one of the largest neonatal units in the country with 30 ICU/DHU cots and 24 SCBU cots. The workload for the neonatal unit involves the management of newborn children with surgical and cardiac conditions as well as those requiring input from the paediatric subspecialty services based on the RCH site. The maternity unit delivers around 6,000 births/year and contains the Ian Donald Fetal Medicine Unit which provides diagnostic and interventional fetal therapy for Scotland. All neonatal intensive care is provided on this site including neonatal cardiology for all of Scotland, the Scottish neonatal ECMO service (one of four centres in the U.K.), a U.K. national intervention service for Vein of Galen aneurysms, renal support therapy, complex airway surgery and comprehensive neonatal surgical services. Newborns are transferred to this unit from across Scotland because of the specialist services offered on this site. Due to the size and complexity of the clinical service there is a consultant available on-site at all times. Consequently the unit can provide a breadth of neonatal clinical experience and trainee support that is unrivalled in the U.K.
Princess Royal Maternity
The PRM is a purpose built 120 bed maternity hospital, with a capacity for 6,500 deliveries per annum. The neonatal unit provides 10 intensive care cots and 23 special care cots. Facilities in intensive care include the latest means of respiratory support and monitoring and it is a tertiary total body cooling service for infants with hypoxic ischaemic encephalopathy. All neonatal intensive care can be provided with the exception of those infants who require neonatal surgery and/or extra-corporeal life support services (ECLS).
PRM acts as a tertiary referral centre for pregnant women who require specialist medical care and has the Regius Chair of Obstetrics & Gynaecology. There is an active fetal medicine service. The neonatal unit accepts infants transferred in- or ex-utero from other units providing less dependent care. The neonatal unit participates in teaching undergraduates from Glasgow University Medical School and supports visiting special study module students.
There is an active and full teaching programme on the unit and an emphasis on evidence based delivery of clinical care. Weekly multidisciplinary high risk and morbidity meetings are held with obstetric colleagues.
The unit actively participates in multicentre research studies and is very active in the field of original research into nutrition, visual development, management of infants of drug using mothers and clinical audit.
The Royal Hospital for Children: Paediatric Oncology
Children's cancer services are provided through Managed Service Netowrk (MSN) which provides single unified service delivered via three CCLG(Children's Cancer and Leukaemia Group) centres across Scotland. The department sees an average of 75 new diagnoses per year, taking children and young adults up to the age of 16 at original presentation. The Schiehallion Unit has a 22 bed (all are individual cubicles) inpatient facility with separate day care and outpatient departments. The department also has a 4 bedded Teenage Cancer Trust unit which works very closely with the TCT unit at Beatson Oncology centre at Gartnavel hospital in Glasgow. The Scottish National Paediatric Bone Marrow Transplant Service is also based on Schiehallion. It conducts 15-20 allo and autografts each year. The BMT unit has been JACIE accredited since 2011.
RCH, Glasgow is one of seven UK centres accredited to deliver phase I/II agents and acts as the national New Agent Service for Scotland. The Glasgow unit therefore sees an average of 100 new patients a year. Patients requiring radiotherapy have their treatment delivered at The Beatson Oncology Centre. The unit also provides comprehensive care for children and young adults with CNS tumours under one roof. Sarcoma surgery services are provided with in the hospital which also receives patients from Aberdeen. This tertiary hospital provides multi specialist paediatric care including HDU and PICU care. The unit is part of CCLG and actively participates in national, international and commercial trials.
The unit also provides service for non malignant conditions such as thalaseemia, haemoglobinopathies and Haemophilia.
There will be a 1:5 out-of-hours commitment responsible for first line management of the Paediatric Oncology patients between 09.00 and 21.30 (after 21:30 this cover is provided by the Hospital At Night team).
The Royal Hospital for Children: Paediatric Intensive Care Unit
The Critical Care department manages 16 intensive care and 6 high dependency beds. The specialist and general intensive care provided reflects the comprehensive tertiary medical and surgical specialties and the major emergency and acute receiving services provided by the hospital. The unit supports the Scottish paediatric cardiac surgery, invasive cardiology and ECMO services which are based here. Consequently the management of cardiac patients forms a significant percentage of PICU workload and experience.
A transport and retrieval service supports critically ill children presenting to other hospitals. The transport and retrieval service is distinctive as it covers both the densely populated central belt as well as the remote and sparsely populated areas of Scotland. Air transport by helicopter or fixed wing aircraft is used to access these areas.
The Paediatric Intensive Care has been equipped to a very high level with paperless clinical information and prescribing system, PACS radiology system and state of the art monitoring.
The High Dependency Unit is managed as an integrated part of the critical care service. A variety of patients are admitted to this area including acute medical, post operative care and intensive care ‘step down’ patients.
There are 12 junior medical staff employed in the unit. Staff members are allocated to ‘senior’ and ‘junior’ groups based on previous intensive care experience. All staff work full shifts. The experienced group staff the retrieval service and are expected to take a supervisory role within the unit.
The unit has six full time intensive care consultants with a mix of paediatric and anaesthetic backgrounds. A number of formal teaching sessions and other learning opportunities are held every week. These include a weekly ‘grand round’; radiology meeting; protected teaching session; departmental CME session; and a cardiac liaison meeting. Other meetings and teaching sessions are held regularly in other departments throughout the hospital. The junior medical staff have access to high quality computer, office and changing facilities within the intensive care unit. There are full opportunities for clinical research and access to laboratory facilities can be arranged as required.
The Royal Hospital for Children: Paediatric Cardiology
The hospital provides the national paediatric cardiac centre for Scotland, serving a population of 5.5 million and undertaking all types of cardiac surgery and catheter intervention with the exception of cardiac transplantation and hypoplastic left heart syndrome surgery. Trainees are involved in the preoperative preparation of patients undergoing elective cardiac procedures as well as the ward based post operative management. They contribute to the daily PICU cardiac ward round, learning more about the ward/PICU interactions. There is also regular involvement in the assessment of infants referred into the neonatal unit with cardiac condition. There are regular outpatient clinic commitments and also the opportunity to learn echocardiography, through a weekly dedicated echo session under the supervision of a senior cardiac physiologist, and attendance at our 4 day paediatric echocardiography course. There is a fully functioning Cardiac Catheterisation Laboratory with diagnostic and interventional procedures undertaken on a regular basis. There will be a 1:5 out-of-hours commitment responsible for first line management of the Paediatric Cardiology patients between 09.00 and 21.30 (after 21:30 this cover is provided by the Hospital At Night team).
Royal Alexandra Hospital, Paisley: Paediatric Department
The Royal Alexandria Hospital (RAH) is a large district general hospital within Greater Glasgow & Clyde. It is located about 10 miles from the Children’s Hospital and has a 31-bed general paediatric ward dealing with medical and surgical paediatric patients. There are approximately 2,000 medical admissions per annum. Close to the ward is the paediatric outpatient clinic (general paediatrics, diabetes, cystic fibrosis, neuro-developmental, neonatal follow up).
The maternity hospital is on the same site and there are 2,500 deliveries each year. The SCBU has 3 intensive care and 10 special care cots. Argyll & Clyde community child health services are based at the Panda Centre (Hawkhead Hospital) and Acorn Centre (Vale of Leven Hospital). Trainees based in these units contribute to the RAH acute out-of-hours cover.
ROTAS
Rota details vary according to the individual placement. All first on-call posts are supported by 24 hour on-site middle-grade cover. The placement involves full shift working on a band 1A New Deal and EWT compliant rota. Day shifts typically start at 08:30. We are constantly endeavouring to improve service delivery and working patterns and in view of this, both hours of work and banding payments may be subject to change. An offer of employment may not reflect the current banding.
TEACHING
There are occasional undergraduate teaching commitments
STUDY AND TRAINING
Study Leave within United Kingdom will be in accordance with the Terms and Conditions of Service and application should be submitted to the relevant Clinical Director.
POSTGRADUATE MEDICAL EDUCATION COURSES AVAILABLE LOCALLY
There are frequent lectures within the University of Glasgow and the Royal College of Physicians and Surgeons of Glasgow relevant to postgraduate medical education. Special courses and seminars are arranged within the hospital from time to time. Formal in-post training within the hospital is arranged by the Medical division, by the postgraduate Tutor and by the Medical Staff Association.
There is a strong educational and training focus within the department and trainee feedback both locally and through the GMC trainees’ survey is very positive.
RESEARCH OPPORTUNITIES
There are opportunities for clinical research and include laboratory and animal facilities if required. Any research protocol must first be agreed by the Hospital Ethical Committee before it can be instituted.
OTHER FACILITIES
The city of Glasgow is excellent for shopping and recreation. The recreational facilities in the surrounding country are outstanding (golf, sailing, fishing, hill walking, mountain climbing, canoeing, skiing etc)