Senior Clinical Fellowship in Vascular Access Surgery

senior clinical fellowship in vascular access surgery

western infirmary

Information pack

reF: 27893d

Closing Date: noon 22nd february 2013

SUMMARY INFORMATION

Post: senior clinical fellowship

in vascular access surgery

Base:western infirmary

Darlinda’s Charity for Renal Research

Applications are invited for this Clinical Fellowshipwhich is available from August 2013, initially for a period of 12 months.

This surgical fellowship provides a full-time post in the Renal Transplant Service of a tertiary referral centre, with exposure to all aspects of vascular access (including imaging, primary and secondary vascular access techniques, and intervention for complications) as well as an active research programme. The Renal Transplant Service provides surgical transplantation for the West of Scotland and (jointly with the Vascular Surgery Department) vascular access surgery for the renal population of Greater Glasgow & Clyde and ForthValley. It undertakes in excess of 400 procedures yearly with a specialist interest in complications of access access, research and end-stage access.

The content of the fellowship is flexible and will be adapted to the successful applicant’s requirements and experience. Applicants should possess the MRCS (essential) and have completed surgical training to ST5 level (desirable). The post does not include an obligatory commitment to an on-call rota and, consequently does not attract an on-call supplement.

The fellowship is generously funded by The Darlinda Charitable Foundation for Renal Research, founded by the late Rita Madhok in 1987. Rita was a renal patient for many years and was known professionally as Darlinda through her work as an astrologer. Following her death the charity continues to support renal research, equipment purchases and improve patient comfort. Now in its 25th year it has already raised over one million pounds. (

This post does not have educational approval from the Postgraduate Dean and will not be recognised for training.

NORTH GLASGOW

UNIVERSITY HOSPITALS

DIVISION

SENIOR CLINICAL FELLOW IN RENAL ACCESS SURGERY

NHS Greater Glasgow and Clyde

Base: Western Infirmary, Glasgow

INFORMATION PACK

TOPIC PAGE NO

1.Brief Description of the Health Board3

2.Hospitals & Clinics where Services are to be provided 3

3.The Work of the Directorate/Department/Specialty 4

4.Current Consultant Establishment 5

5.Duties of the Post 5

Clinical Commitments 5

Teaching 5

ClinicalResearch 5

Laboratory Research 6

Timetable 6

6.Terms & Conditions of Service 6

7.Arrangements to visit 7

8.Return of CV 7

9.Closing Date 7

Post:Senior Clinical Fellow

Renal Access Surgery

Based:Western Infirmary

Reports To:Mr David Kingsmore, Consultant Vascular and Transplant Surgeon

1.Brief Description of the Health Board

NHS Greater Glasgow and Clyde is the largest group of adult acute hospitals in Scotland – offering many opportunities to ensure job satisfaction and career development. It provides a wide range of services from community-based care through to supra-regional services including cardiac and renal transplantation.

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.

Renal services are included within the Regional Services Directorate which manages the following services

-Institute of Neurosciences

-Spinal Injuries Unit

-West of Scotland Beatson Cancer Centre

-Plastic Surgery and Burns Unit

-Renal Services

-HomeopathyHospital

2.Hospitals and Clinics where Services are to be provided

The Renal Transplant Unit at the Western Infirmary is the sole provider of Renal Transplantation for the adult population of the West of Scotland (population approximately 2.7 million). This Service performs more than 90 renal transplants a year, has one of the largest Living Donor programmes in the UK and supports the Scottish Paediatric Transplant Programme which is based at The Royal Hospital for Sick Children. The Department also provides vascular access surgery for the 650 patients on haemodialysis, access surgery for peritoneal dialysis as well as general surgery for patients with renal failure.

The Renal Transplant Unit is now located in a newly refurbished 16 bedded ward, co-located with the vascular surgery unit, on level 9 of the Phase One Building of the Western Infirmary - a modern and well-equipped tower block that also houses a suite of Operating theatres and an 8 bedded Intensive Therapy Unit. All inpatient nephrology services for Glasgow, Clyde and ForthValley now occupy the whole of level 7 in the Western Infirmary. Outpatient haemodialysis activity for the Western Infirmary and the peritoneal dialysis unit are on the second floor of G block – adjacent to a new suite of consultant offices

Most outpatient haemodialysis occurs outside the inpatient facility with units situated at NewVictoriaHospital, Glasgow Royal Infirmary, NewStobhillHospital, InverclydeHospital, Vale of Leven Hospital and LarbertHospital. carried out at satellite haemodialysis units at NewStobhillHospital, NewVictoriaHospital, FalkirkDistrictHospital, InverclydeHospital, and Vale of Leven Hospital.

Paediatric renal transplants are performed at the RoyalHospital for Sick Children working in association with the paediatric surgeons based there.

Renal Access outpatient clinics are conducted in the Western Infirmary plus new Victoria and StobhillHospitals which have excellent modern facilities including day case surgery suites which are used for renal (access) surgery in appropriate patients. The renal access service is integrated between the renal transplant surgeons and the vascular surgeons.

There is a close working relationship between the transplantation programme and the University Department of Surgery where excellent laboratory facilities exit for research related to all aspects of organ transplantation. There is also close collaboration between the vascular surgery service and StrathclydeUniversity.

3.The Work of the Directorate/Department/Specialty

There has been an expansion in renal transplant activity over the last decade and a total of over 2000 transplants have been carried out at the Western Infirmary. More than 90 cadaveric, living related and unrelated donor operations are performed annually with approximately 25-30% being from live donors. The current waiting list for renal transplantation in the West of Scotland is over 300. There are approximately 60 CAPD patients and 600 haemodialysis patients being treated within Greater Glasgow and Clyde and ForthValley on an outpatient basis. In addition to the local catchment population, the renal unit at the Western Infirmary also provides more complicated dialysis access surgery for other renal units and functions as a specialist referral centre. The unit is therefore one of the largest in the country.

The vascular access service has evolved rapidly over the past three years. There are 2 dedicated ultrasound lists, portable US available at clinics, 2 dedicated follow-up clinics and renal surgical follow-up and referral in a further 2 clinics. The service has one renal access nurse supported by seven nurse practitioners. All organisation is carried out through one secretarial office. There are surgical lists every day with both vascular surgery and renal surgery providing a broad range of expertise. We provide primary access work one day lists and more complex procedures as an in-patient, with 8 all-day lists available according to need and expertise. Interventional radiology is a key component of our service and is provided in the Western Infirmary.

There are 5 Consultant Transplant Surgeons and 5 Consultant Vascular Surgeons who contribute to the access service. There is one senior transplant trainee and three senior vascular trainees. There is a regular two-weekly MDT at which all imaging is discussed, the database updated, and waiting list organised. There is an emergency theatre 24 hours a day which is available for emergency and unscheduled work.

As well as being one of the largest transplant programmes in the country with opportunities for clinical research, excellent facilities exist within the University Department of Surgery. There are established links for experimental research in the fields of access with laboratory research extending from cellular biology to small animal models at StrathclydeUniversity. There is a wide range of research on-going in the department, with an expectation of participation and potential for a higher degree. Currently we have two PhD students working in the department of renal surgery and one MD student in vascular surgery.

4.Current Consultant Establishment

Renal Surgery

Mr David KingsmoreConsultant Transplant and Vascular Surgeon,

Clinical Lead for Vascular Access

Mr Marc ClancyDirector of Renal Transplantation

Mr Enric MurioConsultant Transplant Surgeon

Mr John AsherConsultant Transplant Surgeon

Mr Vlad ShumyekoConsultant Transplant Surgeon

Vascular Surgery – involved with access surgery

Mr Kevin Daly

Mr Douglas Orr

Mr Paul Teenan

Mr Gareth Traherne

Interventional radiology

Dr Ram Kusthuri

Dr Mohan Chandramohan

5.Duties of the Post

Fundamentally, this post is designed to allow optimal training exposure that is tailored to the individual requirements of the trainee. It is anticipated that the trainee should have an awareness of the areas of their own training that require improvement. There are no preset obligations and experience is available in several key areas – imaging, operative, and research. Trainees are in post for training in vascular surgery, transplant surgery and interventional radiology. From review of the operative and trainees logbooks, we have become aware that the training in access surgery is variable and often the experience available is not matched by appropriate trainees. Our aim with this post is to allow a period of training without other competing interests that is tailored to individuals’ requirements.

Imaging: It is anticipated that the appointee will take a lead role in acquiring imaging skills through attendance and training with the interventional radiologists. Furthermore, we would anticipate that the access fellow would attend regular dialysis units, perform imaging and detect access complications. We would hope that attendance at the access OPC and MDT would allow experience in imaging and organisation of treatment. There is scope for interventional radiology training according to the previous experience of the candidate and opportunities.

Operative experience: There are many theatre lists available for the access fellow, but perhaps the most important will be the organisation and experience of tertiary procedures e.g. DRIL procedure, declotting + imaging + revision, surgery for end-stage access. This complex surgery is more frequent and often performed in the emergency theatre. It is anticipated that the access fellow will predominantly take a role in this tertiary referral work.

Research: There is a substantial amount of research on-going in the department. There is the opportunity for a higher degree based on on-going projects. We have several randomised trials, prospective observational work, clinical and laboratory work. We have won major funding and we would anticipate that the research fellow would contribute to this.

Timetable:

The appointee will have considerable flexibility to organise a timetable according to opportunity and requirement. There is no service requirement in this post, but it is anticipated that the Access Fellow will be key in running the access service. We believe that this is an essential component of training. The fellow will be expected to attend two OPC per week, one MDT every two weeks, and a minimum of one theatre list per week. All tertiary procedures will be available for the access fellow. A timetable will be drawn up, and subject to monthly review and appraisal. The post is for 1 year in the first instance.

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 Term
GRADE AND SALARY / Clinical Fellow
£29,705 £ 46,708 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

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Applicants wishing further information about the post are invited to contact Mr. David Kingsmore on 0141 211 1813 with whom visiting arrangements can also be made.

How to apply

To apply for these posts please include your CV and names and addresses of 3 Referees, along with the following documents; (click on the hyperlinks to open)

Medical and Dental Application and Equal Opportunities Monitoring Form

Declaration Form Regarding Fitness to Practice

Immigration Questionnaire

Alternatively please visit and click on the “How to Apply” tab to access application for and CV submission information.

Return of Applications

Please return your application by email to or to the recruitment address below;

Medical and Dental Recruitment Team

NHS Greater Glasgow and Clyde

Recruitment Services, 1st Floor

Modular Building, Gartnavel Royal Hospital

1055 Great Western Road

GLASGOW

G12 0XH

CLOSING DATE

The closing Date will be Noon 22nd February 2013