NHS Lothian
Children’s Services
Department of Community Child Health
St John’s Hospital, West Lothian
1.
Outline of the post
Title:
Specialty Doctor in Community Child Health, St John’s Hospital, West Lothian.
This is a full time substantive appointment.
The post is available from 01 December 2014.
Although the main base for this post is St John’s Hospital the Community Child Health
Service is a Lothian wide service and the person appointed may be required to work at other
sites if required by the needs of the service.
2.
Community Child Health Services in Lothian
The appointee will join an established Community Child Health (CCH) service which delivers
secondary and tertiary paediatric services in the community for the children of Edinburgh,
West Lothian, East and Midlothian. Health services in Lothian provide for a total population
of approximately 850,000 people, of whom 500,000 live in the city of Edinburgh. The total
population of 0–18 year olds for the whole of Lothian is about 175,000, of whom
approximately 45,000 live in West Lothian.
NHS Lothian provides Child Health Services based on an integrated and combined model.
There are close links with Primary Care and with the Local Authorities. There are strong
professional links between the Acute and Community Paediatric Services and community
paediatricians deliver undergraduate teaching and postgraduate training, having access to
teaching hospitals, the academic Department of Child Health and both district and regional
paediatric services.
The CCH service covers the geographical boundaries of the city of Edinburgh, Midlothian,
East Lothian and West Lothian. The Community Child Health services in Lothian are
managed as a single service, with CCH teams located in three administrative bases:
10 Chalmers Crescent for the city of Edinburgh;
Musselburgh Primary Care Centre for East and Midlothian;
St John’s Hospital for West Lothian.
The CCH teams are consultant led, and include Associate Specialist and Specialty Doctors
(SAS), plus specialist nurses and administrative support services.
The Department is working towards an equitable service for children throughout Lothian.
The CCH service invested in a modernisation project between 2010 and 2012, to clarify the
role of CCH and improve the efficiency of service delivery across Lothian. The project
defined CCH core business and key performance indicators, reviewed patient pathways,
determined a unified DNA policy and criteria for reviewing children. Two main work streams
were identified:

Neurodisability
o Children with Physical Disability
o Children with Learning Difficulties
o Children with Communication Disorders, including Autistic Spectrum
Disorders.
o Children with Sensory Impairment
o Children with Additional Support Needs, in mainstream and Special Schools

Vulnerable Children
o Child Protection service
o Looked After Children, including the VALAC clinic (Vulnerable and Looked
After Children) and the permanency process.
o Social vulnerability.
The Department has good working relationships with education, social work, the police force
and the voluntary sector. Clinical practice is supported by long term and extensive
experience using a computerised Support Needs System database which contains between
2,500-3,000 children with additional support needs, the majority of whom have a
neurodisability. This affords excellent opportunities for audit and research.
Pre-school multidisciplinary child development clinics are delivered in the Royal Hospital for
Sick Children (RHSC), in four geographical localities in the city of Edinburgh and in East and
Midlothian. West Lothian has a fully equipped Child Development Centre delivering preschool multidisciplinary clinics and specialist clinics.
The child protection service is based within Community Child Health and provides health
input into interagency referral discussions (IRDs) with senior police and social work
colleagues for all children where concerns about any form of abuse or neglect have been
raised. Where indicated, comprehensive medical assessments, specialist medical
examinations and joint paediatric forensic examinations are carried out urgently or electively
through regular SCAN clinics at RHSC, St John’s Hospital or at a police facility. The child
protection team includes Child Protection Advisors (CPAs), SAS doctors, paediatricians in
training and Consultant Paediatricians. From May 2013, the service has been delivered on
a Lothian wide basis, with IRDs being conducted in the three bases by CPAs, trainees
and/or SAS doctors, supervised by a consultant paediatrician for the Lothian region. A 24/7
out of hours service for Child Protection is delivered by CCH consultant paediatricians.
The school health service is nurse led, with secondary level care provided by community
paediatricians. There are a number of Special Schools across Edinburgh, East, Mid and
West Lothian, supported by school nurses, paediatric therapists, SAS doctors and
consultants.
The specialist services led by consultants within the CCH Department include:
Child Development
Physical Impairment including neurodisability
Communication Disorders including Autistic Spectrum Disorders
Child Protection
Looked After and Accommodated Children
Learning Disability
Visual Impairment
Hearing Impairment
Children with complex and exceptional healthcare needs
Lothian CCH Workforce
Currently, there are 13 Consultants (11.5 WTE), 14 Associate Specialists (10.4 WTE) and
11 Specialty Doctors (8.3 WTE) in post in the Lothian CCH Department.
In addition to the permanent staff, junior doctors in training from paediatric and GP training
programmes are attached to CCH for clinical experience and training under the guidance of
a named clinical supervisor.
Lothian CCH Consultants:
Dr Alexandra Baxter
Dr Anna Chillingworth
Dr Sarah Clegg
Dr Lyn Cresswell
Dr Helen Hammond
Professor Anne O’Hare
Dr Dayeel Goh
Dr Susan Kidd
Dr Charlotte Kirk
Dr Shabana Khalid
Dr Lindsay Logie
Dr Lesley Ross
Dr Jill Yates
Consultant Paediatrician, interest in Neurodisability
Consultant Paediatrician, interest in Neurodisability
Consultant Paediatrician, interest in Neurodisability including
Communication Disorders
Consultant Paediatrician, interest in Visual Impairment
Consultant Paediatrician, interest in Child Protection
Consultant Paediatrician, interest in Neurodisability including
Communication Disorders
Consultant Paediatrician (East Lothian)
Consultant Paediatrician, interest in Vulnerable Children
(West Lothian/Edinburgh)
Consultant Paediatrician, interest in Vulnerable Children
Consultant Paediatrician, interest in Neurodisability
(West Lothian/Edinburgh)
Consultant Paediatrician (Midlothian) and Lead Paediatrician
for Child Protection (Lothian).
Consultant Paediatrician
Consultant Paediatrician, interest in Neurodisability
(West Lothian)
Lothian CCH SAS Doctors:
Dr Sonia Bank-Theilen
Dr Jacqueline Bell
Dr Elaine Crummey
Dr Elaine Dale
Dr Jillian Dawson
Dr Jennifer Glen
Dr Jane Hailey
Dr Sheila Halpin
Dr Ruth Henderson
Dr Kemal Ibrahim
Dr Jennifer James
Dr Sheila Kernohan
Dr Naomi Kerr
Dr Joanne Kilpatrick
Dr Rosemary Jones
Specialty Doctor
Specialty Doctor
Associate Specialist
Associate Specialist
Specialty Doctor
Associate Specialist
Associate Specialist
Associate Specialist
Associate Specialist
Specialty Doctor
Specialty Doctor
Specialty Doctor
Associate Specialist
Associate Specialist
Associate Specialist
Dr Jennifer Mackenzie
Dr Heather Marshall
Dr Helen MacInnes
Dr Lisa McClelland
Dr Stephen Meldrum
Dr Liza Neville
Dr Joan Ritchie
Dr Fiona Sandeman
Dr Catherine Scrutton
Dr Soundara Somasundaram
Associate Specialist
Associate Specialist
Associate Specialist
Specialty Doctor
Specialty Doctor
Specialty Doctor
Associate Specialist
Specialty Doctor
Specialty Doctor
Associate Specialist
Community Child Health Department at St John’s Hospital
The CCH Service forms part of a combined hospital and community paediatric service, with
the CCH team based in the Department of Community Child Health within St John's
Hospital, Livingston. The CCH specialist and assessment clinics for pre-school children are
delivered at Beatlie Child Development Centre in Livingston. Historically, the SAS doctors
have delivered clinical services to school aged children in the primary and secondary
schools of West Lothian. This service is currently in a state of transition, moving to clinics
delivered in local health centres from September 2014.
All SAS doctors contribute to the West Lothian Child Protection service, participating in a
daytime rota for Interagency Referral Discussions with Police and Social Work during office
hours (Monday to Friday 0900 – 1700hrs). As part of a further modernisation project
reviewing the Lothian Child Protection service, the current model of IRD service delivery is
being evaluated, with possible centralisation of the Lothian IRD service in the future. This
would require the West Lothian SAS doctors to travel to Edinburgh.
The SAS doctors are encouraged to develop an area of specialist interest. Current SAS
specialist responsibilities include Autistic Spectrum Disorder, Severe Emotional and
Behavioural Needs, Adoption and Fostering, children with Visual or Hearing Impairment and
pre-school Developmental Paediatrics. All SAS doctors are also expected to contribute to
the wider responsibilities of the department, such as undergraduate teaching, trainee case
supervision, organisation of in-service training days, rota master duties and representing
CCH on relevant working groups.
Departmental staffing
The Community Child Health medical team currently comprises:
Dr Jill Yates, Consultant Paediatrician, based in West Lothian.
Dr Susan Kidd, Consultant Paediatrician, based in West Lothian and Edinburgh.
Dr Shabana Khalid, Consultant Paediatrician, based in West Lothian and Edinburgh.
There are 4 (2.2 WTE) Associate Specialists and 4 (3.1 WTE) Specialty Doctors. This is a
replacement post for one of the Specialty Doctor posts.
One paediatric trainee who is on rotation from the South East Scotland training programme.
Child Protection Advisors, Looked After Children Nurses and School Nurses also play an
important role in the work of the department.
Child Development Centre
The Child Development Centre is a joint Education and Health initiative that provides a
focus for services for pre-school children with any form of developmental delay and all forms
of neurological disability. Consultant led multi-disciplinary clinics are run on a weekly basis
including clinics for the assessment and management of autistic spectrum disorders, and
specialist outreach services e.g. for sensory impairment. Therapy, nursing and education
colleagues provide a range of group activities tailored to the needs of the current caseload.
3.
Duties of the Post
3.1
Clinical Duties
The post holder is expected to work as part of a consultant led team to deliver daytime CCH
services to the children of West Lothian. This involves:








Contribution to the Lothian child protection service
o Participation in the IRD rota.
o Attendance at Child Protection Case Conferences (CPCCs).
o Preparation of reports for CPCCs.
o Delivery of child protection medical examinations.
Delivery of CCH clinics to school aged children.
Delivery of CCH clinics to pre-school aged children.
Delivery of CCH services to meet the health care needs of children with
additional support needs, both in mainstream and in Special Schools.
Assessment of children in VALAC clinic.
Development of a special interest.
Participation in weekly allocation meeting, triaging referrals.
Contribution to CCH service developments.
There is no out of hours commitment.
The post holder is expected to participate in NHS Lothian’s medical staff appraisal process
and the General Medical Council’s revalidation process.
If further training or development to allow the post holder to fulfil the commitments in the job
description is required, this will be discussed and planned with the post holder.
3.2
Continuing Professional Development (CPD).
The Specialty Doctor will be expected to maintain his/her professional knowledge and
competencies and participate in an accredited CPD scheme, according to the requirements
of the General Medical Council.
3.3
Conditions
Annual leave and study leave allowances are in line with NHS Lothian Specialty Doctor
Terms and Conditions.
This is an exposure prone post and evidence of the relative immunities will be required by
the Occupational Health Service before permission to start work is given.
4.
NHS Lothian
NHS Lothian is an integrated NHS Board in Scotland providing primary, community, mental
health and hospital services. Mr Tim Davison is the Chief Executive and Dr David
Farquharson is the Medical Director.
The NHS Board determines strategy, allocates resources and provides governance across
the health system. Services are delivered by Lothian University Hospitals Division, the Royal
Edinburgh Hospital and Associated Mental Health Services, four Community Health
Partnerships in Edinburgh, West Lothian, East Lothian and Midlothian, and a Public Health
directorate.
University Hospitals
The University Hospitals Division provides a full range of secondary and tertiary clinical
services to the populations of Edinburgh, Midlothian, East Lothian and West Lothian. The
Division is one of the major research and teaching centres in the United Kingdom.
Hospitals included in the Division are:
The Royal Infirmary of Edinburgh
The Western General Hospital
The Royal Hospital for Sick Children, Edinburgh
St John’s Hospital
Liberton Hospital
The Princess Alexandra Eye Pavilion.
The Royal Infirmary (RIE) is a major teaching hospital on a green field site in the South
East of the city of Edinburgh built in 2003. It comprises 25 wards, 869 beds, and 24
operating theatres, and is equipped with modern theatre and critical care equipment and
monitoring. Within the main building is a dedicated, multidisciplinary, five-theatre day
surgery complex. The hospital provides for most specialities and is the centre for:
General surgery
Vascular surgery
Hepatobiliary and transplant medicine and surgery
Cardiac and thoracic surgery
Elective and trauma orthopaedics surgery
Neonatology
Obstetrics & Gynaecology
Cardiology
Renal medicine
Sleep medicine
Accident and Emergency.
There is a Combined Assessment Unit (CAU) which takes unselected GP or direct
emergency referrals, and from A&E. The CAU includes the Dept of Liaison Psychiatry and
the Scottish Poisons Bureau and Treatment Centre. There are full supporting Laboratory
and Diagnostic Radiology Services (including CT, MR, Ultrasound and NM and PET
scanning). There is a full range of lecture theatres, a library and AV facilities.
The Western General Hospital (WGH) has 600 beds and is equipped with modern theatre
and critical care equipment and monitoring. The Anne Ferguson building was completed in
2001. The hospital provides for most specialties and is the centre for:
Neurology, neurosurgery and neuropathology
UK CJD unit
Colorectal surgery
Urology and Scottish Lithotriptor Centre
Breast surgery and breast screening
Gastroenterology
Rheumatology
Infectious diseases
Haematology and oncology
Medical oncology
Radiation oncology
Dermatology (Inpatient)
Medicine of the Elderly and Stroke Medicine
There is an Acute Receiving Unit, which accepts GP referrals and 999 ambulance medical
cases on a zoned basis within the city, and a nurse led Minor Injuries Unit. There is no
trauma unit. There are full supporting Laboratory and Diagnostic Radiology Services
(including CT, MR, Ultrasound and NM).There is a full range of lecture theatres, a library
and AV facilities.
St John’s Hospital opened in 1989 and is located in the centre of Livingston, about 30
minutes drive west from Edinburgh. The hospital provides most specialties but does not
have emergency general surgery or orthopaedic trauma operating. The hospital has a
paediatric ward and is a centre for:
General Medicine with specialists in Cardiology, Diabetes & Endocrinology,
Gastroenterology, Respiratory Medicine and Care of the Elderly
Obstetrics & Gynaecology
Child Health including paediatrics and community child health
The regional Burns and Plastic Surgery unit for SE Scotland
Oral and Maxillofacial Surgery
ENT
Critical Care (ITU, HDU and CCU)
Accident and Emergency
General Surgery
Orthopaedics
Mental Health including ICCU and ICPU
Recent developments at SJH include a new endoscopy suite, an Intensive Psychiatric Care
Unit, a digital mammography unit, an oncology (cancer care) day centre, a satellite renal
dialysis unit and a £2.75m reprovision of A&E. There are full supporting Laboratory and
Diagnostic Radiology Services (including CT, Ultrasound and NM).
The hospital has been accredited full teaching hospital status by the University of
Edinburgh. There is a full range of lecture theatres, a library and AV facilities.
The Royal Hospital for Sick Children (RHSC) is a 141 bedded hospital providing general
and specialist services for children. The hospital is situated in a residential area close to the
centre of Edinburgh and is approximately three miles from the site of the New Royal
Infirmary and the co-located University of Edinburgh Medical School and three miles from
the Western General Hospital. The RHSC is the main paediatric teaching hospital for the
South-East of Scotland providing general and specialised services on a local, regional and
national basis. It acts as the local paediatric referral centre for the children of Edinburgh and
surrounding areas, and as a tertiary referral centre for intensive care patients;
gastroenterology, hepatology & nutrition; respiratory medicine; cardiology; nephrology;
neurology; oncology; haematology; neonatal surgery; plastic surgery; orthopaedic surgery;
urological surgery and all aspects of general surgery.
Hospital accommodation encompasses five theatres, a critical care unit comprising an eightbedded Paediatric Intensive Care Unit, six-bedded High Dependency Unit and a threebedded Neonatal Intensive Care Unit. There is an excellent library facility and a modern
lecture theatre with a full range of audio-visual equipment.
All services are supported by comprehensive radiology, neurophysiology, laboratory and
therapy services. The local radiology department provides on site Magnetic Resonance
Imaging, CT Scanning, nuclear scanning and ultrasound.
Community Healthcare Partnerships
The four established Lothian Community Health (and Social Care) Partnerships serve the
population of Edinburgh, Midlothian, East Lothian and West Lothian.
Hospitals in the CH(C)Ps include:
The Astley Ainslie Hospital in Edinburgh
Midlothian Community Hospital
Herdmanflat Hospital in East Lothian
Roodlands Hospital in East Lothian.
The four CHPs are co-terminous with Edinburgh, Midlothian, East Lothian and West Lothian
Councils bringing together those responsible for planning, managing and providing
community-based health services for the population of Edinburgh and the Lothians.
There are 7,500 members of staff. In addition, there are approximately 1,000 independent
contractors in General Medical and Dental Practice, as well as pharmacists and opticians. A
population of 850,000 people is served across Lothian health board area. The range of
services include care of the elderly, medical rehabilitation, community mental health,
substance misuse and learning disability, district nursing and health visiting, family planning,
well woman, comprehensive dental care and those provided by Allied Health Professionals,
such as physiotherapists, pharmacists and optometrists. Specialist services provided include
brain injury rehabilitation, bio-engineering and prosthetics, drugs and alcohol misuse and
harm reduction, AIDS/HIV and Child and Adolescent Mental Health Services.
Royal Edinburgh Hospital and Associated Services
The Royal Edinburgh and Associated Services provide a range of Mental Health services to
the population of Lothian and other Boards within Scotland.
The Royal Edinburgh Hospital is located on the south side of the City of Edinburgh. It
comprises some 20 wards, 420 beds, day hospitals and outpatient facilities. The hospital
provides the following range of specialities:Acute Mental Health
Rehabilitation
Psychiatric Emergency Team 24/7
Outpatients
Assessment Psychiatry of Old Age
Forensic Medium Security Unit
Inpatient facilities for under 18s
Psychotherapy Service
Psychology Services
Services for Eating Disorders
Day Hospitals – Psychiatry of Old Age
The hospital is currently housed in a mix of accommodation ranging from 19th century to
present. There is a major project in place to take forward a reprovisioning programme in line
with the strategic vision with the “Delivery for Mental Health” (Scottish Executive 2006).
Department of Public Health Medicine
The aim is to improve the health of the people of Lothian in collaboration with many other
partners. Using a range of knowledge, experience and networking capability, distinctive
contributions are:
the promotion of specific measures to monitor and improve health;
the collation and interpretation of health related information.
The following objectives have been agreed as the basis for the Department’s work plans:
1.
To monitor the health status and health needs of people in Lothian;
2
To promote improvements in the health of Lothian people directly, and by providing
information and advice to the public on health matters;
3.
To assist Lothian NHS Board to fulfil its statutory obligations;
4.
To contribute to strategic changes within the NHS in Lothian by providing information
on clinical effectiveness;
5.
To facilitate improvements in health and health care services directly, and through
‘managed clinical networks’ and wider alliances;
6.
To contribute on a 24 hour basis to the control and prevention of communicable
diseases and environmental hazards;
To maintain commitments to teaching, training, professional development, audit and
research.
To enable efficient management of the Department, there are four groups in the Directorate;
Healthy Communities, Healthcare, Health Protection and Health Information.
5. University of Edinburgh
The University of Edinburgh was established in 1582 and is one of the largest in the United
Kingdom located on a number of prominent sites in Scotland’s capital city. It is Scotland’s
premier research university, graded within the top six multi-faculty British Universities in the
last national research assessment exercise (90 percent of its academic staff were in units
rated 4, 5 or 5*). It has 3,000 academic staff, over 16,000 undergraduate and over 4,000
postgraduate students and an annual expenditure of over £261M for teaching and research.
The University is organised into 3 Colleges: Humanities and Social Science, Medicine and
Veterinary Medicine, Science and Engineering.
6. NHS Library and Postgraduate Facilities
There are excellent facilities on all sites.
7. Research and Development
The University of Edinburgh and Medical School have an outstanding reputation for teaching
and research and are very closely associated with NHS Lothian. Within the university
structure, the Section on Child Life and Health is based at 20 Sylvan Place, in close
proximity to Paediatric Neurology and the Community Child Health Department and forms
part of the Division of Reproductive and Developmental Sciences.
Community Child Health enjoys excellent clinical and academic links with other Allied Health
Professionals and the Universities of Queen Margaret University College and Napier
University have large undergraduate and postgraduate programmes for nursing and AHPs.
8. Teaching
Participation in Undergraduate and Postgraduate paediatric teaching and examination.
Participation in multi-agency teaching and training.
Provision and training of newly appointed medical staff and trainees
9. Indicative Job Plan
Specialty:
Principal place of work:
Community Paediatrics
Community Child Health Department, St John’s Hospital, West
Lothian.
Contract:
Full Time
Programmed activities:
10 PA – 9.0 DCC; 1.0 SPA
On call:
N/A
Managerially accountable to: Lead Professional, Community Child Health and Associate
Medical Director, Women’s and Children’s Services, NHS
Lothian.
Day
Location
Type of work
DCC
Monday
09.00 – 13.00
CCH, St John’s
Child protection IRDs
1.0
13.00 -17.00
CCH, St John’s
Child protection IRDs
Clinical administration
1.0
Community
Health Clinic
CCH clinic
1.0
CCH, St John’s
Staff meeting (monthly)
Multiagency meetings
(CPCCs/GIRFEC CPM)
Clinical administration
1.0
Community
Health Clinic/
Special school
VALAC clinic (alt weeks)
Special school clinic (alt weeks)
1.0
13.00-17.00
Thursday
09.00 - 13.00s
CCH
Core SPA
Community
Health Clinic
CCH clinic
1.0
13.00 - 17.00
CCH/other
venue
Allocation meeting
Clinical administration
1.0
Friday
09.00–13.00
CCH, St John’s
Clinical administration
1.0
13.00–17.00
CCH, St John’s
Child Protection IRDs (alt weeks)
Clinical administration
1.0
Tuesday
09.00 - 13.00s
13.00 - 17.00
Wednesday
09.00-13.00
Saturday
Sunday
SPA
1.0
10. Further information
For further information and arrangements to visit, please contact:
Dr Lesley Ross,
Consultant Paediatrician,
Department of Community Child Health,
10, Chalmers Crescent,
Edinburgh EH9 1TS
Tel: 0131 536 0471
email: lesley.ross@luht.scot.nhs.uk
Dr Edward Doyle,
Associate Medical Director,
Women’s and Children’s Services,
NHS Lothian
Tel: 0131 536 0007
email: edoyle2@nhs.net
11. Person Specification
NHS Lothian - University Hospitals Division
Person Specification Post:
Specialty Doctor - Community Child Health
Division:
Children’s Services
Location:
RHSC
Requirements
Essential
1. Qualifications
Fully registered with the General Medical
Council.
License to practice
Desirable
MRCPCH / DCH
2. Training
Minimum of four years post-qualification full
time training or equivalent.
Minimum of two years of full time or
equivalent paediatric training.
3. Clinical experience
in specialty/subspecialty
A range of clinical experience and
competence in general paediatric medicine.
Level 1 Child Protection training.
Experience in Community Child
Health
Level 2 Child Protection training
4. Research
Evidence of an understanding of the
principles and practice of medical research.
Experience of medical research
5. Teaching
Experience in training undergraduate
medical students.
Experience in training
postgraduate doctors
6. Audit
Demonstrable experience of participation in
clinical audit and the implementation of its
findings.
7. Management
Understanding of current issues and
priorities in the NHS.
8. Interpersonal skills
Demonstrable skills in working with children
and families.
Well organised
Good time management skills.
Effective interpersonal skills.
Demonstrable ability to relate to and work
within a team.
Good oral and written communication skills
Flexible and adaptable.