Important Job Application Information
Thank you for your interest in NHS Tayside vacancies.
Please see below Job Description/Specification and General Conditions of Service.
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Please return your completed Application Form to recruitment.tayside@nhs.net (quoting the
Post Reference Number in the subject box) or to the postal address given on the General
Conditions of Service.
All completed applications are held in Human Resources until the closing date. After the
closing date a panel will meet to prepare an interview shortlist. Once this decision has been
made, all shortlisted applicants will be emailed to invite them to attend for interview. It is
important that you check your emails regularly, including your spam/junk box.
This process takes approximately six weeks. Therefore, if you have not been contacted
regarding interview within six weeks of the closing date, your application has been
unsuccessful and you will receive no further correspondence from Human Resources.
ADDITIONAL INFORMATION:Find out more about living and working in Tayside at:
www.dundeecity.gov.uk
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www.pkc.gov.uk
NHS TAYSIDE – AGENDA FOR CHANGE
JOB DESCRIPTION
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JOB IDENTIFICATION
Job Title
Department(s)/Location
Senior Clinical Vascular
Physiologist
Vascular Laboratory
Number of job holders
3
JOB PURPOSE
The Vascular Laboratory provides a diagnostic specialist vascular imaging service and a
range of other specialist non invasive vascular assessments across Tayside and Fife.
Locally these satellite services cover the vascular outpatient clinics in addition to its main
base. It also provides diagnostic vascular cover for the vascular operating theatre; A/E and
emergency ward admissions.
It provides a wide range of specialist ultrasound investigations and a wide range of other
specialist non invasive vascular assessments (NIVA). It produces clinically relevant and
accurate diagnostic reports for each patient. It provides an autonomous surveillance
service for several vascular procedures to include EVAR, Haemodialysis access, AAA
surveillance.
There is a commitment to the training of vascular technicians, medical students, medical
staff, Radiology registrars and trainee sonographers. It is approved for the teaching and
assessment of students in CASE approved Ultrasound courses.
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ORGANISATIONAL POSITION
The staffing of the Vascular Laboratory consists of this post, 3 other senior vascular
physiologists, 1 vascular physiologist, a clinical specialist, a clinical support worker and
1.5 WTE administration/clerical members of staff.
Head of Vascular and Respiratory
Clinical Vascular Specialist
TAYSIDE – NW and PRI
1.6 Senior Vascular Physiologists
Band 7 (this post)
FIFE - VH Kirkcaldy
1.5 Senior Vascular Physiologist,
Band 7
1.0 WTE Vascular Physiologist, Band 6
1.0 WTE Vascular
Physiologist, Band 5
1.0 WTE Clinical Support
Worker, Band 3
1 WTE Secretarial
Staff
0.6 WTE
Secretarial Staff
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SCOPE AND RANGE
This post is based within the Vascular Laboratory although the post holder is expected to
work autonomously in the clinics at PRI and VHK Kirkcaldy, performing a wide range of
non invasive vascular assessments, including cerebrovascular and lower limb duplex scans,
Ankle Brachial Pressure measurements (ABPIs), aneurysm assessment and aneurysm
surveillance, and producing a complex diagnostic report. Over 20,000 vascular studies are
performed annually by vascular laboratory staff across both Tayside and Fife.
The post holder will also communicate with other key staff to include:
Medical / Surgical / Nursing / Radiology / Support Services / Health and Safety and Risk
assessment.
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MAIN DUTIES/RESPONSIBILITIES
To provide specialist vascular assessments for Tayside and Fife.
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Planning & Organisational
Responsible for managing their own daily workload within the vascular laboratory
and at the satellite clinics
Responsible for co-ordinating vascular and respiratory workload as required
Communicates with scientific, technical and clerical staff as required on a daily basis
to facilitate the smooth running of both departments and to deliver high quality
patient care
Professional
To provide a high quality, safe and supportive environment for the patients, meeting
the identified physical and psychosocial needs
Ensuring that all patients’ investigations are carried out sensitively, and
professionally, meeting the requirements of the Trust, accreditation bodies (ERS,
SVT, BMUS or UKAS), SIGN guidelines and locally agreed protocols for both
respiratory and vascular
Induction Standards & Code of Conduct
Your performance must comply with the national “Mandatory Induction Standards
for Healthcare Support Workers in Scotland” 2009; and with the Code of Conduct for
Healthcare Support Workers.
This post requires PVG Scheme Membership/Disclosure Scotland Check.
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Educational
Attends relevant training courses, seminars, tutorials and conferences as required to
maintain a high level of knowledge and skills
Ensure that on-going personal development and professional education / research
needs are identified and met and that up-to-date personal portfolio of CPD points
available for review
Clinical (85%)
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To produce autonomously a detailed clinical report for each patient and ensuring that
this will be communicated to the referring clinician
To perform a wide range of specialist vascular assessments on patients with a range
of vascular disease and to analyse, interpret and report the result without supervision
To perform a range of respiratory assessments as required by clinical specialist
To use professional judgement when to act upon the results of an investigation and
inform the senior laboratory staff
To provide and expert clinical opinion to support management of the patients
To take full responsibility for patients during the course of each investigation and to
ensure patient safety and well being at all times
To explain the investigation, answer questions and provide reassurance to patients
and relatives relating to the procedure being performed
To provide advice on non-clinical management of the condition including motivating
and
encouraging healthier lifestyle changes
To ensure that the equipment used is functioning reliably, well maintained, and
calibrated if required
To maintain patient confidentiality, only disclosing information to appropriate
persons
Specialist ultrasound scans include:
Cerebrovascular to include: diagnostic carotid and vertebral artery assessment, preoperative marking and post-operative surveillance. These scans require an
extremely high degree of accuracy, as patients will proceed to major surgery (carotid
endarterectomy, surgical re-exploration etc) or may have surgery cancelled as a direct
result of the report generated by the post holder. No additional imaging is usually
performed prior to the patient being listed for surgery.
Venous to include: chronic venous insufficiency assessing patency and competency,
possible DVT, Chronic leg ulcers. Varicose vein treatment is planned on the basis of
the scan performed by the post holder, and the consultant vascular surgeons
frequently require expert opinion as the most appropriate treatment for the patient.
The post holder also performs ultrasound assessment of the suitability of the
superficial veins in the lower and upper limbs for use in bypass grafts. If no suitable
is identified, the patient will generally not be offered surgical reconstruction.
Graft surveillance to monitor the patency of an arterial bypass graft from its
immediate post operative appearance and at regular intervals for a period of up to
2years. These surveillance procedures often replace surgical outpatients
appointments and the findings may influence patient management. This autonomous
post allows direct referral to clinics and radiological services if required. If a graft
stenosis is not recognised and the graft occludes, the usual outcome for the patient is
an above knee amputation.
EVAR and AAA assessments. Post aneurysm repair requires a complex assessment
of the aortic stent, the sensistivity and specificity of this test within this hospital
negates the need for CT surveillance
The post holder must also provide a wide range of other specialist Non Invasive
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Assessments (NIVA) to include:
Ultrasound assessment of the abdominal aorta
Digital cooling
Ankle Brachial Pressure Indices
Exercise testing
Segmental pressures
Toe / finger pressures
Research and Development (5%)
Assists with the introduction of new apparatus and new or modified techniques,
under the guidance of senior officers as required
Contributes to the development and maintenance of departmental protocols,
procedures and patient information as required
Participates in research activities as directed eg testing of new equipment,
development of new protocols
Administration (10%)
Responsibilities for information resources:
The post holder is fully conversant with the vascular laboratory database
Responsible for writing their own factual report
Responsible for organising routine follow up on post operative patients
Responsible for informing the clinical specialist or scientist of any abnormal findings
that might affect patient management or require further investigation with a view to
possible intervention.
COMMUNICATIONS AND RELATIONSHIPS
The post holder must have good communication skills with patients, relatives and
carers, as the post holder provides and receives highly complex, sensitive or
contentious information, where persuasive, motivational, negotiating, training,
empathic or reassurance skills are required.
The post holder must be able to maintain an effective working relationship with staff
from all sectors of the Medical Physics department, Trust and University.
Communication frequently involves cultural and language difficulties, dealing with
patients with physical and/or mental special needs, very sick patients, elderly or frail
patients. This frequently involves, tact, persuasive skills and dealing with sensitive
information, eg many patients have extensive cardiovascular disease and a high
degree of empathy is required. When the patient presents for the procedure, the post
holder will explain what will happen, answer patient or relatives’ queries and
questions, identify the patient, and ensure that the correct test has been requested.
The post holder communicates practical topics to immediate colleagues such as
training colleagues in manual handling and/or CPR. The post holder communicates
with senior technical, scientific and clinical colleagues, passing on information
regarding technical difficulties encountered and receiving guidance and instruction in
return.
Internal Communication links:
Medical / Surgical staff
Nursing staff
Radiology staff
Health and safety
Risk management
Vascular and Respiratory teams
External Communication links:
Patients, carers and relatives
Community Health Practitioners
General practitioners
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KNOWLEDGE, TRAINING AND EXPERIENCE REQUIRED TO DO
THE JOB
The post holder should have developed a general vascular knowledge, underpinned
by theory and experience.
Knowledge:
General knowledge of anatomy and physiology with a Specialist indepth knowledge
of the anatomy and physiology of the circulation including the pathology and
aetiology of vascular disease
Specialist knowledge of the haemodynamics of blood flow
Specialist knowledge of ultrasound instrumentation and the physics and principles of
ultrasound
Specialist knowledge of, and ability in, the principles of vascular technology
including the ability to get high quality images, velocities and waveforms from all
parts of the peripheral circulation and the ability to interpret normal and pathological
data in order to make
General knowledge of vascular anatomy and pathology and aetiology of vascular
disease.
Good knowledge of safety issues including safe use of ultrasound, basic electrical
safety, data protection, infection control, CPR and manual handling/lifting
techniques.
Specialist knowledge of anatomy and physiology of respiratory system and the
impact of disease processes
Conversant in current documentation regarding moving and handling and CPR
Training
A minimum of BSc in a physiology or physiology degree is essential and the post
holder will also have a relevant post-graduate (MSc) specialist qualification (CASE
approved PG certificate in vascular ultrasound, SVT or equivalent ) with substantial
relevant clinical experience. There will be a significant in –house training and
appraisal system to monitor progress.
If this post is recruited as a trainee post The post holder will be expected to work
towards the relevant post graduate qualification
Experience
Technical skills:
The post holder should be actively practising as a Clinical Vascular Physiologist as
their primary skill and have extensive ultrasound experience.
They must be fully competent in the following investigations:
Carotid and vertebral arteries
Peripheral upper and lower limb arterial duplex
Peripheral upper and lower limb venous duplex
Graft surveillance
Aortic aneurysm surveillance
The post holder will also be expected to be able to fulfil the following duties:
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Aortic aneurysm surveillance
Ankle-brachial pressure indices
Exercise testing
Segmental pressures
Clinical skills
Excellent patient handling skills
Excellent communication skills
Ability to take a relevant patient history and apply the information to follow the
appropriate examination protocol.
Ability to assess complex information both during and after a scan, and draw
conclusions to form a diagnostic report that has both quantitative and qualitative
components
Ability to respond calmly and competently, but with vital speed, in the event of
patient problems occurring during an investigation, notably how to perform CPR and
to know when to refer the patient for an immediate clinical opinion.
A knowledge of relative and absolute contraindications to investigations
Numeric and accuracy of a high standard in interpreting and analysing patient data.
An understanding of the conditions affecting the scheduling of patients within the
vascular laboratory such as emergency admissions, theatre bookings and information
contained on the request form.
Ability to work to agreed protocols and procedures.
Ability to work under regular pressure.
A knowledge of relative and absolute contraindications to investigations
Must maintain confidentiality and dignity of the patient at all times
SYSTEMS AND EQUIPMENT
The post holder is required to operate sophisticated and expensive ultrasound
equipment and associated specialised computers to obtain diagnostic images and
information
Responsible for the safe use of the equipment within the vascular all of which
require specific training
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Responsible for input of reports in the system database, which will then be available
for viewing by medical practitioners across the whole of Tayside on the Clinical
Portal.
Responsible for the calibration of equipment (eg treadmill)
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Equipment used:
Siemens S2000 ultrasound scanner
Sonosite ultrasound scanner
Huntleigh Doppler assist
Parkes continuous wave Doppler
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Moving and handling equipment:
Wheelchairs
Glidesheets
Electric/ manual couches
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Software used:
Microsoft Windows 2000 (incl Word, Excel, Powerpoint, Access etc)
Microsoft Windows 7 (incl see above)
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Vascular Database
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Systems:
Maintenance of accurate patient records and reports
Vascular laboratory administration system
General hospital reports system (Clinical Portal)
Radiology Imaging system
Responsibility for Records Management
All records created in the course of the business of NHS Tayside are corporate
records and are public records under the terms of the Public Records (Scotland) Act
1937. This includes email messages and other electronic records. It is your
responsibility to ensure that you keep appropriate records of your work in NHS
Tayside and manage those records in keeping with the NHS Tayside Records
Management Policy and with any guidance produced by NHS Tayside specific to
your employment.
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PHYSICAL DEMANDS OF THE JOB
Physical effort:
Maintaining awkward static postures with extended arm position under tension for
periods of up 5 minutes, 20-30 times per investigation in order to acquire images
and make measurements
Manual dexterity of a high order with excellent hand/eye co-ordination enabling
fine manipulation of the ultrasound probe and simultaneous manipulation of
machine controls to optimise the images and information obtained.
Turning and twisting of back and neck to view monitor whilst stretching to
simultaneously manipulate controls and acquire images.
Performance of vascular scans requires fine manipulation of the position and
orientation of the ultrasound probe on the patient’s skin (to millimetre accuracy) to
produce the correct image and simultaneous manipulation of up to 20 controls on
the scanner involving hand-eye co-ordination of the highest order.
The majority of vascular patients are physically limited (amputation, stroke, post
operative, etc) and require significant physical effort to transfer from trolleys and
wheelchairs to an examination couch.
Assisting patients with dressing and undressing
Removing and re applying wound dressings
Supporting and assisting patient on treadmill tests
Cleaning of machines and examination couches/changing linen on couches
Heavy equipment is moved on a regular basis throughout the working day,
including ultrasound scanners, couches, trolleys and wheelchairs
Constant standing for periods of up to 30 minutes for the duration of some
assessments.
Mental effort:
There is a frequent requirement for concentration where the work pattern is
unpredictable. There is also a frequent requirement for intense concentration for
short periods in order to analyse and interpret audible Doppler signals.
Planned work is subject to frequent interruption throughout the day
Able to utilise complex computer software required for these assessments
Emotional effort:
Communication with distressed / anxious patients and relatives
Communication with verbally /physically abusive patients
Communication of complex issues with the multidisciplinary team
Communication with all staff and supporting their needs
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Working conditions:
Significant exposure to body fluids and odours (weeping wounds, gangrenous toes
/feet, ulcers etc)
Dealing with patients with faecal incontinence, urine catheters, soiled bedding, etc
Significant risk of infection or cross infection
Excessive heat in clinical areas due to heat output from equipment.
Excessive cold room temperatures for certain studies (13˚C) for periods of up 40
minutes - digital cooling and CRPS studies.
Constantly working in low level lighting with VDU equipment either whilst
assessing the patient using the u/s machine or writing the patient report.
DECISIONS AND JUDGEMENTS
The post holder:
Within each patient investigation the post holder is free to adapt or extend the scan
depending on the observations and measurements made during the scan.
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Reports any significant clinical finding to the clinical specialist.
Takes full accountability/responsibility for own actions/decisions.
Works as an autonomous practitioner and is responsible for management of their
own patient workload within each day.
Issues a full clinical report under their own name for each patient.
Is able to alter patient appointment times to adjust the workload.
Analytical and judgement skills required for the post:
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Using all the information obtained to write a full factual report of the investigation,
indicating any difficulties (technical or patient related) leading to limitations for a
full diagnosis
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Deciding when the normal procedure needs to be adapted and when to refer to
senior staff for further investigation
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Deciding when the normal procedure needs to be adapted and the scan (assessment)
be extended or curtailed including deciding what other areas need to be scanned.
Continually analysing and interpreting complex information obtained from the scan
as it is performed, in order to form a vascular diagnosis and to make accurate
measurements to illustrate the pathology seen.
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Using all the information obtained to write a full diagnostic clinical report of the
investigation, indicating any difficulties (technical or patient related) leading to
limitations for a full diagnosis.
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Deciding when the scan is finished, ie when sufficient diagnostic information has
been obtained or the maximum information available has been obtained.
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Determining the urgency of the scan from the information supplied on the referral.
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Using measurements and tables to calculate and determine disease states.
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Judging when an urgent medical opinion is needed based on the results of a scan,
eg an occluded graft is found.
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Knowing when to refer to other experts for advice and using own discretion to
suggest further investigation if scan result considered incomplete or inconclusive
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Using the verbal history and notes on the request form to decide on the appropriate
assessment and knowing when to consult with the referring doctor if information or
clarification is required.
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Prioritising the workload, especially of inpatients.
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Patient related
Assessment must be made of patient status and suitability for a particular
investigation, including assessing patient safety during treadmill testing.
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Judging the need to remove clothing and bandaging in order that adequate and
necessary information may be obtained.
Determining when an assessment should be stopped, based on observable clinical
indicators.
Machine related
Based on the size and status of the patient and the investigation requested the post
holder must choose the correct ultrasound probe to apply to the skin and make
continuous adjustment of the scanner controls throughout the investigation in light
of the observations made.
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MOST CHALLENGING/DIFFICULT PARTS OF THE JOB
To provide a high quality diagnostic service, both in terms of accuracy and technical
complexity.
Acquiring and processing complex diagnostic images and data using specialised
equipment and computer software, and deciding if further imaging is required.
These data are then used by the post holder to generate reports which consultants
will use to formulate patient management decisions.
To be responsible for the accurate documentation of factual reports and correlation
with previous results which may impact on patient management
Dealing with heavy workloads on a daily basis due to large clinical demand,
unusual disease profiles, etc
To develop excellent communication channels between members of the
multidisciplinary team
Time management.
Addressing the equality and diverse needs of patients and staff.
To provide a high quality diagnostic service, both in terms of accuracy and technical
complexity
To be responsible for the interpretation and reporting of investigations and accept
the level of responsibility associated with medical and surgical management plans
often being based solely on results
Dealing with heavy workloads on a daily basis due to large clinical demand,
unusual disease profiles and a varied scan distribution weighted towards urgent
inpatient referrals and pre operative and managing these patient together with
routine outpatient assessments.
To develop excellent communication channels between members of the
multidisciplinary team.
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JOB DESCRIPTION AGREEMENT
The job description will need to be signed off using the attached sheet by each post
holder to whom the job description applies.
PERSON SPECIFICATION
POST REF NO:
D/CH/118/15
JOB TITLE/BAND:
SPECIALIST CLINICAL VASCULAR PHYSIOLOGIST,
BAND 7
LOCATION:
VASCULAR LABORATORY, NINEWELLS HOSPTIAL
HOURS:
37.5 PER WEEK
CRITERIA
ESSENTIAL
DESIRABLE
EXPERIENCE:
Experience of working in a
vascular setting and familiar with
ultrasound assessment to include
Cerbrovascular, Peripheral
arterial, Peripheral venous
Graft surveillance
Experience of working
within a vascular laboratory
setting
Evidence of working in an
autonomous capacity
Experience in quality control
BSc in relevant discipline
(eg physiology, radiography)
Post graduate training in
vascular laboratory
QUALIFICATIONS:
(Training; Research;
Publications)
Experience in carrying out
audit.
Work towards a post graduate
(MSc) in a CASE approved
course for Vascular Ultrasound
KNOWLEDGE &
SKILLS:
Masters level knowledge of:
vascular anatomy and physiology
Aetiology of disease processes
Excellent communication skills
Knowledge of the role of
vascular laboratory in the
assessment and
management of patients
with vascular disease
Knowledge of vascular
surgical procedures and
ultrasound assessment of
these procedures
PERSONAL QUALITIES:
Ability to follow Standard
Operating procedures (SOP)
Ability to work autonomously
taking a patient history and
relating this to u/s findings and
notifying clinical specialist
accordingly
High standard in the
interpretation of patient data
Understanding of booking
systems and surveillance
programmes
Ability to work as part of a MDT
Ability to identify and address own
learning needs
Good organisational skills
Ability to recognise own limitations
and when to ask for help
OTHER:
(eg travel across Tayside)
Flexibility in working hours to suit
the demands of the service
Maintain up to date CPD
Support training schemes as part
of the medical school
General Conditions of Service
POST REF NO:
D/CH/118/15
JOB TITLE/GRADE:
SENIOR VASCULAR PHYSIOLOGIST, BAND 7
LOCATION:
VASCULAR LABORATORY, NINEWELLS HOSPITAL
Conditions of Service
Remuneration
Hours of Duty
Superannuation
The terms and conditions of service for this post are those
determined by the NHS Staff Council.
The current salary scale for the post is £31,383 to £41,373 per
annum (pro rata for part-time staff). Placing on the scale on
appointment is normally at the minimum but may be higher
subject to verification of previous relevant service.
Salary is paid monthly by Bank Credit Transfer.
The hours of the post are 37.5 per week.
Start and finish times will be determined by the needs of the
service.
Membership of the NHS Superannuation Scheme is not
compulsory but is open to all staff between the ages of 16 and
70 (65 in some instances).
The contributions paid are a percentage of superannuable pay,
which is essentially basic pay excluding, for example, overtime
or travelling expenses.
Contribution rates with effect from 01.04.15 are as follows:
Annual Pensionable Pay
(Full-time equivalent)
Up to £15,828
£15,829 to £21,601
£21,602 to £27,089
£27,090 to £49,967
£49,968 to £71,337
£71,338 to £111,376
£111,377 and over
Annual Leave
Contribution
5.2%
5.8%
7.3%
9.5%
12.7%
13.7%
14.7%
Contributions are subject to tax relief and reduced National
Insurance contributions. NHS Tayside also makes a substantial
contribution towards scheme benefits – currently around 14% of
basic pay.
On appointment = 27 days (pro rata for part-time Staff) or 5.4
weeks per year.
After 5 years aggregated service = 29 days (pro rata for part-time
staff) or 5.8 weeks per year
After 10 years aggregated service = 33 days (pro rata for parttime staff) or 6.6 weeks per year
References
Public Holidays = 8 days (pro rata for part-time staff) or 1.6
weeks per year
All offers of appointment are subject to receipt of two satisfactory
references.
Occupational Health
Clearance
All offers of appointment to new entrants to the National Health
Service are subject to a medical examination. Medical
examinations are arranged and undertaken by the Occupational
Health and Safety Advisory Service (OHSAS).
Rehabilitation of
Offenders Act 1974
(Exclusions and
Exceptions) (Scotland)
Order 2003
All current or spent criminal convictions, cautions, warnings or
any case pending must be disclosed prior to commencing in
employment as detailed on the application form.
Disclosure Scotland
Immigration, Asylum and
Nationality Act 2006
Please note that having a conviction will not automatically debar
you from obtaining employment with NHS Tayside. Careful
consideration will be given to the relevance of the offence to the
particular post in question. However, if you are appointed, and it
is found that you did not reveal a previous conviction your
employment may be terminated.
The successful applicant will be required to become a member of
the Protecting Vulnerable Groups Scheme (PVG) in respect of
regulated work with protected adults and regulated work with
children.
It is a criminal offence for an employer to employ anyone who
does not have permission to live or work in the UK.
Shortlisted applicants will be asked to produce specific original
documentation at interview eg Passport, or full birth certificate
together with an official document giving the applicants
permanent National Insurance Number and name issued by a
Government Agency or a previous employer, as well as
photocopies of these documents.
Professional Registration/ New entrants to NHS Tayside will be required to achieve the
Induction Standards &
mandatory Induction Standards for Healthcare Support Workers
Code of Conduct
(HCSWs) in Scotland and comply with the Code of Conduct for
HCSWs throughout your employment.
Internal candidates will be required to comply with the Code of
Conduct for HCSWs
Smoking Policy
NHS Tayside operates a No Smoking Policy and smoking
is prohibited within NHS premises and grounds.
Applications
Completed forms should be returned to:
recruitment.tayside@nhs.net quoting the job reference in the
subject line or to Human Resources Directorate, NHS Tayside,
Level 9, Ninewells Hospital, Dundee DD1 9SY
By closing date of 11 December 2015
Once this decision has been made, all shortlisted applicants
will be emailed to invite them to attend for interview. It is
important that you check your emails regularly, including your
spam/junk box.