CG 738
NHS Lothian
Lothian University Hospitals Division
Directorate of Respiratory Medicine
Hospital Base – Royal Infirmary Edinburgh
CONSULTANT IN RESPIRATORY AND SLEEP MEDICINE
1.
Outline of the post
Further particulars for the post of Consultant in Respiratory Medicine, Lothian University
Hospitals’ Division, based at Royal Infirmary, Edinburgh. This is a locum post for 6 months.
2.
NHS Lothian
NHS Lothian is an integrated NHS Board in Scotland providing primary, community, mental
health and hospital services. Mr Tim Davison is Chief Executive and Dr David Farquharson is
Medical Director. Dr Nik Hirani is the clinical director for Respiratory Medicine
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, 4 community health (and social
care) partnerships (CH(C)Ps) in City of Edinburgh, West Lothian, East Lothian and
Midlothian, and a Public Health directorate.
NHS Lothian serves a population of 850,000.
University Hospitals Division
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 Johns Hospital
Royal Victoria Hospital
Liberton Hospital
The Princess Alexandra Eye Pavilion.
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CG 738
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, 5 theatre day
surgery complex. The hospital provides for most specialities and is the centre for:
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General surgery with a focus on the upper GI tract
Vascular surgery
Hepato-biliary and Transplant medicine and surgery
Cardiac and Thoracic surgery
Elective and trauma Orthopaedics surgery
Neonatology
Obstetrics & Gynaecology
Cardiology
Renal Medicine
Sleep Medicine
Regional major Accident and Emergency centre.
There is a Combined Assessment Unit which takes unselected GP or direct emergency
referals, and from A&E. 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
will be available in 2008). There is a full range of lecture theatres, a library and AV
facilities.
The Western General Hospital (WGH) has 600 beds and 5 operating theatres 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:
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Neurology, Neurosurgery and neuropathology
UK CJD unit
Colorectal Surgery
Urology and Scottish Lithotriptor Centre
Breast Surgery and Breast screening
Gastro-Intestinal disease
Rheumatology
Infectious Diseases
Haematology Oncology
Medical Oncology
Radiation Oncology
Dermatology (Inpatient)
Medicine of the Elderly/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 at this hospital. 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.
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CG 738
St John’s Hospital opened in 1989 and is located in the centre of Livingston, a new town
about 30 minutes drive west from Edinburgh. The hospital provides for most common
specialties but does not have emergency general surgery or orthopaedic trauma
operating. The hospital has a paediatric ward and is the centre for:
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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
Anaesthetics
Mental Health including ICCU and ICPU
Since 2005 general surgery and orthopaedics have been reconfigured in NHS Lothian
with SJH being developed as a major elective centre for the region. Lothian’s ENT service
was relocated to SJH to create an integrated head and neck unit with OMFS and Plastic
Surgery.
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 3 miles from the site of the New
Royal Infirmary and the co-located University of Edinburgh Medical School and 3 miles
from the Western General Hospital. The RHSC is a 151-bedded Hospital, and 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 aspects of general
surgery.
Hospital accommodation encompasses five theatres, a critical care unit comprising a 6/8
bedded Paediatric Intensive Care Unit, 4/6 bedded High Dependency Unit and a 3
bedded 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. On site laboratories provide
biochemistry, haematology, pathology and neuropathology services
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CG 738
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
Rosslynlee Hospital in Midlothian
Herdmanflat Hospital
RoodlandsHospital in East Lothian.
The four CHPs are coterminous 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 health board area. The
range of services 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 Professions
Allied to Medicine, such as physiotherapy, pharmacies and optometrists. Specialist
services provided include brain injury rehabilitation, bio-engineering and prosthetics,
drugs and alcohol misuse and harm reduction, AIDS/HIV and Children and Family
Psychiatric Services.
Royal Edinburgh hospital and Associated Services
The Royal Edinburgh and Associated Services provides 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:
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Acute Mental Health
Rehabilitation
Psychiatric Emergency Team 24/7
Outpatients
Assessment Phychiatry 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
There are an additional 46 bed and 1 day hospitals for Psychiatry of Old Age in the north
of the city at the Royal Victoria Hospital.
The hospital is currently housed in a mix of accommodation ranging from 19th century to
present. There is a major project now in place to take forward a reprovisioning
programme in line with the strategic vision with the “Delivery for Mental Health” Scottish
Executive 2006.
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CG 738
Department of Public Health Medicine
The aim is to improve the health of the people of Lothian in collaboration with many other
partners. Using our range of knowledge, experience and networking capability, our distinctive
contributions are:
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the promotion of specific measures to monitor and improve health;
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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;
7. To maintain commitments to teaching, training, professional development, audit and
research.
To enable efficient management of the Department: there are at present four groups in the
Directorate. These are; Healthy Communities, Healthcare; Health Protection and Health Information.
3. 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.
4. NHS Library and Postgraduate Facilities
There are excellent facilities on all sites.
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CG 738
5.
Departmental Information:
This new post is based at the Royal Infirmary of Edinburgh. To facilitate appropriate levels of
cover at the acute sites, the on call duties are at the Western General Hospital. There will be
cross city cover by the Respiratory consultants of the Royal Infirmary and Western General
between 22.00 and 08.00h.
There are four other F/T NHS respiratory consultants and five senior university staff (who each
contribute 50% clinical work), based at the RIE:
Professor Christopher Haslett, University of Edinburgh (clinical work at WGH).
Professor William MacNee; University of Edinburgh.
Professor Moira Whyte; University of Edinburgh.
Dr Sarah Walmsley; University of Edinburgh.
Dr Nikhil Hirani; University of Edinburgh.
Dr Kev Dhalliwal; University of Edinburgh
Dr Tracey Bradshaw
Dr Tom MacKay (Director Sleep Medicine Unit)
Dr Adam Hill
Dr Renata Riha
Dr Kris Skwarski
Dr John MaCafferty
Subspecialty interests on this site are; sleep disorders; interstitial lung diseases; lung cancer;
bronchiectasis; tuberculosis; COPD; asthma; pleural; disease; thromboembolic disease.
The RIE is supported by two respiratory staff grades, up to 7 respiratory specialist trainees and 5
respiratory nurse specialists
There are 7 other F/T NHS respiratory consultants based at the WGH:
Dr Alastair Innes (clinical lead; director of the pulmonary function services; honorary reader,
University of Edinburgh)
Dr Maeve Murray
Dr Peter Reid (CD respiratory and medicine for the elderly)
Dr Helen Rodgers
Dr Andrew Leitch (respiratory and acute medicine)
Dr Phil Reid (respiratory and acute medicine)
Dr Fredereike Boellart (respiratory and acute medicine)
Dr Gareth Stewart (respiratory and acute medicine)
Subspecialty interests on this site are; Cystic Fibrosis (national adult service); lung physiology;
occupational lung disease; interstitial lung disease; lung cancer; pleural disease
There are three (pending 4) F/T NHS respiratory consultants (with a contribution to acute
medicine), based at St John’s Hospital:
Dr Anna Lithgow
Dr Donald Noble
Dr Iain Murray
Lothian Respiratory Services
Associate Medical Director
Clinical Director
Dr Andrew Flapan
Dr Nik Hirani
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CG 738
Lothian Respiratory Services are well developed and provide extensive subspecialty interests, a
number of which provide support Scotland wide. There is a very strong linkage with the University
services, and Respiratory Medicine is at the forefront of basic and clinical research in Edinburgh.
Services are currently provided on three adult sites in NHS Lothian (1) Royal Infirmary of
Edinburgh (2) Western General Hospital, and (3) St John’s Hospital in West Lothian. Tertiary
services are delivered from the RIE & WGH sites.
There are two principal pulmonary function laboratories based at the Royal Infirmary and
Western General, with some supporting lung function measurement at St Johns.
Service bases are as follows:
Royal Infirmary:
Inpatient bed areas designated in Ward 204: 48 beds
Pulmonary Function Laboratory.
Western General:
Inpatient bed areas designated in Ward 54: 29 beds mixed respiratory/acute medicine plus 6
cardiology beds.
Pulmonary Function Laboratory.
St John’s:
Inpatient beds are part of the general medical admissions service. There is currently in process
work to try to place respiratory patients in one principal area.
RIE
A&E
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Acute Receiving
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Hospital at Night
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Acute Respiratory Ward
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Mixed medical/Respiratory ward
WGH
St John’s
Current Services Provided
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Pulmonary Function Laboratory
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Outpatient Services
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Bronchoscopy
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EBUS
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Lung Surgery
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Cancer Centre
6. Remit of the Post
The successful applicant will be expected to support Respiratory and Sleep Services in the RIE
for a fixed period to cover sick-leave. He/she will be expected to maintain the current sleep
service and contribute to the general respiratory service including on-call commitments (1 in 12
for respiratory medicine)
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CG 738
7. Research and Development
As part of their SPA allocation, the successful applicant will be strongly encouraged and
supported in pursuing research interests. Although this is primarily a clinical service post, a
proven ability to combine clinical research with clinical care will be an advantage and will be
supported. The successful candidate will also be expected to be involved in audit and to
contribute to the administrative activities of the department.
8. Teaching
The successful applicant will be expected to participate fully in undergraduate teaching and
postgraduate training. The successful applicant will be expected to be an educational supervisor
for Foundation Doctors and to provide training in airways diseases to Specialist Registrars
rotating through the Lothian training programme.
The University of Edinburgh may offer the successful candidate an appropriate honorary
appointment. In certain circumstances, where the Consultant has major responsibilities for
organising teaching or has a research interest beyond the standard expectations for NHS posts,
he/she may be offered an honorary Senior Lecturer appointment. Appopriate SPA allocation for
teaching and research would be negotiated during job planning to reflect individual
circumstances.
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9. Job Plan
This post has a basic 10PA contract. Two extra-programmed activities may be available if clinical
demand dictates. On call for Respiratory Medicine, including this post, is 1:9.
Should the successful candidate wish to work EPAs and there were two EPAs available, the job plan
would be the following:
DAY
TIME
Monday
Base
09:00 – 17:00
On-call 1:10
09:00 – 12:00
Tuesday
Base
13:00 – 17:00
Wednesday
Base
Thursday
Base
Friday
Base
Saturday
Base
1:10 on-call
Sunday
Base
1:10 on-call
08:45 – 09:30
09:30 – 13:00
13:30 – 17:00
08:30 – 12:30
13:00 – 17:00
08:30 – 10:30
10:00 – 12:00
13:00 – 14:00
13:00 – 18:00
08:30 – 12:00
16:30 – 20:00
Cross-town
cover
20:00/22:00 –
08:30
08:30 – 12:00
16:30 – 20:00
Cross-town
cover
20:00/22:00 –
08:30
TYPE OF WORK
Admin related to DCC
Combined consultant ward round
Research and teaching
Weekday on call additional DCC
Sleep clinic
Sleep administration and direct patient
care
Research and teaching
1.5
0.5
X-ray meeting
Ward round/other sleep work
Respiratory OPD
Respiratory clinic administration
SPA: teaching and research
Sleep OPD
0.25
0.75
Administration
Sleep MDM
Consultants’ meeting
Sleep OPD alternate weeks
Medical Admissions / A&E / HDU
/ Ward 204
0.5.
0.5
0.25
0.5
0.26
Medical Admissions / A&E / HDU
/ Ward 204
0.26
Total PA’s
AD=Additional Responsibilities
ED =External Duties
(Please specify)
SPA
EPA
Other
Categories
AD OR ED
1
0.48
1
0.25
1
1
0.5
0.5
1
12
Out of Hours PA’s
TOTAL:
10.
DCC
12
Further Information
For further details and arrangements to visit please contact:
Dr. Andrew Flapan, acting Head of Service, Cardiac, Thoracic & Respiratory Medicine Services, LUHD
Tel: 0131 242 1855
Or Dr Nik Hirani Respiratory Medicine, LUHD .Tel 0131 242 1873
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11. Person Specification
Requirements
Qualifications and
Training
Essential
Desirable
GMC Registered medical
practitioner. Be on, or be eligible for
inclusion on the GMC Specialist
Register.
CCT in Respiratory Medicine and at
least level 2 competency in General
Medicine
General respiratory experience
Subspecialty experience within
respiratory medicine, in the areas of
Sleep medicine
Ability to take full responsibility for
independent management of
respiratory patients. Ability to work
collaboratively in the context of a
multidisciplinary team setting
Additional postgraduate
qualifications, e.g. MD, PhD.
Additional training in aspects
of airways disease
management
Research
Track record of completing clinical
or basic audit or research.
Teaching and Audit
Evidence of formal and informal
teaching and training of junior
doctors, medical students and other
clinical staff.
Evidence of learning and
continuous professional
development
Committed to patient focused care.
Ability to work well with colleagues.
Good communication skills.
On call requirement for a 1:12 rota
without prospective cover, for
respiratory medicine, daytime and
evening. Provision of
comprehensive sleep service in
conjunction with colleagues
Original contribution to
respiratory research. Has
attracted research funding for
respiratory research
Experience in undergraduate
teaching.
Experience of designing and
effecting audit programmes
Relevant Experience
Ability
Personal Attributes
Circumstances of Job
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Extensive sleep experience
including uncommon sleep
disorders
Ability to lead new
developments in sleep
medicine
Experience of working in
multidisciplinary teams