NHS Lothian
Children’s Services
Royal Hospital for Sick Children
Consultant Paediatric Surgeon
1. Outline of the post
This is a substantive post available from 7th Jan 2015.
The post is based at the Royal Hospital for Sick Children, Edinburgh with out of hours work there. The
job plan will include sessions at St John’s Hospital, Livingston and Borders General Hospital, Melrose.
There will be the opportunity to develop sub–specialty interests to complement those in the department.
2. NHS Lothian
NHS Lothian is an integrated NHS Board in Scotland providing primary, community, mental health and
hospital services. Tim Davidson is Chief Executive and Dr David Farquharson is 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, 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
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
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 which takes unselected GP or direct emergency referrals, 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:
Neurology, neurosurgery and neuropathology
UK CJD unit
Colorectal surgery
Urology
Breast surgery and breast screening
Gastroenterology
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.
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:
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
Plastic Surgery
Oral and Maxillofacial Surgery
ENT
Critical Care (ITU, HDU and CCU)
Accident and Emergency
General Surgery
Orthopaedics
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Anaesthetics
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;
endocrinology; oncology; haematology; neonatal surgery; plastic surgery; orthopaedic surgery; spinal
deformity surgery; urological surgery and general surgery.
Hospital accommodation encompasses five theatres, a critical care unit comprising an eight-bedded
Paediatric Intensive Care Unit, a six-bedded High Dependency Unit and a three-bedded Neonatal
Surgical Unit. There is an excellent library facility and a modern lecture theatre with a full range of audiovisual 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 and haematology services
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
Roodlands Hospital 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
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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: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 now 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 our range of knowledge, experience and networking capability, our 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 at present four groups in the Directorate.
These are; Healthy Communities, Healthcare; Health Protection and Health Information.
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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 and within the top 5 Universities in Europe for its Biomedical Sciences.
The University of Edinburgh’s College of Medicine and Veterinary Medicine (CMVM; Head Professor Sir
John Savill) is an internationally leading force in basic-to-clinical translational research. The College has
a consistent 30-year strategy of interdisciplinary and integration of basic and clinical sciences. In the
most recent Research Assessment Exercise (2008), the University of Edinburgh was top in the United
Kingdom within the UoA4 category of Hospital-based Clinical Subjects. In 2008/9, CMVM attracted over
£120 million in external peer-reviewed grant funding.
It has established several major interdisciplinary research Centres:
MRC Centre for Inflammation Research (Director, Professor John Iredale)
Centre for Cardiovascular Science (Director, Professor Brian Walker) incorporating the BHF Centre of
Research Excellence (Director, Professor John Mullins)
Centre for Reproductive Biology (Director, Professor Phillipa Saunders) and MRC Human Reproductive
Sciences Unit (Director, Professor Robert Millar) including the Tommy’s Centre (Director, Professor Jane
Norman).
MRC Centre for Regenerative Medicine (Director, Professor Sir Ian Wilmut)
Centre for Molecular Medicine (Director, Professor David Porteous)
Centre for Cancer Research (Director, Professor David Harrison)
Centre for Population Health Sciences (Director, Professor Harry Campbell)
MRC Human Genetics Unit (Director, Professor Nick Hastie)
These Centres are predominantly based at two sites: the Queen’s Medical Research Institute at the
Royal Infirmary, and the Institute of Genetics and Molecular Medicine at the Western General Hospital.
The co-location of basic science and clinical groups within state-of-the-art infrastructure and technology
provides an excellent and exciting opportunity to conduct translational research at the highest level.
This academic power base is supported by clinical research infrastructure that includes:
i
ii
iii
iv
v
vi
Wellcome Trust Clinical Research Facility
Clinical Research Imaging Centre
Edinburgh Clinical Trials Unit (UKCRN Registered) and Health Services Research Unit
Scottish Brain Imaging Research Centre
Experimental Cancer Medicine Centre
Academic and Clinical Central Office for Research and Development
4. NHS Library and Postgraduate Facilities
There are excellent facilities on all sites.
5. Departmental Information
Department of Paediatric Surgery
Paediatric services within NHS Lothian are provided at the Royal Hospital for Sick Children in Edinburgh
(RHSC) and St Johns Hospital, Livingston in West Lothian. There is a close working relationship with
District General Hospitals in Kirkcaldy in Fife and the Borders District General Hospital in Melrose.
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The department at RHSC consists of six other consultants, two of whom are appointed by Tayside but
take part in the acute on-call rota and have clinical sessions in RHSC. The six surgeons are:
Mr Fraser D Munro, consultant paediatric surgeon with a special interest in minimally invasive surgery,
oncology, GI surgery and paediatric thoracic surgery.
Mr Jimmy PH Lam, consultant paediatric surgeon with a special interest in paediatric urology including
urolithiasis management and minimally invasive surgery.
Miss Amanda McCabe, consultant paediatric surgeon (joint post with NHS Tayside).
Mr Merrill McHoney, consultant paediatric surgeon with a special interest in minimally invasive surgery.
Mrs Claire Clark, consultant paediatric surgeon with special interest in paediatric colorectal surgery and
paediatric urology.
Miss Lisa Steven, consultant paediatric surgeon (joint post with NHS Tayside).
There are two urology nurse specialists and two stoma and continence nurse specialists who support the
work of the department.
Administrative Support is provided.
Access to a desk and desktop computer in a shared office.
6. Details of the Post
The post holder will be based in the Department of Paediatric Surgery at the Royal Hospital for Sick
Children in Edinburgh and will have a commitment to outreach services in St John’s Hospital, Livingston
and Borders General Hospital, Melrose. This will be as part of a wider network supporting paediatric
general surgery both within Lothian and across the South East of Scotland including Tayside.
The appointee will join an established paediatric surgical team of four surgeons and additional two
colleagues appointed by NHS Tayside who have clinical sessions at RHSC and take part in the on-call
rota.
The person appointed will be a member of the Lothian Area Division of Paediatrics and of the Medical
Staff Committee of RHSC. He/she will be expected to reside within a 10-mile radius of the Royal
Hospital for Sick Children.
It is anticipated that RHSC will move to a new site on the RIE campus in 2017.
This is an Exposure Prone Post and evidence of the relevant immunities will be required before starting
work.
6.1 Clinical
The post-holder will be expected to carry out outpatient clinics and operating lists in RHSC, St John’s
Hospital, Livingston and Borders General Hospital, Melrose. He/she will share the emergency on-call
rota at RHSC and be responsible for the management of these emergency cases and the supervision of
the trainees during that time. On call cover relates specifically to RHSC.
In St John’s Hospital and Borders General Hospital, the post holder will carry out pre and postoperative
ward rounds, review patients on the paediatric ward and in the neonatal unit and attend supporting
activities, as required, in conjunction with the local paediatric, obstetric and general surgical teams.
He/she will also carry out the clinical administration required.
In Edinburgh he/she will carry out regular ward rounds both in regard to elective and emergency
patients, carry out the necessary clinical administration and attend any supporting activities as required
by the clinical team.
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The post-holder will be expected to have advanced skills in minimally invasive paediatric surgery and
work within the RHSC team who are recognised as national leaders in this area. There will be a
commitment to general paediatric surgery including emergencies. You will also provide support to the
breast-feeding service and specifically supervise a rapid access tongue-tie clinic. There will be an
opportunity to develop other areas of sub specialist interest to complement those in the department.
At RHSC weekly joint x-ray meetings are held along with a Grand Round and rotating audit, morbidity
and mortality, journal club and teaching commitments in the identified Monday afternoon session. The
consultant would be expected to attend, participate in and lead some of these activities. On alternate
Friday afternoons, there is a foetal anomaly meeting that the consultant would be expected to attend and
participate in. In addition, there may be a requirement to attend other multidisciplinary meetings.
The post-holder would be expected to support and contribute to clinical governance activities within the
paediatric surgical service and the operating division, to participate in service audit meetings and to
contribute to national and multi-centre audits.
7. Research and Development
There is an academic department of Child Life and Health with an active research programme led by
Professor Jurgen Schwarze. There are opportunities for individual or collaborative research and
development within the service.
You will participate in clinical audit and research projects, which are regularly undertaken within the
paediatric surgical department.
8. Teaching
The service has a prominent role in teaching undergraduates and postgraduates. The post-holder will
contribute to the undergraduate teaching programme and to the teaching of trainee medical staff. In
addition you would be expected to be closely involved in the supervision, management and support of
doctors in training.
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9. Job Plan
NHS Lothian Notional Job Plan
Name:
Specialty:
Principal place of work:
Contract:
Programmed activities:
Availability supplement:
Managerially accountable to:
a)
Paediatric Surgery
Royal Hospital for Sick Children
Full Time
10 PA
9.0 DCC PA; 1.0 SPA
5%
Clinical Director of Surgery, Anaesthetics and Intensive
Care, RHSC
Timetable of activities that have a specific location and time
Week 1
Day
Monday
RHSC
Time
09.00-10.00
Type of work
Personal CPD
DCC
13.00-14.00
Radiology meeting
0.25
14.00-17.00
Grant Round, Audit, M&M, Journal Club
08.00-18.00
Day case operating list; preoperative
assessment and postoperative review;
related clinical administration
2.5
Thursday
RHSC
08.00-17.00
Day time on site cover for emergencies
2.25
Friday
RHSC
09.00-13.00
Outpatient clinic; 3.5 hour template; clinic
related administration
1.0
14.00-16.00
Tongue tie clinic; 1.5 hour template; clinic
related administration
Tuesday
RHSC
SPA
0.25
0.75
Wednesday
0.5
Saturday
RHSC
Sunday
RHSC
Out of hours
On call - 1:7 with prospective cover
On call - 1:7 with prospective cover
1:6 with prospective cover
1.5
Total PA
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8.0
1.0
Week 2
Day
Monday
RHSC
Time
09.00-10.00
Type of work
Personal CPD
DCC
13.00-14.00
Radiology meeting
0.25
14.00-17.00
Grant Round, Audit, M&M, Journal Club
Tuesday
RHSC
08.00-13.00
Day case operating list; preoperative
assessment and postoperative review;
related clinical administration
1.25
Wednesday
RHSC
13.00-18.00
Operating list; preoperative assessment
and postoperative review; related clinical
administration
1.25
Thursday
RHSC
08.00-17.00
Day time on site cover for emergencies
2.25
SPA
0.25
0.75
Friday
RHSC
Saturday
RHSC
Sunday
RHSC
Out of hours
On call - 1:7 with prospective cover
On call - 1:7 with prospective cover
1:6 with prospective cover
1.5
Total PA
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6.5
1.0
Week 3
Day
Monday
RHSC
Time
08.00-13.00
Type of work
Operating list; preoperative assessment
and postoperative review; related clinical
administration
DCC
1.25
13.00-14.00
Radiology meeting
0.25
14.00-17.00
Grant Round, Audit, M&M, Journal Club
08.00-13.00
Day case operating list; preoperative
assessment and postoperative review;
related clinical administration
14.00-15.00
Personal CPD
Wednesday
RHSC
09.00-13.00
Outpatient clinic; 3.5 hour template; clinic
related administration
1.0
Thursday
RHSC
08.00-17.00
Day time on site cover for emergencies
2.25
Friday
RHSC
09.00-13.00
Outpatient clinic; 3.5 hour template; clinic
related administration
1.0
14.00-16.00
Tongue tie clinic; 1.5 hour template; clinic
related administration
0.5
Tuesday
RHSC
Saturday
RHSC
Sunday
RHSC
Out of hours
0.75
1.25
0.25
On call - 1:7 with prospective cover
On call - 1:7 with prospective cover
1:6 with prospective cover
1.5
Total PA
April 2010
SPA
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9.0
1.0
Week 4
Day
Monday
Borders
General
Hospital
Time
07.00-13.00
Type of work
Day case operating list; preoperative
assessment and postoperative review;
related clinical administration
DCC
13.00-19.00
Outpatient clinic; 3.5 hour template; clinic
related administration
Tuesday
RHSC
09.00-13.00
Day case operating list; preoperative
assessment and postoperative review;
related clinical administration
1.25
St John’s
13.00-18.00
Outpatient clinic; 3.5 hour template; clinic
related administration
1.25
Thursday
RHSC
09.00-17.00
Day time on site cover for emergencies
2.25
Friday
RHSC
09.00-13.00
Outpatient clinic; 3.5 hour template; clinic
related administration
1.0
13.00-17.00
Personal CPD
SPA
3.0
Wednesday
Saturday
RHSC
Sunday
RHSC
Out of hours
1.0
On call - 1:7 with prospective cover
On call - 1:7 with prospective cover
1:6 with prospective cover
1.5
Total PA
10.25
1.0
The attached job plan in its present form describes a 9:1 split between direct clinical care and
supporting professional activities. NHS Lothian allocates all consultants one SPA for CPD,
audit, clinical governance, appraisal, revalidation, job planning and routine internal
communication. As a major teaching and research contributor, it would normally expect to
allocate additional SPA time for activities to do with undergraduate education, educational
supervision of trainee medical staff, research and other activities. These are all areas where
NHS Lothian has a strong commitment and we recognise the contribution that consultants are
both willing and eager to make. The precise allocation of SPA time and associated objectives
will be agreed with the successful applicant.
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10. Contact Details
Mr Fraser Munro, Consultant Paediatric Surgeon. 0131 536 0000; fraser.munro@nhs.net
Mr Jimmy Lam, Consultant Paediatric Surgeon. 0131 536 0726: jimmy.lam@nhs.net
Dr Mary Rose, Clinical Director of Surgery, Anaesthetics and Intensive Care, RHSC. 0131 536
0000 mary.rose@nhslothian.scot.nhs.uk
Dr Edward Doyle
Associate Medical Director. edoyle2@nhs.net ; 0131 536 0007
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11. Person Specification
Person specification for Consultant Paediatric Surgeon
Requirements
Qualifications and
training
Essential
Fully registered with the GMC with a license to
practice.
Desirable
Relevant higher
degree.
Completion of a recognised training programme in
paediatric surgery.
Level 2 or 3 child
protection training.
FRCS (Paediatric Surgery) or equivalent.
On the specialist register for paediatric surgery or
within six months of being eligible for the specialist
register.
Up to date APLS or EPLS provider.
Level 1 child protection training or equivalent.
Experience
Must be able to demonstrate a high level of clinical
experience and competence in all aspects of
paediatric surgery.
Experience of working
in an outreach setting.
Competent in minimal access surgery with
experience of advanced procedures.
Experience in
paediatric
thoracoscopic surgery.
Ability
Ability to take responsibility for management of
patients.
Academic
achievements
Understanding of the principles of medical
research and ability to critically assess evidence.
Publications and
presentations.
Teaching and
audit
Demonstrable experience of participation in clinical
audit and implementation of its findings.
Experience in training
undergraduate medical
students and
postgraduate doctors.
Active APLS or EPLS
instructor.
Motivation
Evidence of commitment to patient focused care,
continuous professional development, effective and
efficient use of resources.
Knowledge of and commitment to the Scottish
Patient Safety Paediatric Programme.
Contributions to quality improvement and patient
safety
Personal
attributes
April 2010
Able to work in a team with colleagues in own and
other disciplines.
Effective communication, team working and
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Able to motivate
colleagues.
interpersonal skills.
Well organised and with good time management
skills.
Flexible and adaptable.
Please amend template attached
Draft Advertisement
To be supplied
Revised Medical and Dental HR December 2009
April 2010
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Able to lead service
developments.