NHS Lothian
University Hospitals Division
Directorate of Clinical Neurosciences
Hospital Base – Western General Hospital
Locum appointment for service / training (registrar level)
1.
Outline of the post
A locum for training (LAT) post is available as a full time / substantial Neurosurgery Specialty
Trainee / Registrar as a trainee has recently vacated it to take up another post. The post will
be available until a new Neurology registrar / specialist trainee starts in post in August 2015.
The post is therefore an integral part of the Edinburgh based South East Scotland
Neurosurgery training programme.
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 Farquarson 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.
2.1 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 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 (including 6 LINACs)
 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:
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General Medicine with specialists in Cardiology, Diabetes & Endocrinology,
Gastroenterology, Respiratory Medicine and Care of the Elderly
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Obstetrics & Gynaecology
Child Health including Paediatrics and community child health
The supraregional Burns and Plastic Surgery unit.
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
2.2 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
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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.
2.3 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.
2.4 Department of Public Health Medicine
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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;
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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Departmental Information –
5.
The Department of Clinical Neurosciences is a supraregional centre providing
comprehensive neurosurgical and neurological services to a population of 1.6 million in
the South East, South West and Central Belt of Scotland.
Clinical Staff
Mr Michael Fitzpatrick
Mr Ioannis Fouyas
Mr Patrick Statham
Miss Lynn Myles
Mr Imran Liaquat
Mr Jothy Kandasamy
Mr Drahus Sokol
Mr Chandru Kaliaperumal
Mr Andreas Demetriades
Mr Pasquale Gallo
Mr Sonnis Khan
Specialist Interest
Clinical Director
Lead clinician, vascular and skull base
Training programme director, pituitary, skull base
Hydrocephalus and spine
Neuro-oncology
Paediatrics and epilepsy
Vascular paediatrics and skull base
Paediatrics pituitary
Complex spine, neuro oncology
Paediatrics
Spinal neurosurgery
Full neurophysiology facilities including videotelemetry are on site. This department has a
complement of two consultants and one specialist registrar.
There is a dedicated neuroradiology service including all imaging modalities.
Neuropathology has close links to the Western General Hospital.
The National CJD Surveillance Unit is on the Western General site.
Consultants from other medical and surgical specialties within Edinburgh combine in teams to
provide a service for conditions affecting the pituitary gland and skull base, and neuro oncology.
6.
Details of the Post
This is a locum for service (LAS) or training (LAT) post at specialty doctor (registrar)
level. LAS / LAT posts do not attract a National Training Number, although up to one
year if appointed as a LAT may subsequently count towards the award of the
Certificate of Completion of Training (CCT) on the advice of the Royal College of
Surgeons from whom recognition must be obtained prospectively. It is expected that
the successful candidate will have passed the MRCSexamination (or equivalent) and
will have neurosurgical experience at SpR level or equivalent. The successful
applicant will be expected to take part in the specialist registrar on-call rota and will
have to be competent in the management of all common neurological emergencies. It
is expected that the successful candidate would cover their SpR colleagues annual
and study leave.
The successful candidate would be expected to take part in daily ward rounds, take
the on-call referrals, manage inpatients and undertake routine and emergency
neurosurgery and review outpatients under supervision. There will be the opportunity
to take part in multidisciplinary meetings and the Friday academic afternoon case
presentations and journal club. They will also be expected to contribute to, and attend
the national neurosurgical training days in Perth, usually once a month.
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The successful applicant will gain experience of a wide range of neurosurgical
conditions.
7.
Teaching
The successful candidate would be expected to take part in the undergraduate and
postgraduate teaching programmes within the department.
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8.
Job Plan
Name:.…………....Specialty:....Neurosurgery
Principal Place of Work:..Western General Hospital, Edinburgh
Contract:
Full Time
Programmed Activities:..10......APAs……
Availability Supplement: Level 1
4%
(delete as appropriate)
ManageriallyAccountable to:.... MR MIKE FITZPATRICK
Responsible for:........NEUROSCIENCES.......
Rota one in nine on call
Remove table :
Ward SpRs
Starts day with brief MDT “board round” at 0800 on ward 33, followed by business ward round
prioritising new and unwell patients; this should be completed by X-ray meeting at 8.45. Attend
consultant ward rounds where possible. Provides continuity of care, timely discharge summaries,
supervises all junior staff and the medical support worker.
On call SpR
Permanently on call 8:45am to 08.45 the follwing day. Should attend morning bed meeting (9.15 ward
32) Answers the enquiries from referring doctors, and arranges investigations and admission where
appropriate. Sees patients on the wards of WGH, documents their history, clinical findings,
investigations and management plan. Discusses all cases seen with on call consultant.
a)
Other compulsory activities:
Daily radiology meeting, 0845 DCN Radiology 08.30 theatre planning meeting, when
attending theatre, or after previous night on call.
Fri 1300 Neuro oncology MDT 1400 clinical meeting/M and M/ journal club.
Once a month: Perth national neurosurgical trainees education day.
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9.
Person Specification
Requirements
March 2011
Essential
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Desirable
Qualifications
GMC Registered medical
practitioner
Additional postgraduate
qualifications e.g. MD/PHD
or specialist training /
qualification
MRCs
Relevant Experience
General experience in
neurosurgery, including the
management of neurosurgical
emergencies.
Ability
Ability to manage day-to-day
acute problems in the
neurosurgical unit, to assess and
formulate a management plan
for outpatients, and to supervise
junior staff.
Knowledge of common
neurosurgical conditions, able to
safely perform lumbar
punctures, place a ventricular
drain to treat acute
hydrocephalus, a craniotomy for
evacuation of an acute extra or
subdural haematoma, and be
able to perform a laminectomy
and microdiscectomy for an
acute spinal emergency, with
assistance.
Research
Teaching and Audit
Commitment to research
Previous publications
Committed to formal and
informal teaching and training of Experience of designing and
junior doctors, medical students effecting audit programmes
and other clinical staff.
Commitment to learning and
continuous professional
development
Committed to patient focused
care
Good team player, good
communication skills,
experience of working in
multidisciplinary teams
Personal Attributes
Circumstances of Job
8.
March 2011
Subspecialty experience in
neurosurgery
Neuro-HDU/ITU
experience
On call requirement at SpR level
Contact Details Interested candidates are invited to contact Mr Ioannis Fouyas, Lead
clinician for Neurosurgery, Ioannis.Fouyas@luht.scot.nhs.uk or Mr Patrick Statham,
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Training programme director for Neurosurgery, Dept of Clinical Neurosciences, Western
General Hospital, Edinburgh, EH4 2XU Patrick.statham@luht.scot.nhs.uk on 0131 537
2106.
9.
March 2011
Person Specification (see outline attached)
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