NHS Lothian
Acute Operating Division
Base: Royal Infirmary of Edinburgh/St. John’s Hospital/Royal Hospital for Sick Children
Fixed Term (6-12 months) ST1-6 LATs in Emergency Medicine at Royal Infirmary of
Edinburgh, St. John’s Hospital, Royal Hospital for Sick Children
Royal Victoria Hospital, Kirkcaldy
1.
Outline of the posts
Applications are invited for the above posts, which are available from 5th August 2015 for a
period of 6 to 12 months. The successful applicant will work a band 1A compliant full shift rota
(including out-of-hours and weekend working) These post would suit a potential/future trainee
in Emergency Medicine, looking to expand their clinical experience.
The seniority of the post will be determined by the level of applicant, and there is potential for
flexibility in the exact make-up of the fixed term placements to allow each successful
applicant maximum opportunity to build on their future experience.
The successful applicants have the potential to rotate through some of the departments listed
above with one post potentially based at the Emergency Department of Victoria Hospital
Kirkcaldy. All LAT posts have training recognition from the Postgraduate Dean. One post is at
the equivalent of ST3 in Emergency Medicine (6 months paediatric EM and 6 months EM).
The appointee will work as part of a team providing both initial and supervisory care to acutely
injured and unwell children presenting to the Emergency Department and to adults at the ED
of RIE with a wide variety of conditions.
The post holder, under the supervision of the ED consultant, is responsible for:
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delivering clinical care to acutely injured and unwell children and adults who attend the
Emergency Departments, including reviewing and actioning results for patients
discharged from the department
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supporting the division’s delivery of the Unscheduled Care ‘4-hour’ target
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contributing to the supervision and training of undergraduate students from the University
of Edinburgh and, if appropriate, more junior doctors in training.
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working closely with colleagues from other specialties and services to ensure the delivery
of high quality care throughout the patient journey
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maintaining and updating their own knowledge and skills
All doctors will be expected to become familiar with the Trak Patient Management System
and to enter clinical details and details of treatment according to the requirements of the
System. At all times doctors will be expected to maintain adequate notes in a legible and
concise manner.
May 2012.
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2.
NHS Lothian
NHS Lothian is an integrated NHS Board in Scotland providing primary, community, mental
health and hospital services. Mr. 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 John’s 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 that 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.
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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 and Stroke Medicine
There is an Acute Receiving Unit, which accepts GP referrals and 999 ambulance
medical cases on a zoned basis within the city, and a nurse led Minor Injuries Unit. There
is no trauma unit 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
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.
May 2012.
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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 the ED. 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 151 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 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
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
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.
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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.
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:
May 2012.
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;
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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.
5.
The Departments
ROYAL INFIRMARY EDINBURGH
The Emergency Department at RIE currently assesses 120,000 new patients per year with a
high acuity case mix. It serves as a tertiary receiving centre for Lothian and Border regions.
The Department houses 2 resuscitation rooms with integral x-ray facilities, 17 High
Dependency/Immediate Care trolley cubicles and 15 Examination/Minor Injury and Illness
cubicles. There is a separate x-ray facility within this area. The Anaesthetic room is utilised
for manipulations and other techniques, which require anaesthetic/resuscitative support.
There is one patient/relative waiting area, 2 distressed/bereaved relatives rooms, Consultant,
Senior Nursing and secretarial office accommodation. In addition to a viewing room and staff
room, there is an office for trainee medical staff and a spacious teaching facility for both
undergraduate and postgraduate teaching. A 12 bedded surgical observation unit is situated
next to the ED.
A helicopter pad is on site. For the past two decades the Department has run an out-ofhospital resuscitation service – MEDIC ONE – which has experience of over 3000 call-outs to
trauma and medical emergencies. MEDIC ONE also forms the focus for major incident
medical team deployment in Lothian and Borders.
The Department has direct radio communication with the Ambulance Service and direct
telephone communication with the Lothian and Borders Police Force, in addition to hosting its
own internal radio system utilised within the Department and MEDIC ONE.
There is ready access to state of the art equipment and monitoring, departmental USS and
adjacent CT and USS.
The average daily attendance is over 300 patients per day made up of 10-12 resuscitation
cases and 120 High Dependency/Immediate Care Trolley Room patients. The remainder
constitute the minor injury and illness population. There are approximately 75-100 in-patient
admissions per day, 50% of whom will be acute medical, 20% surgery, 20% orthopaedic and
May 2012.
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the other specialties making up the balance. A combined Medical and Surgical Assessment
Unit adjacent to the Emergency Department receives direct GP referred cases.
Clinical Director: Dr. David Caesar. From August 2013, 31 Emergency Medicine
Consultants across the NHS Lothian region will provide cover to all 3 Emergency
Departments.
In addition there are 8FY2, 6 GPST, 5 ST1s, 12 ST4+, 1 Specialty and 1 SpR doctors.
ROYAL HOSPITAL FOR SICK CHILDREN
The Paediatric Emergency Department at the RHSC provides an Emergency Service to most
of Edinburgh, Mid and East Lothian, as well as tertiary receiving from the Lothians and
beyond. On site specialties include both trauma and non-trauma Orthopaedics, General,
Plastic and Neurological Surgery, Anaesthetics and Paediatric Intensive Care
Medicine/Retrieval, Paediatric Medicine and sub-specialties including Cardiology.
The
Paediatric Emergency Department sees approximately 40,000 new patients per year with
4,000 returning for review.
Professional Lead: Dr. Paul Leonard
In addition there is one Associate Specialist, 5 ACCS/HST, 5 FY2/GPT doctors. There are 3
WTE Emergency Nurse Practitioners.
ST. JOHN’S HOSPITAL
The Emergency Department at St. John’s Hospital provides an Emergency Service to West
Edinburgh and West Lothian. The department sees approximately 52,000 new patients per
year including paediatric patients. There is an adjoining 14 bedded Observation Ward for the
short term management of a range of medical and surgical conditions under the care of the
Emergency Department.
Professional Lead: Mr. Martin McKechnie
In addition there is one Associate Specialist, 3 FY2, 2 GTST, 3 ACCS/HST and 2 Specialty
Doctors
6.
Research and Development
While the main focus of this post is the provision of clinical care there is a strong track record
of clinical research within the Emergency departments of NHS Lothian. The post holder will
be expected to support ongoing research projects and will be encouraged to undertake
research as part of their continuing professional development.
May 2012.
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7.
Teaching
The post holder may be asked to contribute to the supervision and training of doctors in
training, nursing staff, AHPs and undergraduate medical students from the University of
Edinburgh.
8.
Contact Details
Dr. Stephen Lynch
Consultant in EM and Training Programme Director
Emergency Department, Royal Infirmary of Edinburgh, Edinburgh, EH16 4SA
Tel: 0131 242 1338 / 01506 523025
Email: Stephen.lynch@luht.scot.nhs.uk
May 2012.
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Person Specification
REQUIREMENTS
ESSENTIAL
DESIRABLE
Qualifications/Training
GMC Registration and License to Practice
MBChB or equivalent
ALS / ATLS/ APLS Certificate
Experience/Knowledge
Previous experience in Emergency
Medicine
Previous experience in Paediatric
Emergency Medicine
Motivation
Keen to develop Emergency Medicine
skills
Personal Attributes
Common sense, the ability to motivate
yourself and others, leadership,
organisational and management skills and
a sense of humour.
Ability to manage and cope under
pressure
Able to communicate well and have
communication skills necessary to carry
out duties safely and effectively
Audit
Understanding of audit and how it affects
clinical practice
Evidence of completed audit activity
Research
Understanding of research principles and
how it affects clinical practice
Relevant publications in peer
reviewed journals.
Higher degree
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