SOUTH EAST SCOTLAND / ASTLEY AINSLIE HOSPITAL
LOCUM APPOINTMENT FOR TRAINING (LAT) - SPECIALIST TRAINEE (ST3)
REHABILITATION MEDICINE
JOB DESCRIPTION
Contents

Overview

Departmental Information


Inpatient

Outpatient

Research & Education
NHS Lothian

Community Health Care Partnerships

University Hospitals Division

Royal Edinburgh and Associated Hospitals Division

Edinburgh University

Duties & objectives of the post

Person Specification

Contact details
Rehabilitation Medicine ST3 LAT 01/12/13
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Locum ST3 post within Rehabilitation Medicine, based at the Astley Ainslie Hospital, Edinburgh for in
the first instance, 6 months from February 2014
REHABILITATION MEDICINE
The Rehabilitation directorate provides a full range of rehabilitation services to patients in Lothian,
primarily those of working age. The directorate is currently reconfiguring its inpatient services ahead of a
new build scheduled for 2019. All its inpatient activity is now co-located in 88 beds on the Astley Ainslie
site.
The Lothian Neurorehabilitation Service provides a regional specialist service to patients with a range of
disabling neurological conditions including brain injury, stroke, degenerative and progressive
neurological diseases such as multiple sclerosis, Guillain Barre Syndrome or polyneuropathy, nontraumatic spinal cord injury, and neurological tumours. The service serves a regional catchment
population of 850,000 in Edinburgh, Lothian and Borders regions but includes the Scottish Brain Injury
Service, a tertiary service for patients with brain injuries from around Scotland. The service is led by a
team of 4 consultants, who work closely to ensure that referrals are seen in a timely manner by the
team, utilising the beds flexibly to assist with flow from acute care to rehabilitation. The role of the unit is
supported by the Scottish Neurobehavioural Rehabilitation Unit (Robert Fergusson Unit), based in the
nearby Royal Edinburgh Hospital.
A close working relationship with the acute hospitals in the region is an essential element of the service
and includes a scheduled commitment to the regional Department of Clinical Neurosciences in the
Western General Hospital. In reach is also provided to the acute stroke units in Edinburgh to identify
patients whose rehabilitation might be more appropriately delivered by the neurorehabilitation service, to
the vascular unit to identify patients requiring amputee rehabilitation, and to other acute medical and
surgical wards where the emphasis has traditionally been on assessment of those patients with
deterioration of chronic neurological impairment in association with acute illness, or those with new
neurological impairments arising from anoxic brain injury or post critical care neuropathy.
As part of the reconfiguration of services, the Rehabilitation Directorate has given an undertaking to
develop a “general rehabilitation” service to all patients of working age recovering from critical illness,
surgery, or trauma where early discharge to community services is not possible, and an extended
hospital stay is anticipated. Changes to the existing services have enabled the directorate to identify 8
additional beds for specifically for general and trauma rehabilitation.
Outpatient care is delivered on-site and includes clinics in the recently opened (2007) South East
Mobility and Rehabilitation Technology (SMART) Centre. Close working with the SMART Centre affords
a range of opportunities to utilise the available technologies and skills within the department to jointly
assess and treat patients postural and mobility problems. The service has recently relocated its
spasticity management clinics to the SMART centre with the aim of developing a multifaceted approach
to spasticity management.
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IN-PATIENT REHABILITATION SERVICES ARE CURRENTLY CONFIGURED AS FOLLOWS:
Charles Bell Pavilion – consisting of two wards with 40 beds hosting the Scottish Brain Injury
Rehabilitation Service (SBIRS) which provides both regional and tertiary brain injury rehabilitation
services and the Lothian Neurorehabilitation Service allocated for neurological and neuro-oncology
rehabilitation cases including younger female stroke.

Consultants: Dr Alasdair FitzGerald & Dr Alyson Nelson
Mears Ward – 13 beds allocated to young male stroke patients with complex rehabilitation needs.
These patients are identified in the 3 integrated stroke units in Lothian and transferred for specialist
rehabilitation within the neurorehabilitation service.

Consultant: Dr Lisa Barrett
East Pavilion – (22 beds) Approximately 14 beds are allocated for Progressive Neurological Disorders
(PND). The remaining beds are allocated to Orthopaedic Rehabilitation. A General Rehabilitation
service is anticipated but not yet funded..



Consultant (PND): Dr Stewart Donald
Consultant (Ortho): Dr Lisa Barrett
Staff Grade Specialist: Dr Tashfeen Chaudhry
Scottish Neurobehavioural Rehabilitation Unit – 20 beds in the Robert Fergusson Unit at the Royal
Edinburgh Hospital providing rehabilitation for acquired brain injured patients with complex behavioural
and cognitive issues.


Consultants: Dr Alan Carson & Dr Killian Welch
Associate Specialist in Neuropsychiatry: Dr Lorna Langrell
Sutherland Ward – (13 beds) houses the amputee rehabilitation service. Close links exist between this
service and vascular/orthopaedic surgery services as well as with prosthetics and bioengineering

Consultant: Dr Lynne Hutton, (also with special responsibility for outpatient
Mobility Services)
Additional Medical Staffing within the department


3 Specialist Registrars in Rehabilitation Medicine
5 GPSTs & 1 CMT ST1
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OUT-PATIENT SERVICES ARE CURRENTLY CONFIGURED AS FOLLOWS:
Medical outpatient clinics – based in SMART Centre or Cunningham Unit on-site. Specific clinics for
neurorehabilitation; cardiac rehabilitation (also provided off-site); amputee rehabilitation and pain
management.
Multidisciplinary clinics – based in SMART Centre or Cunningham Unit or other on-site therapy
departments. Includes spasticity management; cardiac rehabilitation; & pain management.
Therapist led clinics - include chronic fatigue management; specialist neurorehabilitation therapy
services; hydrotherapy
Community Services - The consultant responsible for the Lanfine Unit is the primary medical
representative for community services for complex chronic neurological conditions. Medical input is also
provided to the social work day centres in the city. There are a number of community teams serving
neurological patients in the various Lothian sectors.
Cardiac Rehabilitation – The Cunningham Unit is the Base for Cardiac Rehabilitation Lothian, a
Lothian-wide service providing rehabilitation to all eligible patients with heart disease in Lothian.
Treatment programmes run in the unit and also in a number of community venues across Lothian.
Mobility & Rehabilitation Engineering - The South East Mobility & Rehabilitation Technology
(SMART) Centre within the AAH provides a wide range of rehabilitation technology services including
wheelchairs and special seating; prosthetics; orthotics; bioengineering; gait analysis; a Disabled Living
Centre and the national Scottish Driving Assessment Service.
In-reach Services to acute hospitals – Consultant led in-reach is provided to acute hospitals
principally with a view towards in-patient admission, but also with aim of providing management advice
for patients for whom in-patient rehabilitation might not be required. In addition to providing in-reach for
the various neurorehabilitation disciplines and patients with amputations, in-reach assessment is also
provided for those patients defined above in the category of “general rehabilitation”.
RESEARCH AND EDUCATION
There are excellent facilities for postgraduate education. There is a hospital post-graduate library and an
excellent university library, all within easy reach. Directorate and hospital clinical / postgraduate
meetings are held weekly in University term time.
The service is keen to promote research roles. Current and recent interests are in the areas of anoxic
brain injury and post traumatic hypo-pituitarism.
The Department of Clinical Neurosciences (DCN) has a strong research base in neurological diseases
and stroke including an expanding interest in the field of Regenerative Neurology with a new centre
established on the Royal Infirmary site (The Anne Rowling Centre). Plans for DCN include a move to a
new build on the Royal Infirmary site. Opportunities exist and are encouraged for the successful
candidate to develop collaborative research interests in the field of neurorehabilitation.
Along with colleagues in the Scottish Neurobehavioural Rehabilitation Unit, the department has
developed the Edinburgh Brain Injury Rehabilitation Training (EBIRT) modular training programme for
clinicians or carers throughout Scotland who work with brain injured patients. There is an opportunity to
participate in the delivery of this programme.
The department plays a leading role in the National Managed Clinical Network for Brain Injury, which
exists to promote and support best practise in Brain Injury Rehabilitation across Scotland.
Undergraduate teaching in Neurology; Brain Injury and Communication Skills in Edinburgh University
and Queen Margaret University are additional optional non-contractual roles.
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NHS LOTHIAN
NHS Lothian is an integrated NHS Board in Scotland providing primary, community, mental health and
hospital services and determines strategy, allocates resources and provides governance across the
health system. Services are delivered to a population of 850,000 by Lothian University Hospitals
Division; the Royal Edinburgh Hospital and associated mental health services; four Community Health
and (social) Care Partnerships (CHCPs) and a Public Health directorate.
Community Health Care Partnerships
The four CHCPs 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.
The range of services includes care of the elderly; medical rehabilitation; community mental health
services including substance misuse and learning disability services; district nursing and health visiting;
family planning; well woman services; comprehensive dental care; physiotherapy; bio-engineering;
prosthetic; orthotic; occupational therapy; pharmacy; speech & language and optometry services.
Hospitals within the CHCP include:
 The Astley Ainslie Hospital in Edinburgh (Rehabilitation Services)
 Midlothian Community Hospital (Community Hospital)
 Herdmanflat Hospital in East Lothian (Psychiatric Hospital)
 Roodlands Hospital in East Lothian (Community Hospital)
University Hospitals Division
The University Hospitals Division provides a full range of secondary clinical services to the populations
of Edinburgh, Midlothian, East Lothian and West Lothian, and tertiary services for the South East of
Scotland, or the whole of Scotland in some instances. The Division is one of the major research and
teaching centres in the United Kingdom.
Plans are at an advanced stage for the reprovision of paediatric and neurological services on a new site
adjacent to the Royal Infirmary of Edinburgh. It is anticipated that this development will open in 2017.
All hospitals below have 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 in each hospital.
Hospitals included in the Division are:
The Royal Infirmary of Edinburgh (RIE)
 This is a major teaching hospital comprising 869 beds, and provides for most adult acute
specialities, other than rheumatology, neurology, haematology/oncology, infectious disease &
all elective surgical services listed in WGH / SJH below.
 It includes the Regional major Accident and Emergency centre, and a Combined Assessment
Unit which takes unselected GP or direct emergency referrals.
The Western General Hospital (WGH)
 This has 600 beds and is the centre for neurology, neurosurgery and neuropathology providing
tertiary services for South East Scotland, and also including the UK CJD unit
 Other specialties on this site include:
o Surgical - Colorectal; Urology; Breast Surgery
o Medical - Gastro-Intestinal; Rheumatology; Infectious Diseases
o Haematology & Oncology
o 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.
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St John’s Hospital (SJH)
 This is located in the centre of Livingston; about west from Edinburgh. The hospital provides for
most common acute specialties and an A&E department. Emergency general surgery or
orthopaedic trauma operating facilities are not provided, but SJH has been developed as a
major elective centre for the region.
 Surgical specialties include elective General; Orthopaedic; Plastic; ENT & Oral and
Maxillofacial Surgery as well the regional Burns and Plastic Surgery unit for SE Scotland.
 Other specialist services include
o Medical – including Cardiology, Diabetes & Endocrinology, Gastroenterology,
Respiratory Medicine and Care of the Elderly
o Obstetrics & Gynaecology
o Child Health including Paediatrics and community child health
o Mental Health including ICCU and ICPU
The Royal Hospital for Sick Children (RHSC)
 This is a 141 bedded hospital providing general and specialist services for children, and is the
main paediatric teaching hospital for the South-East of Scotland
 It provides tertiary referral services 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.
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, located close to
AAH, has 420 beds, day hospitals and outpatient facilities. The hospital provides subspecialty services
that include:- Acute Mental Health; Rehabilitation; Outpatients; Psychiatry of Old Age; Forensic Medium
Security Unit; Inpatient facilities for under 18s; Psychotherapy & 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, and it is anticipated that
phase 1 of this development will open in 2016. The Robert Fergusson Unit (Scottish Neurobehavioural
Rehabilitation Unit) is currently located within the Royal Edinburgh Hospital and is also scheduled for
reprovision in 2016.
It is anticipated that the Astley Ainslie Hospital will be reprovided on this site in 2018
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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.
It has established several major interdisciplinary research centres including Scottish Centre for
Regenerative Medicine which will carry out cutting-edge stem cell research to help find therapies for
patients with conditions such as multiple sclerosis, Parkinson’s disease, motor neurone disease, and
heart and liver diseases. It is the first large-scale, purpose-built facility of its kind and provides
accommodation for up to 250 stem cell scientists.
In all there are five clinical / medical research institutes:- The Queen's Medical Research Institute;
Edinburgh Neuroscience Institute; Institute of Genetics and Molecular Medicine; Edinburgh Infectious
DiseasesInstitute; The Roslin Institute
FOR FURTHER INFORMATION ABOUT
NHS Lothian:
http://www.nhslothian.scot.nhs.uk/Pages/default.aspx
http://www.nhslothian.scot.nhs.uk/Services/Pages/default.aspx
Edinburgh University Research Institutes and Centres:
http://www.ed.ac.uk/schools-departments/medicine-vet-medicine/research/institutes/centres
Specialty of Rehabilitation Medicine:
http://careers.bmj.com/careers/advice/view-article.html?id=20010302
http://www.bsrm.co.uk/Education/BMA-JobPlans2.pdf
http://www.st3recruitment.org.uk/specialties/rehabilitation-medicine.html
Rehabilitation Medicine Training & Curriculum
http://www.rcplondon.ac.uk/medical-careers/core-and-specialty-trainees/career-profiles/dr-sarah-leeder
http://www.jrcptb.org.uk/trainingandcert/ST3-SpR/Pages/Rehabilitation-Medicine.aspx
British Society of Rehabilitation Medicine:
http://www.bsrm.co.uk
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CLINICAL DUTIES
The successful applicant will work within a multidisciplinary team based structure working closely with
one of 5 consultants in rehabilitation medicine. LAT / ST3+ doctors typically rotate on a 6 monthly basis
through teams specialising in: Amputee Rehabilitation and Mobility Services
 Stroke Rehabilitation & Cardiac Rehabilitation
 Brain Injury / Post-acute Neurorehabilitation
 Rehabilitation for Progressive Neurological Disorders
 Anticipated new General Rehabilitation service (currently advertised post as above)
Within their clinical attachments, the post-holder would have opportunity to play a key role, with
consultant supervision, in in-patient; out-patient and acute hospital in-reach services. They will be
expected to gain experience in ongoing patient management, multidisciplinary working; managing
patient and carer expectations and discharge planning arrangements, providing an excellent all round
training in Rehabilitation Medicine.
The holder of this post may be expected to provide mutual cover for annual and study leave of
colleagues, provided always that the resulting increase in duties does not cause a practitioner’s average
weekly hours to exceed the limits set out in paragraph 20 of the Terms and Conditions of Service.
On-call commitment
The post-holder will be expected to participate in the “first on-call” rota, based within the hospital, on a
roster shared with GPST and CMT trainees. This would involve working in evening (5pm to 9pm) shifts
on weekdays; or overnight shifts (9pm to 9am) on weekends or weekdays on what approximates to a
1:7 rota that is EWTD compliant. “Second on call” cover is provided by consultants, based from home.
Typically, daytime cover at weekends is provided by FY2 grade doctors, who are working off-site during
the week. A switch to nurse provided “Hospital at Night” cover is anticipated in the near future.
Practitioners will be prepared to perform duties in occasional emergencies and unforeseen
circumstances without additional remuneration, but may be granted time off in lieu at the discretion of
their employing authority. Commitments arising in such circumstances are, however, exceptional and
practitioners should not be required to undertake work of this kind for prolonged periods on a regular
basis.
Exposure Prone Invasive Procedures
The holder of this post will be required to undertake on an occasional basis exposure prone invasive
procedures (EPPs). As this could potentially place patients at risk, candidates must show evidence of
immune status to Hepatitis B, or agree to undergo the necessary procedures.
It should be noted that the offer of appointment is subject to confirmation that the successful candidate
is Hepatitis B immune. The Occupational Health Service prior to commencement checks this.
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PERSON SPECIFICATION
LAT SPECIALIST TRAINEE ST3 IN REHABILITATION MEDICINE/ST2 CORE
TRAINING BASED IN REHABILITATION MEDICINE
REQUIREMENTS
Qualifications / Training
Experience / Knowledge
Academic Achievements
Motivations
Personal Attributes
Health
ESSENTIAL
DESIRABLE
 Full MRCP, MRCS, MRCGP, MRCPsych
for ST3 LAT
 Relevant qualification for ST2 LAT e.g.
Part 1 of MRCP, MRCS, MRCGP,
MRCPsych
 EEA eligibility at time of application
By time of appointment, should have at least
24 months experience in one of: Medicine (to CT/ST2 level of competency)
 Surgery (CT/ST2)
 Psychiatry (CT3)
 General practice (ST3)
 Or equivalent
 Demonstrates understanding of research,
including awareness of ethical issues
 Demonstrates understanding of the basic
principles of audit, clinical risk
management, evidence-based practice,
patient safety, and clinical quality
improvement initiatives
 Demonstrates knowledge of evidenceinformed practice
 Intercalated BSc or equivalent
 Higher degrees including MSc, PhD or MD
 Interest in Rehabilitation Medicine as a
career
 Able to organise ward and direct junior
staff
 Demonstrates clarity in written/spoken
communication in English
 and capacity to adapt language to the
situation, as appropriate
 to carry out duties safely and effectively.
 Capacity to take in others’ perspectives
and treat others with understanding;
sees patients as people
 Commitment to personal and professional
development including
 Evidence of attendance at organised
teaching and training programme(s) and
evidence of self-reflective practice.
 Applicants must meet professional health
requirements (in line with GMC
standards / Good Medical Practice)
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 Demonstrates information technology
skills.
 Evidence of achievement outside medicine
 Evidence of teaching experience and/or
training in teaching.
 Evidence of a portfolio of audit / quality
improvement projects, including where
the audit loop has been closed and there
is evidence of learning of the principles
of change management
 Showing some initiative in clinical research
or involvement in a formal research
project
 Extracurricular activities/achievements
relevant to the specialty
 Interest in improvement projects and audit
 Evidence of effective multi-disciplinary
team working and leadership, supported
by multi-source feedback or other
workplace-based assessments
 Able to build rapport, listen, persuade &
negotiate.
 Capacity to manage/prioritise time and
information effectively
 Problem solving & decision making:
 Capacity to use logical/lateral thinking to
solve problems/make decisions,
indicating an analytical/scientific
approach.
CONTACT DETAILS
Dr Alasdair FitzGerald
Consultant in Neurorehabilitation & Local Training Lead
Astley Ainslie Hospital; Edinburgh EH9 2HL
Tel: 0131 537 9040
Email : alasdair.fitzgerald@nhslothian.scot.nhs.uk
Dr Iain Todd
Consultant in Cardiac & Stroke Rehabilitation & Clinical Lead
Astley Ainslie Hospital; Edinburgh EH9 2HL
Tel: 0131 537 9039
E mail: iain.todd@nhslothian.scot.nhs.uk
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