RURAL HOSPITAL DOCTOR
(2 Posts)
Ref: MD388g
As part of the recruitment process for this post,
we would strongly advise that prospective applicants visit the
Galloway Community Hospital in Stranraer.
To arrange a visit you should contact
Alison Burns, General Manager on –
Tel: 01776 707755
or
e-mail - alison.burns2@nhs.net
or Dr Adrienne Swan Clinical Lead Galloway Community
Hospital
tel :01776707707 or email adrienne.swan@nhs.net
Closing Date: 30th April 2015
JOB DESCRIPTION – RURAL HOSPTIAL PRACTITIONER
1. JOB IDENTIFICATION
Job Title:
Rural Hospital Doctor
Department:
Galloway Hospital, Stranraer
Job Reference:
MD388f
Hours of Work:
44 Hours per week (including day time and night work)
Remuneration:
The basic starting salary is £83,266 per annum however
remuneration will average approximately £95,670 per annum
including premium payments for out of hours.
2. JOB PURPOSE
Role Context
The role is based in the Galloway Hospital and will provide medical care to Accident and
Emergency Services, Rehabilitation Ward and the Acute Ward. The A&E department deals
with approximately 15,000 patients per year many with relatively minor conditions but
occasionally severely ill or injured patients when rapid evacuation will be required.
Supervision of the role in A&E is provided by A&E Consultants from Dumfries and Galloway
Royal Infirmary. In the acute ward a range of in-patients are admitted where they can be
managed without direct consultant involvement, complex investigations, or without the need
for a surgical opinion. Support is provided by 2 Consultant Physician visits per week. There
are twice weekly visits from a Surgical Consultant who is able to give advice. There are 2
Consultant Anaesthetists based in the Galloway.
The Rehabilitation Ward is mostly used for patients who are “stepping down” from acute
admissions to the District General Hospital: care is overseen by a consultant geriatrician who
visits twice a week
The post holder may occasionally be required to provide medical support, in an emergency, to
the midwife led Obstetric Unit, the nurse led Renal Dialysis Unit and nurse delivered
Chemotherapy Service. In these settings no specialist knowledge of Obstetrics, Renal Dialysis
or Chemotherapy will be expected: the standard required will be that of the ordinary doctor
exercising due care.
The purpose of this role is to work with visiting consultants, permanent nursing staff and
AHPs in providing the hospital with medical staff appropriately skilled to deal with a wide
range of medical work encountered. In doing so you will assist in providing second tier of
medical expertise in Wigtownshire for its population (30,000). This may involve airway
management and transfer of critically ill patients. You will be expected to undertake training
as required in particular to maintain ALS, ATLS, EPLS and also accreditation and annual
medical updates. This will be assisted by regular rotation into consultant led units within
Dumfries and Galloway Royal Infirmary particularly the A&E Department, Anaesthetic
Department and the Acute Medicine.
3. ORGANISATIONAL POSITION:
Medical
Director
Chief
Operating
Officer
Lead Clinician
Galloway
Community
Hospital
Local GP
Practices
Emergency
Medical
Retrieval
Service
General Manager
Primary and
Community Care
Directorate
(West)
Medical. A&E,
Surgical
RURAL HOSPITAL
Consultants
DGRI
PRACTITIONER
A&E
Nurses
Ward
Nurses
Allied Health
Professionals
Working Relationships: - ……………………………………
Reports to:
______________________________
Professionally accountable:
NHS Board Medical Director
4. SCOPE AND RANGE
The post is based in the Galloway Hospital, Stranraer. The hospital has 20 in patient beds
in the Acute Ward, 24 beds in the Rehabilitation/Care of the Elderly Ward Accident and
Emergency Department, Day Case Surgical Theatre and recovery area, a Midwifery Suite
with 2 delivery beds, Outpatient Clinic facilities, Dental Surgery, AHP Services,
Laboratory and X-ray Departments (including CT Scanner) and a nurse led Renal Dialysis
Unit. Palliative Care provision is provided in a 2 bedded Palliative Care Suite and
Chemotherapy is provided from within the hospital via a consultant led, nurse delivered
Chemotherapy Service.
Within the A&E Department experienced nursing staff including 2 emergency care
practitioners will support the post holder in providing and A&E Service – treating minor
GP Out of
Hours
Service
and moderate illness and injury, admitting selective patients for intermediate care within
the Acute Ward and resuscitation and transfer of more ill patients to Dumfries and
Galloway Royal Infirmary by ambulance or particularly in severe trauma by contacting the
Emergency Medical Retrieval Service in Paisley who will helicopter in a consultant led
retrieval team to transfer the patient rapidly to Glasgow.
Close links are in place with Dumfries and Galloway Royal Infirmary and telephone
advice or decision support can always be sought from experience middle grade and
consultant staff in Dumfries and using the Pacs system, opinions can be provided on Xrays and CT Scans.
Admissions to the ward are covered by protocols with patients who might need a surgical
intervention, extensive investigation or consultant level resuscitation and management
transferred to Dumfries and Galloway Royal Infirmary. Cardiac Monitoring is available
and low risk MIs are cared for after initial thrombolysis with transfer to Glasgow or
Dumfries and Galloway Royal Infirmary if there is a failure of revascularization or
challenging arrhythmia.
Consultant Physicians visit the hospital twice per week primarily to deliver out-patient
consultations and also provide opinions on patients within the ward and informal teaching.
The hospital also is the base for the Primary Care Out of Hours Service which is situated
within the A&E Department. During the Out of Hours periods and weekends it is expected
that the Out of Hours Primary Care GP and the Hospital Doctor will work together sharing
where appropriate the care of patients.
Currently there is a 24 -7 on-call Anaesthetist available.
Your hours of work will be 44 hours per week on a shift system. You will be expected to
cover all aspects of the role including overnight work, daytime hospital work and weekend
work, working in either the A&E Department or the wards depending on the rota. You
will have advance notice of your part in the rota and each member of the team will rotate
through all aspects of the rota and there maybe additional shifts available for you to
undertake and these will attract additional remuneration. GP trained doctors may also (if
they wish) undertake shifts within the General Practice Out of Hours Service by separate
arrangements via a web based session booking system.
You are entitled to 30 days annual leave and 10 public holidays (the rota may require that
you work on a public holiday but time off in lieu will be available). You will be expected
to undertake a 2 week attachment to A&E/Anaesthetics in Dumfries and Galloway Royal
Infirmary prior to starting work and will in addition on a rota system have days within the
A&E Department or Anaesthetics Departments to maintain skills. While it is anticipated
that for GP trained doctors, the bulk of your professional development will be sessions and
informal teaching sessions from visiting consultants, study leave (maximum 5 days per
annum) can be approved by advanced notification to the General Manager .
Other doctors on specialist register will be supported to maintain their CPD and good
standing with the appropriate Royal Colleges.
5. MAIN DUTUES/RESPONSIBILITIES
KNOWLEDGE, SKILLS AND
COMPETENCIES REQUIRED
CLINICAL
Provide day to day cover at the hospital
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Accident and Emergency role dealing with a full
range of trauma and minor injured.
Involvement in follow up fracture clinics
Intermediate care role involving admission and
ongoing care of patients from A&E and the
local GP community taking advice from
appropriate specialities in Dumfries & Galloway
Royal Infirmary
Resuscitation, stabilisation and transfer of
critically ill patients.
Liaison with higher specialist units and the
Scottish Ambulance Service to arrange all
aspects of transfer of critically ill patients
Maintain adequate medical records on all
patients seen including the provision of
discharge summaries following inpatient
discharge.
Operating in accordance with all locally agreed
guidelines and protocols.
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CCT holder in Acute Medicine,
Emergency Medicine,
Anaesthetics or General
Practice.
A&E skills and experience
Resuscitation skills
Airway management skills and
experience
ATLS, ALS or equivalent
Excellent diagnostic skills
In-patient management skills
and experience
Awareness of own limitations
and those of the unit
Planning and organising time
including prioritisation of
patient demands
Management of risk
INTERPERSONAL SKILLS
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Support and encourage Rural Hospital
Doctors and General Practice colleagues,
nursing staff, AHPs and ambulance staff
staff involved in the provision of care
Function within a multi-disciplinary team
delivering care in a holistic manner to patients.
Encourage an environment of team work
within colleagues.
(It is stressed that appropriate
training will be delivered for all
post holders on a regular basis)
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Implementing listening and
communication skills
Diplomacy and trust building
PERSONAL PROFESSIONAL DEVELOPMENT
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The post holder will be required as part of a
contract to undertake annual appraisal which
will be arranged locally
Developing a Personal Development Plan to
include skill areas of clinical expertise
Adopt a personal life long learning culture
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Literature updates
Critical appraisal skills
Awareness of national
standards of care
PROFESSIONAL ISSUES

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Work and practice at all times in accordance
with the GMC code of Professional Conduct.
Actively demonstrates a positive approach to
sustaining and developing personal and
professional knowledge required to undertake
own role.
Complying with all Board policies particularly
in respect of SEAs, complaint handling,
maintaining adequate records and assisting in
local audits.
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In depth knowledge of
professional code of conduct
Creative thinking
Negotiation skills
Motivational skills
Dealing with complexity and
contentious information
Effective communication skills
Ability to work across
organisation boundaries
6.
SYSTEMS AND EQUIPMENT
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PC and Microsoft Office – Operational work
Email system – Day to day communications
Intranet/Internet – Source of reference material and NHS Dumfries and Galloway
Protocols
Laboratory and Imaging Computer interface for results of patient tests
Computer based discharge letter system
Numerous monitoring equipment used in the clinical area
Resuscitation equipment and ventilator
Near patient testing equipment
AD-ASTRA on line Clinician which will need to be used to deal with NHS 24 triaged
calls, car and driver and patient transport system
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7. DECISIONS AND JUDGEMENTS
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Rural Practitioner working mostly autonomously and with minimal supervision.
Ability to recognise scope of personal abilities and clinical judgement.
Ensure safety of practice at all times by liaison with other professionals and by adherence
to national guidelines and standards.
8. COMMUNICATIONS AND
RELATIONSHIPS


KNOWLEDGE, SKILLS AND
COMPETENCES REQUIRED
Responsible for partnership working,
involving all staff at the earliest opportunity
to influence change if required and provide
most efficient, effective and safe service.
Collaborate with a range of colleagues both
locally and in higher specialist units in
provision of patient care and in personal
professional development
9. PHYSICAL DEMANDS OF THE JOB
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Ability to work in a sustained and focused manner
Ability to make immediate decisions
Ability to cope with stressful situations
Resilience
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Leadership and relationship
building
Effective communication skills
Effective interpersonal skills
Good negotiation skills
Strategic thinking
Influencing skills
10. MOST CHALLENGING/DIFFICULT PART OF THE JOB
The Rural Doctor will have a high degree of autonomy in providing patient care with locally
agreed national guide standards. The key challenges will be:
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Providing a very wide range of medical expertise in a challenging/isolated environment
Updating clinical skills and continuing professional development
Gaining respect and developing and maintaining effective working relationships with a
range of colleagues, nurses and other Allied Health Professionals locally and regionally.
Balancing your education and training demands with service demands, satisfying both with
the resources available to you
Determination and persistence in achieving successful team working where there may be
competing priorities and agendas.
Maintaining balance between competing demands in the job and between the job and other
“life priorities”
11. KNOWLEDGE, TRAINING AND EXPERIENCE REQUIRED TO DO THE JOB
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Current full General Medical Council registration
Acute hospital inpatient experience
Accident and Emergency experience
Computer literate
Expert communicator possessing influencing and negotiation skills
Primary Care experience with involvement in Out of Hours work advantageous
Note: This post allows study leave to address any areas of clinical update required