NHS Lothian
University Hospitals Division
Directorate of Medicine
Bases:
Post 1: Royal Infirmary of Edinburgh Hospital
Post 2: Western General Hospital, Edinburgh
Post 3: Rotational Post: Royal Infirmary of Edinburgh & Western General
Hospitals
LOCUM APPOINTMENT FOR TRAINING IN MEDICINE FOR THE ELDERLY:
THREE POSTS (CMT OR ST3 LAT)
Post 1: Royal Infirmary of Edinburgh Hospital:
6 month post: February 4th 2015 until 4th August 2015
Post 2: Western General Hospital, Edinburgh:
4 month post: April 1st 2015 until 4th August 2015
Post 3: Rotational Post: Royal Infirmary of Edinburgh & Western General
Hospitals:
6 month post: February 4th 2015 until 4th August 2015
1.
Outline of the posts
These three LAT (Locum Appointment for Training) posts in medicine with primary experience
in geriatric medicine at CMT or ST3 level 9depending on experience) have become available
due to rotational changes and maternity leave. Two posts are six months posts and one post
is a four month post – all running through to August 4th 2015. All appointees will be rostered to
have sessions in acute medicine unselected take, and be exposed to most aspects of geriatric
medical care.
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 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
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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Acute Stroke and Acute Medicine for the Elderly Services for South Edinburgh
Regional major Accident and Emergency centre.
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
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.
Liberton Hospital, close to the Royal Infirmary (RIE) is the major assessment and rehabilitation
hospital for older adults in South Edinburgh / Mid-Lothian.
The Western General Hospital (WGH) has over 700 beds and 5 operating theatres and is
equipped with modern theatre and critical care equipment and monitoring. The hospital
provides for most specialties and is the centre for:
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Acute Stroke and Acute/Rehabilitation Medicine for the Elderly Services for North
Edinburgh
Neurology, Neurosurgery and neuropathology
UK CJD unit
Colorectal Surgery
Urology and Scottish Lithotriptor Centre
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Breast Surgery and Breast screening
Gastro-Intestinal disease
Rheumatology
Infectious Diseases
Haematology Oncology
Medical Oncology
Radiation Oncology (including 6 LINACs)
Dermatology (Inpatient)
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.
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
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 / RoodlandsHospital in East Lothian / Royal Victoria Hospital
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
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 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
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:
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3.
To monitor the health status and health needs of people in Lothian;
To promote improvements in the health of Lothian people directly, and by providing
information and advice to the public on health matters;
To assist Lothian NHS Board to fulfil its statutory obligations;
To contribute to strategic changes within the NHS in Lothian by providing information on
clinical effectiveness;
To facilitate improvements in health and health care services directly, and through
‘managed clinical networks’ and wider alliances;
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.
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.
Departmental Information:
The Medicine of the Elderly and Stroke Services for Lothian currently include over 25
consultants with a wide variety of special interests. Edinburgh is configured into North
and South Zones, with a team of consultants based primarily at the Western General
Hospital providing care for older patients on the North side of Edinburgh, and a team at
the Royal Infirmary and Liberton Hospitals providing care to patients on the South side of
the city. Consultants based at St John’s Hospital and Roodlands Hospital provide care
for older adults in West and East Lothian respectively. The Astley Ainslie Hospital is also
in South Edinburgh and is historically closely linked with the services in Rehabilitation
Medicine.
In addition, there are NHS Complex Care facilities throughout Lothian. Day to day
medical needs for these beds are provided by local general practices or specialty
doctors, with consultant support. The Clinical Lead for Lothian Complex Care is Dr
Kathryn Anderson.
There is a strong tradition of research in Geriatric Medicine in Edinburgh, with an active
University of Edinburgh Geriatric Medicine Department led by Professor Alasdair
MacLullich.
A new pioneering system of working for Medicine for the Elderly Services is in the
process of being introduced across Lothian. This service redesign will ensure that older
frail adults have access to the specialist Medicine for the Elderly Service throughout the
patient journey within secondary care and will respond to the call for Geriatricians to do
more work outside of hospital and to continue to forge greater links with community
services and Health & Social Care.
The COMPASS (Comprehensive Assessment of Older Adults) initiative is also forging
greater integrated links with community services and Health & Social Care. A one year
pilot of COMPASS was introduced in Spring 2012 in South East Edinburgh with funding
approved from the Scottish Government through the Change Fund. As a result of this
pilot, ongoing funding has been introduced to introduce the model of care across Lothian.
The COMPASS service for North West Edinburgh commenced in April 2013 with a
cross-sector multidisciplinary meeting which has been running successfully. Two of these
posts have been developed to allow the COMPASS service to develop fully across North
Edinburgh. The main aim of the COMPASS service is to identify older frail adults in the
community at risk of admission and to target community and day hospital based care to
that group, thus avoiding unscheduled admission to hospital. The COMPASS service
also tracks and provides input to any such patients who are admitted to hospital and
ensures safe discharge.
Within the main acute hospital sites, the Medicine for the Elderly services continue to
develop their links with all areas involved in the care of older frail adults. The ECAT
(Elderly Care Assessment Team) at the RIE, and TEAM 65 (Targeted Early Assessment
and Management of the over 65’s) at the WGH were developed in 2010 as nurse led
teams who proactively assess patients in the admission areas of the hospitals. The
introduction of the COMPASS model has allowed these services to be developed and
enhanced within the COMPASS service.
Advanced liaison team working across each main hospital site allows early assessment
of frail adults in all specialties to gauge their suitability for rehabilitation.
6.
Details of the Posts
These posts are based across the main Medicine for the Elderly / Stroke Services in
Edinburgh: the Royal Infirmary of Edinburgh (including Liberton Hospital) and the
Western General Hospital. The Medicine for the Elderly Service in Edinburgh has
responsibility for managing inpatient care in the main hospitals and also at various
Complex NHS Care facilities around Edinburgh.
Post 1: Royal Infirmary of Edinburgh Hospital:
6 month post: February 4th 2015 until 4th August 2015
This post has been created through a vacancy in the ST3 Specialist Training scheme in
Geriatric Medicine for South East Scotland.
Candidates with MRCP will be preferentially considered for this post. The post holder will be
based at the Royal Infirmary of Edinburgh at middle grade level and will have the opportunity
to gain experience in Acute Medicine for the Elderly, Stroke, general liaison including
orthopaedic liaison.
On-call will be in Medicine for the Elderly – on the middle grade rota.
Post 2: Western General Hospital, Edinburgh:
4 month post: April 1st 2015 until 4th August 2015
This post has been created through the relocation of an ST3 trainee for a 4 month period. The
post holder will be based at the Western General Hospital and will gain experience in
Medicine for the Elderly assessment and rehabilitation as well as the opportunity to attend
weekly specialist MOE OPD Clinics. The post-holder may also gain experience in Day
Hospital assessments and hospital liaison. On-call will be in Medicine for the Elderly – on the
middle grade rota but depending on the experience of the trainee, sessions in the unselected
medical take admissions unit may be included.
Post 3: Rotational Post: Royal Infirmary of Edinburgh & Western General Hospitals:
6 month post: February 4th 2015 until 4th August 2015
This post has been created through a vacancy in the ST3 Specialist Training scheme in
Geriatric Medicine for South East Scotland.
Depending on service needs, the post holder will likely be initially be based at the Royal
Infirmary of Edinburgh and will rotate to the Western General Hospital MOE Department. The
post holder will have the opportunity to gain experience in Acute Medicine for the Elderly,
Stroke, liaison, day hospital and depending on the experience of the trainee, sessions in the
unselected medical take admissions unit may be included.
Appointed candidates will be allocated to the post most suitable to their training needs and
that of the service. Any appointees with MRCP may be considered for appointment at LAT
ST3 in Medicine for the Elderly.
If appointed at CMT LAT level, the post-holder will be rostered to gain experience in acute
medicine with sessions in the acute receiving units of the hospitals. The trainee will rotate
between various Medicine for the Elderly / Stroke wards – allowing them to gain experience in
the management of most medical conditions including the ‘geriatric giants’ – Immobility,
Instability, Incontinence and Intellectual impairment. The trainees in the WGH will have the
opportunity to gain experience in an outpatient clinic setting - mainly within a Day Hospital
setting.
The trainees will be assigned an Educational Supervisor for the period of each of the
attachments and will be given ample opportunity and support to complete appropriate training
competencies.
Exact on-call commitments will be outlined depending on the experience of the appointee.
7.
Teaching
The Medicine of the Elderly / Stroke services in Edinburgh have a major commitment to the
teaching and training of junior medical staff. There are regular formal educational opportunities
available on site and in the adjacent Western General Hospital. Informal teaching occurs in
ward round and outpatient settings. Consultant and Associate Specialist Staff are trained in
educational supervision and assessment of trainees and take pride in ensuring training
competencies are performed and completed during each trainee’s time at the WGH. Several
of the consultants are active examiners and host examiners for the MRCP (UK) PACES
examination and similar PostGraduate examinations and every effort will be made to tailor
teaching and training appropriate to the trainee’s needs.
Appointees will join in the N.E.S. co-ordinated training days depending on their level of
experience (i.e. CMT V ST3 training).
9.
Example of Typical Timetable
DAY/TIME
Monday
09.00-09.30
09.30-12.30
12.30-13.00
Hospital Handover Meeting
Ward Round (Consultant Led)
X-Ray teaching meeting
13.00-17.00
Ward work
Tuesday
09.00 - 09.15
09.30 - 12.30
12.30-13.30
Handover from HAN team
Ward Round (Registrar Led)
Formal Teaching Session
13.30-17.00
Ward work
Wednesday
09.00 - 09.15
09.30-10.00
10.00-12.30
Handover from HAN team
Ward Reviews
Out-patient Clinic
12.30-14.00
14.00-17.00
Grand Rounds
Ward work
Thursday
09.00-09.15
09.30-12.30
12.30-13.30
13.30-15.30
15.30-17.00
Handover from HAN team
Ward Round (Consultant Led)
Hospital Teaching Meeting
Multidisciplinary Meeting (Case Conference)
Ward work
Friday
09.00- 09.15
09.30-12.30
13.30-17.00
Handover from HAN team
Ward work
Ward work
8.
Contact Details
Dr Conor Maguire
Lead Clinician in Geriatric Medicine
Consultant in Geriatric Medicine
Royal Victoria Building, Western General Hospital
Edinburgh EH4 2XU
Telephone: 0131 5372677
e-mail: yvonne.b.young@luht.scot.nhs.uk
Dr Andrew Coull
Clinical Director for Medicine
Consultant in Acute and Geriatric Medicine
Royal Infirmary of Edinburgh
Edinburgh
Telephone: 0131 242 6927
e-mail: andrew.coull@nhslothian.scot.nhs.uk
9.
Person Specification
GENERAL PERSON SPECIFICATION
Qualifications
Essential
GMC registered medical practitioner
Desirable
MRCP UK
MBBS or equivalent medical qualification.
MRCP Part 1 or intention to sit MRCP
Part 1 by April 2015
Completion of Foundation Training (as
below)
Either:
Evidence of current employment in a
UKFPO affiliated Foundation Programme
OR
12 months experience after full GMC
registration and evidence of achievement
of Foundation competences in the 3 years
before the intended start date (ie.between
1st February 2012 and 4th February 2015
unless a different start date is specifically
indicated in advance by the deanery) from
a UKFPO affiliated Foundation
Programme or equivalent in line with
GMC standards/Good Medical practise
Post Specific
Experience
Experience in Medicine for the Elderly .
Language
Skills
All applicants to have demonstrable skills
in written and spoken English adequate to
enable effective communication about
medical topics with patients and
colleagues demonstrated by one of the
following:
- that applicants have undertaken
undergraduate medical training in English;
or
- have achieved the following scores in
the academic lnternational English
Language Testing System (IELTS) in a
single sitting within 24 months at time of
application – Overall 7, Speaking 7,
Listening 7, Reading 7, Writing 7.
Ability
If applicants believe they have adequate
communication skills but do not fit into
one of these examples they must provide
supporting evidence
Evidence of ability to take responsibility
for management of patients with distant
supervision
Specialty experience in
outpatients and geriatric Day
Hospital
Ability to lead ward teams
Experience at middle Grade
level in Medicine or Geriatric
Medicine
Teaching and
Audit
Motivation
Team Working
Evidence of commitment to formal and
informal teaching and training of Junior
Medical Staff and medical students
Evidence of commitment to patient
focused care,
Evidence of participation in
audit projects
Evidence of teamwork with colleagues in
previous jobs
Able to organise time efficiently and
effectively
Evidence of team leading
experience
Evidence of developing a
career in geriatric medicine.
Person Specification for those applying at CT1 level
Application to enter Specialty Training at CT1: Core
When Evaluated
Medical Training Essential
Qualifications
MBBS or equivalent medical qualification.
Eligibility
Eligible for full registration with the GMC at time of
appointment and hold a current licence to practise.
Either
Evidence of current employment in a UKFPO affiliated
Foundation Programme
Application form
Application form
Application form
OR
12 months experience after full GMC registration and
evidence of achievement of Foundation competences
in the 3 years before the intended start date
(ie.between 1st February 2012 and 4th February 2015
unless a different start date is specifically indicated in
advance by the deanery) from a UKFPO affiliated
Foundation Programme or equivalent in line with GMC
standards/Good Medical practise including
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Fitness To
Practise
Language Skills
Make the care or your patient your first
concern
Protect and promote the health of patients and
of the public
Provide a good standard of practise and care
Treat patients as individuals and respect their
dignity
Work in partnership with patients
Be honest and open and act with integrity
Eligibility to work in the UK.
Not previously relinquished, released or
removed from a Core Medical training
programme or from an ACCS training
programme except under exceptional
circumstances4
Is up to date and fit to practise safely.
All applicants to have demonstrable skills in written
and spoken English adequate to enable effective
communication about medical topics with patients and
colleagues demonstrated by one of the following:
- that applicants have undertaken undergraduate
medical training in English; or
- have achieved the following scores in the academic
lnternational English Language Testing System
Interview /
Selection centre
Application form
Application form
References
Application form
Interview /
Selection centre
(IELTS) in a single sitting within 24 months at time of
application – Overall 7, Speaking 7, Listening 7,
Reading 7, Writing 7.
Health
If applicants believe they have adequate
communication skills but do not fit into one of these
examples they must provide supporting evidence
Meets professional health requirements (in line with
GMC standards/Good Medical Practise).
Application form
Pre-employment
health screening