NHS Lothian
Directorate of Surgical Services
Hospital Base – Western General Hospital.
Title:
Clinical Fellow in Urology with Subspecialist Interest in EndoUrology,
Urology Service, Western General Hospital, Edinburgh
Base Hospital: Western General Hospital, Edinburgh
1. Details of the Post
The successful applicant will be offered a contract from 1st August 2015 or earliest possible start
time until 31.1.2016.
A weekly timetable will be agreed with the successful applicant. The nature of fixed sessions may
vary from week to week.
The post holder will predominantly be required to support the subspecialty of EndoUrology.
Additionally there will be service commitments to provide some General Urology sessions (mainly
lower urinary tract endoscopic surgery [diagnosis/ treatment] and penoscrotal surgery).
Subspecialty sessions are located at the Western General Hospital. General Urology sessions
may involve all sites where Urology services are provided by the network, including St John’s
Hospital in Livingston (West Lothian) and Roodlands General Hospital in Haddington (East
Lothian).
The appointee will have a responsibility for the care of patients at senior urological trainee level
including ward rounds and on call duties. This includes a 1:7 busy, but non residential out-of
hours on call contribution as well as a 1:7 rotational day time on call commitment with emphasis
on providing safe, fast and efficient assessment and management of emergency admissions to
the new purpose designed surgical assessment area. Operative duties include independent and
supervised operating and assisting within the subspecialty interest in theatre as well as largely
independent operating and diagnostic work for General Urology. The post involves contributing to
outpatient clinics, flexible cystoscopy lists and possibly specialised procedures (eg. Urodynamics,
intravesical botulinum toxin injections) as related to their subspecialty allocation and existing
skills. The post also includes administrative duties associated with the care of his or her patients
and an appropriate administrative share in the running of the clinical department.
The successful candidate will be expected to provide prospective cover for his/her colleagues
during periods of annual leave or study leave.
2. Departmental Information Urology services are delivered by all consultants at the Western General Hospital and other
hospitals within the network listed below . Services are currently delivered by a team of twelve
consultants, covering general urology with well-developed sub-specialist interests in all the major
disease areas, as follows:
Mr A. Alhasso – Female and reconstructive urological surgery.
Mr P. Bollina – Prostate Cancer (minimal access surgery) & Bladder cancer
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Mr M Cutress - Endo-urology & Scottish Lithotriptor Service.
Mr R. Donat – Andrology
Mr P. Mariappan – Bladder malignancy
Prof A. McNeill – Minimally invasive management of prostate & renal cancer.
Mr S Phipps - Endo-urology & minimal access surgery ,Scottish Lithotriptor Service.
Mr K. O’Connor – Renal cancer
Mr CJ Shukla – Andrology
Mr G. Stewart – Renal cancer & Academic Urology (University Senior Lecturer)
Mr L. Stewart – Female Urology, Urodynamics and reconstructive urological surgery
Mr B. Thomas - Endo-urology & minimal access surgery, Scottish Lithotriptor Service.
It is a well-equipped unit with endoscopic facilities in all theatres, a full range of endoscopic and
laparoscopic equipment and a full compliment of video-urodynamic equipment. The welldeveloped subspecialist organisation of the unit has allowed it to develop a tradition of leading
developments in Urology in Scotland, in all areas from andrology to laparoscopic pelvic surgery,
and it remains at the forefront in this regard having performed 1200 laparoscopic nephrectomies
and over 700 laparoscopic prostatectomies. The Scottish Lithotriptor Centre is a well-renowned
part of the Department of Urology based at the Western General Hospital, which provides a
secondary and tertiary service for the management of patients with urinary tract stones.
Urology services St John’s Hospital, Livingston include fully equipped theatres allowing
endoscopic and day case procedures. A Green Light Laser (AMS) has been installed and will
allow us to deliver a daycase service for patients with benign prostatic obstruction. TRUSS
biopsies and flexible cystoscopies are performed, with future plans to establish local prostate
assessment and catheter clinics to be run by Urology Nurse Specialists alongside the consultant
staff. At present services are provided by a team of consultant urologists who visit from the
Western General Hospital.
The unit provides training as part of the East of Scotland Training Programme in Urology with and
currently offers training to two surgical core trainees, five Urology specialty trainees, and 1
Laparoscopy Fellow. The advertised post(s) will expand the service with two additional Urology
Fellowship posts. Urology Specialty Trainees and Clinical Fellows share on-call commitments on
a 1:7 non-residential on-call rota. Training opportunities are focussed according to the specific
needs of each trainee.
The medical team is supported by an excellent team of theatre and ward nursing staff and nurse
practitioners who undertake roles such as prostate biopsies and flexible cystoscopy. The Nurse
Urology Unit houses facilities for assessment and follow up of patients with bladder outflow
obstruction and incontinence. This unit also takes pressure off the ward with regard to
performing trial without catheters and teaching intermittent self-catheterisation.
3. Research and Development
The undertaking of research and audit projects or the further continuance of existing projects in
urological surgery will be encouraged but is not mandatory.
4. Teaching
The appointee will be expected to take part in undergraduate and postgraduate teaching activities
associated with the departments links with the University of Edinburgh. This teaching usually
occurs during normal daytime activities, when medical students are present in clinical settings
with teaching in theatres, clinics and bedside teaching during ward rounds. This also involves
contributing to the education of more junior surgical trainees in the department as appropriate.
The post does not involve a specific teaching commitment or time allocation for teaching within
the time table.
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5.
Job Plan
Indicative Timetable of activities: Urology Rotation
Endourology Fellow
ACTIVITY
LOCATION
CONSULTANT
OP-list Endo Ur
Theatre J WGH
BG Thomas
PM
TUESDAY
AM
Admin/stone meetg
WGH
Stone Meeting
+ W.R.
WGH
PM
WEDNESDAY
AM
OP-list Endo Ur
Theatre J WGH
PM
THURSDAY
AM
Stone Clinic
OP-list Endo Ur
Theatre J WGH
S Phipps
PM
FRIDAY
AM
OP–list Endo Ur
Theatre J WGH
S Phipps
OP clinic Gen Uro
SJH 1:2
WGH 1:2
OP-list Theatre 1:2
Flexi List 1:4
Postgraduate
Session 1:4
SJH 1:2
WGH 1:2
MONDAY
AM
ML Cutress
SPA - time
S Phipps
PM
Please note: Job Plans provide a general outline of the post, specific allocation of
clinical sessions may vary at times from the indicative job plans depending on day
time on call provision, cover for absent colleagues and departmental needs, requiring
flexible team working. Specific allocations are reviewed and arranged on a weekly
basis.
May 2014
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6. 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.
6.1 NHS Lothian
NHS Lothain 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:
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.
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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:
Neurology, Neurosurgery and neuropathology
UK CJD unit
Colorectal Surgery
Urology and Scottish Lithotriptor Centre
Breast Surgery and Breast screening
Rheumatology
Infectious Diseases
Haematology Oncology
Medical Oncology
Radiation Oncology (including 6 LINACs)
Dermatology (Inpatient)
Medicine of the Elderly/Stroke Medicine
There is a Surgical Assessment Unit and a Medical 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:
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 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 ICPUO
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.
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The Royal Hospital for Sick Children (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
6.2Community 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 communitybased 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, bioengineering and prosthetics, drugs and alcohol misuse and harm reduction, AIDS/HIV and
Children and Family Psychiatric Services.
6.3 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:Acute Mental Health
Rehabilitation
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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 beds 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.
6.4 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:
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.
7.
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
May 2014
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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.
8. NHS Library and Postgraduate Facilities
There are excellent facilities on all sites.
Contact Details
For further enquiries please contact:
Mr Ben Thomas, Consultant Urologist, Scottish Lithotripsy Centre, Western General Hospital,
Edinburgh
 (0131) 537 1602 (May Docherty, Lithotripsy Secretary)
e-mail ben.tomas@luht.scot.nhs.uk or bthomas2@nhs.net
Mr Roland Donat , Consultant Urologist, Professional Lead Western General Hospital, Edinburgh
 (0131) 537 3261 (Sheila Archibald, Personal Secretary);
e-mail roland.donat@luht.scot.nhs.uk
Person Specification
Please see attachment: - Appendix A
Please note that we no longer accept application by CV.
All suitable applicants are encouraged to apply for this post. However, in accordance with
UK Border Agency guidance, those requiring sponsorship under a Tier 2 visa can only be
appointed to a post if there are no suitable UK/EEA applicants or applicants not requiring
sponsorship (e.g. those on a Tier 1 visa). For more information go to
http://www.ukba.homeoffice.gov.uk/workingintheuk/
We are working towards Equal Opportunities.
May 2014
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2015 Person
Specification
Application to enter Clinical Fellowship Post:
Urology
Entry Criteria
Qualifications
Eligibility
Essential Criteria
When Evaluated1
•
MBBS or equivalent medical qualification
Application form
•
Successful completion of MRCS at time of interview
•
Eligible for full registration with the GMC at time of appointment and
3
hold a current license to practice.
Application form
•
Evidence of achievement of Foundation competences from a UKFPO
2
affiliated Foundation Programme or equivalent by time of appointment
in line with GMC standards/ Good Medical Practice including:
Application form
Interview / Selection
5
centre
2
o
o
o
o
o
o
Fitness To Practise
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 practice and care
Treat patients as individuals and respect their dignity
Work in partnership with patients
Be honest and open and act with integrity
•
Evidence of completion of Urology training to a level of competency in
core Urology (FRCS (Urol), FEBU, CCT or equivalent at time of
appointment.
•
Eligibility to work in the UK
•
Not previously relinquished, released or removed from a training
4
programme in this specialty except under exceptional circumstances
Is up to date and fit to practice safely
Application form/
Interview / Selection
centre
Application form
Application form
References
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:
o
that applicants have undertaken undergraduate medical training in English;
or
o
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.
Application form
Interview / Selection
centre
If applicants believe they have adequate communication skills but do not fit
into one of these examples they must provide supporting evidence
Health
Meets professional health requirements (in line with GMC standards/ Good
Medical Practice)
1
Application form
Pre-employment
health screening
‘when evaluated’ is indicative, but may be carried out at any time throughout the selection process
Time of appointment refers to the date at which the post commences
3
The GMC introduced a license to practice in 2009. Any doctor wishing to practice in the UK after this date must be both registered and
hold a license to practice at time of appointment.
4
Examples might include ARCP outcome 4 or failure to progress after two or more failed RITA Es. Applications will only be considered if
there is a letter of support from the Postgraduate Dean or designated Deputy of the deanery in which they worked. Should the
Postgraduate Dean not support the application, appeal may be made to the Recruitment Lead whose decision will be final. The
Recruitment lead may be the recruitment team at the office managing recruitment or at the deanery to whom you are making your
application.
5
A selection centre is a process not a place. It involves a number of selection activities that may be delivered within the Unit of
Application.
2
May 2014
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Career
Progression6
•
Ability to provide a complete employment history
•
Evidence that career progression is consistent with personal
circumstances
Evidence that present achievement and performance is commensurate
with totality of period of training
7
At least 60 months experience in surgery , of which at least 48
months has been in urology by time of appointment.
•
•
Application
Completion
Application form
Interview / Selection
centre
ALL sections of application form completed FULLY according to written
guidelines
Application form
Essential
Desirable
When Evaluated
Technical Knowledge & Clinical
Expertise:
Personal Attributes:
Selection Criteria
Clinical Skills
•
Capacity to apply sound clinical
knowledge & judgement & prioritise
clinical need.
•
Competencies in core Urology,
including skills of independent
operative practice in lower urinary
tract endoscopic surgery and
penoscrotal surgery.
•
Shows aptitude for practical
skills, e.g. hand-eye coordination, dexterity, visuospatial awareness
•
Attendance at relevant
courses, e.g. ATLS, Basic
Surgical Skills or equivalent,
CCrISP
•
Higher degree equivalent
to MD, ChM or Ph D

Evidence of relevant
academic & research
achievements, e.g.
degrees, prizes, awards,
distinctions, publications,
presentations, other
achievements
•
Evidence of participation in
risk management and/or
clinical/laboratory research

Track record of
undergraduate and post
graduate teaching

Experienced with OSCE type
Application form
Interview / Selection
centre
References
Capable of independent practice in
outclinic including appropriate
technical and clinical knowledge
base, diagnostic skills and clinical
judgement.
•
Validated logbook documentation of
surgical exposure to date.
Evidence of satisfactory continued
medical practice eg appraisals.
Academic /
Research Skills
Research Skills:
•
•
Demonstrates understanding of the
basic principles of audit, clinical risk
management & evidence-based
practice
Understanding of basic research
principles, methodology & ethics,
with a potential to contribute to
research
Audit:
•
Evidence of active participation in
audit
Teaching:
•
Evidence of contributing to teaching
& learning of others
6
examinations
All experience in posts at any level count irrespective of the country the experience
is gained in and PowerPoint
7
Presentations
Any time periods specified in this person specification refer to full time equivalent
May 2014
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Application form
Interview / Selection
centre
Personal Skills
Judgement Under Pressure:
•
Capacity to operate effectively
under pressure & remain objective
in highly emotive/pressurised
situations
•
Awareness of own limitations &
when to ask for help
Application form
Interview / Selection
centre
References
Communication Skills:
•
Capacity to communicate effectively
& sensitively with others
•
Able to discuss treatment options
with patients in a way they can
understand

Ability to function and
communicate at an
appropriate level within
a multidisciplinary team

Able to motivate
departmental colleagues

Driving Licence
Problem Solving:
•
Capacity to think beyond the
obvious, with analytical and flexible
mind
•
Capacity to bring a range of
approaches to problem solving
Situation Awareness:
• Capacity to monitor and anticipate
situations that may change rapidly
Decision Making:
•
Demonstrates effective judgement
and decision-making skills
Leadership & Team Involvement:
•
Capacity to work effectively in a
Multi-Disciplinary Team
•
Demonstrate leadership when
appropriate
•
Capacity to establish good working
relations with others
Organisation & Planning:
May 2014
•
Capacity to manage time and
prioritise workload, balance urgent &
important demands, follow
instructions
•
Understands importance & impact of
information systems
Page 11 of 12
Probity
Commitment To
Specialty
Professional Integrity:
•
Takes responsibility for own actions
•
Demonstrates respect for the rights
of all
•
Demonstrates awareness of ethical
principles, safety, confidentiality &
consent
•
Awareness of importance of being
the patients’ Advocate, clinical
governance & responsibilities of an
NHS Employee
Learning & Development:
Extracurricular activities:
• Shows realistic insight Into Urology
and the demands of a surgical
lifestyle
•
• Demonstrates knowledge of training
programme & commitment to own
development
• Shows critical & enquiring approach
to knowledge acquisition,
commitment to self-directed learning
& reflective/analytical approach to
practice
May 2014
Application form
Interview / Selection
centre
References
Page 12 of 12
urology, including elective or
other experience
Application form
Interview / Selection
centre
References