NHS Lothian
Division/CH(C)P
Directorate of Surgery
Initial Hospital Base: Royal Infirmary Edinburgh
FIXED TERM SPECIALTY DOCTOR IN TRANSPLANTATION / RESEARCH
(10PAs, fixed term 12 months)
1.
Outline of the post
The Transplant Unit at The Royal Infirmary of Edinburgh would like to advertise a
Specialty Doctor post to compliment four existing posts. This post will provide on call
support for the Scottish Organ Retrieval Team and activities of the Edinburgh
Transplant Unit and will also offer the opportunity for a period of dedicated research.
The post will be vacant from the 1st of August 2015. The Transplant Unit will fund the
post.
Research component
To contribute to the development of a programme of high quality research, including
determination of specific research proposals and objectives. Conduct original research
and produce material for publication and dissemination.
3. Main Responsibilities of research component
Approx. %
of time
1. Conduct and facilitate a programme of individual research
in a specified area. Includes creating a research proposal
and
specifying
research
aims
and
objectives.
Responsibility for delivering core elements of the research
programme.
OR; Contribute as a key member of a team of researchers
through input to strategic research planning and
management. Conduct research on a collective basis with
responsibility for delivering on some core element(s) of the
research programme.
2. Maintain accurate and up-to-date records to document the
research progress. Take a lead role in writing up data for
publication. Present data at group meetings, section
meetings, and conferences to make data available for
other workers. Regular reporting of progress to the
PI/other members of the research team is expected.
Presentation of research findings at national and
international level (if appropriate).
April 2008
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50 %
(for all
agreed
activities in
subsections
1-6
3. Contribute to the dissemination and publication of
own/research team’s research findings (as appropriate).
To prepare research proposals and applications to
external funding bodies based on a line of future
research.
5. To continually update knowledge and understanding
in the field or specialism, and update skill base within the
defined research area.
6. To provide guidance and supervision for student projects
and/or instruction of students in the use of
equipment/demonstration of techniques
2.
NHS Lothian
NHS Lothian is an integrated NHS Board in Scotland providing primary, community,
mental health and hospital services. 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.
2.1 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
Royal Victoria Hospital
Liberton Hospital
The Princess Alexandra Eye Pavilion.
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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 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, NM
and PET scanning). There is a full range of lecture theatres, a library and AV
facilities.
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
•
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Gastro-Intestinal disease
Rheumatology
Infectious Diseases
Haematology Oncology
Medical Oncology
Radiation Oncology (including 6 LINACs)
Dermatology (Inpatient)
Medicine of the Elderly/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
April 2008
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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 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 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 SouthEast 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.
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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 audiovisual 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
2.2 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.
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.
2.3 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:-
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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 19 th
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.
2.4 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.
April 2008
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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 and within the top 5 Universities in Europe for its Biomedical
Sciences.
The University of Edinburgh’s College of Medicine and Veterinary Medicine (CMVM; Head
Professor Sir John Savill) is an internationally leading force in basic-to-clinical translational
research. The College has a consistent 30-year strategy of interdisciplinarity and integration
of basic and clinical sciences. In the most recent Research Assessment Exercise (2008), the
University of Edinburgh was top in the United Kingdom within the UoA4 category of Hospitalbased Clinical Subjects. In 2008/9, CMVM attracted over £120 million in external peerreviewed grant funding.
It has established several major interdisciplinary research Centres:
i. MRC Centre for Inflammation Research (Director, Professor John Iredale)
ii. Centre for Cardiovascular Science (Director, Professor Brian Walker) incorporating the
BHF Centre of Research Excellence (Director, Professor John Mullins)
iii. Centre for Reproductive Biology (Director, Professor Phillipa Saunders) and MRC Human
Reproductive Sciences Unit (Director, Professor Robert Millar) including the Tommy’s
Centre (Director, Professor Jane Norman).
iv. MRC Centre for Regenerative Medicine (Director, Professor Sir Ian Wilmut)
v. Centre for Molecular Medicine (Director, Professor David Porteous)
vi. Centre for Cancer Research (Director, Professor David Harrison)
vii. Centre for Population Health Sciences (Director, Professor Harry Campbell)
viii. MRC Human Genetics Unit (Director, Professor Nick Hastie)
These Centres are predominantly based at two sites: the Queen’s Medical Research Institute
at the Royal Infirmary, and the Institute of Genetics and Molecular Medicine at the Western
General Hospital. The co-location of basic science and clinical groups within state-of-the-art
infrastructure and technology provides an excellent and exciting opportunity to conduct
translational research at the highest level.
This academic power base is supported by clinical research infrastructure that includes:
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4.
April 2008
Wellcome Trust Clinical Research Facility
Clinical Research Imaging Centre
Edinburgh Clinical Trials Unit (UKCRN Registered) and Health Services Research Unit
Scottish Brain Imaging Research Centre
Experimental Cancer Medicine Centre
Academic and Clinical Central Office for Research and Development
NHS Library and Postgraduate Facilities
There are excellent facilities on all sites.
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5.
Departmental Information: Transplant Unit.
The Transplant Unit provides medical care at a national level for the whole of Scotland
through the Liver and Pancreas programs as well as supraregional cover for kidney
transplantation. The unit has also been commissioned to provide a national service for
isolation and transplantation of pancreatic islets for the population of Scotland from April
2009.
The Scottish Liver Transplant Unit opened in 1992 and the annual contract for liver
transplant numbers has gradually increased. In 1995 the Renal Transplant Unit moved from
the Western General Hospital so that the Royal Infirmary Transplant Unit became a
combined unit. The number of patients transplanted has gradually increased as well as their
complexity, with the opening of a pancreas program and the development of Living donor
transplantation, for kidney and liver recipients.
Following significant national concerns about the organ donation rate, a UK-wide advisory
committee was setup to advise all departments of health regarding action, which should be
taken to improve the situation. Several recommendations were made to increase the
donation rate and in fact some of them have already been implemented with a significant
effect on the transplant activity. We therefore appointed two specialty doctors (transplant
clinical fellows) last year to provide cover for the transplant unit. This has been successful in
order to cope with the increasing transplant activity. We are now advertising for an additional
two Specialty Doctor posts, of which this is one.
The combined renal, pancreas and liver transplant ward has 18 in-patient beds in addition to
a dedicated transplant high dependency unit with 5 beds. Further beds are funded by the
transplant service in the intensive care unit. The Transplant Unit also contributes to the
fulminant hepatic failure service, which is a further nationally designated service for the
population of Scotland.
The Transplant Unit in the RIE provides a national organ retrieval service throughout
Scotland and also in Northern Ireland. Recent changes in organ allocation based on the
Donor task force recommendations and the commissioning of the National Organ Retrieval
Service (NORS), the transplant unit through the Scottish Organ Retrieval Team (SORT)
provides second on call cover for the north of England, in cooperation with Newcastle and
Leeds Transplant Units. This, similar to liver, pancreas and islet transplantation, is a supra
regionally funded service currently commissioned by National Service Division.
The number and complexity of retrievals has increased considerably being now routinely two
consultants on call (first and second tier).

Names of Clinical staff and any specialist interests
(a) Consultant Transplant Surgeons
Miss Anya Adair
Mr Murat Akyol
Mr John Casey
Mr Ian Currie
Prof John Forsythe
Mr Ewen Harrison
Ms Lorna Marson
Mr Gabriel Oniscu
Mr James Powell
Prof. Steve Wigmore
April 2008
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(b) Transplant Hepatologists
Dr Andrew Bathgate
Dr Carol Blair
Prof. Stuart Forbes
Prof. Peter Hayes
Dr Alastair MacGilchrist
Dr Ken Simpson
(c) Transplant Nephrologists
Dr Bean Dhaun
Dr Paddy Gibson
Dr Lorna Henderson
Dr David Kluth
Dr Wendy Metcalfe
Dr Paul Phelan
Dr Simon Watson
Dr Caroline Whitworth
(d) Transplant Anaesthetists
Dr Craig Beattie
Dr David Cameron
Dr Brian Cook
Dr Rory Mayes
Dr Alistair Lee
Dr Dermot McKeown
Dr Anthony Pollok
Dr Ewan Thompson
Yet again we can report a record year for transplantation activity in the Royal Infirmary of
Edinburgh in this last financial year. This year there have been more assessments, more
retrievals, more transplants (both liver and kidney) and more outpatient consultations than ever
before.
In 20011/2012 financial year 115 retrievals were performed; 109 kidney transplants, 20
pancreas transplants and 96 liver transplants were performed in the Transplant Unit. (This
summary only reflects part of the transplant unit activity, not including outpatient clinics,
assessments and ward rounds,)
6.
Details of the clinical aspects of the post
There are three existing Specialty doctors attached to the transplant unit, who work together
with the trainees. With the two planned additional posts, their main commitment will be to
provide cover to the transplant on call rota, and secondly to participate in the transplant ward
duties. There will be also an element of work at the HPB unit.
The combination of trainees and specialty doctors has contributed largely to develop a rota that
is compliant with EWTD and New Deal and has been a big benefit for the unit.
Applicants must be post CCT or equivalent (be on, or be eligible for inclusion on the GMC
April 2008
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Specialist Register within 6 months of interview). As noted before, the post is part of a national
programme of transplantation. This is an Exposure Prone post.
7.
Research and Development
As noted above, the transplant unit is fully involved in both laboratory and clinical research.
The research element of the post has been described on page 1-2. For some details of
current departmental research activities please refer to:
http://www.ed.ac.uk/schools-departments/surgery/research
There are a number of other projects particularly clinical projects which are available which
are not listed on this site.
8.
Teaching
The unit is involved in undergraduate and postgraduate teaching, training and examinations.
No formal teaching duties are required of this post.
April 2008
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9.
Job Plan
NHS Lothian - Job Plan Format
Name: SPECIALTY DOCTOR.
Specialty: TRANSPLANT UNIT
Principal Place of Work: RIE (ward 206).
Contract:
Full Time
Programmed Activities: 10.
EPAs: not applicable.
Availability Supplement: 6%
Salary will be defined in accordance with the provisions in Schedule 14 of the Terms &
Conditions, appropriate for the individual experience.
Managerially responsible to: Prof Wigmore
Responsible for: see attached job description (appendix 1)
a)
Timetable of activities which have a specific location and time (appendix 2)
See attached job description. In summary, main commitment will be to provide cover
to the transplant on call rota.
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9.
Contact Details
Prof Wigmore
Consultant Transplant Surgeon
Lead Clinician Transplant Unit
Royal Infirmary of Edinburgh
51 Little France Crescent
EDINBURGH
EH16 4SA
Mr Gabriel Oniscu
Consultant Transplant Surgeon
Transplant Unit
Royal Infirmary of Edinburgh
51 Little France Crescent
EDINBURGH
EH16 4SA
Tel: 0131 242 1714
Fax: 0131 242 1739
Tel: 0131 242 1715
Email: s.wigmore@ed.ac.uk
Email: gabriel.oniscu@ed.ac.uk
The NHS Structured Application and job description can be obtained by e-mailing
medical.personnel@nhslothian.scot.nhs.uk. The completed NHS Structured Application and the
names, email and postal addresses of three referees should be sent to the above email address
by the closing date of 12th July 2015. No applications will be considered after this time. Please
quote reference CG865.
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.
April 2008
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10.
Person Specification: Specialty Doctor. Transplant Unit
REQUIREMENTS
ESSENTIAL
DESIRABLE
and

GMC
registered
practitioner
medical
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Research and
experience
Post
Specific
Experience
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Applicant should have some
experience in organ retrieval
procedures.
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Experience of areas of
abdominal
organ
transplantation
Experience
in
assessment of patients
for inclusion on the
active waiting list for
organ transplantation
Qualifications
Training

Ability
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Academic
Achievements
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Evidence of ability to work in a
multi-disciplinary team
Basic surgical skills
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Evidence of commitment to
research,
publications
and
presentations
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Evidence of previous
experience
in
successful
research
funding, review and
publication
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Evidence of teaching
qualification or learning
Designing
and
effecting
audit
programmes
Teaching and Audit
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Motivation
Team Working
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April 2008
audit
Evidence of commitment to:
o Patient focused care,
o Effective and efficient use
of resources
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Evidence of teamwork with
colleagues in own and other
disciplines
Able to organise time efficiently
and effectively
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
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Evidence
of
development
of
services for patients
Clear commitment to
developing
role
in
transplantation/ organ
donation
Able
to
motivate
colleagues
Evidence of ability to
lead service re-design
for the benefit of
patients
APPENDIX 1. TIMETABLE
a) Timetable of activities
DAY
Monday
08-12
HOSPITAL/ LOCATION
TYPE OF WORK
RIE, transplant Unit
SPA
PA
1
07pm-07am
2
Tuesday
07pm-07am
UoE NHS Research
Wednesday
07pm-07am
UoE NHS Research
Thursday
07pm-07am
RIE, transplant Unit
1.5 (1 PEW)
Friday
07pm-07am
RIE, transplant Unit
1
Saturday
09-13h
Sunday
09-13h
2
RIE, Ward rounds
transplant Unit
DCC
1.25 PA (PEW)
RIE, Ward Rounds
transplant Unit
DCC
1.25 PA (PEW)
10 (9+1)
Total number of PA *
* : Predictable on call work is shown as 3.5 PA;
Predictable Emergency Work from on call duties (PEW)(1:5 rota)
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