NHS Lothian
Women’s Services
Royal Infirmary of Edinburgh
Consultant Obstetrician and Gynaecologist
Fixed term one year
1. Outline of the post
Available from 01 April 2015. This is a fixed term post for one year. The post holder
will join a forward looking and vibrant department and play an active role in inpatient
obstetrics as well as having the opportunity to develop their special interests in
fetomaternal medicine, gynaecology, sexual health or medical education. The job
plan will include fixed night and weekend day shift work covering obstetrics and
emergency gynaecology. The existing consultants have either traditional on call or
resident emergency cover in their job plans and it is envisaged that the majority of
consultants (including the new post holders) will move to having a mixture of on call
and resident shifts in their job plans in order to provide 168 hour per week resident
consultant cover.
The posts will also include two Direct Clinical Care Programmed Activities (DCCPA)
per week devoted to special interests. There is the opportunity within the department
to develop or maintain special interests in the following areas
Early pregnancy
Emergency gynaecology
Outpatient gynaecology
Sexual health
Ambulatory obstetrics including fetal assessment
Advanced labour ward practice
Fetal medicine
Medical education.
The posts are advertised as nine DCCPA plus one supporting professional activity
(SPA) but there will be the opportunity for consultants with a particular interest in the
Scottish Patient Safety Programme, risk management or skills and drills training
(such as PROMPT – the PRactical Obstetric Multi-Professional Training course) to
be awarded additional SPA time for these purposes.
The prinicipal base for the posts is the Royal Infirmary of Edinburgh. There may be
clinics in surrounding health centres.
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 the 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, four
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
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.
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,
five-theatre day surgery complex. The hospital provides for most specialities and is
the centre for:
General surgery
Vascular surgery
Hepatobiliary and transplant medicine and surgery
Cardiac and thoracic surgery
Elective and trauma orthopaedic surgery
Neonatology
Obstetrics & Gynaecology
Cardiology
Renal medicine
Sleep medicine
Accident and Emergency.
There is a Combined Assessment Unit which takes unselected GP or direct
emergency referrals, and from A&E. CAU includes the Department 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 PET scanning). There is a full range of lecture theatres, a library and
AV facilities.
The Western General Hospital (WGH) has 600 beds and five 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
The UK CJD unit
Colorectal surgery
Urology and Scottish Lithotriptor Centre
Breast surgery
Gastroenterology
Rheumatology
Infectious diseases
Haematology and oncology
Medical oncology
Radiation oncology
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 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 is located in the centre of Livingston, a new town about 30
minutes drive west from Edinburgh. The hospital provides for most common
specialties, has a paediatric ward and is the centre for:
General medicine with cardiology, diabetes & endocrinology, gastroenterology,
respiratory medicine and care of the elderly
Obstetrics & Gynaecology
Paediatrics and community child health
Plastic surgery
Oral and maxillofacial surgery
ENT
Critical Care (ITU, HDU and CCU)
Accident and Emergency
General surgery
Orthopaedics
Mental Health including ICCU and ICPU
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 three miles from the site
of the New Royal Infirmary and the co-located University of Edinburgh Medical
School and three miles from the Western General Hospital. The RHSC 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 general surgery.
Hospital accommodation encompasses five theatres, a critical care unit comprising
an eight bedded Paediatric Intensive Care Unit, a six bedded High Dependency Unit
and a three 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.
The children’s hospital will be re-located to the Royal Infirmary site in 2017.
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
The Midlothian Community Hospital
Herdmanflat Hospital, Roodlands and Edenhall Hospitals 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 Allied Health Professions, 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.
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
Outpatients
Assessment Psychiatry 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 one 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 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.
Department of Public Health Medicine
The aim of the department is to improve the health of the people of Lothian in
collaboration with many other partners. Using a range of knowledge, experience and
networking capability, the 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:
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.
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, 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 three Colleges: Humanities and Social Science, Medicine and Veterinary
Medicine, Science and Engineering.
A new MRC / University of Edinburgh Centre for Reproductive Health opened in April
2011. There are close links between the centre and the Simpson Centre for
Reproductive Health, with seven of the current clinical staff having dual
appointments, and with further opportunities for collaboration.
4. NHS Library and Postgraduate Facilities
There are excellent facilities on all sites.
5. Departmental Information
The Simpson Centre for Reproductive Health is the main centre for perinatal care in
South East Scotland. The delivery rate in 2013 was approximately 6900 births. The
SCRH is the tertiary referral centre for the South East of Scotland and is the largest
obstetric unit in Scotland with 77 inpatient beds, a four bedded Day Assessment Unit
and a six bedded obstetric triage unit (staffed 24/7). The hospital includes a
Neonatal Intensive Care Unit, with twelve Level 1 Intensive Care, seven Level 2
Intensive Care and twenty four Special Care cots. We have two dedicated obstetric
operating theatres with 24/7 access to interventional radiology. Six weekly high-risk
multidisciplinary antenatal clinics (multiple pregnancy, diabetes, renal, haematology,
epilepsy, infectious diseases and endocrine are held within the SCRH and there is a
comprehensive outreach antenatal service covering the City of Edinburgh and
East/Midlothian. There is a busy Fetal Medicine Unit with daily sessions and regular
multidisciplinary working involving genetics, neonatology and paediatric surgery. A
fetal MRI service is available. A midwifery-led birthing centre opened adjacent to
SCRH in October 2011. 1294 women gave birth here in 2013.
There is large general gynaecological workload with approximately 500
hysterectomies (abdominal and vaginal) and 5,000 day cases being performed per
annum. 3,000 new gynaecological outpatients are seen per year. Sub-specialty
interests include Infertility, urogynaecology, gynaecological oncology and menstrual
dysfunction. Within The Simpson Centre for Reproductive Health, there is a
dedicated centre, The Edinburgh Fertility and Reproductive Endocrinology Centre
(EFREC) for patients with endocrine and infertility problems.
The Obstetric and Gynaecological Services at St. John’s comprises fifty obstetric
beds, including a day bed unit, and twenty gynaecology beds (twelve in-patient and
eight day beds). In 20131 the department handled approximately 2,674 deliveries.
There is an out-reach antenatal service covering West Lothian and part of the west of
Edinburgh. Special interests of the department include urogynaecology, menstrual
dysfunction and fetomaternal medicine. There are strong links between the two
Maternity Units.
Medical Staffing at the Royal Infirmary of Edinburgh
Feto-maternal Medicine Unit
Dr C Alexander
Dr A Campbell
Dr E Cooper
Dr S Cowan
Dr F Denison (University of Edinburgh)
Dr E Doubal
Dr K Dundas
Dr K Edgar
Dr R Hughes (Clinical Director for Obstetrics and Neonatology, NHS Lothian)
Dr C Love
Dr N Mary
Dr H Mustafa
Professor J Norman (University of Edinburgh)
Dr Sarah Stock
Dr N Palaniappan
Dr J Tierney
Gynaecology / Oncology / Urology Unit
Dr C Busby-Earle
Dr P Dewart (Clinical Director for Gynaecology NHS Lothian)*
Dr S Fegan
Dr S Jack
Dr C Martin
Dr S Nicholson *
Dr S Milne (Associate Specialist)
Reproductive Medicine Unit
Professor R Anderson (University of Edinburgh)
Dr B Brady
Professor H Critchley (University of Edinburgh)
Dr W Duncan (University of Edinburgh)
Dr A Horne (University of Edinburgh)
Dr C Tay (Gynaecologist and ACU Consultant)
Dr J Thong (Gynaecologist and ACU Consultant)
Dr C West
Medical staffing at St. John’s Hospital, Howden
Dr A Armstrong*
Dr T Cooper
Dr S Court
Dr S Coutts
Dr S Kallat
Dr A MacLeod
Dr P Mills
Dr S Rane
Dr K Rose *
Dr J Wilkens
Those consultants marked * work at both RIE and St John’s Hospital
6. Details of the Post
The job plans consists of nine direct clinical care programmed activities and one
supporting professional activity. The post holder will join the Fetomaternal Medicine
Unit supporting Labour Ward and inpatient obstetric services.
It is anticipated that the post holder will have a flexible job plan providing prospective
cover for the obstetric service including participation in daytime Labour Ward duties. .
It is anticipated that SPA time will be taken flexibly during the week to ensure
availability to carry out prospective cover for obstetric sessions.
Desk and computer with necessary IT access in a shared office. Secretarial support
as required.
This is an Exposure Prone post and evidence of the relevant immunities will be
required before starting work.
7. Research and Development
The Royal Infirmary of Edinburgh is the site of the University’s newly established
Queens Medical research Institute of which MRC Centre for Reproductive Health is a
key component. This is largest aggregation of Reproductive Scientists and Clinicians
in Europe and offers unique opportunities for research collaboration in all areas of
obstetrics and gynaecology. The MRC Centre for Reproductive Health includes the
Tommy's Centre for Maternal and Fetal Health, which has a research focus on
maternal obesity and preterm birth. The Tommy's Centre currently has around £10
million of pregnancy related research funding, and there are excellent opportunities
for collaboration with interested clinicians.
Currently the most prominent areas of clinical research include fertility control
(conception and contraception), gynaecological endocrinology, mental dysfunction,
gonad and gamete biology, feto-maternal disorders, placental function and the
biological control of parturition.
8. Teaching
The Department of Obstetrics and Gynaecology is recognised for sub-speciality
training in feto-maternal medicine, reproductive medicine and gynaecological
oncology. There are also sub-speciality training opportunities in sexual and
reproductive health at the Family Planning Clinic in Dean Terrace, Edinburgh.
Advanced training skill modules are available for trainees in years ST6/7.
The post holders may be asked to contribute to the organisation, delivery and quality
control of undergraduate and postgraduate medical education and training at the
Royal Infirmary and St. John’s.
9. Indicative Job Plan
Specialty:
Principal place of work:
Contract:
Programmed activities:
Out of hours shift work:
Managerially responsible to:
Obstetrics and Gynaecology
Royal Infirmary, Edinburgh
Full Time
10 PA
9.0 DCC PA; 1.0 SPA
4.0 DCC PA
Clinical Director of Obstetrics, NHS Lothian
The posts include either a Monday and Tuesday 12.5 hour night shift on a 1 in 5
basis or a Wednesday 12.5 hour night shift on a 1 in 2.5 basis ,and both include
weekend 12.5 hour day shifts on a 1 in 6 basis. All rotas include prospective cover
and the annual requirement is for 11 Monday/Tuesday blocks or 22 Wednesday
nights, and 9 weekends (2 x 12.5 hour day shifts per weekend). During out of hours
shifts the consultant will cover a senior trainee slot and will be working with two
FY/GPST/ST1 doctors and an ST 3-5 registrar. There is also a traditiional ‘on call’
consultant. Daytime activity will include labour ward, elective caesarean section lists,
obstetric triage cover and ward rounds for both candidates and is likely to also
include an antenatal clinic.
A timetable of activities, which have a specific location and time, will be agreed once
special interest sessions have been identified.
The attached job plan in its present form describes a 9:1 split between direct clinical
care and supporting professional activities. NHS Lothian allocates all consultants one
SPA for CPD, audit, clinical governance, appraisal, revalidation job planning and
management meetings. As a major teaching and research contributor it would
normally expect to allocate additional SPA time for activities to do with undergraduate
education, educational supervision of trainee medical staff, research and other
activities. These are all areas where NHS Lothian has a strong commitment and we
recognise the contribution that consultants are both willing and eager to make. There
will be the opportunity for consultants with a particular interest in the Scottish Patient
Safety Programme, Risk Management or skills and drills training (such as PROMPT
–the PRactical Obstetric Multi-Professional Training course) to be awarded
additional SPAs for these purposes.The precise allocation of SPA time and
associated objectives will be agreed with the successful applicant.
10. Contact Details
Further information is available from
Dr Corinne Love, Obstetric Lead RIE, corinne.love@luht.scot.nhs.uk
Dr Rhona Hughes, Clinical Director of Obstetrics, NHS Lothian,
rhona.hughes@luht.scot.nhs.uk
Dr Edward Doyle, Associate Medical Director, edward.doyle@luht.scot.nhs.uk 0131
536 0007
11. Person Specification
Requirements
Essential
Desirable
Qualifications
and Training
Registered with the GMC.
Additional postgraduate
qualifications e.g.
MD/PhD.
License to practice
Be on, or within six months of being
eligible for inclusion on the GMC
Specialist Register at the tme of
interview.
MRCOG or equivalent.
Relevant
Experience
General Obstetric and Gynaecology
experience.
Ability
Ability to take full responsibility for
independent management of
patients on labour ward including
supporting women with fetal loss
and undergoing termination of
pregnancy. Ability to manage
patients with acute gynaecological
conditions.
Research
Teaching and
Audit
Evidence of formal and informal
teaching and training of junior
doctors, medical students and other
clinical staff.
Evidence of learning and continuous
professional development.
Personal
Attributes
Evidence of patient focused care.
Good team player, good
communication skills, experience of
working in multidisciplinary teams.
Commitment to improving quality of
care with consultant delivered care
in and out of hours.
Understanding of and commitment
to the work of the Scottish Patient
Safety Programme and the maternal
work stream within this (Maternal
Collaborative Quality Improvement
Programme {McQIC}).
RCOG Advanced Skills
Training Module in
Advanced Antenatal
Practice, Advanced
Labour Practice, Labour
Ward Lead or
Maternal Medicine
Experience of writing
guidelines
Experience of research
desirable.
Publications
Previous experience of
designing teaching
programmes.
Qualification in teaching
Experience of designing
and effecting audit
programmes