NHS Lothian
Acute Operating Division
Childrens Services
Base: Royal Hospital for Sick Children
Subspecialty training in Paediatric Emergency Medicine at the Royal Hospital for Sick
Children, Edinburgh (PEM component)
1.
Outline of the post
Applications are invited for the above post, which is available from August 2015 for a period
of 1 year in total, start date subject to negotiation and level of training. The post consists of 6
months paediatric emergency medicine and 6 months PICU/retrieval. The successful
applicant will be an Emergency Medicine trainee at an equivalent ST4 level. The post holder
will work a band 1A compliant full shift rota in the Paediatric ED. (including out-of-hours and
weekend working). This post is designed to allow the post-holder to achieve the additional
competencies in PEM required for recognised subspecialty training in PEM.
The Postgraduate Dean confirms that this placement has the required educational and
postgraduate dean’s approval.
2.
The Royal Hospital for Sick Children.
Part of NHS Lothian, 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 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.
The RHSC reprovision project is well under-way with plans to build a state-of-the-art
children’s hospital on the current Royal Infirmary site. The aim is to transfer of the current
RHSC services in 2017.
Oct 2011
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3.
NHS Library and Postgraduate Facilities
There are excellent facilities available on site.
4.
The Emergency Department
The RHSC ED provides high quality emergency medical, nursing and AHP care to children
aged less than 13 yrs from Edinburgh and the surrounding areas who have been injured, or
become acutely unwell. The department has an excellent track record for compliance with the
Unscheduled Care ‘4 –hour’ target. The RHSC ED is the only centre receiving paediatric
major trauma in NHS Lothian and is the designated receiving hospital for all paediatric
casualties in the event of a Major Incident. Current attendance rates are approximately
42,000 new patients per annum in addition to a 4,500 patient per annum review clinic.
The Emergency Department operates a ‘combined front door’ with acute paediatrics whereby
the initial assessment and treatment of referrals from primary care is the responsibility of the
Emergency Medicine. In addition, many of the children and young people who have referred
to other specialty teams either by their primary care practitioner, or from other hospitals are
initially assessed and treated within the ED.
Current staffing of the Emergency Department comprises 9 consultants (many of whom also
work elsewhere within NHSL), 2 associate specialists, 3.3 WTE specialty doctors and up to 7
doctors in training (currently a mixture of STs in Emergency Medicine and GPVTS trainees).
5.
Details of the Post
The appointee will work as part of a team providing both initial and supervisory care to
children presenting to the Emergency Department with a wide variety of conditions. This post
is part of a well established EM and PEM training program. In combination with the PICU
component of the 12 month post, the post holder will have ample opportunities to achieve the
additional competencies required for subspecialty training in PEM.
The post holder, under the supervision of the ED consultant, be responsible for:

delivering clinical care to acutely injured and unwell children who attend the Emergency
Department, including reviewing and actioning results for patients discharged from the
department

acting as team member on the RHSC in-hospital Paediatric Emergency Team

supporting the division’s delivery of the Unscheduled Care ‘4-hour’ target

contributing to the supervision and training of undergraduate students from the University
of Edinburgh and, if appropriate, more junior doctors in training.

working closely with colleagues from other specialties and services to ensure the delivery
of high quality care throughout the patient journey

maintaining and updating their own knowledge and skills
All doctors will be expected to become familiar with the Trak Patient Management System
and to enter clinical details and details of treatment according to the requirements of the
System. At all times doctors will be expected to maintain adequate notes in a legible and
concise manner.
Oct 2011
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6.
Research and Development
The post holder will be expected to support ongoing research projects. The successful
applicant will be encouraged to undertake an audit during the post, and opportunities to
undertake research projects are available.
7.
Teaching
Protected time is provided to allow attendance at a formal departmental teaching program.
The post holder will be expected to contribute to the supervision and training of
undergraduate students from the University of Edinburgh and, if appropriate, more junior
doctors in training
Subspecialty training in Paediatric Emergency Medicine at the Royal Hospital for Sick
Children, Edinburgh (Paediatric Intensive Care and Intensive Care Retrieval component)
8.
Outline of the post
The post holder will be offered training in paediatric intensive care and retrieval medicine. The
successful applicant will cover the intensive care retrieval service on a 1:6 rota (1:4.8 with
prospective cover). The paediatric transport team is normally composed of a senior member
of medical staff and a senior PICU transport nurse. The post holder will gain wide experience
in stabilising and resuscitating critically ill children and neonates in peripheral hospitals prior
to transporting them by road or air. The post holder will be expected to attend twice daily
PICU ward rounds and play a role supervising and supporting the resident registrars in PICU.
In addition to retrieval and PICU duties the post holder will be expected to undertake trainee
anaesthetic sessions and to develop a research or audit interest. The rota is compliant for a
2B banding.
The Postgraduate Dean confirms that this placement has the required educational and
postgraduate dean’s approval.
9.
National Overview
Since April 2007 the two Scottish PICUs in Glasgow and Edinburgh have operated as a
National Paediatric Intensive Care Service centrally funded by the National Services Division.
The Edinburgh PICU has admitted continually increasing numbers of patients over recent
years, with more than 450 admissions last year.
The Edinburgh team conducts circa 150 intensive care retrievals from other hospitals in
Scotland per year. The retrieval service is undergoing a harmonisation process which will see
all of the specialist retrieval services in Scotland combine to form ScotSTAR- Scottish
Specialist Transport and Retrieval service
Oct 2011
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10.
Department Information: Anaesthesia and Critical Care
The Anaesthetic department provides anaesthesia for a wide range of paediatric surgical
activity including paediatric Surgery, Orthopaedic surgery, Scoliosis surgery, Neurosurgery,
plastic and Re-constructive Surgery, Burns and ENT Surgery. The service also supports an
acute and chronic pain service. Theatre activity takes place in five recently equipped
operating theatres. In addition the anaesthetic department supports paediatric activity out with
the theatre complex in radiology and occasionally in other hospitals. 10 consultants undertake
general anaesthetic on call.
The Paediatric Intensive Care Unit (PICU) is a multidisciplinary unit that caters for infants and
children from a wide variety of disciplines including paediatric surgery, neurosurgery, medical
paediatrics, plastic surgery, burns and general trauma. The case mix includes a broad
spectrum of critically ill children requiring Level Two and Level Three care, with the exception
of cardiac surgical and transplant patients. 6 consultants undertake on call for PICU.
The retrieval service operates a 1 in 6 on call rota, comprising a combination of consultants
and senior trainees. There are five specialist registrars from the South East of Scotland
paediatric training Programme attached to PICU at any one time.
Both departments have a commitment to teaching for various groups including
undergraduates, anaesthetic trainees, non-anaesthetic trainees in paediatric intensive care
and Emergency Medicine. This includes basic and advanced paediatric life support and
advanced airway management techniques in theatre. Potential applicants should have an
interest in and commitment to undergraduate and postgraduate teaching.
11.
Audit
The PICU holds regular meetings to review the retrieval service. These meetings are copresented by a member of the medical staff and a senior PICU nurse. Retrieval activity, case
review and critical incident analysis are undertaken at these meetings and successful
appointees will be expected to take active participation in unit audit activity.
12.
Teaching
The successful post holder is expected to take an active role in teaching resuscitation skills to
undergraduate medical students, critical care to post graduates and in the ‘in house’
educational programme for medical and nursing staff. The post holder will be expected to
teach BLS and ALS to medical students weekly on a rotational basis with their colleagues.
Each medical student teaching session requires one trainee to be present.
13.
Departmental Meetings
The department holds weekly anaesthesia meetings on Thursdays at 5pm and Intensive Care
meetings on Wednesdays at 2:30pm. In addition RHSC holds Grand Rounds on Tuesdays at
1pm.
Oct 2011
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14.
Person Specification
REQUIREMENTS
ESSENTIAL
DESIRABLE
Qualifications/Training
GMC Registration
MBChB or equivalent
NTN in Emergency Medicine in UK
training programme
MRCEM
EPLS / APLS Certificate
Experience/Knowledge
Previous experience in Emergency
Medicine, Paediatric Emergency
Medicine.
or
Able to demonstrate equivalent
experience and competencies.
Motivation
Keen to develop Paediatric Emergency
Medicine skills and to deliver high quality
care to children attending the department
Personal Attributes
Common sense, the ability to organise
and motivate yourself.
Ability to manage and cope under
pressure
Able to communicate well, complement
the existing multidisciplinary team and
have communication skills necessary to
carry out duties safely and effectively
Audit
Understanding of audit and how it affects
clinical practice
Evidence of completed audit activity
Research
Understanding of research principles and
how it affects clinical practice
Relevant publications in peer
reviewed journals.
Contact Details
Dr. S Lynch, Consultant in Emergency Medicine and Training Programme Director.
Royal Infirmary Edinburgh, EH16 4SA
Tel: 0131 2421338 Email: Stephen.lynch@luht.scot.nhs.uk
Dr. P. Leonard, Consultant in Emergency Medicine
Royal Hospital for Sick Children, Sciennes Road, Edinburgh, EH19 1LF
Tel: 0131 5360216 (mornings only) Email: Paul.leonard@luht.scot.nhs.uk
Oct 2011
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