NHS Lanarkshire – Information Pack POSITION: Consultant Physician in Respiratory & General Medicine Reference Grade Location Hours / PA’s Salary Scale Closing Date MS/1214/02 Quote on all correspondence Consultant Hairmyres Hospital 10PAs per week (Part-time may be considered) £76,001 - £102,465 Thursday 8th January 2015 Your Application Thank you for expressing an interest in the above post within NHS Lanarkshire. Please find all the relevant information attached to begin the application process. Should you require further information regarding this post you can contact the Medical Staffing team or make informal enquiries with the department using the contact details below. To ensure we can process your application as easily as possible please complete all the information required within the Application Pack and email with your CV. Contact Details Telephone Email 01698 377735 Pamela.Migues@lanarkshire.scot.nhs.uk Application Process To apply, please email your CV to the above, along with the attached completed Application Pack. Lanarkshire NHS 5 Recruitment Inserts.pdf Application Pack - Master Sept12.doc Additional Arrangements Informal enquiries regarding this post will be welcomed by:Mr David Hume Director of Hospital Services 01355 584528 Dr Helen Mackie Chief of Medical Services 01355 584485 Dr John Keaney Clinical Director 01355 584726 Dr Sameer Patel Respiratory Physician 01355 584833 Dr Pratheega Mahendra Respiratory Physician 01355 584645 Date when the post is Vacant The post is vacant immediately and a start date will be agreed with the successful candidate. NHS Lanarkshire For further information regarding NHS Lanarkshire and its hospitals, please visit our website:- www.nhslanarkshire.org.uk We are an Equal Opportunities Employer and Positive about Disabled People. Page 1 NHS Lanarkshire – Information Pack POSITION: Consultant Physician in Respiratory & General Medicine Integration of Health and Social Care Services Public Bodies (Joint Working) (Scotland) Bill The purpose of the above Bill is to create statutory Health and Social Care Partnerships in each local authority in cooperation with health boards to replace existing Community Health Partnerships (CHP’s). In Lanarkshire two Health and Social Care Partnerships have been developed, one each in North and South Lanarkshire and these will replace existing CHP’s. Discussions between NHS Lanarkshire and the two Local Authorities are on-going in considering the range of services that will be managed through the Health and Social Care Partnerships. In the North a Shadow Board is being established with ongoing recruitment taking place. In the South a Shadow Board is now in place. A strategic plan will be developed for each Health and Social Care Partnership including considering the range of services that will be managed from April 2015. This service may in the future be included within this range. Management Structure The supporting operational and clinical management structures are focused on enhancing patient safety, quality improvement and local delivery at hospital level, with visibility of clinical leadership and support for individual professional accountability. Our Medical Managers will provide professional leadership to medical staff, ensuring that they are effectively developed, organised, integrated and managed to support the strategic aims of each Division and meet the needs of the patient. Management Structure Overview (Acute) Director of Acute Services Associate Medical Director COTE Director of Hospital Services Hairmyres Director of Hospital Services Monklands Director of Hospital Services Wishaw Director of Access Chief of Medical Services Hairmyres Chief of Medical Services Monklands Chief of Medical Services Wishaw Associate Medical Directors Clinical Directors Deputy CD's Leads Various Specialties Clinical Directors Deputy CD's Leads Various Specialties Clinical Directors Deputy CD's Leads Various Specialties Divisional Medical Director Page 2 NHS Lanarkshire – Information Pack POSITION: Consultant Physician in Respiratory & General Medicine POST INFORMATION The Department The Department of Medicine has 120 beds. The Medical Unit provides an Acute Medical receiving service, and fully staffed specialty services in Cardiology, Respiratory, Gastroenterology and Diabetes. Each of these specialties has its own dedicated ward area. 24 beds are allocated to the Acute Medical Receiving Unit (AMRU). There is also a 10 bedded Clinical decision unit (CDU) adjacent to the medical receiving ward to facilitate the assessment of GP admissions. We have a Neurologist and a Rheumatologist who provide an in reach service for inpatients in addition to outpatient clinics on site. There are also visiting consultants in, Haematology, Oncology, ENT, Dermatology and Ophthalmology. There is a shared Oncology and Haematology Day Unit allowing on site chemotherapy for our lung cancer patients. We also have a visiting Palliative Care consultant. There is an excellent and well staffed Department of Care for the Elderly with a dedicated Stroke Unit and lead stroke physicians. Respiratory Medicine The respiratory ward has 18 beds plus a 4 bedded Medical High Dependency Unit which is covered during the week by the Respiratory consultants, acute Physicians and an associate specialist. The out of hours cover is by the on-call consultant. Respiratory outpatient clinics take place on site in the general outpatients department and are supported by a fully equipped and staffed lung function laboratory. Specialist lung cancer clinics take place on Monday afternoons, supported by a lung cancer specialist nurse. Lung cancer MDTs are held on Tuesday and are attended by Respiratory physicians, Thoracic surgeons, Oncologist and Radiology in addition to the Lung Cancer nurses, either in person or via video link. We have excellent radiology support with both imaging and interventional support of a very high standard. There has been a significant amount of redesign work recently within Lung Cancer which has produced very favourable results in terms of national targets, and this process is ongoing. Sub-specialist clinics in relation to asthma, sleep medicine and interstial lung disease are being proposed. There are three consultant respiratory Physician at Hairmyres. Dr. S Roy, Dr. P. Mahendra and Dr. S Patel. The respiratory unit is supported by an Associate Specialist, Dr L Cochrane, with a specialist interest in Page 3 NHS Lanarkshire – Information Pack POSITION: Consultant Physician in Respiratory & General Medicine pulmonary physiology and cardiopulmonary exercise testing. There is a well-equipped Respiratory Function Laboratory which includes facilities for full body plethysmography, exercise respiratory physiology, histamine challenge and skin testing, and home sleep study (Embletta) in addition to the usual pulmonary function tests. 3 dedicated Respiratory Specialist Nurses, a Smoking Cessation Nurse, Lung Cancer Specialist nurse(s), Palliative Care Nurse, and lung cancer patient pathway co-ordinator help provide a high level of nursing support to the respiratory service. In addition to this, we have a well-developed Pulmonary Rehabilitation Programme with respiratory physiotherapy and occupational therapy input. We operate a Non Invasive Ventilation service administered by nursing staff on the Respiratory ward and the Acute medical receiving ward (with support from our Hospital Emergency Care Team {HECT}). Bronchoscopy takes place weekly on a Wednesday morning in the Day Surgery Unit. A business case is in submission for EBUS on the Hairmyres site. Hairmyres hospital is recognized for training of Respiratory SpR`s. General Medicine The Acute Medical Receiving Unit (AMRU) is situated on Level 1 near to the Accident and Emergency department. All new patients at present are admitted via the Emergency Department. Approximately 10,500 patients are assessed on AMRU on an annual basis. The receiving consultant physician provides a twice daily ward round on the receiving unit at 0900 and 1600. Following assessment by the on-call medical consultant, patients are then triaged to specialty wards. Care of Elderly physicians take over the 8 most appropriate newly admitted patients each morning. Patients with cardiac pathology can be admitted directly to the Coronary Care Unit and then are reviewed by cardiology colleagues. The cardiologists also run a separate interventional cardiology rota and also provide an in reach service during week days for patients on AMRU and Clinical Decision Unit. There are currently 13 consultant physicians participating in the general medicine weekday rota, and 15 on the weekend rota; there are also 2 new acute consultant physician posts currently under recruitment which will bring the total number of consultants including this post, up to 15 Page 4 NHS Lanarkshire – Information Pack POSITION: Consultant Physician in Respiratory & General Medicine covering weekdays and 18 covering weekends Respiratory Medicine in Lanarkshire There are currently 5 Respiratory Physicians in Wishaw General Hospital (Dr K Dagg, Dr KS Tan and Prof H Scott, Dr. Smith and Dr. M Patel, three Respiratory Physicians in Monklands Hospital (Dr. L McAlpine, Dr. S Baird and Dr R. Syyed). There is collaboration between the hospitals in area-wide protocols and clinical audit. With the increase in consultant staffing, it is anticipated that area-wide specialist services could be developed such as in difficult asthma, interstitial lung disease, TB and sleep disordered breathing. A Respiratory Managed Clinical Network was launched in April 2007. It has received substantial investment to develop a number of services for COPD such as open access spirometry, community pulmonary rehabilitation and early supported discharge. Respiratory Medicine in the South West of Scotland More specialist services relevant to Respiratory Medicine including the Beatson Oncology Centre, Regional Thoracic Surgery Unit (Golden Jubilee Hospital, Clydebank), Regional Pulmonary Vascular Unit (Gartnavel), Cystic Fibrosis Unit, Sleep Medicine Unit, and so forth are all easily accessed in nearby Glasgow. Our Lung Transplant Centre is in Newcastle. The West of Scotland organize Regional Respiratory meetings to encourage opportunity to discuss interesting cases and network with colleagues. Page 5 NHS Lanarkshire – Information Pack POSITION: Consultant Physician in Respiratory & General Medicine POST INFORMATION The Post Consultant Physician in General and Respiratory Medicine. The appointee will provide an integral role in the development of Respiratory Services. The appointee will share responsibility for providing general medical services (including acute receiving, outpatient services and domiciliary consultations) with the other physicians. The appointee will contribute to the clinical supervision of the medical high dependency unit. The precise details of the job plan will be dependent on the successful candidate’s subspecialty training and interests. The job is offered as a full-time post on a 10 PA basis but applications will be considered from those wishing to work less than full-time. If fulltime up to 2 EPA’s may be available to undertake additional outpatient and/or procedure sessions or management activity. All new substantive Consultants are initially offered a minimum of 1 PA for SPA duties but this will be reviewed within 6 months (or earlier if required) of appointment and revised upwards if additional responsibilities have been undertaken. Additional SPA time (up to 2.5 PA’s in total) can be incorporated into the job plan depending on the time required to support the successful candidate’s professional activities and the needs of the service. NHS Lanarkshire is supportive of applications from individuals with well developed ideas for improving services who are able to demonstrate a commitment to quality improvement, patient safety (including human factors training), Medical Education and Research & Development. Applicants wishing to commence on more than 1 PA for SPA duties should discuss proposals with the identified Lead contact and Service Medical Manager (Associate Medical Director or Divisional Medical Director) General Provisions You will report to Clinical Director, who will agree your job plan. Page 6 NHS Lanarkshire – Information Pack POSITION: Consultant Physician in Respiratory & General Medicine Health and Safety You are required to comply with NHS Lanarkshire Health and Safety Policies. Junior Medical Staff You will be responsible for the training and supervision of Junior Medical staff who work with you, and you will be expected to devote time to this on a regular basis. In addition, you will be expected to ensure that staff have access to advice and counseling. If appropriate, you will be named in the contracts of Doctors in training grades as the person responsible for overseeing their training and as the initial source of advice to such Doctors on their career. Resources The following department resources are available:Consultants Consultant Physicians (17) Medicine for the Elderly (8) Associate Specialist FY2/ST Trainees FY1 Secretarial Support: WTE Secretary Special Interest Cardiology, Neurology, Rheumatology, Renal, Respiratory, Gastroenterology, Acute, Diabetes & Endocrinology Care of the Elderly 1 3 1 3 Page 7 NHS Lanarkshire – Information Pack POSITION: Consultant Physician in Respiratory & General Medicine DUTIES AND RESPONSIBILITIES Work As required under Section 3 of the Terms and Conditions of Service, the Programme duties and responsibilities are supported by a job plan and work programme detailed as follows: Job Planning/Programmed Activities The job plan will be dependent on the successful candidate’s subspecialty training and interests. A minimum of 1 SPA will be included in the job plan but please refer to the guidance above under the general description of the post. On taking up post a Job Plan will be agreed between the person appointed and the Clinical Director/Associate Medical Director. This job plan is subject to review at least once a year by the post holder and the Clinical Director/Clinical Lead as noted in the terms and conditions. The procedures set out in the ‘Terms & Conditions of Service’ must be followed if it is not possible to agree a job plan, either initially or at an annual review. The timetable is indicative and subject to negotiation with the Clinical Director / Associate Medical Director. The core 10 PA working week will be based on 9 PA’s of Direct Clinical Care (DCC) duties and 1 PA of SPA time for a full-time post-holder. The indicative weekly timetable included in the work programme shows likely elective PA’s within the 10 PA post and indicated the location where each activity will be undertaken and the type of work involved. Fixed Commitments Days Monday Tuesday Hours AM PM AM PM Wednesday AM Thursday Friday PM AM PM AM PM Type of Work Ward Round Clinic Clinical Admin/Referrals Lung Cancer MDT & Respiratory Outpatient Clinic Bronchoscopy in rotation every 3-4 weeks/Admin Respiratory Outpatient Clinic AMRU//On Call/Flexible SPA Respiratory ward round Off Location Hairmyres Hospital Hairmyres Hospital Hairmyres Hospital Hairmyres Hospital Hairmyres Hospital Hairmyres Hospital Hairmyres Hospital Hairmyres Hospital Hairmyres Hospital Page 8 NHS Lanarkshire – Information Pack POSITION: Consultant Physician in Respiratory & General Medicine In addition, other activities not occurring at fixed times. 1.5 PAs for weekend post receiving ward rounds and unpredictable on call. Reviewing new admissions on rota basis. Contributing to the day time MHDU rota (1 in 6) Discussing patient management/reviewing patients with Junior Medical & Nursing Staff out with formal ward rounds Seeing Ward referrals on rota basis. Discussing referrals (in patient & out patient with colleagues). Discussing management/investigation of patients with colleagues in other appropriate Clinical Support Services Discussing management/ investigation of patients with colleagues in Radiology and other appropriate Clinical Support Services. Discussing results with patients Discussing patients with GPs. Vetting Fast Track clinic referrals/ allocating appointments. Attending meetings in relation to duties as member if Respiratory Team. CPD and Appraisal Audit Teaching & Training Audit and research The successful candidate will be expected to participate in audit processes and there is an active clinical audit department available to assist. NHS Lanarkshire is ambitious to build a portfolio of research projects backed by enthusiastic and dynamic individuals. It has an active Research and Development department and would welcome discussion regarding a potential research interest. Continuing Professional Development Study leave is available within the terms and conditions of service with the approval of the Clinical Director/Clinical Lead. The appointee will be required to fulfill such demands for continuing professional development as the Royal College of Physicians (or other relevant bodies) may make. Honorary Academic Status If involved in undergraduate teaching status can be applied for. Applications can be made via the Hospital Sub-dean and then to the appropriate academic department within the University. Page 9 NHS Lanarkshire – Information Pack POSITION: Consultant Physician in Respiratory & General Medicine PERSON PROFILE Attributes Essential Qualifications MBChB or equivalent. MRCP (UK) (or equivalent). Useful Higher Degree or other Diploma. ALS Provider. Current full registration with GMC with a licence to practice. Training Experience Inclusion on GMC’s Specialist Register for General Medicine and Respiratory Medicine or within 6 months of CCT or CESR (CP) at interview. In possession of CCT or CESR for General Medicine and Respiratory Medicine at the time of interview or in an established training programme and within 6 months of CCT (i.e. pending exam). Training at ST/SPR level communication, teaching management. in or Training in advanced clinical procedures e.g. thoracoscopy, pleural ultrasound or EBUS. Training in a subspecialty of Respiratory Medicine or in another Experience within UK training allied area of clinical practice (e.g. establishments. ITU/HDU). Human Factors training. Recent and relevant clinical Well developed subspecialty experience (at least 3 years interest. experience at senior trainee level) in General (internal) Medicine with Administrative/Management regular unselected acute on call experience. commitment. At least 3 years experience at senior trainee level in Respiratory Medicine. Recent and relevant experience and personal qualities to work in a busy unit dealing with the high turnover of planned and unscheduled admissions. Page 10 NHS Lanarkshire – Information Pack POSITION: Consultant Physician in Respiratory & General Medicine Ability to supervise the clinical work of doctors in training and relevant staff in other disciplines. Confident with indirect supervision of varying training grades of doctors in training. Audit/Research Publications Teaching Knowledge and Skills Previous experience in organising NHS Services or equivalent. Understanding of the principles of Experience and interest in General medical audit. or Respiratory medicine practice and experience of design of audit. Evidence of contribution to audit at least at local level. Research within General or Respiratory medicine. Awareness of principles of research with an ability to critically analyse Involved in design of research medical literature. relevant to General or Respiratory medicine. Presentations relevant to the Previous publications relevant to practice of General or Respiratory the practice of General or medicine. Respiratory medicine Presentations at national meetings relevant to the practice of General or Respiratory medicine Previous involvement in the delivery Interest in and commitment to of undergraduate or postgraduate teaching and training. teaching. Experience of providing problemExperience of providing supervision based teaching. and or mentorship. Experience of organising teaching programmes. Formal training in educational/ clinical supervision. Broad based knowledge and skills in Ability to perform trans-bronchial diagnosis and clinical management lung biopsy under screening. within the Specialty and encompassing most sub-disciplines. Experience in the use of pleural ultrasound, thoracoscopy, or EBUS. Page 11 NHS Lanarkshire – Information Pack POSITION: Consultant Physician in Respiratory & General Medicine Wide experience of managing acute Further educational medical emergencies and diploma’s etc. respiratory conditions. Good IT skills. Ability to perform fibreoptic bronchoscopy independently. Disposition Ability to interpret and report pulmonary function tests independently. Committed to Quality Patient Care. Problem solver, counselor. Able to be understanding of and sensitive to the needs of patients. A natural leader. Excellent communication (verbal and written). certificates, diplomat, skills Ability to work under pressure. Ability to work effectively in a multidisciplinary team. Responsive to change and innovation, promoting a culture for organisational development. A flexible approach to duties, which satisfies the needs of the Service in a changing environment. Ability to demonstrate reflective practice with evidence of regular appraisal with clear Personal Development Plan relating to Continuing Professional and Personal Development. Good time organisation. management and Demonstrates commitment and enthusiasm to service delivery. Page 12 NHS Lanarkshire – Information Pack POSITION: Consultant Physician in Respiratory & General Medicine Managerial Leadership Other Awareness of the principles and Involvement in service re-design core practices involved in service management, project management Involvement in project delivery. and effective meetings. Involvement in NHS-related Knowledge of service provision at a meetings. local level. Awareness of the principles of team Evidence of role as leader within leadership and effective people groups. management. Commitment to the Values of NHS Lanarkshire: Fairness, Respect, Quality, Working Together. Satisfactory medical clearance by Current full driving licence. NHS Lanarkshire Occupational Health Service. Satisfactory PVG Check. Fluent in medical English and evidence of ability to communicate in stressful situations. If there is any reason why a disabled person should not be considered suitable for this post, please provide details: Name Designation Date The post requires physical dexterity. Uncorrected visual or hearing defect would be incompatible with the nature of the work. Prepared By:Dr. H Mackie Chief of Medical Services December 2014 Approved By:Dr. J Burns Divisional Medical Director (Acute) December 2014 Page 13 NHS Lanarkshire – Information Pack POSITION: Consultant Physician in Respiratory & General Medicine TERMS AND CONDITIONS a) This appointment is offered on the Terms and Conditions of the new Consultant Contract. Additional NHS Lanarkshire Policies which support the Contract are listed below and are available on request: b) Additional & External Duties Fee –Paying Work in the New Consultant Contract On-Call Availability and Payment of Supplement Generic Objectives Resident On-Call Duties Waiting List/Additional Sessions This appointment is superannuable under the NHS Superannuation Scheme, which is contracted out of the State Earnings Related Pension Scheme (SERPS). New employees commencing employment from 1 March 2013 onwards will automatically be enrolled in the pension scheme and your remuneration will be subject to deduction of superannuation contributions. To opt-out, you must contact the Scottish Public Pensions Agency directly on Tel: 01896 893000. Should you choose to opt-out in accordance with these changes you will be enrolled into the scheme again every 3 years (June 2016, 2019 etc) when the same process will apply. For further information on the benefits of the scheme, please contact an advisor of The Scottish Public Pensions Agency (SPPA) Tel: 01896 893100, or download/view a member’s guide at www.sppa.gov.uk/nhs/forms.htm. c) The employment is subject to 3 months’ notice on either side subject always to the appeal and other provisions of paragraphs 10.4 & 10.5 of the Terms and Conditions of Service of Hospital Medical and Dental Staff and Doctors in Public Health and the Community Health Service Consultant Grade. d) Reimbursement of certain telephone charges may be payable on application to NHS Lanarkshire. The successful candidate must be contactable throughout any on-call period. e) The successful candidate, if not already employed by the NHS Lanarkshire, will be required to complete a medical questionnaire to obtain medical clearance from the Occupational Health Physician. Page 14 NHS Lanarkshire – Information Pack POSITION: Consultant Physician in Respiratory & General Medicine f) The successful candidate will be required to complete a disclosure Scotland PVG (Protecting Vulnerable Groups Scheme) form. No approach will be made without written permission of the successful applicant who will be asked to sign and complete a Disclosure PVG application, giving authorization for the check to be undertaken. g) NHS Lanarkshire does not negotiate salary placements. On commencement the salary will be in line with paragraph 5.1 of the terms and conditions of the new consultant contract. Appointees start on the scale minimum except in the circumstances of paragraphs 5.1.2 – 5.1.7 of the terms and conditions of service. h) From 1st April 2014 the starting salary for the post is £76,001 per annum (based on 10 Programmed Activities per week). The successful candidate’s total salary will be dependent on his/her previous service history. Remuneration for any extra programmed activities will be dependent upon the job plan agreed at the time of appointment. i) Dependent upon present place of residence, NHS Lanarkshire may require the successful candidate to undertake to remove home to a distance acceptable to NHS Lanarkshire, normally within 10 miles of the base Hospital, in which case removal expenses will be payable in accordance with NHS Lanarkshire Policy. In some cases, however, a residence more than 10 miles distant from the base hospital will be acceptable and in this case removal expenses will be subject to the prior approval of the Associate Medical Director for such a residence. The position will be made clear to the successful candidate on application. Page 15 NHS Lanarkshire – Information Pack POSITION: Consultant Physician in Respiratory & General Medicine IMMIGRATION Overseas Doctors and Dentists Changes to Immigration Impact of Change Further Information For the purpose of immigration status, overseas doctors and dentists are those who, regardless of where they obtain their primary medical/dental qualification, are not nationals of the European Economic Area (EEA). A list of EEA countries is attached. On 7th March 2006 the Department of Health announced changes to the immigration rules for postgraduate doctors and dentists. The changes came into effect on 3rd April 2006 and mean that all doctors and dentists who wish to work in the UK from outside the EEA will need to meet the requirements of an employment category such as the work permit provisions. New applications for permit-free training visas will no longer be granted for doctors undertaking training posts Non-EEA doctors and dentists will still be able to come and train in the UK and are still eligible to apply, in open competition for training posts provided all the other eligibility criteria is met. However, training posts will now be considered employment for immigration purposes. Work permits will only be issued where there is a specific post for the overseas doctors that cannot be filled by someone from the EEA. The changes in immigration requirements for trainee doctors and dentists are a result of a Scottish Executive Health Department announcement and immigration issues are the remit of the Home Office. Clarification and further information can be accessed from the following:Home Office Work Permits EEA Countries www.ind.homeoffice.gov.uk www.ukba.homeoffice.gov.uk/workingintheuk/ Austria Greece Belgium Hungary Bulgaria Iceland Cyprus Republic of Ireland Czech Republic Italy Denmark Latvia Estonia Liechtenstein Finland Lithuania France Luxembourg Germany Malta NB – Switzerland is not in the EEA, Swiss as EEA nationals. The Netherlands Norway Poland Portugal Romania Slovakia Slovenia Spain Sweden UK Nationals have the same rights Page 16