NHS Lothian
University Hospitals Division/Primary Care Organisation
Acute Medical Directorate
CONSULTANT LIAISION PSYCHIARIST
NHS Lothian Gender Identity Clinic
Chalmers Sexual Health Centre, Edinburgh
Information and Job Description
JOB DESCRIPTION
1.
The Post
This is a new post in the Gender Identity Clinic at Chalmers Sexual Health Centre, Edinburgh. The
Consultant Liaison Psychiatrist will lead the Gender Identity Clinic working as part of the multidisciplinary team at Chalmers, providing support to those patients who attend the Gender Identity
Service.
Job Title:
Consultant Liaison Psychiatrist, Gender Identity Clinic
Type of Post:
Substantive
Full/Part Time:
Part-time, 4 sessions.
Salary Range:
Will be employed under the Consultants Contract
Basic Salary Range: £ 77,188 to 102,465 pro rata per annum
Base:
Chalmers Centre, Edinburgh.
Occasionally providing clinics at the Sandyford Sexual Health Centre
in Glasgow.
Catchment Area:
South-East Region, Scotland:
Regional service covers Borders, Fife, Lothian and Forth Valley
2.
Principal Duties
2.1
Gender Identity Clinic
The NHS Lothian Gender Identity Clinic offers mental health assessment, support and sign-posting
to transgender patients, patients with gender dysphoria and those patients who feel uncertain
about their gender identity. The service works with a selection of other NHS services to help those
patients diagnosed with Gender Dysphoria or who are transgender, to navigate the Gender
Reassignment Protocol and access NHS services required to help a patient transition. The
Gender Identity clinic acts as the key point of contact and support for patients undergoing gender
reassignment.
The Scottish Government recently released the Gender Reassignment National protocol. The
Gender Identity clinic follows the national protocol, coordinating patient’s gender reassignment
services. The release of this protocol has encouraged Gender Identity services across Scotland to
work closer together. The consultant psychiatrist will lead the NHS Lothian Gender Identity Clinic
and establish a working relationship with the Sandyford Centre gender service in Glasgow.
2.2
Department of Psychological Medicine
It is recognised that this is a highly specialised post. To avoid professional isolation and facilitate
professional development the post will be integrated with other specialist Liaison Psychiatry posts
within the Department of Psychological Medicine. Initially all of the post holder’s duties will be with
the Gender Identity Clinic but it is hoped that future service developments will allow the 4 sessions
of Gender Identity work to be supplemented with generic liaison psychiatry sessions to produce a
job plan comprising a balance of specialist and generic work.
2.3
Key Responsibilities of Post
The following summarises the key responsibilities of this post:
• Assessment, diagnosis and confirmation of gender dysphoria, transsexualism or otherwise
• Discussing the practicalities of a Real Life Experience, working with the patient to consider
solutions and issues that may arise during this period
• Day to day patient care
• Educating patients on hormone treatment and all options for bodily change that are available
• Referring patients to other NHS services where appropriate such as to speech therapy,
counselling, hair removal, surgical treatment and organising second opinions as required
• Supporting patients through the national Gender Reassignment Protocol and Lothian Gender
Reassignment protocol pathway, referring for second opinion when required
• Submitting applications to local IPTR panel for exceptional funding of cases where necessary
• Liaising with GPs on hormone prescriptions and ongoing patient progress
• Liaison with parents, spouses and other family members if required
• Liaison with other specialists for patients who have multiple pathologies
• Follow up after surgery where required if patients are not able to travel long distances to their
surgical team
• Promoting an understanding of Gender Identity issues in other NHS services
2.4
Liaison with other agencies
• Carry out second opinions on patients from other gender clinics who are being referred for
Gender Reassignment Surgery
• Liaison with other Health Boards, NSD and PCTs in North England to secure funding for
procedures
• To undertake regular audit activities to ensure the service complies with standards as laid down
by the Managed Care Network for Gender Reassignment in Scotland
2.5
Management
• To contribute to the continuing strategic development and evolution of Gender Identity services,
in line with national policy and local strategy
• To actively participate in the NHS Lothian Clinical Governance programme, including active
involvement in clinical audit, critical incident reviews and complaints management
2.6
Education, Training & Research
• To participate in the training and development of staff, including medical students on
attachments, nursing staff and other medical staff
• To fulfil the Royal College of Psychiatrists CPD requirements and Consultants’ annual appraisal
process
• To participate in audit, critical incident reviews and the Clinical Governance Infrastructure
3. NHS Lothian
NHS Lothian was created on 1 April 2004 following dissolution of 3 Trusts; Lothian University
Hospitals Trust, Lothian Primary Care Trust and West Lothian Trust. Mr Tim Davison is Chief
Executive and Dr David Farquharson is Medical Director.
3.1 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 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 recently built, major teaching hospital on a green field site
in the South East of the city of Edinburgh. It comprises some 25 wards, 869 beds, and 24
operating theatres, and is equipped with much state of the art 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 Medical, and the following
surgical, specialities:
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General
Vascular
Hepato-biliary and Transplant
Bariatric surgery
Cardiac and Thoracic
Elective Orthopaedics
Orthopaedic Trauma
Obstetrics & Gynaecology
The Western General Hospital (WGH) has approximately 600 beds with the following
specialities represented:
Surgical
 Neurosurgery
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Colorectal Surgery
Urology and Scottish Lithotriptor Centre
Breast Surgery
ENT Surgery
Medical
 General Medicine
 Gastro-Intestinal
 Neurology
 Endocrine and metabolic
 Cardiology
 Respiratory
 Rheumatology
 Infectious Diseases
 Haematology Oncology
 Medical Oncology
 Radiation Oncology
 Inpatient Dermatology
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. The Department of Clinical Neurosciences (DCN) is a
leading centre for neurological disease. This is a tertiary referral centre with a catchment
area extending up the East coast of Scotland. The casemix includes acute brain trauma,
neurovascular, neuro-oncology, spinal surgery and interventional radiology. Trauma
cases requiring the treatment of acute brain injury are transferred from the Royal Infirmary
and other hospitals.
The hospital is currently housed in a mix of accommodation ranging from 19th century to
the present. An extensive treasury funded redevelopment was completed with the
opening of the £40m Anne Ferguson Building in August 2001. This houses medical and
surgical wards, main and day case theatres, high dependency unit, cardiology, endoscopy
suite and the Scottish Lithotriptor Centre. ENT Surgery is carried out in an older theatre
complex, and the service is planned to move out to St John’s Hospital in the near future.
The five main theatres have been finished to a high standard and benefit from natural
light. Medical gases including air are supplied from pendants. There has been a
substantial upgrade in medical equipment with all theatres having uniform modern
equipment.
St John’s Hospital (SJH) opened in 1989 and is located in the centre of Livingston; a
new town about 30 minutes drive from Edinburgh. Services provided include:
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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 regional Burns and Plastic Surgery unit for SE Scotland
Oral and Maxillofacial Surgery
ENT
Critical Care (ITU, HDU and CCU)
Accident and Emergency
General Surgery
Orthopaedics
Anaesthetics
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Mental Health including ICCU and ICPU
Within the last year general surgery and orthopaedics have been extensively reconfigured
in NHS Lothian with SJH being developed as the major elective centre for the region.
Plans are also progressing to relocate all of Lothian’s ENT services to SJH to co-locate
with OMFS and Plastic Surgery to create an integrated head and neck unit.
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 recently been afforded full teaching hospital status by the University of
Edinburgh.
The Royal Hospital for Sick Children (RHSC) is a 141 bedded hospital providing
general and specialist services for children.
3.2 Primary Care Organisation/Community Healthcare Partnerships
The Primary Care Organisation and five established Lothian Community Health
Partnerships serve the population of Edinburgh, Midlothian, East Lothian and West
Lothian.
Hospitals in the Organisation include:
The Royal Edinburgh Hospital
The Astley Ainslie Hospital
St Johns Hospital
Rosslynlee Hospital
Herdmanflat Hospital
The five 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 755,000 people is served across the City of Edinburgh,
East Lothian, West Lothian and Midlothian. The range of services includes
comprehensive mental health, learning disabilities, care of the elderly, medical
rehabilitation, district nursing and health visiting, family planning, well woman, breast
screening, comprehensive dental care and those provided by Professions Allied to
Medicine, such as physiotherapy. 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.
3.3 Sexual and Reproductive Health Directorate
The Sexual and Reproductive Health Directorate is responsible for the delivery of both
sexual and reproductive health services, and STI-related health care. The directorate
delivers these services from its main integrated Chalmers Centre and a number of
peripheral clinics held across Lothian.
Chalmers Centre offers fully integrated, single point of access sexual and reproductive
health, and STI-related health care. The opening hours for the service are 8.30 am to
8pm Mon-Thurs and 8.30 am to 4.30 pm on Friday. Chalmers operates on a booked and
walk-in basis. A number of Sexual and Reproductive Health clinics, including the Gender
Clinic, are held on a booked basis throughout the day and into early evening.
4. University of Edinburgh
The University of Edinburgh was established in 1582 and is one of the largest in the United
Kingdom; located on many 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 3 Colleges: Humanities and Social Science, Medicine and
Veterinary Medicine, Science and Engineering.
5. NHS Library and Postgraduate Facilities
There are excellent facilities on all sites.
6. Departmental Information
The Department of Psychological Medicine (DPM) was established in 1977 with the
appointment of Dr GG Lloyd as Consultant Psychiatrist. The liaison psychiatry service is
clinically and managerially integrated in the Acute Medicine Directorate. The Consultant
establishment is about to undergo significant change, but is currently:
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Dr Eleanor Halloran (0.6 WTE) – WGH, special interest CBT in high demand patients
Dr Ravneet Batra (1.1 WTE) – WGH, special interest in HIV/Blood Borne Viruses
Dr Werner Pretorius (1.0 WTE) – WGH, special interest in diabetes
Dr Stephen Potts (0.4 WTE) – RIE, renal and transplant psychiatry
Dr Roger Smyth (1.0 WTE) – RIE, special interest in liver transplant
Dr Robby Steel (0.9 WTE) – RIE, special interest in obstetric liaison
Dr Tracy Ryan (1.0 WTE) – RIE, special interest in old age liaison
Dr Wojtek Wojcik (1.0 WTE) - RIE, special interest in high demand patients
Dr Nadine Cossette (0.7 WTE) – RIE, special interest in renal and liver transplant
This post (0.4 WTE) – Chalmers, gender identity clinic
7. Job Plan
The job plan outlined below incorporates all of the duties of the post but the precise timing of
clinics etc. is illustrative rather than fixed and there will be some flexibility in how the post
holder’s working week is structured (consideration will have to be given to the impact of any
changes upon colleagues’ job plans).
DAY
HOSPITAL/ LOCATION
TYPE OF WORK
Monday
9am-3pm
Chalmers Centre
Gender Identity Clinic including clinical admin
3pm-5pm
Chalmers Centre
SPA duties
Tuesday
Not working in Gender Identity Service
Wednesday
9am-3pm
Chalmers Centre
Gender Identity Clinic including clinical admin
3pm-5pm
Chalmers Centre
SPA duties
Thursday
Not working in Gender Identity Service
Friday
Not working in Gender Identity Service
Saturday
Not working in Gender Identity Service
Sunday
Not working in Gender Identity Service
Clinical PAs = 3.0 (12 hours)
Support PAs = 1.0 (4 hours)
8.
Organisational Structure
General Manager
Sexual & Reproductive
Health Clinical Lead
Clinical Director
Psychological Medicine
This post
Professional Accountability
Line Management
9. Contact Details
Dr Gordon Scott, Clinical Director, Sexual and Reproductive Health Directorate,
Chalmers Centre, Chalmers Street, Edinburgh. Telephone - 0131 536 2098
Dr Robby Steel, Consultant Liaison Psychiatrist, Royal Infirmary of Edinburgh.
Telephone – 0131 242 1398
Dr Andrew Coull, Clinical Director, Acute Medicine, Royal Infirmary of Edinburgh.
Telephone - 0131 242 1412
PERSON SPECIFICATION
REQUIREMENTS
Qualifications and
Training
ESSENTIAL
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Experience
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DESIRABLE
GMC registered medical
practitioner holding MRCPsych or
equivalent
Inclusion on the GMC Specialist
Register in Psychiatry
CCST endorsement in Liaison
Psychiatry or evidence of
equivalent training
Evidence of training in Gender
Dysphoria
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Extensive clinical experience in the
area of gender identity
Wide experience in the
assessment and management of
psychiatric morbidity in general
hospital
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Other
postgraduate
qualifications, e.g.
M.D., MPhil,
MRCP
Ability
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Ability to take full responsibility for
independent management of
patients
Academic
Achievements
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Commitment to research,
publications and presentations
Teaching and
Audit
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Participation in audit projects
Motivation
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Committed to patient focused care,
continuous professional
development, and effective and
efficient use of resources
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Desire to develop
additional services
for patients
Personal
Attributes
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Able to work in a team with
colleagues in own and other
disciplines
Able to organise time efficiently
and effectively
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Previous
managerial
training and
experience
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 Previous
experience in
research