NHS Lothian
Women’s Services
The Royal Infirmary of Edinburgh
Consultant Gynaecological Oncologists
Two Posts
1. Outline of the Post
These appointments are to enhance the gynaecological oncology service at RIE. The post holders
will be expected to have expertise in gynaecological oncology including surgery for all
gynaecological malignancies.
The posts are available immediately.
The post holders will participate in the on call gynaecology rota (1:7.5 on call with prospective
cover). The post holders may also be asked to assist obstetric colleagues in some emergency
situations, such as major obstetric haemorrhage.
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, 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 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
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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 a centre for:
General surgery
Vascular surgery
Hepatobiliary and transplant medicine and surgery
Cardiac and thoracic surgery
Orthopaedics surgery
Neonatology
Obstetrics & Gynaecology
Cardiology
Renal medicine
Sleep medicine
There is a Combined Assessment Unit which takes unselected GP or direct emergency referrals,
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 and NM and PET scanning will be available in 2008). 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 a centre for:
Neurology, neurosurgery and neuropathology
The UK CJD unit
Colorectal surgery
Urology and the Scottish Lithotriptor Centre
Breast surgery and breast screening
Gastroenterology
Rheumatology
Infectious diseases
Haematology and oncology
Medical oncology
Radiation Oncology
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 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 a centre for:
General Medicine
Obstetrics & Gynaecology
Paediatrics and community child health
Plastic surgery
Oral and maxillofacial Surgery
ENT
General surgery
Orthopaedics
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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, MRI , 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 colocated University of Edinburgh Medical School and three miles from the Western General
Hospital. The 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, 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
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
Midlothian Community Hospital
Herdmanflat and Roodlands Hospital 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 communitybased 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.
Royal Edinburgh Hospital and Associated Services
The Royal Edinburgh and Associated Services provide a range of Mental Health services to the
population of Lothian and other Boards within Scotland.
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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 24/7
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 a 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 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;
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
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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.
4. NHS Library and Postgraduate Facilities
There are excellent facilities on all sites.
5. Departmental Information
The South East Scotland Cancer Area Network (SCAN) comprises the RIE/WGH/SJH in Lothian
as its centre with cancer units in NHS Fife (Victoria Hospital, Kirkcaldy), NHS Borders (Borders
General Hospital, Melrose) and NHS Dumfries & Galloway (Dumfries and Galloway Royal
Infirmary, Dumfries). We see 160 – 180 ovarian cancers per year and around 275 – 300 other
gynaecological cancers in the SCAN region.
There is a weekly core MDM based at the WGH. There is also a fortnightly combined
colorectal/urology/gynaecology/oncology MDM to discuss patients requiring complex pelvic
surgery. This has been introduced specifically to improve radical surgery for ovarian cancer and
exenterative surgery. As a consequence, there are strong links with our colleagues in colorectal
surgery and urology. These two post holders will be expected to participate in and develop further
radical primary surgery for ovarian cancer. Laparoscopic surgery is now standard treatment for
cervical and endometrial cancers and the post-holder will be expected to be competent in these
techniques.
The Simpson Centre for Reproductive Health is the main centre for perinatal care in South East
Scotland. The delivery rate in 2012 was approximately 7,200 births. The SCRH is the tertiary
referral centre for the South East of Scotland and is the largest obstetric unit in Scotland. The
hospital includes an intensive care Neonatal Unit, with 12 Level 1 Intensive Care, seven Level 2
Intensive Care and 24 Special Care cots. Six weekly high risk antenatal clinics are held within the
SCRH and there is a comprehensive outreach antenatal service covering the City of Edinburgh
and East/Midlothian.
The Obstetric and Gynaecological Services at St. John’s comprise 26 obstetric beds, including a
day bed unit, and 20 gynaecological beds (12 in-patient and eight day beds in a dedicated Day
Case Surgical Facility). In 2012 the department handled approximately 2,800 deliveries and had
over 4000 new gynaecological outpatient referrals. Special interests of the department include
gynaeoncology, urogynaecology, menstrual dysfunction and maternal medicine. There are strong
links between the two Maternity Units.
Senior Medical Staffing at the Royal Infirmary of Edinburgh - the RIE Medical Staff is currently
divided into three units:Fetomaternal Medicine Unit
Dr N Aedla
Dr C Alexander
Dr A Campbell
Dr S Cooper
Dr S Cowan
Dr F Denison (Senior Clinical Lecturer)
Dr E Doubal
Dr K Dundas
Dr K Edgar
Dr F Fankam
Dr D Gatongi
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Dr R G Hughes (Clinical Director for Obstetrics NHS Lothian)
Dr C Love
Dr N Mary
Dr H Mustafa
Dr N Palaniappan
Professor J Norman (University of Edinburgh)
Gynaecology / Oncology / Urogynaecology Unit
Dr C Busby-Earle
Dr S Jack
Dr C Martin
Dr S Fegan (joint appointment with NHS Fife)
Dr S Milne
Reproductive Medicine Unit
Professor R A Anderson (University of Edinburgh)
Professor H O D Critchley (University of Edinburgh)
Dr C Duncan (Senior Lecturer, University of Edinburgh)
Dr C Tay (Gynaecologist and ACU Consultant)
Dr J Thong (Gynaecologist and ACU Consultant)
Dr C P West
Dr B Brady
Dr A Horne (Senior Clinical Lecturer)
St John’s Hospital, Howden
Dr T K Cooper (Clinical Lead for O&G, St John’s)
Dr P Dewart
Dr S Nicholson (Clinical Director for Gynaecology NHS Lothian)
Dr A Macleod
Dr S Rane
Dr S Kallat
Dr S Coutts
Dr S Court (Associate Specialist)
Dr P Mills
Dr Karen Rose
Dr J Wilkins
Dr A Armstrong
Medical / Clinical Gynaecological Oncologists
Dr M Mackean
Prof C Gourley
Dr F Nussey
Dr M Zahra
Dr A Stillie
6. Details of the Post
This post is principally designed to support the gynaecological oncology service in NHS Lothian
and wider South East Scotland Cancer Area Network (SCAN).
The job plan will include a weekly all day majors list, a weekly “Rapid Access” new patient clinic
and a surgical follow up clinic.
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There is a requirement to attend the weekly SE Scotland MDM, which is held on a Thursday
morning (08:30 – 10:00), at the Western General Hospital and is followed by a combined
gynaecology/oncology clinic.
In addition the job plan will include involvement with the complex pelvic surgery service which has
been set up to enable organisation of more complex pelvic surgery where bowel or urinary tract
surgery is planned. This involves a fortnightly MDM at the WGH with the colorectal and urology
surgical teams, radiologists, CNSs and support staff.
Sentinel Node and reconstructive surgery for vulval disease is being introduced and would offer an
exciting opportunity for candidates to join this collaborative service with the plastic surgery
department.
The post holder will be expected to have excellent team working skills given the multi-disciplinary
nature of the job.
On call is for gynaecology with a frequency of 1:7.5 with prospective cover. On occasion the post
holder may be asked to assist obstetric colleagues in the case of major obstetric haemorrhage or a
gynaecological complication of pregnancy.
This is an exposure prone post and evidence of the relevant immunities will be required before
starting.
7. Research and Development
The Royal Infirmary of Edinburgh is the site of the University’s newly established Queen’s Medical
Research Institute of which the Centre for Reproductive Biology is a key component. This is the
largest aggregation of Reproductive Scientists and Clinicians in Europe and offers unique
opportunities for research collaboration in all areas of obstetrics and gynaecology. Areas of clinical
research include fertility control (conception and contraception), gynaecological endocrinology,
mental dysfunction, gonad and gamete biology, fetomaternal disorders, placenta function and the
biological control of parturition.
There are close links with the Edinburgh Cancer Research Centre through Professor Charlie
Gourley, and the Clinical Trials Unit, which co-ordinates oncological studies including patients
affected by gynaecological cancers. There is a strong track record of supporting such studies from
the surgical side with ovarian cancer tissue banking and insertion of peritoneal catheters for
administration of intra-peritoneal chemotherapy for the PETROC trial. There is further scope for
future surgical oncology trials.
8. Teaching
The Department of Obstetrics and Gynaecology has been recognised by the RCOG for subspeciality training Gynaecological Oncology.
Advanced training skill modules are available for trainees in years ST6/7.
The post holder will be offered the opportunity to contribute to the organisation, delivery and quality
control of undergraduate and postgraduate medical education and training at The Royal Infirmary.
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9. Indicative Job Plan
Specialty:
Principal Place of Work:
Contract:
Programmed activities:
On call:
Availability supplement
Managerially responsible to:
Gynaecology
Edinburgh Royal Infirmary
Full Time
10 PA
9.0 DCCPA; 1.0 SPA
Level 1; 1:7.5
5%
Clinical Director of Gynaecology, NHS Lothian
Day
Monday
Location
Type of work
0830-1230
RIE
Audit, preparation for appraisal, CPD
1300-1700
RIE
Rapid Access Clinic
RIE
Theatre list
Preoperative
assessment
postoperative review.
DCC
SPA
1.0
1.0
Tuesday
0800-1800
2.5
and
Wednesday
0830-1230
RIE
Surgical review clinic
1.0
WGH
Gynaecological oncology MDM
Gynaecological oncology clinic
1.0
Flexible session; prospective cover
1.0
Clinical administration
1.0
Thursday
0830-1230
Friday
0830-1230
1300-1700
RIE
On-call
1.5
Total
9.0
1.0
The timetable above gives an indication of how sessional commitments will be allocated. It should
not be read as a definitive job plan. The service continues to develop rapidly and the time tabling of
clinical commitments will change during this process.
The job is offered in line with NHS Scotland policy with 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 routine internal communication and
management meetings. As a major teaching and research contributor we 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. We are keen to negotiate
additional SPA time with the successful applicant to pursue mutually beneficial non-clinical
activities. The precise allocation of SPA time and associated objectives will be agreed with the
successful applicant.
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10. Person Specification
Requirements
Qualifications
Training
and
Essential
Desirable
Full GMC registration and licence to
practice.
Additional
postgraduate
qualifications e.g. MD/PhD.
Be on, or be eligible for inclusion on
the GMC Specialist Register (or within
six months of being eligible at the time
of interview.
MRCOG or equivalent.
Relevant
Experience
Subspecialty training in
gynaecological oncology
Accredited in colposcopy
General and emergency gynaecology
experience
Competent in advanced laparoscopic
surgery
Ability
Ability to take full responsibility for
independent management of patients.
Research
Understanding
research
in
outcomes.
of the place of
improving
patient
Evidence
of
publications
presentations.
research
and
Willingness to support academic
colleagues and contribute to the wider
research programme in the specialty.
Teaching and Audit
Evidence of commitment to formal Previous experience of
and informal teaching and training of designing
teaching
junior doctors, medical students and programmes.
other clinical staff.
Experience of designing
Evidence of commitment to learning and
effecting
audit
and
continuous
professional programmes
development.
Personal Attributes
Evidence of commitment to patientfocused care. Good team player, good
communication skills, experience of
working in multidisciplinary teams.
Knowledge of and commitment to the
work of the Scottish Patient Safety
Programme.
Circumstances
Job
November 2014
of
On-call for emergency gynaecology
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11. Contact Details
Informal enquiries to
Dr Simon Nicholson
Clinical Director for Gynaecology NHS Lothian
Simon.nicholson@nhslothian.scot.nhs.uk
0131 242 2503
or
Dr Cameron Martin
Clinical Lead Gynaecology Oncology South East Scotland
0131 242 2516
Cameron.martin@nhslothian.scot.nhs.uk
or
Dr Edward Doyle
Associate Medical Director
edward.doyle@nhslothian.scot.nhs.uk
November 2014
0131 536 0007.
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