Consultants in Paediatric Intensive Care Medicine
– Two Posts
1. Outline of the post
We are looking to recruit two substantive consultants in Paediatric Intensive Care Medicine.
The posts are based at the Royal Hospital for Sick Children. The posts have been created following a review of intensive care provision in Scotland which indicates the need for an expansion in the number of critical care beds in Edinburgh.
The posts will be available from the 01 April 2015.
As a consultant in a National Service with a Scotland wide referral practice, the post holders may be required to work outside Lothian.
There will potentially be sessions available in the individual ’s base specialty e.g. paediatrics, anaesthesia.
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 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, 4 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
December 2014 Page 1 of 11

Liberton Hospital
The Princess Alexandra Eye Pavilion.
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 operating 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 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, 5 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 centre.
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). 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 the centre for:
Neurology, neurosurgery and neuropathology
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UK CJD unit
Colorectal surgery
Urology and Scottish Lithotriptor Centre
Breast surgery and breast screening
Gastroenterology
Rheumatology
Infectious diseases
Haematology/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 the centre for:
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
Burns and plastic surgery.
Oral and Maxillofacial Surgery
ENT
Critical Care (ITU, HDU and CCU)
Accident and Emergency
General Surgery
Orthopaedics
Anaesthetics
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.
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
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Herdmanflat Hospital
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 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 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 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 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
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 l ine 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;
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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 and within the top 5 Universities in Europe for its Biomedical
Sciences.
The University of Edinburgh’s College of Medicine and Veterinary Medicine (CMVM; Head
Professor Sir John Savill) is an internationally leading force in basic-to-clinical translational research. The College has a consistent 30-year strategy of interdisciplinary and integration of basic and clinical sciences. In the most recent Research Assessment Exercise (2008), the
University of Edinburgh was top in the United Kingdom within the UoA4 category of Hospitalbased Clinical Subjec ts. In 2008/9, CMVM attracted over £120 million in external peerreviewed grant funding.
It has established several major interdisciplinary research Centres:
MRC Centre for Inflammation Research (Director, Professor John Iredale)
Centre for Cardiovascular Science (Director, Professor Brian Walker) incorporating the BHF
Centre of Research Excellence (Director, Professor John Mullins)
Centre for Reproductive Biology (Director, Professor Phillipa Saunders) and MRC Human
Reproductive Sciences Unit (Director, Professor Robert Millar) including the Tommy’s Centre
(Director, Professor Jane Norman).
MRC Centre for Regenerative Medicine (Director, Professor Sir Ian Wilmut)
Centre for Molecular Medicine (Director, Professor David Porteous)
Centre for Cancer Research (Director, Professor David Harrison)
Centre for Population Health Sciences (Director, Professor Harry Campbell)
MRC Human Genetics Unit (Director, Professor Nick Hastie)
These Centres are predominantly based at two sites: the Queen’s Medical Research Institute at the Royal Infirmary, and the Institute of Genetics and Molecular Medicine at the Western
General Hospital. The co-location of basic science and clinical groups within state-of-the-art
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i ii iii infrastructure and technology provides an excellent and exciting opportunity to conduct translational research at the highest level.
This academic power base is supported by clinical research infrastructure that includes:
Wellcome Trust Clinical Research Facility
Clinical Research Imaging Centre
Edinburgh Clinical Trials Unit (UKCRN Registered) and Health Services Research
Unit iv v vi
Scottish Brain Imaging Research Centre
Experimental Cancer Medicine Centre
Academic and Clinical Central Office for Research and Development
4. NHS Library and Postgraduate Facilities
There are excellent facilities on all sites.
5. The Department
The RHSC Department of Anaesthesia and Critical Care
Dr Colin Young
Dr Julie Freeman
Dr Edward Doyle
Dr Mary Rose
Consultant in Paediatric Anaesthesia
Consultant in Paediatric Anaesthesia and Intensive Care
Consultant in Paediatric Anaesthesia
Consultant in Paediatric Anaesthesia (CD Surgery,
Dr Jillian McFadzean
Dr David Rowney
Anaesthesia and Critical Care, RHSC)
Consultant in Paediatric Intensive Care and Anaesthesia
Consultant in Paediatric Intensive Care Retrieval and
Anaesthesia
Dr Alistair Baxter
Dr Phil Neal
Dr Carolyn Smith
Dr Emma Dickson
Dr Ulf Theilen
Dr Jon McCormack
Dr Suzanne Krosner
Dr Milly Lo
Consultant in Paediatric Anaesthesia
Consultant in Paediatric Anaesthesia
Consultant in Paediatric Anaesthesia
Consultant in Paediatric Anaesthesia
Consultant in Paediatric Intensive Care and Paediatrics
Consultant in Retrieval/Paediatric Anaesthesia
Consultant in Paediatric Anaesthesia
Consultant in Paediatric Intensive Care
Dr Nandita Chinchankar
Dr Karen McGrath
Dr Catherine McDougall
Dr Pamela Winton
Dr Omair Malik
Dr Suzanne Boyle
Dr Gil Gavel
Dr Kevin McCarthy
Mrs Margaret McPheely
Speciality Doctor in Retrieval/Paediatric Intensive Care
Consultant in Paediatric Anaesthesia
Consultant in Paediatric Intensive Care and Respiratory
Medicine
Consultant in Paediatric Anaesthesia
Consultant in Retrieval and Paediatric Anaesthesia
Consultant in Paediatric Anaesthesia
Locum Consultant in Retrieval and Paediatric Anaesthesia
Senior Lecturer in Paediatric Anaesthesia & Pain Management
Department Secretary
The Paediatric Intensive Care Unit (PICU) is a multidisciplinary unit that caters for infants, children and young people from a wide variety of disciplines including paediatric surgery, neurosurgery, spine deformity surgery, medical paediatrics, plastic surgery, burns and
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general trauma. The case mix includes broad spectrum of critically ill children requiring level two and level three care, with the exception of cardiac surgical and transplant patients.
From April 2007 the two Scottish PICUs in Glasgow and Edinburgh have operated as a national service centrally funded by the National Services Division in Scotland. The
Edinburgh PICU has admitted increasing numbers of patient over recent years, with 500 admissions during the last financial year. There are currently eight paediatric intensive care beds, supported by six high dependency beds on the critical care floor. The high dependency beds can be upgraded for intensive care when the need arises. There are three neonatal surgical cots attached to the surgical ward.
The national Paediatric Intensive Care Retrieval Service is called Scotstar (from April 2014), and is centrally funded and run by the Scottish Ambulance Service. It is delivered by retrieval teams from the two Scottish PICUs in Edinburgh and Glasgow. The Edinburgh team conducts circa 150 intensive care retrievals from other hospitals in Scotland per year.
The post holders will join five existing PICU consultants (two anaesthetists/intensivists and three paediatric intensivists). There are currently 4/5 ST paediatric trainees (incorporated in
MMC training rotations), 2 ANPs, one Clinical Fellow and one ST A&E trainee working on the unit, supporting the resident medical rotas. The medical rotas are also supported by the four
Retrieval Consultants/Specialists. The PICU is staffed to PICS standards with a nursing complement that includes:
1 Clinical Nurse Manager PICU (Band 8)
1 Retrieval Clinical Coordinator (Band 7)
(14 nurses are retrieval trained)
10 Senior Nurses (Band 7)
2.2 WTE Educators (Band 6)
The unit participates in a UK wide audit of paediatric intensive care practice, contributing data to the Paediatric Intensive Care Audit Network (PICANet).
The Department for Anaesthesia and Critical Care provides anaesthesia and intensive care for a wide range of paediatric surgical activity including paediatric surgery, neonatal surgery, orthopaedic surgery, scoliosis surgery, neurosurgery, plastic surgery, burns and ENT surgery, and 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. There is an acute pain service and a chronic pain clinic.
The Department is responsible for all teaching and training in paediatric intensive care and paediatric anaesthesia in the South East of Scotland School of Anaesthesia and the South
East of Scotland School of Paediatrics. There are five ST trainees from the South East of
Scotland School of Anaesthesia attached at any one time. The department has a commitment to teaching for various groups including undergraduates, anaesthetic trainees, non-anaesthetic trainees in paediatric intensive care and accident and emergency medicine and non-medical staff. The department also contributes to the training of the intra-hospital paediatric emergency team. Potential applicants should have an interest in and commitment to undergraduate and postgraduate teaching. Office accommodation and secretarial support will be identified for the appointee.
Departmental Meetings
Administration - There are monthly meetings of PICU/Retrieval senior staff that consider departmental practice and development.
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Academic - The PICU has scheduled time on Wednesday afternoons for an academic teaching session, weekly grand rounds, and business/governance meetings.
6. Details of the Post
Clinical
These are substantive posts which will support the PICU and the development of High
Dependency Care at RHSC.
Applicants should possess MRCPCH, FRCA or equivalent and have been awarded, or be within six months of being eligible for the GMC specialist register at the time of interview.
There should be evidence of two years of training in Paediatric Intensive Care Medicine in a centre recognised by the Intercollegiate Committee. The applicant ideally should have paediatric retrieval experience by road and air. The job plan will include sessions in paediatric intensive care, and potentially base speciality, or a specific relevant clinical interest, of the successful candidates.
This is an exposure prone post and evidence of the relevant immunities will be required before starting work.
7. Research and Development
There is an academic department of Child Life and Health with an active research programme led by Professor Jurgen Schwarze. There are opportunities for individual or collaborative research and development within the service.
8. Teaching
The Royal Hospital for Sick Children is a teaching hospital and as such students are seconded to its departments on a regular basis. There are regular clinical and radiological meetings for staff within the hospitals general (secondary) and specialist (tertiary) departments. There are many and varied opportunities for clinical audit. The appointees will have the opportunity to participate in all of the above teaching exercises and also to participate in adhoc teaching as and when the need arises. Children’s Services and the division of Child Life & Health have a strong research reputation.
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9. Indicative Job Plan
Specialty:
Principal place of work:
Contract:
Programmed activities:
Availability supplement:
Managerially accountable to:
Paediatric intensive care
RHSC
Full time
10.0 PA 9.0 DCC PA; 1.0 SPA
5%
Clinical Director of Paediatric Surgery, Anaesthesia and
Intensive Care, NHS Lothian a) Timetable of activities that have a specific location and time
Day
Monday
Type of work
PICU 7 / 8 weeks per year
DCC SPA
0.5
Tuesday
Wednesday
Thursday
PICU 7 / 8 weeks per year
PICU 7 / 8 weeks per year
PICU Grand Round
PICU 7 / 8 weeks per year
0.5
Friday
On call
PICU 7 Fridays per year
1 in 7 with prospective cover
Saturday
Sunday
Direct Clinical Care
Base speciality
Paediatric Intensive Care (day time)
Paediatric Intensive Care (on call)
9.0 PA
2.75 PA
3.25 PA
3.0 PA
Base specialty DCC will be factored in around PICU commitment.
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 routine internal communication 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. The precise allocation of
SPA time and associated objectives will be agreed with the successful applicant.
10. Contact Details
Dr Jillian McFadzean, Lead Clinician, Consultant in Paediatric Intensive Care,
Royal Hospital for Sick Children Sciennes Road, Edinburgh EH9 1LF.
Tel: 0131 536 0224; e-mail: jillian.mcfadzean@nhslothian.scot.nhs.uk
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Dr Mary Rose, Clinical Director, Surgery, Anaesthesia and Critical Care,
Royal Hospital for Sick Children, Sciennes Road, Edinburgh EH9 1LF.
Tel: 0131 536 0226; e-mail: mary.rose@nhslothian.scot.nhs.uk
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11. Person Specification
Requirements
Qualifications and
Training
Post Specific
Experience
Ability
Academic
Achievements
Teaching and
Audit
Motivation
Personal
Attributes
Essential
GMC registered medical practitioner with a licence to practice.
Be on the GMC Specialist Register or be eligible for inclusion on the register within six months of the date of interview.
Paediatric Intensive Care Medicine training in a recognised PICU.
Experience in Paediatric Intensive
Care Medicine and Retrieval
Evidence of ability to take responsibility for management of critically ill patients. Able to provide decision support to referring and retrieval clinicians caring for patients that need retrieved.
Commitment to research, publications and presentations
Desirable
EPLS/APLS
Provider/Instructor.
Paediatric intensive care and retrieval training in an overseas centre.
Air retrieval experience
Ability to redesign clinical service or process
Evidence of commitment to formal and informal teaching and training of junior medical staff and medical students.
Evidence of participation in audit projects
Evidence of commitment to:
Patient focused care,
Effective and efficient use of resources
Knowledge of and commitment to the work of the Scottish Patient
Safety Programme
Evidence of teamwork with colleagues in own and other disciplines
Able to organise time efficiently and effectively
Evidence of previous experience in successful research funding, review and publication
Evidence of teaching qualification or learning
Designing and effecting audit programmes
Evidence of development of services for patients
Clear commitment to developing role in paediatric intensive care
Able to motivate colleagues
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