Job Description
SPECIALTY DOCTOR
in
ANAESTHESIA and INTENSIVE CARE
(2 x POSTS)
(Ref: MD413)
Closing Date: Thursday 1 May 2014 at 5.00pm
April 2014
Dumfries and Galloway Royal Infirmary
Specialty Doctor in Anaesthetics and Intensive Care
THE POSTS
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Two full time substantive posts are available
The post-holders will be an integral part of the clinical team.
Time will be allowed for suitable CPD according to the requirements of the individual, and the
need to provide on-going service to patients.
Support will be given to individuals working towards external degrees and qualifications.
DUMFRIES AND GALLOWAY REGION
The population of Dumfries and Galloway is 148,000. Dumfries and Galloway covers an area of
2400 square miles stretching from Langholm in the East to Stranraer in the West, and from
Kirkconnel in the North down to the Solway Coast. There are a number of community hospitals in
various towns throughout the region, and an intermediate unit in Stranraer – Galloway
Community Hospital (with medical and maternity in-patient beds).
Dumfries is a market town with a population of approx. 48,000 and is situated in the eastern half
of this delightful rural region. The River Nith runs through the town to the Solway coast and the
city of Carlisle is approximately 45 minutes drive from Dumfries. Glasgow is within 1½ hours,
Edinburgh and Newcastle within 2 hours, and Manchester and Liverpool within 2½ hours driving
time from Dumfries.
Dumfries and Galloway offers the very best of Scottish countryside; from rugged cliffs and sandy
beaches to forests, hills and rolling plains. You’re spoilt for choice in the range of activities on
offer, with watersports, fishing, birdwatching, golf, mountain-biking or cycling along the network
of rural roads, and much more. The Southern Upland Way runs for 212 miles from Portpatrick in
the west to Cockburnspath in the eastern Scottish Borders, through some of Scotland’s wildest
country.
There are many attractions, ranging from the University Town of Dumfries, Scotland’s National
Booktown Wigtown, Artists’ Town Kirkcudbright, Castle Douglas Food Town to the historic
monuments, castles and abbeys, beautiful gardens, fascinating museums throughout the region.
The local Council is committed to investing in education, with high achieving schools that earn
top marks in HM Inspector of Education Reports. Children are encouraged to develop their talents
and interests, with first-class opportunities in music, arts and sports. High quality sport and leisure
facilities are available throughout the region. Property offers exceptionally good value, at very
competitive prices.
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Population – 147,780 (2001 census ie 3% of Scottish population)
Age
> 65 years
> 75 years
> 85 years
Population
28,445
12,558
3,039
% Total Population
19.2%
8.5%
2.1%
The proportion of population over 65 years is the highest in Scotland and is set to rise further
to 24.4% by 2016.
NHS DUMFRIES & GALLOWAY
NHS Dumfries & Galloway became operational on 1st April 2003 when the two Trusts (Acute &
Maternity and Primary Care) were dissolved and one NHS organisation was created,
incorporating all NHS services along with the Health Board. NHS Dumfries & Galloway has led
the process of integration and is seen as the model for the rest of Scotland to follow. Continuing
new investment has resulted from the system always having met all financial and waiting times
targets.
Structure
The NHS Board has its headquarters on the Crichton site in Dumfries. Comprising executive and
non-executive Directors, its key responsibility is to ensure delivery and development of the local
Health & Community Care Plan. You can see a copy of the HCCP on - www.nhsdg.scot.nhs.uk.
Staff
NHS Dumfries & Galloway employs over 4300 staff from a range of different clinical and nonclinical backgrounds, made up of the following broad groupings:
Nursing
Administrative/Clerical
Ancillary
Medical
Technical
51%
16%
14%
9%
4%
AHPs
Scientific
Pharmacy
Maintenance
Management
2%
1%
1%
1%
1%
Services
A wide range of services are provided from over 50 bases across the region. Many of these
services are provided via one of four Local Health Partnerships (Annandale & Eskdale, Dumfries
& Upper Nithsdale, Stewartry, Wigtown), whereas others, such as Mental Health, Child Health
and Sexual Health, are provided as regional services. Most acute services are based at Dumfries
and Galloway Royal Infirmary with a network of out-patient clinics held throughout the region
and a range of acute services provided at the Galloway Community Hospital.
The map below highlights LHP areas and main service bases throughout the region.
NHS
STRATHCLYDE
KIRKCONNEL
SANQUHAR
BORDERS
MOFFAT
THORNHILL
Annandale & Eskdale Locality
Nithsdale Locality
AYRSHIRE & ARRAN
LOCHMABEN
DUMFRIES
LANGHOLM
LOCKERBIE
Stewartry Locality
NEWTON
STEWART
Wigtown Locality
STRANRAER
Gretna
ANNAN
CASTLE
DOUGLAS
Eastriggs
DALBEATTIE
Carlisle
CUMBRIA
KIRKCUDBRIGHT
DUMFRIES and GALLOWAY
Dumfries and Galloway Royal Infirmary
Dumfries and Galloway Royal Infirmary contains 368 staffed beds (+ 11 cots), and includes the
Departments of:
 Accident & Emergency
 Anaesthetics
 Cardiology
 Care of the Elderly/Acute Rehabilitation
 Dermatology
 Diabetes/Endocrinology
 ENT Surgery
 Gastroenterology
 General Medicine
 General Surgery
 Haematology
 Infectious Diseases
 Laboratory Services
 Nephrology
 Neurology
 Obstetrics and Gynaecology
 Ophthalmology
 Oral and Maxillofacial Surgery
 Orthodontics
 Orthopaedic Surgery
 Paediatrics
 Palliative Care
 Respiratory Medicine
 Rheumatology
 Radiology
 Urology
In the summer of 2002, a “New Build” was opened next to the Accident and Emergency
Department, with accommodation for both the GP Out-of-Hours Co-operative and the Musculoskeletal Service. This has released space for the A & E Department, thereby allowing
development of this service. Upgrading work has now commenced, on a phased basis, in the A &
E Department. A helicopter landing site was also provided in Phase I of this development.
The Operating Department, adjacent to the Day Surgery Unit (opened 2003), has six theatres (one
allocated for emergency cases), two endoscopy suites and minor treatment room. The theatres
have been recently upgraded. There is an Intensive Care Unit of four beds, a Surgical High
Dependency Unit of four beds and a Medical High Dependency Unit of eight beds. There is a
separate theatre in the Ophthalmology Day Case ward and an obstetric theatre in the adjacent
Cresswell Maternity Unit
The on-site Macmillan Cancer Centre opened in 2003; this provides oncology out-patient,
chemotherapy and palliative care services.
A new Renal Unit, providing 18 dialysis stations, opened in April 2006, replacing services
previously provided in a former ward in DGRI.
The Radiography Department is currently undergoing extensive refurbishment, both physically
and operationally, with PACS successfully implemented and a new MRI scanner which became
operational in 2008.
Dumfries and Galloway Royal Infirmary is the recognised Post-Graduate Medical Centre for
south-west Scotland. The Education Centre at DGRI provides:
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programme of weekly meetings, covering all specialties
induction programme for junior doctors
well-stocked library
internet access
superb audio-visual facilities
98-seat lecture theatre
Galloway Community Hospital
The Galloway Hospital is located in Stranraer, 75 miles from Dumfries. It contains an Emergency
Department, 50 beds (rehabilitation-24, GP acute-20, maternity-4, palliative care-2), 4 renal
places and an operating theatre. Services also provided at this hospital include Accident and
Emergency, Anaesthetics, Laboratory and Radiology (including a CT scanner).
Midpark Hospital
A new Mental Health facility has opened in January 2012 on a site adjacent to the Crichton
Campus. Facilities provided at the new site include - a 15 Bed elderly ward; 16 bed
dementia/organic illness ward; 6 bed IPCU; 34 Bed adult (2 wards – 17 bed each); Acute hub
accommodation; 8 Bed rehab recovery; 8 Bed rehab long stay; and Rehab hub accommodation.
These facilities have an average annual admission rate of over 700 and approximately 7,000 outpatient attendances per year. They provide a full range of psychiatric services for patients of all
ages in the Dumfries & Galloway region. The Emergency Department is supported by a
Psychiatric Liaison Nurse.
Community Hospitals
There are ten Community Hospitals within Dumfries and Galloway, each managed by local health
partnerships:
Annandale & Eskdale
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Annan Hospital
24 beds (palliative care and rehabilitation)
Lochmaben Hospital
8 beds (palliative care and rehabilitation)
Moffat Hospital
12 beds (GP acute and rehabilitation)
Thomas Hope Hospital
12 beds (palliative care and rehabilitation)
Dumfries & Upper Nithsdale
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Allanbank
23 beds (rehabilitation)
Thornhill Hospital
13 beds (rehabilitation)
Stewartry
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Castle Douglas Hospital
16 beds (GP acute and rehabilitation)
Kirkcudbright Hospital
14 beds (GP acute) and Minor Injuries Unit
Wigtown
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Galloway Community Hospital
50 beds (rehabilitation-24, GP acute-20, maternity-4, palliative care-2)
 Newton Stewart Hospital
23 beds (GP acute, palliative care and rehabilitation)
(In some cases patients may be admitted directly from the DGRI Emergency Department to
Community Hospitals through local General Practitioners)
Day Hospitals (number of places)
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Annan Hospital
Castle Douglas Hospital
Galloway Hospital
Lochmaben Hospital
Moffat Hospital
Newton Stewart Hospital
Nithbank, Dumfries
Thornhill Hospital
Thomas Hope Hospital
8
10
10
10
8
10
10
12
8
THE DEPARTMENT OF ANAESTHETICS
The Anaesthetic Department is based at Dumfries and Galloway Royal Infirmary. There is a
modern 5 theatre operating department suite with recovery area and an adjacent endoscopy/day
case suite with 20 trolley spaces, one day case theatre and two endoscopy rooms. Equipment in
Theatre, ICU and SHDU is of a high standard. There is full Medical Physics back-up, day and
night.
There is a four-bedded, well-equipped, Intensive Care Unit, a separate four-bedded Surgical High
Dependency Unit and an eight bedded Medical High Dependency/Coronary Care Unit. The
Intensive Care Unit runs a ‘semi closed’ model and is staffed by six consultant anaesthetists with
an interest in Critical Care on a weekly daytime rota. The unit actively participates in audit and
multi centre research.
There is a well established Specialist Nurse led Acute Pain Service with Consultant Anaesthetist
support.
The chronic pain service is led by two consultant anaesthetists with interest in chronic pain, with
out-patient clinics and dedicated theatre sessions to perform interventions. There are links with the
acute pain and palliative care services, General Practitioners and the voluntary sector. The
Anaesthetic Department strongly supports multidisciplinary working and has been working
closely with management to establish a multidisciplinary pain team.
The regional Accident and Emergency Department is led by consultants in Emergency Medicine.
The Anaesthetic Department assists in resuscitation and stabilisation of patients in the Emergency
Department and on occasions is responsible for transport of critically ill patients to tertiary
centres, particularly for neurosurgical and cardiothoracic intervention.
Many surgical specialties are supported including ENT, Opthalmology, Vascular Surgery,
Urology, Upper and Lower gastrointestinal surgery, gynaecology, obstetric, orthopaedic and
maxillofacial surgery.
In addition, the Department supports the following facilities:
1. Cresswell Maternity Wing, which provides a specialist Obstetric and Neonatal Service for
south-west Scotland, with around 1,400 deliveries per year. There is a newly established
labour epidural service and support given for Remifentanil PCA. There is an anaesthetist
allocated for unscheduled obstetric anaesthesia each weekday morning and the department is
staffed at other times to provide resident obstetric anaesthesia expertise at all times
There are two Consultant sessions for elective cases on Tuesday and Thursday mornings.
2. ECT. This is now provided in the day surgery unit following the move of psychiatric services
to the new Midpark Hospital.
3. Galloway Community Hospital, which has a separate anaesthetic rota staffed by the two
Galloway Community Hospital (GCH) consultants, supported by a visiting specialty doctor.
There is informal voluntary rotation of DGRI consultants to GCH when the DGRI rota allows.
Locum sessions are currently required to support this rota.
4. Ophthalmology. A fully equipped operating theatre is used in the ophthalmology ward for
occasional general anaesthetic cases.
The Anaesthetic Department establishment at present is as follows:
Consultants:
Dr D R Ball (w/t)
Dr Christie (w/t)
Dr V Edwards (w/t)
Dr H Goonesekera (w/t)
Dr D Macnair (w/t)
Dr J Muthiah (w/t)
Dr J Neil (w/t)
Dr W Peel (w/t)
Dr V Perkins (w/t)
Dr J S Rutherford (w/t)
Dr L Verner (0.5 WTE)
Dr D Williams (w/t)
Dr Wilson (w/t)
Dr W Wrathall (w/t)
Special Interest:
TIVA, Airway Skills
ICU, Deteriorating patient, vascular surgery
Trauma and Emergency Surgery, Rota
Chronic Pain, Vascular surgery
Obstetrics
Chronic Pain, Orthopaedics
Obstetrics, Blood Transfusion
ICU, Vascular Surgery, ECT,
Pre-operative Assessment, VTE prevention lead
ICU, Vascular Surgery, Acute Pain, Paediatric Anaesthesia,
APLS Course Director
Regional Anaesthesia, Orthopaedics
ICU, Vascular Surgery, Specialty Team Lead for ICU,
ALS Course Director
ICU, Airway lead, Vascular Surgery, IT
ICU, Vascular Surgery, Deteriorating Patient Lead,
Clinical Director of Anaesthesia & Intensive Care
Dr R J Spicer (p/t).......GCH
Vacancy........GCH
Inter-hospital Transfer, Asthma, Day Surgery
Currently advertised
Specialty Doctors:
Dr D Ballingall (wt/)
Dr K Shahzad (w/t)
Dr C Fernando (w/t)
Dr R Minhas (w/t)
Vacant posts x 2 (w/t)
Dr J Carruthers (p/t)
These advertised positions
Locum appointment
Dr D Coyle (p/t)…..GCH
Provides 1 in 4 weekend on-call
Trainees:
 Five CT doctors, recognised by the College for basic specialist training, on the West of
Scotland training rotation
Education, Research and Audit
The Department holds weekly Intensive Care lunch-time meetings and monthly half-day
“Continuing Education and Professional Development” sessions. There is a tutorial programme
and a series of lectures to theatre nursing staff.
The Department is heavily involved in Critical Care and Resuscitation teaching with ALERT,
IMPACT, APLS, ALS, SCOTTIE courses, all being run in the Education Centre and
Resuscitation Training Centre. SIM-MAN and HAL mannequins are used in much of the
teaching. Dumfries is a regional centre for APLS, ALS, ALERT, IMPACT paramedic and
undergraduate training and we are recognised for both basic and Higher Postgraduate Specialist
Training.
Key Result Areas
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Maintaining the high quality of clinical teaching for medical students that has existed in
Dumfries & Galloway for some years, with the feed-back reports from students being used as
an outcome measure.
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Taking part in clinical audit, and all aspects of clinical governance as required by the
Department.
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Completing satisfactory CPD, and an appraisal process.
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The Hospital has a Research Department, and the post-holder will be able to obtain support in
the preparation and carrying out of research projects, a development which will be
encouraged.
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The postholder will be expected to work well with an extended multi-disciplinary team,
ensuring good communications and co-operation with all members of the medical staff.
Job Plan
A job plan will be agreed with the successful candidate. Specialty interests may be
accommodated. The job plan will be based on a 10 PA contract (1PA = 4hours) with a minimum
of 1 SPA but up to 2 extra PA’s may be offered. Out of hours work is resident on a partial shift
rota and out of hours commitment may vary from time to time. Currently the frequency of out of
hours commitment equates to one in seven nights and weekends on the ‘first call’ rota. With
successful recruitment to these positions some of the out of hours shifts will become resident 2nd
call, supervising the work of the CT2 trainees. Whilst resident out of hours there are commitments
to emergency surgery, resuscitation, critical care and emergency obstetric care at the adjacent
Cresswell Maternity Wing. Daytime scheduled work averages 4.5 half day operating lists per
week and may include day time duties to the intensive care unit. The successful candidate would
be expected to work flexibly.
TERMS & CONDITIONS OF SERVICE
The terms & conditions of service offered are those determined by the Specialty Doctor Contract
2008 Scotland (as amended from time to time).
These are permanent positions.
Salary scale
£36,807 - £68,638 (basic, whole time equivalent).
New entrants to the NHS or the Specialty Doctor grade will normally commence on the minimum
point of the salary scale (dependant on qualifications and experience).
Availability and out of hours supplements may added to the above basic salary.
Superannuation
You have the option to join the NHS Superannuation Scheme, to participate in the State Earnings
Related Pension Scheme or to take out a Personal Pension. Employee’s contributions to the NHS
Scheme are Tiered based on your earnings and the employers contribution equates to 13.5 % of
salary. Employees in the NHS Scheme are “Contracted-out” of the State Earnings Related
Pension Scheme and pay a lower rate of National Insurance contributions. Employees who
choose to participate in the State Earnings Related Pension Scheme pay the higher rate of National
Insurance contribution. A Stakeholder Pension is also available. A Personal Pension is a private
arrangement agreed with the pension provider that will be an organisation such as a Bank,
Building Society or Insurance Company.
Removal expenses
Assistance with relocation and associated expenses may be given and can be discussed prior to
appointment. A quick reference of entitlements is attached for you.
Expenses for candidates attending for interview / visit
Candidates who are required to attend an interview will be given assistance with appropriate
travelling expenses. Re imbursement shall not normally be made to employees who withdraw
their application or refuse an offer without good reason.
Disclosure Scotland / PVG
This post is considered to be in the category of “Regulated Work” and therefore requires a
Disclosure Scotland Protection of Vulnerable Groups Scheme (PVG) Membership which
currently costs £59.00. The cost of the PVG Membership will be initially paid by NHS Greater
Glasgow and Clyde and will required to be repaid through a payroll deduction mandate from the
successful candidate’s first salary.
Right to work in the UK
NHS Dumfries & Galloway has a legal obligation to ensure that it’s employees, both EEA and
non EEA nationals, are legally entitled to work in the United Kingdom. Before any person can
commence employment within NHS D&G they will need to provide documentation to prove that
they are eligible to work in the UK. Non EEA nationals will be required to show evidence that
either Entry Clearance or Leave to Remain in the UK has been granted for the work which they
are applying to do. Where an individual is subject to immigration control under not circumstances
will they be allowed to commence until the right to work in the UK has been verified. ALL
applicants regardless of nationality must complete and return the Confirmation of Eligibility to
Work in the UK Statement with their completed application form. You will be required provide
appropriate documentation prior to any appointment being made.
Rehabilitation of Offenders Act
The rehabilitation of Offenders act 1974 allows people who have been convicted of certain
criminal offences to regard their convictions as “spent” after the lapse of a period of years.
However, due to the nature of work for which you are applying this post is exempt from the
provisions of Section 4 of the Rehabilitation of Offenders Act 1974 by virtue of the Rehabilitation
of Offenders Act 1974 (Exceptions Orders 1975 and 1986). Therefore, applicants are required to
disclose information about convictions which for other purposes are “spent” under the provision
of the act in the event of employment, failure to disclose such convictions could result in dismissal
or disciplinary action by NHS Dumfries & Galloway. Any information given will be completely
confidential.
Disabled Applicants
A disability or health problems does not preclude full consideration for the job and applications
from people with disabilities are welcome. All information will be treated as confidential. NHS
Dumfries & Galloway guarantees to interview all applicants with disabilities who meet the
minimum criteria for the post. You will note on our application form that we ask for relevant
information with regard to your disability. This is simply to ensure that we can assist you, if you
are called for interview, to have every opportunity to present your application in full. We may
call you to discuss your needs in more detail if you are selected for interview.
Notice
The employment is subject to three months’ notice on either side, subject to appeal against
dismissal.
Medical negligence
In terms of NHS Circular 1989 (PCS) 32 dealing with Medical Negligence the Health Board does
not require you to subscribe to a Medical Defence Organisation. Health Board indemnity will
cover only Health Board responsibilities. It may, however, be in your interest to subscribe to a
defence organisation in order to ensure you are covered for any work, which does not fall within
the scope of the indemnity scheme.
Accommodation
The post is non-resident, but temporary single accommodation may be available for a fixed
period.
ENQUIRY ARRANGEMENTS
For any further details please contact Dr DW Wrathall, Clinical Director for Anaesthesia and
Intensive Care – direct dial - 01387 241873; e-mail address – davidwayne.wrathall@nhs.net or
Dr V Edwards, Consultant Anaesthetist – direct dial - 01387 241887; e-mail address –
vedwards@nhs.net. Arrangements to visit the department can be made through the Department
Secretary on 01387 241622.
DUMFRIES AND GALLOWAY ROYAL INFIRMARY
SELECTION CRITERIA
Appointment of: Specialty Doctor in Anaesthetics
Job Requirement
Essential
Desirable
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MB,ChB or equivalent
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Minimum of 3 years at SHO level or
equivalent
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Trustworthy, hard-working, ability to get
on with colleagues
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Ability to supervise SHOs and assist with
of FY1s, FY2s and medical students
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Familiar with audit process

Completion of previous audits, including
implementation of change

Ability to manage own workload and
contribute to departmental reporting
FRCA(UK)
Qualifications
Experience
Personal attribute and
attitude
Practical skills
Audit
Management ability
Prepared by : Dr W Wrathall
Consultant Anaesthetist
Published/presented work
Date: August 2012