NHSGGC : NHS Greater Glasgow and Clyde - Homepage of …



consultant Physician

RESPIRATORY MEDICINE

Part-time post

(6 PA’s)

glasgow royal infirmary

Information pack

reF: 48858D

Closing Date: 13th October 2017

.uk/medicaljobs

SUMMARY INFORMATION

Post: consultant PHYSICIAN in respiratory medicine

PART-TIME POST – 0.6 WHOLE TIME EQUIVALENT

Base: glasgow royal infirmary

Applications are invited for the post of Consultant Physician in Respiratory Medicine. The post will be based at Glasgow Royal Infirmary. This is a new post with a focus on the development of novel patient pathways.

The successful candidate will integrate with existing consultant colleagues and provide clinical excellence in Respiratory Medicine within Glasgow Royal Infirmary / Stobhill ACH.

This post will offer an opportunity for the successful candidate to be involved in the provision of a successful modern consultant led service, with significant opportunities including sessional time allocated towards the development and support of novel patient pathways. This post has been developed in partnership with the Scottish Government Health Department to implement and assess alternative approaches to patient care and service delivery across a range of Respiratory services.

All major specialties are represented within Glasgow Royal Infirmary currently over 60 Consultant Physicians with special interests in Acute Medicine, Cardiology, Diabetes & Endocrinology, Gastroenterology, Respiratory Medicine, Rheumatology and Elderly Care.

The post is advertised as a part-time post, offering 0.6 whole-time equivalent, including 1 SPA session. By negotiation with the Clinical Director there may be some flexibility in the number of direct clinical sessions, sub-specialty interest and/or out-patient care. This post will include Acute Medical Receiving and may require participation in the Respiratory Specialty component of the General Medical on call rota.

Applicants must have full GMC registration and a licence to Practise. Those trained in the UK should have evidence of higher specialist training leading to CCT in Respiratory Medicine or eligibility for specialist registration (CESR) or be within 6 months of confirmed entry from date of Interview. Non UK applicants must demonstrate equivalent training.

NHS GREATER GLASGOW AND CLYDE

GLASGOW ROYAL INFIRMARY

CONSULTANT PHYSICIAN - RESPIRATORY MEDICINE – 0.6 WTE

BACKGROUND INFORMATION

NHS Greater Glasgow and Clyde (NHSGGC) is one of 14 regional NHS Boards in Scotland.

The Board provides strategic leadership and performance management for the entire local NHS system in the Greater Glasgow and Clyde area and ensures that services are delivered effectively and efficiently.  Responsible for the provision and management of the whole range of health services in this area including hospitals and General Practice, NHSGGC works alongside partnership organisations including Local Authorities and the voluntary sector.  NHSGGC serves a population of 1.2 million and employs around 38,000 staff – it is the largest NHS organisation in Scotland and one of the largest in the UK.   If you want to know more about the NHS in Scotland then please visit show.scot.nhs.uk.

NHS Greater Glasgow and Clyde’s purpose is to: 

 “Deliver effective and high quality health services, to act to improve the health of our population and to do everything we can to address the wider social determinants of health which cause health inequalities”

Facts and Figures

• Serves a population of 1.2 million

• Employs over 38,000 staff

• More than 300 GP Surgeries (General Practitioners)

• 35 Hospitals of different types

• Dental Services in more than 270 locations

• Almost 180 Optician practices

• Over 50 Health Centres and Clinics

• More than 300 Pharmacies.

Area Covered

From Gourock to Easterhouse, Lennoxtown to Eaglesham, Alexandria to Bishopbriggs, NHSGGC serves the people of:

• Inverclyde

• Renfrewshire

• East Renfrewshire

• Glasgow

• East Dunbartonshire

• West Dunbartonshire

• and part of South Lanarkshire, including Rutherglen and Cambuslang.

Acute Services Division

The Acute Services Division is the largest group of adult acute hospitals in Scotland. It enjoys close links with Glasgow’s three universities and makes a significant contribution to teaching at both undergraduate and postgraduate level. Research also has a high profile within the organisation. Education facilities are provided at Glasgow Royal Infirmary and the new ambulatory care hospital at Stobhill Hospital. The service in North Glasgow presently employs more than 14,300 staff serving a core catchment population of 560,000.

Glasgow Royal Infirmary (GRI) & Stobhill Ambulatory Care Hospital (SACH)

Glasgow Royal Infirmary is one of the major teaching complexes of the University of Glasgow. It provides the Emergency Medicine service for the North Eastern districts of Glasgow and has inpatient beds in general medicine and related specialities, medicine for the elderly, general surgery, orthopaedics, plastic surgery and obstetrics and gynaecology. There are also beds in intensive care, medical and surgical high dependency, and coronary care. Following the closure of Stobhill Hospital March 2011 all acute medical beds, with the exception of some long-stay care of the elderly beds, are on the GRI site. The Stobhill Ambulatory Care Hospital is a modern purpose built ACH providing a full range of out-patient and ambulatory care services including an ENP led Minor Injuries Unit (MIU). Radiology, Cardiology and Respiratory diagnostic services are provided both at GRI and nSACH.

Staff at GRI and SACH are proud of the close inter-departmental links and co-operation. They are at the forefront of a progressive agenda in relation to clinical standards, managed clinical networks and patient focused service re-design. There are close clinical links with colleagues in the Community Health Care Partnership and other hospitals in NHS Greater Glasgow and Clyde, Glasgow, Strathclyde and Glasgow Caledonian Universities. There is a dedicated hospital wide academic programme supported by a strong service educational commitment. GRI and SACH are provided with dedicated education centres and IT support. Both have excellent reputations in supporting and nurturing its clinical staff and also have an excellent reputation for under and post graduate training. There are academic units in Anaesthetics, Cardiology, Human Nutrition, Medicine, Surgery, and Obstetrics and Gynaecology.

At GRI medical emergencies are admitted via an Acute Assessment Unit (AAU) run by acute physicians or via the Emergency Department (ED) to an Acute Medicine Unit (AMU). This comprises 4 geographically defined ward areas covered by specific specialty teams – general medical, respiratory, gastroenterology and medicine for the elderly. Where bed availability permits, patients with specific conditions are triaged to the appropriate specialty team e.g. patients with respiratory disease to the respiratory area. Four consultant physicians representing each speciality group take part in acute receiving each day in the AMU with morning and evening ward rounds.

Acute admissions to medicine range from 45 to 70 per day. Patients requiring a short stay are discharged from AMU. Those requiring longer stays are transferred ‘downstream’ to medical, care of elderly or cardiology beds. There are 216 downstream medical beds split into specialty units/wards; Respiratory Medicine, Rheumatology, Gastroenterology, Diabetes and Endocrinology. Consultants from the department of medicine for the elderly (DOME) contribute to receiving duties, but also have 183 in-patient beds in a number of wards within Glasgow Royal Infirmary with additional rehabilitation beds at Lightburn Hospital and Stobhill Hospital. There is a separate Stroke Ward.

Contacts

Dr J. Brian Neilly – Clinical Director for Medicine

0141 211 4971 – James.Neilly@ggc.scot.nhs.uk

Dr George Chalmers – Lead/Link Consultant for Respiratory Medicine

0141 211 4381 – George.Chalmers@ggc.scot.nhs.uk

Mr Russell Coulthard – General Manager, GRI

Russell.Coulthard@ggc.scot.nhs.uk

RESPIRATORY MEDICINE

Respiratory outpatient services are provided at SACH and GRI, with inpatient beds at GRI. The specialty has 16 Acute beds in the Medical Receiving Complex, and 67 downstream beds in Respiratory Medicine (4 wards).

Respiratory Team

Medical Team

The service has the support of middle grade junior doctors and ward based cover by FY1/2 doctors. Middle grade doctors and sessional GPs provide support to out-patient clinics.

Consultants

Dr George Chalmers (Lead Consultant) - Interstitial Lung Disease / Vasculitis

Dr Melanie Brewis – Pulmonary Vascular disease/asthma

Dr Mark Cotton - Respiratory Infections / Airways Disease

Dr Stephen Crawley – COPD/Lung Cancer

Dr Douglas Cowan - Asthma

Dr Brian Choo-Kang – Pleural Disease / Respiratory Infections. GGC Joint Clinical Lead for eHealth.

Dr Eric Livingston – Sleep & Ventilation

Dr John Maclay – Lung Cancer

Dr Joris van der Horst – Lung Cancer / Interventional Bronchoscopy

Dr Brian Neilly - Nuclear Medicine

Dr Robert Milroy – Lung Cancer

Dr Angela Wright – Interstitial Lung Disease/TB

This post

Specialty Trainees

There are currently 4 ST trainees and 1 Clinical Fellow post in Respiratory Medicine.

Sessional General Practitioners

Dr John Farley

Dr Cameron Livingston

Respiratory Nurse Specialists

There are Respiratory Nurse Specialist (RNS) across GGC who specialise in various areas of Respiratory Nursing (Lung cancer, Asthma & COPD, Interstitial Lung disease, Breathing Support, Cystic Fibrosis and Pulmonary Vascular Disease)- 8.4 WTE in North East Glasgow. These RNS’s provide expert respiratory clinical skills to manage patients across both Secondary care and Primary care settings. The RNS's play a key  role on improving the quality of care for respiratory patients by reducing unplanned hospital admissions, facilitating early discharge, offering care at home and improving patient self-management skills. There are well established links with the British Lung Foundation. Two TB nurses are based in the respiratory department.

Respiratory Physiotherapy

A specialist respiratory physiotherapist provides out-patient services and supports in-patient physiotherapy with the assistance of the general physiotherapy service.

Respiratory Clinical Physiology

Respiratory physiology services are based at both Glasgow Royal Infirmary and the new Stobhill Ambulatory Care Hospital. The  respiratory physiology and sleep  laboratories have  the aim of  providing an  efficient, comprehensive clinical, therapeutic  and  pulmonary  function assessment  service for the diagnosis and rehabilitation  of  patients  with respiratory and sleep related breathing disorders.  The two laboratories provide a   full range of routine pulmonary function tests (lung volumes by body plethysmography, spirometry, and single breath gas transfer assessment, response to bronchodilator and blood gas assessment by arterialised ear lobe capillary sampling).  Specialist respiratory physiology and sleep assessment are also provided, in particular Progressive Cardiopulmonary Exercise Testing, Bronchial Provocation Testing, Respiratory Muscle assessment, Oxygen Assessment (LTOT, Ambulatory and Fitness to Fly) and Sleep diagnostic studies (Screening and Full Polysomnography). A full therapeutic service (CPAP/NIV) for patients with sleep related breathing disorders is also provided. The department currently has 10 WTE Clinical Physiologists and 1WTE unqualified Support Worker providing the specialised services in sleep and exercise physiology.

Background to this post:

The Chief Medical Officer for Scotland launched her first Annual Report “Realistic Medicine” in January 2016. This asked clinicians six key questions about (1) Building a personalised approach to care (2) changing our style to shared decision-making (3) reducing harm and waste (4) managing risk better (5) reducing unnecessary variation in practice and outcomes and (6) becoming improvers and innovators. In February 2017 the CMO launched her second Annual Report “Realising Realistic Medicine’. This sets out pathways to develop the approaches, behaviours and attitudes of Realistic Medicine’, and outlines the need for choices in terms of measurement and management in health systems. “The Modern Outpatient: A Collaborative Approach 2017-2020” emphasises the need for enhanced management of patients in the community, with a focus on e-Health and digital opportunities at the primary/secondary care interface, along with review of OP processes.

Building on a history of innovation, and in addition to other current developments, NE Respiratory Medicine has developed a virtual lung cancer clinic, which has delivered significant savings in clinic slots, more efficient use of lung cancer service resources, increased service capacity and an 80% reduction in waiting list initiative clinics for lung cancer. We have identified other areas which may benefit from a similar approach, but recognise that innovation requires preparation, implementation and analysis to ensure that novel pathways are as effective and efficient as we would hope. One such area would be the development of a Respiratory day ward, to facilitate day-patient management of conditions which might otherwise require admission to hospital, and to improve outpatient pathways for investigation and treatment of a range of conditions.

This post will include sessional time allocation to develop, implement and measure the impact of novel patient pathways in Respiratory Medicine, and the post is supported by initial funding from Scottish Government Health Department to make this possible.

It is envisaged that the post-holder will work in collaboration with existing Consultant colleagues and the management team to develop novel patient pathways for out-patient, in-patient and day-patient management of a range of Respiratory conditions. The post will bring the opportunity to apply these principles within an area of personal subspecialty expertise, as well as broadly across Respiratory Medicine. Each sub-specialty pathway would be supported or led by an existing Consultant with that sub-specialty interest, but with the new post having responsibility for operational development of these novel pathways. As part of this, the successful applicant will be required to demonstrate the impact of these novel pathways as they evolve. Experience, aptitude and leadership in similar areas such as research or quality improvement would be considered an advantage.

Duties of Post:

Job plan (illustrative – subject to negotiation)

| |AM |PM |

|Monday |Pathway redesign |OP Clinic |

|Tuesday | | |

|Wednesday |Specialty OP Clinic or list |pathway redesign / Day ward* |

|Thursday | | |

|Friday |Acute receiving (0.5PA) |SPA |

Weekend & out of hours on-call in proportion to job plan

Clinics/clinic admin 2.0 PA

Pathway Redesign/Patient Safety – 2.0 PA

Acute Receiving – 0.5 PA

On-call 0.5 PA

SPA 1.0 PA

TOTAL = 6 PA

Pathway Redesign

Responsibility for redesign requires allocation of time within a job plan, and we have allocated 2 “sessions” initially to this activity. Although these sessions are not identical to clinical sessions, the job plan gives them equal weight, recognising their potential impact on clinical work across the department. It is anticipated that over time, these sessions may evolve towards a balance between direct clinical care and ongoing redesign work, in part through the development of a day ward facility.

*Respiratory Day Ward

Although the model for Respiratory Day ward activity is well-described, GRI does not at present have such a facility. In collaboration with management and colleagues, the post-holder would aim to establish a day ward model, and to provide leadership and clinical input in its operation.

Out-patient clinics.

Respiratory outpatient clinics are provided at both GRI and Stobhill. Outpatient activity includes General Respiratory clinics and Sub-specialty clinics including Lung Cancer, Interstitial Lung Disease, Complex Asthma, Bronchiectasis, TB and Sleep clinics. The post holder will be expected to work with colleagues delivering general and subspecialty clinics to design and implement novel approaches to the delivery of outpatient care (such as the expansion of the ‘virtual’ clinic model and other alternatives to traditional face to face consultant delivered clinics).

Sub-Specialty activity

The successful candidate would be expected to develop a sub-specialty interest, with the option to share that interest with an existing Consultant in keeping with the needs of the service. This could be focussed on a sub-specialty clinic, but could also take the form of a sub-specialty procedural list, as part of our aim to provide Respiratory day-patient services. There may be a requirement to participate in specialty MDT meetings.

Acute Medical Receiving (Glasgow Royal Infirmary)

The Respiratory Unit contributes a speciality component for medical receiving having 16 acute respiratory beds in the receiving complex and continuing care of patients in downstream medical wards. The medical receiving is shared with all the major specialties except Renal and Cardiology. The rota is 1:10 , and includes morning and evening ward rounds in the receiving ward and in-patient speciality referrals from other units.

The respiratory medicine in-patient beds are situated in Wards 2, 6, 7/16 and ward 10. These wards predominantly function as a specialist respiratory unit but may also be used for general medical patients (following acute receiving).

Supporting Professional Activities (1 PA)

The SPA session will reflect activity such as appraisal, personal audit and professional development occurring outside study leave time.  These activities must be specifically and clearly identified and be agreed with the candidate and desired by the department.

Additional Opportunities

Teaching

The Unit has a major commitment to training junior staff and teaching medical students. During term-time the unit has third, fourth and final year students on the ward and there are frequently post-graduate students training for the MRCP examination. Teaching of practical procedures including pleural procedures and bronchoscopy to post graduates is a key component of the work of the unit The Unit runs a weekly clinical seminar in addition to participation in a range of MDT meetings in cancer, TB, ILD and mesothelioma, and participates regularly at grand rounds and postgraduate conferences.

Clinical Audit

The Respiratory Medicine Unit has been actively involved in audit programmes in several areas including Lung Cancer. The new appointee will be expected to have an active involvement in leading clinical audit, initially directed towards their activities in pathway redesign.

Broader Consultant Responsibilities

• As agreed with the Clinical Director in Medical Specialties to provide (with consultant colleagues) a service in acute and respiratory medicine with responsibility for the prevention, diagnosis and management of illness and for the proper functioning of the service.

• To provide cover for consultant colleagues during annual and study leave or at such other times as agreed with the Clinical Director.

• To motivate staff within the service through leading by example and fostering good working relationships at all levels in line with the principles of the local Partnership Agreements.

• To participate fully in consultant appraisal and personal development planning activities.

• To ensure the efficient and effective use of Acute Services resources.

• To participate in the delivery of agreed national and local performance indicators e.g. Health, Economic Access Targets (HEAT).

• To participate in the Health Board and the Acute Division’s Clinical Governance framework and policies.

 

Management Arrangements

General (Internal) Medicine and Acute Medicine are part of the Medical Division within the North Sector of NHS Greater Glasgow and Clyde’s Acute Services. Chief of Medicine in the North Sector is Dr Chris Deighan and the Sector Director is Mr Jonathan Best.

At Glasgow Royal Infirmary the Clinical Director for Medicine is Dr Brian Neilly and local management responsibility for Medicine at Glasgow Royal Infirmary and Stobhill Hospital is held by Mr Russell Coulthard, General Manager, NHS Greater Glasgow and Clyde, supported by Ms Rosemary Brogan, Clinical Service Manager for Medical Specialties. Nursing leadership is provided by a number of Lead Nurses within all specialty areas.

Living & Working in Glasgow

Today Glasgow is a compact, vibrant and modern city. In fact Glasgow’s scale comes as a surprise to many people. It has the largest suburban rail network outside London and is second only to the UK Capital as a retail centre. There are good schools, excellent leisure facilities, beautiful golf courses and elegant accommodation across all price ranges. The night life and restaurants are renowned and its opera, theatres, art galleries and museums offer plenty of cultural stimulation. From Glasgow, it is only a short journey to many picturesque sites including Loch Lomond (45 minutes), the Argyll peninsula – or over the sea to Arran, Skye, Iona and Mull.

TERMS AND CONDITIONS OF SERVICE

The conditions of service are those laid down and amended from time to time by the Hospital and Medical & Dental Whitley Council.

| | |

|TYPE OF CONTRACT |Permanent |

| | |

|GRADE AND SALARY |Consultant |

| |£ 78,304 - £105,570 per annum (pro rata) |

| | |

| |New Entrants to the NHS will normally commence on the minimum point of the salary scale, (dependent on |

| |qualifications and experience). Salary is paid monthly by Bank Credit Transfer. |

| | |

|HOURS OF DUTY |Full Time 24 hours (6PA's) |

| | |

|SUPERANNUATION |New entrants to NHS Greater Glasgow and Clyde who are aged sixteen but under seventy five will be enrolled|

| |automatically into membership of the NHS Pension Scheme.  Should you choose to "opt out" arrangements can |

| |be made to do this via: .uk |

| | |

|REMOVAL EXPENSES |Assistance with removal and associated expenses may be given and would be discussed and agreed prior to |

| |appointment. |

| | |

|EXPENSES OF CANDIDATES FOR APPOINTMENT |Candidates who are requested 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 of appointment. |

| | |

|TOBACCO POLICY |NHS Greater Glasgow and Clyde operate a No Smoking Policy in all premises and grounds. |

| | |

| |This post is considered to be in the category of “Regulated Work” and therefore requires a Disclosure |

|DISCLOSURE SCOTLAND |Scotland Protection of Vulnerable Groups Scheme (PVG) Membership. |

| | |

|CONFIRMATION OF ELIGIBILITY TO WORK IN THE|NHS Greater Glasgow and Clyde (NHSGGC) has a legal obligation to ensure that it’s employees, |

|UK |both EEA and non EEA nationals, are legally entitled to work in the United Kingdom. Before any person can|

| |commence employment within NHS GGC 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 no 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 1974 |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 Greater Glasgow and |

| |Clyde. 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 Greater |

| |Glasgow and Clyde 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. |

| | |

|GENERAL |NHS Greater Glasgow and Clyde operates flexible staffing arrangements whereby all appointments are to a |

| |grade within a department. The duties of an officer may be varied from an initial set of duties to any |

| |other set, which are commensurate with the grade of the officer. The enhanced experience resulting from |

| |this is considered to be in the best interest of both NHS Greater Glasgow and Clyde and the individual. |

| | |

|EQUAL OPPORTUNITIES |The postholder will undertake their duties in strict accordance with NHS Greater Glasgow and Clyde’s Equal|

| |Opportunities Policy. |

| | |

|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. |

FURTHER INFORMATION

For further information on NHS Greater Glasgow and Clyde, please visit our website on .uk

View all our vacancies at: .uk/medicaljobs

Register for Job Alerts at: medicaljobs.scot.nhs.uk

Applicants wishing further information about the post are invited to contact Applicants wishing further information about the post are invited to contact Dr. Brian Neilly, Clinical Director on 0141 211 4971 or George Chalmers, Respiratory Link Consultant 0141 211 4381 with whom visiting arrangements can also be made with whom visiting arrangements can also be made.

How to apply

To apply for these posts please include your CV and names and addresses of 3 Referees, along with the following documents; (click on the hyperlinks to open)

Medical and Dental Application and Equal Opportunities Monitoring Form

Declaration Form Regarding Fitness to Practice

Immigration Questionnaire

Alternatively please visit .uk/medicaljobs and click on the “How to Apply” tab to access application for and CV submission information.

NOMINATION OF REFEREES

It is Board policy that no person can act as a member of an Advisory Appointments Committee and be a referee for a candidate for that post. You should therefore check with your proposed referees whether there is likely to be any difficulty in this respect for we may otherwise have to invite you to submit another name or names

Return of Applications

Please return your application by email to nhsggcrecruitment@ or to the recruitment address below;

Medical and Dental Recruitment Team

NHS Greater Glasgow and Clyde

West Glasgow ACH (formerly Yorkhill)

2nd Floor

Dalnair Street,

Yorkhill,

G3 8SJ

CLOSING DATE

The closing Date will be 13thOctober 2017

INTERVIEW DATE

The interview date will be 3rd November 2017

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