nhs orkney speciality doctor - surgical care orkney application pack sp … · surgical care...

1 Speciality Doctor – Acute Hospital Care Application Pack

NHS Orkney Speciality Doctor - Surgical Care Recruitment and Information Pack Application reference number: 0714/048 Application Closing Date: Friday 10th October 2014

Recruitment Team Human Resources

Balfour Hospital New Scapa Road

Kirkwall Orkney

KW15 1BH 01856 8888186

[email protected]


Application Contents

Welcome..................................................................................................................... 3

Introduction To Orkney And NHS Orkney ................................................................... 4

Speciality Doctor – Surgical Care Advert .................................................................... 8

Information For Applicants ........................................................................................ 10

Selection Process And Recruitment Timetable ......................................................... 11

Job Description: Specialty Doctor - Surgery ............................................................. 12

Person Specification ................................................................................................. 19

To assist you with your application for the post Speciality Doctor – Acute Hospital Care, NHS Orkney, this pack provides useful information about NHS Orkney and post information.

Useful websites NHS Orkney

o http://www.ohb.scot.nhs.uk/

o Our Orkney Our Health – Transforming Clinical Services Orkney Island Council

o http://www.orkney.gov.uk/

Scotlands Health On The Web (SHOW) o http://www.show.scot.nhs.uk/

NHS Orkney Twitter

o www.Twitter.com/nhsorkney NHS Orkney Facebook

o www.facebook.com/nhsorkney

http://www.ohb.scot.nhs.uk/

http://www.ohb.scot.nhs.uk/article.asp?page=25&parent=7

http://www.orkney.gov.uk/

http://www.show.scot.nhs.uk/

http://www.twitter.com/nhsorkney

http://www.facebook.com/nhsorkney


Welcome

Thank you for your interest in our Specialty Doctor vacancies based in the Balfour, Rural General Hospital at NHS Orkney. Our vacancies are specifically to work across a range of Consultant led specialties notably anaesthesia, medicine and rehabilitation and surgery with state of the art clinical decision making support from our specialist centres. We believe working in a rural hospital can be both professionally and personally tremendously rewarding. We pride ourselves in delivering high quality care that is person centred, safe and effective and you would be joining at a time when we are investing in CT scanning and a high dependency care facility whilst at the same developing our Outline Business Case for our new Hospital., Partnership working with our population, our patients, our staff and teams, and our colleagues in Orkney Islands Council and the third sector is important to us and NHS Orkney also for a number of specialist services rely on Service Level Agreements with other Health Boards. Over recent years NHS Orkney has seen significant changes in the delivery of healthcare. The pace of change continues to accelerate as our committed staff adopt new and innovative ways of working fit for the coming decade. Our new hospital is planned for 2017 and we work towards the provision of and investment in our outer island facilities, these developments allow us to drive forward service improvement with confidence. Our ‘Specialty Doctor (s)’will play a vital role in the care and treatment of our patients and in return you can expect a positive experience that will support you develop and grow as a key member of NHS Orkney. If you believe you can fulfil this role, we at NHS Orkney look forward to receiving your application.

Marthinus Roos Medical Director NHS Orkney


Introduction to Orkney and NHS Orkney

Profile of Orkney

Lying off the northern coast of Scotland, between John O’Groats and the Shetland Isles, Orkney is an archipelago of over 70 beautiful islands, 17 of which are inhabited. The total population is approximately 22,000, with most people living on the Mainland. Kirkwall, the capital with its spectacular red sandstone 12th century cathedral, with a population of 7,500, it is the administrative centre of Orkney with a good mix of shops, supermarkets and businesses. Orkney is a wonderful place to live and work and has been voted the happiest place to live in the UK. Orkney also offers; low pollution, low crime, excellent schools, good leisure facilities, unique wildlife and amazing scenery. Orkneys economy is mainly occupied by the farming industry. Commonly within Orkney, farmers breed and rear beef cattle of the highest standard, although dairy cows and sheep are also kept. Agriculture generates some £30 million per year, followed closely by tourism, and oil. And fishermen compete with seals and sea birds to enjoy something of the rich bounty provided by the surrounding seas. Orkney is at the forefront of the renewable energy drive in the UK. Wind turbines are dotted around the islands and wave energy research is on-going. In economical terms Orkney hold an impeccable employment rate of 84.7%, above the average for Scotland and Great Britain.


Kirkwall is truly a place for children, a great place for families. The community spirit is amazing. There is so much for children and adults - theatre, drama, dance and ballet classes. Schools in Kirkwall are very good (no private fees). Imagine all of these within walking distance of your home and workplace. And for adults and visiting relatives and friends there is so much to see and do - playing a round of golf, fishing, kayaking, walking, cycling, diving, wind surfing are but a few. The Pickaquoy centre provides a lovely modern well equipped gymnasium, leisure pool, health suite, squash courts and entertainment centre.

7 Speciality Doctor – Acute Hospital Care, NHS Orkney

Speciality Doctor – Surgical Care Required for the Orkney Islands to provide services to the mainland population

and the outlying islands Are you interested in practising in an area of outstanding natural beauty?

Job Ref - 0714/048

Salary: £37,547 - £70,018 plus Distant Islands Allowance per annum Full Time: 40 hours per week A vacancy for a Specialty Doctor has arisen in the Surgery Department in the Balfour Hospital in Orkney. The post holder will be working closely with the Surgical Consultants to support the surgical team in theatre, Outpatients, the wards and A&E. You would also be working in close teamwork with the Consultant Physicians, Anaesthetists and the team of Specialty Doctors providing hospital wide shared care for patients admitted to the Balfour Hospital. Very sick and complex patients are cared for in the short term in our HDU before transfer to Aberdeen Royal infirmary. The medical and surgical team is supported within the hospital from 8:30 AM to 9 PM by Specialty Trainees and Nurse Practitioners. All the clinical teams have strong established links with NHS Grampian to provide 24/7 multi specialty advice and support via senior staff at Aberdeen Royal Infirmary utilising state of the art telemedicine facilities. Candidates will be part of a rural general hospital team looking after general medical and surgical patients presenting as both elective and emergency admissions. The hospital has a Casualty Department and we see on average 10 to 12 patients per day, a fully functional HDU led by our anaesthetic team and for patients requiring ITU support we have strong decision making support links with EMRS and SAS. The hospital is also in the process of having a 128 slice CT scanner installed with approval for our new replacement hospital just announced by the Minister – impressed? Why not get in touch to find out more about these permanent roles. We have a number of vacancies while NHS Orkney is in the process of redesigning its healthcare services. The new appointees will play a pivotal role in helping us design safe, modern and sustainable services for the people of Orkney. The focus is on the quality of care, with the emphasis on care being person centered, safe and effective. Participation in programs to improve the quality of care, such as clinical governance, clinical audit, the patient safety program, adherence to clinical guidelines and mortality and morbidity meeting, to name but a few, is mandatory. The Balfour Hospital is based in Kirkwall on the Mainland of Orkney, has 53 beds (including day surgery) and serves a population of approximately 20,000. The

9 Speciality Doctor – Surgical Care, NHS Orkney

hospital has an A&E service and has in-patient acute medicine, surgery, HDU, rehabilitation beds, a maternity and a renal dialysis unit, a MacMillan Ward as well as a day surgery ward. There are excellent facilities for education and telemedicine. We are also in the process of sourcing a CT Scanner which will be operated 24/7. The role is based on a 40 hour week predominantly during office hours, allowing for early pre-operative rounds and late theatre finishes. Four hours per week will be allowed for Supporting Professional Activities, such as CPD, teaching, appraisal, etc You should have at least 4 years of postgraduate experience. Applicants must have current ALS, APLS and ATLS skills but individual training and development plans can be considered for the right applicant. Support and training in this role will be available. Job adverts can also be viewed at www.ohb.scot.nhs.uk/vacancies.asp Please contact Marthinus Roos, Medical Director on 01856 888224 or email [email protected] should you require further details regarding the post. For an electronic application pack, including an application form and information on Orkney, please contact Danna Wilson, Human Resources, Balfour Hospital, Kirkwall. Tel: 01856 888186 or email: [email protected] Please note that in order to apply for a position at NHS Orkney the standard NHS application form needs to be completed – CVs are not accepted.

Closing date for applications: Friday 10th October 2014

This post is subject to a PVG Scheme Record check

http://www.ohb.scot.nhs.uk/vacancies.asp

mailto:[email protected]




Information for Applicants NHS Scotland The NHS is one of our nation’s biggest and most important public services. Each day thousands of Scots depend on it for treatment and care. Each day it saves hundreds of lives. The nation’s largest employer, more than 150,000 dedicated and skilled staff work for NHS Scotland. Since devolution, the Scottish Government has been striving to make Scotland healthier for all of us. The work undertaken by the 14 territorial NHS Boards across the country provides the strategic framework to ensure that the management of our healthcare is more efficient, more accountable and more effective. These Boards bring together key partners to deliver healthcare. One of the main functions of these different bodies is to put government policies into practice in the best way possible. An NHS Board is a board of governance, which has responsibility for issues such as health improvement, strategic planning and resource allocation. NHS Orkney The smallest of the territorial Boards, NHS Orkney employs circa 567 substantive employees. The Balfour Hospital is based in Kirkwall on the Mainland of Orkney, has 46 beds and serves a population of approximately 20,000. The hospital has an A&E service and has in-patient acute medicine, surgery, HDU, rehabilitation beds, a maternity and a renal dialysis unit, a MacMillan Ward as well as a day surgery ward. There are excellent facilities for education and telemedicine. We are also in the process of sourcing a CT Scanner which will be operated 24/7. Further information on NHS Orkney can be found at www.ohb.scot.nhs.uk. Terms and Conditions The Terms and Conditions of service are those determined by the New Speciality Doctor Grade (Scotland) 2008 and the post is offered on a 10 programmed activity basis. Applications are sought from individuals who wish to work on part time/ job share basis. Opportunities may exist for Additional programmed activities subject to service requirements. This post attracts Removal expenses in line with the Board’s policy. This will be discussed with you, as part of an offer of employment.

http://www.ohb.scot.nhs.uk/


Selection Process and Recruitment Timetable

KEY NOTE DATES

Recruitment Stage

Recruitment Advert opens 29/07/2014

Closing date for returned applications Friday 10th October 2014

Candidates informed of outcome of

Shortlisting Friday 17th October 2014

Shortlisted Candidates will be invited to

participate in the following:

Panel Interviews

Date to be confirmed

Special Requirements for Selection Events

Where appropriate NHS Orkney is fully supportive in discussing making any

reasonable adjustments to the recruitment process to ensure no candidate is

disadvantaged as a result of a disability or any other health condition.


JOB DESCRIPTION: SPECIALTY DOCTOR - SURGERY

Outline of the post NHS Orkney is recruiting to a number of new posts, which has been created to

support the delivery care of patients in the Balfour Hospital by the Medical and

Anaesthetic Consultants. The posts require mature, experienced clinicians who are

interested in providing direct care to the patients of Orkney in a Remote and Rural

General Hospital. A wide range of clinical skills and knowledge is required to provide

care, which is delivered in close cooperation with the clinicians in NHS Grampian

(predominantly in Aberdeen). Patients whose care needs are exceeding the care

available in Orkney are evacuated to the Scottish Mainland by the Scottish Air

Ambulance utilising fixed-wing aircraft and helicopters. The posts will be for 24 hour

cover of the hospital – predominantly Medicine and A&E during the day, with care of

the surgery patients added after hours.

A broad range of skills will be required to fulfil these posts: Knowledge and skills in

Medicine, Surgery, Paediatrics and A&E are essential, with further knowledge and

skills in Psychiatry, Care of people in police custody and Major Incident Management

will be desirable. The post holders will also provide support for our doctors in training

These posts (subject to annual review and appraisal) will be based in the Balfour

Hospital. These posts will support the medical workforce development and

investment to improve the overall management of acutely unwell patients.

The appointment will contribute to delivering the 4-hour A&E waiting time guarantee

and local HEAT targets.

General NHS Orkney Health Board has one Remote and Rural General Hospital and serves

a population of 20,000. Complex medical and surgical cases are stabilised and

transferred to mainland Scotland.

NHS Orkney is at the forefront of developing sustainable and cost-effective care in a

remote and rural environment to ensure the delivery of quality clinical care, which is

person centred, safe and effective. The successful candidate will have the

opportunity to participate in the challenge of providing this evolving service in a Rural

General Hospital.

The Scottish Government has allocated funding to NHS Orkney for a new care

campus which is expected to be completed in 2017.


The post provides an opportunity to enjoy an outstanding quality of life as part of a

vibrant and forward thinking community, in an area of superb natural beauty,

heritage and culture which also enjoys subsidised and frequent air and sea links to

mainland Scotland.

Description of Hospital The Balfour Hospital provides acute care, with 1200 admissions per annum.

Currently services are configured as follows:-

A&E Dept, which incorporates the Acute Receiving Area - with assessment,

resuscitation and observation areas

Acute ward - male and female, medical and surgical 16 beds

Assessment and Rehabilitation Ward (A&R) 19 beds

Maternity Unit 6 beds

Macmillan Unit 4 beds

HDU 2 beds

Total Bed complement 47 beds.

There is an additional bed within A&R used as a Mental Health Transfer bed.

The Day Surgery Unit has 6 beds.

The Balfour Hospital, Kirkwall provides all the inpatient care for NHS Orkney.

Surgical services are provided by 2 Consultant Surgeons (currently recruiting a

further 2 consultant surgeons) supported by a Speciality Dr and Clinical Assistant, in

addition we have 0.2 WTE Consultant Orthopaedic Surgeon and 3.5 WTE

Consultant Anaesthetist. The medical team consists of 2 Consultant Physicians,

currently 1 vacancy in this team, and we have 2 full time Consultant

Obstetricians/Gynaecologist.

Other services provided by dedicated teams of specialist nurses and GPs at the

Balfour Hospital include cancer and palliative care services (with chemotherapy

being delivered locally through shared protocols with Aberdeen), rehabilitation,

obstetrics and haemodialysis. NHS Orkney has developed very close working

relationships with Aberdeen Royal Infirmary and uses videoconferencing extensively

to help deliver appropriate shared care.

Minor cases are treated and discharged, with more complicated presentations being

dealt within the assessment or resuscitation areas as appropriate. GP referred

medical, surgical, and paediatric patients are initially seen in the Acute Receiving

Unit. Patients can be discharged, admitted to a hospital bed or transferred to a major

centre from here, with a High Dependency Unit available to facilitate this process.

Very effective air ambulance retrieval services for adults, paediatric, neonatal,

maternity and mental health patients are regularly used for transfer of seriously ill


patients to appropriate hospitals in the Scottish Mainland – mainly Aberdeen Royal

Infirmary.

Consultant input is provided to the assessment and rehabilitation unit, which includes

four acute stroke beds, by the Medical Team.

Cancer and Palliative care services are provided in Macmillan House by the patient’s

own GP or the Skerryvore Medical Practice, and Cancer & Palliative Care Specialist

Nurses.

There is a fully equipped modern Theatre Suite and a 6-bedded day surgery unit,

which is being developed to become a unit caring for all short term day cases

(including medical).

Services for children are designed to be appropriate for a non-specialist unit. The

Medical Staff are responsible for the resuscitation, stabilisation and ongoing

management of critically ill children, until the arrival of the nation-wide retrieval team.

It is recognized that the competencies required in a remote and rural setting may be

broader than those obtained through a conventional training scheme, and

supplemental training can be provided to ensure the successful candidate can fully

discharge the clinical duties of the post. Training in the management of Paediatric

Emergencies will be provided as part of induction if required. Neonatal care is

provided by the Obstetric Team and Midwifes, with support from the Anaesthetists.

Patients requiring care which is not available in Orkney are transferred to the

Scottish mainland, predominantly to NHS Grampian, but depending on availability of

beds, expertise and weather conditions, patients may have to be cared for in the

HDU while awaiting transfer, which can be extremely challenging. Such patients will

be cared for jointly by Physicians and Anaesthetists. A Paediatric Emergency Care

Network, a North of Scotland initiative, has recently been launched to help support

the management of children in remote locations.

Training in the management of HDU patients will be provided as part of induction if

required. Excellent support from all disciplines is available for advice and support in

the management of cases where expertise not available on the island is required.

Patients requiring more intensive monitoring, but do not require transfer, are also

cared for in the HDU unit.

Visiting consultants from Grampian and Highland Health Board Areas support a wide

range of additional specialist clinics on Island.

Support services include laboratory and radiological services (including diagnostic

ultrasound), physiotherapy and occupational therapy departments. Plans to locate a

CT scanner on the island are far advanced.


Patient care Emergency medical, surgical, and paediatric patients are initially seen within the

Emergency Department. Non-life threatening conditions are treated and discharged

in close working relationship with the Out of Hours Service, with more serious

presentations being dealt with in the assessment or resuscitation areas as

appropriate. Patients can be discharged, admitted to an appropriate hospital bed or

transferred to another NHS Board with level 2, 3 and 4 specialist care support.

The post holders will be required to provide acute care to all patients presenting with

non life threatening and life threatening conditions at the emergency department.

Care will also be provided to inpatients in the acute ward and other wards/units

within the Balfour Hospital (Assessment & Rehabilitation and Macmillan).

Details of the Post The post is for an experienced doctor with a generalist range of experience, knowledge and skills which include Surgery, Orthopaedics and A&E, who will work under the leadership and supervision of surgical consultants to provide care to surgical patients in A&E, the wards, out-patient department and theatre. The post holder will also be expected to support the Obstetrics and Gynaecology consultants when required. The role will be to provide multidisciplinary care across the full range of pathology seen and cared for in a Remote and Rural District General Hospital, with direct support from the local consultants in, Surgery, Anaesthetics and O&G. The postholder will be expected to provide advice, support and intervention under

the supervision of a consultant to a remarkably broad range of surgical and O&G

presentations. It is recognised that the competencies required in a remote and rural

setting may be broader than those obtained through a conventional training scheme,

and supplemental training can be provided to ensure the successful candidate can

fully discharge the clinical duties of the post. This training will form part of CPD

arrangements. An enhanced induction process tailored to individual needs will be

provided to ensure full competency in the requirements for work in remote and rural

setting of Orkney, with the support of NHS Education of Scotland and NHS

Grampian.

Overall the postholder will be required to diagnose and make clinical decisions in

difficult, complex and often uncertain circumstances under the supervision of the

Specialty Consultant(s).

Candidates should hold (or candidates from the EU should be eligible for) GMC

registration.


The appointment will be according to the contract for Specialty Doctors. The post will

be for 10 sessions (4 hours each) of which one is an SPA session. The hours of

working will be predominantly office hours.

This job is suitable for a job-sharing arrangement.

Main Duties:

Clinical support to the surgical team, such as pre-operative

preparation of patients, managing patients in the out-patient

department, ward work, theatre work, minor operations, endoscopy,

patient discharge.

Undertake regular ward rounds

Enhancing the quality of patient care by participating and fully

supporting quality enhancing activities, such as the Scottish Patient

Safety Program, clinical audit, clinical governance, M&M meetings,

teaching of staff and junior doctors.

Facilitate patient assessment, treatment and admission within the

Emergency Department.

Supervise and provide advice, support and instruction to junior staff

and nursing staff within the department.

Undertake a senior role in the Hospital Trauma Team and in the

resuscitation of seriously ill patients. To clerk patients and keep up to

date histories and records regarding patient care.

Requesting diagnostic tests (such as X-Ray and laboratory

investigations) and taking biological samples.

Undertake any other appropriate duties or responsibilities as directed

by the Consultants for whom you work.

Clinical Leadership

Care will be delivered with the leadership support of the Surgical

Consultants.

All candidates will be expected to take part in the various activities,

such as Mortality and Morbidity Meetings, the Resuscitation

Committee, the Drug and Therapeutics Committee, the Area Medical

Committee, and others as designated by the Board.

Workforce and People Development

Participate in the education and training of doctors, nurses and allied

health professionals including those in primary care, and fostering by

example an atmosphere within the hospital which encourages


learning and reflective practice. It is expected that the post holders will

complete a course such as Training the Trainees to enable

compliance with the upcoming GMC requirements to train junior

doctors.

Participate in annual appraisal, revalidation and licensing, and do

CPD to maintain and refresh their skills and competencies are

required.

Participate in the development and renewal of clinical care models in

preparation for a new build Care Campus.

There is a wealth of opportunity to teach staff across the organisation,

including those in training. Providing a comprehensive teaching

service, and engendering close links to practice and teaching

opportunities with mainland colleagues, is essential to sustaining

services on the island and reducing professional isolation.

Care Delivery & Quality

Demonstrate the delivery of high quality of care, with person-centred,

safe and effective working and contribute to clinical governance

annual work plan

Work under the supervision of the Surgical Consultants and lead in

the immediate care of patients admitted to the Emergency Unit, Acute

Ward, and Assessment and Rehabilitation Ward, working alongside

and utilising a pool of other doctors and nurse practitioners to ensure

medical cover and high quality continuity of care.

Demonstrate commitment and compliance to the principles of clinical

governance and effective clinical audit, and participate in Operational

Clinical Governance, Morbidity and Mortality Meetings, implementing

SIGN/NICE and other national guidance.

Due to the size of the clinical teams in Orkney, assistance from all

medical staff might be required during major incidents, and the post

holders will be expected to act as the medical incident officer, and/or

provide medical care in a major incident (on or off site) if required

Performance Management

Engage and influence the development of hospital and in/out reach

services to meet clinical needs within available resources.

Contribute to all relevant HEAT targets and standards: for example,

early discharge and reducing the length of stay, readmission rates,

A&E waiting targets, and many more.


Job Plan

The job contract will be for a permanent post, under the Terms and

Conditions of Service - Specialty Doctor (Scotland) (2009) as per NHS

Circular PCS (DD) 2008/7.

A job plan will be agreed with the Hospital Manager, and will be

reviewed at least annually, and will be based on an annual

submission of an up to date job diary over a 6 week period.

Assignment and Review of Work Professionally responsible to the Hospital Lead Consultant Managerially responsible to the Hospital Manager

Contact details For more information about the job, please contact: Mr Marthinus Roos, Medical Director, NHS Orkney at: Tel: 01856 888224 | Email: [email protected] Mr Michael Dohrn, Consultant Surgeon, NHS Orkney at Tel: 01856 888000 | Email [email protected]




Person Specification

FACTOR

ESSENTIAL

DESIRABLE

Qualifications

Registered with the GMC with a license to practice Four years full-time postgraduate experience. Broad-based experience in General Surgery, with a validated logbook documentation of surgical exposure to date. Evidence of an aptitude for surgical manual dexterity. Evidence of recent appraisal and if available, revalidation Advanced Life Support provider Advanced Paediatric Life Support provider (or the commitment to successfully complete ALS/APLS training)

MRCS or MRCGP or equivalent Postgraduate experience in Medicine, Paediatrics, and/or A&E ATLS

Clinical Experience

Clinical training and experience in a broad range of Medicine, Surgery, A&E and Paediatrics Expertise in relevant practical procedures e.g. insertion of intercostal drains, complicated wound suturing, plaster cast application & Evidence of the ability to change clinical practice and service provision Up to date practice in line with recent initiatives Ability to take independent clinical

Forensic Medicine. Major Incident involvement Small surgical procedures, such as Insertion of central venous lines, lumbar puncture Clinical experience in upper or lower GI endoscopy


decisions when necessary and to seek advice from senior doctors as appropriate. Experience of the assessment of emergencies

Management and Administration Experience

Evidence of participation in change Able to work effectively within a team of medical and nurse practitioner colleagues Adaptable Open to new ideas and change

Ability to engage and communicate the benefits of organisational change to stake holders Able to operate Microsoft, Outlook, Word, Excel & PowerPoint and hospital IT systems such as PACS, SCI Store, Patient Administration System, Scottish On-line Appraisal Resource (SOAR), etc

Clinical Effectiveness

Active participation in clinical governance and audit

Evidence of having undertaken audit

Teaching

Experience of teaching junior doctors and other staff

Evidence of having developed learning opportunities for others Further relevant degree/diploma/ teaching qualification.

Personal Skills/Attributes

Leadership qualities Effective communicator, able to work in a multi-disciplinary team Ability to create and sustain relationships and motivate and influence others through their enthusiasm. Good inter-personal skills Ability to work under pressure Flexibility in working pattern Commitment to CME/CPD Familiarity with information

Willingness to undertake additional professional responsibilities


technology and general computer skills Evidence of good time management of self and workload.

nhs orkney speciality doctor - surgical care orkney application pack sp … · surgical care...

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