Specialty Doctor Job Description ANAESTHESIA & CRITICAL CARE South West Acute Hospital
TITLE: SPECIALTY: BASE: RESPONSIBLE TO: Specialty Doctor (4 Posts) Anaesthesia & Critical Care South West Acute Hospital Clinical Lead Anaesthesia & Critical Care JOB SUMMARY Purpose of Post To help support & maintain a 24 hour Emergency Anaesthesia & critical care service in the Erne hospital To help provide support for a 24 hour epidural service To help cover the Intensive Care work To aid the work of the Chronic Pain Service To work with Consultant staff to provide a comprehensive anaesthetic service across the Western Trust (principally South West Acute site). The appointees will be expected to participate in the overall provision of anaesthetic services within the Department, to deputise for absent colleagues, to work flexibly, to ensure service and patient care, to achieve value for money through making the most effective use of available resources. This job description is intended to cover the main aspects of the posts; the actual pattern of work is negotiable to meet service needs and is based on the Job Plans outlined in Appendix 3. PROFILE OF HOSPITAL The SWA is a 300-bedded DGH offering a comprehensive range of clinical services in the southwest region of Northern Ireland. Acute surgical services include general surgery, gynaecology, obstetrics, and critical care. In addition there is a acute medical services, paeditarics and radiology. The workload in this unit has increased with the re-alignment of acute surgical and medical services from the nearby Tyrone County Hospital in line with the proposal in DBS (Developing Better Services).
WORK OF DEPARTMENT The staff of the department consists of 8 full-time consultant anaesthetists and 6 specialty doctors. All staff are based in the SWA, but provide cover for elective day-surgery activity on the TCH site. Emergency cover is based solely in the Erne site. On the SWA site, there are 4 main theatres and 1 day case theatre which provide in-patient elective and emergency services for general surgery & gynaecology. Day-surgery services are also carried out in the 3 theatres on the TCH site and this is a service set to see significant development. The department also provides acute and chronic pain management services. There is a maternity unit with approximately 1200 deliveries per year which is supported by the anaesthetic department and includes a 24 hour epidural service. The 10-bedded Critical Care Unit has capacity for 4 HDU beds and 3 ICU (ventilated). This is a state of the art facility with integrated CIS/ARKS. Emergency work out-of-hours is covered by a resident anaesthetists (SAS grades) supported by an on-call consultant. The post is based in the SWA. However as the Trust strives to make best use of it s overall theatres resources, it is possible that in the future anaesthetists will provide anaesthetic services in the other site within the Trust (eg Tyrone County Hospital). It is likely that a post-holder will cover anaesthetic sessions, subject to adequate supervision, in TCH on a day-case basis. There are no plans to present to provide clinical cover at other sites. Any changes to this would require mutual agreement, which should not be unreasonably withheld. Full participation in C.P.D. activities is encouraged within the Department and the post holder is entitled to leave as per national terms and conditions of service. There is an active educational programme including audit and morbidity and mortality meetings. Staff of all grades are encouraged and expected to attend and participate in these meetings. The Directorate of Anaesthesia and Critical Care Medicine is led by two clinical lead clinicians one in the northern sector and one in the south encompasses the acute units in WH&SCT. These are located in Altnagelvin, Tyrone County and Erne Hospitals. These jobs are to provide anaesthetic cover for the southern sector and to be responsible to the lead clinician in this sector. There is an anaesthetic co-ordinator who is responsible for rota writing and day-today coordination of staff. The current establishment of anaesthetic posts is: - Dr C Armstrong General Commitment and ICU Dr M Cody General Commitment Critical Care Services Dr T Auterson General Commitment and Theatre Issues
Dr M Drozdowicz Dr B Iwanacka Dr K Anand Dr O El-Tayyeb Dr Siddiqui Dr R O Hare General Commitment. & Maternity General Commitment General Commitment & Paediatrics covering vacancy(lt) General Commitment General commitment Lead Clinician KEY DUTIES / RESPONSIBILITIES Provision of General Anaesthesia services for the specialties and in the areas outlined above according to service need. To provide and to assist with the delivery of care to patients with critical illness To support continuity of elective & emergency services during periods of consultant & other anaesthetist s leave. To support the emergency anaesthetic, maternity and critical care services outof-hours through participation in duty outside normal hours. To support acute pain services at the SWA Hospital. To undertake professional development activities, audit and engage in appraisal. The post-holder will be encouraged and supported to develop specialist areas of practice in line with service requirements (e.g Opthalmic, ECT anaesthesia) SUPERVISION ARRANGEMENTS The post-holder will be responsible to the Lead Clinician in Anaesthetics & Critical Care. During normal working hours the consultant supervision will be provided by: i) The consultant assigned to the theatre list or critical care. ii) If no consultant assigned to session, then an identified consultant will be present on the hospital site during normal hours (usually ICU or on-call consultant) Out-of-hours the consultant on-call provides cover. The post-holder will be expected to have the skills and experience to allow them to safely anaesthetise adult patients who are straightforward or those who present only moderate difficulty, without immediate supervision. The post-holder will be expected to stand in for absent consultant staff on certain lists. The Clinical Lead and the post-holder will agree which lists are appropriate to cover.
CONTINUING PROFESSIONAL DEVELOPMENT CPD is actively encouraged within the department. The post attracts a minimum of 1 CPD/audit/ admin session per week. Further sessional time may be available by mutual agreement. The post-holder will not be expected to undertake clinical duties during this time. The session can be held flexibly in both time & location. CPD is actively supported in the Department through: 1) Resources on site- Multiple PC access to internet & HONNI in department, Dept library in communal office, Med library on campus. 2) Entitlement to S/L as per national terms & condition of service. 3) Established Departmental appraisal system. 4) Involvement in audit 5) Attendance at regular audit, morbidity & mortality meetings. PROPOSED JOB PLAN The Job Plan must include and clearly identify time for CPD/Audit (minimum1 PA, however agreement should be reached on the amount of SPA and is dependent on the individual post, individual requirements, seniority, progression through thresholds etc.) There must be explicit details of any out of hours / oncall commitments. The Job Plan should also set out any management responsibilities as appropriate. Any work outside 7am to 7pm should be identified as premium time i.e. 3 hours equates to 1PA. This posts are based on an average of 48 hours worked per week, with the postholder initially working on a 1:6 on-call basis.. There is a dedicated 4 hours session for SPA activity per week. The post-holder will not be rostered for clinical activities during this time. Out-of-hours work is allocated according to a 6 week rolling plan (attached). Prospective cover is included for colleague s normal annual leave in the current 6 person rota. Planned clinical sessions for the Specialty Doctors are allocated by the rota organiser based on service requirements. As far as is possible, the rota organiser will schedule regular fixed sessions for each specialty Doctor. However the ability to do this will of necessity be limited by requirements of outof-hours cover and cover for absent colleagues. The job plan for these posts is based on a rota which cycles every 5 weeks (increasing to 6 weeks). The work levels depend on on-call commitment.
1. Fixed session commitment:- up to 6 sessions; this is dependent on the week that is being worked 2. On-call commitment: 1:6 nights on call and weekends 3. Fixed commitment and on-call to change to cover absent colleagues 4. Audit /CPD/ and non patient Administration 4 hour/week The average number of hours to be worked in a 5 week period is 48. A substantial proportion of the weekly hours worked will be in premium time and this will be taken into account in the calculation of the contracted number of PAs. Estimations are that the illustrated job-plan on a 1:6 basis would attract 12.5 PAs. With a tier of 5 on the rota it is calculated that these posts would attract 14.5 PAs in total (see rota templates below). To comply with the EWTD the rota plan may require moving to a shorter- shift based system which is also outlined in the rota templates.
Outlined rota plan to comply with EWTD Hrs Spec Doc Mon Tues Wed Thurs Fri Sat Sun 48 1 N N - L L - - 48 2 L L N N - - - 48 3 H - D - N N N 48 4 - H L H H L L 36 5 (Ann/ L) - D D D D - - Start -Finish Duration Half day H 0900 1300 4 h Normal Day D 0900 1700 8 h Long Day L 0900 2100 12 h Night N 2100 0900 12 h Hours per doc with PC = 48 /wk CME/Audit/ admin = 1 session/doc /wk Time Activity Hours DCC SPA MONDAY 0900-17.00 Clinical session 2 TUESDAY 17-00-07.00 Resident On-call 17-19- 0.5PA 19-07- 4 PA 07-09- 0.5PA 5 WEDNESDAY No committments THURSDAY 09.00-13.00 13.00-17.00 Clinical session SPA CPD/ audit/admin 1 1 FRIDAY 0900-17.00 Clinical session Allow 2 hr/week for early start + late finish finishes 2 0.5
SATURDAY 0900-0900 Clinical shift shared on 1:5 basis 8 SUNDAY 09.00-0900 Clinical shift shared on 1:5 basis 7.33 0.5 Total (Weekend Pas (8+7.33+0.5)/5=3.17 10.5 1 ON-CALL DETAILS 11.5 +3.17 =14.6 PA s (estimated) Increasing to 1in 6 Total =12.5PAs Predictable Emergency On-Call Work Unpredictable Emergency On-Call Work Resident oncall - full shift N/A Agreed On-call Rota Frequency 1:5 (increasing to 1:6) On-call supplement >1 in 4 = 6% of basic salary 1 in 4 to 1 in 8 = 4% of basic salary <1 in 8 = 2% of basic salary N/A JOB PLAN REVIEW The Job Plan should be reviewed annually, but can be reviewed earlier at the request of either the doctor or the Clinical Manager. If it is not possible to agree a Job Plan, either initially or at an annual review, there are agreed procedures for facilitation and appeal with the final decision being binding on both the doctor and the Trust. EMPLOYING AUTHORITY Western Health and Social Care Trust. TERMS AND CONDITIONS The National Terms and Conditions of Service for Specialty Doctors will apply.
As per the current salary scale under National Terms and Conditions of Service for Hospital staff as updated via DHSSPS circular on rates of pay, the most recent HSS (TC8) 3/2008, with effect from 1 April 2008 to 31 March 2009 and all uplifts thereafter. The full-time appointment will be for 10 PAs per week. The successful applicant will normally be appointed to the grade for a one year probationary period which, if confirmed, will be extended without term and held until retirement under the terms and conditions of service. The appointee will maintain registration with the General Medical Council (London). Annual leave entitlement is 5 weeks (25 days) per year until 2 years service have been completed in the grade and 6 weeks (30 days) thereafter for practitioners remaining in the grade. Where the appointee in his/her immediately previous regular appointment attracted the 6 weeks annual leave per annum, this entitlement would remain. Your private residence shall be maintained in contact with the public telephone service He/she will be expected to be flexible and to co-operate with reasonable requests to cover for their colleagues absences where they are safe and competent and where it is practicable to do so. Where doctors undertake duties in accordance with this paragraph and such duties take place outside of their contracted hours, they will receive either an equivalent off duty period or remuneration. The post will be subject to termination at any time, by three months notice in writing given on either side. GENERAL REQUIREMENTS The post holder must: Carry out his/her duties with full regard to the Trust's Equal Opportunities Policy. Co-operate fully with the implementation of the Trust's Health and Safety arrangements and report any accidents/incidents, defects with work equipment or inadequate safety arrangements. Co-operate fully with all policies and procedures relating to Infection Control. Accept individual responsibility for ensuring a suitable, clean, uncluttered and safe environment for members of the public, staff, patients/clients and their relatives. Comply with the Trust's Smoke Free Policy. Treat those whom he/she comes into contact with in the course of work, in a courteous manner. Accept that this job description will be subject to review in the light of changing circumstances and should be regarded as providing guidance
within which the individual works rather than something which is rigid and inflexible. ADDITIONAL POINTS From 1 January 1990, medical staff have not been required to subscribe to a Medical Defence organisation. It should be noted, however, that the Trust's indemnity only covers the Trust's responsibilities and therefore, the appointee is advised to maintain a membership of a recognised professional defence organisation for any work which does not fall within the scope of the Indemnity Scheme. Canvassing will disqualify. Application forms can be obtained by applying online. Candidates wishing to apply online can do so at www.westernhealthjobs.com, alternatively application forms for the post may be downloaded and forwarded to the Human Resources Department. Applications must be made on the prescribed form, and must be returned to the Human Resources Department, no later than the closing date stated A shortlist of candidates for interview will be prepared on the basis of the information contained in the application form. It is therefore essential that all applicants demonstrate through their application how and to what extent their experience and qualities are relevant to this post and the extent to which they satisfy each criterion specified, including clarification around equivalent qualifications. The Trust is committed to Equal Opportunities
EMPLOYEE PROFILE FACTOR QUALIFICATIONS & EXPERIENCE POST: SPECIALTY DOCTOR - MINIMUM CRITERIA ESSENTIAL Candidates must: Hold Full Registration with the GMC (London). Have at least 4 years full-time postgraduate training (or its equivalent gained on a part-time or flexible basis) at least 2 of which will be in a specialty training programme or as a Fixed Term Specialty Trainee in Anaesthesia; or Have equivalent experience and competencies. Wide experience in general anaesthesia, regional anaesthesia and perioperative care. DESIRABLE It is desirable that candidates have: Experience in Obstetric, anaesthesia, Paediatric anaesthesia, interhospital transfers of patients & Critical care, pre-assessment & pain management. FRCA or equivalent. Postgraduate qualification (eg MD, PhD, MRCP,etc) Experience (>6months) in related acute specialty. (e.g. Surgery/ medicine/ A&E/ paediatrics Relevant life support courses: ATLS/ ALS/ FCCS/ APLS ELIGIBILITY FITNESS TO PRACTICE LANGUAGE SKILLS Eligibility to work in the UK. Is up to date and fit to practice safely. All applicants to have demonstrable skills in written and spoken English that are adequate to enable effective communication about medical topics with patients and colleagues which could be demonstrated by one of the following: That applicants have undertaken undergraduate medical training in English; OR Have the following scores in the academic International English Language Testing System (IELTS) Overall 7, Speaking 7, Listening 6, Reading 6,
Writing 6. However, if applicants believe that they have adequate communication skills but do not fit into one of the examples they need to provide evidence. HEALTH CLINICAL SKILLS Meets professional health requirements (in line with GMC Standards/Good Medical Practice). Appropriate knowledge base and ability to apply sound clinical judgement to problems. Competence in anaesthesia and critical care practice appropriate DGH setting. ACADEMIC / RESEARCH SKILLS OTHER WORK RELATED REQUIREMENTS Demonstrate understanding of the importance of audit and research. Ability to work as part of a multidisciplinary team Good communication skills Prepared to be flexible in working patterns Desirable: Either a full current driving licence and access to a car or access to a form of transport which will permit the full requirements of the post to be met.