This is a replacement substantive consultant post to provide medical gastroenterology services in Dumfries and Galloway region.

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1 Job Description THE POST This is a replacement substantive consultant post to provide medical gastroenterology services in Dumfries and Galloway region. The successful candidate will join a team which comprises Consultant, Specialty Doctor and Nurse Specialist. Gastroenterology services currently include out-patient clinics, in-patient treatment for various gastroenterology disorders and a wide range of endoscopy procedures. Gastroenterology patients are admitted in ward 10 at the Royal Infirmary. On average there are 8-14 patients under the care of the Gastroenterology team. The two Gastroenterologists cover the ward on a 6 week rotation (on and off the ward). The consultant covering the ward, also takes inpatient referrals. Whilst off the ward, the other consultant takes GP phone calls and triages outpatient referrals. Liver biopsy, biologic administrations, iron infusion and therapeutic ascitic drainage are carried out in the Ambulatory Care Unit on the 23 hour ward. There are well trained nurses to help and oversee these procedures with minimal supervision from the consultants and middle graders. All liver biopsy patients are admitted under the respective consultants and the procedures are performed by radiologists under ultrasound guidance. It is envisaged that the new gastroenterologist will strengthen and compliment the team. Subspecialty interests will be welcomed such as inflammatory bowel disease, functional bowel disorder, nutrition and oesophageal manometry. The service is supported by 1 x middle grade doctor, an FY1 ( shared on ward 10), 1 x specialty doctor, 2 x part time IBD nurses and secretaries. Funding for an additional specialty doctor post has been approved. Opportunities will be available to undertake ERCP and therapeutic endoscopy. As stated earlier, participation in oesophageal manometry is desirable. Endoscopy procedures are carried out in 2 dedicated rooms within the Day Surgery Unit. We participate in bowel cancer screening and the unit has excellent equipment including Scope Guides in both rooms and Olympus Lucera systems. Usual standard accessories such as APC, Clips and Gold probe are available. Oesophageal stents are deployed in one of the endoscopy rooms under fluoroscopy guidance. There are four Nurse endoscopists to support the service. The new hospital will have 3 endoscopy rooms which will be of great advantage. All the activities are regularly audited according to JAG specification, following Global Rating Scale. ERCPs are performed once a week in the radiology department with modern screening facilities. PTC / biliary drainage can be arranged by the interventional radiologists. Acute GI bleed service is provided by the on call surgeons (with support from the main theatre staff and occasional ICU anaesthetists). We have close links with tertiary centres (Edinburgh and Glasgow) in case patients need TIPSS or coiling of bleeding vessels.

2 Colorectal cancers and hepato-biliary malignancies are discussed at the Friday morning GI cancer MDT meeting. Visiting Consultant Oncologist, Dr Dawson attends this meeting. All UGI cancers are discussed at the weekly Edinburgh Royal Infirmary MDT. The consultant job plan is flexible and open to negotiation on appointment. The post will be offered on a 9+1 contract, depending on the post holder s preference and subject to a agreement of a job plan with the Board. The balance between direct clinical care and supporting professional activities will be discussed and agreed between the Board and the successful applicant. This is a 10 PA job but additional 2 PAs can be arranged. Time for teaching and supervision of juniors will be allocated in the job plan. THE DEPARTMENT OF MEDICINE The Medical Unit provides acute hospital medical services to the population of South-West Scotland. The Division meets once weekly to discuss the challenges of the unit, which recently have included MMC and targets for acute medical admissions. A total of 17 consultants cover the Medical Unit. Their specialist interests are as follows: Name Dr Sian Finlay Dr Charles Isabirye Dr Nadeeka Rathnamalala Dr Thalakunte Muniraju Dr Michael Kelly Dr Catherine Rossiter Dr Stuart Little Dr Alistair MacKay Dr Tumar (commencing November 2017) Dr Shahana Esmail Dr Fiona Green Dr Louise Clark Dr Ondrej Dolezal Dr Michael McMahon Dr Gwyneth Jones These vacancies Dr Ian Hay Dr Roger Holden Dr Alison McKendrick Sub Specialty Combined Assessment Unit Combined Assessment Unit Renal, Ward D8 Renal, Ward D8 Renal, Ward D8 Respiratory, Ward B2 Respiratory, Ward B2 Cardiology, Ward D8 and CCU Cardiology, Ward D8 and CCU Cardiology, Ward D8 and CCU Diabetes & Endocrinology D8 Diabetes & Endocrinology D8 Neurology Rheumatology, Ward C5 Infectious Diseases, Ward C5 Gastroenterology, Ward C5 Care for the Elderly, Ward C4 and B2 Care of the Elderly, Ward C4 and B2 Rehabilitation, Ward D7 The following consultants support the Medical Unit but do not take part in the on call rota:

3 Name Dr Colin Malone Dr Lindsey Yeo Dr Ranjit Thomas Dr Paul Ames Dr Martin Connor Dr Linsey Batchelor Dr Ewan Bell Dr Sarah Pickstock Sub Specialty Dermatology, Dermatology, Haematology, Ward C5 Haematology, Ward C5 Mircobiology Microbiology Clinical Biochemistry Palliative Care Ward B1 The Medical Unit is currently staffed by the following junior doctors: 2 x ST3 6 x CTs 7 X GPSTs 4 X FY2 6 X FY1 Acute Medical Unit Our Acute Medical Unit is run by the Acute Physicians from 8am to 5pm, Monday to Friday. Outwith these hours, clinical cover is provided on a 1 in 12 basis by the oncall physicians (including both general and acute physicians). A consultant physician presence is maintained on the AMU for a minimum of 13 hours per day, 7 days per week, (i.e. from 08:00 to 21:00). During weekdays oncall, the working day commences at 13:00 for the oncall consultant who then takes over on the AMU at 17:00 and remains until 21:00 before being oncall from home. Weekend oncall starts at 08:00 and finishes at 21:00, followed by an oncall from home. After weekends oncall there are compensatory days off (Tuesday and Wednesday after a Friday and Sunday oncall, and Monday after a Saturday oncall). The current on-call commitment is 1 in 12 with prospective cover attracting a 3% availability supplement. The successful applicant would be expected to contribute to the general medicine on call rota (1 in 12). A sample weekend rota is shown below: AMU morning from 08:00 Friday Saturday Sunday Acute Physician Oncall consultants A Oncall consultants A and B and B AMU afternoon Acute Physician Oncall consultant B Oncall consultant A AMU until 21:00 and overnight oncall Oncall consultant A Oncall consultant B Oncall consultant A There are 94 General Medical beds, 75 beds in Geriatrics/Rehabilitation and an 8-bedded Medical High Dependency Unit/Coronary Care Unit (distinct from the Surgical High Dependency Unit and Intensive Care Unit). The 10 bedded Stroke Unit is incorporated into

4 one of the Geriatric wards. There is an 18-station haemodialysis unit for renal patients within the hospital. Out-patient clinics are held at the Royal Infirmary and in a number of peripheral locations throughout the region. The undergraduate teaching commitment is principally to Glasgow and Edinburgh University students during their final two years and to elective students from other Universities, with an increasing number of students applying to undertake Special Study modules. We attract postgraduate Clinical Attachments and have an active programme of teaching for SHOs preparing for MRCP examinations. Gastroenterology services include out-patient clinics, in-patient treatment for various gastroenterology disorders and a wide range of endoscopy procedures. Further service developments are planned for the future. The successful candidate will be expected to take on oesophageal manometry studies. Opportunity will be available to undertake ERCP, therapeutic endoscopy and to train in oesophageal manometry. Hepatitis clinics are covered by the Infectious Diseases team. We also have very strong links with Edinburgh Hepato-biliary service with MDT and Liaison Nurse Specialist who co-ordinate Hepatoma care with TACE, radioablation and visiting oncology. Links with the Scottish Liver Transplant Unit (SLTU) are very good and supportive with shared follow up and telephone follow up. We have regional drug and alcohol services with excellent support from the local Alcohol Liaison Nurse and Consultant. Our experienced Infectious Diseases Clinical Nurse Specialists provide care within DGRI and across the region with nurse led Hepatitis C and Hepatitis B treatment clinics including prison in-reach and collaboration with substance misuse services. There is an ongoing Hepatitis C Action Plan with local MCNs (national meetings for Regional Clinical Leads).

5 THE DEPARTMENT OF GENERAL SURGERY The Department of Surgery provides a comprehensive elective and emergency general surgical service at Dumfries and Galloway Royal Infirmary. Day case/endoscopy/out-patient services are also provided at the Galloway Community Hospital, Stranraer. The Breast Service deals with new breast cancers per annum with triple assessment one stop breast clinics, stereotactic breast biopsies, mammography and weekly MDT meetings with the visiting Specialist Oncologist from the Western General, Edinburgh. Elective and emergency vascular surgery is undertaken. Approximately 20 carotid endarterectomies, 30 aortic reconstructions and 25 lower limb bypass procedures are carried out annually. Emergency vascular services are provided through the Solway Vascular Service (a network for North Cumbria and Dumfries and Galloway managed by Dumfries Galloway Royal Infirmary and Cumberland Infirmary, Carlisle). It is anticipated that links with North Cumbria will become more formalised with the development of a full on-call rota and shared interventional services including EVAR. The combined Gastro-intestinal Services are largely provided by Surgeons with an Upper GI interest and colorectal interest and deal with 40 to 50 oesophageal gastric cancers and 130 new cases of colorectal cancer per annum. Weekly MDT meetings are held with a visiting Specialist Oncologist from Edinburgh when all gastrointestinal cancers are discussed. The Department is responsible for all GI Endoscopy Services including an open-access service, therapeutic endoscopy, ERCP and colonoscopy. Ambulatory Ph monitoring is performed by the upper GI nurse specialist. Oesophageal and ano-rectal manometry is to be commissioned and supported by the Department s two nurse Endoscopy Specialists. There is a well equipped Endoscopy Suite with excellent facilities, scope guide available in both theatres (C02 scheduled for the near future), therapeutic endoscopy and bowel cancer screening. Acute GI bleeding cover is provided by the oncall surgeons. The GI team is supported by the ward Middle Grade Doctor, one full time Specialty Doctor and 2 part time IBD Specialist Nurses. Laparoscopic surgery is undertaken within the Department but plans exist to expand the service by the early appointment of a further Consultant Surgeon with interest in laparoscopic and upper GI surgery. Consultants in General Surgery (with special interest) Sub-specialty Colorectal Colorectal Colorectal Vascular, Endocrine & Paediatric Vascular Breast Breast Upper GI Vascular Name Mr CS Whitelaw, Consultant Mr JS Dreyer, Consultant Mr P Collins, Consultant Mr I Muir, Consultant Mr J Sathianathan, Consultant Vacancy, Consultant Miss Maria Bews-Hair, Consultant Mr JK Apollos, Locum Consultant Mr Muhammed Kabeer

6 General Surgery/ Upper GI General Surgery Breast General Surgery Endovascular Nurse Endoscopy Specialist Colorectal Nurse Endoscopy Specialist Colorectal & Upper GI Stomatherapy, Colorectal Oncology Stomatherapy Nurse Vascular Nurse Specialist Breast Care Specialist Miss Gerte Plappert, Consultant Vacancy, Specialty Doctor Vacancy, Specialty Doctor Mr Sharukh Sami, Specialty Doctor Vacancy, Specialty Doctor Mrs Fiona Darrock Miss Arwen Claydon Mrs Isobel Williams Mrs Hazel Kearney Mrs Shirley Wight Carol McQuade Research Unit Dumfries Royal Infirmary houses the local research unit which has helped in several research projects and audits. Current projects: Collaborative research in PBC, PSC, IBD, and Alcoholic hepatitis. Training and Development Opportunity will be available for oesophageal manometry during initial phase of the post to allow for development of this service. The successful candidate will also have the opportunity to become involved in Endoscopy teaching at the Cuschieri skills centre and to be a PACES examiner in due course.

7 Organisational Chart Lead Nurse (Gail Meier) General Manager (Nicole Hamlet) Medical Director (Dr Kenneth Donaldson) Nurse Managers (Jackie Nicholson / Anne Allison) Assistant General Manager (Callum Ambridge - Surgical) Kirsty Bell Medical) Clinical Leads (Sian Finlay - Medical) Maria Bews-Hair Surgical) Consultant Dr Zahra Bayaty (Locum) (These posts) Specialty Doctor Dr Zahra Bayaty

8 Person Specification Requirements Essential Desirable Assessment Education, Primary Medical Qualification. Qualifications and GMC Registered with Licence to Specialist Skills Practice Entry onto the GMC Specialist Register (within 6 months from the date of the AAC). On GMC register for Gastroenterology and General Internal Medicine Clinical Experience Management and Administration Experience Teaching Research Evidence of experience in the specialty. Evidence of a substantial commitment to the specialty. Ability to offer an expert clinical opinion within the speciality. Ability to take independent responsibility for the clinical care of patients referred to secondary care. Involvement with management and project leadership within the specialty. Evidence of involvement in authoring or reviewing clinical guidelines. An understanding of Clinical Governance. Experience of Teaching and training Undergraduate/ Postgraduate and Junior Medical Staff Evidence of involvement in and understanding of research methodology and publication of findings. Research/critical review of literature. Publications in the last five years. Evidence of experience in Gastroenterology ERCP experience Oesophageal manometry Proven management experience and understanding of management goals. Evidence of leadership / project management. Evidence of having implemented change. Experience in developing and implementing new technologies. Attendance at courses to develop teaching skills. Postgraduate qualification in medical education. Higher degree.

9 Requirements Essential Desirable Assessment Audit Evidence of participation in audit. Evidence of having changed practice as a result of audit. Personal Attributes Alignment with the Board s Core & Professional Behaviours (as outlined on page 14). Flexible approach to service delivery and committed approach to development. Committed to share in professional, managerial and teaching responsibilities necessary to fulfil the obligations of the Directorate to the Board and its workforce. A commitment to personal / unit CPD. Ability and willingness to work the oncall rota. Ability and willingness to work a more flexible pattern of working in the future if required, including evening and weekend work. Evidence of having revisited the audit to assess improvement. Back to Contents Page

10 Job Plan An indicative job plan is shown below for illustration purposes only Monday Morning General Out-patient Clinic (09:00-12:00) 6N N=30 Afternoon SPA DCC SPA Hrs PA Hrs PA Tuesday Ward round/admin (6 week rotation) General OP clinic/admin Wednesday Endoscopy General OP clinic Thursday Ward round/admin (6 week rotation) ERCP/Admin (alternate weeks) Friday MDT/X-ray meeting GI team meeting Stranraer: 1 in 7 Endoscopy Stranraer: 1 in 7 TOTAL 10

11 How to Arrange a Visit and Apply How to Visit If you would like to visit the Department please contact the Medical Staffing Department on / or dumf-uhb.medicaldentaladmin@nhs.net with the date you intend to visit and arrangements will be put in place. How to Apply If you decide to apply for this post, these guidance notes will assist you in making your application. It is important that you read the person specification carefully before you decide to apply. We will assess your application against these criteria for shortlisting. To apply for the post you must: Submit an Application which can be downloaded from the following website or you can dg.recruitment@nhs.net and an application form will be ed out to you. When completing the application you should give full details of your qualifications, training and experience. This must include a full employment history, and clarify any gaps in your employment history Provide the names and addresses of two referees, including your two most recent employers and covering at least 3 years previous employment (where applicable). Please note, if you are successfully shortlisted for interview we will automatically make contact with your referees to seek a reference unless you advise us otherwise when you submit your application. Your personal information will not be sent with the application for shortlisting. The application form will be identified by the candidate number only to ensure that no applicant will be unfairly discriminated against Completed applications should be returned to dg.applications@nhs.net 11

12 Interview Guarantee Scheme NHS Dumfries & Galloway is positive about disabled people and as such we provide job opportunities for disabled people. NHS Dumfries & Galloway operates a Job Interview Guarantee (JIG) which means that if a candidate advises us that they have a disability, and meet the minimum criteria outlined within the Person Specification, they will be guaranteed an interview. Reasonable adjustments will be made for disabled candidates at both the application and selection process stages. 12

13 Main Terms and Conditions of Service The Schedules referred to below are within the Terms and Conditions of Consultants (Scotland) As amended from time to time. Salary: Leave: Occupational Sick Pay: Pension: Base: Notice Period: Appraisal and Job Planning: The current salary applicable to a full time post is 78, , weeks annual leave pro rata plus 10 public holidays pro rata. Entitlement to 30 days study leaves over a 3 year period. During the first year of service one months full pay (and after completing 4 months service) 2 months half pay During the second year of service 2 months full pay and 2 months half pay During the third year of service 4 months full pay and 4 months half pay During the fourth year of service 5 months full pay and 5 months half pay During the fifth year of service 5 months full pay and 5 months half pay After completing 5 years of service - 6 months full pay and 6 months half pay You will be automatically enrolled into the NHS Pension scheme (Scottish Public Pension Agency). The benefits of which can be found at Your principal place of work is the Dumfries & Galloway Royal infirmary. Other work locations and off site working including The Galloway Community Hospital may be agreed in your Job Plan. You may be required to work at any site within your employing organisation, including new sites. 3 Calendar Months. A formal job plan will be agreed between the successful applicant and their Associate Medical Director and General Manager before commencing duty and reviewed annually thereafter, usually following an appraisal meeting. The full Consultant Contract document can be found at: Back to Contents Page 13