job description - NHS Jobs



Locum Consultant in Intensive Care Medicine & Anaesthetics

Salary Range:

£76,761 - £103,490


Royal Surrey County Hospital

Accountable to:

Clinical Director of Intensive Care

Job Purpose This post has arisen to cover a sabbatical period of a Consultant and to increase the Consultant cover of the ICU. The post will also comprise anaesthetic sessions which will be discussed with the successful applicant based on their skills and areas of interest. Approximately 75% of the clinical work will be intensive care medicine and 25% will be anaesthetics. This post will have a 10 PA contract, which will be split between 9 PAs of Direct Clinical Care (DCC) and 1 PA Supporting Professional Activity (SPA). 1.6 PAs of DCC will be delivered in the evenings and at weekends, with a further 1 PA for on-call, subject to review as consultants join or leave the rota. A proportion of the DCC sessions will be annualised to allow flexibility in running the critical care service (e.g. to cover gaps in the Consultant day time cover created by annual leave, study leave, professional leave etc.) however adequate notice will be given (e.g. 6 weeks). Applicants should have been awarded a Certificate of Completion of Training (CCT) in Intensive Care Medicine and Anaesthetics or have suitable equivalence which is GMC recognised. The post-holder will take part in the consultant on-call rota for intensive care and will be expected to participate in teaching and training within their department(s). They will also take part in clinical audit, and will comply with the recommendations of the Faculty of Intensive Care Medicine and the Royal College of Anaesthetists with respect to continuing medical education and professional development. Job Summary This post is for a Locum Consultant in Intensive Care Medicine & Anaesthetics based at the Royal Surrey County Hospital, Guildford. The job is a full time post comprising 10 Programmed Activities (PAs). A proportion of the DCC activity will be worked flexibly. Additional PAs are subject to three months notice. Position of Consultants Unable for Personal Reasons to Work Full Time Any consultant who is unable for personal reasons to work full time will be eligible to be considered for the post; if such a person is appointed, modification of the job content will be discussed on a personal basis, in consultation with consultant colleagues.

Job Description Produced: August 2017

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Location of work All activities will normally be undertaken at the Royal Surrey County Hospital. Prior agreement to undertake any Supporting Professional Activities (SPAs) elsewhere must be obtained from the Clinical Director of Intensive Care. Job Plan The job plan will be discussed with the successful candidate, but will adhere to the principle of fixed regular sessions plus a proportion of flexible sessions. Given the variable nature of clinical work, it is accepted that some activities may both over or under-run. If however an activity regularly finishes outside of the scheduled time then it may be appropriate to review the job plan and/or the support provided. The Intensive Care Unit is run by 2 consultants each weekday Monday to Friday from 08:00. The unit effectively runs as two separate ‘halves’ with sufficient junior doctor, senior nursing and other allied health professional staff to run two simultaneous ward rounds each morning. It also allows for effective support of the Outreach service. Each weekday evening one consultant will remain in the ICU from 18:00 until 20:30 hours. The Consultant who is going to be on-call that night will arrive at 19:30 for a fixed session of DCC in the evening before their on-call. This will allow time for the evening handover ward round to take place with consultants and junior doctors setting a plan for the next 12 hours for each patient. The consultant who has arrived for this evening session before their on-call will then spend their time, following the ward round, reviewing patients where necessary and seeing new admissions to the intensive care before being able to leave and be on-call from home after 22:30. At weekends one consultant will provide 3 PAs of DCC on both Saturday and Sunday from 08:00 to 17:00. A second Consultant will provide 2 PAs of DCC on both Saturday and Sunday from 08:00 to 14:00. This will enable two simultaneous ward rounds to take place as on a weekday, for all patients to be reviewed further as required and for all referrals to intensive care to be seen. All of these sessions of DCC which take place out of routine working hours are included in the overall 10PA job plan. On Call It is expected there will be 12 consultants on the on-call rota. This will equate to 1 in 10.15 nights oncall commitment taking into account prospective cover for annual leave and study leave. Each consultant will provide 4-5 weekends of on-call cover per year. As indicated in the job plan above there is a fixed session of DCC each weekday evening from 19:30 to 22:00. At weekends there are fixed sessions of DCC on Saturday and Sunday from 08:00 to 17:00 for one consultant and from 08:00 to 14:00 for a second consultant, comprising a total of 6 PAs and 4 PAs of DCC for the first and second consultants respectively. These equate to an average of over 1.6 PAs for DCC delivered outside of normal working hours per consultant per week. In addition to this there is 1 PA per week for on-call work that takes place beyond these DCC sessions in the evening and overnight, during the week and at weekends. The on-call availability supplement for this post is 3%. The availability supplement will be reviewed annually with the job plan.

Job Description Produced: August 2017

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Programmed Activities The above timetable represents a job plan totalling 10 programmed activities per week. There will be 9 Programmed Activities for Direct Clinical Care including on-call and 1 for Supporting Professional Activities.

Terms and Conditions of Service Terms and Conditions of service will be those applicable to the new Consultant Contract and any offer is subject to satisfactory Occupational Health clearance. You must not start work until this clearance is received. Employment will also be governed by the Trust’s employment policies and procedures. The appointee will be required to live no more than half an hour drive from the Royal Surrey County Hospital unless specific approval is given to a greater distance by the Chief Executive. Resources The Department of Intensive Care The Consultants, dates of appointment and their special interests are: Dr Michael Scott


Enhanced Recovery/Resuscitation/NIHR Lead for KSS

Dr Mehrun Zuleika


ICU Research

Dr Kristen Carter


Joint Organ Donation Lead/ AKI project

Dr Jane Tilley


Director of Medical Education/ Organ Donation Lead

Dr Mike Carraretto


Clinical Director Intensive Care / Medical Lead Surrey Surrey Critical Care Network / Co-chair Clinical Ethics Forum / CRG representative for South East Coast/ AKI

Dr Amish Patel


Clinical Director/FICM Tutor/ RCoA FRCA Examiner Lead for Clinical Governance / HPB Anaesthesia

Dr Justin Kirk-Bayley


Ultrasound / Research / Trust Trauma Lead / IT

Dr Ben Creagh-Brown


Chair of SPACeR Group (research)/ Respiratory Physician

Dr Ed Walter


Events Medicine / Hyperpyrexia / Muscle physiology

Professor Lui Forni


Acute Nephrology / Acute Medicine / Research

Dr Rachel Savine


Education / Simulation training

Dr Alex Fletcher


Echo / ICIP configuration / operational policies

Dr Michele Bossy


Simulation / Regional Anaesthesia

The Department of Anaesthesia Dr John Stoneham


Maxillofacial Anaesthesia

Dr Hamish Griffiths


OG Anaesthesia

Dr Gareth Jenkins


Dr Paul Saunders


Job Description Produced: August 2017

Page 3 of 10

Dr William Fawcett


Acute Pain/Hepatic Resection Anaesthesia/Enhanced Recovery

Dr Nigel Payne


Acute Pain/Recovery

Dr Girish Dhond


Dr Snjezana Comara


Obstetric Anaesthesia / Gynaecology

Dr Pradeep Prabhu


Hepatobiliary anaesthesia/ Clinical risk management/CPX

Dr Hersh Saxena


Pre assessment/Equipment/CPX

Dr Viswaswar Nataraj


Core TPD for Surrey KSS School of Anaesthesia/ Pre assessment

Dr Mathew Dickinson


OG Anaesthesia

Dr Gillian Foxall


Regional anaesthesia

Dr Mathew Berry


College Tutor / Orthopaedic anaesthesia

Dr Mark Way


TPD HEKSS / Obstetric Anaesthesia Lead

Dr Bhavesh Patel


Clinical Director / Airway / ENT/Paediatric Anaesthesia

Dr Allister Dow


Chronic pain

Dr Catherine James


Chronic pain

Dr Daniella Tonnucci


Chronic pain

Dr Susie Lomax



Dr Wendy King



Dr Chris Jones


Clinical Lead

Dr Piers Johnstone



Dr Leigh Kelliher


DSU Lead

Dr Katie Blightman


Patient Blood Management

Other staff in post as of January 2014: Dr PC Samarasinghe

Specialty Doctor - full time

Dr S Milewczyk

Specialty Doctor - full time

Dr F Lai

Specialty Doctor - full time

Dr A Vivek

Specialty Doctor - full time

7 ST3-7 on rotation from St George’s Hospital 7 ST1-2 with varying experience 4 Clinical Fellows/Research Fellows from anaesthesia. Currently 2 of these are completing MD projects in association with the University of Surrey. The Intensive Care Unit The unit is situated adjacent to the operating theatre suite. There are in total 28 bed spaces including 8 isolation rooms and the unit is currently open to the equivalent of 14 level 3 beds. The Intensive Care Unit has undergone a rapid expansion in the last 3 years, associated with the expansion of specialist cancer services, including the opening of 12 new beds in a beautiful new purpose-built extension in the spring of 2014. Over 1300 patients are admitted annually with

Job Description Produced: August 2017

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approximately 55% coming from surgical specialties. The cancellation rate for elective surgery is negligible. The unit now has the latest Phillips Intellivue monitors and is currently starting the process to change over to paperless electronic records (ICIP) as a forerunner to the rest of the organisation. Puriton-Bennett ventilators are in use along with Prisma/Prismaflex renal replacement machines. A number of separate non-invasive ventilators are available for ventilatory support together with LiDCO, ODM and portable USCOM cardiac output measurement. The ICU also has two high resolution portable ultrasound systems for clinicians’ use. The unit uses the Thermogard intravascular cooling device for temperature control. The Intensive Care Unit (together with the anaesthetic department) has become well known for using enhanced recovery and goal directed therapy for major surgical cases. This has been particularly effective for the hepatobiliary and oesophagogastric patients. The hospital attracts many tertiary referral cases relating to hepatobilary, oesophagogastric and robotic urological surgery. In particular specialist expertise has been developed in the management of severe acute pancreatitis, small liver/ hepatic failure in both surgical and medical patients and perforated oesophagus. A nurse led Outreach service is firmly established in the hospital cover 18 hours per day, seven days per week. MEWS and a specially modified oncological MEWS are particularly helpful in identifying patients who require Outreach service attention or referral to intensive care. The consultants in intensive care carry out ward rounds twice per day. Daily rounds also take place from admitting teams, pharmacy, physiotherapy, microbiology, SALT, dietetics and the parenteral nutrition team. The unit has a regular teaching session and access to advice from a radiologist with a specialist interest in critical care. The Intensive Care Unit is covered 24 hours by 24 junior doctors in three tiers. The most senior tier comprises 8 Senior Supervising Registrars (SSRs) who are all either pre or post CCT doctors in anaesthesia and/or intensive care actively participating in research and educational fellowships either within critical care or anaesthesia. They oversee both the ICU and theatres overnight as the most senior doctor and are available to respond to any acutely ill patient to provide immediate care. The senior tier consists of a mixture of trainees in anaesthesia and ICM and fellows in imaging (ultrasound and echo). At present 2 of these trainees are Advanced/Intermediate Level ICM trainees, the remaining doctors coming from the full range of specialties. The unit is recognised by the FICM for training in intensive care at all levels. A full educational programme is provided to the trainee doctors with monthly teaching afternoons. A monthly morbidity and mortality meeting is held. Regular evening clinical focus meetings have been established. Research Research activity within the directorate is well established. We are proud to have contributed to several large multi-centre trials that have changed practice, including: PROWESS-SHOCK, TRACMAN, OPTIMISE, CALORIES, ENIGMA-II and EuSOS; and others that are yet to be published including PROMISE, ISOS, LAS VEGAS, IOSWean, DREAMS and PROVENT. We have a research office, 2 full-time research nurses and 8 senior research fellows – several of whom are registered for higher degrees. In addition to recruiting to NIHR portfolio studies we conduct investigator-led trials across a wide range of subjects including enhanced recovery, microcirculation, difficult airway management, pleural/lung ultrasound in critical care, muscle wasting, cardiac output monitoring and optimisation of fluid resuscitation and analgesia. There’s also extensive experience of both small-scale quality improvement projects (surgical pathways) and large-scale quality improvement projects such as

Job Description Produced: August 2017

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ELPQuic that have attracted significant funding. Grants have recently been secured from industry, the Health Foundation, DAS and ICF. The Surrey Perioperative Anaesthesia Critical care collaborative Research Group (SPACeR) group ( @SPACeRGroup) is one of the founding Clinical Academic Groups (CAGs) within Surrey Health Partners, with the University of Surrey and Ashford and St. Peter’s Hospitals. Professor Lui Forni joined us in 2014 and is playing a key role in developing our academic strategy and research activity. Several clinicians hold honorary lecturer positions at the University.

The Anaesthetic Department The department provides anaesthetic, acute and chronic pain and intensive care services throughout the Royal Surrey County Hospital Trust. The majority of this work is centred in a central operating suite of twelve theatres with a further two theatres in the Day Surgery Unit. There are also further dedicated maternity and oncology theatres. The trust has developed into the regional oncological surgical centre. Regional surgical referrals include hepatic, pancreatic, oesophagogastric, urology, gynaecological, head and neck cancer (both ENT and maxillofacial). In addition the RSCH provides for a broad range of surgical requirements, including colorectal, endocrine and reconstructive breast surgery. Other specialities include very active orthopaedics (including trauma) and ophthalmic surgery. Anaesthetic services outside these theatre complexes are provided to the X-ray department (for interventional, diagnostic radiology and CAT scanning), the Accident and Emergency department, Endoscopy and Radiotherapy. The Obstetric Department has about 3,500 deliveries per year and the Anaesthetic Department provides 24-hour cover. This is a busy unit for the Anaesthetic Department, with high rates of interventional delivery and epidural requests for labour pain. The unit has a number of research and audit projects currently ongoing. The Anaesthetic Department has up to 8 trainees at ST3-7 level from both KSS and St. George’s and CT1-2 and ACCS totalling 8 from KSS, and 4 Fellows. The department has a very active teaching role within the trust. Separate teaching programmes for the different trainee grades are run throughout the Region on a monthly basis. As part of this programme, the Department hosts a primary FRCA viva/OSCE day twice a year and a Cancer Day once a year. In addition several members of the department are very active in the provision of ALS, ATLS, PALS, APLS, CCrISP and IMPACT courses.

Job Description Produced: August 2017

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Person Specification Essential Registrable medical qualification. CCT in Intensive Care Medicine




Qualifications Completion of Intensive Care post graduate qualification e.g. FICM, DICM, EDICM

Full registration with GMC and name on Specialist Register on date of taking up appointment.

Administration/ Experience in day-today organisation of Intensive Care services. Thorough understanding of the Principles of medical audit. Must have undertaken and completed audit projects. Experience of Clinical Research culminating in publications.

Skills Familiar with current structure Of Health Service and conversant with recent initiatives and changes in Critical Care.

Use of ultrasound for vascular access and use of ultrasound in Intensive Care

Participation in Public Presentations on Critical Care Topics/Issues.

Publication of reviews, articles or case reports. Experience Wide experience in all aspects of Intensive Care culminating in award of CCT or equivalent.

Experience of postgraduate teaching at department and hospital level in Intensive Care including examination preparation. Demonstrate ability to work with colleagues as part of a team


Teaching medical students, nursing staff and other professional groups.

Personal Qualities Management, leadership and initiative

Effective communication skills Commitment to personal development

Active interest in research and commitment to clinical innovation

Enthusiasm and approachability


KEY Application Interview Presentation

Job Description Produced: August 2017

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The Trust The Royal Surrey County Hospital became a Trust in 1991. It is a general hospital situated close to the University of Surrey and Guildford Cathedral and lies just north of the A3. The Royal Surrey County Hospital became one of the first NHS Trusts in 1991 and provides a comprehensive local service to patients in our area. Several of our specialties attract national referrals; supra-regional assay services are provided by pathology; a regional service is provided by the St Luke’s Cancer Centre to the Southern Home Counties; and the Trust is one of only three training units for Minimal Access Therapy (keyhole surgery) in the UK. The Trust has strong links with the University of Surrey and a number of Medical Schools. The RSCH serves a population of 320,000 for emergency and general hospital services, mainly from West Surrey, East Hampshire and North Sussex and 1.2 million people for cancer services. The Trust treats over 260,000 patients a year including more than 80,000 unscheduled attendances – 39,000 in and day case patients and 167,000 outpatients. It employs 2,300 staff, with 280 doctors, 800 nurses and midwives as well as therapists, scientific and technical and support staff. The Trust has 20 wards comprising general and specialist surgery, obstetrics, paediatrics, oncology, orthopaedics, general and specialist medicine, intensive care and coronary care, with 570 beds in total. There are 12 dedicated surgical theatres, 1 obstetric and 1 minor operations theatre, as well as, state of the art outpatients, audiology and rehabilitation departments. Outpatient clinics are also held at Aldershot, Cranleigh, Farnham, Haslemere and Woking. All the acute services are located at the Royal Surrey County Hospital except acute Psychiatry is provided at the nearby Farnham Road Hospital. The hospital has an annual income of more than £200 million and employs around 3,000 people. The Guildford Nuffield Hospital containing 53 private beds, 3 private operation theatres and associated consulting and diagnostic services is an integral part of the Royal Surrey’s campus and opened in January 1999. This new building, linked by corridor to the St Luke’s Cancer Centre, also contains a purpose built Day surgery Unit for NHS patients, which opened in May 1999. The Trust is committed to continually improving the quality of its services to patients, GPs and health authorities. The Education Centre houses the Library, Post Graduate Medical Centre, lecture suite and conference rooms. There is a very attractive multi-disciplinary clinical audit programme and quality programme, which focuses on Health of the Nation, Patient’s Charter, and purchasers’ standards. Additional information can be found in the Annual Report. The Royal Surrey County Hospital has the following specialties: Cardiology Dermatology Gastroenterology Endocrinology Respiratory Medicine General Medicine Paediatric Medicine Geriatric Medicine Neurology Rheumatology Obstetrics and Gynaecology

Gynaecological cancer surgery Oncology and Radiotherapy Oral Surgery ENT Ophthalmology Orthopaedics General Surgery Breast surgery Urology Hepatobiliary Surgery Upper Gastrointestinal surgery

A 28 bed ICU is in close proximity to the 10 main operating theatres and is on the ground floor close to the Accident and Emergency Department. Similarly, the main x-ray department with spiral CAT scan and digital

Job Description Produced: August 2017

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angiography facilities is also on the ground floor near to the Accident and Emergency Department. MRI scanner is on a separate site at the back of the hospital. General Information THE GEOGRAPHY Situated on a green field site on the outskirts of Guildford, the Trust has excellent rail and road links (via the A3 and M25) to London (35 minutes) and to the south coast (35 minutes). A shuttle bus service links the hospital to the railway station and town centre, and the main taxi ranks. The picturesque Surrey countryside is ideal for good walks and outdoor pursuits and has numerous historic village inns. Guildford is one of the best shopping areas outside London centred on its attractive high street, and entertainment for all tastes including clubs, restaurants, theatres, cinema and a new multi-sports complex with swimming pools, ice rink, gymnasium and ten pin bowling. Guildford has a number of schools, both private and state, which cater for all bands of ability. There is a Technical College, with a wide and varied curriculum and a Law College with a national reputation. The University of Surrey is situated beside the Cathedral, adjacent to the A3 trunk road. There is mainline rail link with London and the South West.

POSTGRADUATE MEDICAL SCHOOL UNIVERSITY OF SURREY The University of Surrey has become one of the leading academic institutions of the country. In the recent University Research Assessment exercise it came 4th in the UK for most academics based in 5*A rated departments. Surrey University Campus is adjacent to the hospital and provides excellent opportunities for collaboration in research. The New Postgraduate Medical School building opened adjacent to the hospital in 2005 and provides state–of-the-art facilities for medical research. CONFIDENTIALITY All employees must respect and protect the confidentiality of matters relating to patients or other members of staff and must comply with the requirements of the Data Protection Act (1998). Further details are available from the Trust’s Data Protection Act Designated Officer. CORPORATE GOVERNANCE The Trust, as a public organisation, is committed to acting with honesty, with integrity and in an open way. The Trust Board of Directors is responsible for ensuring that Trust services are managed in this way. We are working together to achieve the highest levels of compliance with the risk management standards promoted through the NHS Executive’s Controls Assurance programme and the Clinical Negligence Scheme for Trusts (CNST). All of us are expected to become familiar with these standards as they relate to our work and further details are available from your manager. One of the controls assurance standards relates to Health & Safety. Under the Health & Safety at Work Act 1974, all of us have a duty: · to take reasonable care of ourselves and others at work · to co-operate in meeting the requirements of the law Further details are available from the Trust’s Health & Safety Advisers.

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INFECTION CONTROL It is now a requirement of the Department of Health that you accept personal responsibility for compliance with infection control policies and procedures at any time when you are working in clinical areas. TRUST MISSION AND VALUES The Values and Behaviours that are both displayed and aspired to at the Royal Surrey are: We work together to serve our community by: • • •

Delivering safe and excellent clinical care Treating others with compassion and respect Driving improvement and efficiency

The behaviours are defined below as: Delivering safe and excellent clinical care • • • •

I share information openly and effectively with patients, staff and relatives I consider safety in my everyday actions and seek to minimise patient and staff harm I work to prevent and control infection I strive to deliver excellent outcomes

Treating others with compassion and respect • • • • • •

I treat others as I would like to be treated I am compassionate and empathetic I treat other people with dignity and respect I am courteous and polite I anticipate the needs of the people I serve I strive to make time

Driving improvement and efficiency • • • • • •

I provide support and challenge I continuously seek to improve service quality and share best practice I listen and act on suggestions for change I work resourcefully to deliver improved outcomes I use resources wisely I am passionate to deliver results Consultant

Signed: …………………… Name: ………………….. Date: ……………………

Clinical Director

…………………… .…………………… …………………….

Job Description Produced: August 2017

Chief Executive

...…………………… ……………………… ………………………

Page 10 of 10


job description - NHS Jobs

JOB DESCRIPTION Job Title: Locum Consultant in Intensive Care Medicine & Anaesthetics Salary Range: £76,761 - £103,490 Base: Royal Surrey County ...

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