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JOB DESCRIPTION

JOB TITLE: Specialty Doctor for service in Anaesthetics and a Special Interest
NHS Jobs reference tbc

LOCATION: The Queen Elizabeth Hospital King's Lynn NHS Foundation Trust

ACCOUNTABLE TO: Clinical Director (Clinical Business Unit 1)

RESPONSIBLE TO: Clinical Director (Clinical Business Unit 1)

JOB SUMMARY

To provide anaesthetic services as directed by the Anaesthetic Department including participation in


out-of hours duties to meet the Trust’s objectives.

The special interest will involve an average of 1 PA per week given to supporting the Trust in the
special interest area (for example, one half-day a week supporting the ACSA / trauma / clinical
governance). The special interest area may be negotiable. You will be mentored and supported in
your specialist work by a consultant.

MAIN DUTIES AND RESPONSIBILITIES

Clinical
 To provide appropriate anaesthetic and critical care services as directed by the Anaesthetic
Department.
 To contribute to the 1st and 2nd on-call tier and provide anaesthetic services accordingly.
 To assist with the service delivery by covering colleagues’ absences
 To carry out pre and post operative assessments as required
 To maintain high quality patient care with minimal risk, enhanced patient satisfaction and
informed consent, following GMC guidelines
 To help in the delivery of effective services within the agreed budget
 To contribute to meeting Departmental and Trust objectives

Organisational
 To undertake appropriate projects or administrative tasks as required by the department.
 To supervise more junior staff as appropriate
 To maintain the Directorate principles of effective multi-disciplinary team working
 To ensure personal knowledge of, and compliance with, Trust and departmental protocols

Teaching
 To help provide training and supervision of junior doctors of appropriate grades in the
Anaesthetic and Critical Care Departments
 To contribute to the education of medical and nursing students, paramedics and trainees in
other specialities as required.

Clinical Governance

To provide clinical services in line with the Trust’s clinical governance arrangements, which are
designed to ensure that agreed quality standards are achieved. These requirements include:-
 AUDIT – To participate in audit of clinical practice to ensure that current standards and evidence-
based practice are applied
 CONTINUING MEDICAL EDUCATION – Individual training and development needs will be
identified through the appraisal process taking into account Royal College and Trust
requirements. Full utilisation of study leave is encouraged. Current entitlement is 30 days in a 3-
year period and there is entitlement to a personal study leave budget. Individual training and
development needs will be identified through an appraisal and revalidation processes taking into
account Royal College requirements including Consultant support for completing the FRCA
examination and further career development.
 RISK MANAGEMENT – To work within the Trust’s clinical risk management policies and in
particular to participate as appropriate in clinical incident reporting
 APPRAISAL – All anaesthetists will participate in the Trust’s appraisal process
 MANDATORY TRAINING – Full compliance with the agreed Trust programme for the anaesthetic
department

PROVISIONAL TIMETABLE

The successful applicant will be offered the 2008 Speciality Doctor Contract of Employment. The
contract will be substantive.

The contract will be for 10 PAs. This will comprise of


 8 PAs clinical work including elective lists and out-of-hours duties per week averaged over a
14-week period
 1 PA of supporting professional activities per week.
 1 PA of special interest work per week

Out-of-hours work will include long days, nights and weekend nights or long days according to the
needs of the department. Starting salary will depend on previous experience and the current
Specialty Doctor pay scale as published in 2013 will apply. There may be a requirement to support
the Critical Care junior doctors’ rota for a period of time which may be 2 or 3 months in duration
during any 12 month period. It is possible that, by mutual agreement, the number of PAs may be
increased, following appointment, to meet the service needs of the department.

Trust Speciality Doctors are required to undertake variable amounts of out-of-hours work at various
times. The successful applicant’s participation is expected to predominantly cover the 2nd on-call.
The 2nd on call rota is primarily responsible for covering obstetric anaesthesia and provide senior
cover for main theatres, the Critical Care Unit and the Emergency Department

Each rota is designed as 1:8 on call on an 8 week cycle with 8 doctors covering a full shift system
with prospective cover.

Samples of on-call rotas are available on demand.

A current typical sample week is shown

Sample Week

Monday
Am Supporting activities
Pm Orthopaedic (main theatres)
Tuesday
Am -
Pm -
On-call overnight 20.30 pm – 8.30am
Wednesday
Am Off call
Pm Off call
Thursday
Am General surgery (DSU)
Pm General surgery (DSU)
Friday
Am Special interest work
Pm Orthopaedic/Trauma (main theatre)

STAFFING
The Anaesthetic department has 25 Consultant Anaesthetists:

Name Primary roles Additional roles


Dr Hari Ankireddy General Anaesthesia
Dr Mark Blunt Critical Care Lead FRCA Examinations
Dr Ping Chen Obstetric Anaesthesia
Regional Anaesthesia
Dr Lorraine de Gray Clinical lead in chronic RCoA Regional Advisor for
pain Pain Medicine
Dr Ben Fox Regional anaesthesia
Lead in Day surgery
Dr Nadya Gabrovska General Anaesthesia
Dr John Gibson Critical Care Organ Donation
Colorectal Vascular Access
Dr Stuart Greenhill Pre-operative assessment College Tutor
Orthopaedics
Dr Robin Heij Critical Care Simulation Lead
Regional anaesthesia
Dr Helen Hobbiger Critical Care Training expertise (Recent
Head of School)
Dr Victoria Howell Paediatrics Anaesthesia Global Anaesthesia
Dr Ogi Ivanov Regional Clinical Governance Lead
Paediatric
Dr Santhosh Pre-Operative assessment
Thandayuthapani General
Dr Manesh Mathew Chronic pain Acute Pain Lead
General anaesthesia
Dr Darcy Pearson Critical Care Medical Student Lead
Paediatric Anaesthesia
Dr Shilpi Pilkington Day Surgery Anaesthesia Cardiac Anaesthesia
Dr Robert Pretorius Paediatric anaesthesia Equipment Lead
Rota coordinator
Dr Jayanth Sampath General Anaesthesia
Dr Bharti Seth Chronic pain

Dr Sherif Shafeek Difficult Airway Lead


Paediatric Lead
Dr Alistair Steel Lead for Major Trauma Pre-hospital Emergency
Clinical Lead Medicine
Dr James Stimpson Lead for Regional Clinical Guidelines
Anaesthesia

Dr Anoop Surendran Lead for obstetrics Health Records


Committee
Dr Peter Young Critical Care Research / Innovation

They are supported by 11 speciality doctors

Trainee Staff Establishment

On average
5 Specialist Registrars
9 trainees working at ST1/2 level, made up of a mixture of core trainees and ACCS posts.
7 trainees from anaesthesia, medicine or surgery cover a separate critical care rota.

Secretarial Establishment

1 whole time secretary and one 30 hours pw rota administrator/coordinator for anaesthetics
1 whole time secretary and 1 whole time administrator for chronic pain
1 whole time for critical care (2 person job-share)

Training & Development

The Department runs an active postgraduate training programme in-house. This takes the form of
journal clubs and other meetings, sometimes followed by an outing to a local restaurant. On first
Friday of every month during the academic term, there is a hospital postgraduate teaching
programme covering all aspects of clinical medicine with invited local, national and international
speakers. The Department 8 to 10 half days are put aside per year for departmental education and
audit presentations.

The Department has an excellent record with exam successes and the placement of trainees and
other staff in higher training positions and consultant posts.

The department is part of the Anglian School of Anaesthesia, and the regional teaching centres are in
Cambridge and Norwich from which Specialist Registrars rotate. The department is also actively
involved in the Joint Regional Course set up in conjunction with the Norfolk and Norwich Hospital to
provide structured teaching for the primary and final FRCA examinations.

BRIEF DESCRIPTION OF THE TRUST

The Queen Elizabeth Hospital Kings Lynn NHS Trust provides a hospital and community health
service serving the principle towns of King’s Lynn, Downham Market, Fakenham, Hunstanton,
Swaffham and Wisbech. The character of the area is predominantly rural but is popular for retirement
and the population is around 220,000. The post is at the Queen Elizabeth Hospital, Gayton Road,
King’s Lynn (488 Beds) which is located on the outskirts of the town of King’s Lynn, some two miles
from the town centre.

SERVICES AND FACILITIES


Critical Care Centre

The Critical Care Centre was opened in 2004 by the Princess Royal. It consists of 5 level 3 beds, 8
level 2 beds and 2 elective level 2 beds. All level 2 beds are worked flexibly so that up to 9 level 3
patients can be managed as required. Approximately 750 admissions per year are managed,
including approximately 30% booked elective admissions. The centre provides invasive and non-
invasive ventilation (including oscillation), renal support, cardiovascular monitoring and support
expected of such a facility. Ventilators and haemofiltration equipment have recently been replaced
with state of the art devices. The department also has an electronic patient record system covering all
medical, nursing and AHP notes on patients.

Outcomes have been consistently good, and are peer reviewed by membership of ICNARC.

Consultant ward rounds each weekday morning are conducted in the seminar room and involve the
full multidisciplinary team. Consultants are rostered to provide cover on site until 10pm (Monday to
Thursday) and during daytime over the weekend, as well as on call cover at all other times. Middle
grade cover is provided out of hours (after 9 pm Monday to Thursday), as well as intermittently during
the day. Junior cover consists of 5 ST1s (from anaesthesia, ACCS, medicine and accident and
emergency) and 2 FT2s providing a full rota.

The team is very active in research and teaching regionally, nationally and internationally. Regular
publications and presentations of original research is undertaken by consultants, junior doctors and
nursing staff, and the department has a reputation for innovation and development, having won
awards for innovation in both of the last two years.

The department works independently as one of the eight clinical service lines within the Trust service
line management structure.

The Arthur Levin Day Surgery Centre

This semi-autonomous dedicated 4-theatre day surgery unit was opened by the Queen in January
1999. The Centre is largely self-contained, with its own staff facilities and administration department
but is linked to the main hospital by a connecting corridor. The Centre opens from 8am to 8pm daily
and employs around 50 nursing, ODP, HCA and administrative staff, most of who work only in Day
Surgery. The Trust has an excellent record for day surgery with around 86% of the elective workload
being carried out on a day-stay basis. Quality indicators used to monitor the work of the Day Surgery
Centre include unplanned admissions, re-admissions and use of the help-line facility. Many
intermediate procedures have been transferred successfully to day surgery including prostate
resection, arthroscopic shoulder surgery, laparoscopic cholecystectomy, paediatric tonsillectomy and
microdiscectomy. The Centre has been at the forefront of national developments in brachial plexus
catheter techniques and ambulatory spinal anaesthesia

Main Theatres

There are 7 operating theatres in the main theatre block. There are modern monitoring and
anaesthetic machines in the anaesthetic rooms (Drager Primus) and theatres (Drager Primus). Other
equipment includes 2 cell savers, rapid infusors, lidco cardiac output monitor and a full range of
devices including the sonosite Xporte and S nerve for regional, plexus and nerve blocks. There is a
range of difficult airway equipment that includes 5 glidescopes, fibreoptics, supraglottic and
transglottic devices. The medical staff are supported by well-trained and highly motivated ODPs and
the recovery room is staffed by fully trained recovery room nurses.

There are 10 General Surgeons covering a wide range of surgical specialties including, major
vascular, colorectal, upper gastrointestinal, laparoscopic and breast surgery.
There are 7 Orthopaedic surgeons with areas of special interest, 1 shared Paediatric Orthopaedic
appointment and one visiting orthopaedic surgeon from The Norfolk and Norwich University Hospital.
The Trust also has 7 Obstetrics/gynaecology consultants, 3 ENT consultants and 5 Urology
consultants, two of which are shared appointments with The Norfolk and Norwich University Hospital.
Ophthalmology, Max Fax and Dental surgical services are also represented.

Delivery Suite

There are approximately 2500 deliveries pa and a caesarean section rate around 25% and epidural
rate around 22%. The anaesthetic department provides a 24-hour epidural service and anaesthesia
for obstetric surgical interventions. The central delivery suite has recently been renovated and has a
recently opened midwife led unit. There are 10 daytime sessions covered by consultants and the
majority of procedures are carried out under spinal anaesthesia. There is extended consultant cover
in the evenings on Monday (excluding Bank Holidays) to Thursday inclusive. There is a single
dedicated obstetric theatre, a high dependency delivery room and an anaesthetic-run high- risk
obstetric clinic every 2 weeks. Computerised record keeping system is improving follow-up and audit
of obstetric anaesthesia and analgesia.

Emergency Department

The Emergency Department is situated at the front of the hospital. It is a Major Trauma Unit and sees
around 60,000 new patients per annum. The department was purpose built and utilises electronic
patient tracking to manage patient flow and has undergone recent refurbishment to suit the needs.
The department benefits from excellent clinical pathology, haematology and microbiology services
and radiology using the Agfa Impax PACS system. There is a well-equipped 4-bed resuscitation
area, 12 cubicle spaces including two rooms plus a see and treat assessment suite.
The department sees the full range of Emergency patients and covers a large geographic area and a
population of around 220,000 people. The department submits Audit data to TARN and have shown
a survival rate for our most seriously injured patients which is comparable to most of the major
teaching hospitals. There are several military bases in the area, which can add to the workload. The
hospital has a fully operational floodlit Helipad which provides easy access to emergency care for
many of our patients who are injured / fall ill in the more remote areas of the region.

Simulation Suite

A high fidelity simulator is now purchased and a purpose built suite is functional. We aim to provide in
house teaching and training based on simulation technology to the medical students, junior doctors
from different specialities simulation in addition to the regional simulation study days.

Chronic Pain

The Trust has recently expanded its pain services and this includes:

• The provision of a local specialised, evidence based pain management service.


• The provision of a multidisciplinary approach to pain management that incorporates the
services of Chronic Pain Consultants , Specialist Nurses, Clinical Psychologists, Physiotherapists
and Occupational Therapists.

There are currently 3 Consultants with an interest in Chronic Pain, two nurse specialists, covering
both acute and chronic pain, clinical psychology support, physiotherapy and occupational therapy.
Clinics take place in recently renovated premises, in clinical psychology department and procedures
in the Day Surgery Centre. A multidisciplinary team meeting is held every fortnight, and there are
close links with the palliative care team.

Acute Pain

The use of continuous epidural and spinal analgesia is encouraged. A “General Surgical Observation
Area” allows the safe nursing of these patients post-operatively. There is a consultant-led acute pain
service and 2 full time pain nurses who are shared with the chronic pain service. The department of
anaesthesia has a long history of teaching and training in a wide variety of regional anaesthetic
techniques which are commonly used both in the main theatres and the Day Surgery Centre.
PERSON SPECIFICATION
SPECIALTY DOCTOR ANAESTHETICS

REQUIREMENTS ESSENTIAL DESIRABLE


QUALIFICATIONS MBBS or equivalent FRCA Primary or equivalent
EXPERIENCE Minimum of 2 years anaesthesia At least 2 years
experience experience in the UK
Initial Assessment of Competency in 3 months experience of
Anaesthetics or equivalent obstetric anaesthesia and
Regular on call experience in completed basic
Anaesthesia competencies in Obstetric
A minimum of 3 months ITU Experience of working at the
experience. Completed basic Queen Elizabeth Hospital
competencies in anaesthesia and
analgesia and able to work with
distant supervision. Completed
basic competencies in Critical care
and able to work with distant
supervision
Teaching and training of other
staff
ABILITY Good team working ability and
ability to priorities
Good theoretical knowledge
Good clinical problem solving skills
TECHNICAL / Good standard of note keeping
CLINICAL SKILLS Computer skills
Spinal and epidural anaesthesia
Experience in ultrasound guided
peripheral nerve blocks upper and
lower limb
AUDIT Understanding of the principles
of Audit
Completed audit projects
Made recommendations
following an audit which
led to a change in practice.
Completed an audit cycle
MOTIVATION Good self organisational skills
Willingness to be flexible.
Willingness to learn
PERSONALITY Good verbal and written Ability to lead
communication skills.
Able to cope in stressful
situations.
Able to work within a team
Caring attitude to patients.
MANAGEMENT Ability to organise others
Ability to organise workload and
arrange priorities
TEACHING Informal teaching experience Formal teaching experience
OTHER Full GMC Registration Experience with appraisal
REQUIREMENTS Appropriate immigration status Current provider of at least
References as per Trust policy one of the following:
ATLS
ALS
APLS
Available to commence post
as of August 2018

CONDITIONS OF SERVICE

This post is being advertised on a whole-time basis. A candidate who is unable, for personal
reasons, to work on full time basis will be eligible to be considered for appointment; if such a person
is appointed; modification of the job content will be discussed on a personal basis, in consultation
with consultant colleagues.

The Trust will take due account of current (2013) National Terms and Conditions and any changes to
these Terms and Conditions of Service which the Secretary of State for Health may authorise from
time to time.

This post is exempt from the provisions of section 4(2) of the Rehabilitation of Offenders Act, 1974 by
virtue of the Rehabilitation of Offenders Act 1974 (Exemptions) Order 1975. Applicants are therefore
not entitled to withhold information about convictions which for other purposes are “spent” under the
provisions of the Act and in the event of employment, any failure to disclose such convictions could
result in dismissal or disciplinary action by the Trust. For this purpose there is a declaration section at
the back of the application form, which must be completed. Any information given will be considered
in relation to the application and will not be used for any other purposes. The Trust requires the
successful candidate to have and maintain full Registration with the General Dental Council of
General Medical Council. Medical staff is advised to continue with membership of one of the Medical
Defence Organisations. Dependant upon the date of the last medical examination for a post within
the National Health Service, the appointee may be required to undergo a medical examination.

Governance and Statutory Requirements

The post holder is expected to comply with the governance arrangements and policies and
procedures of the organisation, available on the Trust intranet site

Equal Opportunities and Diversity

The Trust has an absolute commitment to equal opportunities based on sound management practice,
respect for the individual and legislative compliance. The post-holder must at all times carry out
his/her responsibilities with regard to the Trust’s Equal Opportunities Policy & the Race Equality
Scheme.

Health and Safety & Risk management

Employees must be aware of the responsibilities placed upon them under the Health and Safety
Work Act 1974, to ensure that the agreed safety procedures are carried out to maintain a safe
working environment for patients, visitors and employees.

Employees must wear personal protective equipment where provided.

All employees are expected to comply fully with the Trust and Departmental fire policies and
procedures to meet their responsibilities in relation to fire safety. All staff are also expected to
maintain safe infection control practices at all times.

All employees are responsible for reporting any accidents, untoward occurrence and potential
hazards to their Head of Department even when no injury or property damage has resulted.
Infection control

All staff has a responsibility to contribute to the reduction of the healthcare acquired infection by the
adherence to best practice.

Staff are expected to comply with hand hygiene guidelines and ensure all equipment used for patient
care is clear and fit for purpose.

Staff is requested to report any environmental concerns regarding breach of infection prevention
guidelines to their line manager.

Information Governance

Confidentiality is both a moral and contractual obligation and applies both inside and outside of work.
Any matters of a confidential nature, and in particular any information relating to patients, individual
staff records and details of contract prices and terms must, under no circumstances, be divulged or
passed to any unauthorised persons at any time during your employment or afterwards.

All notes, emails, records and other documents, regardless of medium, are and shall remain the
property of the Trust and shall be handed over by you to the Trust from time to time on demand and,
in any event, upon termination of your employment. All assets issued to you (such as identity card,
car parking pass, equipment, office keys etc) must be surrendered to the Trust upon termination of
your employment and, where applicable, on change of employment within the Trust.

As a user of information you must be aware of your responsibilities, both legal and other, and comply
with all policies and procedures issued by the Trust and associated NHS Codes of Conduct and work
within the principles outlined in the information governance framework. This includes information
security (including encryption and, where applicable, home working and remote access), records
management and information quality responsibilities.

Under the common law duty of confidentiality, you may be personally liable in a court of law for
unauthorised disclosure of personal data. In addition, the wilful or negligent disclosure of confidential
information or disregard for the Trust’s information governance framework would be a breach of the
disciplinary rules and could result in summary dismissal. Should you breach this clause after your
employment has ended, the Trust may take legal action against you.

Confidentiality and the Protection of Data

All employees of the Trust must not, without prior permission, disclose any information regarding
patients or staff. In circumstances where it is known that a member of staff has communicated to an
unauthorised person, these staff will be liable to dismissal. Moreover, the Data Protection Act 1998
also renders an individual liable for prosecution in the event of unauthorised disclosure of information

Safeguarding Children/ Vulnerable Adults

All Staff within the Trust share a commitment to safeguard and promote a Child's or Vulnerable
Adult’s wellbeing. As an organisation we need to ensure that all staff who come into contact with
Children/Vulnerable Adults in their daily activities or provide services to adults with Children or
Vulnerable Adults receives mandatory safeguarding training which is appropriate to their role. In
addition to this you will be expected to work in accordance with the policies and procedures relating
to Safeguarding Children/Vulnerable Adults that have been agreed by the Trust.

ENQUIRIES/VISITING

Candidates requiring further information are warmly invited to contact either

Dr James Stimpson – Clinical Director james.stimpson@qehkl.nhs.uk


Dr Alistair Steel – Clinical Lead alistair.steel@qehkl.nhs.uk

Please contact Dr Stimpson or Dr Steel via the Department co-ordinator Bridget Cox on (01553)
613324 or the department secretary Bev Mussett on (01553) 613583

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