Consultant in Anaesthetics - fixed termNHS

Job summary

We are seeking recruit 2 Locum Consultants on a full-time basis in anaesthesia (with or without an interest in critical care or obstetrics) to join our dynamic and inclusive team at The Rotherham Hospital NHS Foundation Trust.

The post-holder will work alongside the existing team of 31 consultants and 19 Associate specialists, specialty doctors and clinical fellows as well as 12 doctors in training from Health Education England (HEE).

The Anaesthetic and critical care department serves a modern and recently expanded theatre and day surgery complex with adjacent ITU and HDU facilities. The department has an excellent reputation and enthusiasm for undergraduate and postgraduate teaching and would welcome applicants with a teaching interest. The Trust has Associate Teaching Hospital status within the University of Sheffield Medical School.

Main duties of the job

Surgical specialties in the Trust include: general surgery (including laparoscopic colorectal surgery), orthopaedics, Obs & Gynae, urology, ENT, maxillofacial, breast surgery and ophthalmology. We run a busy pre-operative assessment service including cardiopulmonary exercise testing. We specialise in day case surgery (led by recent BADS president) and regional anaesthesia.

The critical care unit consists of 6 funded ITU beds and 8 funded HDU beds. There are consultants with a special interest in critical care medicine. We have also appointed an Associate Specialist in intensive care to support the expanding department. We have FICE echo accreditation.

There are many research opportunities within the Anaesthetic department and the trust as a whole. A consultant colleague is a professor with an active research portfolio and we make a significant contribution in terms of recruitment to prominent trials. Successful applicants will be encouraged to have an active part in furthering projects and quality improvements within the department.

We have a wealth of managerial experience within the department with colleagues currently holding several senior roles within the Trust.

Job description

The Department

We currently have a 30 substantive Consultant Anaesthetists. In addition, there are 14 Anaesthetic Specialty Doctors and two Associate Specialists. The trainee establishment consists of eight stage 1 trainees, together with four stage 2 or 3 trainees all rotating from the South Yorkshire Anaesthetic Training Rotation. The department also has one Foundation Year 2 doctor on a 4-month rotation within critical care.

Elective Surgery

Elective surgical lists are either half or full day and run for either 4 or 8 hours. Anaesthetists are allocated an extra hour per half day for pre-op assessment and post-op care. Surgical specialties include: general surgery (including laparoscopic colorectal surgery), orthopaedics and trauma, gynaecology, urology, ENT, maxillofacial, breast surgery, ophthalmology. We have an excellent Day Surgery Unit and one of our colleagues is the Past-President of the British Association of Day Surgery (BADS).

We have an excellent regional anaesthesia service with higher and advanced training modules.

We have an excellent Paediatric exodontia anaesthesia service and a community dental sedation service. In addition to the above we are the referral centre for ECT and we also provide a regular cardioversion service.

We have a resident Professor and a strong anaesthesia and critical care research portfolio participating in many international and national portfolio studies with input from funded trust research nurses.

Obstetric Anaesthesia and Analgesia

Rotherham has a busy obstetric unit. In 2018 there were approx. 3000 deliveries. 15 sessions per week are currently covered by nine Consultant Anaesthetists. Weekday consultant cover is from 07:40 21:00. Overnight cover is provided by the Registrar on-call and the General Anaesthetic Consultant on call. The weekend days have anaesthetist covering Labour Ward and helping in theatres and ICU if needed.

Acute Pain

An enthusiastic and dynamic team of nursing staff run our nationally renowned acute pain service throughout the Trust. There is a well-established ward-based epidural service for Orthopaedics, General Surgery, Urology and Gynaecology with on-going developments focusing on enhanced recovery, management of acute pain in the patient with chronic pain and analgesia for fractured necks of femur. The Pain team has particular expertise in the management of rib fractures and our protocols have been published and presented nationally. The pain team also provide an acupuncture service which has reduced the incidence of post-operative nausea and vomiting (PONV).

Training & Teaching

In addition to service commitments, there are excellent opportunities for the appointee to become involved in anaesthetic training, module development, educational supervision and appraisal. The Department has an excellent reputation for teaching and training. The department offers training modules in all the surgical specialities available at the Trust, as well as Critical Care Medicine. All consultants are encouraged to participate in teaching and tutorials, in addition to practical aspects of training in the operating theatres and intensive care.

The Critical Care Unit is recognised for basic, intermediate level RCoA training and Stage 1 of the FICM training program. One of our ICU Consultants is FICE accredited and all the remaining ICU Consultants are working towards FICE accreditation.

There is an established teaching programme within the department, with an afternoon of tutorials on topics relating to Anaesthetics and Critical Care Medicine. A lunchtime ICU journal club and a mortality and morbidity meeting is held once a month at the ICU Clinical Governance meeting.

Critical Care Unit

We admit around 630 patients a year, of which 35% are Level 3. Approximately 60% are emergency medical admissions, and around 15% are elective surgical patients. Our mean APACHE II score is 15.2, with a unit mortality of 12%, which is in keeping with other similar units in the ICNARC Case Mix Programme, and we have a risk-adjusted acute hospital mortality of 0.91 (2018-2019 ICNARC data).

There are currently 6 funded Level 3 (ICU) bed spaces and 8 funded Level 2 (HDU) bed spaces. The ICU and the HDU are co-located to make a Critical Care Unit. Theatres, radiology and the brand new Urgent Care Emergency department are in close proximity.

There are currently nine Consultants and one associate specialist, who have a special interest in Critical Care and provide consultant cover for the unit. Two Critical Care consultants cover the unit each weekday, providing a total of 20 clinical sessions. These new posts were approved to help meet the GPICS standards for critical care.

Clinical Governance

The Anaesthetic department also holds regular audit meetings (up to six meetings per annum). These include combined meetings with surgical specialities, mandatory training updates as well as mortality and morbidity reviews, case presentations and discussing new developments.

We undertake a regular morbidity and mortality review to share learning within the department and more widely within the trust.

The successful candidate will also be encouraged to become participate in the governance and service development. Supporting Professional Activity (SPA) time will be available in job plans to support involvement in these activities

Permanent Staff Meetings

Anaesthetic & Critical Care permanent medical staff meetings are held bi-monthly on the day of the audit meetings.

We have a weekly departmental meeting on a Thursday Lunchtime, which is attended by all staff including trainees and representatives from theatres (e.g.) ODPs and management.

Out-of-hours emergency service

The emergency on-call anaesthetic team consists of:

• A CT 1/2 who provides anaesthetic cover for the acute surgical specialties.
• An ST3+ whose duties include the provision of medical cover for the ICU or Labour Ward, Paediatric resuscitation, as well as supporting the CT1/2 anaesthetist.
• SAS doctor whose duties include the provision of medical cover for the ICU or Labour ward, Paediatric resuscitation, as well as supporting the CT1/2 anaesthetist.
• A Consultant Generalist anaesthetist with responsibility for theatres and obstetrics.
• A Consultant Intensivist is on call on weekend days (0800-2000) in addition to the Consultant General Anaesthetist
• Weekdays a Consultant Intensivist is resident until 21:30.

Staffing

The post-holder will work alongside the existing Consultant Anaesthetists.

Relationships with other Departments:

The Department serves all the major specialities appropriate to a District General Hospital, with the exception of Plastic Surgery, Vascular surgery, Cardiac, specialised Paediatric and Neurosurgery.

Office Accommodation

Shared office accommodation and shared secretarial support will be available within the Anaesthetic Department and Critical Care Unit.

The Post

The successful candidates will share responsibilities within the department of Anaesthesia and Critical Care Medicine. The successful candidate will be required to provide 8.0 PA per week of DCC, plus 1.0 PA for on call, and a minimum of 1.5 PA per week of SPA. Additional clinical PAs may be available dependent upon the needs of the anaesthetic department, and the appointee will be encouraged to take on additional SPA roles determined by their interests and the needs of the department.

Critical Care Unit

Critical Care Medicine cover is provided by two consultants on weekdays. One Consultant provides cover from 0800 to 2100 on the Intensive Care Unit (ICU), and the other provides cover between 0800 and 1800 on the High Dependency Unit (HDU). On call during the week is shared between the Critical Care and General Consultants. The Critical Care Consultants provide a weekend on call service which will be on a 1 in 9 basis with prospective cover. There is a resident session on the Critical care unit from 0800-1300, followed by on call till 2000hr. (Consultants will be expected to cross cover colleagues leave in order to cover the Critical Care Medicine service). These are new posts to facilitate a departmental restructure, providing separate rotas for critical care and other duties. The aim is to separate out the ITU and General rotas in time. There are currently 9 Consultant Anaesthetists with sessions in Critical Care. We have recently appointed a trust associate specialist to increase clinical cover in critical care.

Anaesthetics

Each theatre session is 1.33 PAs or 5 hours, which includes 1 hour for pre-operative assessment and post-operative care. The theatre start time for the morning list is 0830 and for afternoon list is 1345. Several theatre lists may be all Day and the trauma list starts at 13:45 and finishes at 20:30.

Supporting Professional Activities (SPA)

The list of activities included in SPA is not limited to activities to support continuing professional development (CPD), but includes mandatory training, appraisal, revalidation, audit, job planning, departmental and personal administration, governance, education and training etc. All of the SPA activities will be required to support revalidation and professional development.

The expected anaesthetic related activities of the job plan, should occur at regular times in the week. Mutual agreement will be reached between the appointee and their Clinical Lead, with regard to scheduling, including SPA.

An example timetable is indicated in this job description, and we are very willing to discuss alternative arrangements with suitable candidates who have a specialist area of interest that complements their primary role.

On Call Availability

The post holder will participate in the General Anaesthesia & Critical Care on call rota for out of hours emergency work. The on call is Category A attracting a pay supplement of 3% and tariffed at 1.0 PA per week on average.

About us

The Rotherham NHS Foundation Trust (TRFT) is a combined acute and community Trust serving our local population of around 270,000 people. Our vision is to always act the right way and be proud to provide exceptional healthcare to the communities of Rotherham.

As a Trust we are on a journey to excellence and our people and culture are at the heart of everything we do for patients. In the latest NHS Staff Survey, we are the second most improved Trust in England for would you recommend the Trust as a place to work? and were one of the most improved for staff engagement overall.

But dont just take our word for it each year hundreds of colleagues receive nominations for our Excellence and Proud awards, showcasing our brilliant people and recognising their achievements. Our people make a difference to the lives of patients every day and we are proud of the improvements we are making.

All of our 5,100 colleagues are key to our improvement journey and we are continuing to improve our services by upholding the Trusts values of Ambitious, Caring and Together. If you are passionate about making a difference, then please apply to join us on our journey to excellence.