RECRUITMENT PACK NHS SHETLAND 1

NHS Shetland

CONSULTANT GENERAL SURGEON

Candidate Information

Pack

April 2021

RECRUITMENT PACK NHS SHETLAND 2

NHS Shetland

Pack Contents

To assist you with your application for the post of Consultant

General Surgeon NHS Shetland, with possible preceding Rural

Surgical Fellowship in Aberdeen, this pack will provide useful

information about the post, about the possible preceding fellowship,

about NHS Shetland and about the region more generally.

Section 1 Welcome from Kirsty Brightwell, Medical Director

Page 3

Section 2 Working for NHS Shetland

Page 4

Section 3 Advert

Page 7

Section 4 Job Description

Page 8

Section 5 Rural Surgical Fellowship Description

Page 14

Section 6 Person Specification

Page 19

Section 7 Terms and Conditions of Service

Page 21

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NHS Shetland

Section 1

Welcome Dear Candidate,

Thank you for your interest in our Consultant Surgeon vacancy based at The Gilbert Bain Rural General Hospital, Shetland. We are looking to work with individuals who understand the needs of small, generalist teams working with the challenges of distance and weather to together provide high quality, person-centred services to the population of Shetland. We understand that having a flexible approach to contracts and supporting people to maintain skills and other interests can create mutually beneficial ways of working. Currently NHS Shetland is recruiting permanent posts in General Practice, Surgery, Medicine and Anaesthetics to create teams in each speciality. This will strengthen current arrangements which are partially dependent on long term locums. We aim to appoint the right individuals to our posts and to achieve this are flexible in the contracts we are prepared to offer to the right candidates. Being remote is also an opportunity and Shetlanders are resourceful and community-spirited. There is a tradition of working together and partnership working with the Scottish Ambulance Service, Primary Care, the local authority and third sector organisations is well-established. Our patients are benefitting from the innovations in IT with more remote consulting locally and with Grampian. The Gilbert Bain Hospital is one of the oldest in Scotland and we are in the process of planning for a new health hub. We have been working with the public and our partners to consider what a building for the next 50 plus years should provide. You will be involved in how we start to meet the changing requirements of our population in preparation to a move to a new site. The balance of diagnostics and definitive care and how we work with our tertiary care centre and ambulance service colleagues are conversations you will help shape. In the meantime our teams provide adult and paediatric surgery both routine and emergency. You would be instrumental to the management and stabilisation of surgical and trauma emergencies. Being a small team means that colleagues will support each other in emergency situations. For the surgeons this particularly means playing a role in Gynaecology and Obstetrics to support single-handed colleagues. You will also need to build networks of support to maintain and improve the quality of care for the diversity of presentations that you will face. We extend a warm welcome to you from Shetland and would love to explore with you how we could support a mutually beneficial relationship to bring you challenge and enjoyment. You can email me at Kirsty.Brightwell2@nhs.scot to organise a discussion about your next steps.

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NHS Shetland

Section 2 Working for NHS Shetland

Who are we? NHS Shetland provides primary and secondary care for the Shetland Islands. The NHS Board determines strategy, allocates resources and provides governance across the health system working in partnership with the Integration Joint Board for Community Health and Adult Social Care services. About NHS Shetland NHS Shetland is the most northerly Health Service in the country and a unique setting in which to provide healthcare services. We are, of course, a small organisation, with around 700 staff looking after the health needs of some 23,000 people spread across 15 islands. However, what we lack in size, we more than make up for by way of the tight-knit, highly professional ethos that characterises every aspect of our operations. Local hospital services are provided from the Gilbert Bain Hospital in Lerwick. In addition, visiting consultants from NHS Grampian provide out-patient clinics as well as in-patient and day-case surgery to supplement the service provided by our locally-based Consultants in General Medicine, General Surgery, Anaesthetics and Psychiatry. There are 10 health centres spread across Shetland, with GPs, Advanced Nurse Practitioners, District Nurses and Practice Nurses providing primary health care. We have a progressive agenda within Shetland and work in partnership, not only with other local stakeholders but with the NHS in Scotland as a whole, and NHS Grampian in particular along with health boards in the North region. Your job, should you care to join us, is to provide surgical services to, and strive to improve the overall health of, the population of this most delightful part of the British Isles. As well as the Gilbert Bain Hospital there are Local Community Services, which are provided via GPs and Community Nurses , Dentists, Pharmacists, Allied Health Professionals and Social Care workers working from one of our ten Health Centres/ or Care Homes and other locations including mobile units and schools. All in all, you’ll find a superb degree of professionalism allied to a practical, resolute approach to the challenges of providing healthcare in a northern island setting. Working at NHS Shetland What’s it like to work in the Health Service in Shetland? Well, the remote and rural nature of our service brings its own challenges, however you can be assured that appropriate facilities and equipment are as good as any you’ll get on the mainland. Moreover, the friendliness and professionalism of your new colleagues will help you to quickly find your feet and feel at home in your new surroundings.

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NHS Shetland

Living in Shetland We cheerfully admit that Shetland is not for everyone – if you want to go on the underground train to a West End Theatre then we’re going to disappoint you – but for those looking for a rural lifestyle and an indisputably higher quality of life then we should be on right at the top of your list. It is a land of many contrasts - rugged hills and flower-strewn meadows; large new houses and traditional crofts; ultramodern ships and small boats which can trace their ancestry back to Viking times. Islands which are distinctly Norse in character yet part of Scotland’s islands with a fascinating heritage and a timeless quality. Watch myriads of seabirds over an ultramarine sea or the breathtaking loveliness of a reflected sunset. Listen to the sigh of the waves or the weird “drumming” of the snipe at dusk. Smell the heady fragrance of massed wildflowers or the evocative tang of peat smoke. Geography 60º North The islands of Shetland lie scattered like the pieces of an elongated puzzle some 93 miles (150 km.) north of the Scottish Mainland. The capital, Lerwick is 211 miles (340 km.) from the Scottish port of Aberdeen and only about 18 miles (29 km) more than this from Bergen in Norway and Torshavn in the Faroe Islands. The 60-degree line of latitude lies across the South Mainland of Shetland, passing through the small island of Mousa with its famous broch. There are over 100 islands ranging in size from the large island of Mainland (351 square miles/909 square kilometres) to the numerous small skerries and islets along the coast. The distance from Sumburgh Head, the most southerly tip of Mainland, to Hermaness at the most northerly tip of Unst, is about 70 miles (113 km). North of Unst, the most northerly inhabited island in the British Isles, lies Muckle Flugga with its lighthouse perched 192ft. (59m) above sea level Fair Isle is 24 miles (39 km) south-west of Sumburgh Head and lies mid-way between Shetland and Orkney. Foula, off the West Mainland, is about 18 miles (29 km) west of Walls.

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NHS Shetland

Travelling to Shetland Shetland lies at the crossroads of the North Sea and the North Atlantic, virtually equidistant from Aberdeen, Bergen in Norway and the Faroe Islands, and there are frequent, efficient air and sea services through Aberdeen. Most major airports and cities in the UK have scheduled flights to Shetland through Aberdeen (50 minute flight), Edinburgh (1hour 20minutes) and Glasgow (1hour 30 minutes). Northlink Ferries currently operate car ferries seven days a week direct from Aberdeen to Shetland on Mondays, Wednesdays and Fridays (via Orkney on Tuesdays, Thursdays, Saturdays and Sundays) in comfortable, well-appointed vessels. There are also connections to Scrabster in Caithness (via Orkney). The ferry journey from Aberdeen to Shetland takes between 12-14 hours, leaving Aberdeen at 1900 hours direct (1700 via Orkney) and arriving in Shetland 0730 hours the following morning. The return journey similarly leaves Lerwick at 1900 hours direct (1730 via Orkney). In the summer an air service connects Bergen with Sumburgh Airport. Links The websites below provide useful information for living and working in Shetland: https://www.shetland.org/ http://www.shetland.gov.uk/

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NHS Shetland

Section 3

Consultant General Surgeon NHS Shetland,

with possible preceding Rural Surgical Fellowship in Aberdeen. We are looking for a General Surgeon to join an established team of three surgeons providing surgical services to a thriving population of 23,000 on the most northerly inhabited islands in the UK. While your surgical training may have restricted you to a narrow field of practice, this post provides opportunity to expand your skills across a number of surgical subspecialties and provide urgent and emergency cover for all surgical specialties presenting to our 52 bed Rural General Hospital in Shetland. Within general surgery, the three surgeons provide services in Upper and lower GI surgery (including OGD and colonoscopy), Emergency Surgery and Breast surgery. Two of the three surgeons provide elective urology services and all three undertake scrotal work and emergency urology. There is now a Consultant led Obstetric and Gynaecological service on the island but the surgeons are still involved in Caesarean sections. All three surgeons undertake a modified range of emergency orthopaedic procedures as well as undertaking minor cold orthopaedics. There is no Consultant in Emergency medicine; trainees in General Practice, Medicine and Surgery cover the department. Surgeons supervise these trainees for any surgical cases from major trauma to minor ENT and eye emergencies. There is also the option of linking the post with a Fellowship in Rural General Surgery based in Aberdeen Royal Infirmary (our main referral hospital), if required to bridge a skills gap. This 0.5 - 2 year NES fellowship could be undertaken prior to taking up the Shetland consultant post, allowing you to expand the knowledge and skills you will require to provide such a broad-based service. Since the Fellow is supernumerary, the training can be made bespoke to individual training needs, in agreement with Shetland colleagues and the different surgical units in Aberdeen. The fellowship and subsequent consultant appointments could be offered at one interview, if agreed by the panel and candidate. This fourth appointment to the surgical team will allow an annualized contract with 10 weeks a year spent outside Shetland for study leave or surgical humanitarian work in LMIC’s

We are looking for motivated individuals to help us achieve our ambitions and welcome applicants at any career stage. If you are excited by the challenges of island surgery and the opportunity to help develop new systems to improve the experience and outcomes for the people of Shetland, then we would love to speak with you. We are open to working flexibly with the right candidates and can offer full-time, part-time or annualised hours contracts. Rise to the challenge and enjoy the opportunity - Shetland is a wonderful place to live and work. Shetland offers low pollution, low crime, excellent schools, great leisure facilities, unique wildlife and amazing scenery, whilst still only a short flight away from the UK mainland. To find out more about living and working in Shetland go to www.shetland.org and learn more about NHS Shetland at www.shb.scot.nhs.uk Informal enquiries regarding the consultant post may be directed to Gordon McFarlane, Consultant Surgeon, Shetland at Gordon.mcfarlane@nhs.scot or Ken Walker, Associate Postgraduate Dean, NES at Kenneth.Walker@nhs.scot regarding the Fellowship component. Closing Date: 16th May 2021 Interview Date: w/c 31st May 2021 Applications via the following Jobtrain website link:- https://apply.jobs.scot.nhs.uk/vacancies.aspx?chkDivision=173 In promoting equal opportunities, we welcome applications from all sections of the community.

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NHS Shetland

JOB DESCRIPTION

CONSULTANT GENERAL SURGEON

Introduction This position is an additional post to the three established Remote and Rural General Surgical posts at Gilbert Bain Hospital, Shetland Islands. An expansion of the current establishment will allow the current post holders along with the additional post holder to participate in voluntary surgical work overseas for 10 weeks per year, while still employed full time by NHS Shetland Board.

Gilbert Bain Hospital The Gilbert Bain Hospital, is the only acute general hospital in Shetland and it serves both the population of approximately 23,000 within the Shetland Health Board area and the 4000 offshore workers in the fishing and oil industries. The hospital is a 3-storey building, opened in 1961, with an extension opened in 1991 and a modern Outpatient department completed in 2008. The bed complement is: Ward 1: Surgical in-patients 22 High Dependency 2 Day Surgery 5 Ward 3: Medical 22 Maternity 5

The Accident and Emergency Department serves not only the islands but also acts as a front-

line station for personnel on marine vessels and offshore installations. A full range of medical and surgical conditions is treated, from minor injuries to major trauma requiring resuscitation, stabilization and aero-medical evacuation to mainland Scotland. It is permanently staffed and has two fully equipped resuscitation bays, a plaster room and three individual cubicles. Medical cover is provided in-hours by a designated surgical junior doctor and junior medical staff, with support from several Advanced Nurse Practitioners and Emergency Nurse Practitioners. At night cover is provided by a junior doctor with medical, surgical, obstetric and anaesthetic consultants available from home. Ward 1 (Surgery) is a mixed-sex ward with 4 single sex bays, two side-rooms and a two-

bedded High Dependency Unit. The surgical consultants share the 22 beds as needs dictate. Staffing levels are appreciably higher than on equivalent mainland wards and allow a thorough and patient-centred approach to surgical nursing. The Day Surgery Unit provides 5 day-case beds staffed by dedicated Day Surgery nurses. There is a fully established pre-assessment service.

Section 4

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The Theatre Suite is spacious, modern and well equipped. It includes two large operating

theatres with adjoining anesthetic rooms. Recent adaptations have been made to allow a red and green pathway for Covid and non-Covid patients. The day surgery unit has been moved to a separate location to make room for a temporary Respiratory Care Unit with negative pressure ventilation. An endoscopy room has been established in the temporary day surgery unit. There is an extensive up-to-date range of surgical equipment including endoscopic and laparoscopic systems that enable the surgeon to undertake most elective and emergency procedures. Instrument sterilization is undertaken within the integral HSDU and is compliant with the recent requirements for hospital sterilization facilities. The Outpatient Department hosts a number of visiting clinics and specialists, as well as clinics

for local consultants. There are a number of procedures undertaken in the OPD, including a regular minor operations list.

The medical unit is based on Ward 3, with 22 beds and adjoining consultant and medical

secretarial offices. The ward environment is mixed sex and consists of 4 single sex bays, 4 side rooms and a 2 bedded area that can be adapted to manage higher dependency or bariatric patients. Support Services. Basic laboratory services are available locally with a full range of services

available in Aberdeen. Radiographers undertake plain film imaging and ultrasound by an ultrasonographer is available in hours. A number of invasive radiological investigations are performed locally on a monthly basis under the supervision of a visiting radiologist. A CT scanner is available with images transferred to a radiologist in Aberdeen or elsewhere for same day reporting. Six doctors working at FY2, or core training level provide surgical support. Currently this consists of one Core Surgical Trainee, one general practice trainee, one Clinical Development Fellow, one LAS post, one FY2 trainee and a Specialty Doctor. Whole and Part time consultant anesthetists provide comprehensive anesthetic and peri-operative care services. Three secretaries will be shared between the four consultants. Standard office facilities include a personal laptop PC with IT support including Internet access, e-mail and electronic shared diary facilities.

Management Structure NHS Shetland is unified Island Board and the Board is responsible for both primary and secondary care services and is accountable directly to the Scottish Executive. Formal medical representation at Board level is through the Medical Director. An Executive Management Team (EMT) provides strategic and organisational direction to both hospital and community care. Primary Care is integrated into the overall structure via the Community Health Partnership. Board philosophy is to involve and integrate senior clinicians into all relevant major aspects of health care management and strategy. The medical Director has an Assistant Medical Director in the hospital and in primary care. Consultant interests are focused into a Consultants Group. The Area Medical Committee, of which all consultants are automatically members is represented on the Area Clinical Forum. The Chair of the Area Clinical forum attends Board Meetings.

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NHS Shetland

Surgical department workload The Gilbert Bain is the most remote of the Rural General Hospitals in Scotland, but enjoys good support from consultants in Grampian. This has allowed the current three general surgeons to maintain a very broad-based general surgical practice, consisting of upper and lower GI surgery (including endoscopic and laparoscopic work), breast surgery, urology (including flexible and rigid cystoscopy, TURP and TUR-BT), orthopaedic trauma (including hip hemiarthroplasty, hip DHS and wiring or plating of commoner fractures), minor cold orthopaedics, very occasional emergency neurosurgery, and all surgical conditions presenting to the Accident and Emergency department including ENT and eye emergencies. There is no Consultant staff in A & E so the post holder would be expected to be attend any major trauma call and lead resuscitation of trauma patients along with the Consultant Anaesthetist. Emergency Obstetrics & Gynaecology is now being covered by O & G consultants but general surgeons are still involved in Caesarean sections in case the Obstetrician has to assist in the resuscitation of the neonate.

A successful applicant might not have expertise in all these areas but might be encouraged by mutual arrangement within the surgical department and with the Medical Director, to broaden their area of expertise by additional training such as a short period of further orientation and specialist training in Aberdeen. A rural Surgical Fellowship based in Aberdeen for six months to two years will be available prior to starting full-time in Shetland (see Rural Fellowship Description below). Regular multi-disciplinary team (MDT) meetings via a video link or Teams take place for breast, colorectal and urological cancer and the surgeons work closely with Aberdeen sub-specialists in other areas such as upper GI cancer. Specialist services in ENT, ophthalmic, and maxillofacial surgery are sustained by visiting consultant surgeons from mainland Scotland. There is a good working relationship between the department and colleagues at Aberdeen Royal Infirmary, run both on informal and formal clinical network lines, and where appropriate this allows the local surgeon to have a significant input into the management of patients traditionally managed in tertiary centres or much larger District General Hospitals (DGHs). While based in Shetland, the post holder would expect to have three sessions in theatre, two general outpatient clinics and one fracture clinic per week. Ward rounds are carried out jointly every weekday morning, along with a review of the previous 24 hours in A & E and an afternoon round undertaken by the on call surgeon for the day. On-call commitment would be one in four with prospective cover, over the whole year and would therefore be 1 in 3 while the post holder is in Shetland. On call is thus more frequent but less intense than that is experienced in a mainland DGH. It is unusual for the consultant to be called into the hospital more than four or five times a week, although telephone advice may be required, and there is rarely the need for emergency operating after 10 o'clock at night.

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Consultant Work Programme A sample weekly timetable of fixed commitments (i.e. regular scheduled NHS activities in accordance with paragraph 30b of the Terms and Conditions of Service) for this post is set out below but will vary every few weeks:

DAY AM PM

Monday Fracture Clinic

Tuesday Theatre Theatre

Wednesday Surgical Outpatients

Thursday Surgical Outpatients

Friday Theatre (half day)

**Joint ward rounds and post-take team meetings take place daily. On-call for out-of-hours emergencies will be roughly equivalent to a 1:3 rota while in Shetland increasing to a 1:2 for short periods only. All fixed commitments are at the Gilbert Bain Hospital. The job plan and work schedule will set out agreed arrangements for how work is organised, when it is performed, and how programmed activities are divided between Direct Clinical Care and Supporting Professional Activities. The job plan is subject to mutual agreement and will initially be reviewed by the Medical Director three months after commencement of employment. In accordance with Section 3 of the Terms and Conditions of Service, the job plan will be reviewed at least annually thereafter.

Principal duties The main duties and responsibilities of the post include:- 1. Provision, with consultant colleagues, of a General Surgical Service to the Health Board:

with responsibility for the prevention, diagnosis and treatment of illness and the proper functioning of the surgical department.

2. Out-of-hours responsibilities on a 1:4 rota with prospective cover to a 1:3, which may occasionally drop to a 1:2 for short periods. Cover of consultant colleagues for periods of absence will be required (in accordance with paragraph 4.10.9/Appendix 3 of Terms and Conditions of Service). This will include cover for the 10 weeks per year for voluntary work overseas, additional study leave, and holidays.

3. Responsibility for the supervision and education of junior staff. It is expected that the

post-holder will devote time to this activity on a regular basis undertaking the required appraisals and assessments as required by the NHS Education for Scotland. In addition the post-holder(s) will be expected to ensure that junior staff have access to advice and counselling and will act as the initial source of advice to such doctors on their careers. There is a requirement to actively participate in the teaching of medical students who attend from Aberdeen and elsewhere on a regular basis.

4. A requirement to undertake other appropriate clinical work on behalf of the Health Board such as domiciliary consultations.

5. A requirement to participate in medical audit and other aspects of clinical governance, continuing medical education, appraisal and revalidation procedures.

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6. A requirement to take part in the activities of various committees an planning groups such as the Clinical Pathways Group and Antimicrobial Committee.

7. A requirement to work with local managers and professional colleagues in the efficient

running of services, and to manage local waiting lists, times and other service delivery targets and guarantees in order to ensure the quality delivery of surgical services.

8. An expectation to share with consultant colleagues in the medical contribution to

management. 9. Subject to the provisions of Terms and Conditions of Service, a requirement to observe

the Board’s agreed Policies and Procedures, drawn up in consultation with the profession on clinical matters, and to follow the standing orders and financial instructions of the Shetland NHS Board; in particular, in formally managing employees of the Board, there is the requirement to follow the local and national employment and personnel policies and procedures.

10. A requirement to make sure that there are adequate arrangements for hospital and other

staff involved in the delivery of medical care to be able to contact the post-holder when on-call, both in and out of working hours. The Board will provide communications equipment as appropriate in order to facilitate this.

11. A requirement to respond positively to appropriate requests for surgical assistance

wherever possible in the event of a major incident. 12. A requirement to comply with Board Health and Safety policies.

Global Citizenship/Voluntary overseas work The appointment includes a Global Citizenship type of commitment with the expectation the post holder would spend 10 weeks of the year in humanitarian type work. Part of this time could be spent in extended study leave, subject to funding. The original Global Citizenship https://www.gov.scot/groups/nhs-scotland-global-citizenship-programme-board/ proposal from the Scottish Government suggests 4 low & middle income countries where a post holder may volunteer and external funding may be available. For other areas of the world the post holder would need to provide or find their own support.

Continuing education and professional development (CEPD) The Board recognises this to be a crucial aspect of the appointment as part of its provision of high-quality health care and responsibility for clinical governance. CEPD is undertaken not only in line with individual Personal Development Plans but also as part of departmental service development. CEPD programmes are encouraged and take full advantage of study leave opportunities. Requests are considered flexibly to allow for the difficulties of off-island travel. In recognition of the potential difficulties of professional isolation the Board also looks favourably on short secondments to other units, especially should they be designed to update clinical skills or to further develop clinical networks. Medical audit is regarded as an integral part of the CEPD package: assistance and guidance in performing medical audit is available from the Clinical Governance team. Regular departmental

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and inter-departmental meetings are in place to capitalise on local expertise and to enhance cross-fertilisation of knowledge, and Microsoft Teams is used for MDT meetings and to access Deanery and Royal College Programs. Inter-disciplinary surgical audit (morbidity and mortality) meetings are currently scheduled every month. Regular service-wide multi-disciplinary clinical governance activities are in place and the surgical team plays an active part in these.

Research Although research is not included as part of the proposed duties of this post the Board will provide active encouragement for the post-holder to pursue any personal research interest, as it would any area of appropriate professional development.

Leave The post-holder will be entitled to 30 days annual leave per year in addition to the 10 public holidays. Study leave of thirty days in any three years is allowed and there is funding available for approved study. Innovative working patterns to accommodate special interests can be discussed within the team following appointment. There is recognition of the complexities of travel to educational events in mainland UK and this is taken into account when study leave is requested. In order to maintain continuity of care and ensure uninterrupted awareness of local constraints to medical management, leave requests resulting in more than one surgical consultant being absent simultaneously will only be granted for short periods.

Locum Arrangements When the full establishment of four consultant surgeons is in place, consultants are expected to provide internal cover for leave absences, including colleagues undertaking voluntary work overseas for 10 weeks per year each. Extended periods of unplanned leave, or extraordinary circumstances might necessitate locum consultant cover, which would be negotiated on an exceptional basis.

Other information a) The post holder’s Responsible Officer is the Medical Director of NHS Shetland. The post

holder is expected to fully comply with Appraisal and Revalidation and any other statutory requirements.

b) The post holder will be indemnified by NHS Shetland and under an honorary contract arrangement but is still advised to hold membership of an appropriate Medical Defence Organisation.

c) There is a restriction on residence: this should be no more than 10 miles by road from the Gilbert Bain Hospital unless the Board grants an exemption.

d) The post is classed as exposure prone and a certificate of immunity against Hepatitis “B” is required.

c) Written evidence of full registration as a Medical Practitioner with the General Medical Council must be produced as well as evidence of admission to the Specialist Register.

d) Proof of identity and evidence that you are entitled to live and work in the United Kingdom must be supplied.

e) The appointment will be subject to the Terms and Conditions of Service for Consultant Grade (Scotland) and the General Whitley Council. A Terms and Conditions statement is attached.

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Section 5

THE RURAL SURGICAL FELLOWSHIP

This is a peri or post CCT Fellowship in Rural General Surgery for 6 months to maximum two

years, funded by NHS Education for Scotland. It is designed to allow surgeons who have

completed or are near completion of their Specialty Registration in General Surgery, to gain

appropriate knowledge and skills to practice in a Rural General Hospital in the North of Scotland

(Orkney, Shetland, Caithness, Elgin, Western Isles, Fort William or Oban). It would also be

suitable for general surgeons considering practising in a rural hospital or in humanitarian relief

work in other parts of the world.

During the fellowship there would be opportunity to acquire the necessary skills to deal with

common emergencies and more minor procedures in Urology, Trauma and Orthopaedics,

Gynaecology and Obstetrics, ENT, Ophthalmology and Neurosurgery.

The fellowship would be based in Aberdeen (there is an Inverness-based fellowship also). It

would normally include 6 to 12 weeks in one or more rural general hospital, the rest of the time

being spent in modular training in other specialties, as determined by a mutually agreed

schedule tailored to the individual fellow’s training needs. Being supernumerary in host

departments means the content of the fellowship can be bespoke. Where a trainee has already

been appointed on a proleptic basis to a consultant post in a Rural Unit, with the fellowship

beforehand, training will be tailored to the expected activity within that unit.

Where longer modules (more than 2 months) are undertaken, in Urology or Orthopaedics for

example, there will be opportunities to participate in emergency services in-hours and there

may be opportunities to join middle grade on call rotas. General Surgery on call, if desired or

appropriate for the trainee, could be considered on a locum basis where it did not interfere with

training opportunities within the module(s) undertaken at the time, (e.g. by limiting to weekends)

and could be on middle grade or consultant rota by mutual agreement.

It may be efficient to undertake various subspecialty components in parallel, for example

attending T&O trauma meetings or obstetric theatre lists while remaining based in a General

Surgery unit.

Rural Surgical Fellowship, North of Scotland Aberdeen-based version, 2021

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Administration of the programme and trainee assessment would be under the auspices of the

North of Scotland Specialty Training Programme in General Surgery, and there will be

requirements for workplace-based assessments. An educational Supervisor will be assigned,

and there will be multiple Clinical Supervisors.

Amongst the essential criteria on the person specification are that applicants must be

Existing NTN holders in General Surgery from anywhere in the UK who are within 2 years

of their CCT date and hold the Intercollegiate Examination in General Surgery by the

time of taking up post

Existing CCT holders in General Surgery who have been in regular practice in General

Surgery within the last 18 months and are on the Specialist Register (UK) for General

Surgery

Trained Specialists in General Surgery who have had their application processed and

are completing final requirements for entry to the GMC Specialist Register by virtue of

European certification or Article 14.

This post is linked to a proleptic appointment to Shetland and advertised jointly. In that case

there would usually be a meeting with any shortlisted candidate prior to interview, to discuss

the specific training needs and how a fellowship could meet them, and to produce a brief report

on that for a subsequent combined (Health Board and Deanery) interview panel.

Informal enquiries may be directed to:-

Prof Kenneth Walker, Consultant Colorectal Surgeon and Associate Postgraduate Dean,

Inverness. kenneth.walker@nhs.scot

Mr Gordon McFarlane, Consultant General Surgeon, Gilbert Bain Hospital Shetland.

Gordon.McFarlane@nhs.scot

POSSIBLE PARTICIPATING HOSPITALS

1. NHS GRAMPIAN a. ABERDEEN ROYAL INFIRMARY b. DR GRAY’S HOSPITAL, ELGIN c. STRACATHRO HOSPITAL

2. NHS SHETLAND a. GILBERT BAIN HOSPITAL, LERWICK

3. NHS ORKNEY a. BALFOUR HOSPITAL, KIRKWALL

4. NHS HIGHLAND* a. RAIGMORE HOSPITAL b. CAITHNESS GENERAL HOSPITAL, WICK c. BELFORD HOSPITAL, FORT WILLIAM d. LORNE & ISLES HOSPITAL, OBAN

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5. NHS WESTERN ISLES* a. WESTERN ISLES HOSPITAL, STORNOWAY

6. OTHER CENTRES IN SCOTLAND MAY PARTICIPATE IF NECESSARY FOR CERTAIN SPECIALTIES, eg EDINBURGH, GLASGOW.

*NHS Highland and NHS Western Isles will more commonly host the Inverness-based fellows, but could be approached for a placement if necessary.

1.NHS GRAMPIAN

NHS Grampian provides medical services for the half-million people who live in the region. It consists of acute services, corporate services and three Community Health Partnerships and works closely with the local authorities. NHS Grampian is also very closely linked with both the University of Aberdeen and The Robert Gordon University, especially in the fields of research, workforce planning and training.

Aberdeen Royal Infirmary (ARI), is the principal adult acute teaching hospital in Grampian.

Situated on a large open site to the North-West of the city centre, it provides a complete range of specialties. The Royal Aberdeen Children's Hospital and the Aberdeen Maternity Hospital are also located on this site.

The University of Aberdeen

The University of Aberdeen is a fusion of two ancient universities: Kings College founded in 1495 and Marischal College which dates from 1592. The University maintains an outstanding record in scholarship and supports a high level of teaching and learning underpinned by a first class portfolio of research programmes and currently has 10,000 matriculated students. The Suttie Centre is a state of the art purpose built clinical skills and postgraduate centre on the Foresterhill site and opened in September 2009.

The Institute of Medical Sciences is adjacent to the University Medical School on the Foresterhill site and this brings together medical scientists and clinicians in a fully integrated research facility.

The Institute has the mission to become an acknowledged centre of excellence in Medical Science Research. The University believes this can only be achieved by the optimal integration of both medical and scientific research.

Robert Gordon University (RGU)

The Robert Gordon University has earned wide recognition for its pragmatic approach to higher education both in Scotland and internationally. For generations it has produced qualified professionals across a broad spectrum of careers in the arts, management, engineering, sciences, pharmacy, health and the professions allied to medicine.

Around 5,800 students study almost 100 full-time and part-time courses at undergraduate, post-experience and postgraduate levels. The University is actively involved in applied research in a variety of fields and many short course programmes are being formulated to meet the growing needs of the community.

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Aberdeen

With a population of approximately 250,000, the city of Aberdeen stands between the Rivers Dee and Don. This historic city has many architectural splendours and the use of the sparkling local granite has earned Aberdeen the name of the ‘Silver City’. Aberdeen is recognised as the oil capital of Europe but nevertheless retains its old-fashioned charm and character, making it an attractive place to live.

Aberdeen enjoys excellent communication services with other British cities - flying time to London is just over one hour with regular daily flights, and road and rail links to all points North and South are excellent. There is a wide choice of high quality housing available within easy commuting distance. Well known for its superb quality of life, Aberdeen enjoys first class amenities including His Majesty's Theatre, Music Hall, Art Gallery, Museums and Beach Leisure centre. Education facilities are excellent and in addition to Regional Education Authority schools, there are two fee-paying schools for girls and one co-educational college. All three cater for primary and secondary pupils.

General Surgery Department

The General Surgery department is a large and expanding department. ARI has two state of the art integrated operating theatres and General Surgery has received approximately 50% of this additional capacity. There are two surgical robots in the theatre suite and we are currently developing the colorectal robotic programme. The department has an active interest in clinical research. Both clinical and basic science research is conducted in the department in collaboration with the University of Aberdeen and Robert Gordon University.

The Fellowship is primarily based in Aberdeen Royal Infirmary with the opportunity to undertake sessions based at Dr. Gray’s Hospital (DGH) or Stracathro Hospital (day case lists only). DGH is a busy District General Hospital in Elgin. Additional operating lists and endoscopy lists may be available at this site.

The General Surgery department deals with 100-120 emergency admissions per week. The elective activity demand is such that 300-400 patients are added to the inpatient waiting list every month. There are 18 WTE General Surgical Consultants. ARI is a designated Major Trauma Centre and the General Surgeons are a part of the Major Trauma Team.

Yellow Team – HPB/ Endocrine

Prof I Ahmed, Mr B Alkari, Mr M Habib, Mr J Milburn, Mr S Aspinall, Mr Ghazanfar and Mr P King (4 sessions)

Purple Team - Colorectal

Mr E Aly, Ms A McKinley, Mr C Parnaby, Miss L Stevenson, Miss S Shaikh, Mr G Ramsay, Mr C MacKay, Mr J On (June 2021), Mr T O’Kelly (6 sessions), Mr Y Kholeif (locum)

Red Team - UGI/ Bariatric

Mr A Qadir, Prof D Bruce (2 sessions), Mr S Nanthakumaran, Mr M Kumar, Ms N Ross, Mr P Mekhail

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NHS Shetland

The junior medical staff includes 2-3 STRs, 2 Core Surgical Trainees, an FY2 doctor and 5 FY1 doctors per unit. The department has permanent Physicians Associate (PA) staff and PA students rotate through the Department. There is funding for 4 senior Clinical Fellows.

There are also fully staffed Vascular and Breast Units in ARI, and the Royal Aberdeen Children’s Hospital Is on site at Foresterhill.

General Surgery has 82 beds in the Core Unit of which 67 are open at present (Ward 206 and 207), 42 of which are on the emergency admissions ward (Ward 208). This is situated beside the Surgical Ambulatory Care emergency clinic. In addition there are 18 integrated Surgical HDU beds, which are close to the Core Unit (Ward 217). General Surgery shares access to the Short Stay Unit beds with the other surgical specialties, and on average uses 8 beds per day.

Quality Improvement / Morbidity & Mortality meetings are held weekly, with the day rotating each term. There are monthly ½ day CPD sessions, when elective activity is cancelled to allow attendance. The dates of these vary within the 4-week cycle so that the same clinical session is not always disrupted. The relevant MDT day will vary depending on the relevant specialty.

NHS Grampian aims to maintain the tradition of clinical excellence. It encourages clinical staff to work in an environment where people are looking to innovate and are aware of, and contribute to, developments within their specialties and are excited by the prospect of involvement in the exchange of ideas within the national and international research community. NHS Grampian’s Research and Development Strategy has been developed to prioritise and stimulate research and development within the organisation’s fields of interest, complementing the research strategies of the Universities and Research Institutes in the area. The Research and Development Directorate exists to support and facilitate research within NHS Grampian.

General Surgery has an active research programme that draws on the excellent clinical and basic science facilities within the hospital and the University of Aberdeen. There are active collaborations with several clinical and basic science departments within the University.

All surgical specialties are present on site in ARI, apart from transplantations surgery. Fellowship opportunities are available to the Fellow as required in all relevant specialties.

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NHS Shetland

PERSON SPECIFICATION Post Title: Consultant Surgeon

FACTOR

ESSENTIAL

DESIRABLE

EXPERIENCE

Application of contemporary practice techniques in Elective and Emergency General Surgery. Upper and lower GI endoscopy/ colonoscopy experience Clinical audit / clinical governance experience.

Orthopaedic Trauma Urology Emergency Obstetric procedures Eye and ENT: minor emergencies Post CCST clinical experience within NHS Experience of Remote & Rural surgery. Teaching experience. Experience of Managed Clinical Networks

QUALIFICATIONS TRAINING RESEARCH PUBLICATIONS

FRCS or equivalent. Existing NTN holders in General Surgery from anywhere in the UK who are within 1 year of their CCT date and hold the Intercollegiate Examination in General Surgery. Existing CCT holders in General Surgery who have been in regular practice in General Surgery within the last 18 months and are on the Specialist Register (UK) for general Surgery.

Evidence of recent research and/or publications CrISP course ATLS or ETC Evidence of teaching and training experience with relevant qualifications or certificates Registration with the GMC as a trainer.

KNOWLEDGE AND SKILLS

Broad knowledge of unselected surgical presentation and diagnosis. Upper and lower GI endoscopy/ colonoscopy The skills to care for surgical patients in Shetland independently and, when necessary to co-ordinate care with local, visiting and mainland colleagues. Demonstrable teaching ability

Orthopaedic Trauma: non-operative treatment of common fractures, K-wiring of selected fractures and operative treatment of hip and ankle fractures. Urology: office urology and immediate emergency care. Emergency Caesarean section. Craniotomy for extradural haemorrhage Eye and ENT: removal FB from eyes, ear and throat, nose packing for epistaxis, tracheotomy

DISPOSITION

Service orientated. Good communication and interpersonal skills with patients, relatives, medical and nursing colleagues. Committed to training and CPD. Commitment to acquire desirable surgical subspeciality experience and skills, with appropriate support, when appointed.

Able to work in local multidisciplinary team Able to work in multi-centre team (Multi-centre Managed Clinical Network, often over video-link)

OTHER

Eligible to work in the UK Current valid driving licence Proof of Immunity against Hepatitis B.

Section 6

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NHS Shetland

HOW TO APPLY AND TO ARRANGE INFORMAL VISITS External Applicants: i.e. if you are NOT currently an NHS Shetland employee or registered on

our Bank, you must apply via the following website link:- https://apply.jobs.scot.nhs.uk/vacancies.aspx?chkDivision=173

……………………………………………………………………………… If you require assistance with your application, please contact the HR office on 01595 743694. Applications should be submitted via the above method by the closing date of 16th May 2021 Informal enquiries regarding the consultant post may be directed to Gordon McFarlane, Consultant Surgeon, Shetland at Gordon.mcfarlane@nhs.scot or Ken Walker, Associate Postgraduate Dean, NES at Kenneth.Walker@nhs.scot regarding the Fellowship component. Informal visits can be arranged as part of the interview process, following short listing. More information about living and working in Shetland (including transport links to mainland Scotland) can be found on the Visit Shetland website on www.shetland.org Thank you for your interest. The Board hope that you will agree with them that the challenges and rewards of this position and life and work in Shetland are worth exploring further and we look forward to receiving your application.

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NHS Shetland

TERMS & CONDITIONS OF SERVICE – CONSULTANT SURGEON

The appointment will be subject to the Terms and Conditions of Service for Consultant Grade (Scotland) and the General Whitley Council.

Location:

Gilbert Bain Hospital (but you may be required to travel to other locations)

Hours of Work:

10 programmed activities (9 DCC: 1SPA) (2 EPAs are available by negotiation). 1:4-1:3 on call rota

Salary:

Salary Range £84,984 - £112,925 per annum, pro rata for part time posts and based on seniority. This post attracts an 8% availability supplement. In addition to salary, all posts qualify for a Distant Islands Allowance of £1,895 per annum (pro rata for part-time and fixed term positions)

Tenure:

Permanent

Notice Period:

3 months from either party

Annual Leave:

30 days per annum

Public Holidays:

10 statutory public holidays each year

No Smoking:

Smoking is not permitted on any Board premises, with the exception of patients detained under the Mental Health Act

Confidentiality:

All information regarding patients, staff personal information that employees may learn in the course of their duties must be treated as confidential. Unauthorised disclosure may lead to disciplinary action.

Pension:

The appointment is superannuable under the NHS (Scotland) Superannuation Scheme unless the post- holder opts out in favour of another scheme or is ineligible to join.

Relocation:

This post is eligible for removal expenses and benefits in accordance with the Board’s Relocation Procedures. There is a maximum of £8,000 related to any relocation package

Health Screening:

All offers of appointment are subject to an Occupational Health screening undertaken by the Board’s in-house service. Candidates invited for interview will be provided with a medical questionnaire for completion and may be asked to have a medical examination. The post is exposure prone and evidence of immunity to Hepatitis ‘B’is required.

Section 7

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NHS Shetland

NHS Shetland Upper Floor Montfield Burgh Road Lerwick ZE1 0LA Telephone: (01595) 743060