MORECAMBE BAY HOSPITALS ACUTE NHS TRUST

 

JOB DESCRIPTION

 

Associate Specialist  IN ACCIDENT AND EMERGENCY

 

 

FULL-TIME            plus 1 session. Total 12 sessions

 

BASE                    The Royal Lancaster Infirmary

 

 

THE LOCATION

 

Lancaster is a University city close to the Lake District, the Yorkshire Dales and Morecambe Bay. This is an area of great natural beauty and offers exceptional outdoor facilities.

                  

The University provides both cultural and sporting facilities. The local educational facilities are excellent. The M6 makes travelling by road very easy. Manchester is one hour's drive away and London three hours by train.

                                              

 

THE HOSPITAL

 

This 495-bedded hospital has all major specialties on site, including Coronary Care, Intensive Care and a 24 hour CT scan service. The Centenary Building opened in 1996, providing new Surgical, ITU and theatre facilities, so that all specialities are on the same hospital site. New MR- and spiral CT-scanners were commissioned in summer 2001.

                                              

Regional Services

 

The specialties of Neurosurgery and Plastic surgery are based at the Royal Preston Hospital, although outpatient sessions    are held locally.  Emergency Cardio-thoracic Surgery is based at Blackpool Victoria Hospital.

 

 

 

 

 

 

 

 

 

 

THE ACCIDENT  AND EMERGENCY DEPARTMENT

 

 

Accident and Emergency Department - Royal Lancaster Infirmary

 

This unit sees 41,000 new patients a year with a seasonal variation.

 

The Centenary Building, which opened in January 1996, includes a purpose built Accident and Emergency department. In addition to the usual facilities it has an overhead X-ray gantry in the Resuscitation Room and a designated eye room with slit lamp.  There is no short stay ward.

 

The department is equipped to receive patients who are critically injured from the South Lakes area as well as the Lancaster District. There is 24 hr Reception cover.

 

There are 3 stretcher bays in the resuscitation room and 10 cubicles in the main A&E area. There is one A&E theatre used for suturing and sedative procedures.  There is a designated decontamination room.

 

There is a separate waiting area for children and a designated children's treatment room.

 

There are two Review Clinics per week held in the adjacent orthopaedic out patient department. The department staffs daily Dressing Clinics in A&E.

 

Equipment in the department includes:

 

4 Propaq Monitors (incl. Pulse Oximetry, E.C.G. & non-invasive B.P. / 1 invasive B.P.)

2 Propaq monitors with end tidal CO2,

1 Transpac Ventilator

2 defibrillators including external pacing facility

Carbon Monoxide breathalyser

Wall mounted ophthalmoscopes and auroscopes in cubicles 

 

There is a Modem/Computer link via the NHS net to the Edinburgh Poisons Unit.

 

A Web Page for the department has been developed, visit the site at

 

http://www.baem.org.uk/aedepartment.htm

The department was a pilot site for the Regional ACT Medisys Unix Computer Software which has been operational since July 1992. The development of this system has improved the capability to audit both nursing and medical activity. Initial Assessment by a nurse is performed within 15 minutes in 96% of new patients and a doctor sees over 50% of new patients within 30 minutes.

As well as co-operating in Regional Audit studies the department is also involved in the UK TARN trauma study.

 

 

 

Minor Injury Unit - Westmorland General Hospital  Kendal

 

This unit sees 19,000 new patients a year. Four full time staff grades and Nurse Practitioners staff it. Between midnight and 0800 am the unit is staffed by a nurse practitioner with a G.P. on-call.

 

There is an X ray link between all 3 Trust A&E sites.

 

This 242-bedded hospital takes acute medical admissions and there is a CCU. Surgery is limited to elective work. There is no resident anaesthetist and no in patient paediatrics.

 

In view of the above the Cumbria Ambulance service is supplied with a protocol to limit the range of ambulance cases presenting to the unit. Major Trauma is diverted to the main unit at Lancaster.

 

 

TEACHING AT LANCASTER

 

There are 12 formal all Wednesday teaching days for SHOs at the start of the posts. Thus this is equal to one session a week over the whole 6-month post. Later sessions are designated for Audit.

 

S.H.O.s are encouraged to attend the Regional A&E induction weekend course at Bolton and the Soft Tissue Injury Course at Oldham.

 

Nursing Staff are taught to suture, cannulate and plaster in the department and there are daily afternoon teaching sessions.

 

There is a departmental book and video library. CD-ROMs are accessed via the departmental computer.

 

From 2005 the department will have a regular attachment of 6 to 8 final year Liverpool medical students. These attachments will last 8 weeks throughout their final year.

 

There is a very active Education Centre adjacent to the Royal Lancaster Infirmary where regular meetings are held. The Post-Graduate Medical Centre also houses an excellent library. The present tutor is Dr D.Burch.

 

 

 

 

 

 

RESEARCH AND CONTINUING PROFESSIONAL DEVELOPMENT

 

The department has a proven track record of published clinical research (see Web Site).  Research activities are led by the A&E Consultants. The previous  post-holders have been actively involved in research in the department with published papers.

 

The successful applicant will be encouraged to attain instructor status in an Advanced Life Support Course (ATLS, APLS) and be expected to have up to date Provider Status in these two courses.  Local courses are held in Westmorland General Hospital, Kendal.

 

A post-graduate qualification is essential.

 

The directorate will support the continuing professional development of the successful applicant with approved study leave and there is also one session allocated per week for CPD and audit.

 

 

MANAGEMENT

 

A Directorate structure was introduced into the hospital in 1992. The Directorate of A&E Medicine consists of the A&E departments at Barrow and Lancaster and the Minor Injury Unit at Kendal.

 

The A&E departments have control of separate A&E budgets.

 

Clinical Director                             -        Dr. Ray McGlone

 

Directorate Manager                     -        Ms. Cathy Tite

 

Assistant Directorate Manager    -        Ms. Lisa Reynolds

 

There is a weekly Thursday morning departmental meeting at Lancaster and a monthly Thursday afternoon Cross Bay Directorate meeting.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

STAFFING

 

Medical Staff

         

Consultant                                             Dr. R. McGlone

Consultant                                             South African Rotation

Consultant                                             Dr.S.Schneidman

Consultant                                             Dr A Webster

Staff Grade                                             Dr.Sivakumar

Staff Grade                                             Dr.T.Fleet

Registrar                                                 SpR Manchester rotation

Registrar                                                 SpR Manchester rotation

Registrar                                                 SpR Cape Town

 

Clinical Assistant                                  2 sessions to cover teaching / audit on Thursdays and 1 session Monday evening

 

Senior House Officers                         6

Foundation Year 2                                1

 

Two S.H.O.s are on a G.P. vocational scheme and two on the Basic Surgical Training Scheme.

 

 

Nurses 

 

1  H Grade – Sr.Sally Young,

 

2 G Grade Nurses, 8 F Grade, 8.1 E Grade Nurses and  11.49 (WTE) D Grade Nurses.

 

This Nursing compliment includes plaster nurses / technicians.

 

Total 32 W.T.E.

 

 

Non-Clinical Staff

 

1 Full time Secretary, 1 Part-time Ward Clerk and 9 (WTE) Receptionists (including 1 "Scale 4" Senior Receptionist). The Reception Staff also have responsibility for the orthopaedic outpatients.

 

 

 

 

 

 

 

PARAMEDICS AND FLYING SQUAD

 

A new "Flying Squad" vehicle is stationed outside the department available to attend serious trauma, primarily for patients trapped in vehicles. Either the A&E Consultant or a Consultant Anaesthetist (I.T.U.) is the team leader of the Flying Squad.

 

Cumbria paramedics and local Lancashire crews have mobile phones and notify the department for stand by cases on a designated wall phone in A&E.

 

Ambulance Paramedics from Cumbria / Lancashire attend the department regularly for training purposes and the successful candidate may be involved in this.

 

All splints in the department are standardised with equipment on the Ambulances such as cervical collars, traction and vacuum splints. The A&E Consultants are on the Paramedic Advisory Committees for Lancashire and Cumbria.

 

 

 


THE POST

 

Responsibilities include assessing and treating patients arriving with minor injuries, major injuries and medical problems. These patients include those referred from GPs and those who refer themselves.  Treatment will include initial assessment, resuscitation and diagnosis and referral to other specialties when appropriate.

 

The Associate Specialist is expected to see new patients alongside the S.H.O.s when scheduled to work in the department on clinical sessions.

 

In case of major trauma the Associate Specialist may take the roll of Trauma Team Leader.

 

The successful candidate would be expected to perform administrative tasks e.g. checking positive X-rays results on patients with no follow up arranged, checking all blood, biochemistry and MSU results on discharged patients and assist in liaison with groups such as General Practitioners and the Ambulance Service.

 

He/she would be expected to assist with the teaching of the nurses, medical students and the junior medical staff.  He/she may also be required to help run the Review Clinic.

 

The Senior House Officers receive teaching from 09.30 – 16.00 hours on Wednesday and it is expected that the Associate Specialist will provide cover for the department during this teaching session as well as leading some tutorials. When no Wednesday teaching takes place Week 2: 0900-1700 may be transferred to Monday pm / evening.

 

The appointment will be for 12 sessions (1 session for audit/teaching/CPD and 2 sessions for on-call / anti-social hours). On call is one night a week and 1 in 4 weekends (Sat/Sun). Clinical duties will rotate between weeks 1 and 2 on the rota. (see below)

 

One audit or research study must be completed in every 6-month cycle. This may include acting as a facilitator for SHO audit projects.

 

The successful candidate will have a named Consultant mentor and there will be a yearly appraisal process.

 

Patient Activity – a minimum number of 2200 points p.a. (new patients discharged = 1 point and admissions = 3 points)

 

The clinical duties include working 4 flexibly worked clinical sessions at weekends on a 1 in 4 basis. The two Associate Specialist doctors will work day  shifts then late shifts alternate weekends when on duty. Holiday entitlement equals 6 weeks (or 30 working days) plus two days and 8 Bank Holidays. Normally working weekends may not be booked as holiday.  Holidays should be booked at least 6 weeks in advance.

 

When covering the absence of a colleague (associate specialist) the Monday and Thursday sessions will be 1800-0200 with no on-call. Then the next day the shift will be Tuesday 1100-1700 and Friday  1100-1800.

 

The successful candidate accepts that he/she will occasionally be asked to perform duties at short notice if a crisis occurs.

 

 

 

ROTA

 

 

 

Monday

 

Tuesday

Wednesday

Thursday

Friday

Sat

Sun

Week 1

1800-0200 +on call

OFF

0900-1700

1300-2100

0830-1700

1800-0200

1 in 8

1800-0200

1 in 8

Week 2

CPD / AUDIT

But OFF after late weekend sessions

0900-1700

0900-1700

1800-0200 + on call

OFF

0900-1700

1 in 8

0900-1700

1 in 8

 

 

 

Main Conditions of Service

 

1.      The post is offered on a whole time basis and covered by the Terms and Conditions of Service for Hospital Medical and Dental Staff (England and Wales) as amended from time to time.

 

2.      Written evidence of current registration with the General Medical Council.

 

3.      Health Clearance

 

The successful candidate will be required to complete a health questionnaire and undergo a pre-employment medical examination before commencing employment with the Trust.

 

4.      Rehabilitation of Offenders Act 1974

 

The post that you have applied for is exempt from the Rehabilitation of Offenders Act 1974. This is because the job is concerned with the provision of health services, which involves access to patients.  You must therefore declare any previous convictions, ‘spent’ or otherwise.  Should you be employed and a failure to disclose a conviction / police caution be discovered, you could be liable to summary dismissal or other disciplinary action.  In addition, successful candidates whose posts involve access to children are required to undergo a police check as a condition of employment.  “If in doubt declare it”.

 

5.      Authorised to live and work in the United Kingdom.

 

Start Date: Summer 2005

 

 

VISITS      Arrangements to visit the hospital may be made with:

                  

                   The Secretary

                   Accident & Emergency Department

                   Royal Lancaster Infirmary

                   Ashton Road

                   Lancaster

                   LA1 4RP

                   Tel:  01524-583004/2

 

To discuss the Job Description further please contact the Clinical Director, Dr.Ray McGlone on 01524 583516 or BT Bleep 07693 941009

 

 

 

                   Visit our Web Site on: http://www.baem.org.uk/aedepartment.htm