Specialty Doctor in Anaesthetics and Critical Care

Job responsibilities

The Department of Anaesthesia and Critical Care Medicine

We currently have 27 substantive Consultant Anaesthetists, 17 Specialty Doctors and two Associate Specialists. The trainee establishment consists of eight core trainees, together with four intermediate and higher-level 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.

Non-consultant colleagues are represented in senior roles in our department and very much valued for their clinical and non-clinical experience and capabilities. Specialty doctors occupy senior roles within our department with colleagues currently working as Associated Medical Director, Trust appraisers, LNC deputy chair and undertaking the departmental lead role for clinical effectiveness and audit as examples.

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 President of the British Association of Day Surgery (BADS).

We have an excellent regional anaesthesia service with higher and advanced training modules and a 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. Many colleagues take advantage of this expertise to participate in research.

Obstetric Anaesthesia and Analgesia

Rotherham has a busy obstetric unit. In 2018 there were approx. 3000 deliveries. Fifteen sessions per week are currently covered by seven Consultant Anaesthetists and senior SAS colleagues with dedicated consultant cover until 9pm in the evenings. Out of hours, cover is provided by the resident doctor on-call as part of the team with consultant cover. 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 lead by an anaesthetic consultant colleague. 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 specialties available at the Trust, as well as critical care medicine. All colleagues 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 trainee 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 <1 pre-COVID 19.

There are currently 5 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 / Emergency Care Department are in close proximity.

Relationships with other Departments:

The Department serves all the major specialties appropriate to a District General Hospital, with the exception of plastic surgery, vascular surgery, cardiac, specialised paediatric and neurosurgery.

Accommodation

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

Clinical Governance

The anaesthetic department also holds regular audit meetings (up to six meetings per annum). These include combined meetings with surgical specialties, 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 (eg) ODPs and management.

Out-of-hours emergency service

The emergency on-call anaesthetic team consists of:

• One CT 1/2 who provides anaesthetic cover for the acute surgical specialties
• One ST3+/fellow whose duties include the provision of medical cover for the ICU or labour ward as well as supporting the CT1/2 anaesthetist.
• One SAS doctor covering Labour Ward or ITU overnight working with the ST3+/fellow. This role is fulfilled by two consultant colleagues intermittently too.
• One Consultant general anaesthetist on call with responsibility for theatres and obstetrics at the weekend.
• One Consultant Intensivist is on call on weekend days and at the weekend (0800-2100) in addition to the Consultant General Anaesthetist

Detailed Job Description

The successful candidates will share responsibilities within the department of Anaesthesia and Critical Care Medicine. The successful candidate will be required to provide 8.5 PA per week of clinical activity arranged as day time and out of hours working and 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 2130 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 aim is to separate out the ITU and General rotas in time. There are currently eight Consultant Intensivists who are also 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. Some theatre lists may be all day lists.

Specialty doctors provide out of hours cover as part of a mixed rota made up of other SAS colleagues, ST trainees, senior clinical fellows and consultant colleagues. There are three resident doctors overnight, a successful applicant would be one of these, covering theatres, labour ward and ITU as a team with a consultant on call from home. At the weekend there is a larger team in the day to cover dedicated ITU consultant ward rounds and trauma and similar cover at night. More detail on working patterns is provided in section 5.

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.

Teaching and Training

The appointee is expected to participate in informal theatre based teaching and training of junior staff, medical students and other clinical staff groups.

Please see job pack for further information.

Research and Audit

Essential

• Trained in research methodology. Committed to evidence-based practice.
• Evidence of audit and the implementation of change following the audit

Desirable

• Relevant research published in peer review journal

Clinical Skills

Essential

• Acute care: up to date ALS. Out of hours experience relevant to the job.
• Relevant specialty clinical knowledge: capacity to apply sound clinical knowledge relevant to the job, specialty knowledge exam.
• Clinical judgement: experience in making clinical decisions and managing risk. Knows when to seek help, able to prioritise clinical need.
• Practical skills: shows aptitude for practical skills required in the job.
• Proven ability to work effectively in obstetrics and/or critical care.

Experience

Essential

• A demonstrable amount of experience in anaesthesia commensurate with basic anaesthetic training
• Eligibility to work in the UK

Qualifications

Essential

• MBChB or equivalent
• Full registration and a licence to practise with the GMC
• Evidence of basic level anaesthetic competencies or evidence that they will have these at the time of taking up the post.
• Please enter your GMC number

Desirable

• Higher Medical Degree
• Primary or Final FRCA or FFICM

Education and Teaching

Essential

• Demonstrates a commitment to the delivery of high-quality teaching and training to junior colleagues and multidisciplinary team

Desirable

• A qualification in teaching or instructor status relevant to anaesthesia e.g. ATLS, APLS

Other

Essential

• Demonstrate innovation and problem solving abilities
• Clear, fluent and articulate in verbal and written presentation

Desirable

• IT Skills

Management Skills

Essential

• Demonstrate effective team working skills
• Time management/organisational ability. An example may be they have developed and run training programmes.
• Proven knowledge of systems and process of NHS or equivalent
• Sense of understanding and commitment to corporate responsibility
• An understanding of and ability to demonstrate your ability to: Empower others, Lead through change, Influence strategically, Collaborative working, Drive for improvement, Integrity

Desirable

• Ability to consolidate and organise change.
• Knowledge of the implementation of Clinical Governance within the directorate.
• Familiarity with issues of service

Disclosure and Barring Service Check

This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.

Certificate of Sponsorship

Applications from job seekers who require current Skilled worker sponsorship to work in the UK are welcome and will be considered alongside all other applications. For further information visit the UK Visas and Immigration website (Opens in a new tab).

From 6 April 2017, skilled worker applicants, applying for entry clearance into the UK, have had to present a criminal record certificate from each country they have resided continuously or cumulatively for 12 months or more in the past 10 years. Adult dependants (over 18 years old) are also subject to this requirement. Guidance can be found here Criminal records checks for overseas applicants (Opens in a new tab).

UK Registration

Applicants must have current UK professional registration. For further information please see NHS Careers website (opens in a new window).