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					THE WHITTINGTON HOSPITAL NHS TRUST


      SURGICAL DIRECTORATE


         JOB DESCRIPTION




   Staff Grade in Anaesthesia




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             THE CLINICAL DIRECTORATE OF SURGERY
              THE WHITTINGTON HOSPITAL NHS TRUST

                         Staff Grade in Anaesthesia

1. SUMMARY

This is a replacement post in the department that came up due to the relocation
abroad of the existing post holder.

The post holder will join a well-structured department that is renowned for
providing high quality training and education for junior staff and a professional
service to patients. The post holder will be required to contribute fully to the
ongoing activities and development of the department, including active
participation in weekly educational, clinical governance and audit meetings.

The successful candidate will be involved in a wide range of elective and
emergency anaesthetic activities and will contribute to the on-call rota for general
anaesthetics and obstetrics. The on-call commitment is a 1:5 shift system (with
external cover).

Ideally the candidate will have the FRCA or equivalent, but this is not mandatory.
Should the candidate be attempting the fellowship exams, every support from the
consultant staff can be expected.


2. THE DEPARTMENT

The Department provides comprehensive services for the following areas:

Inpatient and Day Surgery

There are 180 inpatient surgical beds including a 5-day ward. Four theatres are
used for elective and emergency in-patient surgery covering general and vascular
surgery, orthopaedics, gynaecology and urology lists.

Additionally, the Day Surgery Unit has two theatres in the main complex with
separate ward and recovery facilities, and has a large throughput on Consultant
led lists in the specialities above, plus ENT. A new Ambulatory Care Unit is part of
the current redevelopment, with 4 theatres due to open 2005.

Emergency surgery is allocated to a designated theatre all day every weekday
enabling this workload to be dealt with promptly and within CEPOD
recommendations.

Anaesthesia is also provided for CT Scans and for ECT at the Waterlow Unit.


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Obstetric Anaesthesia

Five consultants and one Associate Specialist have sessions to cover the labour
ward. Dr Olusola Makinde leads this service, which is based on well-established
standards and protocols. There is designated 24-hour trainee cover at SpR grade
for Obstetrics.

Acute Pain Service

Dr Samina Ishaq leads this service and is supported Dr Basel El-Behesy and a
team of pain nurses including a full-time Clinical Nurse Specialist. Trainees
participate in the daily Pain Team rounds.

Chronic Pain Management Service

Dr Gnanie Panch and Dr Sarah Ward (Starting March 04) provide this Consultant
led outpatient service. Referrals originate from General Practitioners and Hospital
Consultants. The Pain Clinic is located in the spacious and well-equipped
Outpatients Department and is supported by Clinical Psychologists, an
Acupuncturist and a Sports Therapist. There are weekly theatre lists for nerve
block procedures. Experienced trainees who require exposure to this sub speciality
area attend both Pain Clinic and theatre sessions.

Intensive Care Unit

The ICU is staffed for seven ventilated and two High Dependency beds. Four
Anaesthetists, Dr Chris Hargreaves, Dr Basel El-Behesy, Dr Sarah Gillis and Dr
Nick Harper provide consultant cover in a separate rota. The hospital has also
recently started an “Outreach Service” which is run by ICU-trained senior nurses
and is led by Dr Gillis. A fifth ICU consultant/senior lecturer post has been
appointed. Trainee cover for ICU comprises 5 resident SHOs of which one is a
secondment in 12 weeks blocks from the Anaesthetic Department. The new
development includes a 15-bedded Critical Care Unit.

Trauma & Resuscitation

This is an integral part of the Department's on-call cover.


3. THE ESTABLISHMENT

 Consultant Staff

        1. Dr G. Lim                 Divisional Chair
        2. Dr R. Jayaweera           Lead clinician for postgraduate education



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       3. Dr G. Panch             Lead clinician for chronic pain
       4. Dr C. Hargreaves        Director of intensive care
       5. Dr B. El-Behesy         Intensive care and acute pain
       6. Dr J. Powney            Undergraduate tutor
       7. Dr N. Harper            College tutor
       8. Dr C. Shaw              Lead clinician for trauma and emergencies
       9. Dr S. Ishaq             Lead clinician for Acute Pain
       10. Dr O. Makinde          Lead clinician for obstetric anaesthesia
       11.Dr M. Dunstan           Lead clinician for equipment and pre-
                                  assessment
       12.Dr S. Walker            Director of day surgery
       13.Dr S. Gillis            Intensive care and lead clinician for outreach
       14.Dr M. Grocott           Academic Senior Lecturer in Intensive Care
                                  Medicine (Starts March 04)
       15.Dr S. Ward              Chronic pain specialist (Starts March 04)


Associate Specialist

1   Dr Subir De                   Lead Clinician for audit

Staff Grade

1. Dr. A. Landeck
2. This post

Clinical Assistant (Part Time)

1. Dr. Mamamta Saha

Trainees

All training posts are incorporated into rotations of the Central London School of
Anaesthesia (UCLH/RFH). Rotations are 6-12 monthly for SpRs and 9 monthly
for SHOs.

The Whittington is the base hospital for some of the SHO rotations.

Year 3/4/5 SpR         2
Year 1/2 SpR           5

Year 2 SHOs            3
Year 1 SHOs            4    (1 brand-new trainee arrives approx. twice per
                            year and is supernumerary for 3 months)




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4. THE POST

 The post would be for 40-48 hrs/wk and compliant with the European Working
 Time Directive. The post holder will be required to participate in the on-call rota
 on a 1:5 basis, working a shift system, alternating between providing anaesthetic
 services for the maternity unit and providing general emergency cover for
 theatres and the rest of the hospital (with a 1st 0n-call SHO). Duties would include
 supervising the 1st on-call SHO in theatre, trauma and paediatric arrest calls,
 stabilising and transferring patients to ITU, CT scan and inter-hospital. This rota
 is repeating and therefore predictable long in advance.
 The post holder will undertake at least two lists per week, one of which will be
 directly supervised by a Consultant. The weekly daytime sessions will be
 discussed with the successful applicant, and are fixed a week in advance

 All middle grade doctors, including staff grades, are expected to try and cover
 unexpected absences internally, where possible. It is accepted the post holder
 will perform duties in occasional and unforeseen circumstances at the request of
 the appropriate consultant. Such additional commitments arising under this
 subsection will be exceptional and in particular the doctor should not be required
 to undertake work of this kind for prolonged periods or on a regular basis.

5. EDUCATION AND TRAINING

 The post holder will be allocated a nominated educational supervisor. Staff grade
 doctors are expected to undertake CME activities and should liaise with their
 educational supervisor for guidance in this area. As well as weekly educational
 departmental meetings, the post holder is expected to attend the training and
 audit half day each month. All staff are expected to complete a clinical audit
 project each year. The Clinical Lead for audit can advise and facilitate this.

 Induction is organised for all newly appointed staff, and attendance at induction
 sessions is compulsory.

 Formal appraisal will be conducted annually.

 TERMS AND CONDITIONS OF SERVICE

 This post is subject to the Terms and Conditions of The Whittington Hospital
 NHS Trust and in particular to the Pay and Conditions of Service relating to
 Consultants.   Copies of these may be seen in the Human Resources
 Department. The appointment is superannuable, unless you choose to opt out of
 the National Health Service Superannuation Scheme.




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The salary scale of Staff Grades is £29,060 - £43,340 per annum plus £2,047
London Weighting Allowance. This is exclusive of any Additional Programmed
Activities, On-Call Availability Supplement, Distinction Awards or Discretionary
Points that may be payable. Part time staff will be paid pro rata.

Offers of employment are subject to the Occupational Health Service clearing
you as fit for the post. If successful you will be given a health questionnaire
which should be completed fully and mailed to the Occupational Health Service
by return of post; you will not be able to take up employment with the Trust until
clearance has been given.

Because of the nature of the work of this post, it is exempt from the Section 4(2)
of the Rehabilitation of Offenders Act (1974) by virtue of the Rehabilitation of
Offenders Act (Exemption Order 1975). Applicants are therefore not entitled to
withhold information about convictions including those 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. Any information given will be completely confidential and will be
considered only in relation to application for positions to which the order applies.

The successful candidate will be required to live within 30 minutes by road from
the hospital, unless the Trust determines that residence at a greater distance is
acceptable. The private residence must be maintained in contact with the public
telephone service. Assistance may be given with the cost of installation and
rental charges.

Applicants are therefore advised to study the Trust‟s Terms and Conditions of
Service of Hospital Medical and Dental Staff and the Trust‟s Removal Expenses
Agreement.

Annual Leave

Annual leave is given in accordance with the Terms and Conditions of Service
relating to Medical and Dental staff. Full time Staff Grades are entitled to six
weeks and two days leave a year. Annual leave for part time staff is given on a
pro rata basis.

Staff Grades are expected to plan their annual leave well in advance so that their
absence is not detrimental to the service. Staff Grades are requested to give no
less than 6 weeks notice of intention to take leave. Leave requests with less
than 4 weeks notice must be made to the Consultant who will only grant such
requests in exceptional circumstances.




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Study Leave

Study leave is given in accordance with the Terms and Conditions of Service
relating to Medical and Dental Staff. It is the current policy of the Trust to assist
doctors with reasonable fees and expenses associated with approved continuing
medical education.

Continuing Professional Development

The Whittington Trust values and supports the continuing professional
development of all its consultant staff. As part of this, all consultants employed by
the Trust are expected to comply with their Royal College or specialty association
requirements for continuing medical education, and to provide the Trust with
information to demonstrate this compliance.

Confidentiality

You are required to maintain confidentiality of any information concerning
patients which you have access to or may be given in the course of your work, in
accordance with current policy on confidentiality in the Whittington Hospital NHS
Trust.

Clinical Governance

All staff with clinical responsibilities are expected to work within the clinical
governance arrangements agreed by the Trust. This is through an established
framework through which clinical staff are continuously accountable for improving
the quality of services and safeguarding high standards of care by creating an
environment in which excellent care will flourish. All clinical staff are expected to
maintain appropriate knowledge about, and involvement in, agreed strategies
and programmes to continually improve their standards of clinical care through:

   Patient and user involvement
   Risk and complaints management
   Clinical effectiveness and audit programmes
   Continuous Professional Development
   Clinical research in accordance with DOH Governance requirements

Protection of Children

In order to protect children from the risk of abuse some posts are offered subject
to the appointee‟s agreement to the police being approached for the disclosure of


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any criminal record. If your post falls into this category you will be asked to
complete a form giving this permission for the check to take place.

Personal Conduct

All staff within the Trust are expected to treat other members of hospital staff with
courtesy and respect. The Trust‟s rules and policies including the disciplinary
procedure apply to all staff without exception. The attention of consultant
medical staff is drawn to the GMC document, „The Duties of the Doctor‟ and the
hospital‟s policy on „Maintaining Medical Excellence‟. The Trust will take this into
account when considering the conduct of medical staff in relation to any incident.

Health & Safety Policy

Employees must be aware of the responsibilities placed on them under the
Health and Safety at Work Act 1974, to ensure that the agreed safety procedures
are carried out to maintain a safe environment for employees and visitors. The
appointee will be required to provide evidence of his/her Hepatitis B immune
status before employment.

Security

It is the responsibility of all employees to work within the security policies and
procedures of the Whittington Hospital NHS Trust to protect the patients, staff
and visitors and the property of the Trust. This duty applies to the specific work
area of the individual and the Hospital in general. All staff are required to wear
official identification badges.

Data Protection

This post has a confidential aspect. If you are required to obtain, process and/or
use information held on a computer or word processor you should do it in a fair
and lawful way. You should hold data only for the specific registered purpose
and not use or disclose it in any way incompatible with such a purpose and ought
to disclose data only to authorised persons or organisations as instructed.
Breaches of confidence in relation to data will result in disciplinary action.

No Smoking

The Hospital has promoted a No Smoking Policy as part of its responsibility for
the provision of health. You will be expected to work within the framework of this
policy and to give advice on its development. Smoking is not permitted in offices.
Equal Opportunities



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It is the aim of the Trust to ensure that no job applicant or employee receives less
than favourable treatment on grounds of sex, race, colour, nationality or national
origins and is not placed at a disadvantage by conditions or requirements that
cannot be show to be justifiable. To this end the Trust has an equal opportunities
policy and it is for each employee to contribute to its success.

Method of Payment

Payment of salary is made into bank account/building society account by direct
bank system. Details of a bank account or building society account will be
required on the first day at work. There is no facility for any other form of
payment.



THE HISTORY OF THE WHITTINGTON HOSPITAL

Medical services were first provided on the site of the Whittington in 1473.
Originally a leper hospital during the reign of Edward IV, by the time of Elizabeth I
the hospital was caring for the poor chronic sick who had been transferred from
St Bartholomew‟s and St Thomas‟. In 1848, a new hospital was built on the St
Mary‟s Wing site. This had 108 beds and cared for patients with smallpox.
During the great smallpox epidemic between 1855 and 1859, the hospital
admitted 1185 patients of whom 20% died. The Smallpox and Vaccination
Hospital is currently known as the Jenner Building and is used as office
accommodation.

Independently managed hospitals were opened on the Archway Wing site in
1877 and the Highgate Wing site in 1866. These hospitals had 625 and 543
beds respectively. In August 1900, Highgate Hill Infirmary with 780 beds opened
adjacent to the Smallpox and Vaccination Hospital. The two hospitals soon
amalgamated and the Smallpox Hospital was transformed into a nurses home.

Edith Cavell worked as a night sister for three years from 1901 at the Infirmary on
the current Highgate Wing site. The Infirmary had been described in 1870 by
Florence Nightingale as ”by far the best of any workhouse infirmary we have” and
indeed “the finest metropolitan hospital”.

In 1947/8 the hospitals were brought together under Dr Cecil Coyle, who as
Medical Superintendent was responsible for the administration of all three sites.
The three hospitals had between them just under 2000 beds. With the coming of
the NHS in 1948, the sites began to modernise. The past 50 years have seen
the consolidation of all clinical services onto the St Mary‟s Wing site with a
reduction of beds from nearly 2000 to around 500. In 1977 a new block was
opened which currently houses Emergency, out patients and the pathology


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laboratories. In 1992 the Great Northern Building opened with its modern ward
accommodation, staff restaurant and education facilities.

As clinical services moved to the main site, so both Archway Wing and Highgate
Wing changed function. Highgate Wing has been chosen by Camden and
Islington Community Trust as the site for the consolidation and development of
the district‟s mental health services. Archway Wing is owned by UCL and The
Middlesex University as an education and research campus.

In October 2002 the Whittington agreed a 30-year contract with Jarvis plc to
design, construct and maintain a new £30 million clinical services building. Work
is now underway and completion is due in late 2004. This new building will
double the capacity of critical care and day surgery and will significantly improve
the environment in which staff work. Planning for further site development is now
in progress.

THE HOSPITAL TODAY

The Whittington Hospital is a medium sized district teaching hospital. The site
contains a mixture of modern, good quality accommodation and older Victorian
building which are in need of replacement. Despite the age of the older
buildings, ongoing refurbishment has been carried out to ensure ward and other
accommodation is suitable for modern medical practice. The hospital is well
provided with equipment, with considerable ongoing investment to ensure that
practitioners have the „tools to do the job‟. The hospital is proud of its tradition of
providing high quality medical education. We seek to provide academic and
clinical excellence without losing sight of our rôle as a community based hospital
supporting our local GPs.

We are located in Archway, North London and have traditionally served the
populations of North Islington and West Haringey. Our catchment population is
around 240,000. Our local population is a diverse mix in terms of social class,
economic status and ethnicity and the communities we serve embrace Highgate,
Finchley, Haringey, Camden and Islington. We have close working relations with
tertiary centres at the Royal Free Hospital and the UCLH group of hospitals.

All main branches of medicine and surgery are provided at The Whittington
Hospital with the exception of neurosurgery and cardiothoracic surgery. Plastic
surgery and ophthalmology are represented by outpatient services.

A combined Diagnostic and Outpatient block is situated on the site. This block
accommodates the newly upgraded Emergency Department, together with main
supporting services such as Pathology, Radiology and Pharmacy.               The
Radiology Department has an MRI scanner and a spiral CT scanner to provide a
comprehensive investigatory facility. The first phase of a Picture Archiving and
Communication System (PACS) has been rolled-out in Emergency, with



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electronic links to the Hospital for Nervous Diseases at Queen Square
anticipated in the near future.

A seven bedded General Intensive Care Unit (5 ITU, 2 HDU beds) is located
adjacent to the six bedded Coronary Care Unit. Both units are well equipped and
well staffed.

An 89 bedded Mental Health Unit is located adjacent to St Mary‟s Wing on
Highgate Hill and is managed by the Camden and Islington Mental Health
Services Trust. Building work is well underway to relocate district Mental Health
services on the nearby Highgate Wing in new accommodation. The Sexual
Health Clinic, managed by Camden & Islington Community Trust, is located in
Archway Campus.

The hospital is divided into five main divisions each managed by a Divisional
Manager who reports to the Medical Director (Operations) as follows:

Medical Director: Mrs Celia Ingham Clark
Director of Operations: Ms Tara Donnelly
Divisional Manager Acute Medical Services: Ms Fiona Elliott
Divisional Manager Medicine and Clinical Services: Mr Adam Smith
Divisional Manager Rehab and Primary Care Interface: Mrs Kate Slemeck
Divisional Manager Surgery: Ms Sarah Metson
Divisional Manager Children & Women‟s Health: Mrs Bernadette Herbert

Dr Norman Parker is the Executive Medical Director for the Trust as a whole. Dr
Jane Young is the Trust‟s Director of Medical Education.

Apart from medical undergraduate and postgraduate training commitments, the
hospital provides recognised training for nurses, midwives, Allied health
Professionals, Biomedical Scientists and operating department practitioners.

APPROXIMATE BED NUMBER

Surgery             104
Medical             221
Orthopaedic         56
Gynaecological      19
Maternity           47
Paediatrics         35 (of which 8 are day care)
Neonatal Unit              18 (including 6 intensive care cots)
Day beds            22
Emergency           8
ITU                 7




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All figures are approximate because beds are used flexibly and because ongoing
strategic planning processes may affect individual speciality provision from time
to time.




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PERSON SPECIFICATION FOR STAFF GRADE ANAESTHETIST

  REQUIREMENTS                ESSENTIAL                     DESIRABLE
   Qualifications            GMC Registration            FRCA (or equivalent)


Professional Experience    At least 4 years post
                          registration experience

                           At least 3 years (or
                          equivalent) experience
                             in anaesthesia

        Ability           Knowledge and skills in           A.L.S./A.T.L.S.
                           general and regional
                          anaesthetic techniques
                            appropriate for the
                           surgical and obstetric
                                  patient.

                          Ability to work as part of
                          a multidisciplinary team

                           Ability to communicate
                          effectively with all levels
                            of staff and patients

         Audit                Interest in and           Evidence of active audit
                           knowledge of medical               experience
                                   audit

      Education           Evidence of Continuing
                                 Medical
                           Education/Continuing
                          Personal Development




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Standards        High ethical/
            Professional standards

                Familiarity with
             standards laid out in
             GMCs “Good Medical
                  Practice”
 Others      A willingness to accept       IT and presentation
            that flexibility is required          skills
              to meet the changing
                needs of the NHS




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