The Royal Free Hampstead NHS Trust

THE ROYAL FREE HAMPSTEAD NHS TRUST

One full Time (10 PA’s) Consultant in Anaesthesia

With an interest in General Anaesthetics (Post 3)

And HONORARY SENIOR LECTURER (on further application to the

medical school).

At The Royal Free Hospital

JOB DESCRIPTION POST 3

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ROYAL FREE HAMPSTEAD NHS TRUST – background information

Introduction

The Royal Free London NHS Foundation Trust has around 10,000 staff
serving 1.6 million patients. It comprises Barnet Hospital, Chase Farm
Hospital, the Royal Free Hospital and more than 30 services in the
community. This larger scale organisation provides an unprecedented
opportunity for us to continue our pioneering work, particularly in finding
ways to deliver even better care to our patients.

As well as services for local people, such as accident and emergency

service, and all branches of surgery and medicine, the Royal Free is
renowned for providing a large number of specialist services. These
include, amongst others, solid organ and bone marrow transplantation,
nephrology and hepatology, HIV and infectious diseases, plastic surgery,
immunology, paediatric gastroenterology, ENT surgery and audiological
medicine, amyloidosis and scleroderma.

The Royal Free is a leading cancer centre with a range of specialist

diagnostic and treatment services in oncology and haematology, and a
major neuroscience base with a network extending throughout north
London, Hertfordshire and Bedfordshire.

The Royal Free’s research priorities in collaboration with the medical school
are translational and clinical research underpinned by a strong basic
science. Areas of particular research excellence include organ failure and
transplantation, haematology and oncology, immunity, inflammation, and
neurosciences.

In August 2008 the Royal Free became a founder member of UCL Partners,
a federation of UCL with associated specialist trusts. UCL Partners was
designated as an academic health science centre by the secretary of state
in March 2009.

The Royal Free is also a member trust of NT LCRN, our National Institute of
Health Research Clinical Research Network (NIHR CRN) partner. NT LCRN
encompasses 26 NHS trusts across central and east London, Essex and
Hertfordshire. The Royal Free is continually working in close collaboration
with these partner trusts’ to deliver NIHR research.

Early history

The Royal Free Hospital was founded in 1828 by William Marsden, a

surgeon who later also founded the Marsden Hospital and became the first
hospital in London, and one of the first few in the country, to treat patients
without any letter of introduction or payment. The Royal Free moved to
Gray’s Inn Road in the 1840s and the title 'Royal' was granted by Queen
Victoria in 1837 in recognition of the hospital's work with cholera patients.

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The Royal Free Hospital moved to its present site in the mid-1970s, bringing
together the old Royal Free Hospital in Gray's Inn Road with the Lawn
Road, New End and Hampstead General Hospitals.

Today

The Royal Free Hospital is being extensively upgraded to bring its condition
and equipping up to the best contemporary standards.

Across our three London hospitals, our vision is clear: to deliver world class
expertise and local care. We combine globally recognised clinical expertise
with local and friendly hospital care to represent the NHS at its best.

Our mission is to be world class in terms of healthcare treatment, clinical

research and teaching excellence. We aim to deliver and develop leading
local healthcare in all three of our hospitals, to improve lives and help
people thrive

The University College London (UCL) Medical School has an annual intake
of 330 students and accepts an additional 55 Oxbridge students for clinical
training. The Hampstead campus provides clinical training for
approximately 200 students in Phase 2 and staffs also contributes to the
Phase 1 (life sciences) course. There are established clinical academic units
of medicine, surgery, clinical neurosciences, obstetrics and gynaecology,
psychiatry, haematology, histopathology, medical microbiology, virology,
chemical pathology, immunology, public health, general practice, travel
medicine and vaccines, oncology, child and family mental health, paediatric
gastroenterology and community child health.

Organisation
The Royal Free’s Patient services are managed under four clinical divisions,
each led by a clinically qualified divisional director, who is supported by a team
of clinical directors, a divisional director of operations and a divisional nurse
director. These divisions are:

 Transplant and specialist services

 Urgent Care
 Surgery and associated services
 Women’s and children

The Royal Free also has a separate private practice department and
consultants undertaking private patient work are encouraged to use these
facilities within the Trust.

The Royal Free also has contracts with most PCTs in England and their

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equivalents in Wales, as well as with a number of specialised services
consortiums.

The following staffs have primary responsibility for running the services of the
Directorate of Anaesthesia, Theatres and Ambulatory Care:

Dr Duncan Jackson - Clinical Director from 1/04/12

Dr Sandi Wylie - Clinical Lead from 1/3/18

3. Responsibilities of the Post

This full time post comprises 10 programmed activities. A timetable of fixed

sessions is shown below. This new post has been created through
retirements. The post is based at the Royal Free site in Hampstead
although the successful candidate may be expected to work on any site
where the Royal Free Hampstead NHS Trust supplies anaesthetic services.
The timetable must be considered an outline of the eventual sessions. Days
for particular activities may well have to be changed as services expand and
moved. An elective Saturday operating list 1 week in 10 is incorporated into
the timetable to help accommodate these expanding services.
The successful applicant will be more than a competent anaesthetist. They
will be someone with proven organisational skills who can work within the
department in a cohesive and dynamic manner. As a major teaching
hospital a track record in teaching and training would be expected. The
Royal Free anaesthetic department services a large range of specialities
with a relatively small Consultant body so Consultants are encouraged to
have interests in more than one sub-speciality.
The Anaesthetic Department operates 3 consultant on-call rotas – general,
paediatrics & plastics, and liver transplantation. On-Call commitment will
not exceed 1 in 14 on the general rota. The post holder will join this on-call
rota.
The consultant appointed will be expected to:
Provide Anaesthetic Services in support of fixed commitments in the job
plan in particular working flexibly to ensure high quality care for the
specialties and case mix we serve.
Participate in the supervision, training and professional development of the
junior staff at both CT and SpR level. This will include planned teaching
sessions, audit, clinical governance and support in pursuing research
activities.
Share administrative responsibilities for the department including the
support and development of nursing and other staff.
Co-operate and liaise with other consultants in the continuing care of
patients across a range of the Trust’s activities.
Maintain skills and knowledge through CME/CPD activities in accordance
with the requirements of the Royal College of Anaesthetists and undergo
annual appraisal and periodic revalidation as directed by competent
authorities.

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Consultant Anaesthetists and Intensivists
Dr M. Alousi Plastics and Paediatrics
Dr G. Atwal Regional and Simulation
Dr P Berry Plastic Surgery, Urology, Pre-assessment

Dr Jude Cheong- Paediatric Lead

Leen
Dr G Collee
Dr J Cooper Lead in Day Case Anaesthesia, Liver Transplant, Pre-
assessment.
Dr O. Dulan Plastics and Paediatrics
Dr C Donohue Vascular & HPB
Dr L Dinner Neurosurgery / regional Advisor
Dr A England Obstetric Anaesthesia
Dr A Evans Plastics, Undergraduate teaching, Paediatrics
Dr Emanuel- Kole Training and Simulation
Dr J Forsyth Plastic Surgery, paediatric surgery
Dr T Fregene Paediatrics
Dr S Harrison Obstetrics, Liver Transplant
Dr A Hayward Plastic Surgery

Dr D Jackson Clinical Director, Hepatobiliary & Liver Transplant Anaesthesia

Dr N Jenkins Vascular
Dr T Jones Hepatobiliary and obstetrics
Dr R Khan Orthopaedics
Dr C Kidel Training Programme Director & CPOD Lead
Dr J Lowery Vascular
Dr C Lyness Vascular and. Liver Transplantation
Dr S Mallett Research
Dr W Marchant Paediatrics, Orthopaedics
Dr R Marks ENT
Dr A McGlennan Medical Director Chase Farm Hospital
Dr C Melikian Liver Transplantation lead
Dr S O’Malley Plastics Surgery

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Dr D Patel Plastic Surgery
Dr P.Pemberton Acute Pain
Dr J Prout HPB Surgery & Liver Transplantation
Dr J Read Hepatobiliary and Enhanced Recovery
Dr S Renwick Paediatrics, Associate Medical Director
Dr N Schofield Vascular and Liver Transplant
Dr R Simons Obstetrics
Dr M Smith Orthopaedics and Audit
Dr D Soltanifer HPB and Obstetrics
Dr S Wylie Vascular & POA Lead
Dr L Ward Pain Management Lead
Dr J Watts Orthopaedics & Urology

Trainee Staffing:
CT: 9 WT
StRs: 21 WT of which 3 are OOPE plus 2 flexible trainees
Clinic Research Fellows: 2 WT

Secretaries
1 office manager, 1 ITU, 2 Pain Unit.

4. Work of the Anaesthetic Department

The Royal Free Hospital has 16 main operating theatres on the third floor of
the tower. There are three further theatres on the first floor, one for plastics,
one for gynaecology and one for ophthalmic. There are also two obstetric
theatres. The Department is involved in providing anaesthesia for most
major specialities including vascular, hepatobiliary, renal cancer,
orthopaedic, urological, ophthalmic, colorectal, upper-gastrointestinal,
plastic surgery and liver and kidney transplantation. The Division also runs
an acute pain service. The Intensive Care Unit is administratively within a
different Division. It has 34 level 3 beds in a brand new state of the art new
facility. The Department actively encourages clinical research and has
strong links with the Academic Department of Surgery. The Obstetric
Department sees approximately 3,500 deliveries. It has a newly refurbished
theatre suite with two operating rooms and a three bedded high dependency
unit. The obstetric service is consultant led and deals with a mixture of local
referrals and high risk patients. There has been an increase in live related
kidney donations with two way and three way matched pairs. Live related
Liver Transplantation is also performed. The rebuilding of the vascular
theatre with integrated X-Ray facilities has already increased the numbers
and complexity of aortic stenting procedures.

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The Anaesthetic Department at the Royal Free Hospital is one of two major
teaching hospital departments within the Royal Free and University College
Hospitals School of Anaesthesia. The school operates training rotations for
60 CTs and >200 StRs.

5. Anaesthetic Teaching/Audit
There is a protected teaching by the anaesthetic consultants for trainee
anaesthetic staff for 3 hours each week, a weekly Journal Club meeting on
Wednesday and programmed SHO teaching on Tuesdays. In addition there
is a weekly departmental meeting at 07.30 on Friday mornings. Consultants
are encouraged to attend these meetings and will be expected to contribute
to both formal and informal teaching sessions and to take part in medical
audit. The post holder will have a contractual obligation to meet CME/CPD
and Clinical Governance guidelines and will be required to undergo annual
appraisal in accordance with national guidelines.

6. Research and Development

Research and development is a major component of the Royal Free
Hampstead NHS Trust strategy and reflects the Trust's desire to maintain its
position as one of the top ten Trusts for R&D income in the UK. There
are 10 research programmes. Our research programmes have
collaborations nationally and internationally and attract funding from
prestigious bodies.

The Trust in the fortunate position of being co-located with and Medical
School and their research agenda is closely integrated. There are extensive
facilities for both clinical and basic science research. The Corporate objective
under current strategic activity affecting R&D is a joint approach to research
and development with UCL and UCLH.

Consultants are expected to participate in research, according to their skills

and specialty, and publish their research findings. Annually, the R&D Office
conducts a quality assessment exercise (QAE) on the publications in highly
cited peer-reviewed journals. All research undertaken is bound by the
research governance framework.

The Anaesthetic department has strong links with the Centre for
Anaesthesia of the medical school.

7. Undergraduate & Postgraduate Teaching Duties Expected of

Consultants
The Royal Free Hampstead Trust is closely associated with University
College London (UCL), London’s Global, and multi-faculty university. UCL
Medical School (UCLMS), which is one of the highest rated medical schools
in the country, forms the largest element of the UCL Faculty of Biomedical
Sciences (FBS), which was formed on 1st August 2006.

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The academic activity of FBS is delivered by 14 Divisions and Institutes:
Cancer Institute, Institute of Child Health, Ear Institute, Eastman Dental
Institute, Division of Infection and Immunity, Division of Medical Education,
Division of Medicine, Institute of Neurology, Institute of Ophthalmology,
Division of Population Health, Division of Research Strategy, Division of
Surgery and Interventional Science, Wolfson Institute for Biomedical
Research and Institute for Women’s Health. The Divisions/Institutes are
situated on three main sites - the Bloomsbury Campus, the Royal Free
Campus and the Whittington Campus. Associated hospitals include
Eastman Dental Hospital, Great Ormond Street Hospital for Children,
Moorfields Hospital; University College Hospitals, including the National
Hospital for Neurology and Neurosurgery; Royal Free Hospital and the
Whittington Hospital. There are also strong academic links with NHS Trusts
in Greater London and the South East.

UCLMS comprises the Faculty of Biomedical Sciences and that part of the
Faculty of Life Sciences which provides the basic science teaching for the
medical undergraduates. It also offers a wide range of graduate
programmes and houses many interdisciplinary research teams. The
Medical School has consistently received one of the highest ratings in the
UK in the HEFCE research assessments undertaken during the last twelve
years. Professor Edward Byrne is Dean of the Faculty of Biomedical
Sciences and Vice-Provost Health and Professor Ian Jacobs is Dean for
Health Services Research, UCL and Partners. Professor Raymond
MacAllister is Vice Dean for Research, Professor Jane Dacre is Vice-Dean
for Medical Education and Professor Irwin Nazareth is Vice Dean for
Population Health, Professor Humphrey Hodgson is Vice-Dean and
Campus Director of the Royal Free Campus and Professor David Patterson
is the Whittington Campus Vice-Dean and Campus Director.

The Trust has an arrangement with the Medical School to provide clinical
teaching for the MBBS undergraduate programme, for which purpose it
receives NHS funds from the Workforce Development Confederation. The
Trust is recognised by the University of London for this purpose.

The successful candidate for this Consultant post will be eligible to become
an Honorary Senior Lecturer of UCL on the understanding that he/she will
participate in undergraduate teaching, including acting as an examiner, and
support and facilitate research activities in the Division of Surgical and
Interventional Sciences. He/she will take direction in these activities, via
the academic lead, from the Division, currently Professor Marc Winslet. The
agreement to define the Honorary Senior Lecturer's responsibilities and
associated programmed activities in relation to teaching time and research
will be negotiated jointly between the post holder, the Medical School (via
the Division/Institute Director and/or the Vice-Dean/Campus Director) and
the NHS Trust. It will form part of the successful candidate’s job plan. The
award of the Honorary Senior Lecturer contract will be dependent upon a
request being submitted by the Division/Institute to Medical School
Management.

The annual consultant appraisal procedure will include review of teaching

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performance, and consideration will be given to joint academic appraisal of the
consultant staff/honorary senior lecturers, in the same way as for the clinical
academics/honorary consultants.

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8. Job Description (Hepatobiliary/Vascular Interest) (4)
Timetable of Fixed Commitments

Day times location work Category DCC SPA

DCC/SP PAs PAs
A

Monday 0730- Theatres ERCP/Endoscopy DCC 3

1920

Wednesday 0730- Theatres Fixed Uncommitted DCC 1.5

1920 Session
Weeks 1 & 3

Thursday 0800- Theatres 0800-1100 SPA 0.75

1800

Friday 0715- Dept Department Meeting SPA 0.25

0800

0800- Theatres Breast Anaesthesia DCC 3

1930
Saturday 08.00- Theatre Acute/trauma DCC
18.00 (see below)

Additional SPA 1.0

agreed activity
worked flexibly
Unpredictable variable DCC 0.5
emergency
on-call work
Subtotal PAs 8.0 2.0
10.0
Total PAs

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For the purposes of contracting these operating sessions including
preoperative and postoperative visiting are assumed to take 32 hours. (7.5
PA’s). 2.0 PA’s are allocated for supporting activities and 0.5 PA for on call
attendance. This will be negotiated with the clinical and divisional directors.
The job plan will be reconsidered 3 months after appointment as
administrative responsibilities may need incorporation.

A regular Saturday trauma/acute list is incorporated into the job plan at a

frequency of no more than a 1:6 and is reimbursed with time in lieu at
premium time the following week or at the consultants discretion.

The timing and location of the fixed sessions may be changed after
consultation with the successful candidate. The timetable should be
considered illustrative as the theatre timetable is likely to be changed with the
transfer of services from other hospitals.

Applicants should be aware that the Royal Free is increasing operating theatre
utilisation moving towards evening sessions and routine Weekend operating.
In 2008 the majority of theatres started working to 19.00. Also in 2013 routine
weekend working was introduced. This job plan includes an acute Saturday
session 1 week in 6 that is incorporated into the job plan.

All future Consultant appointments to the liver Transplant, Paediatric and

General on-call rotas will include weekend working.

9. Fixed Uncommitted Session

Fixed uncommitted sessions are provided to allow annual and study leave
cover for colleagues. This session is therefore fixed in time but not in place
and the post holder may be asked to undertake any anaesthetic commitment
which falls within their range of skills. The same applies to sessions in which
the regular commitment is cancelled for any reason.

10. On Call Commitment

The on call requirements of the post will not exceed 1 in 14. Rota systems
may change over the next year and the exact on-call duties may change.

Applicants are invited to visit the department and discuss the job with the
Clinical Director Dr Duncan Jackson or Dr Sandi Wylie Clinical Lead via the
Anaesthetic Department on 0207 7940500 extension 36503.

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TERMS AND CONDITIONS GUIDE FOR APPLICANTS

ALL APPLICANTS SHOULD ENSURE THEY HAVE READ AND UNDERSTOOD

THE FOLLOWING CONDITIONS

1. Applicants should hold the Fellowship or Membership of the appropriate Royal

College or Faculty or overseas equivalent and maintain appropriate CME
accreditation. Applications will be considered from those unable for personal
reasons to work on a full-time basis. Any candidates wishing to work on a
part-time basis should indicate this when submitting his/ her application.

2. The NHS (Appointment of Consultants) Regulations 2005 prevent

appointment of any applicant for consultant posts commencing after 1st
January 1997 who is either not:

• On the GMC specialist register

• In possession of the CCT, or EEA/EU equivalent, (although doctors
who have completed higher specialist training and are within 6 months
of being placed on the specialist register may be appointed)

It is the responsibility of applicants to satisfy all necessary GMC requirements

prior to appointment. Applicants must ensure they provide evidence in their
application identifying eligibility to be placed on the specialist register. This
would ideally be in the form of a notification from the GMC.

3. The appointment is covered by the Terms and Conditions of Service of the

Royal Free Hampstead NHS Trust and is subject to the National Health
Services (Superannuation) Regulations.

4. As an employee of the Royal Free Hampstead NHS Trust you will be

expected to practice at all times in accordance with the infection control standards
specified in trust policies and procedures and the Health Act (2006) Code of
Practice for the prevention and control of health care associated infections.

5. The full time basic salary for the first appointment of an NHS consultant (as at
1st April 2009) is set out below, including payment for agreed additional
programmed activities. Part-time consultants will be paid pro rata, based on
the number of agreed weekly Programmed Activities in the consultant’s Job
Plan.
Salary on commencement and subject to progression will be in accordance
with Paragraphs 4-9 of Schedule 14 of the Terms and Conditions.
Pay thresholds

Threshold Period before Basic salary Payment for Annual

eligibility for (full-time) one additional payment for
threshold (2006/07) Programmed one additional
Activity Programmed

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 Activity per
week
1 N/A(full-time £74,504 £143 £7,450
starting salary)
2 One year £76,837 £147 £7,683
3 One year £79,170 £152 £7,917
4 One year £81,502 £156 £8,150
5 Five years £83,829 £161 £8,382
6 Five years £89,370 £171 £8,937
7 Five years £94,911 £182 £9,491
8 £100,446 £193 £10,044

A London Weighting Allowance of £2,162 per annum is payable and pro rata for part-
time consultants.

6. There are separate arrangements for those whose first appointment as an

NHS consultant was before 31st October 2003. These are stated in the terms
and conditions of service. The successful applicant will be required to
complete a health statement and the Trust may require an appointee to pass
a medical examination as a condition of appointment.

7 Private Professional Services and NHS Programmed Activities: subject

to the provision in Schedule 9 of the Terms and conditions, you may not carry
out Private Professional Services during your Programmed Activities.

8. Significant new clinical services may only be developed after agreement has
been reached with the relevant management team and the financial
arrangements approved.

9. Assistance may also be given to newly-appointed consultants towards the

cost of the removal expenses, provided that the consultant moves from a
position within the National Health Service, also that removal is necessary to
comply with the Trust's requirements concerning the place of residence and a
written request is sent to Medical Personnel before or immediately after
appointment.

10. It is now NHS policy that all new staff with patient contact will require
satisfactory disclosures from the Criminal Records Bureau. With effect from 1
November 2004 the Human Resources department will therefore seek
disclosures for all new medical appointments. The Trust must check the
criminal background of all employees. Candidates must provide information
on application relating to any criminal convictions they have had, even if they
are ‘spent’ for other purposes. Posts in hospitals are exempt from the
provisions on Section 4 (2) of the Rehabilitation of Offenders Act 1974 by
virtue of the Rehabilitation of Offenders Act 1974 (Exemptions) Order 1975.
We will keep any information given completely confidential.

11. A final shortlist is expected to be completed within approximately three weeks

after the closing date. Shortlisted candidates will be invited to visit the hospital
before being interviewed.

wp\consults\term&con.con
June 2009

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RFH Consultants General Anaesthesia Post 3 2018