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NHS Tayside Consultant Radiologist Post 1. NHS Tayside NHS Tayside was established on 1st April 2004. It is composed of a single system operating and delivery structure with responsibility for secondary care and primary care services. NHS Tayside continues the effective provision of a comprehensive range of core health services previously provided by Tayside University Hospitals NHS Trust and Tayside Primary Care Trust to the local population of Dundee, Perth and Kinross, Angus and North East Fife, and it delivers a number of specialist services for Tayside region and beyond. There are five principal hospitals - Ninewells Hospital and Medical School, Perth Royal Infirmary, Stracathro Hospital, Arbroath Infirmary and Dundee Dental Hospital and School. It has an outstanding reputation for undergraduate and postgraduate medical and dental education, and provides training for nurses, paramedical and technical staff. NHS Tayside embraces a wide spectrum of clinical specialties and is at the forefront of service provision and cutting edge research in many areas. It has a workforce of around 14,000 and a £750 million budget. As a major cancer centre it has benefited from significant investment. A particular feature of the hospital is the world renowned Minimal Access Therapy and the Surgical Skills Unit. Biomedical research is a strength of Dundee University especially in the area of basic research into cancer and vascular disease. A Clinical Research Centre has opened on the Ninewells site with a dedicated 3T MRI and a PET CT scanner operational from February 2010. A Medipark is adjacent to the Ninewells site to promote ancillary technological advances. 2. NHS Tayside Management Arrangements NHS Tayside Board Chairman Chief Executive Deputy Chief Executive Chief Operating Officer Medical Director Mr. S. Watson Mr. G. Marr Ms. C. Selkirk Ms. L. McLay Dr. A. Russell NHS Tayside Delivery Unit: Associate Medical Directors: Dr. Alan Cook Dr. John Colvin Dr. David Johnston Access Directorate: Associate Medical Director: General Manager: Dr. Alan Cook Ms. Lorna Wiggin Diagnostics Group: Joint Clinical Directors: Clinical Service Manager Dr. G. Main /Dr. W. Bartlett Mr. T. Chima Clinical Radiology Tayside Radiology Clinical Leader Angus Radiology Co-ordinator Dundee Radiology Co-ordinator Perth Radiology Co-ordinator CT Lead MRI Lead Ultrasound Lead Dr. K. Fowler Dr. K. Brauer Dr. S. Pillai Dr. J. Flinn Dr. I. Zealley Dr. G. Houston Dr. S Pillai The management structure of NHS Tayside Delivery Unit is configured as three directorates, Access, Surgery and Medicine. Each Directorate is composed of a number of groups. The Diagnostics group includes Clinical Radiology along with Microbiology, Haematology, Biochemistry, Immunology, Virology and Medical Physics. Current NHS Tayside Bed Complement (July 2008) CLINICAL GROUPING: Specialty MEDICINE General Medicine General Medicine - Stroke beds Gastroenterology Respiratory Medicine Communicable Diseases Geriatric Medicine Cardiology Cardiology (CCU) NINEWELLS GLENLAW 87 18 54 30 14 22 54 9 PRI ANGUS TOTAL 73 160 4 18 54 30 14 22 54 13 SURGERY & ONCOLOGY General Surgery Urology Clinical Oncology Cancer Medicine Clinical Haematology 130 24 27 11 13 50 0 180 24 27 11 13 MUSCULOSKELETAL Orthopaedics Accident & Emergency 105 8 54 159 8 SPECIALIST SERVICES ENT Surgery Ophthalmology Plastic Surgery 23 12 22 Dermatology ** Oral & Maxillo-facial Surgery Neurology Neurosurgery Pain 13 6 14 22 0 WOMEN & CHILD HEALTH Gynaecology Obstetrics Obstetrics Transitional Care Paediatric Medicine Mixed Surgical Paediatrics SCBU Transitional Care Unit 20 42 4 40 0 17 4 CRITICAL CARE ITU Surgical Unit Nephrology 21 TOTAL 873 23 12 22 13 6 14 22 0 0 12 6 6 8 0 0 7 3 6 202 32 56 4 46 0 17 4 16 10 16 21 24 1105 Current Tayside Primary Care Bed Complement (March 2008) Location Aberfeldy Aberfeldy Total Adolescent Unit Adolescent Unit Total Ashludie Ashludie Total Blairgowrie Blairgowrie Total Carseview Carseview Total Childrens Unit Childrens Unit Total Crieff Crieff Total Forfar Inf Forfar Inf Total Little Cairnie Little Cairnie Total Murray Royal Murray Royal Total Ninewells Ninewells Total PRI PRI Total RDLH RDLH Total Facility Name Long Stay GP Other Than Obstetrics Adolescent Unit Dementia Continuing Care Long Stay Long Stay GP Other Than Obstetrics not specified Acute Admission Intensive Care Other Children's Unit Dementia Assessment Long Stay GP Other Than Obstetrics Dementia Continuing Care GP Other Than Obstetrics Long Stay Acute Admission Continuing Care Dementia Assessment Dementia Continuing Care Forensic Functional Acute Admission Rehabilitation Not specified Other Geriatric Assessment Stroke unit Continuing Care Dementia Assessment Dementia Continuing Care Rehabilitation Functional Elderly Assessment Functional Elderly Continuing Care Functional Elderly & Dementia Continuing Care not specified Grand Total 0 12 12 7 7 13 35 48 0 25 12 37 48 12 13 73 0 0 10 0 24 34 0 0 0 28 28 43 0 38 12 28 0 0 13 134 0 0 54 8 62 0 34 17 25 17 11 0 0 104 Royal Victoria Royal Victoria Total St Margarets St Margarets Total Stracathro Stracathro Total Strathmartine Strathmartine Total Sunnyside Sunnyside Total The Firs The Firs Total Whitehills CBIR Geriatric Assessment Long Stay Palliative Care Unit Rehabilitation not specified GP Other Than Obstetrics Dementia care Long stay Assessment Stroke unit Other Acute Admission Alcohol Problems Continuing Care Dementia Assessment Dementia Continuing Care Functional Acute Admission Rehabilitation not specified Other Long Stay Other Whitehills Total Windyridge Other Windyridge Total Beechgrove House Other Beechgrove House Total Whitehills HCCC GP other than Obstetrics not specified Assessment Whitehills HCCC total Arbroath Inf. Dementia Continuing Care GP Other Than Obstetrics Arbroath Inf. Total Montrose Inf. Long Stay GP Other Than Obstetrics Montrose Inf. Total Brechin Inf. Long Stay GP Other Than Obstetrics Brechin Inf. Total Irvine Mem. Long Stay GP Other Than Obstetrics not specified Irvine Mem. Total Grand Total 16 68 28 25 47 184 12 12 0 0 24 10 34 34 34 28 12 0 15 0 12 0 67 0 0 0 0 0 0 0 0 0 20 20 20 60 20 20 40 0 16 16 20 19 39 0 9 7 16 1041 3. Clinical Radiology Service Clinical Radiology is part of the Access Directorate and has responsibility for the provision of radiological services throughout NHS Tayside with major departments in Ninewells Hospital, Perth Royal Infirmary, Stracathro Hospital and Arbroath Infirmary. There is a GP access plain film unit at Kings Cross hospital. In addition, radiographic services are provided on smaller sites. NHS Tayside management recognise the pivotal role of Clinical Radiology in the provision of high quality clinical services and are committed to the development of our services. This is reflected in the recent upgrading of the departments at Ninewells, Perth and Stracathro, their support of clinical radiology specialist registrar training and the implementation of the Tayside Acute Services Strategy with the complete redevelopment of the imaging department at Stracathro. Advanced development of a Tayside-wide PACS as part of the Scottish PACS implementation is in place. Services in Angus, Dundee and Perth are delivered on a filmless basis. Skill mix is supported with radiographers trained to perform barium enemas and IV injections in CT and MRI. A number of qualified sonographers are employed across the area. Many consultant radiologists work across different sites to support MRI and CT sub-specialty interest and service requirements. Clinical Radiology in Angus The main radiological services are delivered from Stracathro hospital and Arbroath Infirmary. Radiologist input in Angus is delivered by the consultant radiologists mentioned below. These consultants also have sessional commitments to Ninewells Hospital and are supported by other consultants colleagues across Tayside. There is no on-call radiological requirement for Angus and Angus based radiologists contribute to the Dundee on-call service. Consultant Radiologists in Angus Special Interests Dr Katrin Brauer Dr Winston Erng Dr Sanjay Pillai Dr John Tainsh Breast Radiology Oncology/gynae imaging Paediatric Radiology Musculoskeletal Radiology The departments have full radiographic support. Mrs. Lynda Marshall is clinical specialist 1 sonographer/Angus radiography manager, Mrs. Ilona Graham is clinical specialist 1 sonographer and Mrs. Lorna Anderson is the highly specialist radiographer in CT. Mrs. Linda Dickerson is the specialist radiographer at Arbroath. Stracathro Hospital Stracathro hospital itself is being developed as an ambulatory diagnostic centre. Following the withdrawal of acute medical and surgical specialties, Stracathro’s role in Tayside has been redefined and there is committed substantial development of the site to operate as an outpatient diagnostic centre. Outpatient planned day surgery is provided on site. The Stracathro radiology department underwent a major refurbishment. The department opened on its new site in Stracathro Hospital in January 2006. The equipments in Stracathro are as follows 2 Wolverson arcoma plain film units connected to a fuji CR system and a Philips diagnost eleva fluoroscopy unit was installed in December 2005. A 64-slice GE CT scanner was installed in February 2009. A 1.5 Tesla Siemens Avanto MRI unit was installed in January 2006. There are two ultrasound units, both Siemens antares which were installed in March 2003 and November 2005. . Arbroath Infirmary The radiology department in Arbroath infirmary has completed a refurbishment with a redeveloped ultrasound room. The examinations are predominantly from outpatient clinics and general practitioner referral along with a small number of inpatients from the geriatric unit at Arbroath Siemens plain film unit A Siemens antares ultrasound unit was installed in March 2006 Links Health Centre Montrose and Whitehills Hospital, Forfar Siemens plain film unit at each site. Clinical Radiology in Dundee Radiology services are provided by the consultants mentioned below. On call services based in Dundee is supported also by Angus radiology consultants. As the PACS implementation is complete, the department functions as a film less unit. Consultant Radiologists in Dundee Special Interests Dr. Raj Bhat Dr. John Brunton Dr Roddy Cameron Dr. Sam Chakraverty Dr Alan Cook Dr Bob Doull Professor Graeme Houston Dr Gavin Main Dr Alan McCulloch Dr Barry Oliver Dr. Prasad Guntur Ramkumar Dr. Thiru Sudarshan Dr Tom Taylor Dr Naveena Thomas Dr Christine Walker Dr. George Watson Dr. Ian Zealley Vascular/Intervention Head/neck and Gynaecological oncology Chest and uroradiology Vascular/Intervention Breast Imaging Uroradiology MRI & Vascular/Intervention Neuroradiology & Paediatrics GI radiology Musculoskeletal, MRI, Teaching Lead Cardiac Imaging and Nuclear Medicine Oncology imaging, head and neck imaging GI & Chest radiology Musculoskeletal and Nuclear Medicine Musculoskeletal & Breast Imaging Vascular/Intervention Vascular/Intervention Dundee Radiography Manager Senior Charge Nurse: Mrs. Jane Williams-Butt Mrs. Jane Neill Radiographic Rooms There are four plain film rooms within the main department. The A & E x-ray department includes specialised plain film equipment in the resuscitation room. To coincide with the closure of in-patient facilities in Kings Cross Hospital a new x-ray room has been built in Ninewells which incorporates digital imaging There are two fluoroscopy units, one a Philips MD Eleva C-arm digital fluoroscopy room, which was installed in December 2004 and the other a Siemens ICONOS digital fluoroscopy unit. Ultrasound There is a 4 room ultrasound suite which is integral to the department containing three Siemens antares units installed in March 2006 and one Siemens S 2000 unit installed in April 2009 Interventional/vascular radiology suites There are two units, one is in a theatre style environment. Both are Siemens Artis dTA units with flat plate detectors. The first was installed in November 2004 and the second in April 2005. Computed Tomography There are 2 G.E. 64-slice CT units, which were installed in February 2009. Magnetic Resonance Imaging There are 2 MRI scanners, a Siemens Magnatom Avanto 1.5 Tesla installed in November 2004 and a Seimens Aera 1.5 T Tclass installed in January 2011 Clinical Radiology in Perth The main radiological service is provided from Perth Royal Infirmary. There are limited plain film facilities at the community hospitals in Blairgowrie, Crieff and Aberfeldy. All general radiology including reporting, ultrasound and CT is shared between the consultant radiologists, who also have a range of special interests. The on call work is shared equitably between 7 whole time equivalents consultants based at Perth Royal Infirmary. This equates to a frequency of 1 in 5.65 on call when prospective cover for annual and study leave is included. Consultant Radiologists in Perth Special Interests Dr Janet Flinn (part-time) Dr Kenneth Fowler Dr. Avinash Kanodia Dr Suzanne McClelland (part-time) Dr Robin Pearson Dr Olivia Thomas (part-time) Vacant Post 1 Vacant Post 2 Breast Imaging, CT, Ultrasound Chest, Breast Imaging, Stroke & MSK Neuroradiology CT, MRI CT, MRI, Neuro, GI CT & Paediatrics Perth based radiologists are on call for the provision of emergency radiology services in Perth. Senior Radiographic Staff in Perth Superintendent Radiographer/Radiographer Manager Superintendent 3 Superintendent 3 (CT Scanning) Ultrasound Clinical Specialist I Ultrasound Clinical Specialist II Mr. Douglas Mitchell Miss Beryl Pritchard Mrs. Linda Cruickshank Mrs. Margaret Taylor Mrs. Gill Millar The Department of Radiology in Perth Royal Infirmary comprises: Radiographic Rooms Fluoroscopy – Siemens Axiom Luminos TF installed October 2008 General – IGE Dual couch tomography/IVU – Siemens General/A&E – Siemens Orbix Mammography –Siemens Novation full field digital mammography unit and Opdima stereotactic biopsy unit installed April 2006 Dental – Philips OPG, Siemens IO unit Computed Tomography Toshiba Aquilion TSX101A 64 multislice CT scanner with 2 Vitrea workstations installed January 2007 Ultrasound 2 Siemens antares scanners both installed in March 2006 3rd Siemens antares scanner March 2007 Magnetic Resonance Imaging Siemens Avanto 1.5 T Class fully specified unit was installed in April 2009. 4. East of Scotland Postgraduate Clinical Radiology specialist registrar, student radiographer and nurse training schemes NHS Tayside is accredited by the Royal College of Radiologists for Higher Training in Clinical Radiology. The scheme is run in conjunction with Edinburgh for year 1 training and some specialist blocks. There are currently 12 radiology SpR NTNs. The specialist registrars are trained at Ninewells, Perth Royal Infirmary, Stracathro hospital and Arbroath Infirmary. The academic lectures to support training before sitting parts 1 and 2a of the FRCR exam as well as some subspecialty blocks are delivered in Edinburgh. Regional Postgraduate Education Adviser Tayside Programme Training Director Angus College Tutor Ninewells College Tutor Perth College Tutor Dr. Tom Taylor Dr. George Watson Dr. Sanjay Pillai Dr. Ian Zealley Dr. Robin Pearson Student radiographer training The department is involved in the training of diagnostic radiography students as part of their Robert Gordon University BSc course. In year 2008/2009 a total of 21 student radiographers were in attachments, 4 in first year, 4 in second year, 5 in third year and 8 in fourth year. There are also 2 Healthcare Academy students present within the department. 5. Academic radiology Research and Development Clinical radiology has a key role in the Tayside research and development activity undertaken across a broad range of clinical specialities. Over the last 5 years, individuals within the radiology department have been involved in obtaining £4.6 million in grants associated with multidisciplinary collaborative projects developed with other departments and centres. The department is actively involved in several ongoing national multi-centre trials in association with other university and NHS departments. These are focused on predominantly MRI and vascular topics. In addition the department undertakes CT, ultrasound and plain film examinations as part of multicentre and local research projects conducted primarily by other departments. Current departmental research activities have a particular emphasis in joint projects with the departments of clinical Pharmacology, Vascular Medicine and Surgery in vascular imaging, and with the oncology departments in cross sectional imaging and with neurosciences in neuro imaging. The department has established links with non-radiological post graduate students who are researching aspects of imaging which interrelate with areas of their specialist research interest, and there are students working in the department who are studying for MSc, MD and PhD degrees. Undergraduate Teaching Dundee University has a new medical curriculum and achieved the highest award of “excellent” in the SHEFC Assessment. Undergraduate teaching in radiology involves formal lectures, student attachments, special study modules and integrated teaching. Academic developments The University of Dundee in collaboration with NHS Tayside opened a Clinical Research Centre (CRC) in May 2008. This contains a Siemens 3 Tesla MRI scanner and a Siemens PET CT operational from February 2010. The clinical research centre represents a major investment by the University of Dundee and NHS Tayside and its anticipated that there will be heavy utilisation of imaging aimed at facilitating joint clinical/imaging research activity across the university and NHS. NHS radiologists support imaging based research in the CRC and this will increase with the appointment of a planned additional consultant. The University plans has created 2 professors in imaging. Professor Andrew Evans started in November 2009 and Professor Graeme Houston took up post in December 2009. A Senior Lecturer post was created and Dr Sarah Vinnicombe commenced May 2011. These positions are intended to link between the NHS clinical department and the university to facilitate academic and research activity throughout clinical radiology and continue to build expertise in the fields of imaging as an integral component of our cancer, cardiovascular and neurosciences research strategies. 6. East of Scotland Vascular Network (ESVN) The ESVN is a developing Managed Clinical Network for the care of patients with vascular disease in the Tayside and Fife Health Board Areas covering a total population of 750,000. Out-patient services are delivered at multiple localities in Tayside and Fife. In-patient services are based on a dedicated 24 bed ward at Ninewells Hospital and an 18 bed ward at Queen Margaret Hospital. All emergency services are centralised at Ninewells Hospital. Fife-based surgeons rotate to Ninewells when on call, and during this time, their elective work is performed in Fife by rotating Tayside-based surgeons. There are currently 6 vascular surgeons, 4 vascular physicians and 5 radiologists with a vascular/interventional interest contributing to network services. Vascular laboratory services are present on all sites. One of the vascular surgeons is trained in endovascular techniques and performs a list within the Radiology department at Ninewells. All patients from Fife and Tayside undergoing radiological and surgical investigations and treatments are discussed at a weekly multidisciplinary meeting at Ninewells which is linked to rapid clinic review. There are regular surgical audit meetings and close links and regular vascular access meetings with nephrology services on both sites. TIA clinics are run in close co-operation with the vascular service. 7. East of Scotland Breast Screening and Imaging Service Breast screening is combined with the Dundee and Angus symptomatic breast service in one breast imaging unit which is separate from the main radiology department. Managerially, this unit is within the Surgical Directorate. Dr. John Colvin is the Associate Medical Director, and within breast imaging Mr. Douglas Brown, consultant surgeon is Clinical Leader. Dr. Denis McLean is a full time dedicated breast radiologist and is involved in the screening and symptomatic breast services. Dr. Katrin Brauer, Dr. Alan Cook and Dr. Christine Walker each have input into breast screening. Mrs. Elizabeth Stormonth has an extended departmental role and undertakes screening mammography film reporting and stereotactically guided core biopsy. In Perth Royal Infirmary the surgical and radiology departments deliver all symptomatic breast services and have developed a one-stop service. Dr Janet Flinn and Dr Kenneth Fowler are the radiologists involved. The breast services are delivered by a multi-disciplinary team with breast surgeon, breast clinician, specialist breast nursing, and pathologist and radiologist input. The symptomatic service has weekly multi-disciplinary team review meetings. 8. Nuclear Medicine Service The Nuclear Medicine Department in Ninewells is one of the busiest in Scotland. It provides the full range of diagnostic imaging studies, laboratory based studies and Nuclear Medicine therapies with unsealed sources. The imaging department is located in the polyclinic complex adjacent to Radiology. At present it has three gamma cameras which perform approximately 7100 imaging studies per year. The department possesses one single headed GE Millenium camera, one dual headed variable geometry Picker Axis camera with attenuation correction capabilities and a new GE Infinia Hawkeye dual headed variable geometry camera. A Nuclear Medicine department opened in February 2011 at PRI with a new gamma camera and building work has started on a new nuclear medicine department on the Ninewells site to replace the existing department. The imaging service supports virtually all of the clinical specialties across Ninewells, the Royal Victoria Hospital, PRI and Stracathro sites. We are supported and supplied by an on-site radiopharmacy which also provides the sterile product handling required to provide a labeled white cell scan service. The Department has a total of 10 PA’s from a combination of a Nuclear Medicine Physician, Dr. John Davidson and a Consultant Radiologists Dr John Brunton and Dr. Prasad Guntur Ramkumar. Drs T Taylor, T Sudarshan and J Davidson provide PET CT service at the CRC There are three Medical Physicists, 8 whole time equivalent Nuclear Medicine MTO’s, 2 Grade E staff nurses and 1.5 w.t.e A&C staff. The imaging service provides a comprehensive range of investigations including bone scans, V/Q lung scans, myocardial perfusion imaging, isotope renography, MUGA, labeled white cell scintigraphy, DaT scans, thyroid and parathyroid imaging, MIBG scans and Octreotide scans. The Department is actively and enthusiastically involved in teaching at both and undergraduate and postgraduate level. The Department is heavily committed to the training programme of Specialist Registrars in Radiology based in Ninewells and is one of only two recognised training centres in the East of Scotland. The Department also continues to have a number of research projects made up of NHS clinical projects and commercially funded studies. 9. Duties of the Posts Successful applicants will be expected to: work flexibly with other members of the imaging teams; participate in the work of the departments as allocated on the duty roster (see appended job plans which are subject to annual review). participate in the provision of the on call service; contribute to undergraduate and postgraduate teaching; participate in audit and research activity; support clinical-radiological meetings; undertake the administrative duties associated with the care of his/her patients and the running of his/her department; be flexible in any future discussion re: allocation of duties. 10. Conditions of Service The terms and conditions of employment will be subject to the Terms and Conditions of Service for Consultant Grade (Scotland) and the General Whitley Council conditions of service, both as amended from time to time. Membership of the NHS Superannuation scheme is not compulsory, but all medical and dental staff are entitled to choose if they wish to join the scheme. Until such time as a positive option not to join the scheme is expressed, a member of staff will be regarded as a member of the scheme from the first day of service. This will not affect any individual rights to make alternative arrangements. Initially, the employment covered by this contract will be contracted out of the State Pension Scheme. The post holder requires to be a car user. Working in Tayside provides opportunities for a full and active lifestyle. There is a good supply of affordable quality housing in Tayside. There are many opportunities with leisure and educational pursuits with easy access to fine countryside but also good transport links to the rest of Scotland and beyond. 11. Responsibility for Records Management All records created in the course of the business of NHS Tayside are corporate records and are public records under the terms of the Public Records (Scotland) Act 1937. This includes email messages and other electronic records. It is your responsibility to ensure that you keep appropriate records of your work in NHS Tayside and manage those records in keeping with the NHS Tayside Records Management Policy and with any guidance produced by NHS Tayside specific to your employment. 12. Applications Applications should be submitted in the form of 2 CV’s (including the supporting documents available from the NHS Scotland Recruitment website or by e-mailing [email protected]) to Imogen Scott, Workforce Services Adviser, Workforce Directorate, NHS Tayside, Level 9, Ninewells Hospital, Dundee, DD1 9SY. January 2012