HSE Consultant Anaesthesia ICU/ ITU in Munster Region - Republic of Ireland on a fixed term / permanent basis; working for our client via Workplace Doctors

*** Must have IMC (Specialist Division) Registration (Irish Medical Council) - Essential
*** Location: Republic of Ireland – Munster Region (Clare, Cork, Kerry, Limerick, Tipperary, Waterford)
***Speciality: Anaesthesia ICU/ ITU Intensive Care Anaesthetist

*** Role: Consultant (6+ years post graduate experience)

*** Duration: 12 months (FREE visa & work permit + relocation package offered)

*** Start date: ASAP

***IELTS Score of 7.0 Overall (minimum) – Essential

***Exact location details provided on application

*** €217,235 to €261,051 Euro’s (dependent on experience) basic salary (allowances paid extra)

Irish Teaching Hospitals and Medical Universities receive great international acclaim & recognition throughout the world, doctors with experience and training in Ireland typically enjoy great success in terms of professional career development & job satisfaction.

Overview

This post is for a Consultant anaesthetist with an interest in Intensive Care. 

The post will involve flexible day-time working with anaesthetic provision for lists across a range of specialities in addition to regular intensive care sessions.  The successful applicant will participate in the intensive care on-call rota at secondary site, which is currently 1 in 9, or at the main hospital 1 in 8.

There are 9 bed spaces, including a cubicle, with current staffing for up to 8 patients, admitting approximately 840 patients per year. There is executive approval for a 13 bedded rebuild. The unit has 9 consultants with daytime and on call sessions in ICU all of whom have ICU as a major element of their job plan. Thus a consultant rota of 1 in 9 with prospective cover operates. The unit has 24/7 cover by consultants with daytime sessions in ICU, with 2 consultants per day – a ‘hot week’ consultant (to provide continuity) and a 24hour consultant, who is on call. The operational policy of the ICU is of consultant to consultant referral from the referring team. Senior nursing is provided at band 7 and there is a Nurse Educator. Trainee resident staffing is provided by 8 anaesthesia trainees and 4 ACCS trainees as well as 4 Medical Training Initiative Doctors shared with the Anaesthetic Dept and two staff grade doctors. The unit has 24/7 dedicated resident ICU cover. The unit is approved by FICM for all levels of intensive care training and has a Faculty Board Tutor. The hospital have 3 Advanced Critical Care Practitioners in post and another 2 recruited for training in a nearby University. We aim to have 9 in post by 2021

There is specific clerical time allocated for ICNARC data collection and the unit has a clinical information system (Metavision) which integrates patient observations, medical and nursing notes, prescribing and results systems at the bedside. This has ongoing customisation which has provided the ICU with a wealth of data capture opportunities. The ICU also has a 24/7 band 7 critical care outreach service to facilitate both admission to and discharge from the ICU as well as numerous educational and audit initiatives. The ICU staff have monthly meetings incorporating clinical policy making, audit, morbidity and mortality and other governance issues. ICU consultants and trainees also attend the theatres division monthly audit meetings.

We have a developing Rehabilitation After Critical Illness (RACI) service with 2 HCA trainees qualifying soon and band 7 nurse input for follow up on both sites.

Our research Lead has overseen entry to a number of portfolio studies including PEPTIC, DREAMY and OPTIMISE

Please note that full IMC registration and license to practice is an essential for this role. If you do not currently have IMC registration, but you are in the process of applying, please use the supporting information section of the application form to provide an update about the status of your IMC application.

Candidates without IMC registration at the time of shortlisting will not be considered- as per hospital requirements.

Additional Information

You will be able to take advantage of the excellent Consultant contract for the Republic of Ireland. The basic salary range for this post is euros 120,000 per annum to euros 160,893 per annum plus a further euro 26,672 per annum available in Commitment Awards.

Theatres

The anaesthetic department at secondary site provides anaesthetic services for elective surgery in 6 inpatient, and 3 day surgery theatres, as well as a separate “NCEPOD” theatre and obstetric theatre. 

Anaesthetic Services

All anaesthetic consultants at the second site work flexibly in time and theatre location, with rotas published 6 weeks in advance.  This enables consultants to maintain their skills across a wide range of specialities. For more complex areas – for example ICU, vascular, upper g-i, and major ENT a smaller pool within the body of Consultants with special interests will work flexibly to provide cover for elective lists.  This flexible working enables the department to provide a high quality out-of-hours service across the full range of specialities, including paediatric anaesthesia – as required, despite there being only 2 Consultants on-call.

Surgical specialities hospital provide anaesthetic services for a wide range of surgical specialities from day-case to complex surgery.  Surgical specialities include general surgery, vascular, urology, ophthalmology, obstetrics and gynaecology, trauma and orthopaedics, maxillo-facial, ENT, and community dentals. 

Obstetrics. There are approximately 1800 deliveries a year at the secondary site, with a Caesarean section rate of about 28%.  There are 3 elective LSCS lists per week that are staffed by a Consultant anaesthetist. There is an antenatal anaesthetic assessment service, with a clinic once a fortnight.  Currently there is no obstetric epidural service at CIC due to the limited out-of hours resident anaesthetic staffing, but there is an intention to introduce this service soon. 

Paediatrics. Anaesthetic services are provided for straightforward paediatric surgery, mainly ENT and dentals down to an age of 1 year, or 10kg, this, along with CPD enables members of the department to maintain their skills for management of paediatric emergencies that inevitably present.

Pre-assessment The department staffs and supports an active anaesthetic pre-assessment service, with a combination of nurse and Consultant led clinics. 

Emergency Theatre and Trauma   There is a staffed trauma list Monday to Friday 08:00-18:00, with a separate staffed trauma list all day Monday to Saturday and afternoons, Sunday and Bank Holidays.  There is a 24/7 emergency ‘CEPOD’ theatre.

Outside these hours there is an on-call service, with one resident anaesthetist in the hospital covering theatres and obstetrics (including the epidural service) and another covering ICU. They are supported by on call consultants in anaesthesia and ICU

Chronic Pain The chronic pain service is led by Dr B Van Mourik, and there are currently 7 chronic pain sessions a week, divided between clinic and treatment sessions and covered by 2 Consultants.

Intensive Care Described above

Specific Duties

INTENSIVE CARE

All appointed ICU consultants undertake to work both in both clinical sites of the hospital.

The following is an example of a 10PA job plan:

6 PA DCC weekday working 0800-1800 theatres / ICU.

2 PA DCC for weekend and out of hours unpredictable work.

2 SPA with 1.5 Core SPA and additional 0.5 SPA role agreed with Clinical Director at job planning meeting.

Working patterns:

1 in 10 weeks are ‘hot weeks’ at CIC (0800-1800 Monday to Friday -12.5 DCC)

1 in 10 weeks are ‘light weeks’ at CIC following the hot week – 1.25 DCC)

10 x 2 days per year working at the main hospital ICU with travel supported as per trust policy.

24 hours on call on a 1 in 9 basis.

Remaining DCC are spent flexibly working in theatres.  Currently the theatre lists are allocated to members of the department on a non-fixed, flexible basis to provide optimal cover for surgical theatre lists.  Within this, there is an agreed level of cover between consultants depending on preferences and skills to provide anaesthesia for the surgical specialties.  As such, the post holder on job planning can discuss with both ICU and anaesthesia clinical directors their preferences, skills, and an agreement made for their theatre allocation.  Such an agreement would also be in line with annual appraisal and development needs.

On a 10 PA job plan, approximately 60% or more of time is spent in ICU.

Additional clinical PA may be available on discussion with the clinical director.

The trust has a flexible working policy which also may be discussed at job planning.

Teaching Commitments

·       regular commitments to ward based teaching of undergraduates.

·       participation in the lecture programmes for 2^nd and 4^th & 5^th year medical students.

·       teaching of other groups as required including other specialty juniors and specialist nurses.

Job Plan

A formal job plan will be agreed between the appointee, the Operational Medical Director and Lead Anaesthesia Consultant, on behalf of the Trust’s Medical Director, based on the provisional timetable. This will be signed by the Chief Executive and will be effective from the commencement date of the appointment.

It will be reviewed at 3 months & thereafter annually or at any time, but no less than 3 months after a previous review, as requested by the appointee, Operational Medical Director or Clinical Lead & adjusted accordingly to the agreement of both parties.

Example Job Plan – Consultant in Anaesthesia and Intensive Care

Consultant Anaesthetists work as a team to undertake their clinical and related duties for the Trust.  Individuals’ job plans vary in accordance with their skills and interests as well as their role within the department.

The standard Job Plan is for 10PAs comprising of 8.0 Direct Clinical Care PAs, of which job diaries have shown 2PA required for predictable and unpredictable on-call and 2.0 Supporting Professional Activity PAs.

Direct Clinical Care

6.0 PAs per week in ‘routine’ DCC activity made up of a combination of some or all of the following:

All day operating list or intensive care                         2.5 PAs

Half day operating list or intensive care                      1.25 PAs

Clinics, including clinic admin time                              1.25 PAs

Daytime On Call                                                                    2.5 Pas

In addition a further average of 2 PAs per week allocated for provision of out of hours on call cover on a 1 in 8 rota:

Predictable (weekday evenings and weekend mornings)          1.0 PA

Unpredictable                                                                                             1.0 PA

Anaesthetists’ duties when covering operating lists include pre- and post-operative ward work. Depending on when patients are admitted, this work is usually done on either the same day as the list, or the preceding day.  The PA calculation is therefore based on an average notional 0800 – 1800 working day.

Daytime on call runs from 0800 – 1800, during the week, with change-over at 08:30 Saturday, Sunday and bank holidays.

There are predictable periods of on call activity during early evening on weekdays and in the mornings at weekends.  It is normally expected that the on call Consultants will come in on Saturday and Sunday mornings at, or soon after 8:30.

Routine and on-call duties are shared between Consultants according to an agreed and published rota.  Every effort is made to make efficient use of the staff available whilst maintaining on call cover.  Rotas will normally be published 6 weeks in advance and after that any change in time of sessions should be agreed by individual and the department.  Location and nature of lists or clinics may be changed at shorter notice if the anaesthetist concerned is informed.

The intensive care team is committed to a joint approach and common working practices across the two units. All appointees may be required to work up to 20 days (50PA per annum) in the hospital when based on the site. Travel for a daytime 0800-1800 activity normally attracts up to 0.5PA per day worked which can be used as additional payment or time in lieu.

All doctors should be familiar with the HSE requirements governing good medical practice, which is supported by the Trust.

Standard Duties and responsibilities

a) To participate in development of and undertake all duties and functions pertinent to the Consultant’s area of competence, as set out within the Clinical Directorate Service Plan  and in line with policies as specified by the Employer.

b) To ensure that duties and functions are undertaken in a manner that minimises delays for patients and possible disruption of services.

c) To work within the framework of the hospital / agency’s service plan and/or levels of service (volume, types etc.) as determined by the Employer. Service planning for individual clinical services will be progressed through the Clinical Directorate structure or other arrangements as apply.

d) To co-operate with the expeditious implementation of the Disciplinary Procedure 

e) To formally review the execution of the Clinical Directorate Service Plan with the Clinical Director / Employer periodically. The Clinical Directorate Service Plan shall be reviewed periodically at the request of the Consultant or Clinical Director / Employer. The Consultant may initially seek internal review of the determinations of the Clinical Director regarding the Service Plan.

f) To participate in the development and operation of the Clinical Directorate structure and in such management or representative structures as are in place or being developed. The Consultant shall receive training and support to enable him/her to participate fully in such structures.

g) To provide, as appropriate, consultation in the Consultant’s area of designated expertise in respect of patients of other Consultants at their request.

h) To ensure in consultation with the Clinical Director that appropriate medical cover is available at all times having due regard to the implementation of the European Working Time Directive as it relates to doctors in training.

i) To supervise and be responsible for diagnosis, treatment and care provided by non-Consultant Hospital Doctors (NCHDs) treating patients under the Consultant’s care.

j) To participate as a right and obligation in selection processes for non-Consultant Hospital Doctors and other staff as appropriate. The Employer will provide training as required. The Employer shall ensure that a Consultant representative of the relevant specialty / sub-specialty is involved in the selection process. 

k) To participate in clinical audit and proactive risk management and facilitate production of all data/information required for same in accordance with regulatory, statutory and corporate policies and procedures.

l) To participate in and facilitate production of all data/information required to validate delivery of duties and functions and inform planning and management of service delivery

Essential Requirements

This post is open to doctors who hold Registration as a Specialist in the Specialist Division of the Registrar of Medical Practitioners maintained by the Medical Council in Ireland in the specialty of Anaesthesia.

Office Accommodation

Office accommodation will be provided for the appointee with secretarial support

Service Provision and Cover during Absences

The consultant has a continuing responsibility for the care of patients in his/her charge and for the proper functioning of the service allowing for appropriate delegation for the training of his/her staff.

He/she must be available by telephone and able to attend the hospital in a timely fashion when on-call (40 minutes journey time).

Consultant staff must ensure that services are covered during his/her planned absences. Where fixed commitments need to be cancelled during planned absences appropriate notice (8 weeks) must be given. Absences must be co-ordinated with other consultant staff in the specialty to ensure senior cover is always available.

Management Responsibility

All Consultants are required to attend the monthly Directorate Meetings. Post holders will be expected to share in administrative duties allocated by mutual agreement within the Directorate. As part of the Consultant Team, the consultant  will offer mentoring support and lead the existing clinical team through; joint clinics, one-to-one support, individual case management and complex cases, identifying development needs and suggesting CPD (Continuous Professional Development) opportunities and responding to clinical enquiries via e-mail and telephone.

If you are interested in working in growing your career and increasing your income, then talk to our healthcare team today. If you can fill the above requirements, we will give you the following benefits:

*** Visa & Work Permit for FREE!

*** Guidance, Training & Career Development

*** Dedicated & Supportive team- Consultant available when you need.

*** Excellent Basic Pay, Overtime paid for extra hours
***Assistance provided with relocation

We look forward to helping you progress your career and find you the ideal position.

Doctors Guide to working in the Republic of Ireland – Click here

The hospital welcomes all applications irrespective of age, disability, gender, sexual orientation, race or religion- essentially the applicant must meet the criteria mentioned above

Call us today on +44 (0) 1234 889213 to discuss this vacancy or email your CV to info@workplacedoctors.co.uk  or apply online today (see below).

***Please note due to the high number of applications, we do answer every application in turn.***