ISLE OF WIGHT NHS TRUST

JOB DESCRIPTION

Associate Specialist Anaesthetics and Chronic Pain

The Trust website www.iow.nhs.uk

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 ISLE OF WIGHT NHS TRUST
JOB DESCRIPTION

POST

Title: Associate Specialist

Location: Isle of Wight NHS Trust (St Mary’s Hospital, Newport)
New /Replacement post: This is a replacement post
Accountable to: Consultant Anaesthetists

The job offered involves a mixture of duties in all aspects of anaesthetic care common to a
district general hospital but with a particular focus on chronic pain management.

A particular interest in chronic pain management is expected but other interests may be
accommodated by mutual agreement.

ANAESTHETIC DEPARTMENT

The Anaesthetic department and the Intensive Care Unit are part of Clinical Support,
Cancer and Diagnostics business unit and Dr Mike Pearson is the Lead Clinician for
Anaesthesia and Dr Muriel Prager Clinical Lead for Intensive Care.

The Department provides anaesthetic services for general, ophthalmic, maxillofacial, ENT,
urological, orthopaedic and gynaecological surgery. We also provide anaesthetic services
to obstetrics, radiology, ECT and the A&E. The relative geographical isolation means that
all anaesthetists must maintain a wide range of core skills. The department consists of 13
consultants and 12 SAS doctors. There is presently one anaesthetic trainee working at the
department. The main theatre complex consists of 4 operating theatres and 2 separate
day case operating theatres. There is a dedicated obstetric theatre. All standard modern
equipment and drugs are available.

CHRONIC PAIN SERVICE (CPS)

This is an outpatient service open to GPs for malignant and non-malignant pain
syndromes. It is provided by a team of two consultants from the Department, one
Associate Specialist (advertised post), a Clinical Psychologist and part-time Nurse
Specialist, as well as Specialist Physiotherapists providing Physical Therapy and
Acupuncture sessions.

The Earl Mountbatten Hospice provides malignant pain control, respite services and
terminal care and cooperates closely with the Hospital CPS.

The service runs a Pain Management and a Fibromyalgia Program on the Island.

The clinical lead for the CPS is presently Dr Isobel Rice.

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Jobplan (Associate Specialist in Chronic Pain and Anaesthetics)

1. Overview

The specific job plan is based around a full time contract delivering an average of 10
Programmed Activities (PA) per week. These PA are made up of 9 Direct Clinical Care
(DCC) and 1 for Supporting Professional Activity (SPA). The DCC shall be allocated to
slots on the department’s 12 week rolling Rota.

By local negotiation this contract may be reduced to a minimum of 6.5 PA per week. There
is also potential to add up to 2 regular extra-contractual PA if departmental workload can
support the activity.

The Associate Specialist may be asked to work in any area that is presently covered by
staff in the anaesthetic department to include 1 st OC, ICU resident, maternity and theatre
work but excluding consultant O/C.

2. Details of expectations

2.1- First on-call Resident (FOC)

The FOC day runs from 08:00 until 08:00 the next day (24 hours with variable DCC
remuneration – see 3.8 below). It is expected that you shall be present and ready receive
the FOC bleep and that you stay to hand on the bleep the following morning.

The FOC is primarily responsible for attending medical emergencies but also responsible
for anaesthetising for surgical emergencies. The FOC is not responsible for covering
overrunning elective lists after 17:00. Orthopaedic trauma, however, is an exception to this
rule.

2.1- Intensive Care Resident (ICR)

The ICR day runs from 08:00 until 08:30 the next day (24 ½ hours with variable DCC
remuneration – see 3.8 below). It is expected that you shall be present and ready to start
receiving handover at the beginning of the day and that you stay to give a handover the
following morning.
Between 17:00 and 08:00, the ICR will carry the Maternity Bleep 500 and be primarily
responsible for covering anaesthetic requirements in both ICU and maternity.

2.2 Elective Surgical Lists

The remuneration for covering a theatre list includes time allocated to see all the patients
before the list and attend the anaesthetic room 5 minutes before the official start time to
attend the WHO team briefing. Secondly there is a financial allocation to cover your care of
the patients in recovery. There is no obligation within your contract to stay after the
advertised finish time of the list. If you choose to start a case that is going to cause the list
to overrun, however, you are obliged to stay and finish the case.

2.3 Maternity daytime cover

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The maternity day runs from 08:00 until 17:00. The Maternity Bleep 500 must be collected
from the ICU staff room at 08:00 and then attend the obstetric handover in the labour ward
coffee room. Responsibilities during the day include siting epidurals, attending caesarean
sections, advising on pain relief, reviewing women who may be ill / be difficult to cannulate
/ need advice regarding caesarean section at the request of the obstetricians or midwives.
Finally the Maternity Bleep 500 must be returned to the ICR at 17:00 on the ICU.

2.4 Chronic Pain Service

There is an initial expectation that between 4 and 6 PA shall be undertaken to support

activity within the chronic pain team. The time shall be divided between clinics and
procedure lists in theatre in a proportion to fit the workload generated. Each session shall
be 1.2 DCC in length so making an allowance for consenting patients and paperwork.

3. Details of expectations during flexible rota period

3.1 Session delivery

Sessions are to be delivered to the service over a series of 12 week Rota’s. In total 10 PA
x 12 PA shall be available each Rota = 120 PA.

3.2 Calculation of available Direct Clinical Care PA (DCC)

Total PA to be delivered over 12 weeks 120 PA in 12 weeks

Subtract SPA (12 x 1) = 12 SPA 108 DCC

This final figure is the number of Available DCC (ADCC) that shall be allocated by the
departmental co-ordinator over each 12 week Rota.

3.3 Completion of owed DCC

These 108 ADCC must be completed within the 12 week Rota or they shall be added to
the succeeding period.

The department shall give at least 3 weeks’ notice of expected duty. Work may be offered
at shorter notice but may be declined by the associate specialist.

No more than 2/3 of the ADCC (72) shall be assigned to resident shifts without the express
consent of the associate specialist.

3.4 Holiday

Associate Specialists are entitled 33 working days holiday per year plus 8 Bank Holidays.
This increases to 35 working day after 2 years’ service for the NHS.

Holiday must be requested at least six weeks in advance and not more than a year in
advance. It is expected that the majority of the leave is taken in week or longer blocks.
A calendar week shall remove 5 days’ holiday from the total allocated and no weekend
work shall be allocated to the weekends either side of the requested 5 working days.

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Unless a Bank Holiday is specifically requested as leave, the department may allocate
work to the associate specialist on those days. If part of the ADCC allocation, each day or
part of day worked shall earn an extra day added to the annual holiday allocation. If
worked as Extra Duty, each hour earns double the enhanced rate of pay.

There are further guidelines specific to the department to ensure fair allocation of annual
leave and continuing ability to deliver the service. The above apply to the whole
department and are not unique to this job plan.

The department reserves the right to allocate work on any day (Bank holiday, weekday or
weekend) not set aside as holiday by the associate specialist.

For each period of leave taken, the ADCC per Rota shall be reduced at the average rate
remunerated (10 per week or 10/5 = 2 ADCC per working day) or removed from the
following Rota’s allocation at the discretion of the department.

ie If a weeks’ leave is taken, the ADCC owed over the 12 week rota that includes the leave
period shall be reduced by 10.

3.5 Study Leave

Study Leave entitlement is 30 days over three years. For each study day taken, the ADCC
per Rota shall be reduced at the average rate remunerated (10/5 = 20 ADCC per working
day) or removed from the following Rota’s allocation at the discretion of the department.

3.6 Sickness

Periods of Sickness experienced shall likewise reduce the ADCC per by 2 per day per
Rota. Sickness that occurs after the Available PA per Period has been used shall reduce
the Available of the following Period by 2 ADCC per day sick.

3.7 Extra Duty (overtime)

Once the Available PA per Rota have been used, Extra Duty may be offered at an
enhanced locally negotiated hourly rate of pay that presently stands at £45 per hour
between 08:00 and 20:00. The rate increases to £55 per hour between 20:00 and 08:00.
These rates further increase to £55 in hours and £65 out of hours after 5 years in post on
the Isle of Wight. Note that this hourly rate is not enhanced further by the effect of PA
compression out of hours as detailed in 3.8 below. There is absolutely no compulsion to
complete Extra Duty.

3.8 Value of completed sessions

The various sessions that are required for completion by the department are remunerated
as follows:

Theatre list 1.2 DCC Orthopaedic list 1.4 DCC

Maternity half day 1.2 DCC Pre assessment session 1.2 DCC
Consultant O/C from home 3DCC Chronic pain clinic 1.2 DCC
1st OC shift (24 hours) Mon-Friday 7 DCC Sat/Sun 8 DCC
ICU OC shift (25 hours) Mon-Friday 7.25 DCC Sat/Sun 8.25 DCC

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The remuneration for these shifts is instead calculated on an hourly rate if completed as
Extra Duty. (see 3.7 above)

Shifts are remunerated at double the above rates during bank holiday hours.

3.9 Supporting Professional Activity

At three months and annually thereafter, SPA activity shall be reviewed. The first 1SPA is
automatically provided to support essential professional development. Allocation above
1PA will only be awarded for activity related to the administration of the department and
are at the discretion of the Lead Clinician.

4. Further Notes

4.1 Fixed Activity

It is often possible to arrange a regular commitment to a particular activity or surgical

session within the Rota. These arrangements can be organized as part of the Job
Planning process but are always subject to the service needs of the department.

4.2 If ADCC not completed

DCC not completed shall be added to the succeeding Rota whilst DCC completed over the
agreed total shall be paid at Extra Duty rates.

4.3 Salary

The contract with The Trust involves the payment of a full time 10 PA contract plus 2
additional PA. The pay point is calculated according to the number of years’ working in
anaesthesia since completion of anaesthetic training.

https://www.bma.org.uk/advice/employment/pay/sas-pay-england

4.4 Terms and Conditions

The terms and conditions outlined above are determined by the anaesthetic department
according to service needs. The terms and conditions shall be subject to a 6 monthly
review with the departmental lead alongside representation from the Local Negotiating
Committee if required by either party. Every attempt shall be made by the department to
meet the needs of the employee within the confines of a requirement to deliver a
departmental service need.

There is no obligation on any individual to work hours beyond a standard full time contract
of 10 PA

Should service requirements or employee requirements (such as a limit to resident on-call

work) change such that a reduction to the standard 10 PA contract is required, the
anaesthetic department reserves the right to do this.

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The Anaesthetic Department

Consultants
Dr Oliver Cramer Intensive care specialist, deputy medical director
Dr Gabor Debreceni Intensive care specialist, educational lead
Dr Michael Luckmann Chronic pain specialist
Dr Szymon Maternik Intensive care specialist
Dr Antina Michalou Pre-assessment lead
Dr Mike Pearson Clinical director for anaesthesia, obstetric anaesthetist
Dr Gosia Pirga Acute pain specialist, obstetric anaesthetist
Dr Piotr Pirga General anaesthetist
Dr Muriel Prager Intensive care specialist, director of intensive care
Dr Isobel Rice Lead for chronic pain specialist
Dr Mariam Rice Paediatric anaesthetist
Dr Sauvik Sanyal Intensive care specialist
Dr Obaid Tarin Intensive care specialist

Associate Specialists
Dr Gay Francis Dr Fiona Henderson
Dr Sunil Saxena

Specialty Doctors
Dr Abhinav Anghotra Dr Valentina Casula
Dr Raymond Foster Dr Vasil Kiryazov
Dr Michael Nadstawek Dr Pankaj Sharma
Dr Magda Tsoneva

Visiting the Isle of Wight

We would encourage prospective candidates to visit the Isle of Wight as part of the
application process. You would have an opportunity to meet anaesthetists in post and
discover the work / life balance opportunities that are on offer.

For further information or to organize a visit to the hospital

Dr Michael Pearson email: mike.pearson@iow.nhs.uk

Clinical director for Anaesthesia

Charlene Summerfield email: charlene.summerfield@iow.nhs.uk

Departmental Administrator

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 04/09/2018

PERSON SPECIFICATION

Post Title: Associate Specialist in Anaesthesia and Chronic Pain

Essential Criteria Desirable Criteria Where evaluated

 MBChB or equivalent Primary FRCA or equivalent
Professional  Full GMC Registration Application Form
Qualifications GMC
 Licence to practise

Clinical  Core competencies and at least 4 Advanced specialty training Application Form
Experience years’ experience in General in Obstetric Anaesthesia or References
Anaesthesia. Intensive Care Medicine. Interview
 Core competencies in Obstetric
Anaesthesia
 Core competencies in Intensive Care
Medicine.
 Advanced training in chronic pain
management
Clinical Skills  Practical skills commensurate with the ATLS/ EPLS/ APLS Provider Application Form
above. References
 ALS Provider Interview

Clinical  Widespread broad based knowledge Widespread broad based Application Form
Knowledge in all aspects of Anaesthesia & knowledge in all aspects of References
Intensive Care Medicine. Intensive Care Medicine Interview

 Demonstrate evidence of robust Application Form

Audit clinical audit practice and clinical References
Management governance Interview
& IT

 Commitment to medical education. Ability to teach in clinical Application Form

Academia settings. References
Interview
Teaching skill &
experience

Personal  Ability to work within a team Demonstrated leadership References

Qualities  Demonstrate ability to take ability. Interview
responsibility, lead, make decisions
and exert appropriate authority.
 Demonstrate good time management
skills
 Ability to adapt and work in differing
environments
 Excellent communication skills, oral
and written, including the ability to
communicate and interact effectively
with colleagues and patients.
Other Access to transport