Specialty Doctor - Anaesthetics

Job overview

We are seeking to recruit One substantive specialty doctor anaesthetist to our current department of 22 whole time consultants. These posts have arisen due to expansion.

The Royal Orthopaedic Hospital NHS Foundation Trust is located in Birmingham and is an independent trust providing high quality and multidisciplinary care for patients undergoing orthopaedic, spinal (including complex spine) and oncological surgery. The Trust is a tertiary referral centre for both these specialties and revision arthroplasty surgery.

Applications are invited from enthusiastic and highly motivated anaesthetists to join our friendly and supportive department. Currently we have 28 consultants, 5 SAS doctors, 7 Anaesthetic Associates in Theatres and between 4-8 rotating registrars from the Birmingham school of Anaesthesia.

Within our department are five substantive specialty doctor anaesthetists who cover first on call duties with the registrars. The post holder will work within the Anaesthetic team and will undertake theatre and on call duties.

The successful candidate will undertake perioperative care of the patients undergoing orthopaedic surgery. He/she will administer general, regional or combined anaesthesia. The candidate will be expected to know the basic and advanced skills of managing anaesthetic emergencies in patients of all age groups.

Main duties of the job

He / she will cover the High Dependency Unit and attend cardiac arrests and critically ill patients on the ward. He / she will participate in the inter-hospital transfer of the critically ill patients. The candidate will ensure that he / she follow up the patient in the post-operative period and has understanding of and practiced regional anaesthesia.

There are also seven Anaesthetic Associates (AA) working in our department. They work under the supervision of a consultant anaesthetist in line with RCOA recommendations in a ratio of 1:1 or 1:2. Twin theatre working is embedded in our rota.

The Anaesthetic Department provides anaesthesia services for all orthopaedic surgical procedures being carried out in the hospital including interventional radiology. We currently also have consultants contributing to pre-assessment, HDU, acute and chronic pain and perioperative medicine. We are also in the process of developing an acute pain service to complement the critical care outreach service already in place.

Detailed job description and main responsibilities

Pre-Operative Assessment Clinic (POAC)

Anaesthesia Pre op Clinical Lead – Dr Egidio da Silva

The hospital has a well-established Nurse-led Pre-Operative Assessment Clinic. Recently this has been expanded and is now staffed daily by a consultant anaesthetist. Consultant Anaesthetists are also involved in the Preoperative assessment of children, ensuring that appropriate patients are selected for their procedures at the Royal Orthopaedic Hospital. As part of our SLA with a local cardiology department, we also host an echocardiography clinic for our patients every fortnight.

He / Operating Theatres

There are ten operating theatres in our theatre suite. All theatres have modern anaesthetic machines (GE Healthcare). There are four ultrasound machines (sonosite) and one BK machine used for regional anaesthesia and vascular access. TIVA is widely used and BIS monitoring available. Cell salvage is widely used. Our current difficult airway equipment includes the Glidescope, disposable fibre optic scopes and ET view tubes. The theatres will be increased in number this year with plans for a modular theatre build.

High Dependency Unit

Anaesthetic HDU Lead – Dr William Tosh

Speciality Doctor Lead - Dr Anil N Rao

In order to provide clinical continuity our consultant group has nine members at any given time that will provide Monday to Friday daytime cover of the high dependency unit in a five-day stretch. Membership of this group is anticipated to change bi-annually, in order for us all to maintain clinical skill in critical care. All consultants cover the HDU and theatre out of hours.

The High Dependency Unit (HDU) has 6 beds in line with CQC requirements. The HDU is equipped with invasive monitoring equipment, TEG and other bedside tests for clotting and a blood gas analyser. Non-invasive ventilatory support is available. However, elective post-operative ventilation is not carried out.

Any patient who may require post-operative ventilation is transferred to the parent unit from where the patient was referred or a local hospital with level three care available. Careful assessment of cases reduces this to a minimum. On occasion surgeons carry out surgery in the other hospitals if the condition of the patient demands elective post-operative ventilation.

Management Service:

The hospital has an established chronic pain management service with new appointments of two consultant anaesthetists who will also be part of the anaesthesia team and the acute pain service being created. The service is completed with input from a multi-disciplinary team comprising of psychology, nursing, physiotherapy and occupational therapist.

Surgical Services:

Hand and Elbow Surgery: Most hand surgery is carried out using regional techniques with only a very low percentage of patients having general anaesthesia.

Spinal Service - There are eleven spinal surgeons. Their work includes anterior and posterior stabilisation of cervical, thoracic and lumbar spine within deformity, degenerative and spinal oncology surgery. Children under the age of five and those with a predicted requirement for post-operative ventilation are treated at the Birmingham Children’s Hospital.

Paediatric Surgery - Paediatric surgery is run jointly with the Birmingham Children’s Hospital. Younger and more challenging children are treated at the Birmingham Children’s Hospital.

Joint Replacement Surgery - Arthroplasty involves primary and revision surgery. There is an extensive rheumatoid practice, which is supported by on-site rheumatologist. The successful candidates should be proficient in performing regional blocks for extremity surgery.

Foot and Ankle Surgery - General and regional techniques are used for adult and paediatric patients, some of whom may have global musculoskeletal morbidity.

Oncology Surgery - Covers adult and paediatric patients who may require diagnostic or treatment operative procedures, which can therefore be extensive in duration. The catchment area is very wide and patients can be at any stage in their overall treatment plan.

Continuing Professional Development

The post holders will be expected to undertake continuing medical education along the lines recommended by the Royal College of Anaesthetists. As a standalone surgical facility, all anaesthetists have current ALS and APLS certification. We also undertake regular CPD at Birmingham Children’s Hospital or on paediatric anaesthesia related courses as well as updates in adult critical care.

Clinical Governance

The Specialty Doctor will practice within the framework of clinical governance and infection control; participate in clinical audit, morbidity and mortality meetings and report critical incidents. There is an active audit program at the ROH and the candidate is expected to participate in departmental audit.

Teaching & Audit

The candidate will be expected to take part in departmental teaching and audit activity.

Applicant requirements

You must have appropriate UK professional registration.

This post is subject to the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (Amendment) (England and Wales) Order 2020 and it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service.