THE UNIVERSITY OF DUBLIN
PROFESSOR OF NEPHROLOGY / CONSULTANT NEPHROLOGIST &
The Adelaide & Meath Hospital, Dublin Incorporating
the National Children’s Hospital (AMNCH)
Table of Contents
1. Background 3
2. University of Dublin / Trinity College 3
3. The Faculty of Health Sciences 4
4. The Adelaide & Meath Hospital, Dublin Incorporating 5
the National Children’s Hospital
5. Trinity College, Dublin - Department of Medicine 10
at The Adelaide & Meath Hospital, Dublin Incorporating
the National Children’s Hospital
6. Position of Professor / Academic Consultant 14
7. Contact Information 17
8. Applications 17
Appendix 1 HSE Approval Letter 18
Appendix 2 Teaching Facilities in the Trinity Centre for Health Sciences
and the Hospital’s Education Centre 21
Appendix 3 Hospital Statement 23
Appendix 4 Renal Dialysis Expansion in Dublin, Mid Leinster HSE 25
Area with Particular Reference to AMNCH
Appendix 5 Strategic Plan – Trinity College Dublin 31
Appendix 6 School of Medicine Staff List 32
Appendix 7 Draft Consultants Contract 33
Trinity College, Dublin and the Adelaide & Meath Hospital, Dublin Incorporating
the National Children‟s Hospital (AMNCH) seek to appoint a Professor of
Nephrology / Consultant Nephrologist & General Physician with a distinguished
reputation in research and teaching to provide leadership in both the University
and the Hospital.
The appointment of Professor of Nephrology/ Consultant Nephrologist &
General Physician based in the AMNCH should be seen in the context of an
unprecedented rate of development in the national economy, the University,
and, within it, the Faculty of Health Sciences and the Medical School. The
College has invested heavily in teaching and research facilities and Medicine at
Trinity College, Dublin is the most sought after university course in the country.
In recent years, the University has embarked on a building programme which
has transformed its city centre campus. In addition, €38.09m has been invested
in the Trinity Centres at St. James‟s and the Adelaide & Meath Hospital, Dublin
Incorporating the National Children‟s Hospital. Planning for a Phase II building
at AMNCH has commenced.
2. The University of Dublin/Trinity College Dublin
Trinity College is the single constituent college of the University of Dublin,
founded in 1592 by Royal Charter of Queen Elizabeth I. The College has
grown rapidly in recent years in response to the high demand in Ireland for third
level education and to government policies designed to meet this demand.
Today there are some 15,000 students and 2,000 full-time staff of which about
600 are tenured academics. There is, in addition, a large number of part-time
staff, particularly in the Faculty of Health Sciences. In recent years the
University has embarked on a €200m building programme and has a current
external research income of some €70m per year.
The College has implemented fundamental structural reform. In excess of 60
departments have been combined into 24 schools and are grouped into three
faculties. These reforms have been complemented by the introduction of a new
academic resource allocation model (ARAM) based on teaching/education and
In Health Sciences the original seven schools have been restructured into
School of Medicine
School of Dental Sciences
School of Nursing and Midwifery
The School of Pharmacy and Pharmaceutical Sciences has also been
incorporated into the Faculty of Health Sciences.
In the School of Medicine nineteen departments/academic units have been
restructured into six academic divisions. One of the Divisions is devoted to
education and the other five are interdisciplinary and research driven. It is
envisaged that departments will be replaced by disciplines and that disciplines
may be involved in more than one division.
Funding for university research has received significant government support in
recent years. The new National Development Plan (2000 – 2006) included
approximately €2.53bn for research, development and innovation and the
College has been very successful in competing for these funds particularly from
Science Foundation Ireland. Trinity has also been highly successful in securing
funds under the Programme of Research in Third Level Institutes (PRTLI)
funded through the Higher Education Authority, winning €101.57m to date,
including €15.4m for an Institute of Molecular Medicine to conduct a
programme of research with University College Dublin as the Dublin Molecular
Medicine Centre. In the most recent round of HEA funding, Trinity was
awarded €25.39m for the Trinity Institute of Neurosciences.
In 2006, the College updated its five-year Strategic Plan launched in July 2003
which further outlined commitments to build on current strengths, to further
develop an internationally competitive research and scholarship programme
and an education programme characterised by quality and innovation.
3. Faculty of Heath Sciences and the School of Medicine
The Faculty of Health Sciences at Trinity College Dublin has four constituent
The School of Medicine.
The School of Dental Sciences.
The School of Nursing & Midwifery.
The School of Pharmacy & Pharmacological Sciences.
Within the School, the Professor of Nephrology post is associated with the
Clinical Medicine academic unit in The Adelaide & Meath Hospital, Dublin
incorporating The National Children‟s Hospital.
The Faculty of Health Sciences provides education and training for medical
doctors, dentists, nurses, midwives, physiotherapists, occupational therapists,
radiotherapists and pharmacists. The Faculty has a strong graduate
programme with over 170 students registered for research degrees (Ph.D.
/M.D.) and over 250 participating in the wide range of taught M.Sc./Diploma
programmes. The Faculty promotes an environment which fosters a team
approach to the delivery of healthcare in the hospital and the community. This
multi-professional ethos seeks to encourage mutual respect and understanding
between health professionals and the sharing of knowledge and skills, which
facilitates efficient teamwork and healthy professional relationships. This
shared experience also promotes co-operation in education and research
within the professions and allows more efficient use of expertise and
The Faculty is actively working with its teaching hospitals on joint initiatives in
postgraduate education and research. These initiatives complement and
underpin the Faculty‟s own developments in the area of postgraduate studies.
A wide range of over 25 taught courses leading to Postgraduate Diplomas and
M.Sc. degrees have been developed in recent years and a number of further
courses are in the process of development. Some of these courses are
targeted at a specific profession, such as the M.Sc. in Physiotherapy; others
are directed towards research such as the M.Sc. in Molecular Medicine and the
M.Sc. in Molecular Pathology, whilst others are of an interdisciplinary nature,
such as the M.Sc. in Health Services Management. Some courses are part-
time, providing opportunities for individuals to continue in their professional
work and others are full-time. There are 291 students registered on taught
postgraduate courses (M.Sc./Diploma) in the School of Medicine for 2007/08
and 199 students registered for postgraduate research degrees.
Educational facilities for the professional schools in the Faculty are situated
both on the city centre campus and in the Trinity Centres associated with
affiliated hospitals. In 1994 the College opened major new academic facilities
at St. James‟s Hospital located approximately 2 miles from the main campus,
and it has a complementary facility at the new Hospital at Tallaght,
approximately 7 miles from the main campus. In all, the College undertook a
€39m capital programme in Health Sciences in the ten-year period to 2004.
A new Biosciences Building will be opened in 2011. The building is situated on
Pearse Street as part of the main campus of Trinity College Dublin. It will
house the School of Medicine including Anatomy, Physiology, lecture theatres,
seminar/teaching areas and an administration block. This will be a significant
contribution to the School of Medicine in the University.
At present, the majority of didactic clinical lectures and teaching in the clinical
laboratory sciences is based at the Trinity Centre for Health Sciences at St.
James‟s Hospital where there are lecture theatres, seminar rooms and the
John Stearne Medical Library
The Trinity Centre in the Adelaide & Meath Hospital, Dublin incorporating the
National Children‟s Hospital, Tallaght contains office accommodation, a lecture
theatre, seminar rooms, a 40 workstation computer-teaching laboratory and
research space. Discussions have commenced aimed at devising specific
computer-based modules in pathology that can be delivered at the Adelaide &
Meath Hospital, Dublin incorporating the National Children‟s Hospital using this
technology. Clinical teaching takes place on both hospital sites.
Students are also accepted in the Faculty to work towards the degrees of M.D.,
M.Ch., M.A.O., M.Sc. and Ph.D. by research. Such students work under the
supervision of a designated member of the Faculty.
There are ongoing discussions in respect of shared governance/partnership
between the College and its teaching hospitals.
The School will celebrate its Tercentenary in 2011. A Tercentenary Committee
has been established and it will focus on fund-raising, emphasising the central
role of the medical school in the scientific and cultural life of the city. The
primary focus will be on resourcing the capital development of building
programmes on the College Green campus, St James‟s Hospital campus and
the campus at the Adelaide & Meath Hospital, Dublin incorporating the National
Children‟s Hospital, Tallaght. Emphasising the key role of the Meath and
Adelaide Hospitals in the history of medicine and of medical education, it is
proposed to work towards establishing a facility incorporating clinical skills
coupled with integrative medicine and surgery and preventative medicine on
the Tallaght campus. Translational medicine will be primarily based at the St
James‟s campus, and central administration and non-clinical teaching at the
College Green campus. All three strands will be integrated in a historical sense
with particular emphasis on: (i) marrying traditional and new technologies; and
(ii) complementary developments on the three sites.
The current Strategic plan for the School of Medicine is available via the
4. The Adelaide & Meath Hospital, Dublin Incorporating the National
Children’s Hospital, Tallaght, Dublin 24.
The Adelaide & Meath Hospital, Dublin incorporating the National Children‟s
Hospital (the Hospital) has been developed as a result of the merging of three
distinguished city-centre teaching hospitals: the Meath Hospital (founded
1753), the National Children‟s Hospital (founded 1821) and the Adelaide
Hospital (founded 1839). Some of the internationally known medical names
associated with the history of the Hospital include Robert Graves (1796-1853),
William Stokes (1804-1877) and Denis Burkitt (1911-1996). The famous
Adelaide School of Nursing was founded in 1859 in the Nightingale tradition.
The three former hospitals continue their tradition through their legally
constituted successors (Foundations): The Adelaide Hospital Society, The
Meath Hospital Foundation and The National Children's Hospital which support
the Hospital through Board representation and fund-raising activities.
The three hospitals moved from their existing locations in 1998 to a newly built
state-of-the-art Hospital on a 38 acre campus in Tallaght, South County Dublin.
The new hospital represents the largest single hospital project ever
commissioned by the State and was incorporated under Charter on 1 August
1996, bringing together over 600 years of renowned medical training, research
and nursing excellence.
The Hospital provides a comprehensive range of diagnostic and treatment
services, many with national or regional status commensurate with a university
teaching hospital. The Hospital delivers medical and surgical services to
children, adolescents, adults and the elderly. There are designated accident
and emergency, out-patient, in-patient, theatre and diagnostic services for
children. In addition to these services the Hospital embraces the acute in-
patient psychiatric services hitherto provided by St. Loman‟s Hospital.
The Hospital operates under the unique legal framework of the Charter which
was enacted by Dáil Eireann on 1st August 1996. The voluntary and
independent character of the Hospital, which stems from the Charter, will
ensure an imaginative, innovative atmosphere for fulfilling the objectives of the
Charter in respect of university teaching, medical research and flexibility in
responding to new developments. The Hospital in partnership with other Irish
major academic teaching hospitals, has embarked on an accreditation
programme and has achieved Pre-Accreditation Advanced.
The Hospital also has a comprehensive range of Information Technology /
Information Systems. All areas within the hospital are computerised and
networked. Facilities available on the system include Patient Information
Management System (PIMS), Accident and Emergency System (Footman
Walker), Order Communications, Laboratory Information System (LIS),
Electronic Mail, Intranet, and the Hospital‟s own web site www.amnch.ie .
The Board of Management of the Hospital, of which the Dean of the Faculty of
Health Sciences, Trinity College, is a member, has an explicit commitment to
academic excellence and a Teaching Agreement between Trinity College and
the Hospital, agreed on 26th October 1995, recognises the Hospital as one of
the College‟s two main clinical teaching centres.
There is a strong academic commitment between the Hospital and the Trinity
Centre for Health Sciences which opened in 2000. The Adelaide Hospital
Society, The Meath Hospital Foundation and The National Children's Hospital
and St James‟s Hospital are partners in their development of education and
research facilities for the School of Medicine and Faculty of Health Sciences.
This building is interlinked with the Hospital's Education Centre and together
they accommodate the Medical School, the Postgraduate Medical Centre, the
Hospital's School of Nursing and Midwifery, the library and research facilities.
4.2 Corporate Strategy
The Hospital has completed the exercises of transferring the services from the
four hospitals and of integrating them into a functioning whole at Tallaght. It
has now embarked on a planning exercise to delineate a corporate strategy
which will guide the development of services for the next three to five years. It
is very much hoped that the Professor appointed would be able to share in this
planning process. The objective is to improve the way patients are dealt with
and treated, bearing in mind quality, timeliness and cost.
4.3 Catchment Area
The Hospital serves a rapidly growing catchment population (currently
550,000+) and also continues its national tertiary referral and regional services.
The catchment area includes North Kildare area, which is the fastest growing
“young family” area in Europe. Approximately 40% of the population are less
than 15 years old. The Hospital also has a unique clinical and executive
relationship with Naas General Hospital which has undergone a major re-
building programme (€63.49m) to provide Accident and Emergency, Surgical
and Medical Services with a number of joint Consultant appointments in
medicine and other specialities. There are shared lecturers posts in medicine
and surgery between Tallaght and Naas. The holders of these posts co-
ordinate teaching for undergraduate students and are involved in research in
the surgical and medical professorial departments. There is also a unique
clinical and executive relationship with Peamount Hospital with a number of
4.4 Surgical Facilities
There are twelve major operating theatres, including state of the art
instrumentation, laparoscopic facilities and extensive clinical support services.
There are also two minor operating theatres in the day area for ambulant
procedures performed under local anaesthetic. The Endoscopy Unit consists
of three endoscopy suites and a 13 bed day-ward area. A comprehensive
diagnostic and therapeutic service is provided including therapeutic ERCP,
endoscopic ultrasound, haemostatic techniques, enteral stenting and laser
therapies. The Hospital has been at the forefront in developing rapid access
4.5 Nephrology Facilities
The Adelaide & Meath Hospital, Dublin incorporating the National Children‟s
Hospital (AMNCH) is the principal Nephrology service in the Dublin and South
Leinster HSE area (Population 1.2 million). The hospital has a 12 station
dialysis unit with two isolation rooms. It operates a satellite dialysis facility in
Beacon Renal Unit, Sandyford in conjunction with St. Vincent‟s Renal service
(30 Stations). AMNCH provides chronic Haemodialysis dialysis services for its
own population, Naas and St. James‟s Hospitals. It also provides a supra-
regional peritoneal dialysis service and has the largest peritoneal dialysis
programme in Ireland. The unit is the second largest non- transplant centre in
Ireland and as of the end of June 2008 was treating 190 Dialysis patients and
223 renal transplants. It supervised in excess of 15,000 dialysis sessions in
The hospital is actively pursuing the establishment of a Regional Renal
Medicine Clinical Network with St. Vincent‟s University Hospital and the
Midlands Regional Hospital in Tullamore.
4.6 Initiatives in Planning
Currently there are four groups planning interdisciplinary initiatives in clinical
service, education and research. These include an Institute of Preventative
Health, “Cancer Prevention Institute” involving six major disciplines, a
Neurosciences Axis involving 12 disciplines and a Cardiovascular Institute
which also involves a large number of disciplines. All involved consider that
these strategies will provide significant opportunity to make a notable
contribution to the international field of research and science.
4.7 Emergency Medicine
The Hospital plays an integral part in the provision of Emergency Medicine
services together with the other major Dublin hospitals. There is a separate
designated Emergency Medicine Department for children.
4.8 Diagnostic Services
All conventional X-Ray services are available including Magnetic Resonance
Imaging (MRI), CT Scanning, Ultrasound, Nuclear Medicine, Angio-
Interventional and Mammography. The Hospital has incorporated a fully
filmless PACS and Radiology Information System (RIS) integrated with the
Hospital's Information System. Development plans for the department include
an increase in Consultant manpower and expansion of links with Naas General
There are comprehensive pathology laboratory services encompassing all
laboratory medicine disciplines: Clinical Chemistry, Haematology,
Histopathology / Cytopathology and Medical Microbiology. The laboratory is
equipped to a high standard and offers all routine diagnostic modalities
including flow cytometry, computerised image analysis and molecular
techniques (in-situ hybridisation, FISH, PCR). The laboratory is fully
computerised and on-line result reporting is available in ward and out-patient
areas over the hospital network. Clinicopathological meetings take place on a
regular basis including a weekly gastroenterological conference and a weekly
multidisciplinary meeting with pathologists, radiologists, surgeons and
Integration of laboratory services with Naas General Hospital is proposed,
including referral of samples from Naas to the Hospital for specialised tests
together with a number of joint Consultant appointments.
There are active research programmes in many disciplines and collaborative
research with clinical services is facilitated. Areas of research include cystic
fibrosis and Helicobacter pylori (microbiology), apolipopotein and homocysteine
metabolism and medical informatics (clinical chemistry), myelodysplasia and
haematological malignancy (haematology), Inflammatory Bowel Disease,
colorectal carcinogenesis, breast cancer prognostic indices, urologic
4.9 Clinical Support Services
The full range of clinical support services is available on site in the Hospital.
These include physiotherapy, psychology, occupational therapy, speech and
language therapy, clinical nutrition and dietetics, social work, pastoral care,
medical physics and clinical engineering and pharmacy.
4.10 Education Facilities
The Hospital has a long and distinguished history in medical education and
research and with the support of funding from the three base hospital
foundations, built and equipped the Trinity Centre for Health Sciences which is
intimately linked with the Hospital's Education Centre. The two together
provide a significant academic and educational presence on the hospital site.
Strong research and teaching in laboratory-based medicine is seen as
essential for the development of the Hospital. The Laboratories in Phase One
of the Health Sciences Building provide research space which requires
expansion. Phase Two development provides for a dedicated Research
Centre which is presently at advanced planning stages.
A state-of-the-art integrated audio-visual system has been commissioned which
supports education and training to all students of various disciplines in the
Hospital. This system provides links between the main Operating Theatres and
Endoscopy and Angiography to the Education Centre and the Trinity Centre for
Health Sciences building as well as Tutorial rooms dispersed throughout the
The Robert Graves Centre is located in the Education Complex and represents
a joint initiative between the Postgraduate Medical and Dental Board, the
Hospital and Trinity College, Dublin. In conjunction with its sister centre, the
William Stokes Postgraduate Centre in St James‟s Hospital, it provides
postgraduate facilities and resources for doctors in South and South-West
The Hospital currently provides local, regional or national services in the
Emergency Medicine Services Medical Oncology
Anaesthesia, Intensive Care, and Nephrology
Pain Clinic Neurology
Dermatology Orthopaedic Surgery - Elective
Diabetic and Metabolic Disorders Orthopaedic Surgery - Trauma
Diagnostic Services - Laboratory Otolaryngology
Medicine, Radiology Palliative Medicine
Endocrinology Paediatric Medicine
Gastroenterology Paediatric Surgery
General Medicine Psychiatry
General Surgery Rehabilitation Medicine
Geriatric Medicine: Assessment Respiratory Medicine
Rehabilitation and Day Hospital, Rheumatology
Stroke Service, Dysphagia, Driver Urological Referral and Stone
Gynaecology Vascular Surgery
5. Trinity College, Dublin - Department of Medicine at the Adelaide &
Meath Hospital, Dublin Incorporating the National Children’s
The Trinity Centre for Health Sciences at the Adelaide & Meath Hospital, Dublin
incorporating the National Children‟s Hospital includes in-whole or in-part many
of the Faculty‟s clinical departments, including Paediatrics, Clinical Medicine,
Surgery, Public Health and Primary Care and Psychiatry. These areas combine
with a number of key hospital strengths to provide a unique opportunity for
Fifty percent of the TCD medical students rotate through the hospital at any
one time. In common with all clinical departments, the Professorial Surgical
Unit has a significant responsibility both to its students and to its patients at the
hospital. The Hospital has a very large local catchment population of
approximately 500,000 and has also patients referred nationally.
The Trinity College Professor and senior lecturers/lecturers based in AMNCH
together with their areas of interest is listed below.
Academic Head and Dean of Faculty of Health Sciences: Professor Colm
Professors/Associate Professors: Cardiology (I. Graham); Age Related (D.
General Practice (T.O‟Dowd); Clinical Public Health Medicine (J. Barry); Clinical
General Practice (F. O‟Kelly)
Senior Lecturers & Lecturers: Age Related Health Care (R. Collins, T.
Coughlan, A. O‟Driscoll, P. O‟Brien); Cardiology (D. Mulcahy, D. Moore, D.
O‟Gorman); Dermatology (M Connolly); Emergency Medicine (J. Gray, G. Little,
J. O‟Sullivan, M. Rochford); Endocrinology (J. Barragry, J. Gibney, K. Moore);
Gastroenterology (N. Breslin, B. Ryan, H. O‟Connor); Gynaecology (P.
Crowley, P. Bowman, C. Murphy, G. von Bunau, W. Prenderville);
Haematology (H. Enright, N. O‟Connell); Medical Oncology (R. McDermott, J.
Walshe); Nephrology (G. Mellotte, C. Wall, A. Watson); Neurology (R. Murphy,
D. McCabe); Neurophysiology (M. Alexander); Palliative Medicine (S. Higgins),
Respiratory Medicine (S. Lane, E. Moloney, J. Power); Rehabilitation Medicine
(J. McElligott), Rheumatology (D. Kane).
5.2 Physical Facilities
The Department of Medicine has office space and research space in the Trinity
Centre at the AMNCH Education Centre for the Professor and secretary and
associated academic staff.
5.3 Departmental Governance and Headship
The Head of the Department of Medicine at AMNCH, Tallaght is Professor
Colm Ó‟Moráin. The Professor of Nephrology will play a major role in
education, research, administration and ongoing audit and development within
the Department. Academic Staff and individual consultant hospital staff and
heads of specialist departments contribute substantially to the Department as
part-time members of the academic staff. Regular departmental meetings are
held with integration of its part-time members into the decision making process,
good communication and close contact between the staff in both hospitals.
The Department of Medicine engages in a wide range of teaching to
undergraduates and postgraduates. It makes significant teaching contributions
to other departments, to the clinical staff of the hospital and to other institutions
both nationally and internationally.
The Departments of Medicine, located at AMNCH and St James‟s Hospital are
responsible for the teaching of medical undergraduates of Trinity College,
Small group clinical bedside teaching is the cornerstone of surgical
undergraduate teaching. Wide spread curricular reform has improved the
quality of surgical rotations in the hospital.
The course content is delivered via a small group clinical bedside teaching,
clinical skills laboratory, problem based learning sessions. A research project
is encouraged in order to develop scientific methods, analytical skills and
encourage student collaboration skills. This is supported by the Health
Student progress is assessed by continuous assessment, clinical examination,
multiple choice examination, case report, individual project, group project,
OSCE (Objective Structured Clinical Examination). Currently the final exit
exams are organised and managed from the Adelaide & Meath Hospital, Dublin
incorporating the National Children‟s Hospital.
In our undergraduate surgical training we aim to foster a supportive,
enthusiastic attitude among staff and students. This has been commented on
favourably by the Irish Medical Council. We involve our students in the working
life of the hospital and foster an environment where the students are free to
express their ideas, ask questions and seek help where needed.
Arrangements for elective exchanges have been concluded with several
Medical Schools both nationally and internationally.
Postgraduate Teaching and Research
The Department of Medicine offers the following degree programmes by
The Doctor of Medicine (MD and Ph.D)
The Professor of Nephrology will be actively involved in the development of the
undergraduate and post graduate curricula, their delivery, assessment and
ongoing development and will also promote and support research.
The School of Medicine is continuously reforming the undergraduate
curriculum, a process which is being monitored and encouraged by the Medical
Council. To date, the first three years have been restructured and a
comprehensive course in medical ethics has been introduced commencing in
year three. The task of reforming the clinical years and increasing the linkage
with the pre-clinical curriculum is still in progress and it is expected that the
successful candidate will play a role in this reform. Students rotate equally
between the Adelaide & Meath Hospital, Dublin incorporating the National
Children‟s Hospital and St. James‟s Hospital for their medical and surgical
attachments in the third and fifth years thus experiencing the particular features
of both hospitals.
The School is currently exploring computer based teaching using expertise and
resources at the Adelaide & Meath Hospital, Dublin incorporating the National
Children‟s Hospital. In the past three years there has been an investment in
clinical skills facilities located in the Trinity Centre at the Adelaide & Meath
Hospital, Dublin incorporating the National Children‟s Hospital and this facility is
used heavily by students. There is also an emphasis on providing students
with good research skills. Foundations are laid in the first year and project
work and special study modules are provided in the fourth year. There is still a
strong emphasis on clinical bedside teaching in all the clinical disciplines.
The Department of Medicine at AMNCH has developed a successful research
programme since the hospital opened in 1998 and is involved in a wide variety
of collaborative research projects with many institutions nationally and
Existing research interests and strengths include such areas as cardiovascular,
neurosciences and aging, rheumatology, gastroenterology.
Potential areas of collaboration for research and education exist due the on-site
presence of Departments of Surgery, General Practice, Public Health, Medicine
and Psychiatry. With the relocation of the Coombe Women‟s & Infants
University Hospital to the Tallaght campus, research opportunities are further
There are significant opportunities in our catchment area for important research
with practical and useful outcomes and analysis of the specific population
characteristics including higher than average birth rate, large numbers of
asylum seekers, of the unemployed, and of single parent families.
The development of an Institute of Preventive Health has been agreed by the
Board of the AMNCH and has been included as part of the School‟s strategic
plan in order to promote the early detection and screening and assessment of
risk factors for a wide spectrum of medical disease.
5.6 Department of Public Health and Primary Care
The department is located at the Trinity College Centre for Health Sciences at
the Adelaide and Meath Hospital Dublin, Incorporating the National Children's
Hospital (AMNCH). The mission is to foster the study and understanding of
health issues through teaching, research, advocacy and clinical care, with
particular emphasis on health deprivation and chronic disease, and societal
health problems such as alcohol, tobacco, and illicit drug dependency.
The Department came into being with the establishment of the Chair of Social
Medicine in 1952. The establishment of the Chair recognised the contribution of
the social environment to people's health or ill-health, and that medical students
needed a perspective beyond their traditional hospital oriented training.
Departmental staff form a multi-disciplinary team with public health, general
practice, epidemiology, biostatistics, medical ethics and psychology all
contributing to our research and teaching agenda.
The department contributes to the 5-year medical undergraduate curriculum
with courses in the 1st and 4th years. The 1st year course is the Human
Development and Behavioural Science Course, incorporating Medical Ethics.
This is an early patient contact course, as part of which students are assigned
in pairs to visit families with young babies in the families' own homes.
The People, Practices and Populations course is delivered in the 4th medical
year. As part of this course the students are attached to two different general
practitioners for a total of four weeks, where they can observe the wide range
of ill health presenting in the community setting.
The department incorporates the Small Area Health Research Unit (SAHRU)
(www.sahru.tcd.ie) which provides in-house statistical expertise, along with
statistical consultancies for external bodies and web based distance learning
courses in biostatistics.
The TCD/HSE Specialist Training Programme in General Practice is also part
of the department, providing us with a network of training practices which
contribute to our teaching and research.
5.7 College and Other Funding
The Department of Medicine receives a budget from the College designed to
meet its teaching and routine administrative commitments. The Department or
its members compete for major equipment funding to the Higher Education
Authority (HEA), the EU, the Wellcome Trust, the Provost‟s Fund, the Irish
Heart Foundation, the Cancer Research Fund, the Arthritis Foundation and the
Health Research Board (HRB). The HRB has significantly increased its
commitment to a strategic research policy that is expected to increase the level
of funding available. The Faculty of Health Sciences is a member of the newly
established EUROLIFE EU Network of long established European Medical
The Department of Health and Children has also made a strong commitment to
quality in the Health Service, and has introduced a structured programme for
speciality training and research infrastructure. The State‟s direct contribution to
the Health Research Board has almost doubled in two years which coupled
with matching funds creates a positive environment for active researchers.
Finally the Faculty and the College are exploring the possibilities of new
funding models for the academic developments with the service agencies as
well as with the educational authorities.
6 Position of Professor of Nephrology / Consultant Nephrologist &
The College is seeking to appoint an innovator to provide strong leadership in
research and teaching. A clinical team with secretarial staff will be available to
support the clinical interests of the incoming Professor of Nephrology/
Consultant Nephrologist & General Physician . In addition, Trinity College may
contribute to providing essential research equipment.
The following professional qualifications shall apply to this appointment
(a) Registration as a specialist in the Specialist Division of the Register of
Medical Practitioners maintained by the Medical Council in Ireland in the
specialities of nephrology and general (internal) medicine.
The appointee will:
co-ordinate the development of an integrated teaching program in
Clinical Nephrology that will include integration of undergraduate
lectures, tutorials and examinations in the biomedical sciences, together
with the teaching of clinical nephrology in the hospital setting.
develop and maintain an internationally competitive research group in a
recognized area of research in Clinical Nephrology including acquiring
the necessary funds and recruiting, supervising, and supporting through
to successful completion of post-graduate degrees of research students
and/or post-doctoral fellows.
be expected to contribute to ongoing curricular reform in the context of
an expanding molecular medicine knowledge base and developing a
structured teaching programme incorporation an e-learning platform for
undergraduates in TCD and IUMC Medical Schools and contribute to the
development of a curriculum.
represent the Faculty of Health Sciences at Trinity College Dublin, on
appropriate national and international advisory boards and professional
be expected to assume a leadership and managerial role within the
Faculty of Health Sciences at Trinity College Dublin.
work with the officials in the Medical Education, Training & Research
(METR) Unit and will collaborate with senior officials throughout the HSE
and externally to ensure an integrated and multidisciplinary approach to
education, training and research, in line with HSE Board policy.
develop interactive teaching programmes for graduates studying for
membership of the Royal College of Physicians in Ireland and for those
engaged in the Specialist Registrar training schemes in Ireland
have an appointment as a consultant at AMNCH and be expected to
contribute to the teaching, assessment and research activities in the
have an opportunity to pursue their clinical interest in the department by
holding Outpatient clinics, participate in the dialysis unit service and
nephrology on call rota.
be expected to develop a sub-speciality nephrology clinic in Beaumont
Hospital which will be provided on an alternative week basis
be expected to take a national role in renal transplantation medicine that
will be provided by access to the national transplant centre in Beaumont
be expected to participate in monthly transplant multi-disciplinary
meetings held in Beaumont Hospital and actively contribute to and
participate in the formulation of policies and protocols governing all
aspects of renal transplantation medicine working with the transplant
team in Beaumont
be expected to contribute to the overall development of National Renal
Programme and to support and contribute to the development of
multidisciplinary education, training and research within the HSE.
The normal duties for the post will include inter alia;
Trinity College Dublin
8.5 hours per week for teaching duties
8 hours per week for research activities
Adelaide & Meath Hospital, Dublin incorporating the National Children‟s
3 hours per week for out-patient clinics
3 hours per week for consultation services
3 hours per week for dialysis
Participation in the nephrology on-call rota
6.5 hours per week for administrative / management duties and clinical
interaction with the national Renal Programme and National Renal
3 hours every second week for out-patient clinics
3 hours per month for multi-disciplinary meetings
The foregoing list of duties will form part of the Clinical Directorate Service
Plan. The remaining commitments are to be assigned by the employers and
may be adjusted by the Clinical Director of AMNCH / Trinity College Dublin in
consultation with the Consultant appointed to this post.
The Academic Consultant is accountable for the delivery of the clinical
component of the post as provided for in the body of the Consultant Contract
2008, and s/he is accountable via the management and governance structures
in place in the University in relation to the delivery of their academic
Commencement: by mutual agreement
Hourly Commitment: 18.5 Clinical/18.5 Academic (week)
New Entrant Academic Consultants on Type B contract:
Point 1 - €254,896 (please note candidates must enter at point 1)
Further information on the College may be obtained at the following web
Further information on the School may be obtained at the following web
Conditions of Employment: The Consultant Contract 2008 for HSE
approved Consultant appointments
(Category Type B whole-time) apply to
7. Contact Information
Interested applicants should contact in the first instance:
School of Medicine, The Adelaide & Meath Staff Office – Trinity
Trinity College Dublin Hospital, Dublin College Dublin
Incorporating the National
Professor Shaun Professor Kevin C. Conlon Ms Ann-Marie Farrell
McCann Chief Executive Officer Recruitment Officer
Professor of Academic The Adelaide & Meath House 4 -Staff Office
Medicine Hospital, Dublin Trinity College
School of Medicine Incorporating the National Dublin 2
Trinity College Children's Hospital
Dublin 2 Tallaght Telephone: +353-1-896
Dublin 24 1030
Telephone: +353-1- Email:
896 3069 Telephone: +353-1- firstname.lastname@example.org
Applicants should provide the following information in applying for the Chair:
A comprehensive curriculum vitae including full data on publications
Names and contact details (i.e. addresses, e-mail etc) of five referees
Completed applications should be submitted to:
Ms. Ann-Marie Farrell
House 4 – Staff Office
The closing date for receipt of applications for all posts is noon, Friday, 15th
Consultant Appointments Unit
Dr. Steevens‟ Hospital
Aonad Cheapacháin na nDochtúirí Comhairleacha
Ospidéal an Dr. Steevens
Baile Átha Cliath 8
Tel / Guthán: (01) 635 2500
Appendix 1 – HSE Approval Letter
Mr. John Bulfin
Hospital Network Manager Our Ref: TTGMNF12
Health Service Executive
11th September 2009
Dear Mr. Bulfin,
I refer to Ms. A. Larke‟s e-mail of 3rd November 2008, attached application and all
related documentation. This letter supercedes the previous letter of 22nd January 2009.
The Health Service Executive has approved the appointment of a:
PROFESSOR OF NEPHROLOGY / CONSULTANT NEPHROLOGIST & GENERAL
This is a joint academic appointment on a Type B basis under the Consultants‟
Contract 2008 by the University of Dublin, Trinity College (18.5 hours per week) and
the Adelaide & Meath Hospital, Dublin incorporating the National Children‟s Hospital
(18.5 hours per week). This is a new post. It is noted that the appointee will be
expected to develop a sub-specialty nephrology clinic in Beaumont Hospital, which will
be provided on an alternative week basis. The postholder will also be expected to
participate in the monthly transplant multi-disciplinary meetings held in Beaumont
Hospital, and actively contribute to and participate in the formulation of policies and
protocols governing all aspects of renal transplantation medicine, working with the
transplant team in Beaumont.
Arising from a national programme to increase the number of academic clinicians in
Ireland, funding for this post is being provided on a 50:50 basis between the Health
Service Executive and the Higher Education Authority. The appointee will be expected
to contribute to the overall development of medical education and training from a
national perspective and to support and contribute to the development of
multidisciplinary education and training within the Irish health service. In particular, the
appointee will be expected to actively contribute to the development of a national core
curriculum that will be developed by, and available to, all Irish medical schools.
The Consultants‟ Contract 2008 provides for a normal working week of 37 hours. This
37 hour commitment will normally be delivered across a span of 12 hours between the
hours of 8am and 8pm Monday to Friday. The normal duties for the post as outlined in
the documentation and agreed by the HSE, will include inter alia:
University of Dublin, Trinity College
8.5 hours per week for teaching duties
8 hours per week for research activities
Adelaide & Meath Hospital, Dublin incorporating the National Children’s Hospital
3 hours per week for out-patient clinics
3 hours per week for consultation services
3 hours per week for dialysis
Participation in the nephrology on-call rota
6.5 hours per week for administrative / management duties and clinical
interaction with the national Renal Programme and National Renal Registry
3 hours every second week for out-patient clinics
6 hours per month for multi-disciplinary meetings
The foregoing list of duties will form part of the Clinical Directorate Service Plan. The
remaining commitments are to be assigned by the employer(s) and may be adjusted
by the Clinical Director / Employer in consultation with the Consultant appointed to this
If a significant change to this post is contemplated e.g. location, structure, title, contract
type etc. the prior approval of the Health Service Executive is required.
Approval to this post is subject to the following conditions
Total employment remaining within your approved ceiling.
That normal recruitment procedures for the filling of consultant posts are applied.
That there are no additional non-consultant hospital doctor posts attached.
This post may be subject to restructuring in the future to facilitate the
reorganisation of acute services in line with new clinical models of acute and
The following qualifications shall apply to this appointment:-
1. Professional Qualifications, experience etc
Registration as a specialist in the Specialist Division of the Register of Medical
Practitioners maintained by the Medical Council in Ireland in the specialties of
nephrology and general (internal) medicine.
Age restriction shall only apply to a candidate where he/she is not classified as a new
entrant (within the meaning of the Public Service Superannuation (Miscellaneous
Provisions) Act, 2004). A candidate who is not classified as a new entrant must be
under 65 years of age on the first day of the month in which the latest date for
receiving completed application forms for the office occurs.
A candidate for and any person holding the post must be fully competent and capable
of undertaking the duties attached to the post and be in a state of health such as would
indicate a reasonable prospect of ability to render regular and efficient service.
A candidate for and any person holding the post must be of good character.
5. Entry to competition / recruitment process
For the purposes of eligibility for entry to any competition or recruitment process
associated with this post, applicants currently in employment as Senior or Specialist
Registrars in HSE or HSE-funded agencies may participate in the competition on the
basis that, on the latest date for receipt of applications, they are within 6 months (26
weeks) of certification of completion of specialist training and that evidence for same is
provided from the relevant recognised postgraduate medical training body in writing.
Requirements vis-à-vis approval letter
All documentation relating to this post, including the job description, should be
consistent with the contents of this letter.
The Contract offered to the appointee should be consistent with the Consultant
This letter of approval shall be made available to all applicants for the post.
This letter of approval must be attached at Appendix 1 to the contract to be made
with the successful candidate as per the Consultants‟ Contract 2008.
The regulation of consultant appointments transferred from Comhairle na nOspidéal to
the Health Service Executive with effect from 1st January, 2005. In the event of the
above post becoming vacant at any future date, whether by reason of resignation,
retirement or death, the vacancy must be notified to the Health Service Executive
which will then review the position and decide whether to ratify the continuation of the
I would be grateful if, in due course, you would let me have, for record purposes,
details (the name, date of birth and date of appointment) of the person appointed to
the above permanent position.
Office of the National Director of Human Resources
Appendix 2 - Teaching Facilities in the Trinity Centre for Health Sciences
and the Hospital’s Education Centre include:
a health sciences/medical library
a 300 seat lecture theatre
a 130 seat lecture theatre
College of Nursing with 4 seminar rooms and three partitionable tutorial
four seminar rooms including a clinical skills laboratory
a 40 workstation computer teaching laboratory
a suite of clinical teaching, observation and treatment rooms for
multidisciplinary clinical teaching
a canteen and common room area
departmental accommodation for Community Health and General
Practice, Clinical Medicine, Surgery, Psychiatry, Paediatrics, Clinical
Microbiology, Obstetrics and Gynaecology
wet and dry research laboratories and associated instrument rooms
postgraduate study space
the Robert Graves Postgraduate Centre for continuing medical
Audiovisual links between a number of operating theatres and the main
Appendix 3 Hospital Statements
II.1 MISSION STATEMENT
In accordance with the Charter of the Hospital our mission is to be a public,
voluntary and teaching hospital operated in the interests of our patients in
which we -
identify and meet the health care needs of the communities we serve so
that our Hospital is a Hospital for everyone
provide for all patients the highest quality health care
undertake and support research in health care
educate all staff and students to highest international standards in health
seek for each member of staff and each student equal opportunity to fulfil
their potential in health care
Develop voluntary involvement and support for our hospital to the maximum
II.2 VISION STATEMENT
Our Hospital is for Everyone
Patients, especially those from minorities, will choose to be cared for in our
Hospital because we will approach them as a whole person with our
innovative and inclusive pastoral care support.
We will be international experts on inclusive pastoral care for patients.
A Centre of Quality and Excellence in Healthcare
Our Hospital will be the best academic teaching community Hospital with a
reputation as a centre of healthcare excellence locally, nationally and
Leading edge technology and patient focused caring systems will be
constantly reviewed to provide the best care for patients.
World Class Research
Our state of the art research facilities will enable us to pursue ground-
breaking research in Health Sciences and Health Services earnin0g our
Hospital world-wide recognition.
Our Staff will be Renowned for their High Standard of Education
This Hospital will focus on continuous learning and development for our
Our educators will continuously update themselves with new trends to
achieve the highest international standards of healthcare education.
Students will seek our educational programs above all others.
We Will Treat our Staff Respectfully and Equally
Our secure, confident and competent staff will meet our patients‟ needs in
an exemplary fashion.
We will respect and encourage our staff by recognising their input and
The most highly qualified and motivated healthcare professionals from
Ireland and abroad will want to work in our Hospital.
We Will be Partners With Our Community
The partnerships we create with our enthusiastic and motivated community
will rapidly materialise through dialogue and voluntary support for our
Through partnerships with the Department of Health and health providers in
our area we will support the health system and achieve lasting respect for
We will support and will be fully accessible to healthcare professionals.
III.3 VALUES STATEMENT
I respect myself and value my integrity. Consequently each person I meet, my
work colleagues, my patients, their families, and the environment I work in
deserves, and will have, that same respect.
We wish to provide an excellent standard of care to everyone in our Hospital.
Within a supportive and friendly environment we aim to meet the physical,
emotional and spiritual needs of:-
Their families and carers
The communities we serve
We will always communicate and share information with patients, the public
and each other in an open, friendly and truthful manner. By aiming to build and
maintain trust at all times.
We will ensure an environment that is free of hidden agendas and without fear
of speaking the truth.
FAIRNESS AND EQUITY
We are committed to ensuring that everyone is treated as an individual with
fairness and equity. The same high standards of care will be provided for all
patients, relatives and staff throughout our Hospital.
PARTNERSHIP AND TEAMWORK
Co-operation in building a wide range of partnerships will be the hall-mark of
our Hospital. This requires combining our effort with voluntary and statutory
agencies to raise the health status of the communities we serve.
Sharing with others in teams to provide all our Hospital‟s services is essential.
This will ensure -
in providing the highest quality of care to our patients.
Appendix 4 - RENAL DIALYSIS EXPANSION IN DUBLIN MID LEINSTER
HSE AREA WITH PARTICULAR REFERENCE TO AMNCH
The aim of this submission is to address the medium to long term needs of
patients with End Stage Renal Disease (ESKD) in South Dublin, Kildare and
West Wicklow with a particular focus on AMNCH (Tallaght) Hospital.
For the past three years the hospital has been operating at capacity with the
result that all newly diagnosed patients have had to be referred to the private
sector for their dialysis treatment. There are currently 38 AMNCH patients being
treated in Beacon Dialysis in South Dublin.
RENAL SERVICES AMNCH:
The Adelaide & Meath Hospital (AMNCH) is the principal Nephrology service in
the Dublin & South Leinster HSE area. The hospital has a 12 station dialysis
unit with two isolation rooms. In additional the unit has to accommodate acute
dialysis for in-patients with renal failure.
AMNCH provides chronic dialysis services for its own population and for St.
James‟s Hospital. The unit is the second largest non- transplant centre in
Ireland and as of the end of June 2008 it was treating 190 ESKD patients. It
has the largest peritoneal dialysis programme in the country. AMNCH is one of
the five most congested Haemodialysis facilities as demonstrated in recent
HSE national renal surveys. The unit operates three shifts with all 14 stations
International recommendations also advise that the dialysis of chronic stable
haemodialysis patients be delivered separately from the treatment provided to
acutely unwell patients. This minimises the risk of cross infection and, from a
patient perspective, separates stable, well ESKD patients from those acutely ill
patients receiving the same treatment as themselves.
In the immediate term, over 30 additional haemodialysis stations are needed in
the catchment area. Each year will bring a requirement for up to 10 additional
stations. In line with national projections it is expected that it will need to treat
up to 400 such patients by 2011.
The hospital is actively pursuing the establishment of a Regional Renal
Medicine Clinical Network with St. Vincent‟s University Hospitals and the
Midlands Regional Hospital in Tullamore.
In addition has seen the unit has expanded by 300% since its opening ten years
The term renal disease typically refers to diseases of the kidney other than
cancers of either the kidney or associated organs of the urinary tract. Renal
failure refers to the ability of the kidneys to clear blood of waste products per
unit of time. Renal replacement therapy (RRT) is the treatment for renal failure
in which removal of waste products from the body is achieved by haemodialysis,
peritoneal dialysis or renal transplantation.
The number of patients suffering from chronic kidney disease (CKD) in Ireland is
rising and will continue to rise. As the population ages, the number of patients
with chronic kidney disease will escalate further, as the incidence of the disease
rises steeply with advancing age. The increase in diabetes in the population is
an important determinant of this escalation. Between 20-40% of people with
diabetes ultimately develop renal complications.
Work undertaken by the as yet unpublished National Renal Strategic Review
(NRSR) estimates that the number of people needing dialysis will double by
2011 because of ageing of the population and the current number of people with
diabetes and high blood pressure.
This increase in the number of patients developing renal disease, coupled with
increased survival and improved treatments for those with established disease,
poses unprecedented challenges for renal services in this country.
Within the HSE Dublin Mid Leinster region dialysis services are currently
provided in the following units.
HSE Area Dialysis Unit Satellite/Other Capacity
Routine & isolation Stations
Dublin Mid Tullamore 10+2
Leinster St. Vincent's 16+2
NATIONAL RENAL STRATEGY REVIEW
A National Renal Strategy Review (NRSR) was commissioned by the
Department of Health and Children (DOHC), following the publication of the
Health Strategy, ‘Quality and Fairness – A Health System for You’ in 2001. The
Health Strategy made a commitment that „A national review of renal services
will be undertaken‟ (Item 60) . The purpose of this Review was to develop a
framework to meet anticipated growth in demand for renal services.
Responsibility for delivery was initially with the DOHC and was later devolved
to the HSE in 2005. The final report of the National Renal Strategic Review
Group was presented to the HSE in December of 2006. It was at the time not
endorsed by the Management Team.
The Renal Strategy Review Group undertook its work before the
commencement of the HSE Transformation Programme. It has since been
decided that it is now appropriate that the report would be reviewed by an
external expert/consultancy working with the NRSR Chairman to ensure that
the Strategy is aligned with the HSE Transformation Programme and that work
practice recommendations reflect the integrated model of care particularly in
terms of services that people with chronic illness might receive from primary
care with disciplines working across the community / hospital divide. This
external review is currently under consideration and is expected to be
completed by the end of 2008.
NRSR has reviewed epidemiological data regarding the projected number of
patients on dialysis and the need for additional dialysis stations. A priority is to
avoid overcrowding dialysis units as the consequences are significant with
patients travelling long distances for dialysis treatments often at unsociable
hours. Patients are at increased risk of transmission of infection and at
increased risk of receiving an inadequate dose of dialysis.
While the external review of the NRSR has not yet begun at the time this
submission was being compiled, many of the best practice recommendations
identified by the NRSR have been used as a basis for this business case. It is
unlikely that these assumptions will be changed in any review as they are all in
line with international best practice and the HSE Transformation programme.
NRSR recommends that HD facilities should avoid exceeding a ratio of
2.5 treatments per HD station per day on 6 days per week.
Minimise travel time to achieve target whereby 90% of patients receive
dialysis at a facility within a one hour travelling time of their home, and
majority of these journeys should be within 30 minutes
Each HSE area should have the capacity to provide a haemodialysis
service for its own population
Data from the work of the NRSR Group indicate that the prevalence of ESKD
treated by dialysis has increased by 50% in the 4 years to 2007. The
prevalence of ESKD treated by haemodialysis has increased by 61% in that
interval. On 31st December 2007 there were a total of 1,520 patients with ESKD
receiving dialysis treatment, an increase of almost 12% on December 2005. Of
these, 1328 were on HD and 192 were on peritoneal dialysis.
The incidence of ESKD was 103 per million of the population (p.m.p.) in 2007.
The prevalence of ESKD was 741 p.m.p. 1623 (52%) of prevalent patients
have a functioning renal transplant (TX), 1329 (42%) are treated with
haemodialysis (HD), and 191 (6%) with peritoneal dialysis (PD).
Based on analysis of national data and on the observed increment in prevalent
dialysis patients between 2004 and 2007 it is probable there will be an
annual national increase in haemodialysis dialysis patients of between 20 and
45 per million of the population. However there may be a wider spread in this
figure if treatments are focused on smaller population areas.
REQUIREMENTS FOR DUBLIN MID LEINSTER
It must also be recognised that AMNCH also provides chronic dialysis services
for St. James‟s Hospital (SJH). Both hospitals have seen a considerable
expansion of their services over the past 10 years. This has been driven by a
number of factors including an increase in absolute numbers living in the local
area, an ageing population and the establishment of a number of new services.
The area served by AMNCH Renal Unit has specific demographic risk factors
that are associated with an increased prevalence of renal disease.
SJH serves an inner city area with the largest absolute number and the highest
percentage of deprived elderly (IMJ 2004) in the Dublin area. Many patients
are diabetic. There is also sizeable African and Asian population living locally
and these ethnic groups have a higher than average prevalence of renal
disease. The Tallaght GP study identified a higher than average prevalence of
premature vascular disease and diabetes in Tallaght. Kildare in the 2006
census experienced a 13.5% increase in its population.
Predicted future requirement for HD Stations in each HSE Area, 2006
Census Data (adapted from NRSR 2006)
Provision 200 201 201 201
Year 2008 9 0 1 2012 3 2014 2015
Dublin NE 90 99 107 116 124 132 141
Dublin Mid Leinster 32 20* 99 110 121 132 143 154 165
South 103 112 122 132 142 152 161
West 92 101 110 119 128 137 146
Total 382 421 459 497 535 573 612
*Virtual equivalent provided by Beacon (was 8 in 2006)
Local demand for services has led to the expansion of many services. Certain
specialities manage patients who are at an increased risk of developing renal
disease. Chief among these are Diabetes/ Endocrinology, Geriatric Medicine,
Cardiology, Vascular Surgery, Cardiac Surgery, Urology, Rheumatology,
Haematology/Oncology and Genito-Urinary Medicine. In all of the specialities
mentioned above, there has been an increase in consultant numbers (in some
a 400% increase!) in the past 10 years. While these developments have
improved patient survival, it has also increased the need for specialist renal
input and for dialysis provision.
It is recognised that expansion of renal services will leads to demands on other
medical specialities. Other disease processes almost always complicate renal
failure either due to the underlying disease (e.g. diabetes) or as a consequence
of renal failure itself such as ischaemic heart disease and peripheral vascular
disease. An ESKD program placed demands on Urology, Vascular Surgery,
Radiology, and Laboratory Medicine. Most patients spend 10 -15 days as
inpatients per year.
An initiative to identify and prospectively manage patients with renal failure in
SJH has been in place since 2002. Screening has identified >600 patients with
significant renal failure (stage 3). Currently (2007) 245 patients are attending
SJH with severe renal failure (stage 4 or 5), of which at least 100 are likely to
require dialysis within 2-3 years. A similar project in AMNCH was recently
commenced concentrating on stage 4/5 only due to the larger numbers.
Already 372 patients are being monitored with 24 already being worked up for
pre-emptive renal transplant.
Typically, each year 40-50 patients commence chronic dialysis. Losses to
transplantation and death has resulted in a net increase in dialysis number of
10-15 patients per annum. These receive their dialysis in Beacon (35) or
Tallaght (100 which is over maximal capacity) with 56 on peritoneal dialysis
Unit activity in 2007 was 11,625 OPD haemodialysis sessions in Tallaght, 4723
OPD haemodialysis sessions in Beacon Renal, and 1,800 inpatient sessions.
The total number of dialysis sessions (in & out patients) in 1999 was 5,574.
The following Capital elements are required. Some are in situ or can be
Chronic dialysis unit(s) for well out patients- between 40 - 60 stations
o This would set out in a number of bays with 3 / 4 stations per
bay, with appropriate hand washing and isolation facilities in each
Dialysis machines, water treatment plant, dialysis machine maintenance
workshop and Hepatitis dialysis machine storage area.
Appropriate IT systems to monitor dialysis treatments and provide
adequate documentation in case of look back requirements for Blood
Appropriate office space to accommodate the staff employed to run the
Staffing as per national recommended guidelines. (appendix 1)
AMNCH can provide the remaining elements
8-single bedded acute dialysis isolation unit – for acutely ill inpatients,
and with patients with blood borne viruses (Hepatitis B, Hepatitis C or
o The current unit can be reconfigured to an 8 station acute dialysis
Dedicated Out-Patient/Day ward treatment area for dialysis related
complications (In situ)
A 35 bed inpatient ward in close proximity to the acute dialysis unit for
inpatient care. These need to be ring fenced to support the proposed the
regional Renal Medicine Clinical Network. (In situ but beds are not
A CAPD Treatment area. – This is to provide outpatient care for patients
on peritoneal dialysis. (In Situ)
This will allow a total of between 240 – 300 patients to receive dialysis
This will require approximately 3,000m2 to accommodate the above and
assumes a new build for the chronic unit. This can be physically separate from
the inpatient treatment and/or acute dialysis unit. A two phase or two site
approach to utilisation could be employed, i.e. additional stations would open
when the number on dialysis warrants such expansion.
Access to the facility is required by car and taxi, as many patients are not very
mobile. Parking facilities will be required for patients who use their own
transport. The dialysis company typically deliver consumables directly once-
twice weekly and will need a service entrance.
In order to address the capacity shortfall for renal patients in AMNCH the
following are recommended.
1. The HSE should immediately tender for the provision of a satellite
dialysis unit of 16-20 stations in Kildare/Naas. This will accommodate
64 patients (2 shifts) and could immediately facilitate the 38 patients
from Kildare to have their treatment locally. Options include use of
the existing hospital in Naas stations or allowing the private sector to
find a suitable location & secure planning permission (preference for
the former). The viability of tendering for this facility on the grounds
of Naas hospital is currently being examined by the network.
2. In parallel with this AMNCH needs to embark on an expansion of the
existing chronic dialysis facility which would be the main chronic
renal facility for the South West Dublin Area. This could be on site or
in the immediate vicinity of the hospital. In order to accommodate
growth the unit should provide 30 stations. AMNCH are to consider
this further in line with the hospital development control plan which is
currently being reviewed. There are options to include this unit (which
could be a public or privately provided facility) as part of capital
expansion programmes which are currently underway. Should this be
a commercial unit the existing tender specifications could be used &
the tender run by AMNCH itself or by the HSE.
3. The existing dialysis unit should be converted to an acute renal unit
with 8 renal stations which would serve as the regional dialysis
4. Further discussions are being progressed to establish a south Dublin
dept of renal medicine which would incorporate SVUH, AMNCH, and
all associated satellite units.
5. The establishment of a renal south Dublin department/division of
renal medicine would provide an appropriate opportunity to address
the governance issues relating to Beacon
6. AMNCH should be the regional centre for provision of vascular
access for the Dublin Mid Leinster area
7. On an immediate basis additional capacity may be required in the
commercial sector pending local expansion
8. Consideration must be given to addressing staffing needs in terms of
nephrologist, clinical nurse specialists and dietetic support for both
AMNCH as a parent renal unit and the supporting satellite units.
9. Posts of CNSs for management of early kidney disease, dialysis
access and vaccinations needs to be prioritised.
Appendix 5 – Strategic Plan – Trinity College Dublin
The current Strategic plan for the School of Medicine is available via the
Head of School and Vice-Provost for Medical Affairs
1.2.06 Dermot Patrick Alfred Kelleher, B.A., M.D., F.R.C.P.I., F.T.C.D.
(2004) (first term expires 2009)
Professor of Academic Medicine/Director of Teaching and Learning
Shaun Richard McCann, M.B. (N.U.I.), F.R.C.PATH., F.R.C.P.I.,
F.R.C.P.ED., HON. F.T.C.D.
Director of Teaching and Learning (Postgraduate) (2008-11)
Thomas Joseph Connor, B.SC. (N.U.I.), M.A., PH.D. (N.U.I.), F.T.C.D.
Director of Research (2008-10)
Aiden Corvin, M.B. (N.U.I.), PH.D., M.R.C.PSYCH.
1.12.05 Fedelma McNamara, B.B.S. (LIMERICK)
Senior Lecturer in Nephrology
1.10.02 * George Joseph Mellotte, M.B. (N.U.I.), M.SC. (LOND.), M.R.C.P.I.
Clinical Professor of Neurology
1.1.07 * Orla Hardiman, B.SC. (N.U.I.), M.B. (N.U.I.), M.D. (N.U.I.),
Senior Lecturer in Neurology
1.10.98 * Raymond Murphy, B.A., M.B., M.R.C.P.I.
Clinical Senior Lecturer in Neurology
1.10.07 * Dominick McCabe, M.B. (N.U.I.), PH.D. (LOND.), F.R.C.P.I.
Lecturers in Neurology
1.10.92 * Janice Redmond, M.D. (N.U.I.), DIPL.A.B.P.N., DIPL.A.B.E.M.,
1.8.05 * Colin Doherty, M.B. (N.U.I.), M.D. (N.U.I.), M.R.C.P.I.
1.2.07 * Ronan Walsh, M.B. (N.U.I.), F.R.C.P.CAN., M.R.C.P.I.
Draft Consultants’ Contract
Table of Contents
Preamble ...................................................................................................................... 34
Section A - Terms and Conditions ............................................................................ 35
1) Core Principles ................................................................................................................ 35
2) Appointment and tenure .................................................................................................. 35
3) Probation ......................................................................................................................... 36
4) Mutual Obligations ......................................................................................................... 37
5) Contract designation ....................................................................................................... 37
6) Reporting relationship ..................................................................................................... 37
7) Hours of work ................................................................................................................. 38
8) Location and Residence .................................................................................................. 39
9) Scope of post ................................................................................................................... 39
10) Role of Consultant ..................................................................................................... 40
11) Professional Competence ........................................................................................... 41
12) Standard Duties and responsibilities ......................................................................... 41
13) Intellectual Property ................................................................................................... 42
14) Medical Education, Training and Research ............................................................... 42
15) Provisions specific to Academic Consultants ............................................................ 43
16) Advocacy ................................................................................................................... 45
17) Consultative structures ............................................................................................... 45
18) Leave, holidays and rest days ..................................................................................... 45
19) Locum Cover............................................................................................................... 47
20) Regulation of private practice ................................................................................... 48
21) Contract Type .............................................................................................................. 48
22) Change in Contract Type ............................................................................................ 53
23) Salary and other payments .......................................................................................... 54
24) Superannuation............................................................................................................ 56
25) Confidentiality ............................................................................................................ 57
26) Records / Property ....................................................................................................... 57
27) Clinical Indemnity....................................................................................................... 57
28) Grievance and Disputes Procedure ............................................................................. 58
29) Role of Review Body on Higher Remuneration ......................................................... 59
30) Conflict of Interest / Ethics in Public Office ............................................................... 59
31) Review by Employers and medical organisations....................................................... 61
32) Acceptance of Contract ............................................................................................... 61
Section B – Appendices .............................................................................................. 63
Appendix I – HSE Letter of Approval ..................................................................................... 63
Appendix II – Disciplinary Procedure ..................................................................................... 64
Appendix III – Clinical Directorate Service Plan .................................................................... 74
Appendix IV – Clinical Director Appointment and Profile ..................................................... 77
Appendix V – Extracts from Consultants Contract 1997 ......................................................... 80
Appendix VI – Granting of Sick Leave ................................................................................... 81
Appendix VII – Correspondence between the parties .............................................................. 83
Appendix VIII – Special leave provisions for Consultants in non-HSE employment ............. 86
Appendix IX – Committees to advise HSE on Consultant Applications ................................. 87
This document is comprised of the following:
a) Terms and Conditions;
c) Correspondence exchanged between the parties as set out at Appendix VII
d) Terms expressly incorporated
The foregoing, constituting the contract documents, shall be read together and
embody the entire understanding of the parties in respect of the matters contained
Note 1: Throughout this document the use of the masculine pronoun is
intended to also denote the feminine gender, save where the context
does not admit of such meaning.
Note 2: Job descriptions for new appointees will form part of the Consultants‟
Section A - Terms and Conditions
1) Core Principles
The core principles of this Contract are:
a) that both the Consultant and the Employer recognise that the relationship must
be founded upon mutual trust and respect for each other and that any
differences under the agreement should be processed expeditiously through
the grievance and disputes procedure or such other procedures provided for
b) recognition of the importance of the role of Clinical Director, which places
Consultants within the leadership structure in the management of the health
c) recognition of clinical independence and the unique nature of the relationship
between each Consultant and his/her patients;
d) recognition by the Consultant that (s)he must operate within a system in which
policy and procedures are determined through the corporate entity in which
staff at all levels must be accountable;
e) recognition of the Consultant‟s role as an advocate and the concomitant
responsibility, in the first instance, to express any concerns within the
f) recognition of the Consultant‟s role in the delivery of education and training
2) Appointment and tenure
a) This Contract is a contract of employment between XXXXXXXXXXXX
b) A candidate for and any person holding the office must be in a state of health such
as would indicate a reasonable prospect of ability to render regular and efficient
c) The qualifications required for this post are set out in the Health Service
Executive‟s Letter of Approval as attached at Appendix 1.
d) Should the Consultant be required by the terms of the offer of appointment to
comply with specified requirements or conditions (including a requirement or
condition that (s)he shall acquire a specified qualification) before the expiration of a
specified period the employment shall be terminated unless within that period the
Consultant has complied with such requirements or conditions.
e) With regard to resignation or retirement, the holder of a joint
appointment2 must act similarly in relation to each of his / her component
commitments, e.g. (s)he cannot retire or resign from one participating
Employer and not from the other(s).
f) If the Consultant wishes to terminate this employment (s)he shall provide the
Employer(s) with 3 months notice of his/her proposed termination date.
g) Except in cases of serious misconduct, the Employer will provide the Consultant
with 3 months notice of the intention to terminate his or her employment.
a) Appointment to a Consultant post is dependent upon the satisfactory
completion of a probationary period of 12 months. The probationary period may
be extended at the discretion of the Employer for a period of not more than 6
months. In such event the specific reasons for the extension shall be furnished in
writing to the probationary Consultant.
b) At the end of the probationary period, the Employer shall either:
i) certify that the Consultant‟s service has been satisfactory and confirm the
appointment on a permanent basis;
ii) certify, with stated specified reasons, that the Consultant‟s service has not been
satisfactory, in which case the Consultant will cease to hold his/her appointment;
c) If the Employer should fail to certify in accordance with (b) above, the
Consultant shall be deemed to have been appointed on a permanent basis.
d) The Employer undertakes to advise the probationary Consultant on a timely
basis of issues likely to result in the termination or extension of the
e) A Consultant who currently holds a permanent Consultant appointment in the
Irish public health service will not be required to complete a probationary
period should (s)he have done so already.
f) A Consultant will not be required to complete the probationary period where
(s)he has for a period of not less than 12 months acted in the post pending its
filling on a permanent basis.
2 A joint appointment is one which involves a
commitment by the Consultant to two or more employing authorities. Consultants
appointed on such a basis are entitled to a single contract or interdependent contracts
(with reciprocal clauses). The Consultant‟s total commitments should not exceed that
which is expected from Consultants in the same specialty who have a full-time
commitment to one employer.
g) During the probationary period, the probationary Consultant will be subject to
ongoing review and a formal review will take place not more than 6 months
after the date of first appointment on a probationary basis.
h) In cases where an allegation of serious misconduct is made against a
probationary Consultant, the matter will be dealt with in accordance with
Stage 4 of the Disciplinary Procedure (attached at Appendix II). This does not
affect the Consultant‟s statutory rights under the Industrial Relations Acts,
1946-2004 or any other statute.
i) In the case of joint appointments, the holding of any one part of the post is
contingent on continuing to hold the other part or parts of the post.
j) Employment may be terminated by either party during the probationary
period. Should employment be terminated by the Employer, the Employer
shall set out in writing the specific reasons for such termination.
4) Mutual Obligations
a) Both the Consultant and the Employer recognise the need for mutual trust,
confidence and respect in giving effect to the terms of this contract.
b) Both the Consultant and the Employer shall co-operate in giving effect to such
arrangements as are put into place to verify the delivery of the Consultant‟s
c) The determination of the range, volume and type of services to be provided and
responsibility for the provision of same within available resources rests with the
Employer. Services not provided as a consequence of a resource limit are the
responsibility of the Employer and not the Consultant.
d) The Employer recognises the Consultant‟s obligations regarding the
application of the Medical Council's (or Dental Council, as appropriate)
ethical and professional conduct guidance to the clinical and professional
situations in which (s)he works.
5) Contract designation
This contract is designated as a Type XXX Contract as set out in the HSE Letter of
Approval for this post attached at Appendix I. Details regarding Type of Contract and
change of Type of Contract are set out at Sections 21 and 22.
6) Reporting relationship
The Consultant‟s reporting relationship and accountability for the discharge of
his/her contract is:
i) to the Chief Executive Officer/General Manager/Master of the hospital (or
other employing institution) through his/her Clinical Director3 (where such
is in place). The Hospital Network Manager or Assistant National Director
HSE PCCC Directorate may require the Consultant to report to him/her
from time to time.
ii) in the case of Consultant Psychiatrists, to the Clinical Director and the
Local Health Office Manager PCCC Directorate (where the Consultant is
employed by the HSE) / Chief Executive Officer (where the Consultant is
not employed by the HSE).
7) Hours of work
a) The Consultant is contracted to undertake such duties / provide such services
as are set out in this Contract in the manner specified for 37 hours per week.
This 37 hour commitment will normally be delivered across a span of 12 hours
between the hours of 8am and 8pm Monday to Friday. The Consultant will not
be obliged to work more than 8 hours in any one day. This will be structured
as a single continuous episode. Scheduling arrangements may be changed
from time to time within the 8am to 8pm period in line with clinical and/or
service need as determined by the Clinical Director / Employer in consultation
with the Consultant.
b) The aggregation of the Consultant‟s commitments in a given time period shall
be on a cumulative basis of 37 hours per week. This does not imply that the
Consultant‟s work is organised in equal periods of time. If the time worked
consistently and significantly varies from the scheduled commitment, there
will be a review of the commitment to ensure that the Consultant is not
working regularly in excess of or less than the 37 hour weekly commitment.
Where the commitment is being unavoidably exceeded for reasons of a
temporary nature, local arrangements will be made to compensate the
c) In addition to the contracted commitment per week specified at Section 7 (a)
i) the Consultant may be required to participate in the on-call roster as
determined by the Clinical Director / Employer. Payment arrangements for
on-call liability are set out at Section 23 (i) and for the provision of call-out
services when on-call outside scheduled commitments at Section 23 (j).
ii) the Consultant rostered on-call may be required to provide a structured
commitment on-site of up to 5 hours on a Saturday and / or 5 hours
overtime on a Sunday and / or 5 hours on a public holiday. Consultants on
onerous on-call rosters4 shall not be expected to deliver the upper end of
this requirement as determined by the Clinical Director. The Consultant‟s
liability for on-call outside such structured or other scheduled overtime
hours will continue to apply.
3 Details of the Appointment and Profile of the Clinical
Director are contained in Appendix IV
4 Only on-call rosters of 1:4, 1:3, 1:2 or 1:1 are regarded as onerous.
d) As a senior professional employee, the Consultant may be required, from time
to time, to work beyond his/her rostered period in line with the exigencies of
the service. The Employer will endeavour to ensure that this will be an
exceptional rather than a standard requirement.
e) Where there is local agreement to implement different work patterns,
(including any arrangements providing for up to 24/7 hour working) the
involvement of any individual consultant in any such arrangement(s) shall be
subject to his/her agreement.
8) Location and Residence
The Consultant‟s appointment shall be to the XXXXXXXXXXXXXXXX
a) The Consultant‟s employment location may be changed within the functional
area and service range applicable to his/her Employer. In the first instance, this
will be within the Hospital Network area / remit of the HSE-funded Hospital /
Agency. The Consultant shall be consulted should (s)he be required to change
to an employment location outside the (Hospital Network Area / HSE-funded
Hospital / Agency). In circumstances where a change of location is required,
(e.g. - hospital closures or major changes taking place in the character of the
work being carried out there) the Consultant will be offered an appropriate
alternative appointment without competition and consideration will be given
to any request from the Consultant to change Contract Type or title of post.
Subject to the provisions of the removal expenses scheme for the Health
Service Executive, removal expenses shall be payable, if claimed.
c) The Consultant shall be available to respond readily to clinical or service
needs at the location(s) specified above. This will require the Consultant to
reside convenient to the hospital / agency in which (s)he holds his/her
9) Scope of post
a) The scope of this post is as set out in the HSE letter of approval for this
position at Appendix 1 and the Job Description as issued by the Employer.
These describe the Consultant‟s service commitments, accountabilities and
b) The Consultant‟s annual Clinical Directorate Service Plan will detail how
these are to be implemented and will be validated by a series of performance
c) Certain decision-making functions and commensurate responsibilities may be
delegated to the Consultant by the Employer. These will be documented in the
Clinical Directorate Service Plan.
d) The Consultant may apply through the Employer to the Health Service
Executive to change the structure of this post as set out in the HSE Letter of
Approval. Any change in the structure of the post is subject to the
determination of the HSE.
e) The Consultant may apply for atypical working arrangements under the
relevant health service scheme.
10) Role of Consultant
a) For the purposes of this contract, a Consultant is defined as a registered
medical or dental practitioner who by reason of his/her training, skill and
expertise in a designated specialty, is consulted by other registered medical
practitioners and who has a continuing clinical and professional responsibility
for patients under his/her care, or that aspect of care on which (s)he has been
b) The Consultant is clinically independent in relation to decisions on the
diagnosis, treatment and care of individual patients. This clinical
independence derives from the specific relationship between the patient and
the Consultant in which the patient places trust in the Consultant personally
involved in his/her care to make clinical decisions in the patient‟s best
interests and to take continuing responsibility for their consequences.
c) The Consultant acknowledges that (s)he is subject to statutory and regulatory
requirements and corporate policies and procedures.
d) The Consultant has a substantial and direct involvement in the medical
diagnosis, treatment and delivery of care to patients. Each patient will have a
named Consultant who has continuing responsibility for his/her diagnosis,
treatment and care.
e) The Consultant may discharge his / her responsibilities through:
i) a direct personal relationship with the patient;
ii) shared responsibility with other Consultants who contribute significantly
to patient management;
iii) delegation of aspects of the patient‟s care to other appropriate staff.
Delegation of responsibility to other doctors or staff by a Consultant is
(1) the Consultant being satisfied that the relevant staff member has the
necessary professional capability and
(2) the continued provision of a commensurate level of diagnosis,
treatment and care to the patient.
The Consultant shall retain a continuing overall responsibility for the care
of the patient.
f) The Consultant will generally work as part of a Consultant team. The primary
purpose of Consultant teams is to ensure Consultant provided services to
patients on a frequent and continuing basis. In effect this requires that the
Consultant provides diagnosis, treatment and care to patients under the care of