JOB DESCRIPTION. Electrophysiology and Devices Fellow PORTSMOUTH HOSPITALS NHS TRUST

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1 JOB DESCRIPTION Electrophysiology and Devices Fellow PORTSMOUTH HOSPITALS NHS TRUST HG/Jan

2 PORTSMOUTH HOSPITALS N.H.S. TRUST IELECTROPHYSIOLOGY AND DEVICES FELLOW INTRODUCTION Portsmouth Hospitals NHS Trust is a major provider of Acute Health Services, primarily under contract to Portsmouth City and Hampshire PCTs as well as the Isle of Wight PCT and the Ministry of Defence. These links bring the total catchment to over 700,000 people. The geographic area served by the Trust is the Eastern Solent and includes the City of Portsmouth and the Boroughs of Gosport, Fareham and Havant, extending from Warsash in the west to Emsworth on the Sussex border, Liss to the north and Isle of Wight in the south. The bulk of the population live on Portsea Island or along the semi-rural coastal strip from Emsworth to Hamble. Portsmouth itself is an urban area developed over the past 100 years around the Royal Naval establishments. Much of the original Naval Dockyard is now preserved as a museum, housing HMS Victory, Warrior and the Mary Rose. Portsmouth now provides a wide range of modern high-tech industry and the facilities associated with a commercial port and crosschannel ferry terminal. The recently developed waterfront 'Gunwharf Quays' and Port Solent residential, shopping and entertainment complexes have gained international acclaim. Southsea and Hayling Island are both holiday resorts. The mid and northern parts of the area are rural and embrace the South Downs - designated areas of outstanding natural beauty and recently accorded National Park status. Chichester, Langstone and Portsmouth harbours provide World class sailing facilities in the Solent area. In June 2009, an extensive redevelopment of the Queen Alexandra Hospital site was completed under a private finance initiative, bringing together all acute medical services in Portsmouth onto a single site 1400 bed facility. This redevelopment includes a 50 bedded purpose built cardiology unit, with 3 cardiac catheterisation laboratories, a 12 bedded CCU, 4 echo rooms, 2 treadmill suites, a 14-bedded day ward, a TOE and stress-echo room, as well as a dedicated cardiology out-patient suite including rooms for device follow-up, ambulatory monitoring and heart failure nurses. DUTIES OF THE POST Applications are welcomed from specialist registrars training in adult cardiology and with the necessary experience to take up sub-speciality training in electrophysiology and ablation. The successful fellow should expect to work in the Device and Electrophysiology lab for initially 5 sessions increasing to 7 sessions with appointment of a second elctrophysiologst. There is currently no out of hours commitment but a middle grade out of hours service is likely to start in 2014 and the post-holder will contribute to this on a 1:10 basis. There is no formal commitment to ward cover but the successful candidate will be expected to assess patients with arrhythmia who are potential candidates for devices or ablation and contribute to their care before and after their procedure. There will be a weekly outpatient clinic and some cross cover in general cardiology should be expected. The successful applicant can expect to perform 200 first operator procedures per year. These will initially include Conventional Ablation, implantation of Cardiac Resynchronisation Devices, Implantable Defibrillators and some Pacemakers. HG/Jan

3 Opportunities to participate in coronary angiography, TOE or Device follow-up will be scheduled into the timetable if required but are not expected. ELECTROPHYSIOLOGY AND DEVICES SERVICE Currently we perform 110 electrophysiological and conventional ablations procedures and 100 ICD/CRT implants per annum. The service is provided by two Electrophysiolgists (Dr Neil Andrews & Dr Senthil Kirubakaran) and a Heart Failure / Devices Consultant (Dr Paul Kalra). Approximately 550 pacemaker implants are performed annually by 4 noninterventional cardiologists. The electrophysiology lab is equipped with facilities for conventional ablation as well as an electro-anatomical mapping system (CARTO 3). The latter is already in use for atrial tachycardia and idiopathic VT ablations. A Complex Ablation Service including Atrial Fibrillation will commence in August Approval for the appointment of an additional Consultant Electrophysiologist, Arrhythmia Nurse Specialist and a Physiologist has been granted. The approved Business Case for complex ablation anticipates an AF ablation rate of 112 cases per year. We anticipate that other technologies including Balloon Cryoablation will become available once the AF ablation service has started. CARDIOLOGY SERVICES Cardiology is the largest directorate within the Clinical Service Centre of Medicine employing 160 personnel and with an annual budget of 13 million. Cardiology is led by a Clinical Director supported by the CSC General Manager, Business Manager, Operational Manager and Matron. There are 13 consultant cardiologists and 2 visiting cardiologists from the Isle of Wight. We perform 24/7 primary PCI to a population of approximately 1.3 million across West Sussex, the Isle of Wight, Portsmouth City and East Hampshire. Over 1100 PCI procedures are performed annually including 400 primary angioplasties, 50 rotablations and a small number of balloon aortic valvuloplasty procedures. Approximately 1200 elective angiograms are performed annually. Non invasive services including transthoracic, transoesophageal and stress echo services are well established and all cardiac data are available throughout the hospital to cardiologists on the Medcon database. Nuclear cardiology and cardiac CT are available on site and cardiac MRI is under development. There are 19 WTE cardiac physiologists with national specialist accreditation (BSE or Heart Rhythm UK) who independently run pacemaker and echo clinics as well as supporting all laboratory activities. In addition, there are 5 WTE student physiologists and 7 WTE cardiographers who provide resting and ambulatory ECG services. 3 fully trained EP cardiac physiologists. We see approximately 1600 patients in our Fast Access Chest Pain Clinics, and more than 5500 other new patients. On average, we admit 10 emergency patients every 24 hours. HG/Jan

4 RESEARCH AND TEACHING Dr Paul Kalra leads the clinical research programme and supervises the MD theses one or two research fellows. We have 3 cardiology research nurses and we participate actively in multi-centre research. We have recently completed recruitment in the X-VeRT study (randomised study of Rivaroxaban vs Warfarin in patients undergoing cardioversion of non-valvular AF). In addition the interventionists have participated in the following studies: the BIOMATRIX Registry, Ripcord, the Cappella registry and SLEEVE 2. They are currently recruiting into LEADERS 3 and Odyssey. The successful candidate will be encouraged to develop and implement local research protocols and 1 session of research per week will be timetabled. Undergraduates from Southampton Medical School are attached to the Department. There is an established Postgraduate Medical School at the University of Portsmouth where several multidisciplinary research projects are being developed. We have a regular educational session for all cardiology medical staff as part of our commitment to CME on a Tuesday afternoon. This session includes case presentations, governance topics, talks from invited speakers and a MDT. CARDIOLOGY MEDICAL STAFF Dr Huw Griffiths Dr Richard Jones Dr Neil Andrews Dr Senthil Kirubakaran Dr Paul Kalra Dr Geraint Morton Dr Tom Farrell Dr Michael Stewart Dr Anjana Siva Dr Philip Strike Dr Ali Dana Dr Alex Hobson Dr John Watkins Dr Mark Connaughton Dr Dallas Price 6 Specialist Registrars 1 PCI Fellow 1 EP Fellow (this post) 1 Heart Failure Fellow 1 Research Fellow 5 Senior House Officers 4 Foundation Year 1 Doctors 2 Physicians Assistants and Clinical Director Consultant Electrophysiologist Consultant Electrophysiologist & Heart Failure Specialist & Heart Failure Specialist Locum (IOW) 3 sessions + 1:5 on call for PPCI (IOW) 1 session HG/Jan

5 1 Hospital Practitioner session VISITING Those who wish to visit the hospital should contact Dr Neil Andrews secretary on x4611. HG/Jan