St Helens & Knowsley Teaching Hospitals NHS Trust (an equal opportunities employer) Medical Care Group

Transcription

1 St Helens & Knowsley Teaching Hospitals NHS Trust (an equal opportunities employer) Medical Care Group CONSULTANT CARDIOLOGIST JOB DESCRIPTON

2 INTRODUCTION This is a substantive NHS post which will enable the Cardiology Department to continue to develop high quality cardiology services in a large district general teaching hospital that has been completely rebuilt over the past few years. The appointee will be expected to have extensive general cardiology training and experience and hold CCT or equivalent or within 6 months of holding CCT or equivalent. Cardiology subspecialty competencies in heart failure and cardiac imaging are especially desirable in line with increasing demand and existing facilities in multi-modality cardiac imaging. General Internal Medicine (GIM) experience is essential but formal GIM accreditation is not required. This post is not intended for interventional or complex devices candidates.. The Trust has, for decades, been one of the most popular teaching venues for medical students from the University of Liverpool and is an extremely popular choice for the University s pre-registration house officers, ensuring a succession of high quality, enthusiastic trainees. ST HELENS & KNOWSLEY TEACHING HOSPITALS St Helens & Knowsley Hospitals Trust serves a population of 400,000. The District is of mixed residential, industrial and rural character situated on the edge of Merseyside between the open countryside of Cheshire to the south and Lancashire to the north. The Trust has 875 beds and has been re-built over the past few years as part of a brand new 240 million development. Whiston Hospital - is a Teaching Hospital that provides a comprehensive range of acute medical and surgical services, major accident and emergency services, maternity services, paediatrics, care of the elderly and the Regional Burns and Plastic Surgery Unit. The Critical Care Unit comprises an Intensive Care Unit and High Dependency Unit (20 beds) and a 17-bedded Coronary Care Unit. St Helens Hospital - has been recently re-built and opened as an Ambulatory Care Centre with Intermediate Care and Day Surgery in This contains a large outpatient facility and state of the art diagnostic services together with brand new day case theatres and day wards. PROFILE OF THE TRUST The Trust is made up of three Divisions: Medical Care, Surgical Care and Clinical Support Services, together with Education and Training, Facilities Management, Finance and various corporate functions.

3 THE MEDICAL CARE GROUP The Medical Care Group comprises Acute Medicine, Emergency Medicine, Critical Care, Cardiology, Endocrinology, Respiratory Medicine, Gastroenterology, Haematology and Care of the Elderly departments. THE MEDICAL DIVISION Medicine has been recently divided into speciality directorates each with a clinical director and an enhanced governance structure. An exciting medicine redesign project is underway aims to enhance consultant led care in General Internal Medicine and Speciality care across 7 days working. The Acute Medicine Unit at Whiston compromise 48 beds with further 16 GP assessment unit. Acute admission beds also include a 17-bedded CCU, a 14-bedded Acute Stroke Unit and the Stroke Rehabilitation Unit).There is a new Intermediate Care Unit and Rheumatology Unit at St Helens. The Whiston site also includes: a full Endoscopy Suite and a Haemodialysis Unit. In addition to General Medicine, the following medical specialist services are offered: Acute Medical Unit Cardiology Care of the Elderly Dermatology Diabetes and Endocrinology Dr P Williams (Clinical Director) Dr C Molugu Dr R Varia Dr A Clewes Dr N Furlong Dr A Mohammed (Clinical Director) Dr C Hammond Dr M Royle Dr K Murthy Dr A Hussein (Locum) Dr V Gowda (Clinical Director) Dr T Smith Dr J Abrams Dr A Capewell Dr J Bussin Dr S Allsup Dr SS Meenakshisundaram (Stroke Lead) Dr J Ellison (Clinical Director) Dr S Hickey Dr K MacBeth Dr K Rutter Dr E Hindle Dr A Alkali Dr K J Hardy (Medical Director) Dr S McNulty Dr N Furlong (Clinical Director)

4 Dr U Srinivas-Shankar Gastroenterology Genitourinary Medicine Haematology/Oncology Nephrology Neurology & Neurophysiology Whiston) Respiratory Rheumatology Dr A Bassi (Clinical Director) Dr J McLindon Dr R Chandy Dr S Priestley Dr J Dobson Dr M Fox Dr L Kingsley Dr J A Tappin Dr T Nicolson (Clinical Director) Dr M Gharib Dr E Marshall (Regional CCU & Whiston) Dr C Littlewood (Hospice & Whiston) Dr Schulz (Hub & Spoke arrangement with RLBUH Renal Unit) Dr M Steiger (Regional Neuro Unit & Dr P Ray (Regional Neuro Unit & Whiston) Dr J Hendry (Divisional Director) Dr S Twite (Clinical Director Dr P Stockton Dr S Agarwal Dr V Shankar Dr V Abernethy (Clinical Director) Dr J Dawson Dr A Clewes There is also a Consultant Clinical Biochemist with an interest in Metabolic Disorders, Dr M A Al Jubouri. There has been considerable (much needed) expansion of the Medical Division in recent years, which is ongoing and reflected in the number of new consultant posts. Further expansion in consultants as part of the medicine redesign project is underway. THE WORK OF THE MEDICAL DIVISION The work of the Directorate includes the management of medical emergencies and elective (specialist) work, which is mostly out patient work. The Trust admits approximately 24,000 patients per year, including approximately 15,000 acute medical admissions. On average, there are approximately 50 emergency medical admissions per day.

5 Emergency medical admissions either pass through the Emergency Department to the Medical Assessment Unit, or through the GP Admissions Unit (30%). There is also a Surgical Assessment Unit. During the week there is a physician of the day (POD) on call (whose other activities are cancelled). Post-take ward rounds on the AMU are performed by dedicated Acute Medicine Physicians during the week. At weekends, there are two on-call physicians who do post-take ward rounds (one on call for calls throughout the weekend) and the rota frequency is approximately 1:10.The Cardiology Department has its own speciality rota on a weekly basis where cardiologist of the week manages CCU and emergency referrals supported by the cardiology middle grade doctors. DEPARTMENT OF CARDIOLOGY Coronary Care Unit (CCU) The purpose-built seventeen-bedded Coronary Care Unit is supported by excellent nursing staff who are closely involved in clinical and research developments within the Unit. Two dedicated CCU Trainees provide medical cover during the day with out-of-hours cover provided by medical StRs and CTs. The Consultant Cardiologists undertake daily ward rounds and provide out-of-hours consultant cover. They are not involved in the General Medicine on call rota. The CCU has the usual facilities for invasive monitoring, echocardiography and telemetry together with continuous 12-lead ST segment monitoring. In addition there is a dedicated 'procedures' room for temporary pacing wire insertion, DC cardioversion, pericardial aspiration, etc. Invasive Cardiology The new Cardiac Catheterisation and Pacing Laboratory at Whiston Hospital opened in June It is linked directly to both the CCU and the Cardiology Ward (1D). The laboratory is designed with facility to allow coronary intervention development in the future. Junior Medical Staff The five Consultant Cardiologists are supported two StRs, one Speciality Doctor, two CT1/CT2 s, two F2 s and two F1. There are also a nurse consultant, two nurse clinicians and nine clinical nurse specialists. Cardiorespiratory Department The technical staff within the Department performs cardiological investigations. The inpatient ECG service provides 24-hour cover for all Departments including the Emergency Department. In addition to the usual non-invasive investigations such as ambulatory ECG and BP monitoring,transtelephonic cardiac arrhythmia recording, echocardiography, exercise ECG testing and tilt table testing; the Department provides transoesophageal, 3-D and stress echocardiography service and uses state-of-the-art digital archiving for all echocardiography. The Department is to be fully integrated to the PACS solution commissioned through Connecting for Health. The Department has three treadmills and six cardiac ultrasound machines. The staff are highly motivated and keen to develop the role of the Department

6 further. The Department also provides full pulmonary function testing, cardiorespiratory exercise testing and blood gas analysis facilities. Cardiac Imaging: In addition to the full range of echocardiography imaging the department in collaboration with radiology provides nuclear cardiology service including stress myocardial perfusion imaging, MUGA and CT calcium scoring and CT coronary angiography. Cardiac MRI is being planned for the near future. The department aims to develop and expand our cardiac imaging service offering exciting opportunity for the right candidate to develop this with our existing imaging consultants. Cardiology Clinics: General cardiology outpatient clinics are held at both Whiston Hospital and St Helens Hospital. Other speciality clinics:'rapid Access Chest Pain', 'Post-MI', 'Post Revascularisation', 'Heart Failure', Arrhythmia 'Post-cardioversion', Pacing, and Valve clinics are held at Whiston Hospital and at St Helens Hospital. The service operates through Choose and Book and current new patient appointment waiting time is 4 weeks. 14 day waiting time targets for RACPC appointments are routinely achieved. The Department is innovative, particularly in the area of outpatient services and is constantly looking to improve patient access and quality of care. Direct access services for echocardiography and ambulatory monitoring are well established. Cardiac Rehabilitation The Cardiac Rehabilitation Service comprises three hospital-based nurse specialists and twelve community-based nurse specialists including a coordinator. The objective is to provide a comprehensive service to all patients with coronary heart disease in St Helens, Halton and Knowsley implementing secondary prevention interventions that are of proven benefit. Individually prescribed exercise programmes are provided for all patients recovering from myocardial infarction or revascularisation procedure (PCI and CABG) and patients with chronic stable angina and heart failure. Research and Audit The Department of Cardiology is committed to involvement in research. The Department is keen to continue this involvement but also to develop a local research programme and applications have been made for funding of research proposals. THE JOB PLAN Title: Consultant Cardiologist This post is based on a whole time appointment (10 PAs). Working Relationships The employer is St Helens & Knowsley Teaching Hospitals NHS Trust. Managerial accountability is to the Clinical Director.

7 Timetable The work schedule will be based on a standard 40-hour contract of 10 programmed activities (PA's). The clinical timetable has been designed to attract the best candidates to this Trust. It is however; open to discussion and alteration with the aims of being in the best interests of the service and meeting individual needs. The work schedule is designed to include periods on and off the wards and on average include 7.5 PA's for direct patient care and 2.5 PA s for supporting professional activity. 3 PA average outpatient clinic (supported by middle grade and/or nurse clinician) 1.5 PA equivalent ward rounds (supported by middle grade, F2/ST1 and F1) 1 PA catheter laboratory sessions (Coronary Angiography/Pacing) 1.5 PA direct patient administration. 0.5 PA weekend (on call) ward rounds. Inpatient responsibilities will be for the Coronary Care Unit while on call and the cardiology ward during the ward cover week. The arrangement for Coronary Care cover and ward cover is designed to achieve consultant continuity of care for the maximum period for newly admitted patients. This has good evidence for better patients outcome. The arrangement is subject to review as clinical demand change. 2.5 PA will be for supporting profession activities such as teaching and training (1 PA); CPD, job planning and appraisal (1 PA); clinical governance, clinical networking and research (0.5 PA Indicative Timetable: The exact allocations for consultant s subspecialty interests and invasive cardiology will be arranged for each consultant according to competencies and coordinated with further new sessions created as required. Week1: CCU on call week Time Saturday Sunday Monday Tuesday Wednesday Thursday Friday CCU WR CCU WR CCU WR CCU WR CCU WR CCU WR CCU WR CCU WR CCU WR CCU WR CCU WR CCU WR CCU WR CCU WR CCU WR CCU WR CCU WR CCU WR CCU WR CCU WR CCU WR Ward Ward Cases Referrals Referrals Referrals Referrals Referrals Cases Review Review Board Board WR Referrals Referrals Referrals Referrals Referrals WR SPA SPA SPA SPA SPA SPA SPA SPA SPA SPA

8 Week 2: Cardiology Ward cover week Time Monday Tuesday Wednesday Thursday Friday Ward Round Ward Round Ward Round Ward Round Ward Round Ward Round Ward Round Ward Round Ward Round Ward Round Ward Round Ward Round Ward Round Ward Round Ward Round Ward Round Ward Round Ward Round Ward Round Ward Round Board Round Board Round Board Round Board Round Board Round SPA SPA SPA SPA SPA SPA SPA SPA SPA SPA Week 3-7 Time Monday Tuesday Wednesday Thursday Friday OPD Admin OPD SPA SPA OPD Admin OPD SPA SPA OPD Admin OPD SPA SPA OPD Admin OPD SPA SPA Angio/ SPA Subspecialty OPD OPD Subspecialty Angio/ SPA Subspecialty OPD OPD Subspecialty Angio/ Subspecialty OPD OPD Subspecialty Angio/ Subspecialty Subspecialty OPD OPD The post holder will take an equal share of the cardiology ward inpatient beds in a rotational basis. During CCU and ward cover other usual fixed commitments will be cancelled or covered by a colleague consultant cardiologist. During the CCU on call week, the consultant cardiologists undertake daily ward rounds on the CCU including weekends, and provide out-of-hours consultant cover with a frequency of 1 in 7 weeks. A supplement of 5% is paid for on call availability. They are not involved in the General Medicine on call rota. There is no commitment to General Internal Medicine on call or GIM post take ward rounds. Consultant Cardiologists provide out-of-hours cover to the CCU only. The post holder will be mentored by Dr A Mohammed and Dr C Hammond (Consultant Cardiologists). There are regular departmental management and educational meetings and an active contribution to the Trust s education, training and audit programmers. The appointee will be supported in the development of their own subspecialty interests and research. The Trust supports the requirements for continuing medical education as laid down by the Royal College of Physicians and is committed to providing time and financial support for these activities.

9 The post holder will act as educational and/or clinical supervisor for one or two junior medical staff, usually FY1 or FY2 trainees. The Department is friendly and supportive, providing an excellent mentoring environment. The appointee will have an office equipped with a PC and internet access. IT training is available if required. There will be designated full time secretarial support. In addition, there will be equal access to the admitting beds together with the training and non-training grade support staff. It is a requirement of the post that the post-holder comply with Trust policies and procedures, have (and maintain) GMC registration/licensing and participate in a formal CPD programme. The Trust supports the requirements for continuing medical education laid down by the Royal College of Physicians and is committed to providing time and financial support for these activities. The post-holder must also participate in regular medical audit and in annual appraisal and job planning. AUDIT AND EDUCATION The hospital has a clearly defined programme of medical audit. All specialties devote one PA per month on audit. This occurs at the same time for all specialties allowing the exchange of views between specialties and encourages multidisciplinary audit. The audit session is on a rolling rota. The hospital has a weekly grand round in the Postgraduate Centre. All disciplines participate on a rotational basis. The centre has a purpose built lecture theatre and 3 seminar rooms. There is also a well stocked library which includes electronic databases and internet access. The Trust is an Associate Teaching Hospital for undergraduate medical students from the University of Liverpool Students from 2 nd, 4 th and final year are attached. The appointee will share responsibility for teaching trainee medical staff, students, other physicians and non-medical colleagues. VISITING Candidates may visit Whiston Hospital by arrangements with Dr A Mohammed, Consultant Cardiologist, Department of Cardiology, Whiston Hospital, Prescot, Merseyside, L35 5DR Tel OTHER FACILITIES The hospitals are in easy reach of the City of Liverpool (10 minutes by car), including the University and access to the motorway network (M62, M6, M57, M58) is within easy reach.

10 LIFE IN MERSEYSIDE Merseyside is close to North Wales, the Lake District, and the Peak District, and provides an interesting mix of rural and urban life with the rolling countryside of Wirral, Lancashire and Cheshire surrounding the City of Liverpool. Liverpool itself is a vibrant city, which has undergone something of a renaissance in recent years and has recently been the European City of Culture. The extensive re-development of Victorian dockland is now a major tourist attraction. Merseysiders are renowned for their friendliness and quick-witted humour and the region sports two of the finest football teams in the premier league. First class schools are available both in Liverpool and on Wirral and the area has many sports facilities, including championship golf courses, several sailing clubs and one of the finest windsurfing venues in Britain.