Royal Liverpool and Broadgreen University Hospital NHS Trust

Royal Liverpool and Broadgreen University Hospital NHS Trust Job Description: Consultant Cardiologist with a Special Interest in Cardiac Imaging 1

Consultant Cardiologist with a Special Interest in Cardiac Imaging Introduction An exciting opportunity has arisen to join the teams at the Royal Liverpool and Broadgreen Hospitals NHS Trust. You will be joining the largest university teaching hospital in Cheshire and Merseyside. This is a full time substantive position and the opportunities on offer are detailed below: Royal Liverpool and Broadgreen University Hospitals The Royal Liverpool and Broadgreen University Hospitals NHS trust comprises 3 hospitals; The Royal Liverpool University Hospital, Broadgreen Hospital and the Liverpool University Dental Hospital. The Royal Liverpool University Hospital The Royal Liverpool University Hospital is the largest university teaching hospital in the Cheshire and Mersey Region. It serves a population of approximately 550,000 from across the North West, North Wales and the Isle of Man. In addition it provides tertiary services for a population of over 2 million. It has the main Emergency Department for the city of Liverpool, one of the largest of its kind in the UK. The Royal Liverpool Hospital has been a designated Major Trauma Centre since 2012. It currently has around 40 wards and more than 710 beds (excluding day case and dialysis beds). It is a main tertiary centre for Vascular Surgery, Trauma and Orthopaedics, ENT, renal medicine, renal transplant, haematology, Ophthalmology and Pancreatic Surgery. In addition it is a major cancer centre and a national centre for Ocular Oncology and Alkaptonuria. There is a large cardiology department providing secondary care cardiology to the inhabitants of Central and Southern Liverpool. 2

Broadgreen Hospital Broadgreen Hospital is situated 3 miles away from the main Royal Liverpool Hospital site. It is the main location for all elective general, urological and orthopaedic surgery, together with specialist rehabilitation. Most of the Urology services are located on the Broadgreen site including our state-of-the-art davinci robot, the only one in Merseyside and Cheshire. Liverpool Heart and Chest Hospital is co-located on the Broadgreen site but managed separately. LHCH is the major tertiary cardiothoracic centre for the region and is the largest PCI centre in the UK. There are close links between LHCH and the Royal Liverpool Hospital with the majority of consultants working across both sites. The New Royal University Hospital The replacement of the existing Royal University Hospital with a new state of the art facility has commenced and is due to open in 2017. The new hospital will include 664 beds, including a 40-bed Intensive Therapy Unit. There will be 18 state-of-the-art operating theatres and 23 wards and units, including a large clinical research facility. The hospital will be the largest in the UK to provide every patient with their own private room, many with en suite facilities. There will also be the development of comprehensive cancer services in collaboration with Clatterbridge Cancer Centre which will be moving onto the Royal site in 2018. 3

The Cardiology Department at Royal Liverpool and Broadgreen You will be joining a team of 12 Consultant Cardiologists with a wide range of subspecialty interests: Dr Khaled Albouaini - Complex Devices and Intervention Dr Adrian Chenzbraun - al Lead for Echocardiography Dr Mike Fisher - Interventional Cardiology and Research Lead Dr Jonathan Hasleton - Interventional Cardiology and Cardiac MRI Dr Julian Hobbs - General Cardiology, arrhythmias and Pacing Dr Scott Murray - Consultant, Cardiovascular Prevention Dr Jason Pyatt - Heart Failure, Complex Devices and al Lead for Cardiology Dr Balazs Ruzsics - Cardiac CT and Cardiac MRI Dr Stephen Saltissi - General Cardiology Dr Satya Verma - General Cardiology Dr Vishal Sharma - Cardiac Imaging and Obstetric Cardiology Other members of the team We have a 3 Speciality Trainee Registrars, 1 Trust Grade Registrar, 1 Imaging Fellow, 4 Senior House Officer Grade doctors and 4 Foundation Year 1 doctors attached to the cardiology team. There is a strong emphasis on teaching and training for our junior doctors and the successful applicant would be expected to support the training of junior doctors. We are also supported by a strong component of specialist nurses, including 3 Heart failure Specialist nurses, 3 clinical nurse specialists and 5 chest pain nurses. Heart Emergency Centre (HEC) and Coronary Care Unit (CCU) HEC consists of 12 beds with central monitoring and an assessment area for direct GP admissions. HEC is a high turnover area dealing with patients with acute coronary syndromes, significant arrhythmias and other cardiac emergencies. For patients requiring additional monitoring or support there is an adjacent 4 bedded Coronary Care Unit. We operate a Consultant of the Week system (Monday to Sunday) on a 1 in 10 basis. The Consultant of the Week is responsible for all patients admitted to HEC and CCU. Out of hours there is a Cardiology Registrar on call until 21:00 with the consultant non-resident on call. In addition at the weekend the Consultant of the Week is responsible for seeing any urgent referrals and reviewing any sick patients or potential discharges on the general cardiology ward 3A. 4

Key Contacts: HEC/CCU Ward Manager: Sister Jo Culverston 0151 706 2992/3270 Matron: Amanda Mulhaney (bleep via switchboard) General Cardiology Ward (Ward 3A) Ward 3A is a 35 bedded general cardiology ward. Patients from HEC who require ongoing care or patients triaged by the acute medical teams to cardiology are admitted to 3A. These patients are cared for by one of 2 cardiology consultants who are covering the ward. The consultants cover the ward in a block of 4 weeks on a 1 in 20 basis. During this time they are expected to deliver 3 Consultant Ward Rounds per week and be available to provide advice and support to the junior medical staff at other times. Cardiology Day Case Unit There is a 6- bedded cardiology day case unit. This provides ambulatory care for the elective admissions for angiography and pacemaker implantation. Key Contacts 3A/Day Case Ward Manager: Sister Carol Way 0151 706 2335 Matron: Amanda Mulhaney (bleep via switchboard) Outpatient s There are outpatient departments at both the Royal Liverpool and Broadgreen sites. The successful applicant will be expected to undertake approximately 1.5 outpatient s clinics per week (annualised) with a possible additional specialist clinic such as rapid access chest pain clinics in parallel with one of these clinics. We currently provide 5 Rapid Access Chest Pain (RACP) clinics per week with capacity of up to 30 patients per week. These are conducted in accordance with NICE guidance for the assessment of chest pain of recent onset with prompt access to Cardiac CT, stress echocardiography or invasive angiography. Our consultation times are 30 minutes for a new patient and 20 minutes for a followup patient. A typical new patient clinic will consist of 7 new patients if it is a standalone clinic or 5 if there is a nurse specialist led RACP clinic running in parallel to the main clinic. This is to allow time for the consultant to review these patients after they have been assessed. A typical RACP clinic will consist of 5-6 patients. Teaching Commitment The Royal Liverpool University hospital is a major teaching hospital. Consequently the successful applicant will be expected to participate in the training and supervision of junior doctors. This will include being an Educational Supervisor for trainees that rotate through cardiology. 5

Cardiac Imaging Services We have a strong, well established imaging department with 3 existing consultants with a strong track record in cardiac imaging. In addition we have a strong nuclear medicine department which provides our myocardial perfusion service and Cardiac FDG-PET CT service. The Cardiorespiratory Department The main Cardiorespiratory Department is located on the Royal Liverpool University Hospital with an additional satellite department located on the Broadgreen site. The department offers a comprehensive range of specialist diagnostic procedures across Cardiology and respiratory. These services include: Echocardiography Service. The department has been awarded BSE accreditation in TTE, TOE, training and stress echocardiography. There are state of the art echo machines including 6 Philips IE-33s and 2 portable echo machines. Three of these machines are equipped with the latest 3D transthoracic transducers and we have two 3D-TOE probes. There is a fully integrated archiving and off-line reporting system (Philips Xcelera). The department currently performs over 14000 TTEs per year and 700 TOEs, stress and contrast echocardiograms. There is a full range of diagnostic services including ECG, Ambulatory monitoring, tilt testing, carotid sinus massage and implantable loop recorders. There is a full range of Respiratory diagnostic services and a comprehensive Oxygen Assessment service. Key Contacts: Head of Department: Mrs Karen Wardle - 0151 706 2710 al Lead for Echocardiography: Dr Adrian Chenzbraun Cardiac CT and Cardiac MRI service There is a well-established Cardiac CT and Cardiac MRI service provided by Level 3 Certified Cardiologists. We currently perform approximately 2000 Cardiac CT examinations and 800 Cardiac MRI examinations per annum. We have 2 cardiac capable CT scanners, a state of the art dual source Siemens Somatom Definition FLASH and a 64 slice Siemens AS+ scanner. It is anticipated that an additional dual source CT scanner will be included on the Royal site as part of the plans for the new hospital. Cardiac MRI is performed on one of two 32 channel Philips 1.5T Achieve scanners, one on the Royal site and one on the Broadgreen site. There is also an additional 2 Siemens research scanners situated at the University of Liverpool. There are 6

designated reporting workstations on both the Royal and Broadgreen sites. A full complement of Cardiac MRI protocols are utilised including stress perfusion. Key Contacts: Superintendent Radiographer (CT): Miss Julie Houghton Superintendent Radiographer (MRI): Mr Jon Hannah (Royal) Superintendent Radiographer (MRI): Mr Kieran Murphy (BGH) al Lead for Cardiac CT/MR: Dr Balazs Ruzsics Cardiac Imaging Consultant: Dr Vishal Sharma Invasive Cardiology at RLBUHT There is a modern on-site cardiac catheterisation laboratory equipped with a biplane flat plate Siemens Cardiac Imaging System. There is an integrated archiving solution with a web based viewing of angiogram images available throughout the trust. We currently perform approximately 1000 diagnostic angiogram procedures per year. There is onsite implantation of cardiac rhythm management devices for Bradycardia indications. We perform approximately 200 pacemaker implantations per year. Currently all complex cardiac rhythm management devices are implanted at the Liverpool Heart and Chest Hospital. There are 2 intra-aortic balloon pumps available on site and the ability to provide invasive monitoring on the coronary care unit. Key Contacts: Cath Lab Director: Dr Khaled Albouaini Superintendent Radiographer: Mr Gavin Flintham Head of Cardiorespiratory: Mrs Karen Wardle Liverpool Angina Management Programme Formerly the National Refractory Angina, this unique service provides a comprehensive range of services for patients with difficult to manage angina. It is unique in the region and has been shown to reduce the readmission rates for this difficult to manage group of patients. Cardiac Rehabilitation Services We have a well-established range of cardiac rehab services for cardiac patients. This service is offered to patients following myocardial infarction or heart failure. There is a good integration between the hospital and community based programmes. 7

Research The Royal Liverpool University Hospital is a major teaching hospital with close links to Liverpool University, John Moore's University and the Liverpool School of Tropical Medicine. It also boasts two National Institute of Health Research Biomedical Research Centres in Pancreatic Surgery and Infectious Diseases. There is a strong emphasis on research within the Royal Liverpool University with numerous peerreviewed articles being published each year. In addition we are involved in a number of NIHR CRN portfolio trials. With the development of the new Royal Liverpool Hospital, the Liverpool Health and Life Sciences Bio Campus will be created adjacent to the new hospital. The new Royal and Bio Campus will make Liverpool a city that attracts global talent. It will create up to 5,000 high tech and well-paid jobs and be a magnet for leading international clinicians, pioneering researchers and entrepreneurs. Other Regional Units There are stand-alone units for Paediatrics, Neurology and Neurosurgery and Women s services. Consequently these are not provided at the Royal although there are close links with these units, particularly with the Liverpool Women s Hospital. 8

Details about the post itself The post will comprise of a combination of general cardiology commitments with subspecialist sessions in cardiac imaging. There is no general medicine commitment. General Cardiology Commitments There are 4 main cardiology wards areas, the Heart Emergency Centre, the Coronary Care Unit, the General Cardiology Ward (3A) and the Cardiology Day Case Unit. The care of patients on the cardiology wards at the Royal Liverpool is full ward based with patients providing care for patients according to a 20 week cycle. Within any 20 week period there are 2 weeks where the consultant will be consultant of the week on HEC and a further 4 weeks were they will be expected to care for patients on ward 3A and provide cover for in patient referrals. For the remaining 14 weeks there is no inpatient commitment. On-call Commitment You will also contribute to the general cardiology on call rota at the Royal on a 1 in 10 basis. This is remunerated at an additional 0.4 PA for weekend work as well as attracting a category A (5%) on call supplement. The weekend working will include a full ward round on HEC on both Saturday and Sunday, reviewing any urgent referrals and seeing any new patients or patients in who review is indicated (highlighted by the weekday team or nursing staff). There are 4 PAs per weekend allocated for this work. The on call is supported by a Registrar on site until 9pm. There is further support from the LHCH on call registrar on a 24/7 basis. Consequently it is unusual to be disturbed whilst on call overnight but if necessary compensatory rest can be provided. Office and secretarial support It is Trust policy that full-time consultant appointments are afforded appropriate secretarial time and office space. Office space will be provided (on either the RLUH or BGH site) but will be shared. There will be a 0.5 FTE personal assistant allocated. A personal computer with internet facilities, IT support and training, if required, will be provided. Terms and Conditions Main Conditions of Service The appointment is subject to the Terms and Conditions of Consultant (England) 2003 as amended from time to time. A copy of these terms and conditions are available from the NHS Employers website. Hours of Work The contracted hours for this post are 40 per week (10 Programmed Activities) and is adherent with the European Working Time Directive. Consultants are required to participate in the monitoring of working hours. 9

Additional Programmed Activities The Trust may offer you additional programmed activities over and above the standard 10 PA contract. The additional Programmed Activity is not pensionable. Additional Programmed Activities are not subject to pay protection arrangements. At present there is additional PA payment of 0.4PAs for the weekend ward rounds on HEC, Coronary Care and 3A. This will be reviewed subject to a reduced frequency of weekends worked in line with consultant expansion. Additional Increments Increments over and above the minimum of the salary scale will only be given for previous consultant level experience or where training has been lengthened by virtue of being in a flexible training scheme or because of undergoing dual qualification. Mentoring The Trust generates a mentoring programme for new Consultants. On commencement, mentors can be allocated through discussion and agreement. The successful applicant will be offered the opportunity to select a consultant mentor either within the cardiology department or if the applicant prefers, a non-cardiologist within the Medical Directorate. Infection Control All medical staff must co-operate with infection control measures which are in place throughout the Trust and comply with any guidance and best practice relating to infection control. All healthcare professionals have a statutory duty to promote ways for the service user and the community they serve to improve their own health and provide services to enable this to happen (e.g. smoking cessation, lifestyle and weight management). Safeguarding Children and Vulnerable Adults All Trust employees are required to act in such a way that at all times safeguards the health and well-being of children and vulnerable adults. Familiarisation with and adherence to Trust Safe guarding policies is an essential requirement of all employees, as is participation in related mandatory/statutory training. Management of Risk & Health and Safety All employees have a duty to take reasonable care to avoid injury to themselves or to others and to co-operate with the Trust in meeting its statutory requirements. All employees will proactively contribute to the management of risk by identifying hazards in the workplace which have the potential to cause harm, raising issues of concern and risk to the appropriate level. Appraisal and Revalidation The Trust has a supportive and well-resourced revalidation department within the Medical HR department. The revalidation process is underpinned by the Trust s robust clinical governance systems. Supporting information such as clinical outcome data, significant events and complaints is made available to individual doctors prior to appraisal. The Trust has invested in an electronic appraisal portfolio system based on the Medical Appraisal Guide (MAG) form to assist in the appraisal process. Multisource feedback is arranged for each doctor as required. There are an adequate number of trained appraisers who are supported by an Associate Medical 10

Director for Appraisal and Revalidation. Top-up appraiser training and training in multisource feedback facilitation is arranged on a regular basis for all appraisers. Equal Opportunities The trust is an equal opportunity employer. Members of staff are expected to treat other members of staff with dignity and respect at all times. Occupational Health Clearance All appointments are conditional upon appropriate Occupational Health Clearance. Disclosure and Barring Service Applicants for posts in the NHS are exempt from the Rehabilitation of Offenders Act 1974. All applicants who are offered employment will be subject to a Disclosure and Barring Service check before the appointment is confirmed. Further information is available at from the Disclosure and Barring Service website at: https://www.gov.uk/government/organisations/ disclosure-and-barring-service About the City Liverpool is a dynamic maritime city. It has experienced a major revival over the past few years and is now recognised as a World Heritage Site. It was selected as the European Capital of Culture for 2008 which led to further investment and renovation of the city. There are numerous theatres and museums in the city and Liverpool has the largest art collections of any city outside of London. Liverpool is a major tourist destination with over 55 million people visiting the city each year. There are 4 universities in the city; the University of Liverpool, Liverpool John Moore s University, Hope University and Edge Hill University. Liverpool is a relatively compact city and there is an excellent motorway and major road network. There are a number of pleasant suburbs within easy travel distance of the hospital extending from the Wirral, Formby and Cheshire. There are also extensive developments in the city centre particularly around the waterfront. There is an international airports in Liverpool with access to more international destinations available from Manchester.There are excellent Rail links with London a 2 hour journey away. The national parks of North Wales, the Peak District and the Lake District are a relatively short drive away. Sport is synonymous with Liverpool and there are 2 successful football teams within the city. There are many excellent golf courses and the Open Golf Tournament returned to The Royal Liverpool Golf Club at Hoylake in 2006. There are numerous sailing clubs and facilities for windsurfing. Job Plan A sample job plan is included at the end of the job description. However the exact job plan will be mutually agreed with the successful applicant prior to commencing work. Where possible job plans will be arranged to minimise travel between Broadgreen and the Royal sites. The two sites are approximately 3 miles apart however travel time can be up to 20 minutes. When it is necessary to travel between sites on the same day this will be factored into the job plan. There is a complimentary shuttle bus for staff running every 30 minutes between the 2 sites. 11

Visiting the Departments The opportunities on offer can be best appreciated by visiting the department. For informal inquires please contact: Dr Jason Pyatt al Lead for Cardiology, Royal Liverpool Hospital Switchboard: +44 (0)151 706 2000 E-mail: jason.pyatt@rlbuht.nhs.uk Those short listed for interview should consider arranging an appointment with Dr Peter Williams Medical Director and Mr Aidan Kehoe, Chief Executive. 12

Sample Job Plan The job plan is flexible with many components delivered on an annualised basis. The general job plan is based on 10PAs with additional PAs allocated for the on call commitments. The typical weekly commitments (averaged over 20 week cycle) are as follows: General Job Plan General Cardiology 2.4 PAs per week Cardiac imaging 3 PA per week OP clinics (Royal Liverpool) 1.6 PAs per week Administration 1.0 PA per week 2.5 PAs per week There is additional administration time built into lists and ward rounds On Call activity Weekend Ward rounds 0.4PAs per week An example working cycle is shown below. 13

Sample Job Plan CT TOE 1 Admin Stress echo CT TOE 2 Admin Stress echo CT TOE Referrals 3 Admin Stress echo CT TOE 4 Admin Stress echo CT TOE Referrals 5 Admin Stress echo HEC HEC HEC HEC HEC HEC HEC 6 HEC/Admin HEC/Admin HEC HEC/Admin WR WR 7 WR (RUH) WR TOE WR 14

Admin Stress echo WR Referrals WR Referrals WR 8 Referrals Referrals/ Referrals Referrals Referrals/ Mon Tues Wed Thurs Friday Sat Sun WR CT TOE WR 9 Admin Stress echo Mon Tues Wed Thurs Friday Sat Sun WR Referrals WR Referrals WR 10 Referrals Referrals/ Referrals Referrals Referrals/ 11 Admin Stress echo CT TOE Referrals 12 Admin Stress echo CT TOE CT TOE Referrals 13 Admin Stress echo 14 Admin Stress echo CT TOE 15

CT TOE Referrals 15 Admin Stress echo HEC HEC HEC HEC HEC HEC HEC 16 HEC/Admin HEC/Admin HEC HEC/Admin WR WR 17 Admin Stress echo CT TOE 18 Admin Stress echo CT TOE 19 Admin Stress echo CT TOE 20 Admin Stress echo CT TOE 16

Getting there: Royal Liverpool Hospital Prescot Street Liverpool L7 8XP Broadgreen Hospital Thomas Lane Liverpool L14 3LB Trust Website: www.rlbuht.nhs.uk 17

Person Specification for the Role Attributes Essential Desirable How Judged Qualifications MRCP or equivalent CCT in Cardiology (or within 6 months) Higher Degree (MD or PhD) CV al Experience Strong background in all aspects of general cardiology Ability to develop new, integrated services CV Accredited with subspecialty expertise in cardiac imaging Special interest in echocardiography and stress echocardiography Management and Administrative Experience Ability to lead a cardiology/ MDT team Ability to manage elective and emergency workload Interview Research Peer reviewed publications in cardiology Strong track record in original research including relevant higher degree CV Personal Attributes Ability to work in a team Good interpersonal skills Caring attitude to patients Good communication skills Leadership skills Willingness to undertake additional professional responsibilities at local, regional or national level Interview Commitment to Continuing Medical Education 18

Attributes Essential Desirable How Judged Teaching experience Evidence of teaching junior doctors/allied health professionals Formal qualifications or training teaching CV Interview Ability to supervise postgraduate research students Audit Understanding of principles of clinical audit Track record in audit CV Interview Probity Treat members of staff with dignity and respect Interview Honesty, integrity, appreciation of ethical dilemmas Physical requirements Occupational health clearance for the role specified Occ. Health. 19