REFERENCE NUMBER: CTR/0910/155
JOB TITLE: Chief Cardiac Physiologist
GRADE: Band 7
LOCATION: Cardiac Physiology / ECG, The Royal Infirmary of Edinburgh
CONTRACT DURATION: Permanent
CLOSING DATE: 2nd July 2010
SALARY SCALE: £30,460 - £40,157 per annum
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RECRUITMENT CENTRE, ST JOHN’S HOSPITAL, LIVINGSTON, EH54 6PP
GENERAL INFORMATION FOR CANDIDATES
This information package has been compiled to provide prospective candidates with details of the post
The contents of this package are as follows:
• Person Specification and Job Description
• Working Time Regulations Form (please complete and return with application form)
• Guidance on completion of Application Form
• Agenda for Change Terms & Conditions
• Equal Opportunities Policy Statement
Please note that any personal information obtained from you throughout the recruitment process will be
collected, stored and used in line with the Data Protection Act 1998. Information will be available to the
recruiting manager and to the Human Resource staff.
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information is available at http://www.audit-scotland.gov.uk/work/nfi.php. Information can also be obtained by
contacting Dave Proudfoot, Deputy Chief Internal Auditor on 0131 537 9267.
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I would ask you to note that if you do not hear from us within six weeks of the closing date, I regret to say that
you will have been unsuccessful on this occasion.
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regardless of their abilities. As part of our ongoing commitment to extending employment opportunities, all
applicants who are disabled and who meet the minimum criteria expressed in the job description will be
guaranteed an interview.
Please send your completed application to:-
The Recruitment Centre
St. John’s Hospital at Howden
Howden Road West
WORKING TIME REGULATIONS
In accordance with Working Time Regulations, no individual should knowingly be
contracted to work for more than an average of 48 hours per week.
For Completion by Applicant (to be submitted along with application form)
- Do you intend on holding any other employment (either NHS or non-NHS)
YES / NO
If yes please complete the details below:
Name and address of additional employer(s)
Average number of hours worked for this employer per week
For Completion by Appointment Panel
- Would the offer of this post put the applicant in a position whereby they would
exceed the 48-hour working limit? YES/NO
Please Note - It is the responsibility of the appointment panel to ascertain whether the
prospective employee intends to retain any other post held in addition to the one for
which they are applying.
Refer to the Recruitment Guidance Pack for further information regarding working
Career opportunities in Cardiac Physiology
LOTHIAN UNIVERSITY HOSPITALS DIVISION
Royal Infirmary Edinburgh
Highly Specialist Cardiac Physiologists
Salary £30,460 - £40,157
Cardiac Clinical Physiologist
Salary £25,472 - £34,189
Exciting opportunities to work in a major Tertiary centre.
We are looking for enthusiastic Cardiac Physiologists to join our busy team. We are recruiting
to both the CRM and the Echo teams. Successful candidates will be expected to hold NASPE
for the CRM post or BSE for the Echo post.
The Royal Infirmary is a large Interventional centre and experience in all aspects of both
invasive and non- invasive Cardiology is essential.
Trainee Cardiac Physiologist applicants should have academic qualifications allowing
entrance to an Hons degree in Clinical Physiology.
Pre registration applicants would also be considered.
For an informal visit or more information contact
Cardiac Physiology Service Manager on 0131 242 1814.
1. JOB IDENTIFICATION
Job Title: Highly Specialist Cardiac Clinical Physiologist (Cardiac Ultrasound).
Responsible to: Cardiac Clinical Physiology Service Manager.
Department(s): Cardiac Clinical Physiology (NRIE)
Operating Division: Medical
No of Job Holders: 2 (1.37wte).
Last Update: October 2004
2. JOB PURPOSE
• To support the Cardiac Clinical Physiology Manager in the delivery of Cardiac Physiology
• To manage the Cardiac Ultrasound Service by providing an efficient scanning and reporting
service for patients, whilst undertaking the responsibility for the training and development of
Specialist Cardiac Clinical Physiologists and Medical staff.
• To regularly participate in National, International research and clinical trials.
• To maintain clinical commitment in other areas of the service as required.
• The department carries out 6200 Cardiac Ultrasound scans annually. This includes routine,
(Post Myocardial Infarction) complex (Valvular Heart Disease) highly complex (Regional
Adult Congenital Heart Disease) and emergency Cardiac Ultrasound.
• The post holder manages the operational challenges of the service by prioritising based
on clinical need whilst providing a rapid and prompt access to Cardiac Ultrasound for A/E
and Acute Medicine.
• The post holder is responsible for the training and development plans and appraisal of 3
Specialist Cardiac Clinical Physiologists.
• The post holder is responsible for training Cardiology SPR’s in scanning and reporting
• The post holder is responsible for reporting scans of Specialist staff who are not British
Society of Echocardiography (B.S.E.) Accredited. This includes Cardiology SPR’s in
training. This role was formally that of a Consultant Cardiologist.
• The post holder provides expert support and advice to other Departments and Specialities and
4. ORGANISATIONAL POSITION
Cardiac Clinical Physiology Service Manager
Highly Specialist Cardiac Clinical Physiologist. (Cardiac Ultrasound)
Specialist Cardiac Clinical Physiologists.
Cardiac Clinical Physiologists
5. ROLE OF DEPARTMENT
The Department of Cardiology is a nationally and internationally acclaimed unit, providing a supra-
regional comprehensive service to a population of 1.7 million.
LUHD delivers services within the environment of a University Teaching Hospital setting.
The Department of Cardiology is a centre for National and International Research and Clinical Trials.
The Cardiac Clinical Physiology Department NRIE site plays a pivotal role by providing a full range of
Cardiac investigations to A/E and Acute Medicine all In-patients and Out patient Specialities including
Neo Natal Services.
The role of the Cardiac Clinical Physiologist has expanded to encompass many duties which
were formally that of a Consultant Cardiologist.
• Routine ECGs
• 24hr ambulatory ECG monitoring and analysis. (Including event recorders.)
• Cardiac Clinical Physiology (C.C.P.) led Exercise Tolerance Tests; this includes Rapid Access
Chest Pain services.
• CCP led Cardiac Ultrasound service.
• CCP led Pacemaker follow-up clinics.
• CCP led Paediatric pacemaker follow-up service at Royal Hospital for Sick Children.
• CCP led follow up service for Implantable Cardiovertor Defibrillator (ICD) devices, and Bi-
Ventricular pacemakers for Cardiac Resynchronisation for Lothian and the Region.
• ECG training for Nursing staff and Clinical Support Workers.
• Intra cardiac pressure monitoring during Cardiac Catheterisation and Coronary Intervention.
• CCP support during Pacemaker implantation for Bradycardia.
• CCP support for implant and follow-up of Loop Recorders.
• CCP support for ICD and Bi-Ventricular implants. (Lothian and Regional Service)
• Assist Consultant Electrophysiologist during Electrophysiology studies and Radio Frequency
Ablation with highly complex intracardiac signal analysis. (Curative procedure for patients with
arrhythmias) This is a Regional service.
6. KEY RESULT AREAS
Clinical Provision: Manage the Cardiac Ultrasound Service by:
• Prioritising requests based on clinical need.
• Providing rapid access for A/E and Emergency Medicine for Cardiac Ultrasound
scans, by performing and providing immediate reports, which will directly influence
patient management and care.
• Providing One stop clinic provision for Outpatient services.
• Undertaking Lead role in the South East Region Adult Congenital Heart Disease
clinic. This requires highly specialist skills and expertise in scanning techniques
specific to Congenital Heart Disease.
• Delivering specific investigations in association with Consultant colleagues e.g.
Dobutamine Stress Echo’s and Contrast studies.
• Facilitating Dobutamine Stress Echo and Contrast studies the post holder is
expected to perform IV cannulation.
• Providing highly specialist support to Consultant Electrophysiologist using Cardiac
Ultrasound to optimise Bi-Ventricular pacemaker devices for Cardiac
Resynchronisation Therapy. This is a Regional Service.
• Providing specialist support and advice to other specialities.
• Responsible for reporting Cardiac Ultrasound scans performed by Specialist staff
in training that are not B.S.E. accredited. This includes Cardiology SPRs in
• Developing operational protocols, identifying and implementing change.
• The efficiency of the Cardiac Ultrasound Service depends solely on the post holder
being an autonomous independent practitioner.
• Maintaining clinical commitment in other areas of the service both invasive and
• Participating in on-call rota for the Cardiac Catheter Lab when required.
• Maintaining appropriate professional and personal development.
• Responsible for delivering specialist training in Cardiac Ultrasound for Cardiac
Clinical Physiologists, including other hospitals.
• Responsible for Appraisal and Personal Development planning of 3 Specialist
Cardiac Clinical Physiologists.
• Responsible for specialist training of Cardiology SPRs and reporting progress to
their Post Graduate tutor.
• Introduction to Cardiac Ultrasound for Medical Students.
Research Development and audit:
• Regularly participate in both National and International research and clinical trials.
• Expert advice resource for clinical trial co-ordinators.
• Quality assurance audits to ensure scanning and reporting standards are in line with the
department protocols, and provide monthly activity information.
7a. EQUIPMENT AND MACHINERY
The post holder will ensure all equipment used is inspected regularly and is safe for use, and all
faults reported appropriately.
Bleep system, Fire Equipment, Oxygen Cylinders, Pat Slides, Wheelchairs/Trolleys/Beds
12 Lead ECG machine, (£5000) 24 hr Ambulatory Monitors, (£1800) Event recorders, (£1000)
Transtelephonic Signal Receiving Centre.
Cardiac Monitor, Computerised Stress Testing System including Archiving (£24,000) Manual Defibrillator
(£7000), Dynamap, Sphygmomanometer, Pulse Oximeter.
Cardiac Ultrasound Scanner (£120,000) Transthoracic Multi frequency Ultrasound Probes (£20,000)
External Pacing Box. (£1500)
Transoesophageal Ultrasound Probes (£20,000)
Intracardiac Pressure and ECG Monitoring and Recording Equipment in Cardiac Catheter Lab. (£40,000)
Defibrillator Remote Use (£7000), Intra Aortic Balloon Pump, (£42,000), RADI pressure Wire Sensor
(£10,000), Rotablator (£6000) and Blood Oximeter (£7500).
* The Intra Aortic Balloon Pump is an emergency life support system used to increase Coronary and
Peripheral blood flow.
*RADI analyser calculates fractional flow reserve identifying significant flow restricting lesions in the
*Rotablator burrs down calcified plaque deposits in the Coronary Arteries into fragments smaller than
Red blood cells in order to allow balloon angioplasty.
Patient information data bases and report archiving for:
• Exercise Tolerance Tests. (GE system)
• Cardiac Catheterisation (Minerva and GE system)
• Manual logbook for cross-referencing procedure data in the Catheter Lab.
• Cardiac Ultrasound (Rickett system)
• Internet and Intranet for personal and business.
• Manual logbooks for Non invasive services.
• Maintain patient records.
8. ASSIGNMENT AND REVIEW OF WORK
• Post holder is a Lead Specialist Independent Advanced Practitioner, and works autonomously
within the broad parameters set by the Cardiac Clinical Physiology Service Manager.
• Workload is generated by the demands on the service by Cardiology, other Specialities, A/E and
Emergency Medicine and the Region.
• Performance Appraisal Reviews annually by Cardiac Clinical Physiology Service Manager.
9. DECISIONS AND JUDGEMENTS
The post holder works independently and their decisions and judgements have a direct effect on
• The post holder is responsible for prioritising Cardiac Ultrasound referrals.
• The post holder makes decisions and gives advice to referring physicians regarding the most
appropriate type of Ultrasound scan.
• The post holder’s report will aid and influence Cardiac Surgeons in decisions about Valvular Heart
• The post holder makes decisions about findings that require immediate or further medical attention.
eg. Cardiac Tamponade where fluid from around the heart would require draining, or apical
thrombus where the patient would be required to be assessed for anti coagulation therapy.
• The post holder offers advice, support and training to other centres in the Region. E.g. offering
personal/professional development opportunities.
• The post holder decides when specialist trainees are competent to scan unsupervised, and on their
suitability to sit the British Society of Echocardiography Accreditation exam.
• The post holder makes decisions regarding stock control for Cardiac Ultrasound.
• The post holder makes decisions about ECG abnormalities, which would require either immediate or
further medical attention.
• Exercise Tolerance Tests are Specialist CCP led for Coronary Heart Disease, and the post holder is
responsible for ensuring the safety of the patient by:
(a) Vetting the request for contraindications
(b) The test is conducted in accordance with The British Cardiac Society
(c) Terminating the test when criteria are met e g ECG changes,
Hypo/hypertension, Ventricular arrhythmias.
(d) Abnormalities are brought to the attention of the referring Physician.
10. MOST CHALLENGING/DIFFICULT PARTS OF THE JOB
• Routine Cardiac Ultrasound numbers for year 2004 were 6200 patients using predominantly 2
Ultrasound machines. This requires efficient time management skills balancing both scanning
• Cardiac Ultrasound for patients with highly complex Adult Congenital Heart Disease.
• The New Royal infirmary’s Accident and Emergency department and Acute Medical Admissions
Unit is one of the busiest in the country. To maintain rapid turnover of patients prompt access to
cardiac investigations is necessary and the post holder provides a diagnostic service for Cardiac
Ultrasound with a rapid turn round in the delivery of reports, a process that is facilitated by their
independent and autonomous practice
• Increase in the demand for Cardiac Ultrasound as a result of National guidelines and
11. COMMUNICATIONS AND RELATIONSHIPS
The post holder communicates on a daily basis with a broad range of Health Care Professionals.
The post holder has a persuasive and encouraging disposition in order to enable co-operation with
confused or anxious patients.
The post holder communicates and advises routine and highly complex information regarding the results
of Cardiac Ultrasound scans to Medical staff offering a detailed explanation when necessary.
• INTERNAL (within the Division)
Patients and Relatives: - To explain procedures, to reassure and convey test results.
Cardiac Clinical Physiologists: - Daily to convey information on aspects of the service, rotas, supervising
Cardiologists – For Professional and Clinical decision-making.
Cardiac Surgeons. - To convey test results and recommendations based on Ultrasound findings
Vascular Surgeons - As above.
Medical staff from other Specialities - As above.
Nursing staff – Overall patient management and communication on behalf of the Cardiologist.
Clerical staff – For out -patient appointment scheduling and patient transport.
Procurement – Regarding Echo supplies.
Management – Line manager for staffing issues.
Research and Development
Health and Safety
• EXTERNAL (out with the Division)
General Practitioners: - To both give and receive sensitive and complex information regarding patient
Medical and Cardiac Physiology staff in South East Scotland Consortium: – To provide expert advice and
Cardiac Ultrasound Industry: - (a) Maintenance departments for routine servicing and fault finding.
(b) Product specialist for new developments and training courses.
12. PHYSICAL, MENTAL, EMOTIONAL AND ENVIRONMENTAL DEMANDS OF THE JOB
• Manoeuvring heavy equipment in the Catheter Laboratory. (Occasional)
• Pushing trolleys/wheelchairs. (Frequent)
• The majority of in patients require assistance to transfer from a wheelchair to the Cardiac
Ultrasound examination couch. (Frequent)
• Ultrasound equipment is very heavy and the post holder requires a moderate level of fitness to
position the machine for optimal scanning. Occasionally the post holder will be required to
transfer the machine to emergency situations in another part of the hospital
• There is a requirement to change an oxygen cylinder. (Occasional)
• Ultrasound scanning requires the operator to sit for prolonged periods of time in a restricted
position (approx 25 mins per patient) complex studies may take longer than this. (Frequent)
• Haemodynamic monitoring in the Catheter Lab requires the operator to sit or stand for prolonged
periods of time. (Occasional)
• Requirement to wear Lead apron for radiation protection. (Occasional)
• Using a desk top PC (frequent)
• The post holder requires physical skills to operate the full range of diagnostic equipment used
within the non-invasive and invasive Cardiac Clinical Physiology speciality.
• The post holder must be able to demonstrate skilful handling of Cardiac Ultrasound probes and
have a high degree of manual dexterity to optimise cardiac images,
• Be able to work at speed when performing emergency scans.
• Possess good keyboard skills for entry of data and report writing.
• Prolonged concentration is required during a Cardiac Ultrasound session (4hrs) and need to be
fully conversant with all the modalities of imaging i.e. M mode, 2 Dimensional imaging, Spectral
and Colour Flow Doppler mapping in order to obtain optimal cardiac images. (Frequent)
• The post holder is expected to make measurements and use complex algorhythms and formulae
to formulate conclusions on which to base their final report. (Frequent)
• Prolonged concentration during a Cardiac Catherterisation session (4hrs). (Occasional)
• On-call sessions.
• Shorter periods of concentration are required for individual diagnostic tests. E.g. approximately
20mins during Exercise Tolerance Tests. (Occasional)
• Maintenance of precise and accurate records.
• Time management
• Communication difficulties with patients (multicultural, deaf, blind)
• Service changes.
• Post holder communicates with distressed and anxious patients and relatives. (Frequent)
• Dealing with critically ill patients in the Catheter Lab. (occasional)
• Patients death (occasional)
• The post holder will be expected to work for prolonged periods of time in a darkened room.
• The post holder is exposed to body odours and body fluids. (Frequent)
• There is a potential risk of verbal and physical abuse from patients who are confused or
• Temperature/air quality of working environment.
• Radioisotopes. (Thallium stress exercises) (Occasional)
• Radiation exposure in the Cardiac Catheterisation Lab. (occasional) Health and Safety guided.
• Prolonged periods using monitoring equipment. (VDU) frequent
13. KNOWLEDGE, TRAINING AND EXPERIENCE REQUIRED TO DO THE JOB
• Professional qualifications: BSc.Hons Clinical Physiology (Cardiology) or equivalent.
• The Post holder must be registered with the Health Professions Council (HPC) or a recognised
equivalent statutory body as a Cardiac Clinical Physiologist.
• Post Graduate/qualification experience in both non-invasive and invasive Cardiology.
• Post Graduate British Society of Echocardiography (B.S.E.) Accreditation Exam (Master’s
• Post B.S.E. Accreditation experience.
• Highly developed specialist knowledge and extensive experience in Cardiac Ultrasound.
• Highly Specialist study and extensive experience in Adult Congenital Heart Disease.
• Highly specialist study and extensive experience in Stress Echo.
• Specialist study and experience in optimising Cardiac Resynchronisation Therapy Devices (for
heart failure) using Cardiac Ultrasound.
• Evidence of continuing professional development.
• Extensive knowledge and experience in ECG interpretation.
• Evidence of excellent training and teaching skills.
• ALS/BLS with defibrillation skills.
• Excellent communication and interpersonal skills.
• The post holder will be required to demonstrate excellent team working skills with ability to work
using own initiative.
• Good IT skills.
• Good time management and organisational skills.
• Knowledge of Child Protection and Vulnerable Adults Act.
• Knowledge of Division Policies on:
(a) Health and Safety, Infection Control and Manual Handling
(b) Local policies and National Guidelines in Specialist areas.
(c) Knowledge of National guidelines SIGN, NICE, DVLA.
14. JOB DESCRIPTION AGREEMENT
A separate job description will need to be signed off by each jobholder to whom
the job description applies.
Job Holder’s Signature: Date:
Head of Department Signature: Date:
Guidance on how to complete the NHS Scotland application form
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elimination of discrimination.
Please return completed application forms to:
The Recruitment Centre
St John’s Hospital
Howden Road West
Please note that if you do not hear from us within six weeks of the closing date, I regret to say that you will
have been unsuccessful on this occasion.
Terms & Conditions
The NHS has recently undergone one of the most significant changes in relation to staff grading, pay
and terms and conditions of service, known as Agenda for Change (AFC). Agenda for Change
introduces harmonised NHS Terms and Conditions of Service based on the principle of equal pay for
work of equal value, to ensure a fair system of pay for all NHS employees whilst supporting modernised
For further information visit - www.paymodernisation.scot.nhs.uk
It is important to note that some contractual conditions of service remain under review and may change
subject to final agreement.
Pay / Policies
Pay progression through AFC salary band is by annual increment subject to performance review.
Within each pay band there are 2 gateways: the foundation gateway and the second gateway. The
foundation gateway is applicable to new or promoted staff and applies no later than twelve months after
appointment to the pay band regardless of the pay point to which the person is appointed. The second
gateway follows the foundation gateway and the point at which it applies will vary between pay bands.
Annual Leave & Public Holiday Entitlement
All NHS Lothian employees receive an entitlement to annual leave and public holidays, combined this
gives a total leave entitlement. An employee’s leave is based on their length of service and hours
worked per week.
Annual Leave + Public Holidays = Total Leave Entitlement
On Appointment – 27 days per annum plus 8 public holidays (pro rata)
After 5 Years Service – 29 days per annum plus 8 public holidays (pro rata)
After 10 Years Service – 33 days per annum plus 8 public holidays (pro rata)
NB: previous NHS service will count towards entitlement.
NHS Pension Scheme
The NHS provides an occupational pension scheme, membership of which is optional.
The Scheme is currently under review however key provisions include the Scheme being contributory
by the employee and employer and in addition to retrial benefits the Scheme also provides for ill health
retrial, death gratuity, and widow’s/widower’s benefits.
Workforce Equality Monitoring
NHS Lothian is committed to supporting and promoting dignity at work by creating an inclusive working
environment. We believe that all staff should be able to fulfil their potential in a workplace free from
discrimination and harassment where diverse skills, perspectives and backgrounds are valued.
In order to measure and monitor our performance as an equal opportunities employer, it is important that
we collect, store and analyse data about staff. Personal, confidential information will be collected and used
to help us to understand the make-up of our workforce which will enable us to make comparisons locally,
regionally and nationally.
Equal Opportunities Policy Statement
NHS Lothian considers that it has an important role to play as a major employer and provider of services in
Lothian and accepts its obligations both legal and moral by stating commitment to the promotion of equal
opportunities and elimination of discrimination.
The objectives of its policy are that no person or employee receives less favourable treatment on the
grounds of sex, disability, marital status, age, race (including colour, nationality, ethnic or national origin),
creed, sexuality, responsibility for dependants, political party or trade union membership or activity, HIV/AIDS
status or is disadvantaged by conditions or requirements which cannot be shown to be justifiable.
Provision of Services
The organisational objective is to provide equality of access to provision of services through:
• consultation over services to ensure that groups concerned are consulted over existing services and
• epidemiological studies, patient satisfaction surveys and qualitative research to ensure that specific
reference is made to the needs of the groups covered by the policy.
Equal Opportunities in Employment
2.1 Recruitment and Selection
The organisation aims to ensure that:
• all sections of the community know about job opportunities within NHS Lothian
• where possible, under statutory rules, members of groups who are under-represented in the workforce
will be encouraged to apply for jobs through positive action programmes;
• everyone who applies or a job or promotion within the organisation will receive fair treatment and will be
considered solely on ability to do the job against justifiable selection criteria and unbiased personnel
• records are kept so that the organisation can monitor how the policy is working. To do this, applicants
and employees will be asked to provide information for their records. All information will be confidential;
• all procedures and practices used in recruitment and selection are reviewed, to ensure that there is no
The organisation intends that:
• all its employees, including part time staff, will be advised at induction and regular in-service training that
they have equal access to training and are encouraged to take advantage of such training;
• all managers and those responsible for appointing staff receive training in the organisational Equal
• in-service staff are trained as trainers and external expertise identified in sufficient quantity, quality and
range to support induction, on-going and update training in Equal Opportunities for all staff;
• the organisation will also work with medical schools and other training agencies to ensure that Equal
Opportunities training is integrated into courses for health workers.
The organisation intends that:
• all staff will be protected from discrimination or harassment because of their sex, disability, marital status,
age, race (including colour, nationality, ethnic or national origin), creed, sexuality, responsibility for
dependants, political party or trade union membership or activity or HIV/AIDS status;
• staff who discriminate or harass employees on the grounds of any of those factors will face disciplinary
• staff who, in good faith, have raised or intend to raise a grievance against alleged discrimination or who
give/intend to give evidence/information in connection with such grievance; must not be treated less
favourably than other employees;
• all grievances and complaints will be recorded, information on investigations and outcomes to
The organisation will require contractors to comply with its Equal Opportunities Policy and this will be a
condition of contract.
It should be noted that the organisation’s Equal Employment Opportunities Policy extends to groups which
are not specifically covered by anti-discrimination legislation. The policy intends that the elimination of
discrimination in the employment field be related to discriminatory actions or omissions which are unlawful,
unfair or inappropriate.
Guidance on unlawful discrimination or unfair discrimination for appointment panels is available from HR
The organisational policy does not detract from individual rights.
This policy does not prevent an individual from pursuing contractual rights through the Grievance Procedure
or from pursuing statutory rights through any body which deals with the enforcement of the particular