The Friarage Hospital, Northalleron (FHN)


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The Friarage Hospital, Northalleron (FHN)

  1. 1. JOB DESCRIPTION CONSULTANT CARDIOLOGIST WITH SPECIAL INTEREST IN PERCUTANEOUS CORONARY INTERVENTION SOUTH TEES HOSPITALS N.H.S. TRUST THE JAMES COOK UNIVERSITY HOSPITAL MIDDLESBROUGH This Consultant Cardiologist appointment, a new post, will play a vital part in delivering the Cardiology service in the newly expanded Regional Cardiothoracic Unit at The James Cook University Hospital, Middlesbrough. The postholder will join the existing team of 9 cardiologists, 6 cardiothoracic surgeons and 7 cardiothoracic anaesthetists in providing a comprehensive adult cardiothoracic service to the population of Teesside, Durham and parts of Cumbria and North Yorkshire (population 1.5 million). The postholder will have responsibility for general adult cardiology and interventional cardiology . THE LOCALITY Cleveland (land of the cliffs) consists of the compact boroughs of Hartlepool, Stockton and Middlesbrough, which together with the borough of Langbaurgh has a population in excess of 570,000. Cleveland contains one of the largest petro-chemical complexes in Europe and has become a development area particularly for computers/electronics firms. Away from the major conurbations are the delightful countryside areas of the North Yorkshire Moors National Park, North East beaches and attractive countryside in South Durham. Teesside is also within easy access of the Yorkshire Dales, the Lake District and Northumberland with their excellent rural pursuits. Cultural and leisure activities are well provided. There are good schools in the vicinity. There are excellent road and rail links, with regular trains from Darlington making central London accessible in less than 2 1/2 hours. Teesside International Airport with regular shuttles to Heathrow and Amsterdam is less than 20 minutes drive from The James Cook University Hospital. 1
  2. 2. THE HOSPITAL South Tees Hospitals NHS Trust This large acute Trust was formed in 1992, incorporating three hospitals across Middlesbrough. It merged with the Friarage Hospital in Northallerton in April 2002, and now provides all secondary care to Middlesbrough, Langbaurgh and Hambleton & Richmondshire PCTs, a population of approximately 400,000. It also provides tertiary services to the wider Tees valley area, and parts of County Durham, North Yorkshire and Cumbria. The James Cook University Hospital (JCUH) This modern hospital of over 1000 beds was formally opened in October 2003. Based on the original site of South Cleveland Hospital, first opened in 1981, a major private finance initiative build was completed in 2003. All acute and elective medical and surgical specialties are accommodated on this site. Tertiary services, in addition to Cardiology and Cardiac Surgery, include Renal Medicine/Haemodialysis, Neurosurgery, Vascular Surgery and the Regional Spinal Injuries Unit. The Accident and Emergency Department is on this site and is the designated Regional Trauma Centre for Teesside, South Durham and North Yorkshire. There is a modern Radiological/Imaging Department with Ultrasound, CT Scanner, MRI, Digital Vascular Imaging suite and Gamma Camera. There is a hospital wide digital PACS system for radiology images and reports. There is a Peripheral Vascular Angioplasty service provided by the Consultant Radiologists. There is a purpose built Surgical Day Unit and an Endoscopy Centre. The District Pharmacy Department is on site as is the Supra-District Public Health Laboratory Service with microbiology. There is an established Education Centre embracing Postgraduate Medical Education, Nurse Training School, the School of Radiography and Library facilities. It encompasses 2 large lecture theatres with the latest audio-visual aids and a considerable number of classrooms and seminar rooms, including ward facilities for teaching and examining. There is a new library with comprehensive IT suite. The Friarage Hospital, Northalleron (FHN) This small district general hospital, 25 miles from Middlesbrough, merged with South Tees Hospitals NHS Trust in April 2002. The Cardiology Department, encompassing CCU and Cardiography, functions as a self-contained unit but is part of the Cardiology Directorate. There are two Cardiologists in post. Increasing integration of the Cardiology services across the two sites is planned. 2
  3. 3. THE CARDIOTHORACIC UNIT THE DEPARTMENT OF CARDIOLOGY The successful applicant will join the existing team of nine Cardiologists at JCUH and two cardiologists at FHN - Dr Adrian Davies General Cardiology and Heart Failure), Dr Jim Hall (Coronary Intervention), Dr Mark de Belder (Coronary Intervention), Dr Michael Stewart (General Cardiology and Imaging), Dr Nick Linker (Electrophysiology), Dr Rob Wright (Coronary Intervention), Dr Andrew Sutton (Coronary Intervention), Dr Douglas Muir (Coronary Intervention, Dr Stephen Murray (Electrophysiology), Dr Upendra Somasundram (General Cardiology) and Dr Richard Graham (General Cardiology and Imaging). The Cardiothoracic Unit opened in 1992 with cardiac surgery and interventional cardiology established in 1993. We have 2 Cardiology Wards, a Cardiology HDU and a purpose built day unit, a Cardiothoracic Surgical Ward and a mixed Surgical/Cardiology ward. There is a 14 bed CCU and a 12 bed Cardiothoracic ITU. The CCU accepts direct paramedic admissions and currently processes almost 3000 admissions per year, with 200 - 250 ST elevation infarcts and 600+ other acute coronary syndromes. We utilise three catheter labs, 2 Philips digital single plane and one Philips biplane lab, all adjacent to the cardiac theatres. A full array of ancilliary diagnostic and treatment options are available within the catheter laboratory, including facilities for IVUS, pressure wire studies (Radiwire), thrombus removal devices and rotablation. All images in the department are acquired, reported and archived digitally, using ProSolve analysis software. There is a dedicated cardiothoracic OPD suite. There are 3 dedicated cardiothoracic theatres. There is a flourishing Cardiac Rehabilitation service in South Tees based on the cardiothoracic wards. The new Cardiac Investigations Unit opened in May 2002. There are two GE Vivid 7 echocardiographic machines with omniplane TOE probe and stress echo facility, one GE Vivid 5, three Hewlett Packard machines and a Cypress portable scanner. There are full Holter/transtelephonic monitoring facilities. There are two treadmills in the department and a further treadmill in the CCU. Nuclear Medicine is currently provided through the Radiology department in conjunction with the South Cleveland Medical Physics Department (a major branch of the Regional service on site). There are new MRI and CT Scanners in the Hospital X-ray Department. An electrophysiology programme began in 1998 and is continuing to expand. This involves diagnostic procedures, radiofrequency ablation and the implantation of cardioverter defibrillators. The programme is supported by a team of specialist nurse practitioners forming a cardiac rhythm management team, undertaking pre- and post- procedure assessment and counselling. Electrophysiology procedures take place in the biplane catheter laboratory, which also has a Medtronic Localisa EP mapping system installed. 3
  4. 4. Investigations performed by the department in the last twelve months are as follows: District ECG in-patient service: 12,000 Echocardiography: 7,800 (Stress echo 174, TOE 284, + intra- operative) Holter Monitoring: 3,054 (Transtelephonic monitoring 93) Exercise Stress Tests: 2,592 (Myocardial perfusion scans 105) Cardiac catheterisation: 3, 133 PCI: Total 1249 (8590%tents; 66% urgent or emergency) Pacemaker implants: 500 (Pacemaker checks 3,362) ICD implants: 47 EPS/ablation: 120 CARDIOTHORACIC SURGICAL DEPARTMENT There are six cardiothoracic surgeons and seven cardiothoracic anaesthetists operating through 3 dedicated Cardiothoracic Theatres and 12 Cardiothoracic Intensive Care beds. Surgical procedures are expected to number as follows for the forthcoming year: CABG 1100, Valves 200 and Thoracic 150. The provision of an HDU facility within the surgical ward allows for fast-tracking of patients from theatre. There is close co-operation between the cardiologists, surgeons and anaesthetists with regular combined administrative, planning and academic meetings. Development areas In order to meet the demand for tertiary services and as part of the implementation of the NSF for CHD phased expansion of the revascularisation programme has been agreed with commissioners, planning to provide 1500 PCI and 1500 CABG procedures per annum. This appointment, the sixth Consultant in Interventional Cardiology, is integral to this development. We have introduced primary PCI for the local catchment population and have plans for the further development of this service to the wider Network. We are a pilot site for the National Infarct Angioplasty Program. There has been a year on year increase in PCI since the Unit’s inception 10 years ago, with over 60% of workload urgent or emergency. Transfers from local DGHs and scheduling of workload is coordinated centrally by a nurse specialist. Care of both elective and emergency PCI patients is shared by junior medical staff and a team of specialist nurse practitioners. Secondary care cardiology services to the District, including a busy CCU, and daily Rapid Access Chest Pain Clinics, form a vital part of the workload. 4
  5. 5. Integration with surrounding units Consultant cardiologists from adjacent hospitals visit the unit to undertake diagnostic catheterisation. Paediatric cardiologists from Newcastle undertake outpatient clinics in conjunction with the paediatricians at The James Cook University Hospital. Patients for heart or heart-lung transplantation are referred to the Freeman Hospital Newcastle. CARDIOLOGY STAFF 11 Cardiologists + NEW APPOINTMENT 2 Clinical Assistants/GPsI 8 Specialist Registrars (Northern Deanery Cardiology program) 1 - 2 Research Registrars 1 Teaching Lecturer (Registrar Grade) 9 SHOs 1 Trust Registrar/Staff grade (FHN) 5
  6. 6. THE JOB ITSELF Title: CONSULTANT CARDIOLOGIST TO SOUTH TEES HOSPITALS NHS TRUST Provisional Job plan A.M. P.M. Evening Monday Ward Round (0.5 CPA) Research/Audit (1 SPA) Tuesday Cath lab Cath lab WR (2.25 CPA) Wednesday Out Patients (1 CPA) Clinic Admin (1 CPA) Thursday Cath lab (1 CPA) Friday Academic (1 SPA) Ward Round (0.5 CPA) Admin (0.5 SPA) (Management meetings, CME, Audit/Clinical governance meetings) Sat/Sun CCU Ward Round 1:11 (0.25 CPA) Emergency on call cover for coronary intervention 1 CPA Direct clinical care 7.5 programmed activities (CPA) Supporting professional activities 2.5 (SPA) Additional PA(s) for prospective cover and/or additional activity may be available subject to agreement. N.B. This timetable is indicative only and it is anticipated that this will form the basis for a job plan for the first 3 months in post. A formal job plan will then be agreed by the successful applicant, the Director of Cardiology and/or the Chief of Service, on behalf of the Medical Director. This will be signed by the Chief Executive and be effective from the commencement date of the appointment. The job plan will be reviewed annually, following an Appraisal Meeting. The job plan will be a prospective agreement that sets out a consultant’s duties, responsibilities and objectives for the coming year. It should cover all aspects of professional practice including teaching, research, educational and managerial responsibilities and provide a clear schedule of commitments, both internal and external. In addition, it should include personal objectives, including details of the support required by the consultant to fulfil the job plan and objectives. The remaining sessions are flexible and will provide time for audit/clinical governance, teaching, research, emergency work and the usual administrative duties of a consultant. Out-patients will be held at the James Cook University Hospital and potentially also at the Friarage Hospital. Out-patient clinics are usually for both new and review patients and undertaken by the consultant with a registrar and SHO. Emergency cardiology cover will be provided 1 in 11 covering junior staff and 1 in 6 providing an emergency coronary intervention service to the Region.. Consultants will provide full time cover for periods of leave of absence of colleagues. The appointee will be expected to reside within 10 miles of the hospital (or further afield with agreement of Chief of Service/Medical Director). 6
  7. 7. The incumbent will have a personal secretary and an office, providing PC with access to both local cardiology intranet and the internet. The unit has its own IT support officer and is actively recruiting additional staff to help develop ambitious plan for the local intranet, to provide access to images and databases at workstations across the Division. TEACHING, RESEARCH and CPD There is an active Postgraduate district and divisional curriculum on site based at the Postgraduate Education Centre under the direction of District Tutor Prof Ben Corbett – General Surgery. There is an up-to-date medical library within this centre. The consultant will be expected to undertake activities suitable for continuing medical education in accordance with Royal College of Physicians guidelines. Funded leave for continuing professional development will be provided by Trust for suitable courses or meetings. Training of junior medical staff in all aspects of cardiology and medical aspects of cardiac surgery is required. Research is actively encouraged and the Department of Cardiology is developing an active programme. Academic links with Newcastle, Durham and Teesside University departments are being established and joint research encouraged. As part of the national expansion of medical student numbers the Universities of Newcastle and Durham have formed a partnership increasing the undergraduate intake to 340 students as from September 2002. The first 2 years of the curriculum are being taught at the Queen’s Campus of the University of Durham in Stockton as well as the Medical School in Newcastle. Currently it is planned that 95 students will be based in Stockton and 220 in Newcastle. At the end of year 2 the entire cohort of students will be divided up for their 3rd year between Base Units of Acute and Community Trusts and PCT’s around the Northern Region. South Tees has been designated the lead Trust for the Teesside Unit which currently comprises Bishop Auckland and Darlington, North Tees and Hartlepool, as well as South Tees and the corresponding Community Trusts of Tees and North Yorkshire and South Durham and the associated PCT’s. In order to accommodate these students, a new purpose-built Clinical Academic Centre, including a Teaching Unit, has recently been completed at The James Cook University Hospital. There are active plans to further develop both teaching and research within Cardiology, with the potential for a Senior Lecturer or Chair in Cardiology being created in the future. JUNIOR DOCTORS' HOURS AND IMPLEMENTATION OF THE CALMAN RECOMMENDATIONS The Region and Trust are committed to these nationally agreed initiatives. All consultant staff are expected to contribute to the education supervision, appraisal and assessment of junior medical staff. 7
  8. 8. MANAGEMENT STRUCTURE The Trust Board have responsibility for strategic and policy issues. Day to day management is delegated from the Trust Board to the Management Group which includes all Divisional Chiefs of Service and Chief Executive. The current Chief of Service for the Cardiothoracic Division is Mr Simon Kendall. The Division has its own business manager Mrs Ruth Potiphar and a Deputy Divisional Manager Mrs Sam McLoughlin. The Cardiothoracic Division is sub-divided into directorates each with its own Clinical Director: Cardiothoracic Surgery Mr Andrew Owens, Cardiothoracic Anaesthesia Dr Khalid Khan, Cardiology Dr Michael Stewart. There is a collective responsibility of all Consultants to co-operate with and work closely with all colleagues especially their designated Clinical Director and Chief of Service in order to ensure effective and efficient running of the Division. This post includes the ordinary administrative duties of a Consultant including participation in professional audit, business planning, multidisciplinary team working and related activities. Consultants are members of the Senior Medical Staff Committee. Consultants are required to provide continuity of care to their patients. South Tees Hospitals N.H.S. Trust is committed to Total Quality, has established core values and places patients at the centre of its activity. 8
  9. 9. MAIN CONDITIONS OF SERVICE (i) The terms and conditions of service will be those agreed by the appointee and the Trust Board. At the time of writing these are identical to the terms and conditions of the hospital medical and dental staff (England and Wales) and General Whitley Council conditions of service, as amended from time to time. (ii) Appointment will be on the new Consultant Contract and is dependant upon negotiation of an annual job plan. (iii) The successful applicant will be required to reside within 10 road miles of the James Cook University Hospital unless specific approval is given by the Medical Director to a greater distance. (iv) The appointment will be subject to a medical examination. (v) The current salary scale for this post is £xxxxx increasing in line with the new consultant contract. (vi) Relocation expenses will be offered and are negotiated on an individual basis with the successful applicant. (vii) This post is available on a part time basis to any candidate who is unable to work full time. 9
  10. 10. PERSON SPECIFICATION ESSENTIAL DESIRABLE BASIC Registered medical degree QUALIFICATIONS On the Specialist Register HIGHER or within 6 months of Higher Degree QUALIFICATIONS expected CCST Proficiency in adult CLINICAL SKILLS cardiology Proficiency in all aspects of Coronary Intervention with SUB-SPECIALTY Experience of infarct evidence of current SKILLS angioplasty experience in latest techniques Desire to participate in the MANAGEMENT Management training Unit’s management Experience of conducting AUDIT clinical audit Experience of TEACHING undergraduate and postgraduate teaching Evidence of research and publications in peer- ACADEMIC/RESEARCH reviewed cardiology journals Publications relevant to ACHIEVEMENTS clinical expertise Evidence of ability to PERSONAL SKILLS communicate, organise and lead Satisfactory pre- PHYSICAL employment health REQUIREMENTS screening 10