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             NHS TRUST




          TRUST FELLOW




               NOVEMBER 2005

                              The Royal Wolverhampton Hospitals NHS Trust
                                            Cardiothoracic Services Division

                                      Trust Fellow in Cardiothoracic Anaesthesia

                                           This post is not recognised for training

The Royal Wolverhampton Hospitals NHS Trust is one of the largest acute Trusts in the West
Midlands. We are currently expanding to provide a diverse range of general and specialist acute
services. A major site redevelopment programme is underway, and includes the opening of the region’s
fourth Cardio-thoracic Centre, a “state of the art” integrated facility, which has cost over £60 million to
build and equip.

The Heart and Lung Centre, operational since October 2004, is the first in the UK to deliver an integrated Cardio-thoracic
Surgery and Cardiology service. The Centre delivers 875 cardiac cases and 350 thoracic cases annually, but has the capacity
for expansion to 1500 cardiac and 500 thoracic operations. In addition there is a large PCI programme.

We are looking for a Trust Fellow in Cardiothoracic Anaesthesia to join our enthusiastic team to commence with immediate
effect and participate in the development of a first class anaesthetic service in the Heart and Lung Centre. Although not an
approved training post, the post will provide significant training and development opportunities for the successful candidate
who wishes to further their experience in the fields of adult cardiac, thoracic and intensive care anaesthesia. We are
therefore seeking candidates who have the drive, vision and energy to help continue to make this Centre a success.

Wolverhampton City borders the rolling countryside of Shropshire and Staffordshire. There are excellent local social
entertainment and sporting facilities, schooling and communications, with close links to the motorway and rail networks.
Single accommodation is available on the New Cross site; however married accommodation is subject to availability.

Enquiries regarding the post should be made to: Dr Andrew Frost, Lead Anaesthetist, Cardiothoracic
Services Division – 01902 307999 ext. 4357

To be considered for this post you must possess, or be eligible for full GMC registration. To apply for this post please
submit 4 copies of your C.V. to: Mrs Jo Duckham, Human Resources Assistant, Medical Personnel Department, 2 nd floor,
Hollybush House, New Cross Hospital, Wolverhampton, WV10 0QP quoting reference MD…….. Faxed or emailed copies
will not be accepted.

Please note due to the changes in the Government Immigration and Nationality Department regulations,
applications for work permits may not be successful where suitable EU or EEA candidates apply for this
post. This should not deter doctors from other countries submitting their applications.

BMJ Linage –
Closing date –


                            GENERAL DIRECTORATE
                              JOB DESCRIPTION

The City of Wolverhampton

Wolverhampton is a modern industrial city situated on the western fringe of the Black Country. It is
approximately a 30 minute drive to Birmingham (15 miles) and 1 hour 20 minutes to Manchester (60
miles). The counties of Shropshire and Staffordshire are only a few miles away, where some of the
most beautiful countryside in the country is to be found.

Wolverhampton is an urban multiethnic city with a population of around 250,000. This is made up of
80% of Caucasian, 12% Indo-Asian and 8% Afro-Caribbean people at the 1990 census. The wider
catchment area has a population in excess of 350,000.

Shopping in Wolverhampton offers a varied selection of facilities and amenities. There is a modern
shopping precinct (The Mander Centre) with further shopping areas in Darlington, Victoria and
Dudley Street along with Queen Square.

The Civic and Wulfrun Halls are used for concerts and promotions. In addition, there is an art
gallery and a good public library. A theatre in the city centre has recently undergone extensive
refurbishment. The city centre has an active nightlife, offering a variety of nightclubs, bars,
restaurants and a cinema. Sporting facilities include Wolverhampton Wanderers Football Club,
several health and fitness clubs as well as clubs for cricket, hockey, rugby, tennis, squash, athletics,
and sailing. In addition, there is an all weather racetrack for horses and at least six golf clubs are
within easy reach of the city.

Accommodation and Education

The main residential areas within the borough are situated on the western boundary and include
Tettenhall, Wergs, Wightwick, Compton, Finchfield, Merry Hill and Penn. In addition there is a
modern housing development at Perton, which offers housing at all price levels. The development
has its own supermarket and supporting shops, schools and churches which make this area a self
contained community.

Outside the town there are numerous villages, both small and large, which offer attractive
opportunities for housing. Such villages include Beckbury, Ryton, Burnhill Green, Pattingham,
Worfield, Claverley, Seisdon, Trysull and Albrighton to the west, Brewood and Codsall to the north
and Womborne to the south.

Education is well catered for with many excellent maintained schools and colleges of further
education, including Wulfrun and Bilston Colleges and Wolverhampton University. Independent
schools include the Wolverhampton Grammar School, the Royal Wolverhampton School, Tettenhall
College, St Dominics, Brewood, Birchfield Boys Preparatory and Newbridge Girls Preparatory


The Environs

To the southeast is the Black Country, the industrial heartland of England. There is a working
museum (The Black Country Museum) at Dudley which offer an opportunity to see the cultural
heritage of the Industrial Revolution. In addition, Birmingham another major cultural centre in the
West Midlands is only 15 miles away. Facilities include theatres, concert halls and the major sporting
facilities of Aston Villa and Birmingham City Football Clubs, Warwickshire County Cricket Club and
the Alexander Athletics Stadium. There is also the National Indoor Arena and National Exhibition
Centre, which host many events.

The surrounding countryside of Staffordshire, Shropshire and Worcestershire is delightful. To the
north are Cannock Chase and the west the Shropshire borders with attractions of Bridgnorth, the
Clee Hills, the Long Mynd, Wenlock Edge, and the Severn Valley. South of Wolverhampton, the City
of Worcester is easily accessible.


Travel communications to Wolverhampton are excellent, the area being well served by the motorway
network, with the M1, M5, M6 and M54 within easy access. There are regular and frequent intercity
rail services to London Euston and Manchester. Birmingham International Airport is 30 minutes
away by road and Manchester Airport can be easily reached within 1 hour 20 minutes.


       The Royal Wolverhampton Hospitals Trust successfully achieved Trust status in the Fourth
       Wave of Trusts [1994-95]. However the main characteristics of a NHS Trust had been in place
       for some considerable time before achieving Trust status. The Royal Wolverhampton
       Hospitals NHS Trust adopted a Directorate Management structure in 1990.

1.1    New Cross Hospital

       New Cross Hospital first opened in 1905, stands in 65 acres of land two miles from the centre
       of Wolverhampton and was originally the Local Authority Hospital.

       A number of the old buildings have been upgraded or replaced with modern units and the
       building programme continues. Specialities include ENT, Oral Maxillo Facial Surgery,
       General Surgery, Orthopaedics, Urology, Obstetrics and Gynaecology, Paediatrics, Psychiatry,
       General Medicine, Haematology, Coronary Care, Dermatology, Neurology and G.U.
       Medicine. There is a modern well-equipped Out-patient Department, a purpose built
       Diabetic Centre, as well as a purpose built Accident and Emergency Department. There is a 16
       bedded Critical Care Unit, a Renal Unit comprising 21 Dialysis stations. A purpose built Day
       Surgery Unit opened in August 1995 and endoscopy work is undertaken there. There is a
       purpose built Cancer Centre housing all Radiotherapy and Oncology Services and in 1999 a 50
       bedded medical admissions unit was opened.

       New Cross Hospital has been designated as the fourth cardiothoracic centre, which was
       completed in October 2004. The centre comprises of 167 beds with the appropriate level of
       ITU, HTU and surgical facilities. Within the next 3 years, 150 medical students will undertake
       their clinical teaching at New Cross Hospital and it will therefore have very close links with
       the University of Birmingham.


1.2   Wolverhampton & Midland Counties Eye Infirmary

      A 20 bedded Unit dealing solely with Ophthalmology and providing eye casualty facilities
      during the day.

1.3   West Park Hospital

      This is run by the community trust and provides rehabilitation for the elderly as well as a
      young rehabilitation unit.

1.4   Penn Hospital

      This is also run by the community trust, and provides long stay care for elderly patients.


2.1   Radiology

      The Radiology Department provides expertise and facilities that one would expect from a
      large district general hospital. A range of therapeutic interventional radiology is provided,
      including Luminal Vascular Stents, Vascular Dialitation, and Percutaneous Biliary Stenting.
      There is a nuclear imaging department with a gamma camera. A £13.5m Radiology Centre
      opened in June 2003 which includes 2 CT scanners, 2 MRI scanners, 1 gamma camera, 2
      angiography suites, 5 ultrasound rooms, 5 general rooms and a breast unit.
2.2   Pathology

      There are excellent fully developed services in all departments of pathology covering most
      aspects of clinical biochemistry, haematology and microbiology. The latter includes facilities
      for rapid assessment of suspected TB material. A new Histopathology department has
      recently been opened and clinical chemistry is sited in a modern well-equipped department.
      There is an excellent and rapid histology service.

2.3   Paramedical Staff

      Both New Cross and West Park sites are supported with Physiotherapy and Occupational
      Therapy staff. Speech Therapy is available on the New Cross Hospital site and in the
      community. There is a Placement Officer, a Liaison Nurse and a Support Team to facilitate
      early discharge (Support Team for the Elderly).

3.0   The Division of Cardiac Services

      A major site redevelopment programme is underway and included the opening of the
      region’s fourth Cardio-thoracic Centre, a “state of the art” integrated facility, in October 2004.

      The Heart and Lung Centre is the first in the UK to deliver an integrated Cardio-thoracic
      Surgery and Cardiology service. The centre delivers in excess of 1000 cardiac cases, and
      around 350 thoracic cases and 1000 PCIs at capacity. We aim to provide the finest service in
      the UK and develop strong Research and Development capacity. There are three dedicated
      theatres, a 30-bedded critical care unit and a 27 bedded cardio-thoracic ward on the first floor
      and 3 catheter labs and two cardiology wards on the second floor.



      Cardiology                                                  Cardiothoracic Surgery
      Dr Richard Horton                                           Mr W Pugsley
      Dr Singh                                                    Mr W Bhabra
      Dr M Norell                                                 Mr Billing
      Dr S Khogali                                                Mr Morgan
                                                                  Mr Yiu
                                                                  Mr Matuszewski
                                                                  Mr Luckraz

      Dr J Cotton
      Dr M Cusack                                                 Cardiothoracic Anaesthetics
      Staff Grades – 1 in Cardiology                              Dr A Frost – Clinical Director
      Trust Fellows – 12 in total (both specialties)              Dr S Lakshmanan
                                                                  Dr R Giri
                                                                  Dr M Fayaz
                                                                  Dr A Ng
                                                                  Dr D Morrice
                                                                  Dr A Zmuda
                                                                  Dr Martinelli


4.1   Clinical Audit and Effectiveness

      The culture of clinical audit and effectiveness has seen considerable advances over the last 4
      years. We have a dedicated team of audit officers, each of whom has gained specialist
      knowledge of the directorates within which they work.

      A director of audit and effectiveness, in liaison with the clinical audit co-ordinator, steer the
      department in ensuring that clinical audit is:

      Undertaken by multi-professional teams
      Focused on patients
      Driven by evidence-based medicine, clinical effectiveness and outcome closely involved with the
      production and evaluation of guidelines and patient pathways.

      The department liaises closely with risk management, complaints and R&D. There is
      increased promotion of patient/carer involvement in the development of audit projects and
      path analysis. Training packages in audit, critical appraisal skills and governance are being
      developed. A number of integrated care pathways have been developed throughout the Trust
      and a dedicated lead is identified for this initiative.

      There is regular dissemination of relevant information on evidence based medicine to target
      at health care professionals and interactive dialogue is encouraged. Strong recommendations
      from the annual audit programme are followed up and specific issues targeted for action
      through the governance director’s board, ensuring completion of audit loops highlighting of
      risk areas and complaints. The links between primary and secondary care with reference to
      patient pathways, interface audit and information technologies are strongly encouraged and
      development of clinical sub-specialty governance teams is ongoing.

4.2   Research and Development

      Research and development is held in high regard by the Trust and will become increasingly
      important with the advent of further development of the medical school and the broader
      academic framework.
      The Directorate provides significant advice on Trust governance and risk policy and its
      director is a member of the Governance Board. The Directorate offers help in facilitating
      research and the development of intellectual property to all members of staff by offering an
      information network on ethics methodology, research costs, and potential funding
      and from time to time direct assistance.

      It receives Culyer I funding at present on behalf of the Trust and administers the Black
      Country Research Network. The Directorate is responsible for research nurses who have
      specific project responsibilities and one of its major functions is to ensure good clinical
      practice within an established research governance framework.

      Research is well established within the Trust with multiple University and commercial
      partners. Staff are encouraged to engage in research and it is the Trust’s policy to develop
      specific research time within job descriptions where possible. This will become an increasing
      priority within the Trust’s overall development.

      The Trust’s reputation for publication in peer reviewed journals is high. The development of
      intellectual property to patent stage is well established and mechanisms are in place for the
      further development of such projects to commercialisation and marketing.

4.3   Educational Facilities

      The Wolverhampton Medical Institute on the New Cross site provides excellent library and
      post-graduate facilities with a new well equipped lecture theatre. There is a very active
      postgraduate programme for hospital staff, General Practitioners and nurses. Regional and
      national meetings are regularly held in the centre.

4.4   Study & Training

      The post is not recognised for training, but the objective is to provide training and educational
      opportunity equivalent to a recognised post.

      This Trust recognises and values training needs and ambitions of all its doctors. You will
      have the rights and responsibilities of a CME process. This will be under the management of
      the Director of Education. It includes a named educational supervisor; an appraisal and
      assessment process; an agreed professional development plan.

      A minimum study leave entitlement of 50% of equivalent training grade with the opportunity
      to take up to 100% of equivalent training grade at the discretion of the educational supervisor.
      A study leave budget of 100% of equivalent training grade will be allocated.

      You will be required to maintain an educational portfolio and will undergo an appraisal
      equivalent to the level of your post.

      The postholder has full access to library and IT facilities in the postgraduate centre, and to the
      support and advisory services offered by the Director of Education and Postgraduate Clinical
      Tutor. There are tutorials and meetings in which the postholder is expected to participate.

      Facilities exist for clinical research and audit, which will be actively encouraged.

4.5   Risk Management

      Clinical risk management has assumed increasing importance in the Trust over the last two
      years. All members of staff are encouraged to complete incident forms to record either
      clinical incidents or “near misses”.
      The degree of risk is assessed using a scoring matrix, which is widely published around the
      hospital. Incidents, which have a low chance of recurrence and a low impact on the
      organisation, are investigated and managed at Directorate level.

      Those in the red and amber category where the risk of recurrence is high and the potential
      damage to the Trust is significant are investigated with the assistance of the risk management

      The Trust emphasises that clinical incidents and clinical “near misses” are nearly always the
      result of a system failure and not due to poor practice in individual staff. The department’s
      overriding emphasis to put in place the systems, which minimise risk to patients, staff and
      visitors and avoid placing individual staff in situations where they do not receive proper and
      adequate support.


5.1   The appointment is initially for a fixed term of 6 months which may be renewable, and
      governed by the terms and conditions of service, Hospital and Dental staff in England and
      Wales, an up to date copy of which may be seen upon request in the Human Resources
      Department of the Trust.

      The post is for a maximum of 48 hours per week.

      Your contract of employment will be with The Royal Wolverhampton Hospitals NHS Trust.

      You will be responsible to the Lead Cardiothoracic Anaesthetist.

5.2   Duties and Responsibilities

      You will form part of the anaesthetic team in the Heart and Lung Centre at Wolverhampton.
      Your duties will include involvement in pre-operative, operative and post-operative
      anaesthetic management of cardiothoracic patients. You may also be required to attend pre-
      operative assessment clinics and sessions in the cardiology catheter laboratories.

      You will required to participate in on call duties for the Heart and Lung Centre.

      Involvement in data collection, audit and research activity will be encouraged.

      You will be an integral part of the anaesthetic team and be requires to participate in the on-
      call rota at middle grade level. Additional duty hours will be paid as appropriate.

5.3   Job Plan

                                    TRUST FELLOW ROTA

      Work will necessarily be flexible, but this is an example of the expected duties

                      Monday           Tuesday         Wednesday         Thursday         Friday

                         Cardiac           Cardiac             CCU          Day off         Cardiac
      am                 theatre           theatre                                          theatre

                         Cardiac           Cardiac             CCU          Day off         Cardiac
      pm                 theatre           theatre                                          theatre

5.4        Terms and Conditions of Service

           The annual leave entitlement for this post is 6 weeks per annum plus bank holidays.
           However, leave entitlement for each 6 month period must be taken in those 6 months.

           All requests for annual leave and study leave must be approved by your Consultant, the
           Clinical Director and Specialty Manager. It is each doctor’s responsibility to inform the
           Clinical Director / Specialty Manager of:

           (a)    proposed date they wish to take
           (b)    who is covering their routine and emergency work rota commitment

           Leave will not be granted unless this information is provided. It is your responsibility to
           swap duties with colleagues to provide cover for your absence.

           You are expected to cover the absence of colleagues on study and annual leave during the day

           The post is a whole time appointment.

           The post is graded as Specialist registrar/middle grade equivalent.

           It is expected the banding for this post will be 1A and it is on this basis that the appointment
           is offered. The duty pattern is a Full Shift conforming to European Working Time Directive.

           Salary scale for this post is £29,364 rising to £45,598.

           The post is for six months in the first instance.


                                              PERSON SPECIFICATION

POST TITLE: Trust Fellow – Cardiothoracic Anaesthetist                    Key: -    A=Application form
ACCOUNTABLE TO: Lead Cardiothoracic Anaesthetist

                           Job Related Criteria                                How measured       Weighting

   1.   Education, qualification & experience

       2 years at SHO level with minimum 1 year in Cardiothoracic                  A                    H
       Certificate of Completion of Training in Cardiothoracic Anaesthesia        A,I                   H

       Full (or eligible for) GMC registration                                     A                    H

       FRCS or equivalent                                                          A                M

       ALS/ATLS or equivalent                                                      A                    H

       Experience in Cardiothoracic Anaesthesia                                   A,I               M

       Evidence of teaching experience                                            A,I                   L

       Research experience                                                        A,I                   L

       Audit experience                                                           A,I               M

       Experience in the use of PCs and other IT equipment                        A,I               M

   2.   Skills and Aptitudes

       Highly motivated                                                           A,I                   H

       Strong interpersonal skills                                                A,I                   H

       Excellent communication skills                                             A,I                   H

       Ability to work under pressure                                             A,I                   H

       Organisational ability                                                     A,I                   H

       Flexible approach to work                                                  A,I                   H

       Problem solving ability                                                    A,I                   H

   3.   Personal Circumstances

       Full GMC registration (or eligible)                                        A,I                   H

       Reside within 30 minutes travelling time of the Heart and Lung             A,I                   H
       Ability to provide an on call service


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