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					                      Heart of England NHS Foundation Trust

                                    Directorate of Cardiology

                     Consultant Cardiologist Job Description




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                     Consultant Cardiologist Job Description
Introduction

This post is for a Consultant Cardiologist based at Solihull Hospital, part of the Heart of
England NHS Foundation Trust. The successful applicant will cover the vacancy created
by the departure of Dr. K A Priestly and join a team of 13 other consultants, to provide
and develop cardiology services for the Trust. The appointee will be expected to
participate in undergraduate and postgraduate education and develop a research
programme. The post is intended as a whole time appointment but applicants wishing to
work part-time will also be considered and the programme will be modified accordingly.

The Trust

Heart of England NHS Foundation Trust delivers its services across four sites, namely
Birmingham Heartlands Hospital, Solihull Hospital, Good Hope Hospital and Birmingham
Chest Clinic. The Cardiology department provides services locally for the residents of
north and east Birmingham, Solihull, Tamworth, Burntwood and Lichfield and parts of
Warwickshire and South Staffordshire from Birmingham Heartlands, Solihull and Good
Hope Hospitals. The Trust serves a population of around one million. The local
population surrounding each of the 3 hospital sites varies in their ethnic mix and also in
their demand for health care. The organisation will place emphasis on patient and public
involvement to ensure the health care requirement and delivery meets the need of the
local area.

The area served by Birmingham Heartlands Hospital is essentially urban with some
relatively deprived inner city areas. The catchment area extends into dormitory suburbs
and further afield into rural populations.

There is a rising rate of diabetes and coronary artery disease, which is particularly
prevalent among our Asian community. The hospitals in Solihull and Sutton Coldfield
provide a service for a mainly Caucasian population with a recognised increase in the
ageing population, particularly in Solihull. The proportion over retirement age potentially
rises to 20%.

Birmingham Heartlands Hospital has just under 800 beds and provides the full range of
acute hospital services.        In addition to Cardiology, regional specialties include
nephrology, thoracic surgery, clinical haematology, oncology and infectious diseases.
The regional cytogenetics, virology and immunology departments are all on site together
with the Birmingham Public Health Laboratory. Other specialised units include a large
department of thoracic medicine with a supra-regional cystic fibrosis unit. There has
been considerable capital investment in the Trust over recent years with older buildings
replaced with state of the art facilities.

Solihull Hospital opened in July 1994. The layout and features are, therefore, very
modern and appropriate for the delivery of first class health care. The hospital has
approximately 280 beds. A full range of clinical services currently exist including the

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main medical specialties, a large Obstetrics and Gynaecology unit, 24 hour Accident and
Emergency and a fully established Orthopaedic service. Full paramedical support
services exist with a particularly well-established Physiotherapy Unit.

The X-ray department provides a full range of services, including ultrasound, angiography
and isotope imaging. New equipment for MRI scanning and digitalised angiography has
recently been installed and two of the radiologists take a special interest in renal and
vascular access angiography and angioplasty.

Good Hope Hospital is a busy District General Hospital with close University and tertiary
centre links and a comprehensive cardiology service. It is situated in Sutton Coldfield and
serves the communities of North Birmingham and South Staffordshire (Lichfield,
Tamworth and surrounding areas). The Hospital has over 500 beds and offers a full
range of acute specialties including an Accident and Emergency Department, General,
Vascular and Orthopaedic surgery, Obstetrics and Gynaecology, Paediatrics and
Anaesthetics with Intensive Care. There are also independent departments of Radiology
and Pathology including Clinical Haematology. There are several linked smaller hospitals
with Elderly Care and General Practitioner beds along with outpatient departments.
These include Sutton Cottage Hospital, the Victoria Hospital, Lichfield and the Sir Robert
Peel Hospital, Tamworth.

The Trust has a major teaching commitment to undergraduates and postgraduate
students. There is a large academic presence on site covering Medicine (Diabetes and
Endocrinology), Vascular Surgery, Thoracic Medicine, Rheumatology, Paediatrics,
Bacteriology and Histopathology. The hospital has a full spectrum of clinical services and
a very active postgraduate centre with regular clinical meetings and audit.

The Directorate

Medical Staff

   Dr R G Murray, Clinical Director and Consultant                 Birmingham Heartlands Hospital
   Dr J M Beattie, Consultant                                      Birmingham Heartlands Hospital
   Dr N El Gaylani, Consultant                                     Birmingham Heartlands Hospital
   Dr J Ment, Consultant                                           Birmingham Heartlands Hospital
   Dr M Pitt, Consultant                                           Birmingham Heartlands Hospital
   Dr J R Panting, Consultant                                      Solihull Hospital
   Dr. J V Naiker, Consultant                                      Solihull Hospital
   Vacancy,                                                        Solihull Hospital
   Dr P Jordan, Consultant                                         Good Hope Hospital
   Dr R Smith, Consultant                                          Good Hope Hospital
   Dr Francisco Leyva-Leon, Consultant                             Good Hope Hospital
   Dr H El-Gendi, Consultant                                       Good Hope Hospital
   Dr K Mahmood, Locum Consultant                                  Good Hope Hospital

The following staff are also assigned to the Directorate:-

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        5 x Specialist Registrar
        5 x Staff Grade Physicians
        1 x Clinical Fellow
        1 x Research Registrar
        5 xSHO
        1 x Foundation Year 2 HO
        1 x Clinical Assistant

The wider team of the directorate encompasses, Medical Secretaries, Cardiac Clinical
Physiologists (including trainees), Matrons and nurses.

The Directorate is supported by a Directorate Manager, Clinical Financial Advisor and an
Information Analyst.

Facilities

Solihull Hospital

The Cardiology facilities in Solihull Hospital include a four bedded Coronary Care Unit
managed by the Consultant Cardiologists, a 26 bedded Cardiology ward (ward 17)
incorporating a 5 bedded Chest pain Assessment Unit for the management of patients
with Acute Coronary Syndromes (with near patient Troponin testing). Non-invasive
facilities include exercise testing, 24 hour Holter monitoring, 24 hour BP monitoring,
transthoracic and transoesophageal echocardiography and Tilt testing. The pacing
service for the Trust is based at Solihull Hospital and there is an opportunity to develop
ICD Implantation.

A Cardiac Catheterisation Suite was opened in Solihull Hospital in February 2004. This
incorporates a dedicated 6 bedded day case area and state of the art cardiac
catheterisation laboratory which is used for elective diagnostic cardiac catheterisation for
Birmingham Heartlands and Solihull Hospital, non-elective diagnostic procedures for
Solihull Hospital, pacing and ICD implantation.

Birmingham Heartlands

The Cardiology facilities in Birmingham Heartlands Hospital are located on the first floor
of the “New Ward Block”. The Cardiology Department houses facilities for non-invasive
cardiology, offices and a seminar room. Nuclear cardiology is provided in collaboration
with the Directorate of Radiology. The Cardiology ward (Ward 6) is adjacent to the
Cardiology Department and has 26 beds and a 5/6 bedded Coronary Care Unit. The
Cardiology service also provides a ten-bedded Chest Pain Assessment Unit for the
treatment of patients with Acute Coronary Syndromes, with near patient Troponin testing
(in the Emergency Admissions Ward).

A Cardiac Catheterisation Suite adjacent to the Cardiology Department is used for the
elective and non-elective PCI programme. At present this is being replaced with a state


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of the art bi-plane facility which will open in the spring of 2009. In the meantime the PCI
programme is being delivered in a customised on-site modular laboratory.

Good Hope Hospital

The Department has recently moved into a new, purpose-built Treatment Centre. The
department is led by a senior technician/assistant general manager Mrs Su Baxter with a
full complement of technical staff including trainees, cardiographers and a dedicated
receptionist.

There is a 30 bedded Cardiac Care Ward, which includes a 5-bedded acute CCU and 8
telemetered step-down beds. There is a dedicated Temporary Pacing/Procedures room
and invasive pressure monitoring is available in the acute beds.

The main outpatient base is Good Hope Hospital but clinics are also held at the Victoria
and Sir Robert Peel Hospitals. There are Rapid Access Chest Pain Clinics undertaken by
Staff Grade Cardiologists with consultant supervision and nurse-lead post-MI and one-
stop heart failure clinics running parallel with the general clinics.

Cardiac Catheterisation - There is a dedicated Vascular Radiology suite with a purpose-
built cardiac catheter room, and an adjacent multi-purpose room with a recovery bay.
Day Case patients are nursed in a dedicated Angiography Recovery Unit adjacent to the
suite. The majority of in-patients requiring angiography are also investigated on-site.

Pacemakers and Cardioversion - A comprehensive physiological pacing service is
offered with implantation and follow-up. There is a well established Cardiac
Resynchronisation Service and a developing ICD service.

Clinical Activity

A full range of Adult Cardiology Services is provided to the Trust. This includes General
Cardiology Outpatient Clinics, Rapid Access Chest Pain Clinics on three sites for patients
with new onset angina and a recently developed Heart Failure Service. This year we will
undertake approximately 26,000 outpatient consultations.

The Heart Failure Service includes dedicated Rapid Access Heart Failure clinics for
referral of patients with suspected heart failure, with strong nurse support and nurse led
outreach in the community linking with primary care.

On each site there is a Chest Pain Assessment Unit for the care of patients with Acute
Coronary Syndromes with bed-side Troponin T testing. Across Birmingham Heartlands
Hospital and Solihull Hospital we have a pro-active strategy for intervention in patients
with ACS performing angiography with a view to intervention in all high risk patients. This
year we will perform approximately 2,700 invasive investigations and 750 PCIs, including
elective and non elective emergency/rescue and primary PCI. More than 60% of PCIs
are non elective and we have provided primary PCI for STEMI round the clock 7 days a
week since 2005. We also perform complex interventional procedures including
rotablation, pressure wire, IVUS and thrombectomy.
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We have a strong nurse led Cardiac Rehabilitation programme on all sites for patients
recovering from acute myocardial infarction and revascularisation.

The directorate provides a range of non invasive tests, including exercise testing, 24 hour
holter monitoring, 24 hour BP monitoring, transthoracic, transoesophageal, stress and
bubble echocardiography, Tilt testing, Cardiac MRI and Myocardial Perfusion Imaging.
This year we will perform in excess of 10,000 echos.

The Directorate has close links with cardiac surgical services at the University of
Birmingham Hospitals NHS Foundation Trust and University Hospitals Coventry NHS
Trust with regular MDT meetings in collaboration with surgical colleagues.

The Directorate participates in undergraduate and postgraduate education and local,
regional and national audit.

The Post

Location

The primary work location is at Solihull Hospital where office accommodation and
secretarial support (1 WTE) will be provided. However since the Trust operates its
services from three hospitals, cross site activity is expected.

General Responsibility

The post holder will be expected to work with local managers and professional
colleagues in the efficient running of the service. The appointee will

   be a full member of the Consultant body of the Trust and will be accountable to the
    Clinical Director, Dr R G Murray
   work with other Consultants to develop cardiology services for the Trust
   deliver agreed standards of care
   provide continuing patient care in partnership with consultant colleagues
   assist in compliance with activity targets in line with Local Delivery Plans
   assist in compliance with national performance targets
   comply with mandatory training requirements of the Trust
   provide professional supervision, direction and training for junior medical staff
   be committed to CME, Professional Development and Appraisal
   participate in Clinical Audit
   participate in Clinical Governance
   contribute to risk management strategies of the Trust
   participate in Undergraduate and Postgraduate teaching
   conduct appropriate Research in Cardiology
   the postholder will be expected to fulfil all the requirements for revalidation relevant to
    Cardiology when it is introduced, the Trust will provide the necessary support.

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Subject to the provisions of the terms and conditions of service he/she must observe
agreed policies on clinical matters and should follow the standing orders and financial
instructions of the Hospital. This is to support the development of evidence-based
medicine and is not intended to constrain individual consultant freedom.

In the management of employees of the Trust, he/she will be expected to follow
legislation and personnel policies and procedures and in particular to act in accordance
with the legislation laid down in this respect.

Specific Responsibility

The post holder will be part of the team responsible for the continued development of
Cardiology Services in Heart of England NHS Foundation Trust. The successful
candidate will be experienced in adult general cardiology, will share the management of
cardiology patients admitted to Solihull CCU, Ward 17 and the Chest Pain Assessment
Unit and will provide care for his/her own patients admitted to the Trust. In addition,
he/she will be experienced in coronary intervention and will participate in the Trust’s
elective and non-elective PCI programme.

Cardiology On-Call

We provide on call cover for cardiac emergencies across all sites in the Trust. The new
appointee will share the day to day management of cardiac emergencies at Solihull
Hospital with the existing 2 consultants based at Solihull Hospital and will participate in
the weekend cover for Solihull Hospital on a 1:6 basis. This will dovetail with weekend on
call cover for non-elective intervention (primary and rescue PCI for STEMI) provided at
Birmingham Heartlands Hospital for the Trust. He/she will provide out of office on call
cover 1 week night in 6 for similar non-elective patients at Birmingham Heartlands
Hospital. During the year 2007/08 there were 61 primary PCIs performed out of hours,
this equates to just over 1 per week on average. The Trust will make every effort to
ensure there is no fixed commitment the day following night time on call. Routinely,
Solihull Consultants provide on call cover for Solihull Hospital and Good Hope
Consultants for Good Hope Hospital, however barn door MI patients from the wider
catchment population are transported to Birmingham Heartlands Hospital for primary PCI.




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                  Provisional Cardiology Consultant Job Plan – To be agreed

                                      Programmed Activity            Direct    Supporting    Location
                                                                    Patient   Professional
                                                                     Care       Activity

 Monday
      09:00       13:00     OP Clinic                                1.00                    SOL
      13:00       15:00     Ward Round                               0.50                    SOL
      15:00       17:00     Patient Admin                            0.50                    SOL

 Tuesday
      09:00       11:00     CCU/CPAU Ward Round                      0.50                    SOL
      11:00       13:00     CPD                                                   0.50       SOL
      13:00       17:00     Clinical Management                                   1.00       SOL

 Wednesday
      09:00       11:00     Ward Round                               0.50                    SOL
      11:00       13:00     Clinical Management                                   0.50       SOL
      13:00       15:00     Teaching                                 0.50
      15:00       17:00     Research/General Admin                                0.50       SOL

 Thursday
       09:00      13:00     Angioplasty List                         1.00                    SOL
       13:00      17:00     OP Clinic                                1.00                    SOL

 Friday
          09:00   13:00     Diagnostic Cath List                     1.00                    BHH
          13:00   16:00     MDT Meetings/Cath Conference/Surg Mtg    0.75                    BHH
          16:00   17:00     CCU/CPAU Ward Round                      0.25                    SOL

 Total No of Programmed Activities                                   7.50        2.50


Direct patient care               7.50
Supporting professional activity 2.50
Total                            10.00

On Call Work

Non-elective patients on CCU, Ward 17 and the Chest Pain Assessment Unit will be
shared by the 3 consultants based at Solihull Hospital. Out of office on-call will be 1:6
week night and 1:6 at the weekend. This will dovetail with cover for out of office hours
PCI at Heartlands Hospital.




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Schedule of Commitments: Weekend Template

Undertaken on a 1:6 basis

                                                     Saturday              Sunday
7am to 7.30
7.30 to 8.00
8.00 to 8.30
8.30 to 9.00
9.00 to 9.30                            Ward Round SOL              Ward Round SOL
9.30 to 10.00                           Ward Round SOL              Ward Round SOL
10.00 to 10.30                          Ward Round SOL              Ward Round SOL
10.30 to 11.00                          Ward Round SOL              Ward Round SOL

Category A

Unpredictable emergency work plus weekend ward rounds

Negotiable PAs

A minimum of 1 PA to support the on call rota and to provide flexibility to accommodate
lab overruns can be negotiated. This will be assessed through job diaries.

As already stated applicants wishing to work part-time will be considered and the
successful applicant can negotiate a revised job plan.




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BIRMINGHAM HEARTLANDS AND SOLIHULL NHS TRUST (TEACHING)

DIRECTORATE OF CARDIOLOGY

CONSULTANT PERSON SPECIFICATION

  FACTORS                          ESSENTIAL                        DESIRABLE       IDENTIFICATION
Qualifications/         Eligibility for entry on GMC              Higher Degree     Certificate
Formal legal            Specialist Register or entry              eg. MD/PhD
requirements.           within six months of interview.
Experience              Wide experience in                        Experience in     Curriculum Vitae.
                        Cardiology                                Non-invasive
                        Experience in Invasive                    Cardiology,
                        Cardiology and PCI                        including TOE
                                                                  and DSE
Training                Undergraduate and                         Appraisal and     Attendance at
experience              Postgraduate                              assessment        courses.
                        teaching/training skills                  skills.           Application form.
                                                                                    Demonstration at
                                                                                    interview.
Practical/              Effective communication                   Knowledge and     Application form.
Intellectual            skills.                                   experience of     Demonstration at
skills                                                            the application   interview.
                                                                  of IT in
                                                                  Cardiology.
Research and            Evidence of original research.                              Curriculum Vitae
Service                 Ability to apply research                                   and Bibliography.
Development             outcomes to clinical                                        Demonstration at
                        problems. Awareness of                                      interview.
                        current developments.
Personal                Effective team member.                                      References.
Attributes              Effective interpersonal skills.                             Curriculum Vitae.
                        Ability to perform under                                    Demonstration at
                        pressure. Commitment to                                     interview.
                        Continuing Medical Education
                        and Professional
                        Development.
Physical                Acceptable health record over                               Application Form.
requirements.           previous 2 years (in                                        References.
                        accordance with standards
                        identified in Heartlands
                        policy).
Personal                Able to fulfil agreed on-call   Live within 10              Application form.
Circumstances           commitments.                    mile radius of              Demonstration at
                                                        hospital.                   interview.



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