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ST GEORGE HOSPITAL MEDICAL SCHOOL

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					                         ST GEORGE’S, UNIVERSITY OF LONDON

                         Division of Cardiac and Vascular Sciences
                         (CENTRE FOR CLINICAL NEUROSCIENCE)

                                        JOB DESCRIPTION

       Senior Lecturer / Honorary Consultant Neurologist / Stroke Physician

                                             Ref: 403/08

INTRODUCTION

This new appointment is to strengthen further the internationally competitive stroke
research programme at St George’s. We are looking for a Senior Lecturer/Consultant
Neurologist or Physician with an interest in stroke. The successful applicant will be
expected to develop a programme of stroke research, complimentary to existing stroke
research within the department. Clinical duties will include cover for the Acute Stroke
Unit and Outpatient stroke service. Other clinical duties will be determined according
to the area of clinical expertise of the post-holder.

Applicants with expertise in any area of stroke research are invited to apply. Areas
which might be particularly complimentary to our current research themes (see below)
include hyperacute stroke care, treatment of acute stroke, stroke rehabilitation, stroke
prevention, animal and cellular models of cerebral ischaemia, and stroke clinical trials
but this list is not exclusive.

STROKE RESEARCH AT ST GEORGE’S

St George’s is one of the leading centres for stroke research in the United Kingdom
with internationally competitive teams in stroke imaging and stroke genetics within
Clinical Neuroscience, and carotid artery disease (carotid plaque instability, Professor
Matt Thompson and Dr Gill Cockerill, Vascular Surgery; carotid endarterectomy trials,
Professor Alison Halliday, Vascular Surgery; interventional cerebrovascular
neuroradiology, Dr Andrew Clifton, Neuroradiology ).

The academic stroke environment at St George’s is further enhanced by the institution
recently being awarded the contract to host the South England Stroke Research
Network which covers South London, Kent, Surrey and Sussex. In addition there are
close links with active stroke research teams within the King’s College School of
Medicine (Professor Charles Wolfe, Professor Lalit Kalra and Dr Anthony Rudd). We
have regular South London Stroke Research Group meetings between the two
institutions.

Our current stroke research programme is a combination of translational work and
clinical studies. Current work is funded from a variety of organisations including
programme grant support from the Stroke Association, British Heart Foundation,
Wellcome Trust, and Research into Ageing, and project grant and studentship support
from the Stroke Association, MRC, PPP Healthcare, British Heart Foundation,
Neuroscience Research Foundation, St George’s Trustees.

RESEARCH FACILITIES AT ST GEORGE’S

As well as a well developed infrastructure for clinical stroke research, there are
excellent support and basic science facilities. These include good access, with
dedicated research time, on two 1.5T MRI scanners within the Trust. Approval has



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been given for a new 3T MRI for Radiology with 50% of its time available for research.
There are excellent biological research facilities as well as a fully equipped Biomics
centre, which provides state of the art facilities for proteomics and genomics.

CLINICAL STROKE CARE AT ST GEORGE’S

As well as a leading academic centre, St George’s is one of the leading clinical stroke
centres within the UK. Stroke is entirely cared for within Neurology by a multi-
disciplinary team of three consultants (Professor Hugh Markus and Dr Anthony
Pereira, are Neurologists, and Dr Geoff Cloud is a Geriatrician). All three consultants
are responsible for cover for the fourteen bedded Acute Stroke Unit on a rotating
basis. Dr Geoff Cloud is also responsible for cover for ten stroke recovery beds on
site and ten stroke rehabilitation beds at the Wolfson Regional Neurorehabilitation
Centre (part of St George’s). Thrombolysis is in place in the Acute Unit and this will
become 24 hour from September 2007. There are a wide range of stroke outpatient
clinics including biweekly one stop TIA/minor stroke clinics, referral clinics for more
complex stroke problems, monthly subcortical stroke and stroke genetic clinics and a
weekly stroke recovery clinic. There is a specialised nurse for stroke (Helen Mann) as
well as a stroke/TIA co-ordinator.

The quality of care in the unit is evidenced by a high ranking in the Royal College of
Physicians Stroke Audit (top ten out of over three hundred Trusts in both 2004 and
2006) and an award for best clinical service in South West Thames 2005.

Specific research areas within stroke in Clinical Neuroscience include the
following;

Magnetic Resonance Imaging in Stroke
We have a long standing programme applying novel magnetic resonance imaging
techniques to investigate the pathogenesis of cerebrovascular disease, and
particularly subcortical vascular disease. Much of this work centres on using diffusion
tensor imaging to look at white matter damage, and white matter tract disruption, and
related to cognitive impairment. We have performed studies in this area in a
respective cohort looking at mechanisms of normal ageing (GENIE Study), in patients
with cerebral small vessel disease, and in hypertensive individuals. We are now
developing tractography to look at the specific tracts disrupted in these conditions and
use this as an insight to investigate neural networks involved in specific cognitive
processes. We are also combining DTI with other MRI techniques (particularly brain
atrophy, perfusion, and spectroscopy) to develop surrogate markers for assessing
disease progression in the hope that we can use them to test novel therapeutic
interventions. More recently we have been using MRI to investigate blood brain
barrier permeability as a pathogenic mechanism in patients with cerebral small vessel
disease. The stroke group works closely with the magnetic resonance spectroscopy
group (Dr Franklyn Howe) and particular expertise in tractography and diffusion tensor
image analysis, is led by Dr Tom Barrick (Lecturer in MR image analysis).

Cerebral Small Vessel Disease
A major research interest is in cerebral small vessel disease. This includes both
studies looking at risk factors and disease mechanisms, and also investigating the
mechanisms of cognitive impairment with MRI (see above). We have a large
database of patients with cerebral small vessel that we use for these studies. Much of
our risk factor work focuses on the role of endothelial dysfunction, and the underlying
genetic predisposition, as a risk factor. We have developed novel neuropsychological
tools (METB) to assess to assess cognitive impairment in patients with this disease
and are currently evaluating this new tool in a recently funded study.




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We are a national referral centre for patients with CADASIL, an autosomal dominant
hereditary form of stroke causing recurrent lacunar stroke and subcortical dementia.
We are using this as a model of pure vascular dementia to investigate underlying
pathological mechanisms and diagnostic tools. We have developed optimal genetic
screening protocols for this disease and are now looking at the role of genetic
modifiers.

Genetics of Ischaemic Stroke
Genetic studies are looking primarily at genetic risk factors for sporadic ischaemic
stroke. We have a large database of carefully phenotyped cases of stroke (>1000).
We have an active programme looking at the genetics of an intermediate phenotype
for stroke, carotid artery intima-media thickness measured using high-resolution
ultrasound. This is primarily working on a large prospective community study of 5,000
individuals (the Carotid Atherosclerosis Progression Study). We are particularly
interested in the role of cytokine genes and gene-environment interactions. We also
have a strong programme investigating the genetics of cerebral small vessel disease
and the role of variation in genes affecting endothelial function. We have recently
been awarded a functional genomics grant from the Wellcome Trust to establish a UK
wide DNA resource of young lacunar stroke. We are also investigating the genetics of
stroke in UK African Caribbeans as part of the South London Ethnicity and Stroke
project. This project collects samples from patients presenting with stroke throughout
South London. We have already shown an excess of lacunar stroke in this group and
are now investigating the underlying genetic susceptibility.

Ultrasonic Imaging in Stroke
There is a well-established programme looking at both technical developments and the
clinical application of the use of Doppler ultrasound to detect asymptomatic circulating
emboli. This work ranges from signal processing to improve the detection of emboli, to
a large international multi-centre study to look at their predictive value. Other
ultrasound studies have looked at methods for measuring absolute volume flow, and
have also applied the measurement of common carotid intima-media thickness to
investigate genetic risk factors for atherosclerosis.

Clinical Studies in Stroke
We are involved in a number of clinical studies and trials in stroke (e.g. COSSACS,
ICSS, and PERFORM). We lead the CADISS trial looking at treatment of cervical
dissection (Professor John Norris, Professor Hugh Markus) and are involved in a
number of multi-centre trials.

Carotid Artery Disease and Stroke
St George’s co-ordinates the Asymptomatic Carotid Surgery Trial (ACST) led by
Professor Alison Halliday, Vascular Surgery. This is the largest vascular surgical trial.
She is now also leading a trial comparing endarterectomy and angioplasty for
asymptomatic carotid stenosis (ACST 2). Dr Andrew Clifton, Neuroradiology, is the
lead neuroradiologist for the International Carotid Stenting Trial (ISCC) which is
comparing carotid angioplasty with carotid surgery for patients with asymptomatic
carotid stenosis. Professor Hugh Markus leads the Asymptomatic Carotid Emboli
Study (ACES) which is an international study with 20 centres worldwide determining
whether asymptomatic emboli detected by transcranial Doppler ultrasound can predict
stroke in patients with asymptomatic carotid stenosis. Professor Matt Thompson and
Dr Gill Cockerill in Vascular Surgery run a programme of research looking at carotid
plaque and mechanisms causing plaque instability.




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ACADEMIC AND RESEARCH STAFF IN THE CENTRE FOR CLINICAL
NEUROSCIENCES – AND THEIR INTERESTS

The Stroke Research Group is part of Clinical Neurosciences which also
includes epilepsy and epilepsy research group and neurosurgery research
group.

Stroke Research Group
Prof. Hugh Markus               Professor of Neurology                     Stroke
Prof. John Norris               Honorary Professor in Neurology            Stroke
Dr Steve Bevan                  Non-clinical Senior          Lecturer   in Stroke Genetics
                                Stroke Genetics
Dr         Atticus              Non-clinical Senior Lecturer               Stroke Models
Hainsworth
THIS POST                       Clinical Senior Lecturer                   Stroke
Dr Tom Barrick                  Lecturer in MR Image Analysis              MR Image Analysis
Rebecca Charlton                Research Psychologist                      Neuropsychology
Rebecca Brookes                 Research Psychologist                      Neuropsychology
Laura Collins                   Research Technician (Genetics)             Stroke Genetics
Paul Cross                      Clinical Studies Co-ordinator              Stroke Imaging
Kelly Jones                     ACES Research Technician                   Stroke Imaging
Alice King                      Research Associate                         Stroke Imaging
Dr Ranjith Menon                Clinical Research Fellow                   Stroke Trials
Ann Marie Murtagh               SELRN Network Co-ordinator                 Stroke Trials
Emma O’Connor                   SELRN Clinical Trials/Nurse Co- Stroke Trials
                                ordinator
Jennifer Peycke                 SELRN Facilitator                          Stroke Trials
Alison Rasmussen                SELRN Co-ordinator                         Stroke Trials
Jennifer Siegel                 Study Co-ordinator                         Stroke Imaging
Francesca                       MRC PhD Student                            Neuropsychology
Schiavone
Raffi Topakian                  Honorary Research Fellow                   Stroke Imaging
Alan Zanich           Research Associate                                   Stroke Genetics
Epilepsy Research Group
Dr Hannah Cock                  Clinical  Senior           Lecturer     in Epilepsy
                                Neurology
Nicola Hamil                    PhD Student                                Epilepsy
Dr Andrew Kelso       Clinical Research Fellow                             Epilepsy
Other Neurology Research
Dr Fred Schon                   Honorary Reader in Neurological            Neurological
                                Education                                  Education
Dr Franklyn Howe                Senior Lecturer in MRI Physics             MRI
Neurosurgery Research Group
Prof Anthony Bell               Professor of Neurosurgery                  SAH/Brain Tumours
Dr Marios                       Wellcome        Senior      Lecturer    in Aquaporins




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Papadopoulos                    Neurosurgery
Mr Suresh                       September              Lecturer    in SAH
Pushpananathan                  Neurosurgery
Dr Samira Saadoun               Post Doctoral Research Associate     SAH
Dr Matthew Tait                 McKissock Clinical Lecturer          SAH
Mr Greg Fellows                 e-Tumour Clinical Research Fellow    SAH
Mr Jonathan Bull                CRUK Lecturer in Neurosurgery        Neuro-Oncology

DETAILS OF POST

There will be five PAs for Medical School work and five PAs for clinical work.

A. Clinical (NHS) Duties;

    The post holder will be expected to;

    1. Develop an independent research programme in an area of stroke research
       complimentary to those already taking part in the department.

    2. Participate in teaching clinical students and other staff. This may include
       formal lectures, special study modules, supervision of research students, and
       other teaching. It is expected that the candidate will spend about one PA per
       week on teaching.

    3. Supervision of Research Fellows, BSc student projects, and other research
       staff within the department.

    4. Assist with administrative duties within the department including organisation of
       the seminars and other meetings.

B. MD Duties;

    1. Sharing of cover for the Acute Stroke Unit with Professor Markus, Dr Pereira,
       and Dr Cloud. It is anticipated that the successful candidate will share one slot
       with Professor Markus (i.e. provide alternate cover for one month in three,
       including cross-cover during Professor Markus’s leave). While covering the
       Acute Stroke Unit, the consultant in charge carries out two daily ward rounds
       (Monday and Thursday mornings) and ward rounds of new admissions on
       other days as well as being available for review of acute admissions on the
       thrombolysis cases, and stroke referrals.

    2. Outpatient clinics. The post holder will be expected to carry out two clinics per
       week. One will be a general stroke/TIA clinic. The other clinic could be a
       general neurology clinic, a clinic in another speciality (if the post holder was not
       a neurologist) or a specialist clinic in a certain area of stroke. This could be in
       an area which fitted with the candidate’s personal interests, subject to
       agreement with the Neurosciences Clinical Director.

    3. On call; the post holder will be expected to participate in the thrombolysis rota
       which currently involves cover for one week in five. If they are a consultant
       neurologist they would be expected to participate in the neurology consultant
       on call rota (for the regional unit) which involves approximately one week in
       twenty. This week would coincide with the week covering the thrombolysis
       rota.



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    4. The post holder will be expected to attend stroke and neuroscience meetings
       including; stroke radiology meeting (Monday 9.00-9.30am), carotid intervention
       meeting (Tuesday 12.00-12.30pm), and regular in-house CME meetings
       (radiology, case presentation, and audit meeting on Friday mornings).

    5. Ward referrals. The post holder will be expected to see referrals of stroke
       cases including referrals within general medicine, vascular surgery, and
       regional neurology beds, on a rotating basis with the other stroke consultants.

TIMETABLE

There are separate timetables for when Acute Stroke Unit ward cover is provided. The
timing of clinics is provisional and will be decided after appointment to fit in with clinical
demands and the post holder’s clinical interests.

A: When Covering Acute Stroke Unit

          Monday            09.00am        - 09.30am        Stroke radiology meeting
                            09.30am        - 1.00pm         Stroke Unit ward round
                            2.00pm         - 5.00pm         Stroke clinic

          Tuesday           09.30am        - 10.30am        Stroke Unit ward round         (new
                                                            admissions)
                            12.00pm        - 12.30pm        Carotid intervention meeting
                            1.00pm         - 5.00pm         Medical School Work

          Wednesday         09.30am        - 10.30am        Stroke Unit ward round         (new
                                                            admissions)
                            10.30am        - 1.00pm         NHS Admin.
                            2.00pm         - 5.00pm         Second outpatient clinic

          Thursday          09.30am        - 12.30pm        Stroke Unit ward round
                            1.00pm         - 5.00pm         Medical School work

          Friday            09.30am        - 10.30am        Stroke Unit ward round         (new
                                                            admissions)
                            11.30am        - 12.30pm        Clinical meeting
                            12.30pm        - 1.00pm         Neurology radiology meeting
                            2.00pm         - 5.00pm         Stroke ward referrals

B: When Not Covering Acute Stroke Unit

          Monday            09.00am        - 09.30am        Stroke radiology meeting
                            09.30am        - 1.00pm         Medical School Work
                            2.00pm         - 5.00pm         Stroke clinic

          Tuesday           09.00am        - 12.00pm        Medical School Work
                            12.00pm        - 12.30pm        Carotid intervention meeting
                            1.00pm         - 5.00pm         Medical School Work

          Wednesday         09.00am        - 10.30am        Medical School Work
                            10.30am        - 1.00pm         NHS Admin.
                            2.00pm         - 5.00pm         Second outpatient clinic



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          Thursday                   ALL DAY                Medical School Work

          Friday            11.30am        - 12.30pm        Clinical meeting
                            12.30pm        - 1.00pm         Neurology radiology meeting
                            2.00pm         - 5.00pm         Medical School Work




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PERSON SPECIFICATION

We are looking for a clinician trained in Stroke Medicine with CCST in their parent
specialty who has an excellent track record in stroke research with the potential to
develop an independent internationally competitive programme of stroke research.
The post is ideal for a neurologist, but would also be suitable for a geriatrician or
physician from another specialty with an interest in stroke who would like to work
within a vibrant neuroscience department. In such cases necessary additional
attachments to other departments could be made.



      Criteria                         Essential                            Desirable

Qualifications               BM BCH or equivalent

                             MRCP

                             Higher research degree
                              (MD or PhD)

Experience                   Experience in stroke care              Subspecialty training in
                              to consultant level                     stroke

                             Experience to CCST level               Previous experience in
                              in parent specialty                     acute stroke care including
                              (neurology or other                     thrombolysis
                              medical specialty)

                             Publications in scientific
                              journals or presentations

Knowledge/Skills             Excellent communication
                              and interpersonal skills

                             Good computer literacy

                             High level of
                              organisational skills

Personal                     Enthusiastic

Attributes                   Self motivating

                             Ability to work as part of a
                              team and excellent
                              collaborative skills




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                                         About St George’s
St George’s, University of London, is the only remaining independently governed
medical school in the country and has been providing medical training for over 250
years. St George’s is closely integrated with one of the UK’s busiest hospitals, St
George’s Healthcare NHS Trust, which gives us a unique opportunity for teaching and
research.
Our Mission

“To promote by excellence in teaching, clinical practice and research, the prevention,
treatment and understanding of disease.”

Teaching

St George’s is teaching approximately 5,500 students at any one time, divided
between courses in medicine, biomedical sciences, nursing, midwifery, physiotherapy,
and therapeutic and diagnostic radiography and post graduate courses.

St George’s has a long history of innovation in teaching. In 2000 St George’s was the
first University to introduce a four year MBBS Graduate Entry Programme (GEP) open
to graduates from any discipline

St George’s has a joint Faculty of Health and Social Care Sciences with Kingston
University, established as a joint venture in response to the training needs of the local
NHS and Social Services. The Faculty now includes Nursing, Midwifery, Diagnostic
and Therapeutic Radiography, Physiotherapy and Social Work.

A common foundation programme has been set up which allows all students following
degree courses at St George’s and the Faculty to benefit from studying together
across both campuses for their first semester, giving them a useful insight into all of
the health professions.

More recently St George’s has again collaborated with Kingston University to introduce
a Foundation to Medicine programme and an MPharm Degree.

Research

St George’s is extremely active in research and has an especially good reputation in
diseases of the heart and circulation and in the science and clinical practice
associated with problems of infection and immunity, both of which were flagged as
being of special excellence in the last Research Assessment Exercise. Research is
also strong in basic medical sciences, particularly cell biology and molecular genetics.
Our research continues to be influential in the fields of medical epidemiology and
health psychology.

St George’s academic provision is organised into 6 divisions with research centres and
sections within them, which encourages interdisciplinary working. There are divisions
of Basic Medical Sciences, Cardiac and Vascular Sciences, Clinical Developmental
Sciences, Cellular and Molecular Medicine, Community Health Sciences, and Mental
Health. More information about these divisions and their research specialisms can be
found at www.sgul.ac.uk




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BACKGROUND

St George’s Healthcare NHS Trust is one of the largest healthcare units in the United
Kingdom accommodating around 1170 beds and treating around 80,000 inpatient and day
cases, and over 300,000 outpatients annually. The Trust serves three local Primary Care
Trusts with a resident population of about 300,000. The Trust employs over 4000 staff
incorporating 575 medical & dental staff. It provides general acute services together with
speciality services including neuroscience, cardiothoracic, and specialist children’s services.

The Trust is on two main sites: St George’s Hospital, the base for acute general medicine and
surgical services and the Wolfson Neurological Rehabilitation Centre in Wimbledon. St
George’s Hospital is the main teaching hospital in the south west sector of London and as such
has developed links with most district general hospitals throughout Surrey and Sussex, and
supports a significant training programme for junior doctors who rotate through the Trust.

In 2003, the Atkinson Morley’s Hospital closed and moved to a new, purpose-built wing on the
Tooting site, sharing accommodation with the regional cardiothoracic unit. The new Atkinson
Morley Wing is arranged over four floors, around inner courtyards and incorporates 233 in-
patient and day-case beds, eight operating theatres, and a range of state-of-the-art diagnostic
and treatment facilities. It is the regional neuroscience centre for south-west London and a
large part of Surrey and Sussex.

Organisation
The Trust board is chaired by an Independent chair and in addition there are five non-executive
directors from outside the NHS including some from Industry and Commerce. The Trust is
organised as seven Directorates: Medicine, Surgery & Theatres/Anaesthetics, Cancer, Children
& Women’s, Cardiothoracic, Neurosciences, Professional & Scientific. Each of which has a
core management group of a consultant (Clinical Director), Head of Nursing, and general
manager. Below is a list of all the service centres with specialties they encompass:

Neuroscience Services
Neurosurgery; neuroradiology;          neurology;     neurorehabilitation;   neuroanaesthetics   and
neuropathology.

The Directorate of Neurosciences is a dynamic group of 24 consultant neurologists. St
George’s provides both a district neurology care to our large local population as well as a
regional service to our partner DGHs in London, Surrey and Sussex.

The neurology service is based in the Atkinson Morley Wing at St George’s Hospital. It
provides a large and comprehensive regional neuroscience service and is well supported by
specialist departments in neurosurgery, neuroradiology, neurophysiology and neuropathology.
There are specialist clinics in stroke, neuromuscular disease, movement disorders, botulinum
toxin injection, epilepsy, multiple sclerosis & neurogenetics and Tourette’s syndrome.

The regional neuroscience structure provides considerable support for neurological care for the
local population. The most recent development has been the extension of thrombolysis for
stroke patients to 24 hour service.

The Wolfson Neurorehabilitation Centre is renowned for excellence in neurological
rehabilitation and serves both as a local and a tertiary care facility.

Department of Neurology, AMH Regional Neuroscience Centre, St George's Hospital
Consultant neurologists with majority sessions at St. George’s Hospital include Dr Oliver
Foster, Dr Anthony Pereira, Professor Hugh Markus, Dr Hannah Cock, and Dr Marie-Helene
Marion. The district neurology service is closely linked to the regional neuroscience service in
the Atkinson Morley Wing. There are 21 consultant neurologists. St George’s provides a
comprehensive neurology service as well as many specialist clinics. The neurologists at St
George’s Hospital are:




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              Dr. Ali Al-Memar                        Kingston Hospital
              Dr. David Barnes                        St. Peter’s Hospital, Chertsey
              Dr. Hannah Cock                         St George’s Hospital and Medical School
              Dr. Oliver Foster                       St. George’s Hospital
              Dr. Paul Hart                           Kingston Hospital
              Dr. Geoff Kimber                        East Surrey Hospitals
              Dr. Ron McKeran                         St. Helier’s Hospital
              Dr. Bridget MacDonald                   Mayday Hospital
              Dr. Marie-Helene Marion                 St George’s Hospital
              Prof. Hugh Markus                       St George’s Hospital and Medical School
              Dr. Jane Meuller                        St. Helier’s Hospital
              Dr. Salah Omer                          Kingston Hospital
              Dr. Anthony Pereira                     St George’s Hospital
              Dr. Fred Schon                          Mayday Hospital
              Dr. Jeremy Stern                        Frimley Park Hospital
              Dr. Stephen Wilson                      Epsom General Hospital
              Dr. Tim Von Oertzen                     Kingston Hospital
              Dr. Stephen Wilson                      Epsom & St Helier’s Hospital
              Dr. Damian Wren                         Frimley Park Hospital
              Dr. Colette Griffen                     St George’s Hospital
              Dr. Matthew Craner                      Frimley Park Hospital

The junior staff include:
             o 8 SpRs in neurology & 4 SHOs
             o 2 SpRs in stroke & 2 SHOs
             o 1 SpR in rehabilitation & 1 SHO
             o 1 SpR in neurophysiology


Additional specialist activities in the group
There is a great breadth of expertise available at St George’s as evidenced from the list below:
1.      Stroke Imaging meeting. This is held on Monday at 09:00.
2.      Neurology Teaching. Dr Schon every Tuesday at 11:00
3.      Neurology SHO teaching. Dr MacDonald every Wednesday at 11:00.
4.      Stroke teaching. This is taken by Dr Pereira every Thursday at 12:30.
5.      A combined X-ray/pathology meeting of all the Neurological/Neurosurgical/Medical staff
        is held on Friday mornings at 10:00am in the X-ray room
6.      Academic seminar. This is held on the first Monday of each month at 12:00 noon.
7.      Neurophysiology                  St George's              Core
8.      Neuro-genetics                   St George's              Core
9.      Neuropathology            St George's             Core
10.     Neuroradiology            St George's             Core
11.     Neurosurgery                     St George's              Core
12.     Rehabilitation                   St George's &Wolfson Core
13.     OPD Foster                       St George's              General
14.     OPD Marion                       St George's              General
15.     OPD Omer                         St George's              General
16.     OPD Cock                         St George's              General
17.     OPD Pereira                      St George's              General
18.     OPD Epsom                        Epsom                    General
19.     OPD Wren/Stern                   Frimley Park             General
20.     OPD Al-Memar              Kingston                General
21.     OPD Schon/MacDonald              Mayday                   General
22.     OPD Hart                         St Helier's              General
23.     OPD Barnes                       St Peter's               General
24.     OPD Tourette's            St George's             Specialist
25.     OPD MultipleSclerosis DMT        St George's              Specialist
26.     OPD Autonomic disease            St George's              Specialist
27.     OPD Botulinum Toxin Inj          St George's              Specialist
28.     OPD Movement Disorder            St George's              Specialist
29.     OPD Epilepsy                     St George's              Specialist




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30.      OPD Neuromuscular            St George's           Specialist
31.      Epilepsy surgery             St George's           Specialist
32.      Theatre Muscle Biopsy        St George's           Specialist
33.      Theatre Nerve Biopsy         St George's           Specialist
34.      OPD Stroke                   St George's           Specialist
35.      OPD CADASIL           St George's          Specialist
36.      OPD Neuro-otology            St George's           Specialist
37.      Neuropsychiatry              St George's           Specialist
38.      OPD Paediatrics              St George's           Specialist
39.      Neuropsychology              St George's           Specialist
40.      OPD Neurosurgery             St George's           Specialist
41.      ITU experience        St George's          Specialist
42.      Sleep                        St George's           Specialist
43.      Dementia                     Springfield           Specialist
44.      OPD Neuroophthalmoplogy      St George's &Wolfson Specialist
45.      OPD Pain                     Wolfson               Specialist



St George’s Hospital Cardiothoracic Clinical Directorate
Background
The Cardiothoracic Clinical Directorate comprises the Departments of Cardiology,
Cardiothoracic Surgery and Chest Medicine. For management purposes the unit is divided into
three Care Groups : i) Cardiology & Blood Pressure Unit, ii) Cardiothoracic Surgery, and iii)
Chest Medicine

Together the unit provides services in cardiology, cardiac surgery and thoracic surgery. In
September 2003 the Unit moved into a new building on the St George’s site. The expanded
facilities comprise four general cardiac wards, a day care ward, six bedded coronary care unit
and intensive care unit/progressive care unit. There are four cardiothoracic operating theatres,
a suite of five cardiac catheter laboratories and dedicated outpatient facilities – nine
cardiothoracic outpatient rooms, a rehabilitation suite and a clinical investigation area (ECG,
Echocardiography, Pacing and X-ray).

A full range of adult non-invasive, invasive and interventional cardiology is provided at St.
George’s to a catchment area comprising most of South West London (Wandsworth, Merton,
Sutton, Croydon, Kingston and Richmond) and to large parts of Surrey and Sussex. During
2006 the unit undertook 3,500 angiograms, 2,000 angioplasties, 400 pacemaker insertions, 250
electrophysiology studies and 600 other complex procedures including 120 ICD insertions and
70 ASD/PFO closure procedures. In addition the deprtment carries out valve interventions and
part of the development plan includes percutaneous valve implantation. With respect to
coronary intervention, the unit is active and one the busiest in the UK. All adjunctive
technologies including intravascular ultrasound, rotational atherectomy. thrombectomy etc are
available.

There is a busy primary percutaneous coronary intervention service for acute myocardial
infarction and it is anticipated that the successful applicant will participate in this programme.
The echocardiography department is one of the largest in the country. It has a long established
reputation in non-invasive techniques. It is well equipped with six echocardiography machines.
It is active in transoesophageal echocardiography and runs a two day transoesophageal
echocardiography course, attracting an international faculty and audience. Approximately
10,000 echocardiographic studies are performed each year, of which approximately 500 are
transoesophageal studies. The facilities are state-of-the-art and include five recording rooms,
one dedicated to transoesophageal echo, stress and contrast studies. All our echo machines
are fully digital and integrated into a local network. All echocardiographic data is stored on
digital storage media as part of an integrated information system within the Department of
Cardiology.



Children & Women’s




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Paediatric medicine and surgery; gynaecology, gynae-oncology, reproductive medicine,
urogynaecology, fetal medicine; neonatology; obstetrics; clinical genetics; and clinical
psychology.

Medical Services
General medicine; Accident & Emergency; communicable diseases; genito-urinary medicine;
diabetes/endocrinology; oncology; bone marrow transplantation; chest medicine;
gastroenterology; renal medicine and transplantation; haematology; dermatology and
hypertension, rheumatology, geriatric medicine (acute and rehabilitation services).

Surgical Services
Ear, nose & throat; audiology; ophthalmology; vascular surgery; urology; general surgery;
trauma and orthopaedics; maxillofacial and dental surgery; and plastic surgery and
theatres/anaesthetics. Includes a range of specialist tertiary services in orthopaedics (pelvic
reconstruction) and is the main ENT inpatient base for South West London.



Professional & Scientific
Clinical biochemistry; medical microbiology; haematology; histopathology; pharmaceutical
services; medical physics; diagnostic radiology, PRU/Immunology, Breast Screening, Clinical
Support Services

Operational Management
In addition, the Service Centres are supported by the following Directorates:

Finance                             Human Resources                Operations
Information & Computing             Estates                        Nursing

Management
The successful candidate will be expected to work with professional colleagues and local
managers in the efficient running of the Service, and will share with Consultant colleagues in
the medical contribution to management. He/she will be expected to participate in the Trust’s
system of governance and audit, and maintain their CME/CPD. He/she will also have a
commitment to participate in the Trusts professional development. The appointee will be
expected to observe the Trust’s agreed policies and procedure, drawn up in consultation with
the profession on clinical matters, and to follow the standing orders and financial instructions of
the Trust.




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Brief Summary of Main Terms and Conditions of Post

It is a requirement of the post that the successful candidate have:

        MRCP or equivalent
        GMC Registration
        Registration with a recognized Medical Defence Organisation for insurance and
        indemnity
       CCT and/or entry onto the Specialist Register

The post is available on a full-time basis (5 clinic and 5 academic PA’s)

Annual Leave
There are 32 days annual leave plus 11 public and other holidays.

Pension Arrangements

Membership of USS (Universities Superannuation Scheme) is optional; the employee's
contribution rate is 6.35%. Existing members of the NHSSS (National Health Service
Superannuation Scheme) may elect to remain members of that scheme.

Honorary Consultant Contract

An Honorary Consultant Contract will be sought from St George’s NHS Trust for the
successful candidate.

Salary Scale
The appointment will be made to the appropriate point of the new Consultant Contract
salary scale: £71,822 - £96,831 per annum depending on the seniority of the
successful candidate. London allowance of £2,162 per annum will also be payable.

A full statement of the terms and conditions of the post will be sent to the successful
candidate.

Season Ticket Loan

Employees are entitled to apply to the Finance Office for an interest free annual
season travel ticket loan.

Place of Residence

It is St George’s policy that all post holders must live within 30 miles of St George’s on
appointment unless otherwise agreed by Council.


Medical Clearance

St George’s reserves the right to request successful candidates (including internal
candidates) to complete pre-employment health questionnaires. In accordance with
this, any offer of employment is made subject to satisfactory health clearance by the
Staff Health Department.




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Offers of Appointment

Offers of appointment are only valid if made by the Director of Administration or
designated members of the Personnel Office staff acting on his behalf.

Offers of appointment are made subject to receipt of satisfactory references and
satisfactory completion of probationary periods where appropriate.

Right to work

St George’s will comply with the Asylum and Immigration Act 1996 which requires all
employees to provide documentary evidence of their legal right to work in the UK prior
to commencing employment. For posts requiring a recognised degree level
qualification and where there is no suitable UK or European Economic Area candidate,
St George’s will take necessary steps to secure a work permit from the Home Office in
order for a foreign national to take up employment.

All candidates invited to interview will be asked to provide copies of one of the
following official documents:

       Copies of the identification pages or appropriate visa pages of their passport
      describing the holder as a British citizen or an EEA national or showing that they
      are otherwise entitled to work in the United Kingdom.
       A birth certificate issued in the UK or in the Republic of Ireland.
       A certificate of registration or naturalisation as a British citizen.
       A letter issued by the Immigration and Nationality Directorate of the Home
      Office indicating that the person has permission to take up employment.

All successful candidates will be required to provide the originals of one of the above
documents on commencing employment.


Further Information
Interested applicants are encouraged to contact Professor Hugh Markus on (020 8725
2735 or by email hmarkus@sgul.ac.uk , to discuss the post and research opportunities
in more detail. Short listed candidates are strongly encouraged to visit the Division
prior to formal interview.


Policy on Smoking at Work
St George’s University of London has established a no-smoking policy to minimise
risks to the health of our staff and to maintain a tobacco smoke free working
environment, where non-smoking is the norm. The policy stipulates that smoking
inside the Medical School is not permitted, except in certain areas of the school club.
The policy also contains provision to eliminate passive smoking exposure within the
medical school.


Equal Opportunities

St George's, University of London confirms its commitment to a comprehensive policy
of equal opportunities in employment in which individuals are selected and treated on
the basis of their relevant merits and abilities and are given equal opportunities within
St George’s. The aim of this policy is to ensure that no job applicant or employee
should receive less favourable treatment on any grounds not relevant to good




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employment practice. St George’s is committed to action to make this policy fully
effective.

Applications
Application forms should be returned to;
The Recruitment Team
Personnel Office
St George's, University of London
Cranmer Terrace
London SW17 0RE,

Closing date: 11th April 2008

It is likely that interviews will be held in the middle of June 2008. References will be
taken up before interview unless you indicate otherwise on the application form.

Please quote reference: 403/08

Acknowledgement of Applications

If you would like your application acknowledged, please enter your name and address
on the reverse side of the enclosed postcard, with a stamp and return it with your
application.




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                                ST George’s, University of London
                                         RANGE OF STAFF BENEFITS
The following is a list of Staff benefits and facilities:

Pay and Pensions

Final salary pension schemes (including option to continue existing membership of NHS pension scheme)

      Pension Scheme               Employee’s Contribution             Employer’s Contribution
      NHSS                         6%                                  14%
      SAUL                         6%                                  13%
      USS                          6.35%                               14%

   Promotion procedure (annual) to recognise increases in responsibilities
   Merit Increments reviews (annual) to recognise and reward outstanding performance

Annual Leave

   Minimum entitlement of 23 days per year or maximum 32 days for academic and related staff (pro-
    rata for part-time staff)
   8 Bank Holidays
   3 extra statutory days per year (normally between Christmas and New Year, when the School is
    closed)

Work/Life Balance

   Flexible Working (part-time or reduced hours of work, opportunities to work from home for many
    posts, local flexibility in agreeing start and finish times of work)
   Generous maternity leave benefits (8 weeks full pay and 16 weeks half-pay) after completing one
    year's continuous service
   Long term sickness absence pay (rising to 6 months full pay and 6 months half pay after 5 years'
    service)
   Adoption and Paternity Leave entitlements
   Paid Time Off for Dependants (compassionate leave or for domestic emergencies)
   Parental Leave

Staff Development Programme

   Personal Development Review (appraisal) scheme for all staff.
   Comprehensive programme of training and development
   Management Development programme
   Learning and Teaching Support programme for teachers of students
   Dedicated programme for Research Staff, including career development, writing for publication and
    planning and managing a research project.
   Departmental and central funding for staff development
   Opportunity to achieve European Computer Driving Licence qualification

Trade Union and Staff Representatives

   Staff Forum for representatives of all staff groups to raise employment issues
   Formal recognition agreements with a number of trade unions

Staff Support

   Occupational Health Service
   Staff counselling and support service
Staff Facilities

   Sports Club (gymnasium, exercise classes, four open squash courts, two aerobics room, one
    resistance machine room and one free weight rooms)
   School Club and Bar
   Interest-free loans for season tickets, car parking permits and costs of training courses.




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