Consultant Cardiologist With An Interest In Cardiac MRI

United Hospitals NHS Trust

JOB DESCRIPTION

May 2020

1 JOB DESCRIPTION

This is a whole time (10 Programmed activities) appointment as a full-time Consultant Cardiologist with special interest in Cardiac MRI and Imaging to complement the expertise of the other 14 Consultant Cardiologists at United Lincoln Hospitals NHS Trust. The post has no general medical commitment. The post will based at Hospital with in-patient and acute cardiology commitment at Lincoln County Hospital. Another sub-specialty interest such as heart failure / cardiomyopathy can be accommodated by mutual agreement. Comprehensive imaging, intervention and community heart failure links are available within the Trust

The main objectives of this post are to support the delivery of general cardiology at Lincoln County Hospital, and, in collaboration with colleagues, expand and develop the Cardiac imaging service across ULHT.

The post-holder will part-take in a 1 in 8.5 out-of-hours county-wide non-interventional cardiology on-call rota. A proposed job plan for the post is outlined below. The job plan can be adjusted dependant on the skills of the post-holder.

LINCOLNSHIRE Lincolnshire is a scenically and geographically varied county. It includes the Lincoln escarpment, the North which are designated as an area of outstanding natural beauty, and extensive beaches on the coastal strip.

Lincolnshire scores highly when it comes to education from nursery through to and has a growing university culture. In your free time there are many places of interest to visit in Lincolnshire with motor racing at Cadwell Park, lakes for sailing, some of the best coarse fishing in the country and horse racing at Market Rasen. There are a number of historic architectural gems including Lincoln Cathedral, Lincoln Castle, Castle, Belton House, Belvoir Castle, and the Boston stump.

Lincolnshire offers an attractive choice of pretty rural villages or for those who prefer urban living there is a choice of the City of Lincoln which dates back to Roman times, or the traditional market towns of Grantham, Boston and Louth. The property market offers potential buyers high quality modern and traditional housing at attractive prices. is only an hour away via mainline train services from Grantham.

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THE TRUST OPERATING MODEL (TOM) On 1st April 2019, the trust implemented the new Trust Operating Model, which includes a new organisational structure and ways of working for everyone. The TOM is an exciting opportunity to make sure we are fit for purpose and that employees get what they require out of the organisation they work for, as well as making sure we get the best that you have to offer. We have gone from 16 Clinical Directorates to streamlining the services into 4 divisions.

THE TRUST The United Lincolnshire Hospitals NHS Trust is a large acute NHS Trust which is responsible for a

comprehensive range of health services to a local population of 730,000. It has a total bed complement of 1267 and delivers health care at 3 principal sites: Lincoln County Hospital, Pilgrim Hospital at Boston and Grantham & District Hospital. Many local general practitioners are known personally to the consultant staff and are met at postgraduate meetings and elsewhere.

Lincoln County Hospital is situated close to the centre of Lincoln. It is a large and modern complex, catering for most of the major specialties and has 547 acute beds. There is a large, well-staffed Emergency Department and Intensive Care Unit. There is an Ophthalmic Unit, Surgical Day Unit and a purpose-built Clinical Oncology Department. The Trust runs a countywide Primary PCI programme from the Lincolnshire Heart Centre, a Level 1 Heart Attack Centre. Renal beds and inpatient dialysis facilities are co-located on Burton ward and there are plans to develop this area to accommodate all Lincolnshire acute and inpatient dialysis. 4

Grantham & District Hospital is a small district general hospital with 144 acute beds, of which 91 are acute medical beds. It has close links with Lincoln, Boston and Newark hospitals as well as teaching centres in Nottingham and Leicester. Primarily it serves the people of Grantham, and Newark with a total catchment population of around 120,000.

Grantham provides Integrated Medicine, Elective General Surgery, Orthopaedics, Anaesthetics and a daytime Emergency Department Service. There is an ambulatory Paediatric service and Midwife Managed Maternity Unit. There is a fully equipped X-Ray Department with a modern CT scanner (regular sessions for cardiac CT maybe available in the future) and MRI scanner (with two sessions per week of cardiac MRI), as well as a Pathology Department providing all pathological services on site. There is a Medical Physics Department, which does all cardio-respiratory work as well as gamma camera work including myocardial perfusion imaging and radionuclide ventriculography. There are no in-patient cardiology services at Grantham but a middle grade in-reach service is provided to support the acute medical take under the supervision of the Consultant Cardiologist of the week at Lincoln.

Pilgrim Hospital is a modern 566 bedded District General Hospital pleasantly situated in Boston with good transport links. A full range of clinical specialties and laboratory facilities of the highest standard are provided. It has close links with community hospitals in and Spalding and is the main hospital centre for South Lincolnshire. The hospital includes an Emergency Department and beds for General Medicine, Elderly Care, General Surgery, Orthopaedic Surgery, Vascular Surgery, ENT, Ophthalmology, Paediatrics, Psychiatry, Oral Maxillofacial Surgery, Obstetrics and Gynaecology and Intensive Care with 12 beds, an endoscopy Unit and a new MRI scanner.

Pathology The PathLinks Consortium provide all the pathology services in Lincolnshire including histopathology, immunology, biochemistry, haematology and microbiology. There are specialists on site for each of these disciplines at Pilgrim Hospital and Lincoln County Hospital. They provide a high quality and comprehensive service.

LINCOLN - DIRECTORATE OF CARDIOLOGY & CARDIAC PHYSIOLOGY

The Department of Cardiology is contained in the Cardiovascular Clinical Business Unit which includes Diabetes & Endocrinology, Sttroke Medicine and Nephrology. This comes under the umbrella of the Division of Medicine. The Division of Medicine Directorates comprise circa 88 wte consultant physicians with specialist interests. Inpatient care is provided in modern specialty based wards. There is a dedicated Medical Emergency Assessment Unit (MEAU) where emergency medical admissions from Primary care and the Emergency Department are treated and a separate Surgical Emergency Assessment Unit (SEAU).

5 The Directorates have an active postgraduate education programme with weekly physicians meetings and Monthly Grand Rounds.

The Directorates are completed by tiers of Staff Grade Practitioners, Specialist Registrars, CMT level doctors who are part of the North Trent rotation, VTS SHOs, F2s and F1s who rotate with posts in the Nottingham and Leicester PRHO schemes. The Directorates maintain an excellent nursing workforce, many of whom have extended their skills to enable them to complement the work of the medical teams. There are also nurse consultants in both Emergency Medicine and Cardiology.

All consultants have medical secretarial support and office accommodation with Internet access provided.

CARDIOLOGY SERVICES

The Lincolnshire Heart Centre at Lincoln County Hospital is a busy non-surgical Cardiology tertiary referral centre with a high volume Interventional Cardiology department performing more than 1100 PCI procedures a year. It is now one of the largest services in the providing elective, urgent and emergency treatment to a population of 750,000 patients over a large geographical area. There are seven interventional consultants who provide a 24-hour, 365 day primary PCI service treating over 500 patients a year. Median door-to-balloon times are consistently below 30 minutes and outcomes are substantially better than the national average. Elective patients are referred from all over Lincolnshire and acute cases admitted to Pilgrim Hospital, Boston and Grantham Hospital are also transferred to Lincoln for treatment. The department has two co-located purpose-built cardiac catheterisation laboratories with integrated IVUS & pressure wire capability and OCT with angio-coregistration.

There are three consultants with an interest in imaging in addition to an associate specialist. The imaging service is also supported by a Consultant Echocardiographer who leads a pan-trust Stress Echocardiography service, coordinates the QA for routine and specialised echocardiography and leads dedicated valve registry / clinics. Transoesophageal echocardiography is provided at Lincoln and Pilgrim Hospitals. There is an established cardiac CT service performing about 1000 scans a year currently based at Lincoln but due to expand shortly to Pilgrim and Grantham. The post-holder has the opportunity to support this service if interested.

The cardiac MRI service is currently based entirely at Grantham Hospital and performs about 900 stress and non-stress cardiac MRIs a year. There are two consultants currently providing the service and this post has been created to support a reduction in their commitments. There are plans to develop an MRI service at Lincoln which the post-holder will be expected to support.

6 A full simple pacemaker implant (350 pacing procedures per year) and device follow-up service has been in operation for several years. In October 2018, we started our complex device service with one implanter. and have performed approximately 150 complex devices in the last 12 months.

There are weekly Multi-disciplinary Team (MDT) meetings attended by the whole department and by visiting cardiac surgeons from Nottingham and Leicester to discuss management of patients with cardiac disease. In addition, there are weekly angiographic review sessions and General Cardiology education meetings which consist of Journal Club and talks by departmental and external speakers. In addition there is a monthly Heart Failure MDT and a bimonthly device MDT.

There are dedicated inpatient Heart failure Nurse Specialists in post at both Lincoln and Pilgrim Hospital sites and a comprehensive team of community based Heart failure Nurse Specialists across Lincolnshire with a monthly pan-health community heart failure MDT.

The Trust also has a Cardiovascular Research Programme with dedicated Cardiovacsular Research Nurses, and is participating in a number of NIHR portfolio clinical trials, industry and commercial clinical studies as well as investigator-led studies. The post-holder will have the opportunity to contribute to a rapidly expanding research portfolio.

CARDIOLOGY MEDICAL STAFF Lincoln County Hospital Dr Vinod Venugopal Consultant Interventional Cardiologist and Clinical Lead Dr David O’Brien Consultant Interventional Cardiologist Dr Richard Andrews Consultant Cardiologist (Imaging and Cardiac MRI) Dr Steve Kelly Consultant Interventional Cardiologist Dr Wayne Arthur Consultant Cardiologist (Devices) Dr Percy Jokhi Consultant Interventional Cardiologist Dr Juan Fernandez Consultant Interventional Cardiologist Dr Kelvin Lee Consultant Interventional Cardiologist, Research Lead Dr David Morgan Consultant Cardiologist (Complex Devices) Vacancy advertised Consultant Cardiologist (Complex Devices) Mr Waheed Akhtar Consultant Echocardiographer TBC Consultant Cardiologist (Coronary Intervention)

Pilgrim Hospital Dr Jaroslav Skopal Consultant Cardiologist (imaging) Dr A Ravi Locum Consultant Cardiologist Dr Sanjay Dhar Locum Consultant Cardiologist Dr D Taleyratne Consultant Interventional Cardiologist

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Grantham Hospital Dr Andrew Houghton Consultant Cardiologist (Imaging and Cardiac MRI) This post Consultant Cardiologist (Imaging and Cardiac MRI)

DUTIES AND RESPONSIBILITIES This is a new post to accommodate the reduction in hours of one of the imaging cardiologists and facilitate the expansion of the cardiac MRI service to Lincoln. Cardiac MRI sessions will be based at Grantham Hospital but the post-holder will be expected to support the development of the service at Lincoln with the planned upgrade of the scanner. Additional sessions maybe available in Heart Failure / Cardiomyopathy. There is also the potential to undertake additional activity in cardiac CT at the Lincoln or Grantham site by mutual agreement. General cardiology services will be provided at the Lincoln site on a 1:8.5 rota for wards and 1:14.5 for coronary care. Two clinics a week will be provided at Grantham and it is expected that the individual will provide in-reach services for the Grantham acute medical take during their time at Grantham.

Other general requirements would be:  The appointee will be expected, in conjunction with his/her Consultant colleagues, to provide a comprehensive general cardiology service to the hospitals within Lincolnshire.  To provide cover for Consultant colleagues during periods of absence.  To carry out teaching duties as required, and to take an active part in the Postgraduate Medical Education programme. The appointee will have the opportunity to teach Specialist Registrars on the Trent and Leicester rotations as well as other junior doctors and medical students. There is an active education programme for cardiac physiologists, nursing staff and General Practitioners.  To attend the Cardiology Team meetings.  To take part in the Team, Department, District, Regional and National Audit programmes  To be involved in research where appropriate.  To actively participate in the operational, day to day, management of cardiology services in the Trust and undertake such other duties as may be identified to meet the needs of the service.  To partake in the pan-trust non-interventional Cardiology on call rota

On call responsibilities There is currently a 1 in 8 pan-trust cardiology non-interventional on call commitment with the appointment of this post. There is no commitment to the general medical on call rota.

Proposed Job Plan The post-holder will be on a 1 in 8 weekends and weeknights on-call for non-interventional cardiology pan-trust. There will in addition be a commitment to CCU consultant of the week and referrals on a 1:14 rota at Lincoln. Sample timetables and PA allocations are given below.

8 Example Timetable (Subject to job planning) Week 1-3 AM PM Monday Cardiac MRI (LCH-planned) Admin 13:00-17:00 (1PA DCC) (1PA DCC) Tuesday Cardiac MRI (GDH) Clinic (GDH) (1 PA DCC) (1PA DCC)

Wednesday CPD / Audit SPA (1PA, SPA) Thursday Complex Echo (GDH) Clinic (GDH) (1 PA DCC) (1PA DCC) MDT (LCH / Video Conference) (0.25) Friday Cardiac MRI (GDH) 13:00 - 15:00 Meetings SPA (0.5PA (1PA SPA) SPA)

Weekly DCC – 7.25 Ward Cover DCC (Lincoln) 1:8.5 – 0.75 CCU Consultant of the week (LCH) 1:14 – 0.5 Non-Interventional on call 1:8 – 1.5PA DCC Total DCC – 8.5PA SPA – 1.5PA

Total 10.00 PA

An additional Programmed Activity (1 PA) may be available for undertaking additional activity in cardiac imaging by mutual agreement. Should the appointee take on any other managerial/educational roles, the SPA allowance would be reviewed accordingly.

POSTGRADUATE MEDICAL EDUCATION There is an active Postgraduate Medical Education Centre with excellent facilities for study and a well- equipped medical library with internet facilities. There is a professional librarian and a part time postgraduate centre manager. The trust supports the requirements for Continuing Medical Education as laid down by the Royal College of Physicians and is committed to providing the time and financial support for these activities.

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CLINICAL AUDIT An active audit Programme exists within the Trust and within the Department of Medicine. The post holder is expected to carry out audit and participate in the programme. Audit is supported by a Clinical Effectiveness Unit.

CLINICAL GOVERNANCE The Trust has developed a Clinical Governance Strategy which seeks to deliver the Quality agenda. The post holder is expected to work within this framework and contribute to its continued development.

RESEARCH There are opportunities for clinical research. The Trust and the Cardiovascular Research Programme has developed good links with the Institute of Health Studies at Lincoln University and as part of the Clinical Research Network is also affiliated with the Leicester University Biomedical Research Unit. The Cardiovascular R&D department has dedicated Cardiac Research Nurses and has a wide portfolio of active Research Studies with ample scope for research and further study.

MAIN CONDITIONS OF EMPLOYMENT The post will be offered on the Consultant contract. The Terms and Conditions of employment will be determined by the United Lincolnshire Hospitals NHS Trust Terms and Conditions of Employment. The post holder shall have medical clearance arranged by the Trust before taking up employment.

Any Applicant who is unable for personal reasons to work full time will be eligible to be considered for the post. If such a person is appointed, modification of the job content will be discussed on a personal basis with the Trust in consultation with Consultant colleagues.

The Trust is committed to supporting re-accreditation and CPD with dedicated SPA time allocated as part of the successful applicants job plan.

RESIDENCE The person appointed will be required to maintain his/her private residence in contact with the public telephone service and reside within reasonable access when on-call.

REMOVAL EXPENSES Relocation expenses will be payable to the successful candidate in accordance with the Trust policy on relocation.

OFFICE ACCOMMODATION

10 Office accommodation with a personal computer with Internet access will be available. Secretarial support is provided.

HEALTH AND SAFETY The United Lincolnshire Hospitals NHS Trust recognises its duties under the Health and Safety at Work Act 1974 to ensure, as far as is reasonably practicable, the health, safety and welfare at work of all its employees. In addition the business of the Trust shall be conducted so as to ensure that all patients’, their relatives, contractors, voluntary workers, visitors and members of the public having access to the Trust premises and facilities are not exposed to risk to their health and safety. All Medical and Dental staff under contract to the United Lincolnshire Hospitals NHS Trust will be expected to comply with Trust Health and Safety policies.

MENTORSHIP Mentorship is available for newly-appointed consultants.

FURTHER INFORMATION Potential applicants are invited to contact the following key staff for further information:

Dr Richard Andrews Consultant Cardiologist, Lincolnshire Heart Centre Associate Medical Director ULHT Lincoln County Hospital Tel: (01522) 582565 [email protected]

Dr Vinod Venugopal Consultant Interventional Cardiologist and Clinical Lead Lincolnshire Heart Centre, Lincoln County Hospital Tel: (01522) 597873 [email protected]

Dr Andrew Houghton Consultant Cardiologist, Grantham and District Hospital Tel: (01522) 464791 Andrew,[email protected]

11 UNITED LINCOLNSHIRE HOSPITALS NHS TRUST PERSON SPECIFICATION POST: Consultant Cardiologist with an interest in Complex Devices

REQUIREMENTS ESSENTIAL DESIRABLE Qualifications/clinical On GMC Specialist MD or PhD skills Register for Cardiology, or within 6 months of CCT Possession of MRCP or equivalent Special Substantial experience of Additional subspecialty knowledge/abilities working in clinical interest in cardiac imaging and/or experience cardiology in a UK setting Experience in coronary Evidence of intervention at post CCT comprehensive Fellowship level experience in coronary intervention HRUK accreditation or equivalent Person skills/qualities Interest in teaching medical students, trainees and general practitioners Interests and motivation Enthusiasm and drive to to the job assist in the development and expansion of the existing cardiology service Academic Understanding of research Interest in research achievement/research methodology MD or PhD publication Other skills (e.g. audit/ Experience of clinical audit ALS provider teaching/management) Good communication skills Ability to teach Ability to work with a multi- disciplinary team Full Driving Licence Health Satisfactory Occupational Health Clearance

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