Job responsibilities
The appointee will be joining a team of ten full time in-house interventional cardiologists, and six joint appointees in intervention. This is a new post for an interventional consultant with an interest in TAVI/structural intervention. The TAVI/structural team currently consists of 5 interventional cardiologists, supported by imaging cardiologists, dedicated nurse specialists, cardiac and vascular surgeons. The programme is well established and undergoing expansion: last year we delivered 380 TAVIs with a plan for >450 this year, and the TEER programme was more recently established. There are twice weekly TF TAVI lists (8-10 cases per week) with ad hoc procedures as required, and a monthly surgical TAVI list, weekly MDT and a dedicated weekly TAVI clinic. We have nurse led follow up clinics and pre-admission clinics. Structural lists are monthly and encompass TEER, PFO, paravalvular leak, and VSDs as required. We run a successful TAVI training programme with our previous Fellows obtaining consultant posts in tertiary centres in the UK and abroad. The successful candidate would be expected to help maintain the wide-ranging interventional cardiology programme including an extensive primary PCI service.
There has been a major increase in the PCI service in recent years, an increase in complex intervention in an ageing population and a PPCI service delivering 800-1000 cases per year. There is an established ACHD programme, a large ASD/PFO closure practice; mitral balloon valvotomy, septal alcohol ablation for HCM and aortic and large vessel stenting. There are currently three interventional catheter labs each with biplane Phillips flat plate imaging, integrated virtual histology intravascular ultrasound, optical coherence tomography and pressure wire. The cath lab sessions are utilised flexibly with an annualised job plan.
The LHCH is one of the largest transradial PCI centres in the UK and has an innovative day case lounge model for elective patients. There is integrated working to provide the regional transfer service for ACS cases with excellent liaison between colleagues. Many ACS cases are performed as day cases. There is no formal spilt of beds for subspecialty cardiology. Junior staff are shared between consultant teams. There will be specific junior staff allocated at registrar level. Specialty registrars undergo modular training and the appointee would be involved in training and would have the opportunity to be an educational supervisor. Level 1 accreditation (E & D certificate and teaching course attendance) is required to be an educational supervisor. Participation in the undergraduate and junior doctor teaching programmes would be expected.
There is a Consultant of the Week structure, to which the new appointee will contribute, whereby all cardiology IP are reviewed daily. There is an MDT/heart team structure, involving several areas (revasc, high risk surgical, TAVI, mitral, structural, imaging) to which the appointee would be expected to contribute. New consultant appointments would have an appointed mentor and would receive clinical support from all senior colleagues. There are opportunities for joint lab working. We have a system of exclusive named consultant performance for the specialist procedures (eg ASD closure, HOCM ablation, complex CTO) and allocation to specific sub-specialisation interests is on the basis of interest and training, with departmental consensus.
The service is also supported by six interventional cardiologists jointly appointed with six partner hospitals in the region (Royal Liverpool and Broadgreen University Hospitals; University Hospital Aintree; Warrington District General Hospital; Countess of Chester Hospital, Wirral University Teaching Hospital and Whiston Hospital). All these colleagues have weekly lists and contribute to the regional ACS and PPCI services.
There is a significant commitment to research and audit and a training commitment to the SpRs in general training and those who wish to specialise. The LHCH is a national leader in PCI data handling and publishes named consultant outcomes on its website. There has been a major development of research facilities; this is spearheaded by the research alliance with the Brompton Hospital and Imperial College London as the university academic partner. The Institute of Cardiovascular Medicine and Science was launched in September 2011.
The attached job plan represents the proposed job plan for the post. The timetable is fairly flexible and can be adjusted to suit the needs of the appointee and any specific interests they may have.
On-call 1:13 for Primary PCI on call day in lieu after on call (Cat B 3%)
On call is 5pm-8am, Monday-Friday, and 8am-8am Saturday or Sunday. It is non-resident though the intensity is such that repeated return to site is likely. There is a commitment to weekend ACS lists as part of the on-call commitment, with predictable on site work 9am-5pm. Activity during on-call is recognised in the job plan and there are no clinical commitments following a night on call.
It is expected that secondary and tertiary referrals will predominately reflect the appointees special interest in intervention, but clinics are available through choose and book and general cardiology is referred. The trust accepts referrals though choose and book relevant to listed keywords appropriate to subspecialty interest.
Outpatient work will be either at LHCH (weekly) or in the community flexibly. Travel between sites would be included in DCC. This is in line with the trust policy of stakeholder engagement and it is anticipated all the consultants will spend clinical time in the KCCV clinics or DGH cardiology units for outpatient or MDT purposes. Clinic duties vary depending on the specialty but on average new patients are allotted 30mins, and follow up 15mins with a ratio of 4 new:8 f/u.
The successful candidate will have full secretarial support, a personal computer (training available if required) and office accommodation.
The successful candidate will undergo annual appraisal and job planning. The appointee will be expected to work flexibly on the basis of the needs of the cardiology directorate and the trust.
The Trust has the required arrangements in place, as laid down by the Royal College of
Physicians, to ensure that all doctors have an annual appraisal with a trained appraiser and
supports doctors going through the revalidation process.
The Trust supports the provision of a mentor for newly-appointed consultants
