JOB DESCRIPTION Consultant Cardiologist South West Acute Hospital, Enniskillen, Co Fermanagh (with sessions at Altnagelvin Hospital, Londonderry) July 2013 1 BACKGROUND The Western Health and Social Care Trust provides services to a 3,800 square miles area of outstanding beauty in the west of Northern Ireland. It delivers acute services across this region through two main acute hospitals (Altnagelvin Area Hospital in Londonderry, South West Acute Hospital in Enniskillen), supported by a non acute local hospital the Tyrone County Hospital in Omagh. Southern Sector The South West Acute Hospital (SWAH, opened in June 2012) now provides all the acute inpatient care for Fermanagh and South Tyrone. This incorporates accident and emergency, critical care, acute surgical, acute general medicine, cardiology, stroke, rehabilitation medicine and care of the elderly services. It is also the base for maternity and paediatric services across the Southern Sector. The radiology department offers comprehensive services including spiral CT and MRI scanning. The hospital has full 24 hour laboratory services. TCH now provides non-acute inpatient rehabilitation, ortho-geriatric care and stroke rehabilitation. There is an Urgent Care and Treatment Centre incorporating a cardiology assessment service, a Diabetes Day Resource Centre, and a full range of outpatient facilities. Support facilities include a full radiology department with multi-slice spiral CT scanning, a dedicated day procedure unit and a purpose built laboratory block. Non invasive diagnostic CT coronary angiography is performed at both the SWAH and TCH site, and cardiac magnetic resonance scanning is planned to start on the SWAH site. The SWAH, following full implementation of the TCH transition plan, anticipates receiving approximately 5,000 acute medical admissions per year. Northern Sector The Western Health and Social Care Trust “area” hospital Altnagelvin is situated in Derry/Londonderry and provides a full range of acute services. It is the largest district hospital in Northern Ireland and has the widest range of specialties outside Belfast City and Royal Group of Hospitals. There are approximately 450 beds on the site covering all the acute specialities including Trauma and Orthopaedics, Maxillo-Facial surgery and Ophthalmology in addition to the usual DGH specialities. It is designated as a Cancer Unit linked to the Cancer Centre at Belfast and construction work is about to start on a satellite radiotherapy unit, serving the population of both the western part of Northern Ireland and also Donegal. Altnagelvin Hospital has undergone extensive recent refurbishment. There are new Outpatients Department, X-Ray Department, Intensive Care Unit, High Dependency Unit, Theatre complex and purpose built Day Surgery Unit. The main hospital has undergone an extensive redevelopment which includes a new coronary care unit and cardiac step down beds. A new purpose built rehabilitation unit for the Young Chronic Sick patients opened on the hospital site in April 2004. CONSCARD. 2 The Pathology Laboratory offers a fully comprehensive service with each of the major disciplines staffed by experienced Consultants supported by skilled technical staff. There is an established and developing on site Chemotherapy Unit. There is an established team of Consultant Radiologists with expertise and facilities for the full range of diagnostic and therapeutic procedures. In addition to Conventional Radiography, Bone Density Scanning, Venometry, Fluoroscopy, Computed Tomography (64 slice currently being installed), Nuclear Medicine, Ultrasound including Doppler, Digital Angiography Interventional Radiology, percutaneous coronary intervention and an MRI scanner are also provided. The Radiology Department offers a wide range of conventional and interventional radiology, which is increasing rapidly. There is a dedicated Breast Screening Department, which also provides facilities for a rapid access one-stop breast clinic. STUDY AND TRAINING Both hospitals have Post-graduate Medical Education Centres attached to the hospital with comprehensive information services to support clinical practice, teaching, learning and research. Full participation in CME activities is encouraged, with study leave being granted whenever possible. Library Facilities: The MDEC Library at AAH is part of the N.I. Health and Social Services Library system and provides services to Altnagelvin, Erne and Tyrone county Hospitals and to Western Health & Social Services Board as well as to anyone eligible to use the Queen’s University Library. It is located in the Multidisciplinary Education Centre on the Altnagelvin Area Hospital site. Both Altnagelvin and the Erne support education for a range of medical students and other disciplines including practical skills training. The SWAH has established links to the Royal Colleges of Physicians (UK) and the Royal College of Physicians of Ireland providing live, interactive video linked CPD approved training. There are also well established “image links” to neuroradiology/neurosurgery at the Regional Unit in Belfast and all three hospitals support active involvement in cancer care networks through use of videoconferencing links. CARDIOLOGY SERVICES Planned developments “Programme for Government” published in 2012 by the Northern Ireland Executive indicates a plan “to expand cardiac catheterization capacity to improve access to diagnostic intervention and treatment and further develop a new primary percutaneous coronary intervention (PPCI) service model to reduce mortality and morbidity arising from myocardial infarction”. To allow delivery of this service on a province-wide basis, the Northern Ireland Health and Social Care Board (HSCB) have commissioned the development of a PPCI service on the Altnagelvin Hospital site, thereby allowing patients with CONSCARD. 3 ST elevation myocardial infarction to be treated according to NI Regional Cardiology Network standards, and in keeping with best practice clinical guidelines. The successful applicant will use the South West Acute Hospital as their main base, but will participate in the Altnagelvin interventional rota; there will be no on call commitment in the South West Acute Hospital. Southern Sector At present the cardiology service in the SWAH is provided by two consultants (Prof Mahendra Varma and Dr Andrew Hamilton) and a Staff Grade in Cardiovascular Medicine (Dr Brian Mc Aleer) supported by coronary care specialist nurses. The unit has a progressive outlook in service provision, teaching and training and was at the forefront of development of pre-hospital thrombolysis and preventive cardiology programmes. The SWAH also provides rapid access cardiology services by Dr. Shanker Singeravelu, medical staff grade. Outpatient cardiology services are supported by heart failure specialist nurses, secondary prevention nurses and a cardiac rehabilitation programme has been developed. There is a full non-Invasive cardiology investigation services on both the SWAH and TCH sites incorporating ECG, Transthoracic and Transoesophageal Echo, a range of Ambulatory Monitoring, Exercise Stress Testing, and Tilt Table Testing and cardiac CT scanning. MRI scanning with cardiac software is available in SWAH and a service is currently being developed to allow service provision throughout the Trust and for patients from other Trusts. This is in keeping with the plan that the Trustwide network of cardiac services already established between Altnagelvin, Tyrone County and the South West Acute Hospitals will be further developed, and candidates with interests complementary to the current staff will be encouraged to develop the service. The new appointee will work as part of this network and non-invasive and interventional skills will be supported through appropriate sessions, The Western Trust plans further development of pacemaker implantation, in addition to the full PCI services at Altnagelvin; these developments are in keeping with the strategic vision of the Trust and the NI cardiology network. Cardiology is part of the Acute Services Directorate. A lead clinician, Dr. A. Mc Neill, provides clinical and managerial leadership and is responsible to the Acute Services Director. Northern Sector The cardiology department at Altnagelvin Hospital provides a full range of acute and ambulatory cardiology services. Currently diagnostic angiography and inpatient PCI for Altnagelvin patients is delivered at this site and plans to develop a Trustwide PCI service are well advanced. Nuclear Medical imaging, CONSCARD. 4 echocardiography, cardiac CT and MRI are available at Altnagelvin. There is a rapid access chest pain clinic, and nurse specialists in secondary prevention, rehabilitation, and heart failure. Consultant Cardiology Team at Altnagelvin Dr A McNeill (Clinical lead) Dr J Purvis Dr P McGlinchey Dr Sinead Hughes Dr Michael Moore Dr Adesh Ramsewak Dr Aaron Peace Associate specialist Dr Stephen Barr Dr. Mc Glinchey and Dr. Hughes provide outreach support to a nurse led cardiac assessment unit at the Tyrone County Hospital. CONSCARD. 5 2 JOB TITLE Consultant Cardiologist 3 4 JOB PURPOSE • To provide a specialist Cardiology services as part of the cardiology network of the Western Health and Social Care Trust, working principally at the South West Acute Hospital, Enniskillen • To share in the provision of interventional cardiology services including both primary percutaneous coronary intervention (PPCI) for patients with ST elevation, and also elective/urgent coronary intervention by participation in the emergency coronary intervention rota in Altnagelvin hospital, Londonderry. • To provide investigative procedures relating to the speciality and develop same in keeping with medical advances. • To promote and develop multidisciplinary teamwork within the speciality. • To further develop the current networks (both within the Trust and within NI) to best serve the interests of cardiology patients from the Trust and in keeping with the strategic vision of the Trust and the NI cardiology network. JOB ROLE To provide specialist cardiology services as part of the provision of acute medical services within the Medical Division, Acute Services Directorate, Western Health and Social Care Trust and to contribute to the development of excellence in clinical practice through research, audit and participation in clinical and social care governance. 5 JOB LOCATION The post holder will be based at the South West Acute Hospital, Enniskillen with one/two day(s) per week spent in Altnagelvin Hospital, Londonderrry performing invasive and interventional cardiological procedures. He/she will participate in the emergency interventional cardiology on call rota in Altnagelvin; there will be no on call duties in SWAH. The postholder will be facilitated in maintaining specialist skills, including working as part of a team of interventional and non-interventional cardiologists with opportunities for audit, teaching, research and multidisciplinary meetings to promote best practice; it is anticipated these supporting activities will occur in both sites, and the Job Plan will be flexibly arranged to allow adequate supporting activities and travel time. CONSCARD. 6 6 KEY CLINICAL TASKS: - 6.1 The post holder shall further develop the cardiology service, particularly in the area of percutaneous coronary intervention, working with the multidisciplinary team including medical technical and nursing staff within the hospital and across the Trust. 6.2 The post holder will have clinical responsibility and accountability for the continuous care of his/her patients in SWAH. 6.3 The post holder will work as an integral part of the Trust cardiology network. 6.4 The post holder must ensure appropriate standards of care for patients and appropriate standards of education and training for medical staff in training. 7 KEY ORGANISATIONAL RELATIONSHIPS The post will be based in Western Health and Social Care Trust and, in delivering services, the post holder shall: • Provide advice to the Trust Chief Executive, Medical Director and Director of Acute Services via the Clinical Director, Emergency Care and Medicine Division on all aspects of cardiology services. • Be responsible to the Director of Acute Services. • Report to Clinical Director of Emergency Care and Medicine Division through the Cardiology Lead Clinician. • Be accountable to the Medical Director for the maintenance of personal and professional standards. • Undergo appraisal on an annual basis by the Clinical Director of Medicine. • Establish a clear work plan for medical staff in training and provide clinical supervision. • Participate in teaching and development of undergraduate medical students and postgraduate medical staff. • Participate when required in committees or consumer forums. • Be a member of the Medical Division Committee. • Ensure that equality and human rights issues are addressed within his or her area of responsibility, in accordance with Trust’s Equality Scheme. CONSCARD. 7 7.0 RESPONSIBILITIES 7.1 QUALITY • The post holder will continue to develop protocols for the establishment and monitoring of standards of care and reviewing effectiveness of practice in the light of available evidence and recommended guidelines. • The post holder in conjunction with the medical consultant team will assist with the development and implementation of systems under Clinical and Social Care Governance that ensure the quality of general medical care offered by Western Health and Social Care Trust. • The medical consultant team will participate in medical and clinical audit activities and apply the results to improve the service. A yearly programme identifying priorities for audit will be agreed. 7.2 EDUCATION AND RESEARCH • The post holder will participate in teaching, appraisal and development of undergraduate medical students, Foundation house officers and other postgraduate medical staff. • Any research undertaken by the post holder will be conducted in accordance with available resources and guidelines laid down by the Trust Research Ethics Committee. 7.3 MANAGERIAL • The post-holder will be a member of the Medical Division of Acute Services Directorate. (S)he will be expected to work effectively with consultant colleagues, the Lead Clinician, Assistant Director, Clinical Director, Divisional Managers, senior nursing staff and others in the formulation and updating of policy guidelines and initiatives to develop and enhance services within the Trust. The post-holder will be expected to undertake administrative duties associated with patient care and to ensure arrangements are in place to meet quality standards for appointments and discharge procedures etc. within contracts. CONSCARD. 8 Medical Division, Western Health and Social Care Trust (Southern Sector Medical Team) Consultant Physicians Areas of Special Interest SWAH Prof . MPS Varma Cardiology/ Diabetes/General Medicine Dr Andrew Hamilton Consultant Cardiologist Dr JF Kelly Geriatric Medicine/Stroke Medicine Dr. B. Keegan Acute Medicine / Stroke Medicine Dr. T. Mc Manus Respiratory Medicine / General Medicine Dr. A. Helmey Endocrine / General Medicine Dr M Geoghan Endocrine / General Medicine Dr. E. Campbell Gastroenterology/General Medicine Dr S Sreenivasan Acute Medicine Dr. K. Amir Locum Geriatric Medicine Dr B McAleer Staff Grade Physician Dr. Shanker Singeravelu Staff Grade Physician VacantPost Staff Grade Physician 10 F1 grade doctors, 12 F2/CMT/ST doctors TYRONE COUNTY HOSPITAL 7 Dr S Khwaja Locum Geriatric Medicine Dr F Robinson Palliative Care Medicine Dr I Kadir Locum Specialty Doctor Dr K Mann Specialty Doctor Dr T Novak Specialty Doctor ACCOMODATION The appointee will have office accommodation fully equipped with CONSCARD. 9 e-mail/internet enabled PC provided on the SWAH site access to supporting clerical staff and IT facilities to allow performance of clinical duties in Altnagelvin. Secretarial support will be provided to the post-holder by the Medical Specialty Team. (Approximately 0.5 WTE per consultant) The systems used to support administration and information are largely computerised and all clerical support staff are trained in diagnostic coding, audio typing and all other office automation and clerical tasks. 8 QUALIFICATIONS Candidates must be eligible for inclusion on the UK General Medical Council Specialist Register in cardiology, or for candidates in training or working outside the UK, be within six months of eligibility by the interview date. He/she must fulfil British Cardiovascular Interventional Society (BCIS) criteria as an independent operator for percutaneous coronary intervention by the time of taking up post. 9 TERMS AND CONDITIONS NHS Terms and Conditions of Service for Hospital Staff will apply. Contributions will be payable under the Health and Social Service Superannuation Scheme. There is reciprocity between the Northern Ireland scheme and that in operation in Britain.Remuneration will be governed by the New Contract Framework for Northern Ireland. ANNUAL LEAVE Annual leave will be six weeks and 3 days per annum plus statutory and public holidays. START DATE Appointment to the post will be as soon as possible, subject to the period of notice required by the successful candidate. RESIDENCE The post holder must live within an agreed acceptable travelling distance of the "On Call" Hospital and must maintain contact through the public telephone service. REGISTRATION AND DEFENCE Registration with the GMC must be maintained. License to practice arrangements and the proposed revalidation procedures for 2010 must be complied with. The Trust bears responsibility for claims of Dental/Medical negligence against practitioners occurring in the course of their Health Service employment. Practitioners are advised to maintain their defence body membership in order to ensure that they are covered for any work that does not fall within the scope of the indemnity scheme. PRIVATE PRACTICE Participation in private practice will be governed by the terms of the post holder individual contract. MEDICAL EXAMINATION CONSCARD. 10 Any offer of appointment will be subject to the completion of a satisfactory general health assessment. This will be arranged by the Trust through its Occupational Health department. 10 LOCALITY PROFILE Local Council and Northern Ireland Tourist Board publicity brochures are enclosed with application forms, and these give a detailed description of the locality. There are outstanding educational facilities at primary and secondary school levels. There is also ample provision of modern leisure facilities, ready access to some of the finest countryside in Western Europe and unparalleled value in housing and education. Derry/Londonderry is the UK City of Culture 2013. 11 SUPPLEMENTARY Canvassing will disqualify. Any approach to a member of the Trust Board by or at the request of the candidate for the purpose of obtaining support for his/her application will be treated as canvassing. Supplementary Information for Job Descriptions 1. Providing a Quality Service Western H&SS Trust is committed to providing a Quality Service for its patients. Every employee has a responsibility to support the Trust in this aim by: Adhering to policies, procedures and standards adopted by the Trust. Supporting and contributing to Trust quality initiatives Evaluating personal practice. At all times upholding high standards of courtesy, respect and care towards patients and colleagues. The Trust wishes to encourage staff to air clinical or other concerns in a responsible manner and at the earliest opportunity and employees attention is drawn to the Clinical Incident Reporting Policy and the Whistleblowing Policy. 2. Working with Children and Vulnerable Adults The Trust is committed to carefully screening all staff and volunteers who work in a regulated position and have substantial, unsupervised access to children and vulnerable adults in accordance with the “Protection of Children and Vulnerable Adults (NI) Order (2003). 3. Confidentiality Clause All information concerning patients and staff must be held in the strictest confidence and may not be divulged to any unauthorised person. A breach of confidentiality will result in disciplinary action being taken in accordance with the Trust’s disciplinary procedure and may lead to dismissal. 4. Data Protection Computer data should only be accessed if this has been authorised and is necessary as part of your work. Unauthorised access to computer data or helping others to access such data will result in disciplinary action being taken in accordance with the Trust’s disciplinary procedure and may lead to dismissal. CONSCARD. 11 5. Health and Safety The post holder has personal responsibility for safety as outlined in the Trust’s Health and Safety Policy and the Health and Safety at Work NI Order 1978. 6. Smoking, Alcohol and Nutrition The Trust operates a policy on smoking, alcohol and nutrition and staff are requested to participate with the implementation of these policies. 7. Job Description Review The duties of the post may be reviewed and, if appropriate, changed by discussion with the post holder to ensure the provision of effective and efficient services. 8. Standing Financial Instructions All staff must comply with the Standing Financial Instructions of the Trust. 9. Equality & Human Rights In accordance with Altnagelvin Hospitals H&SS Trust’s Equality Scheme, to ensure that equality and human rights are addressed with the post holder’s area of responsibility. Candidates selected for interview are encouraged to visit the Hospital by request to HR Dept – Employee Resourcing at Tyrone and Fermanagh Hospital, Omagh, County Tyrone, BT79 0NS, Telephone: 028-82-835331 who make the necessary arrangements in conjunction with the Trust Chief Executive. Further information may be obtained from Professor. MPS Varma, Consultant Cardiologist, Erne Hospital (02866382000 ext 2341 or Dr. Albert Mc Neill, Clinical Lead Cardiology, Medical Directorate Tel 028 71345171 from NI and (048) 71345171 from ROI Ext 3356. The duties and responsibilities outlined in the above job description are not intended to be definitive nor restrictive, and may be amended to meet the changing needs of the Trust. The Western Health and Social Care Trust is committed to providing the highest possible quality of service to patients, clients and community. Members of staff are expected, at all times, to provide a caring service and to treat those with whom they come into contact in a courteous and respectful manner. Western Health & Social Care Trust is committed to the development and implementation of systems under Clinical and Social Care Governance to ensure continuous improvement in the quality of services provided. The post-holder will be expected to co-operate and work with such systems. The postholder is required to ensure that equality and human rights issues are addressed within the postholder’s area of responsibility in accordance with Western Health & Social Care Trust’s Equality Scheme. Records Management: All employees of the Trust are legally responsible for all records held, created or used as part of their business within the Trust including patient/client, corporate and administrative records whether paper-based or CONSCARD. 12 electronic and also including emails. All such records are public records and are accessible to the general public, with limited exceptions, under the Freedom of Information Act 2000, the Environmental Information Regulations 2004 and the Data Protection Act 1998. Employees are required to be conversant with the Trust’s policy and procedures on records management and to seek advice if in doubt. You should note that under Health & Safety at Work Legislation you are required to take all reasonable steps while at work to ensure your own health and safety and the health and safety of those who may be affected by your acts or omissions at work. You should also be aware that we operate a No Smoking and No Alcohol Policy within the Trust. The Trust is an equal opportunities employer. Applications must be made on the prescribed form and must be returned to: Medical HR Department Tyrone and Fermanagh Hospital Omagh County Tyrone BT79 0NS CONSCARD. 13 JOB PLAN The job plan is not meant to be restrictive and will be subject to review in the context of annual appraisal and will be subject to modification by mutual consent of the postholder, the lead clinician for cardiology and the clinical director to fulfil the needs of the job and to fit with the job plans of the other consultant staff. In summary the 10 programmed activities will be distributed as follows: Consultant cardiologist: South West Acute Hospital with sessions at Altnagelvin Hospital Cardiac catheterisation/PCI 3 sessions in Altnagelvin Administration (incl heart team meeting) 2 sessions (0.5 per cath lab session + further 0.5) On call 1 (Alt pPCI rota) Ward round 1.0 Outpatients 0.5 Travel 1 Supporting PAs 1.5 Total 10 PAs Indicative timetable Monday Tuesday Wednesday Thursday Friday Am 0.5 Ward Round 0.5 SPA Cath/PCI Heart team/ Pt admin 0.5 Ward Round 0.5clinic 1SPA Pm Cath/PCI Cath/PCI Pt admin Oncall (Altnagelvin Primary PCI rota) 1 in 6. This will include predictable on call for a weekend coronary care and cardiology pick up round 1 weekend (Saturday and Sunday) , 1 in 30. There will be no on call commitment in SWAH and no general medical commitment. The Western Trust has had an innovative approach to supporting consultants newly appointed and early in career and has provided development programmes CONSCARD. 14 which it would hope to offer into the future. The Trust has arrangements in place to offer mentoring to new appointees. PERSONNEL SPECIFICATION POST DEPARTMENT: LOCATION DATE Consultant in Cardiologist Emergency Care and Medicine Directorate SouthWest Acute Hospital/Altnagelvin Hospital July 2013 Each statement contained in the Personnel Specification must be justifiable by evidence obtainable from an analysis of the job. The specification should describe the person who is capable of doing the job adequately. Factors shown below are examples and may not be relevant for all posts. If so they should be marked “Not Applicable”. Blank boxes are available to note additional factors. Please note, however, that the completion of the qualifications and/or experience section is compulsory. See paragraph 7.5.5 for examples. CONSCARD. 15 FACTORS QUALIFICATIONS AND/OR EXPERIENCE (Length and Type) ESSENTIAL % DESIRABLE % Higher Qualifications Eg. MD, PhD Be on or be eligible to have their name included on the GMC Specialist Register for cardiology OR. Doctors in Training or working outside UK must be within 6 months of completion of CCT at date of interview. Fulfil BCIS criteria as an independent operator for percutaneous coronary intervention by date of taking up post Research Publications/ Presentations . TOTAL FACTORS PROFESSIONAL OR CLINICAL/ DEPARTMENT KNOWLEDGE ESSENTIAL Ability to demonstrate up to date knowledge and skills in all aspects adult clinical cardiology % DESIRABLE % Ability to demonstrate knowledge and skills which are complementary to the current consultant staff Ability to provide on call cover for acute cardiac care on a rota basis TOTAL CONSCARD. 16 Clinical Governance. Revalidation/Appraisal. COMPETENCES Audit Teaching Good Communication / Interpersonal Skills. Teamwork/Leadership Innovation TOTAL SPECIAL CIRCUMSTANCES TOTAL TOTAL CONSCARD. 17
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