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Detailed job description and main responsibilities

The main department is currently based at Princess Royal Hospital. There are 8 enhanced cardiac care beds, 15 acute cardiac care beds on ward 6 and 14 stepdown beds with telemetry links on ward 7.  A cardiac catheter laboratory on site is used for diagnostic coronary angiography, simple and complex device implantation. This is supported by a cardiac day care unit with capacity for 8 ambulatory patients. The main cardiorespiratory department is located here and performs a comprehensive range of investigations. A dedicated room is used for TOE and temporary pacing.

 A pacemaker clinic is based at PRH and provides long term device follow up service. Designated cardiac CT lists runs at the Royal Shrewsbury and Princess Royal hospitals. Cardiac MRI is run from the Royal Shrewsbury Hospital.  A satellite cardiorespiratory department provides selected investigations for in- and out- patients at the Royal Shrewsbury hospital site. A weekly MDT is held with a local tertiary centre, to facilitate urgent cardiothoracic/cardiology care for in patients. We have established links with three local tertiary centres for elective procedures including cardiac surgery, congenital heart disease, electrophysiology and PCI.

Approximately 11,000 new out-patient Cardiology referrals were seen by a consultant within the Trust last year using “one-stop” clinics supported by either pre-investigation or on-demand tests. The trust provides circa 10,000 follow up appointments per year for cardiology follow ups. Allied health professional (nurses, pharmacist and Echo physiologist) provide cardiac rehabilitation clinics, heart failure ambulatory clinics, post infarct medical optimisation clinics and valve clinics. There is a Rapid Access Chest Pain Clinic meeting the two-week target at both Hospitals.

A multidisciplinary post-infarction clinic focuses on pharmacy, clinical biochemistry, rehabilitation and dietetics. This is run by specialist nurses and a pharmacist prescriber.  A further MDT team provides heart failure  service for optimisation and ambulatory monitoring. An arrhythmia nurse specialist runs our cardioversion service, implantable loop recorder service and arrhythmia clinic.  A senior physiologist runs a valve clinic independently. In addition, we have an expanding team of advanced cardiac nurse practitioners/prescribers, who support the in patient referrals and chest pain clinics. Outreach cardiology clinics are provided at Oswestry, Bridgnorth and Whitchurch Community Hospitals.

The same juniors that support the in-patient Cardiology Service also support the General Medical Take Rota and the care of all in-patients under the care of the Cardiology team.  All Cardiology Consultants have equal access to the juniors. You will be expected to supervise junior Doctors and to be actively involved in their postgraduate training and audit.

Currently the subspecialty is led by consultant cardiologists (2) and a consultant radiologist, who are accredited to British/European/American societies’ standards. Depending on his/her skills sets, the newly appointed colleague will join us in providing cross modality imaging in complex Echo, cardiac CT and MRI. This will be determined prior to commencement of employment.

Our Cardiorespiratory department is accredited by the British Society of Echocardiography (BSE). It is staffed by a team of committed and experienced Physiologists, the majority of whom have BSE accreditation. It operates as a single team with commitments shared across both Hospitals. It is comprehensively equipped with twelve echo machines (GE Vivid S70 and GE Vivid E95) supporting 3D echo, trans-oesophageal imaging, Dobutamine stress echocardiography and contrast echocardiography. Image archiving and reporting is performed via the Philips IntelliSpace Cardiovascular system which is also used by our Paediatric and Intensive Care colleagues. Our senior physiologists run a physiologist led valve clinic, supported by our imaging cardiologists. The newly appointed colleague will have opportunities in further service development (for example physiologist-led stress echocardiography) and providing mentorship to physiologists. The department is actively involved in teaching, and received STP students from HEE. There is a strong track record of innovation and research/quality improvement activities within the department. Our department runs a mandatory monthly MDT meeting to maintain standard and provide further education. Most of our STP students presented their final year dissertation at National and International conferences. Many chose to work with us upon completion of their training.

Working closely with our Radiology colleagues, we have an established Cardiac CT service. The Royal Shrewsbury Hospital has a 128-slice Siemens Definition AS+ CT scanner. The Princess Royal Hospital has a 320-slice Canon Aquilion One CT scanner. Currently there are two cardiac CT lists per week with plan to increase capacity when new colleagues in cardiac imaging and radiology join. We provide a service in CT calcium scoring and coronary angiography, gated thoracic aorta and TAVI pre procedure planning. There is a plan to adopt a novel technology, CT FFR, in line with cotemporary national guideline.

Our Cardiac MRI (Siemens Magneto Aera scanner) service is based at The Royal Shrewsbury hospital. We provide comprehensive imaging in cardiac MRI including viability assessment, stress perfusion and tissue characterisation. The new appointee will contribute to this and help maintain the thrice weekly sessions.

A formal job plan will be agreed between the successful candidate and their Clinical Director and consultant colleagues, on behalf of the Medical Director within 3 months of starting in post. A full-time job plan is based on a 10 PA working week. The job plan will be reviewed annually and is a prospective agreement that sets out the consultant's duties, responsibilities, and objectives for the coming year. It covers all aspects of a consultant’s professional practice including clinical work, teaching, research, education and managerial responsibilities. It will provide a clear schedule of commitments, both internal and external and will include personal objectives, detailing links to wider service improvements and trust strategic priorities.

For a full-time contract, the job plan will be divided on average per week (pro-rata for a part time post) as:

• 7.5 Programmed Activities (PAs) of Direct Clinical Care - includes clinical activity, clinically related activity and predictable and unpredictable emergency work.
• 2.5 Supporting Professional Activities (SPAs) - includes CPD, audit, teaching and research.

The allocation of PAs is reviewed and may be subject to adjustment when a further diary exercise is undertaken or if the service demands a review of the team job plan.