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THE LEEDS TEACHING HOSPITALS NHS TRUST
DEPARTMENT OF CARDIOLOGY
JOB DESCRIPTION
CONSULTANT INTERVENTIONAL CARDIOLOGIST WITH A SPECIALIST INTEREST IN
PERCUTANEOUS CORONARY INTERVENTION (PCI)
1. BACKGROUND
Leeds Teaching Hospitals is one the largest teaching hospital trusts in Europe, with access to leading clinical expertise and medical technology. We care for people from all over the country as well as the 780,000 residents of Leeds itself. The Trust has a budget of £1.1 billion. Our 20, staff ensure that every year we see and treat over 1,500,000 people in our 2,000 beds or out-patient settings, comprising 100,000 day cases, 125,000 in-patients, 260,000 A&E visits and 1,050,000 out- patient appointments. We operate from 7 hospitals on 5 sites – all linked by the same vision, philosophy and culture to be the best for specialist and integrated care.
Our vision is based on The Leeds Way, which is a clear statement of who we are and what we believe, founded on values of working that were put forward by our own staff. Our values are to be:
Patient-centred Fair Collaborative Accountable Empowered
We believe that by being true to these values, we will consistently achieve and continuously improve our results in relation to our goals, which are to be:
- The best for patient safety, quality and experience
- The best place to work
- A centre of excellence for specialist services, education, research and innovation
- Hospitals that offer seamless, integrated care
- Financially sustainable
Leeds Teaching Hospitals NHS Trust is part of the West Yorkshire Association of Acute Trusts (WYAAT), a collaborative of the NHS hospital trusts from across West Yorkshire and Harrogate working together to provide the best possible care for our patients.
By bringing together the wide range of skills and expertise across West Yorkshire and Harrogate we are working differently, innovating and driving forward change to deliver the highest quality care. By working for Leeds Teaching Hospitals NHS Trust this is your opportunity to be a part of that change.
WYAAT is the acute sector arm of the West Yorkshire and Harrogate Health and Care Partnership, one of the largest integrated care systems in the country. The Partnership’s ambition is for everyone to have the best possible health and wellbeing, and the work of WYAAT, and each individual trust, supports that ambition.
In relation to this post, Leeds Teaching Hospitals is appointing one interventional cardiology consultant post with a specialist interest in coronary intervention. This is a new post.
The appointee will be based at the Yorkshire Heart Centre (on the Leeds General Infirmary site). The appointee will be on the on-call rota for coronary intervention including primary PCI, and will be responsible for assessment and management of in-patients with acute coronary syndromes in the cardiology unit at Leeds General Infirmary
The appointee will contribute to the delivery and development of complex coronary intervention in Leeds and will be expected to provide leadership in the coronary intervention clinical research department, and to enhance the reputation of the centre nationally and internationally.
The appointee will participate in the existing out-of-hours coronary intervention rota. In addition to PPCI, out-of-hours on-call activity will expand to include non-STEMI patients. In-hours there will be the requirement to participate in the rota for acute intervention. The appointee will join a team of 8 interventional cardiologists responsible for the assessment and management of ACS patients on the wards. There is a separate consultant on call rota for general cardiology.
There are currently 31 consultant cardiologists working part or full-time in Leeds. All consultants are based at the Yorkshire Heart Centre on the Leeds General Infirmary site. There are currently 9 consultants (7 NHS, 2 University) delivering the interventional and adult structural programme at Leeds. The planned post is in addition and complementary to the existing coronary interventional team.
There are seven full time cath labs at the Yorkshire Heart Centre (YHC), currently under high spec refurbishment. There is a progressive move to 7 day working. The Yorkshire Heart Centre provides a PPCI service to Leeds and West Yorkshire currently delivering PPCI 1100 procedures annually led by Dr Jonathan Blaxill. The YHC is the regional lead for TAVI and delivers 250-300 procedures annually. The YHC as a single centre delivers the highest number of PPCI and TAVI procedures nationally. There is a strong research base within interventional cardiology with a desire to further enhance this profile.
There are active Teaching and Research links with the Leeds School of Medicine and the University of Leeds, both well situated on adjacent sites.
2. OBJECTIVES OF THE POST
The main objective is to contribute to the delivery of the coronary intervention service and expansion of the existing clinical coronary intervention research programme. Applicants with a specific interest in complex coronary intervention will be encouraged.
3. REQUIREMENTS OF THE POST
3.1 Service Delivery
General
The Trust expects consultants to deliver clinical service as agreed with commissioners and other stakeholders. This will include:
meeting the objectives of the post (see above) continuously improving the quality and efficiency of personal and team practice working with other staff and teams to ensure that the various criteria for service delivery are met, such as o achieving the best clinical outcomes within the resources available o waiting times o infection control standards
Consultants in LTHT are line managed by their specialty Lead Clinician working in conjunction with a Business Manager. This specialty team is then managed alongside a number of other specialties in a Clinical Service (or Support) Unit (CSU) led by a Clinical Director as the responsible person and supported by a full time General Manager and a full time Head of Nursing.
The Clinical Director and their team report operationally to the Chief Operating Officer (COO). The Clinical Director will work closely with the Chief Operating Officer’s team which includes two
Outpatient Services at the Yorkshire Heart Centre
Cardiology Outpatients are currently held at Leeds General Infirmary, St James’s University Hospital, Seacroft Hospital and Wharfedale Hospital. The appointees will undertake out-patient clinics focussed on rapid access chest pain referrals and specialist management of ACS and coronary intervention patients. We anticipate the development of new ways of working in relation to both the inpatient and outpatient services and this post will be actively involved in helping to shape these.
On call arrangements
The appointee will join the existing out-of-hours coronary intervention rota, which will involve 1 weekday night on-call every 5 weeks and 1 weekend on-call every 10 weeks. Weekends will consist of 24 hours Friday and Sunday, and will include NSTEMI and PPCI in an 8am to 5pm shift, followed by non-resident on-call for PPCI 5pm to 8am. The emergency PCI service between 8am Saturday and 8am Sunday is currently provided by a separate rota of interventional cardiologists based outside Leeds. There is appropriate time off after weekend and overnight working.
The appointees will join the existing weekday acute PCI rota Monday-Thursday 8am to 6pm (two weeks in seventeen).
The appointee will join with colleagues in delivering a Monday-Friday in-hours acute coronary service, assessing and managing acute coronary syndrome and coronary intervention patients on CCU and the Cardiology ward, supported by the General Cardiology consultant on-call. This is likely to be one week in seven.
There is a separate consultant on call rota for General Cardiology. The posts have no on call commitment for Acute Medicine.
3.2 Quality
The Trust has a programme of activities that are designed to help consultants improve the quality of the service they offer. This includes a range of activities shown below as examples – not all activities can be undertaken every year! Consultants are expected to routinely engage in relevant activities in their specialty that are focussed on quality improvement. This participation should be reflected at annual appraisal and job planning and will be discussed in specialties as part of clinical governance programmes and meetings.
Clinical Audit and standard setting Clinical audit projects Development and application of agreed clinical guidelines Ensuring compliance against relevant national specifications, e.g. NICE guidelines External Peer review and relevant national audits Implement improvements identified in GIRFT reviews
Clinical outcome review Mortality and morbidity reviews Structured Judgement Reviews Monitoring of outcomes reflected in routinely collected data Participation in clinical coding review and improvement
Improving patient safety Participation in Trust-wide programmes, including mandatory learning Respond to national patient safety alerts Implementation of local improvements, including actions from serious incident investigation reports, following clinical review Promptly record patient safety incidents on Datix and immediately escalate potential serious incidents to the CSU management team
Ensure Duty of Candour requirements are met
Improving service effectiveness and efficiency Service or system improvement projects, including small scale change, lean or other recognised improvement methods Conducting or considering reviews of the evidence to plan better service delivery Where agreed, working with commissioners to match service delivery with requirements of relevant populations
Improving the patient experience Implementing service improvements based on individual or service feedback from patients or carers Raising the profile and impact of patient participation in decisions about their own care Involvement in understanding and improving the ethical basis of care provided, utilising where necessary the trust’s clinical ethics committee Respond to complaints in a timely and open manner and ensure lessons are learned for future patient care
3.3 Research
The Trust’s Research Strategy encourages all clinicians to participate in high quality, nationally- recognised clinical research trials and other well-designed studies, with a particular emphasis on work supported by the National Institute for Health Research. The Trust has a number of major programmes in experimental medicine and applied health research, developed in partnership with the University of Leeds, which reflect particular strengths described in the Strategy and clinicians are encouraged to participate in these programmes.
The Trust also supports bespoke academic development and participation programmes linked to the Research Strategy, including academic mentoring and embedding of clinicians within the major research programmes.
The interventional cardiology service has a strong research group led by Professor John Greenwood, Dr Blackman and Professor Stephen Wheatcroft supported by 4.5 WTE research nurses. The successful applicant will be encouraged to lead on the coronary intervention clinical research programme and a higher degree is essential.
Sessional time required for any participation in research activity will be agreed on commencement and kept under review, but not all consultants will require such sessional time.
3.4 Teaching
The Trust is a Teaching Hospital and therefore considers the active participation of consultant and other medical staff in teaching and training to be part of our core activities. Not all consultants will have regular and substantial teaching commitments, but all will be involved in related activities from time to time, if only through informal opportunities, for example as part of service quality improvement (see above). It is therefore expected that all consultants will be familiar with the principles of effective teaching and will enable the service and colleagues to fulfil their obligations to learn and teach about effective care.
The remainder of this section concentrates on teaching and training for medical colleagues, but the Trust actively supports and encourages consultant medical staff to participate in and deliver teaching and training to any colleagues, within and outside of the Trust, where this is agreed as an appropriate time commitment.
Undergraduate medical teaching
The Trust actively promotes links with the University of Leeds, School of Medicine for teaching medical undergraduates and all consultant medical staff are required to participate to the level
teaching
The Trust supports these activities as part of the normal job plan commitments of any consultant.
On appointment, all consultants will be encouraged to participate in the activities established by the Trust to support doctors in their new role, such as the New Consultants’ Network and a formal mentoring programme (see below).
4. STANDARDS OF CONDUCT AND BEHAVIOUR
All consultants are required to work to the standards set out by the General Medical Council in Good Medical Practice. This includes protecting patients when you believe that a doctor’s or other colleague’s conduct, performance or health is a threat to them. If, after establishing the facts, it is necessary, you must follow the Trust’s procedures in this matter and inform your Clinical Director in the first instance.
5. JOB PLAN AND WORKING ARRANGEMENTS
The job plan review will take place annually, normally with the Lead Clinician / Clinical Director. Any job plan review may result in a revised prospective job plan where duties, responsibilities, accountability arrangements or objectives have changed or need to change significantly within the area.
5.1 Proposed Job Plan
DCC acute and on-call activity summary
Duty Responsibilities Hours of work Expected frequency
No. of days or weeks per annum
PA allocation / week (corrected for 42 working weeks / annum)
Interventional ward team
CCU ward round
Cardiology Ward round
RACPC OP clinic
8 - 9am M-F
9 - 12:30 M-F and 5 - 6pm M-F
1.30 - 5pm M-Th
1 week in 7 7.4 weeks 2.
Interventionist of the week
Cath lab activity (PCI and PPCI)
8am - 6pm (includes 30 minute lunch break) M - Th
2 weeks in 19 (1 in 9.5)
5.5 weeks 1.
PPCI on-call rota
Cath lab activity (PCI and PCI)
8am-6pm Friday plus on call 6pm - 8am
8am-5pm Sunday plus on-call 5pm-8am
6pm-8am on midweek nights
1 in 10
1 in 10
1 every 5 weeks
5.2 Fridays
5.2 Sundays
10.4 nights
Total 5.
DCC elective activity summary
Direct Clinical Care Expected number of sessions to be delivered per annum
PA allocation / week (corrected for 42 working weeks / annum)
Cardiac catheter lab activity: (8am - 6pm to include admin) a. Diagnostic angiogram b. Routine elective PCI c. Complex PCI
25 all day (8am - 6:30pm) PCI / angio sessions (includes 30 minutes for lunch)
Outpatient clinics: a. Ischaemic Heart Disease b. RACPC
OP Clinic n = 21
MDTs: PCI MDT (Tu 8-9)
Revascularisation MDT (Th 8-9)
DCC admin: Letters, angio review etc. 1.
Total 3.
5.7 Infection Control All consultants must always comply with the Leeds Teaching Hospitals NHS Trust Infection Control policies, by practising Universal Infection Control Precautions. Hand hygiene must be performed before and after contact with patients and their environment.
5.8 Secretarial Support As part of the resource commitments to enable the postholder to fulfil their job plan, the appointee will have access to such secretarial assistance as is required.
5.9 Health & Safety The Trust has a responsibility to provide a safe working environment for all staff. As an employee/supervisor/manager you are responsible for your own safety and that of others. This will require you to comply with the Trust arrangements for Health & Safety and Risk Management, by following agreed safe working procedures, and reporting incidents using the Trust Incident Reporting system. As a supervisor/manager, you will be responsible for ensuring your teamwork in a safe manner and are competent to do so.
5.10 Equality & Diversity The jobholder must comply with all policies and procedures designed to ensure equality of employment and that services are delivered in ways that meet the individual needs of patients and their families. No person whether they are staff, patient or visitor should receive less favourable treatment because of their gender, ethnic origin, age, disability, sexual orientation, religion etc.
The Trust's Equality and Diversity Policy ensures that barriers to employment for disadvantaged groups are identified and removed, and that no person is treated less favourably on the grounds of their race, ethnic group, religion, impairment, age, gender, sexual orientation, or mental health status. Reasonable adjustments will be made for disabled applicants and post holders where required.
5.11 Smoking Policy The Leeds Teaching Hospitals NHS Trust recognises the serious hazards to health caused by smoking and has adopted a strict no smoking policy. Under the terms of our policy, staff, visitors, and patients will not be permitted to smoke at any time or in any part of Trust property, whether inside or outside the hospital buildings.
5.12 Rehabilitation of Offenders Act & DBS Check This post involves access to patients during the normal course of duties and is therefore subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975. As such you must reveal any information which you may have concerning convictions which would otherwise be considered as ‘spent.’
An offer of appointment to this post would be subject to the express condition that the Leeds Teaching Hospitals Trust receives a Disclosure and Barring Services (DBS) Disclosure which will check the existence and the content of any criminal disclosure received. The Trust has the right to withdraw an offer or employment if not satisfied of a candidate's suitability for this position by reason of criminal record or antecedents, especially in cases where no declaration of criminal proceedings has been made on a candidate’s application form or Criminal Declaration Form. The Trust reserves the right to determine this issue at its sole discretion. If you are successful in being short listed for this position you will be asked to complete a criminal disclosure form to be handed to a representative at interview. Furthermore, if appointed to this post you will be asked to complete a 'DBS Disclosure Application Form' which will be submitted to the DBS.
Leeds Teaching Hospitals NHS Trust has a Policy Statement on the Recruitment of Ex-offenders which is available on request.
5.13 Respect for Patient Confidentiality As set out in GMC guidance ( Good Medical Practice , paragraphs 20, 50, 69 and 73) the jobholder should always respect patient confidentiality and not divulge patient information unless sanctioned by
the requirements of the role.
5.14 Patient and Public Involvement The Trust has a statutory duty to involve patients and public in evaluating and planning services. All staff have a responsibility to listen to the views of patients and to contribute to service improvements based on patient feedback.
6. TERMS AND CONDITIONS OF EMPLOYMENT
6.1 Conditions of employment are determined by the Leeds Teaching Hospitals Trust in accordance with the Terms & Conditions – Consultants (England) 2003, as amended from time to time in the light of national or local collective agreements. 6.2 The postholder, as a practitioner with continuing responsibility for the care of patients must be able to respond promptly to emergency calls from the Hospital. 6.3 A consultant is required to reside within a distance of 30 minutes or 10 miles by road from their principal place of work unless an employing organisation agrees that they may reside at a greater distance. 6.4 A consultant must be contactable by telephone in their contracted work time. 6.5 The consultant must ensure that there are clear and effective arrangements so that the employing organisation can contact him or her immediately at any time during a period when he or she is on call. 6.6 The postholder should note, however, that where the Trust agrees that the postholder may live further than ten miles from the hospital, the Trust will only reimburse travelling expenses up to a maximum of twenty miles return, in accordance with Trust Terms and Conditions of Service. 6.7 Assistance with relocation to the Leeds area may be provided to the successful candidate. A copy of the Trust’s Relocation Policy is available on request. 6.8 The normal NHS requirements for indemnity of medical and dental staff in cases of medical negligence apply. 6.9 Subject to the provisions of the Terms and Conditions of Service, the appointee is expected to observe the Trust’s policies and procedures, drawn up in consultation with the profession on clinical matters, and to follow the standing orders and financial instructions of the Leeds Teaching Hospitals NHS Trust. Where the postholder is responsible for managing employees of the Trust, they will be expected to follow the local and national employment and personnel policies and procedures. 6.10 The Trust is reconfiguring services and your base hospital may change during your employment, if and when your department transfers base, following consultation.
7. CONTRACT
The post is available on a full or part time basis or as a job share.
8. ENQUIRIES
Prospective applicants are encouraged to visit the Departments and are invited to contact any of the following persons:
Prospective applicants may wish to visit the Department and are invited to contact the following persons:
Mrs Gina McGawley, General Manager for cardio-respiratory CSU Dr Chris Pepper, Clinical Director Dr Jonathan Blaxill, Lead for Coronary Intervention
