NHS Lanarkshire – Information Pack
POSITION: Consultant Cardiologist
Reference
Grade
Location
Hours / PA’s
Salary Scale
Closing Date
MS/0613/01
Quote on all correspondence
Consultant
Hairmyres Hospital
10 PAs per week (Part-time may be considered)
Consultant
Friday 5th July 2013
Your Application
Thank you for expressing an interest in the above post within NHS
Lanarkshire. Please find all the relevant information attached to begin the
application process.
Should you require further information regarding this post you can contact the
Medical Staffing team or make informal enquiries with the department using
the contact details below.
To ensure we can process your application as easily as possible please
complete all the information required within the Application Pack and email
with your CV.
Contact Details
Telephone
Email
Application
Process
To apply, please email your CV to the above, along with the attached
completed Application Pack.
Application Pack .doc
01698 377735
pamela.migues@lanarkshire.scot.nhs.uk
Lanarkshire NHS
Inserts.pdf
Additional
Arrangements
Informal enquiries regarding this post will be welcomed by:Dr M Malekian
Associate Medical Director
01698 366041
Dr B O’Rourke
Lead Cardiologist
01355 584828
Dr. H. Mackie
Clinical Director, Medicine
01355 584633
Date when the
post is Vacant
The post is vacant immediately and a start date will be agreed with the
successful candidate.
NHS Lanarkshire
For further information regarding NHS Lanarkshire and it’s hospitals, please
visit our website:- www.nhslanarkshire.org.uk
We are an Equal Opportunities Employer and Positive about Disabled People.
Page 1
NHS Lanarkshire – Information Pack
POSITION: Consultant Cardiologist
CARDIOLOGY
There are four Consultant Cardiologist based at Hairmyres Hospital
(including this post).
Since the amalgamation of the three acute Lanarkshire Hospitals under one
body, there has been closer integration allowing the development of a Clinical
Network in Cardiology throughout Lanarkshire and strategic planning for
cardiology services. This aspect is particularly well developed for invasive
cardiology. .
Cardiology Department Hairmyres Hospital
The Cardiology service is centered around a well equipped department which
includes two new GE Vivid 9 scanners, a multi plane TOE probe, 3-D
transthoracic and TOE probes, state-of-the-art Holter equipment, cardiomemo event recorders, two treadmills and a Tilt-table. The Department
performs over 5000 transthoracic scans and over 100 transoesophageal
scans per year as well as 2000 treadmill exercise tests and 120 stress
echocardiograms. The unit is well staffed with experienced technicians and
has a training programme for students. There is a weekly departmental
meeting for review of interesting cases, teaching and governance, and the
new appointee will be encouraged to attend.
Coronary Care Unit
The cardiologists run 8 monitored beds with provision for dynamic STsegment monitoring and Swan Ganz Catheterisation. The CCU also
incorporates a procedures room suitable for temporary pacing, DC
cardioversion, trans-oesophageal echo and balloon pump insertion.
Lanarkshire benefits from a cardiac catheterisation facility based at
Hairmyres Hospital. The Lanarkshire interventional cardiologists provide a full
diagnostic and interventional service from this facility and carried out over
1400 percutaneous interventions (PCI) in 2012, This equates to
approximately 1800/million PCI procedures per year. This level of activity has
increased with the introduction of the Optimal Reperfusion Service for STEMI
patients in 2008.
Outpatients
The West of Scotland has the highest prevalence of coronary heart disease
in the UK and therefore there is considerable demand for outpatient services
to deal with this. There is a well established Nurse-led Rapid Access Chest
Pain (RACP) clinic and recently introduced Nurse-led Rapid Access Atrial
Fibrillation clinic. Hairmyres Hospital also benefits from a busy Heart Failure
Nurse Service and Cardiac Rehabilitation Program for patient post MI and
revascularisation
Page 2
NHS Lanarkshire – Information Pack
POSITION: Consultant Cardiologist
Cardiology In-patients
In addition to CCU the cardiologists are responsible for in-patients on ward 9.
This is a 24-bedded acute ward with a mixture of patients with cardiology and
general medical diagnoses. Patients will often be stepped down from CCU
and the Cath Lab ward to ward 9 for continuity of care. The cardiologists now
also provide a daily Cardiology In-Reach service to advise of the
management of patients in the new Clinical Decisions Unit (CDU) and Acute
Medical Receiving Unit (AMRU). This commitment is shared equally
between the 4 consultants on weekly rota.
STAFFING
Medical
In addition to the four consultant posts, there are 4 ST level staff – (FY2,
CMT/ ST1,2) usually supplemented by an ST3 in cardiology from the West of
Scotland rotation.
Technical
As above.
Paramedical
Cardiology Specialist Nurses oversee the cardioversion service, provide a
screening service for cardiac catheterisation and assess patients in the Rapid
Access Chest Pain Clinics. A Specialist Nurse supports an established Heart
Failure Nurse Service and new Rapid Access Atrial Fibrillation clinic.
Rehabilitation
2 cardiac rehabilitation nurses and a dedicated physiotherapist provide inpatient and outpatient rehabilitation. There are exercise and lifestyle classes
held in the hospital. All post MI patients are invited to attend a dedicated
clinic 4-6 weeks after discharge. Rehabilitation is offered, where appropriate
to this group of patients and also to patients following cardiac surgery.
Rehabilitation data is recorded on a database and regular audits are held to
determine the effectiveness of the service.
Imaging Facilities
A new CT scanner has recently been installed in Hairmyres which has the
capacity for 64-multislice CT coronary angiography (CTCA). A business case
has been submitted in early 2013 with a view to commencing a CTCA service
in Hairmyres. It is anticipated that this will occupy one session per week (at
least initially). The successful appointee will be expected to take a leading
role in developing this novel service in Lanarkshire. Experience in CTCA is
therefore mandatory.
Page 3
NHS Lanarkshire – Information Pack
POSITION: Consultant Cardiologist
There are 3 MRI scanners in Lanarkshire. The Hairmyres MRI scanner has
appropriate field strength for cardiac imaging and is the scanner of choice in
Lanarkshire for cardiac MRI imaging (with upgrades required). A business
case has been submitted in early 2013 with a view to commencing a cardiac
MRI imaging service in Lanarkshire. Similar to CTCA, the successful
appointee will be expected to contribute to this service if approved;
experience in cardiac MRI is therefore essential.
Invasive Facilities
Lanarkshire benefits from a cardiac catheterisation facility based at
Hairmyres Hospital. The Lanarkshire interventional cardiologists provide a full
diagnostic and interventional service from this facility and carried out over
1400 percutaneous interventions (PCI) per year, This equates to
approximately 1800/million PCI procedures per year. This level of activity has
increased with the introduction of the Optimal Reperfusion Service for STEMI
patients.
All data in the Catheterisation laboratory is recorded onto the Medcon
Database which provides a printed procedure record and information for
audit. There are currently seven interventional and one non-interventional
cardiologists in Lanarkshire and one interventional cardiologist from Ayr
Hospital sharing these facilities.
The catheter labs are situated next to a dedicated day-care unit and adjacent
to the Coronary Care Unit in Hairmyres Hospital. Equipment includes two
intra-aortic balloon pumps and integrated coronary pressure wire system for
estimation of Fractional Flow reserve and integrated intravascular ultrasound.
Pacing
The Lanarkshire cardiologists provide a pacing service based at Hairmyres.
In 2012, 140 new systems and a number of Loop recorders were implanted.
There are fully weekly follow-up clinics at each of the 3 Lanarkshire hospitals.
A device implantation commitment would not be expected of this post.
Cardiac Surgery
Pre-operative Surgical Clinics are held once weekly.
following a joint angiogram review session.
Patients are seen
Audit Facilities
The hospital benefits from a very active clinical audit department. Regular
meetings are held to review performance and other aspects of clinical
effectiveness.
Page 4
NHS Lanarkshire – Information Pack
POSITION: Consultant Cardiologist
Teaching
The Cardiologists participate in postgraduate meetings and teaching
sessions for the Junior Medical Staff. The hospital also receives Medical
students from Glasgow and Dundee and the Cardiologists have an
involvement in their training.
Research
Department has active research interests including a number of industry
funded projects. The successful applicant will be encouraged to pursue
his/her own research projects.
Page 5
NHS Lanarkshire – Information Pack
POSITION: Consultant Cardiologist
POST INFORMATION
The Post
The indicative job plan for the post is for a full-time Consultant. Where
part-time working is preferred, an individualized job plan would be
agreed. Both non-invasive and invasive candidates will be considered for
this post. Non-invasive candidates would be expected to undertake
general medical receiving duties and limited ongoing care of general
medical patients who are triaged from the Acute Medical Receiving Unit
(AMRU) to the Cardiologists’ beds (typically, such patients will have a
cardiological diagnosis). Invasive candidates would be expected to take
part in interventional Cardiology rota (currently 1 in 8)
The successful applicant will hold a CCT in Cardiology (and if non
invasive a CCT in General (Internal) Medicine would also be required), or
be within 6 months of obtaining these qualifications. Applications will be
accepted from those unable to give the usual whole time commitment and
from those who wish to job share (a suitable modified individualised
contract would be offered in those circumstances). The post-holder will
be expected to agree duties at other hospitals in the NHS Lanarkshire,
depending on agreed job plan, and duties in the Primary care division
when required.
General
Provisions
You will be answerable to Clinical Director, who will agree your job plan.
Health and
Safety
You are required to comply with NHS Lanarkshire Health and Safety
Policies.
Junior Medical
Staff
You will be responsible for the training and supervision of the Junior
Medical staff who work with you, and you will be expected to devote time
to this on a regular basis. In addition, you will be expected to ensure that
staff have access to advice and counseling. If appropriate, you will be
named in the contracts of Doctors in training grades as the person
responsible for overseeing their training and as the initial source of advice
to such Doctors on their career.
Page 6
NHS Lanarkshire – Information Pack
POSITION: Consultant Cardiologist
DUTIES AND RESPONSIBILITIES
Cardiology Duties (see also Appendix 2)
Main Duties




The successful applicant will share responsibility for the day to day
running of the Cardiology department. This will involve being
available to review investigations at the request of the technicians
and other specialists.
The cardiologists provide continuous cover for the Coronary Care
unit, 09.00 – 17.00. The Cardiologists are also available to discuss
and review patients from other specialities including intensive care
when requested.
Appropriately trained applicants will have access to catheterization
laboratory sessions at Hairmyres Hospital.
The appointee will be required to run general cardiology clinics
including new and return patients. He/she will share responsibility for
the Post MI and Rapid Access Chest pain Clinics with the other
cardiologists in a supervisory capacity.
Duties and Responsibilities (see also Appendices 1 and 2)












Provision of an integrated Medical Service with the other
Consultants at Hairmyres Hospital.
Participating with colleagues in Lanarkshire in the planning of the
future delivery of General Medical and Cardiology Services in
Lanarkshire.
Participation in the supervision, training and management of Junior
Medical staff.
Provision of cover for colleagues during periods of leave as
appropriate.
Participation in General Medical and Sub- Specialty meetings and
multidisciplinary meetings.
Responsibilities for teaching, accreditation and examination duties
as required.
Managerial duties including, budgetary responsibilities (where
appropriate) as agreed with colleagues and the Clinical Director.
Participation in appropriate internal and external quality assurance
schemes.
Participation in a staff appraisal system as appraiser or appraisee as
required.
Participation in continuing professional development relevant to the
Joint UK Colleges CPD scheme
Participation in clinical audit.
Appropriate involvement in research as agreed by NHS Lanarkshire.
Page 7
NHS Lanarkshire – Information Pack
POSITION: Consultant Cardiologist
Work
Programme
As required under Section 3 of the Terms and Conditions of Service, the
duties and responsibilities are supported by a job plan and work
programme detailed as follows:
Job Planning/Programmed Activities
The job plan will be dependent on the successful candidate’s
subspecialty training and interests. A minimum of 1 SPA will be included
in the job plan. Additional SPAs (up to 2.5 in total) can be incorporated
into the job plan depending on the time required to support the
successful candidate’s professional activities and the needs of the
service.
On taking up post a Job Plan will be agreed between the person
appointed and the Clinical Director/Associate Medical Director. The Job
Plan will be reviewed informally after 3 months in post and then again on
a formal basis after 6 months in post.
The timetable is indicative and subject to negotiation with the Specialty
Clinical Director / Associate Medical Director. The core 10PA working
week will be based on 9 PAs of Direct Clinical Care (DCC) duties and 1
PAs of SPA time for a full-time post-holder. The weekly timetable
included in the work programme shows your elective programmed
activities and indicates the location where each activity will be
undertaken and the type of work involved.
The timetable identifies those fixed commitments which are dependent
on other hospital resources, both physical and human.
The commitments above are indicative of the post. However, these will
be subject to negotiation with the successful applicant. As far as
possible, the particular interests and skills of the successful applicant will
be accommodated, as long as these are relevant to the wider aims of
the Cardiology service and the Department of Medicine.
Page 8
NHS Lanarkshire – Information Pack
POSITION: Consultant Cardiologist
Fixed
Commitments
DAY
MONDAY
HOURS
AM
8AM-9AM
CCU (1 in 4)*
WARD ROUND
TYPE OF WORK
0.75 DCC
PM
TUESDAY
WEDNESDAY
AM
CCU
PM
NON-INVASIVE
IMAGING
CCU
MDT
AM
1 DCC
0.25 DCC
PM
THURSDAY
AM
CCU
WARD ROUND 0.75 DCC
PM
OUTPATIENT
1 DCC
CLINIC
FRIDAY
AM
CCU
CATH LAB**
1 DCC
CCU WARD ROUND*in rotation with Cardiology consultants 1:4
Cardiology CDU clinical decision unit & AMRU in reach service - 1 DCC
** 2 Cath lab sessions will be available for individuals with interventional experience
Split of PA’S will depend on which on-call rota the successful candidate contributes
to
Non- interventional/GIM rota
On call:
1.5
WARD ROUND
1.5
CCU &Cardiology in-reach
1
Cardiology OP
2
Cardiac imaging
1
Admin & reporting
1
Subspecialty Sessions
1 AMU/GIM
SPA
1
TOTAL
10
Total
DC PA
9.0 PAs
1 SPA negotiable but up to a maximum of 2.5 PAs as required particularly to develop and
manage non-invasive imaging service
Page 9
NHS Lanarkshire – Information Pack
POSITION: Consultant Cardiologist
In addition, other
activities not
occurring at
fixed times.








Reviewing new admissions.
Discussing referrals, in patient and out patient with Colleagues
(daily).
Discussing management/investigation of patients with colleagues in
other appropriate Clinical Support Services
Ward Referrals, Discussing patient management/ reviewing patients
with doctors in training and Nursing Staff out with formal ward
rounds.
Speaking to GP’s, outpatients re results.
Vetting Fast Track clinic referrals/ allocating appointments (daily).
CPD and Appraisal
Audit
Review of the
Job Plan
This job plan is subject to review at least once a year by the post holder
and the Specialty Clinical Director as noted in the terms and conditions.
The procedures set out in the ‘Terms & Conditions of Service’ must be
followed if it is not possible to agree a job plan, either initially or at an
annual review.
Audit and
research
The successful candidate will be expected to participate in audit
processes and there is an active clinical audit department available to
assist. An interest in research will be supported.
Page 10
NHS Lanarkshire – Information Pack
POSITION: Consultant Cardiologist
Continuing
Professional
Development
Study leave is available within the terms and conditions of service with
the approval of the Specialty Clinical Director/Clinical Lead. The
appointee will be required to fulfill such demands for continuing
professional development as the Royal College of Physicians (or other
relevant bodies) may make.
Honorary
If involved in undergraduate teaching status can be applied for.
Academic Status Applications can be made via the Hospital Sub-dean and then to the
appropriate academic department within the University.
Page 11
NHS Lanarkshire – Information Pack
POSITION: Consultant Cardiologist
PERSON PROFILE
Attributes
Qualifications
Training
Research
Essential
Useful
GMC Registration with a
Licence to Practice. MRCP or
equivalent.
CCT in General Medicine (for
non-invasive candidates) and
Cardiology or within 6 months
of attainment.
Recognised
training
in
Cardiology.
Expertise in cardiac MRI and
CT coronary angiography
Understanding of research
techniques and evidence of
having
undertaken
audit
activities.
Publications
Experience
Knowledge and Skills
Experience in all aspects of
adult cardiology is essential.
Experience in acute general
medicine (for non-invasive
candidates)
An understanding of the
working of the NHS as well as
core skills in Cardiology and
General Medicine.
Disposition
Other
If there is any reason why a disabled person
should not be considered suitable for this
post, please provide details:
Prepared By:Name
Designation
Date
Ability to work as a team member
with excellent communication
skills.
Full UK Driving Licence.
The post requires physical dexterity.
Uncorrected visual or hearing defect would
be incompatible with the nature of the work.
Approved By:Dr. M Malekian
Associate Medical Director
Page 12
NHS Lanarkshire – Information Pack
POSITION: Consultant Cardiologist
TERMS AND CONDITIONS
a)
This appointment is offered on the Terms and Conditions of the new Consultant
Contract.
Additional NHS Lanarkshire Policies which support the Contract are listed below and are
available on request:





b)
Additional & External Duties
Fee –Paying Work in the New Consultant Contract
On-Call Availability and Payment of Supplement
Generic Objectives
Resident On-Call Duties
This appointment is superannuable under the NHS Superannuation Scheme, which
is contracted out of the State Earnings Related Pension Scheme (SERPS). New
employees commencing employment from 1 March 2013 onwards will automatically
be enrolled in the pension scheme and your remuneration will be subject to
deduction of superannuation contributions.
To opt-out, you must contact the Scottish Public Pensions Agency directly on Tel:
01896 893000. Should you choose to opt-out in accordance with these changes you
will be enrolled into the scheme again every 3 years (June 2016, 2019 etc) when the
same process will apply.
For further information on the benefits of the scheme, please contact an advisor of
The Scottish Public Pensions Agency (SPPA) Tel: 01896 893100, or download/view
a member’s guide at www.sppa.gov.uk/nhs/forms.htm.
c)
The employment is subject to 3 months’ notice on either side subject always to the
appeal and other provisions of paragraphs 10.4 & 10.5 of the Terms and Conditions of
Service of Hospital Medical and Dental Staff and Doctors in Public Health and the
Community Health Service Consultant Grade.
d)
Reimbursement of certain telephone charges may be payable on application to NHS
Lanarkshire. The successful candidate must be contactable throughout any on-call
period.
e)
The successful candidate, if not already employed by the NHS Lanarkshire, will be
required to complete a medical questionnaire to obtain medical clearance from the
Occupational Health Physician.
Continued………..
Page 13
NHS Lanarkshire – Information Pack
POSITION: Consultant Cardiologist
f)
The successful candidate will be required to complete a disclosure Scotland PVG
(Protecting Vulnerable Groups Scheme) form. No approach will be made without
written permission of the successful applicant who will be asked to sign and complete a
Disclosure PVG application, giving authorization for the check to be undertaken.
g)
NHS Lanarkshire does not negotiate salary placements. On commencement the salary
will be in line with paragraph 5.1 of the terms and conditions of the new consultant
contract. Appointees start on the scale minimum except in the circumstances of
paragraphs 5.1.2 – 5.1.7 of the terms and conditions of service.
h)
From 1st April 2012 the starting salary for the post is £74,504 per annum (based on 10
Programmed Activities per week). The successful candidate’s total salary will be
dependent on his/her previous service history. Remuneration for any extra
programmed activities will be dependent upon the job plan agreed at the time of
appointment.
i)
Dependent upon present place of residence, NHS Lanarkshire may require
the
successful candidate to undertake to remove home to a distance acceptable to NHS
Lanarkshire, normally within 10 miles of the base Hospital, in which case removal
expenses will be payable in accordance with NHS Lanarkshire Policy. In some cases,
however, a residence more than 10 miles distant from the base hospital will be
acceptable and in this case removal expenses will be subject to the prior approval of
the Associate Medical Director for such a residence. The position will be made clear to
the successful candidate on application
Page 14
NHS Lanarkshire – Information Pack
POSITION: Consultant Cardiologist
DECLARATIONS/CONVICTIONS STATEMENT
The following should be used when completing DECLARATIONS/ CONVICTIONS within the
application pack.
Registration with the General Medical Council or General Dental Council imposes on doctors
and dentists the duty to provide a good standard of medical care and to behave
appropriately, towards patients. NHS Employees also have a duty to ensure that patients
receive a good standard of medical care and ensure as far as possible the safety of patients.
We therefore need to establish if you have been found guilty of a criminal offence, been
bound over or cautioned or are currently the subject of proceedings which might lead to a
conviction, an order binding you over or a caution, in the UK or any other country.
Applications for posts in the NHS are exempt from the Rehabilitation of Offenders Act 1974.
Application forms will include a declaration for applicants to complete declaring any previous
or pending prosecutions or convictions, including those considered “spent” under the Act.
Forms will also include a declaration of any cautions or bind overs.
We also need to establish if you have been the subject of any fitness to practise proceedings
in the past, or if any fitness to practise proceedings are being contemplated, by a licensing or
regulatory body in the UK or another country and this is also reflected in the declaration.
This information will be treated in confidence and will not debar you from appointment unless
the selection panel considers that it renders you unsuitable for appointment. In reaching
such a decision we will consider the nature of the conviction/action, how long ago it took
place and any other factors which may be relevant
Failure to disclose a criminal offence, having been bound over or cautioned or that you are
currently the subject of criminal proceedings, which might lead to a conviction, an order
binding you over a caution, or fitness to practice proceedings undertaken or being
undertaken by an appropriate licensing or regulatory body, may disqualify you from
appointment, or result in summary dismissal/disciplinary action and referral to the General
Medical Council (General Dental Council) for consideration if such a discrepancy came to
light.
If you would like to discuss what effect any previous convictions, police investigations or
fitness to practice proceedings taken or being taken either in the UK or by an overseas
licensing or regulatory body might have on your application, you may telephone: Marlene
Fraser (01698) 377752 in confidence, for advice.
Page 15
NHS Lanarkshire – Information Pack
POSITION: Consultant Cardiologist
IMMIGRATION
Overseas
Doctors and
Dentists
Changes to
Immigration
Impact of
Change
Further
Information
For the purpose of immigration status, overseas doctors and dentists are
those who, regardless of where they obtain their primary medical/dental
qualification, are not nationals of the European Economic Area (EEA). A
list of EEA countries is attached.
On 7th March 2006 the Department of Health announced changes to the
immigration rules for postgraduate doctors and dentists. The changes
came into effect on 3rd April 2006 and mean that all doctors and dentists
who wish to work in the UK from outside the EEA will need to meet the
requirements of an employment category such as the work permit
provisions. New applications for permit-free training visas will no longer
be granted for doctors undertaking training posts
Non-EEA doctors and dentists will still be able to come and train in the
UK and are still eligible to apply, in open competition for training posts
provided all the other eligibility criteria is met. However, training posts
will now be considered employment for immigration purposes. Work
permits will only be issued where there is a specific post for the
overseas doctors that cannot be filled by someone from the EEA.
The changes in immigration requirements for trainee doctors and
dentists are a result of a Scottish Executive Health Department
announcement and immigration issues are the remit of the Home Office.
Clarification and further information can be accessed from the following:Home Office
Work Permits
EEA Countries
www.ind.homeoffice.gov.uk
www.ukba.homeoffice.gov.uk/workingintheuk/
Austria
Greece
The Netherlands
Belgium
Hungary
Norway
Bulgaria
Iceland
Poland
Cyprus
Republic of Ireland Portugal
Czech Republic
Italy
Romania
Denmark
Latvia
Slovakia
Estonia
Liechtenstein
Slovenia
Finland
Lithuania
Spain
France
Luxembourg
Sweden
Germany
Malta
UK
NB – Switzerland is not in the EEA, Swiss Nationals have the same
rights as EEA nationals.
Page 16
NHS Lanarkshire – Information Pack
POSITION: Consultant Cardiologist
General Medicine, Hairmyres Hospital: Consultant provision of care
General Medical Receiving Duties
a) The current rota is 1 in 13, with prospective cover.
b) Consultants must be contactable at all times during the period that they are on-call. Consultants
should normally be physically present within the hospital during normal working hours(weekdays)
whilst on-call; if this is not the case, a suitable deputy should be agreed (inform AMRU and
switchboard).
c) All other clinical commitments (e.g. clinics) will be cancelled during on-call days.
d) The receiving physician must be available to return to the hospital at short notice if this should be
required.
e) The current system for medical receiving at Hairmyres follows a consultant of the week approach;
details are as follows:
i.
Monday – Friday: 1st on consultant receives all patients in AMRU only from 12 PM on
Monday to 12 PM on Friday. Post-take ward-rounds performed at 8 AM and 4 PM as a
minimum, with physical presence in AMRU (at least intermittently) encouraged during the day.
A separate rota exists for 2nd on consultant, who will review all new boarders outwith AMRU
(1:13 at present).
ii. Friday - Monday: 1st on consultant receives all patients from 12 PM on Friday to 12 PM on
Monday. Post-take ward-rounds performed at 8 AM and 4 PM as a minimum, with physical
presence in AMRU encouraged (at least intermittently) during the day. A separate rota exists
for 2nd on consultant on Saturday and Sunday, who will review patients in medical HDU (4
beds), CDU (8 beds) and any new boarders outwith AMRU.
iii. A formal handover will take place between the outgoing consultant (of weekend or week) and
the next consultant at mid-day on Monday and mid-day on Friday
f)
Post-take ward-rounds must take into account restrictions on junior doctors working hours, to
ensure that these are not breached
g) The on-call physician must familiarise himself/herself with unwell patients outwith AMRU that the
junior staff are dealing with, reviewing such patients personally if required.
h) All consultants should familiarise themselves with the Major Accident Plan and be aware of their
responsibilities in the event of a Major Accident being declared.
i)
Rota arrangements may change over coming years ; physicians involved in General Medical
receiving may therefore be required to modify this area of their job plan, as determined by service
needs.
Page 17
NHS Lanarkshire – Information Pack
POSITION: Consultant Cardiologist
Ward Rounds
a) In keeping with NHS Lanarkshire policy, at least 2 formal rounds per week should normally be
conducted.
b) In the event of a consultant being absent (e.g. annual leave or study leave), arrangements must
be made to ensure that a consultant colleague either personally undertakes clinical review of any
existing inpatients, or else undertakes to carefully supervise a nominated junior doctor
undertaking this role.
Outpatient Clinics
a) At least one sub-specialty clinic should be provided per week; most physicians will undertake 2
clinics. All physicians should make a contribution to general medical outpatient work (new and
return patients), unless alternative arrangements have been specifically agreed.
b) Clinics will typically be scheduled to last for 3.5 hrs. The time allocated per patient will depend on
the complexity of the clinic case-mix, on whether or not a full multidisciplinary assessment is to be
undertaken, and on whether or not same-day investigations & review with the results of these is
planned (‘one-stop’ clinics). Typical allocations might be 20-30 mins per new patient and 10 -15
mins per follow-up patient. Some highly specialised clinics may require longer time allocations.
The overall number of patients listed will need to take account of the total number of doctors
available to undertake the clinic.
c) Junior doctors providing assistance with clinic work must be adequately supervised. Clinics
should generally be cancelled in their entirety if the consultant is unable to attend (unless robust
alternative mechanisms to ensure adequate supervision of junior doctors’ work can be identified.)
d) Reductions to a clinic will generally need to be made if a junior doctor is unable to attend a given
clinic due to rota commitments etc. Consultants must ensure that they emphasize to their junior
staff the importance of anticipating these types of events and of notifying their supervising
consultant as soon as possible (minimum of 6 weeks notice) so that the appropriate clinic
reduction can be made.
e) Any clinic cancellations should be notified in writing (not just verbally) to the Medical Records
Department.
f)
No less than 6 weeks notice should be given for clinic cancellations, other than in exceptional
circumstances.
g) Unnecessary clinic cancellations/reductions must be avoided. Consultants are expected to
comply with NHSL policy on patients who fail to attend for their appointments. Consultants
should also comply with NHSL (and predecessor Trust) policy on ‘Adding patients to waiting lists’
Page 18
NHS Lanarkshire – Information Pack
POSITION: Consultant Cardiologist
Administrative duties (clinical)
a) Administrative duties directly related to clinical care (e.g. Clinic dictation, correspondence, review
of results, discharge summaries, complaints, grading referral letters, etc) are considered as Direct
Clinical Care duties. This reflects the importance of these tasks to the overall clinical service
which is provided.
b) Clinical administrative duties should be performed promptly and thoroughly.
Administrative duties (non-clinical)
a) The importance of non-clinical administrative duties of consultants for NHS Lanarkshire and the
wider NHS is recognized. However, such duties will usually fall under Supporting Professional
Activities, Additional Responsibilities or Other External Duties for job planning purposes (see
NHSL document ‘New Consultant Contract – Supporting Professional Activities’)
b) Non-clinical administrative duties should not be allowed to impact adversely on agreed Direct
Clinical Care duties.
c) Where a consultant has substantial non-clinical administrative duties, which may affect their
performance of programmed duties, agreement must be sought (in advance) from the Clinical
Director and Associate Medical Director for the substitution of such work for programmed
activities.
Procedures
a) No procedures should be undertaken unless adequate training in the technique involved has
been undertaken.
b) Junior staff undertaking procedures on behalf of a consultant should be adequately trained and
supervised.
Private Practice and fee-paying work
a) Consultants wishing to undertake private practice must follow the ‘Code of conduct for private
practice’ at appendix 8 of the TCS, and advise NHSL of their intention to do so.
b) Fee-paying work should be performed in accordance with the NHSL document ‘fee-paying work
in the new consultant contract’.
Page 19
NHS Lanarkshire – Information Pack
POSITION: Consultant Cardiologist
Supervision of Junior Doctors
a) The clinical work of junior doctors, including in-patient work, out-patient work, procedures and
administrative work, must be adequately supervised at all times.
b) Consultants are expected to act as Educational Supervisors for junior staff, following the
appropriate NHSL and RCP guidance. Such activity is recognised under ‘Supporting Professional
Activities’.
c) Consultants must take into account restrictions on junior doctor’s working hours, to ensure that
these are not breached
Medical Education
a) Undergraduate and Postgraduate education is an important function of the Medical Directorate.
All consultants are therefore expected to make a contribution to this area.
b) Whilst consultants will differ in their exact contributions, key activities undertaken within the
Medical Directorate include the formal junior doctor teaching programme, medical student bedside teaching (3rd/ 4th/5th years), facilitating problem based learning for medical students (3rd yrs)
and medical student educational supervision.
c) A contribution to these areas should be agreed with the Clinical Director. These activities qualify
as Supporting Professional Activities for job planning purposes.
Audit and research
a) Regular audit of clinical activity is strongly encouraged. It links with Appraisal and, in turn, with
Revalidation.
b) Research is also encouraged. The appropriate NHSL guidance on research and ethical approval
must be followed.
c) If a major audit or research commitment which could impact on the performance of other
programmed duties is planned, agreement must be sought (in advance) from the Clinical Director
and Associate Medical Director for the substitution of such work for existing programmed
activities.
Appraisal
a) All consultants are required to participate fully in the annual appraisal process.
b) Specific objectives for individual consultants, encompassed within a personal development plan,
will be developed through the Appraisal process.
Page 20
NHS Lanarkshire – Information Pack
POSITION: Consultant Cardiologist
Annual and Study leave
a) NHSL policies for annual and study leave should be adhered to. All study leave must be formally
applied for. , Any commercially supported educational activities must comply with NHSL
‘Standards of business conduct’. Further guidance is also provided in the T&C document,
Chapter 7.
b) Applications for UK and EU study leave should be made to the Clinical Director on the
appropriate form; for non-EU study leave the Overseas Study Leave application form should be
used.
c) Appropriate cover from a consultant colleague must be agreed well in advance of any leave being
taken. The details of the cross-cover arrangements should be circulated within the Directorate
using the appropriate form.
Page 21
NHS Lanarkshire – Information Pack
POSITION: Consultant Cardiologist
Page 22
NHS Lanarkshire – Information Pack
POSITION: Consultant Cardiologist
Cardiology at Hairmyres Hospital: consultant provision of care
The elements of the job plan which pertain to specialist work undertaken as a Consultant in
Cardiology are described here. The objectives and guidelines contained within the NHSL documents
‘Service objectives for Physicians’ and ‘General Medicine at Hairmyres Hospital: consultant provision
of care’ can be assumed to apply to specialty work as well as to GIM work. Thus the guidance
relating to outpatient clinic provision, inpatient supervision, administration, procedures, leave
arrangements; appraisal, etc. will not be repeated again in detail here.
General
a) There are at present 3 Consultant Cardiology posts based at Hairmyres Hospital. In addition,
specialist nurses and cardiology technicians are attached to the Cardiology Department.
b) All 3 current posts are in Interventional Cardiology.
c) The Interventional Cardiologists will provide a broad range of procedures, including diagnostic
and interventional cardiac catheterisation, transoesophageal echocardiography and permanent
pacemaker and ICD implantation.
d) The Non-Interventional Cardiologist will provide a narrower range of procedures, but will include
trans-oesophageal echocardiography.
e) The 3 Consultant Cardiologists are based at Hairmyres Hospital for all inpatient and outpatient
work.
f)
One cardiologist assumes prime responsibility for the Coronary Care Unit (CCU) for 1 week at a
time (Monday to Friday), in rotation with colleagues. During this week the cardiologist responsible
for CCU will perform a ward-round in the morning (full) and will also aim to visit CCU again in the
late afternoon (new patients and problems). He/ she will also be available for advice and to
undertake procedures, if required.
g) Although the Cardiologists will principally provide a clinical service for patients from the
Hairmyres Hospital catchment area, it is expected they will work closely with colleagues from
other Lanarkshire Hospitals to develop Cardiology services as a whole for Lanarkshire. This will
include participation in the Cardiology Managed Clinical Network (MCN).
h) The Interventional Cardiologists participate on a 1:8 basis in a Interventional on-call rota for
Primary PCI.
Page 23
NHS Lanarkshire – Information Pack
POSITION: Consultant Cardiologist
Outpatient clinics
a) The guidance on outpatient clinics contained within ‘Service objectives for Physicians in NHS
Lanarkshire’, together with ‘General (Internal) Medicine at Hairmyres Hospital: guidelines and
objectives for Consultant provision of care’ should be adhered to.
a) A Consultant Cardiologist will provide 1-2 outpatient clinics per week in total, the exact
commitment being determined by other duties within the job plan.
b) Twenty to 30 minutes per new patient will be allocated, depending on whether or not this
represents a “one stop” clinic appointment, with 10 minutes per follow-up patient. Each clinic will
last 3.5 hours.
Ward rounds (Cardiology/CCU and General Medicine)
a) A CCU ward round will be performed in the morning (full) and the consultant on-call for CCU will
also aim to visit CCU again in the late afternoon (new patients and problems), Monday to Friday.
At weekends the on-call General Medical Consultant will see all new admissions to the Coronary
Care Unit.
b) Formal Consultant ward rounds will normally be undertaken twice per week for both Cardiology
and General Medical inpatients.
Cardiology Laboratory
a) The Cardiology Department will remain under the managerial supervision of a designated Senior
Cardiology Technician. All of the consultant cardiologists will provide input into the clinical
reporting of studies, where required.
On call (cardiology)
a) This pan-Lanarkshire service is provided by the Interventional Cardiologists and is based around
the Primary PCI service at Hairmyres Hospital.
On call (General Medicine)
a) The non-invasive Cardiologist will participate in the General Medical Receiving rota (currently
1:10).
Page 24
NHS Lanarkshire – Information Pack
POSITION: Consultant Cardiologist
Prospective cover
a) Prospective cover for the duties of an absent colleague is expected. Whilst outpatient clinics will
normally be cancelled or reduced in the event of annual or study leave, clinical supervision of
exiting inpatients is expected (see ‘General Medicine at Hairmyres Hospital: consultant provision
of care’)
b) Appropriate cover from a Consultant colleague (not necessarily a Cardiology Consultant) must
also be agreed for General Medical receiving duties well in advance of any leave being taken.
Referrals
a) The consultants in Cardiology will, on request, see clinical referrals from other wards and
departments.
Other duties and responsibilities
The following additional duties and responsibilities are identified:











Participation in the cardiology managed clinical network.
Participating with colleagues in Lanarkshire in the planning of the future delivery of cardiology
services in Lanarkshire.
Providing expert input into NHSL working groups and standing committees, as required.
Participation in the supervision, training and management of junior medical staff and specialist
nurses.
Participation in general medical and sub-speciality meetings and multidisciplinary meetings.
Managerial duties, including budgetary responsibilities (where appropriate) as agreed with
colleagues and the clinical director.
Participation in appropriate internal and external quality assurance schemes.
Participating in continuing professional development relative to the specialty of Cardiology, as
well as General (Internal) Medicine, in accordance with Royal College of Physicians guidelines.
Participation in relevant formal training courses and for the provision of interventional procedures
Participating in clinical audit.
Appropriate involvement in research, as agreed by the NHSL.
Page 25