CARDIFF AND VALE NHS TRUST
JOB DESCRIPTION
CLINICAL FELLOW IN ELECTROPHYSIOLOGY
1. THE JOB ITSELF
Title:
Clinical Fellow (Specialist Registrar) in Electrophysiology
Base location:
University Hospital of Wales
This is a Cardiology Sub-Specialty Training post, approved for training by the Wales Deanery
Postgraduate School of Medicine. It is ideal for a Cardiology Specialist Registrar (SpR) or
Specialty Trainee (ST) holding a National Training Number (NTN) who is seeking Subspecialty Training in Echocardiography.
The post is based at the University Hospital of Wales, in the tertiary Cardiothoracic
Directorate. The appointment is fixed term for an initial period of 1 year. Subject to
satisfactory appraisal and review, the term may be extended to 2 years.
In view of the fact that the Trust is currently undertaking a review of its services and the
locations at which they are undertaken, it is important to be aware that work patterns may
change and the place(s) of duties modified.
2. THE TRUST
Background
Cardiff and Vale NHS Trust was launched on 1 April 2000. The Trust comprises eight
hospitals and over thirty-four health centres and clinics situated in and around the city of
Cardiff, the capital of Wales and the Vale of Glamorgan. The Trust is regarded as a
‘centre of excellence’ for many clinical services. There are close links with Cardiff
University having a major teaching, research and development role both nationally and
internationally. The Trust serves a population of approximately five hundred thousand
residents with its services being commissioned by Cardiff and the Vale Local Health
Boards and Health Commission Wales. In addition it provides a number of Regional
specialties and acts as a tertiary referral centre for specialist arrhythmia services for a
population of 1.3 million. The Trust employs over 11,500 staff with an annual contract
income of over £520,000,000.
3. The University Hospital of Wales
In 1971, UHW was officially opened and rapidly established itself as one of the foremost
teaching hospitals in the UK and the flagship of Wales.
In addition the hospital manages a number of services of a regional and sub-regional
nature, namely Cardiology, Electrophysiology, Cardiac Surgery, Neurology,
Neurosurgery, Medical Genetics, Bone Marrow Transplantation and Renal Transplant.
The University of Wales College of Medicine is based on the site consequently the
hospital is regarded as the major teaching hospital within Wales. With one or two
exceptions the NHS service side is interlinked with professorial departments and both the
NHS and College elements are heavily involved in research and development and have
gained eminent reputations both nationally and internationally.
The hospital provides the fullest integration of a 968-bed hospital and medical school in
one complex. Three blocks running north south with 6 subsidiary ‘link’ blocks comprise
the main complex. The main building is 10 storeys high with numerous peripheral
developments.
Each week the hospital sees around 5,000 outpatients, 500 inpatients and 200-day
cases. The main operating theatre suite is one of the largest in Great Britain with 10
theatres and 12,000 cases per year.
In March 1999 Cardiff Royal Infirmary closed, and the emergency services transferred to
a brand new state of the art emergency unit on the University Hospital of Wales campus.
It is an extremely busy department, with approximately 100,000 attendances per year.
4. THE WORK OF THE DEPARTMENT
4.1. Adult Cardiology service
The Adult Cardiology service provides a full range of secondary and tertiary care to
patients based in South East Wales. There are presently 11 NHS Consultants and an
academic team comprising a Professor of Cardiology and a Reader in Cardiology. The
Interventional Cardiology service is provided by six NHS Consultants. Two NHS
Cardiologists and the Reader in Cardiology specialise in echocardiography. The
electrophysiology service is provided by 2 resident Consultant Electrophysiologists and 2
visiting Consultant colleagues from Swansea (Morriston Hospital) and Royal Glamorgan
Hospital. The Heart Failure service (including device implantation) is led by an NHS
Consultant.
Cardiology services at University Hospital of Wales are provided through eight CCU
beds, 19 step-down cardiology beds, a 38-bedded routine cardiology ward, a 12-bedded
Cardiology Day Case Unit, three cardiac catheterisation laboratories, a dedicated pacing
theatre and a dedicated outpatient department. The non-invasive echocardiography
service is provided through four dedicated rooms and a reporting office.
The service provides 1,500 coronary interventional and 2,300 diagnostic cardiac
procedures. In addition to standard coronary interventional stenting procedures, the
cardiac interventional programme offers intravascular ultrasound, coronary
thrombectomy, rotational atherectomy, mitral balloon valvuloplasty and percutaneous
ASD closure.
In total the department is contracted to see 4,300 new outpatients per year and to treat
3,500 in-patients and 2,300 day cases. The echocardiography service undertakes
approximately 7,500 TTE’s and 500 TOE’s per year.
4.2. The Arrhythmia Service
The University Hospital of Wales is the regional tertiary arrhythmia centre for South East
Wales, servicing a population of 1.3 million. In 2008/09, the University Hospital of Wales
performed 250 ablations, 150 diagnostic EP studies, 163 ICD implants (46 CRT-D) and
416 device implants (35 CRT-P). Training in Interventional electrophysiology is provided
by Dr Peter O’Callaghan and Dr Fong Leong. The overall success rate for conventional
ablation at UHW is 98%, a figure that compares favourably with international standards.
Within the last 12 months we have obtained both the NavX and Carto mapping systems
and we have started a regional AF ablation programme. Training in device implantation
including complex pacing, ICD and CRT implantation is provided by four device
implanters – Dr Zaheer Yousef (Heart Failure Specialist), Dr Rob Bleasdale (visiting DGH
Cardiologist), Dr O’Callaghan and Dr Leong. We provide an inherited cardiac conditions
service for the region. The service is supported by three arrhythmia specialist nurses.
Each week there is a formal ECG/Intracardiac electrogram teaching session. Device
extractions for the region are performed at UHW.
4.3. Adult Cardiac Surgery
The Adult Cardiothoracic Surgical Centre provides a full range of cardiac and thoracic
surgical services to South East and Mid Wales. There are presently six Consultant
Cardiac Surgeons. The centre is funded to undertake 1200 cardiac operations per year.
The cardiac and thoracic surgery service is provided through three dedicated cardiac
theatres, a dedicated 14-bedded cardiac combined intensive care and high dependency
unit, a 37-bedded cardiothoracic ward and a 10-bedded thoracic surgical unit.
Arrhythmia surgery is now performed routinely and we are one of the few UK centres
capable of performing map-guided VT surgery.
4.4. Names of Senior and Consultant members of the Department
Adult Cardiology (NHS)
Dr P H Groves
Dr W J Penny
Dr N Ossei-Gerning
Dr R A Anderson
Dr T Kinnaird
Dr A Buch
Dr P A O’Callaghan
Dr N D Masani
Dr R Wheeler
Dr Z Yousef
Dr S Leong
Consultant Cardiologist (intervention) & Clinical Director
Consultant Cardiologist (intervention)
Consultant Cardiologist (intervention)
Consultant Cardiologist (intervention)
Consultant Cardiologist (intervention)
Consultant Cardiologist (intervention)
Consultant Cardiologist (electrophysiology)
Consultant Cardiologist (echocardiography / GUCH)
Consultant Cardiologist (echocardiography/nuclear)
Consultant Cardiologist (tertiary heart failure)
Consultant Cardiologist (electrophysiology)
Cardiothoracic Surgery
Mr E N P Kulatilake
Mr A A Azzu
Prof U Von Oppell
Mr P A O’Keefe
Mr D Mehta
Mrs M Kornaszewska
Mr J Pillai
Consultant Cardiothoracic Surgeon &
Lead Surgeon
Consultant Cardiac Surgeon
Consultant Cardiac Surgeon
Consultant Cardiothoracic Surgeon
Consultant Cardiac Surgeon
Consultant Thoracic Surgeon
Locum Cardiac Surgeon
Adult Cardiology (Academic Unit)
Prof J N Halcox
Dr A G Fraser
Professor of Cardiology
Reader in Cardiology
4.5. Other Medical Staff in the Department
Adult Cardiology
10 Specialist Registrars. We intend to appoint three Clinical Fellows, one each in
Electrophysiology, Intervention and Echocardiography.
6 Senior House Officers
Cardiothoracic Surgery
4 Specialist Registrars
4 Staff Grades
5 Senior House Officers
1 Clinical Fellow
The review of services and the implementation of Government initiatives may result in
revision to junior staffing levels and support.
4.6. Other Relevant Staff
Mrs Jessica Castle
Ms Sara Weare
Dr Andrew Wood
Dr John Dunne
Dr Dirk Wilson
Mrs Claire Gill
Mrs Maureen Edgar
Mrs Lynda Jenkins
Mrs Lynda McGurk
Mr Martin Jones
Directorate Manager
Assistant Directorate Manager
Consultant Vascular Radiologist
Consultant Anaesthetist & Lead Clinician
Anaesthesia, ITU & Perfusion
Consultant Paediatric Cardiologist / GUCH
Directorate Lead Nurse
Senior Nurse – Cardiology
Senior Nurse – Cardiothoracic Surgery
Chief Cardiac Physiologist
Principal Clinical Perfusionist
for
Cardiac
4.7. Administrative Responsibilities
You will be responsible for undertaking the administrative duties associated with the care
of patients and the administration of the department in the respective Trusts.
You will be required to comply with the appropriate Health and Safety Policies as may be
in force.
Travel between Hospitals/clinics will rarely be required but a planned and cost effective
approach will be expected.
You will be required to have input into postgraduate teaching.
5. WORKING PATTERN INCLUDING OUT-OF HOURS COMMITMENT
The successful candidate will be required to participate in a full shift system with other
junior doctors in the Department. The post is compliant with the European Working Time
Directive and New Deal compliant. All posts and working patterns are under constant
review in line with both New Deal and EWTD guidelines.
6. CLINICAL
The successful candidate will be expected to participate and get trained in all aspects of
diagnostic EPS, ablation and device procedures. They are expected to participate in all
clinical activities of the unit including the management of arrhythmia and device patients
on the wards, participate in the arrhythmia tertiary consult service and attend the
specialist arrhythmia out-patient clinics. In addition they will be expected to participate in
clinical audit, clinical governance and morbidity and mortality departmental sessions.
Finally they will be expected to supervise the clinical work of more junior staff and teach
them as appropriate to their needs.
7. RESEARCH
The successful candidate will be expected to participate in ongoing research and audit
activities within the Department, and will be encouraged to initiate projects of his/her own.
Excellent research facilities are available on site in the Wales Heart Research Institute;
the post holder will be invited to develop collaborative links appropriate to his/her
research interests. It is expected that the successful candidate will present results at
academic meetings and submit manuscripts to peer reviewed journals during the time
they are in post.
8. TEACHING
The successful candidate will be expected to partake in the teaching commitments of the
Department, including teaching of undergraduates, cardiac physiologists and
postgraduate trainees.
9. CONTINUING EDUCATION
Access is available to the Medical Library at the Cardiff University, which provides
excellent facilities. There is also a regular programme of academic activities within the
Department that includes weekly clinical teaching meetings in echocardiography,
electrophysiology and interventional cardiology, cardiology rounds and invited lectures.
Post-holders will be allocated an Educational Supervisor from the Consultant body with
whom a educational contract will be agreed and appropriately reviewed. Levels of
responsibility may be extended to encompass the ability of the post-holder, particularly in
the case of CCT holders. The proposed timetable will therefore be agreed after
appointment to the post and will be subject to job plan review.
10. STUDY LEAVE
Study Leave may be granted for education purposes to attend courses at the discretion
of the Clinical Director, provided the clinical service is covered and must be planned well
in advance. At least six weeks notice is required. Study Leave Approval Form must be
completed and authorised the Consultant and Clinical Director.
11. POSTGRADUATE TRAINING
This post has Postgraduate Deanery approval for training.
12. LEAVE
A Clinical Fellow is entitled to 5 weeks annual leave. Applications for annual leave must
be signed by the Clinical Director 6 weeks in advance of leave to be taken. It must also
take into account colleagues’ leave so as to enable adequate clinical cover to maintain.
13. MAIN CONDITIONS OF SERVICE
The appointment is fixed term for an initial period of 1 year. Subject to satisfactory
appraisal and review, the term may be extended to 2 years.
a) The post is covered by the Terms and Conditions of Service for Hospital Medical and
Dental Staff [England and Wales] and the General Whitley Council Terms and Conditions
of Service as amended in negotiation with the Trust Medical and Dental Staff Negotiating
Committee. Details of these may be obtained from the Medical/Dental Personnel
Department.
b) The post is full time, with a normal working week of 40 hours, up to a maximum of 48
hours when on-call hours are included, ensuring that the post is compliant with the
European Working Time Directive.
c) You will receive the remuneration equivalent to Band 1A in addition to the mean of the
salary scale for the SPR grade. The posts are inclusive of cover of colleagues’ annual
and study leave depending upon the rotation.
d) The appointment is designated non-resident but is resident when working out-of-hours.
e) The appointee accepts that he/she will also perform duties in occasional emergencies
and unforeseen circumstances at the request of the appropriate Consultant, in
consultation with his colleagues both junior and senior.
14. JOB LIMITATION
At no time should you work at level exceeding your competence. All medical staff
therefore have a responsibility to inform those supervising their duties if they have any
concerns regarding this or if they feel that they are not competent to perform a particular
duty.
15. OTHER FACILITIES
Cardiff, the City and Capital of Wales, has a typical air of a cosmopolitan city, being the
administrative, business, cultural and education centre for Wales. Cardiff has much to
offer, modern shopping centres, Edwardian arcades with exclusive boutiques and a large
indoor market.
Cardiff Castle sits in the middle of the city along with impressive buildings such as the
City Hall and National Museum of Wales. For entertainment, Cardiff has many venues St
David’s Hall for world class concerts, the New Theatre and Sherman Theatre, large
cinema complexes as well as Chapter Arts Centre.
The city also contains the Welsh National Ice Rink and the National Sports Centre and
the new Millennium Rugby Stadium. The development of some 2,700 acres of Cardiff
Bay has created a 500-acre lake, 8 miles of waterfront and a new commercial and leisure
environment. The Vale of Glamorgan stretches to the coast and is dotted with small
country villages. Situated in the Vale are the picturesque beaches of Southendown and
Llantwit Major. Within an hour from Cardiff is varied countryside – the Brecon Beacons
and the Wye Valley.
Night Life
Restaurants in Cardiff are excellent and there is a wide choice of nightclubs discos, a
jazz centre and bars.
Clubs
All staff within the Trust are eligible for membership of the University of Wales Hospital
Sports and Social Club which includes facilities for squash, badminton, swimming etc., a
sauna and Jacuzzi together with a large social club.
Car Parking
There are parking facilities at all the hospitals in the Trust.
Shopping
Adequate shopping facilities within a convenient distance of all hospitals.
Transport
All hospitals are on regular bus routes with rail stations nearby.
16. CONDITIONS OF APPOINTMENT
The completion of a satisfactory health declaration questionnaire and screening is a
condition of the appointment. The post holder must comply with the UK Health
Department guidance on ‘Protecting health Care Workers and Patients from Hepatitis B’
[PSM [93] 12] as implemented by the Trust.
Because of the nature of the work of this post it is exempt from the provision of Section 4
[2] of the Rehabilitation of the Offenders Act 1974 [Exemption Order 1975]. Applicants
are therefore not entitled to withhold information about convictions of the Act. In the
event of employment, failure to disclose such convictions could result in dismissal or
disciplinary action. Any information given will be completely confidential and will be,
considered only in relation to application to which the order applies.
You must hold a current, full registration with the General Medical Council/ General
Dental Council throughout the duration of this contract.
You are normally covered by the NHS Hospital and Community Health Services
indemnity against claims of medical negligence. However, in certain circumstances [e.g.
in service for which you receive a separate fee or in an emergency situation outside of
work] you may not be covered by the indemnity. The Health Departments, therefore,
strongly advise that you maintain membership of your medical defence organisation.
The
Ionising
Radiation
[Medical
Exposure]
Regulations
2000
This post may involve the direction of medical exposure of ionising radiation. The Ionising
Radiation [Medical Exposure] Regulations 2000 impose a legal responsibility on Trusts
for all staff that refers patients for medical radiation exposure such as diagnostic x-rays to
supply sufficient data to enable those considering the request to decide whether the
procedure is justified.
Cardiff and Vale NHS Trust operates a No Smoking Policy within the Trust.
Removal Expenses are in accordance with the Trust policy.
The Trust is contractually obliged to monitor junior doctors’ New Deal compliance and the
application of the banding system, through robust local monitoring arrangements
supported by national guidance. You are contractually obliged to co-operate with those
monitoring arrangements.
i)
This is a one year fixed term contact.
17. DISCLOSURE OF CRIMINAL BACKROUND OF THOSE WITH ACCESS TO
PATIENTS
It is the policy of the Trust that, in accordance with the appropriate legislation, preemployment Disclosure Checks are undertaken on al newly appointed Doctors and
Dentists. The Criminal Records Bureau is authorised to disclose, in confidence to the
Trust, details of any criminal record, including unspent and spent convictions, cautions,
reprimands and final warnings.
Applicants being considered for this post must provide this information on the application
form before they can be considered.
Any information disclosed will be treated in the strictest confidence and all circumstances
will be taken into account before any decision is reached. The successful applicant will
be required to complete CRB Disclosure Check application form and to provide the
appropriate documentation. Applicants should be aware that refusal to comply with this
procedure may prevent further consideration for the post.
18. DATE POST IS VACANT
1st August 2009
19. DETAILS OF ARRANGEMENTS FOR APPLICANTS VISITING HOSPITAL
Candidates wishing to visit the hospital can make arrangements by contracting: Dr Peter
Groves, Clinical Director on 029 2074 3533 or Dr Peter O’Callaghan, Consultant
Cardiologist on 029 2074 3892.
CLINICAL FELLOW IN ELECTROPHYSIOLOGY
PROPOSED WEEKLY TIMETABLE OF PROGRAMMED DUTIES
This timetable is by way of example to show the breakdown in terms of clinical sessions and
supporting professional activities. The final timetable can be biased in favour of either
interventional EP or device implantation depending on the career aspirations of the
successful candidate.
The final timings of duties (e.g. clinics) may vary during the course of the appointment
Day
AM/PM
Type of work
Monday
AM
Pacing Lab
PM
Pacing lab
AM
Arrhythmia Clinic
PM
Ward Round
AM
Ablation Lab
Ablation Lab
Tuesday
Wednesday
PM
Thursday
Friday
Other
AM
EP Teaching meeting
Arrhythmia Clinic
PM
Audit and Service development
AM
Patient related admin
PM
CPD and Research
Emergency duties to be determined. This
may include evening shift on call (5 – 9pm),
and weekend day shifts (9 – 5pm). Duties will
not include night shift (H@N). Total hours will
not exceed 48 hours.
CARDIFF AND VALE NHS TRUST
PERSON SPECIFICATION FORM
GRADE:
Clinical Fellow for EP
SPECIALITY:
Cardiology
BASE:
UHW
HOURS:
Full Time
CRITERIA
QUALIFICATIONS
ESSENTIAL
MRCP or overseas equivalent
Current GMC Certificate
PREVIOUS
EXPERIENCE
At least four years experience in Cardiology
on a full-time basis with an ability to perform
diagnostic angiography and basic pacing
SKILLS
KNOWLEDGE
ABILITY
 Experience and competence in basic pacing
and diagnostic angiography
 Experience and competence in core clinical
cardiology
 Ability to undertake cardiology on call at
Specialist Registrar level
 Up-to-date with current medical practices
 Ability to take independent clinical decisions
when necessary and to seek advice from
senior doctors as appropriate
ATTITUDE
APTITUDE
PERSONAL
CHARACTERISTICS
 Motivated and efficient
 Able to relate to patient, relatives, staff and
medical colleagues
 Effective communication skills – verbal and
written
 Genuine commitment to working as part of a
multi-disciplinary team
MANAGEMENT
Evidence of understanding of role of clinical
management
OTHER
REQUIREMENTS
Resident when performing out of hours
commitments
Satisfactory Immigration status for length of
contract
Satisfactory Health Clearance
Satisfactory CRB Clearance
Fluency in English
DESIRABLE
Higher degree
National Training Number (NTN)
in Cardiology
 Initial experience in
electrophysiology studies
 Audit
 Research (preferably in
electrophysiology)
 Experience with IT
Management Training;
participation in the development
of clinical services