Trust Fellow in Cardiothoracic Anaesthesia and Intensive Care (ST3+)

Job responsibilities

The post is based in our Cardiothoracic anaesthesia (CTA) theatres and/or Cardiac Intensive Care unit (CICU).

Cardiothoracic theatres for adult cardiac & thoracic patients:

The Freeman hospital has 2 adult cardiac theatres and 2 adult thoracic theatres running on almost daily basis. However, adult congenital anaesthesia run in different theatre and is provided by a different congenital anaesthesia team but ultimately come to our adult CICU after surgery where we manage them thereafter. One of the thoracic theatres is usually for Robotic surgeries.

The average number of cases for each cardiac theatre is usually 2 elective operations daily, while the average number of cases for thoracic theatres is 3 cases / theatre daily.

Parallel to CT theatres, we run daily anaesthetic list for cardiology patients in cath labs.

The CTA department also run a cardioversion theatre on weekly basis.

The CTA department also provide urgent and emergency perioperative care for all heart, lung or heart lung transplant patients, in addition, the service extends to cover MCS provision and aortic surgery covering the 24 hrs.

Intensive care for adult cardiac patients (CICU):

The CICU has twenty-one level three beds (six isolation cubicles) and seven level two beds in an adjoining area. CICU duties are based in these areas but extend to support deteriorating patients on the wards, support for cardiology emergencies and accompanying patients during transport to other centres.

We work closely with the transplant, VAD and ECMO teams, and the successful candidate will be expected to take a particular interest in the management of our complex patients requiring advanced support. There are twice daily transplant and VAD rounds with further mutual support and joint decision making as required. Freeman is unique in the UK in offering transplant services for all solid organs on one site and there are close ties with experts in other disciplines such as microbiology, radiology and haematology who frequently assist our team.

We support the cardiothoracic surgical programme which includes revascularisation, valve surgery, aortic root surgery, pericardiectomy and the successful candidate will be involved in the postoperative management of these patients in addition to adult congenital patients. We are a national centre for adult congenital cardiac surgery and we care for these incredibly complex patients on our ITU following their surgery. Our cardiology colleagues require support for some primary PCI or heart failure patients and we provide support in the management of patients who have had an out of hospital cardiac arrest. We have a thoracic surgical programme which includes laser and stents for major airway obstruction, robotic and minimal invasive lung resection. We have a team specialising in the management of pulmonary hypertension and we provide critical care support for their challenging patients.

We offer advanced haemodynamic monitoring for example by PA catheter and echocardiography. Besides pharmacological cardiovascular support we use various forms of mechanical support such as intra-aortic balloon counter pulsation, Impella, LVAD, RVAD, VV and VA ECMO.

There are two medical ward rounds each day led by a consultant with an interest in Cardiothoracic Critical Care. Our morning round which is concerned with the detail of patient management and there is an evening business round to plan for overnight care.

We have a multidisciplinary approach, working closely with, for example nursing, physiotherapy, microbiology, nutrition, pain, psychology, speech and language therapy.

The trust is adopting a paperless medical record. Our medicines prescription, administration, investigation ordering and results with various documentations are electronic, and we will be adopting a fully paperless system for critical care medical and nursing records in the near future.

Echocardiography

The appointee will have the opportunity to acquire a working knowledge of the fundamentals of echocardiography during the tenure of the post. The cardiothoracic anaesthetic department runs a week long TOE course once a year. The appointee will be encouraged to get accredited with British Society of Echocardiography or European Association of Cardiovascular Imaging in Trans-oesophageal Echo with all possible help for theory exams and collection of cases for logbook.

Post-operative analgesia techniques, with special reference to thoracic surgery

Attendance on pain ward rounds is offered.

Cardiothoracic Theatres & CICU

Audit and research

The appointee will be encouraged to undertake audit and research projects during the post.

Education

The appointee will be encouraged to participate in teaching for medical students, nursing staff and less experienced trainees, and to undertake the preparation of topical reviews. There are weekly departmental educational meetings which are co-ordinated by the Specialist Trainees.

On-call

There is a 2-tier rotational trainee / fellow rota, with advanced critical care practitioners participating in the first tier rota. A rotating ST3+ from the Northern region or an ACCP will be on a full shift rota covering ITU mainly. The appointee will be 2nd on-call on a full rota covering predominantly ITU, but providing support to theatres if required or appropriate, or if split rota is active which depends on the total number of fellows and trainees, in addition to ACCPs.

The Trust Fellow appointed to this post will be allocated a consultant educational supervisor. The fellow will be expected to maintain a logbook of activity, to ensure that his/her training can be easily reviewed and optimised in conjunction with the educational supervisor. This logbook should be made available for external assessment if required.

Flexibility:

In line with the Trusts core value of placing patients at the heart of everything we do, we are developing our service provision to be responsive to the needs of our patients. To meet those needs some staff groups will be increasingly asked to work a more flexible work pattern so that they can offer services in the evening or weekend. As a result any offer of employment to a consultant post will be subject to you agreeing to work a new more flexible pattern or working in the future if required, including evening and weekend work.

Please read attached Job Description and Person Specification.

Education and Qualifications

Essential

• MBBS or equivalent.
• Must hold full GMC registration or be eligible to obtain full GMC registration within 3 months.
• Must have or working towards FRCA, FFICM, EDAIC or similar

Desirable

• Other relevant qualifications (ALS, PALS/ CALS, CcrISP, EDIC).
• TOE/ TTE certification or working towards it.

Clinical Skills and Knowledge

Essential

• Cardiothoracic anaesthesia and/or cardiac ICU exposure/experience.
• Good history and examination skills.
• Experience in US guided lines insertion
• Ability to formulate a differential diagnosis.
• Able to order appropriate investigations.
• Able to manage common medical emergencies and ongoing management in critical care.
• Knows when to appropriately seek assistance from a senior colleague.

Desirable

• Previous NHS Experience
• Experience in TOE
• Experience in TTE
• Experience in POCUS/ FoCUS or similar.
• Experience in bronchoscopy
• Neat, legible writing of notes/charts
• Computer skills

Maintaining Clinical Competence

Essential

• In 4th year or equivalent of SpR training.
• Evidence of smooth progression through training programmes

Teaching

Essential

• Have experience in teaching undergraduate medical students, foundation year 1 doctors, nursing or allied health professional staff

Desirable

• Willingness to develop new approaches to teaching and learning.
• Postgraduate diploma/ certificates in medical education

Clinical Governance, Audit and Research

Essential

• Experience of Audit/ QI projects.
• Understanding of research principles.

Desirable

• Current Good Clinical Practice certification
• Active in research

Communication, Relationships and Working with Colleagues

Essential

• To be clear, fluent and articulate in communication in English
• Experience and ability to work in multi-professional teams.
• Able to prioritise work appropriately
• Able to take a clinical leadership role where an acute situation demands

Desirable

• Ability to organise.
• Willingness to take part in departmental organisation

Personal Attributes

Essential

• Alignment with the Trust's Values
• Flexible approach to service delivery and committed approach to development.
• A commitment to personal / unit CPD
• Time management skills.
• Honesty, integrity, awareness of ethical dilemmas, respect for confidentiality

Desirable

• Evidence of leadership skills.
• IT literate

Disclosure and Barring Service Check

This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.

Certificate of Sponsorship

Applications from job seekers who require current Skilled worker sponsorship to work in the UK are welcome and will be considered alongside all other applications. For further information visit the UK Visas and Immigration website (Opens in a new tab).

From 6 April 2017, skilled worker applicants, applying for entry clearance into the UK, have had to present a criminal record certificate from each country they have resided continuously or cumulatively for 12 months or more in the past 10 years. Adult dependants (over 18 years old) are also subject to this requirement. Guidance can be found here Criminal records checks for overseas applicants (Opens in a new tab).

UK Registration

Applicants must have current UK professional registration. For further information please see NHS Careers website (opens in a new window).