Job responsibilities
The single-site Acute Hospital will benefit from co-located specialist services which will support the new Emergency Department with dedicated imaging facility and Assessment Units. It will provide state-of-the-art treatment and care for patients from Sandwell and across the region and will become the civic heart of the area and a point of pride for the community.
Cardiology wards/CCU:
The cardiology consultants provide a seven day service for cardiology patients on the two sites (Sandwell and City). The Consultant Cardiologist of the Week on each site carries out a ward round every day, supported by junior staff. Sandwell Ward Rounds are covered by Interventional Cardiologists in the morning. City Hospital Ward Rounds are covered by Non-Interventional Cardiologists (all-day). This will alter after the move to the state of art MMUH acute hospital. All the patients requiring cardiology management are reviewed by the cardiology team with daily ward rounds on the cardiology wards, acute medical unit and ward referrals. All suspected acute coronary syndrome patients will be seen, as well as those with significant arrhythmias and those with heart failure. Junior medical staff for the department are shared by the consultants. The cardiologist of the week has also recently started supervising the virtual ward, after experienced nurses have visited patients at home including facilitated early discharges. Weekly triage of referrals is performed by one Cardiologist currently with scope to expand the remit of other Cardiologists to be involved in this service.
Out-patient Clinics:
At Sandwell Hospital, the out-patient department is directly adjacent to the cardiology department and therefore access to exercise testing, echocardiography and rhythm management facilities. At City Hospital, the recently-built Birmingham Treatment Centre also provides out-patient facilities adjacent to the Cardiology Department. The appointee would have two cardiology clinics per week. There may be a requirement for the appointee to do outpatient work outside the hospital in line with the Right Care Right Here programme. At present there were a total of about 18000 outpatient attendances per year in the cardiology Dept. Modern IT systems (UNITY) support delivery of service to improve rapid turnover and communication with primary care. Electronic Patient Records are widely available throughout the Trust on Trust issued desktops and laptops.
Other services:
A primary angioplasty service for acute myocardial infarction is present , with 24 hours, 7 day service running since January 2005. The Unit enjoys close links with the Cardiac Surgery Departments at New Cross Hospital, Wolverhampton, and also the Queen Elizabeth Hospital, Birmingham. Twice weekly lunchtime surgical MDTs are held with the team of cardiac surgeons from Wolverhampton (normally via Teams since the pandemic). Professor Connolly and the senior rehabilitation nurses run a comprehensive and evidence based secondary prevention service. There is a comprehensive Device service for the Trust. Bradycardia pacing has been carried out on the Trust sites for over 40 years and biventricular pacing (CRT) and implantable cardioverter-defibrillator (ICD) implantation. We have also recently introduced subcutaneous ICD implantation and follow-up. There is an established Heart Failure Service with strong links over both Sandwell and City campuses. We have an established percutaneous mitral valve program (PTMC) and SWBH is one among the top 3 UK PTMC centres.
Cardiac Imaging:
There are well-developed cardiac imaging services at both City and Sandwell Hospitals.
Our echocardiography department is fully accredited by the British Society of Echocardiography for all provided services: Transthoracic echocardiography, transoesophageal echocardiography, stress echocardiography and training. We have developed an extensive Departmental Quality Assurance programme including frequent audits of performance, weekly echocardiography meetings and educational activities. The department is also IQIPS accredited.
The department is split over 2 sites and most staff rotate to ensure continuity of services. This is a busy department with 12 sonographers (8 with BSE accreditation), performing more than 12,000 TTEs. The department also performs more than 600 stress echocardiograms and more than 100 TOEs per year. We offer a range of stress echocardiography services including dobutamine stress echo, treadmill exercise stress echo and supine bike exercise stress echo. We apply stress echocardiography for a variety of indications including risk stratification of coronary artery disease, myocardial viability, and assessment of valve disease. Participation in the service would be required from a suitably qualified applicant. A comprehensive nuclear cardiology service is well established on the City site.
Coronary CT is performed at Sandwell [and soon at City Hospital] with a Siemens Somatom Definition Flash 256 slice scanners, capable of acquiring a full CT coronary angiogram in a single heartbeat with minimal x-ray exposure. This has been used for coronary studies since 2010. The Cardiac CT programme is expanding rapidly; currently we do over 2000 scans a year. Cardiologists work in collaboration with radiologist providing a joint reporting and same day results/outcome delivery service. There is an established CT TAVI service providing a comprehensive workup prior to aortic valve intervention. Participation in the cardiac CT service would be welcome from a suitably qualified applicant or training will be given if requested.
Cardiac MRI was introduced in February 2015 with a Siemens Avanto1.5 TeslaMR scanner at the City site. The service is on an expansion curve and 800-1000 scans a year are now being done. It is anticipated that stress perfusion CMR will become incorporated into the normal workflow in the future-participation in the service would be required from a suitably qualified applicant. Weekly MDT meetings occur in, echocardiography, electrophysiology, heart failure, CMR and PCI and alternate week Academic/CTCA MDT.
Proposed work programme:
The working week for a full-time consultant is comprised of 10 programmed activities (PAs) each of which has a nominal timetable value of 4 hours. Programmed activities that take place outside the hours of 7am and 7pm Monday and Friday or at weekends or on public holidays will have a timetable value of three hours rather than four.
A job plan and work schedule will set out agreed arrangements for how work is organised, where it is located, what in general terms the work comprises and when it is to be performed.
For this post direct clinical care (work relating directly to the prevention, diagnosis or treatment of illness) includes emergency work (including whilst on-call), outpatient activities, multi-disciplinary meetings about direct patient care, and administration directly related to the above. Supporting professional activities (that underpin direct clinical care), include participation in training, medical education, continuous professional development, formal teaching, audit, clinical management and local clinical governance activities.
Supporting Professional Activities (SPAs) are an essential part of the work of a doctor and the organisation is fully committed to supporting this work. Effective job planning will define the detail of what activities are to be delivered and how much time is to be given to undertaking these activities. This post will initially have 1.5 PAs of the 10 PA job plan for supporting professional activities to cover Continuous Professional Development (CPD) and General SPA (formal teaching activities outside clinical and education supervisory roles, participation in training, medical education, audit, research, annual appraisal and job planning leading to revalidation), local clinical governance activities, dealing with non-patient administration e.g. organisational communication and attendance at operational/staff meetings.
For more information on the job role and responsibilities, please refer to the Job Description attached.
For an informal discussion, please contact:
Group Director : Dr Chetan Varma, Consultant Cardiologist and Group Director for Medicine on 0121 507 5841; email: c.varma@nhs.net
Clinical Director: Dr Stavros Apostolakis, Consultant Cardiologist on 0121 507 5634;email: stavros.apostolakis@nhs.net
Specialty Lead: Dr Vinoda Sharma, Consultant Cardiologist on 01215075841; *email: vinodasharma@nhs.net
