Job responsibilities
INTRODUCTION
The Thoracic Aortic
Aneurysm Service at Liverpool Heart and Chest Hospital is one of the busiest
specialist thoracic aortic services in the UK providing comprehensive care for
patients with complex aortic disease.
Six cardiac surgeons with
a specialist interest in thoracic aortic surgery operate on more than 300
patients per year.
At the centre of the
service is the Aneurysm Clinic which has well over 3000 operated patients under
follow-up and another 1000 under surveillance. Patients are discussed at a
weekly multidisciplinary team (MDT) meeting which includes cardiac surgeons,
vascular surgeons, intensivists and physicians ensuring appropriate bespoke
patient centred care.
Facilities include a
specialist hybrid theatre allowing hybrid procedures using stents and
conventional surgery. A 24/7 specialist aortic on-call service is available 365
days per year.
The service is integrated
with Vascular Surgery in the form of Liverpool Cardiovascular Surgery (LCS)
with weekly open and endovascular intervention by vascular surgeons. Joint
weekly clinics are scheduled for complex intervention. The service is supported
by two Aortic ANPs and Aortic Administrator.
We are also involved in research and
innovation through collaboration with The University of Liverpool.
Training is important to
us and we have had a succession of aortic fellows from around the UK and the
world, with both cardiac and vascular backgrounds, who have spent time with our
team. In a recent review of the last 5 years of training, Type A dissection
repairs were done by trainees. Patients are supported by a specialist Aortic
Nurse Practitioner.
We have a Proximal Aortic
Fellow and a Distal Aortic Fellow, one supported by Terumo and one by
Artivion. If possible new fellows start as a Proximal Fellow focusing on root
and arch surgery, then transitioning to the Distal Fellowship, for
thoracoabdominal aortic surgery experience. The distal fellow works closely
with our Vascular colleagues. It is expected that the two fellows will work
collaboratively to cover on-call, clinics and theatre with agreement on who
would benefit most from opportunities. Although typically the fellows are
cardiac surgery trainees, on occasions we have appointed vascular surgery
trainees.
https://www.lhch.nhs.uk/our-services/aortic-aneurysm-surgery/
MEDICAL
STAFF
There are
5 Consultant Aortovascular Surgeons in the Trust:
Mr M Kuduvalli Cardiac
Surgery and Aortic Surgery (DMD)
Professor M Field Cardiac
Surgery and Aortic Surgery (Clinical Lead)
Miss D Harrington Cardiac
and Aortic Surgery
Mr O Nawatou Cardiac
and Aortic Surgeon
Mr Othman Cardiac
and Aortic Surgeon
Mr Kenawy Cardiac
and Aortic Surgeon
There are also dedicated ANP for Aortic
Surgery as well as an Aortic Administrator.
Aim
of Fellowship:
To provide a comprehensive experience of
managing patients with thoracic and thoracoabdominal aortic pathology. The post is initially for 6 months
extendable to 12 months after review and mutual agreement. There is no
commitment to general cardiac / thoracic surgical duties or to the on call rota
for middle grade surgeons. The focus will be on complex proximal aortic surgery
from root to total arch, and where opportunity allows, thoracoabdominal
intervention.
Funding:
The Fellowship is funded by Terumo at
£35K per year and an additional supplement by LHCH. There will be a deduction
of basic rate of income tax from this amount at source.
Experience
offered dependent on background:
Operating:
To provide:
1) First operator experience of proximal
thoracic aortic surgery including root replacement, proximal arch and total
arch surgery, including emergencies
2) Experience of the management of
thoracoabdominal aortic disease, and dependent on experience, duration of
fellowship and opportunity, progression to operative experience.
Critical
Care:
1) Experience
of managing patients in the critical area including MEP and spinal drains
Ward
Care:
1) Experience
of managing aortic patients on the ward
Outpatient:
1) Experience
of assessing new patients including patients undergoing staged procedures as
well as surveillance and post operative follow-up.
MDT:
1) Experience
of presenting and discussing complex aortic cases in a multidisciplinary
forum.
On-call
dependent on background:
1) First
on-call experience for all urgent and emergency referrals. No commitment to
general junior on-call system. The exact arrangements depend on experience and
background on the two fellows.
Audit
and research:
1) Opportunities
to engage in routine audit of clinical practice and be involved in research
projects.
Commitments
and responsibilities (Example):
Monday
All
Day Theatre including TAAA list
Tuesday
All
Day Theatre including TAAA list
Wednesday
0815-0900
Weekly
Regional MDT (Distal Fellow)
Presentation
of cases and provisional plans.
0800-1200 (Proximal Fellow)
1)
Clinic scrutiny for following week
including a patient-by-patient review confirming imaging and a plan.
2)
Admin
/ Discharge paperwork / database completion.
0800-1200 (Distal Fellow)
1) Liverpool Cardiovascular Service Clinic.
1200-1300
Weekly
Proximal MDT (Proximal Fellow)
1300-1800
Aortic
Clinic (Proximal Fellow)
1300-1800(Distal Fellow)
1)Clinic scrutiny for following week including a
patient-by-patient review confirming imaging and a plan.
2) Admin / Discharge paperwork / database
completion.
Thursday
All
Day Theatre including Vascular List
Friday
All
Day theatre
In
addition to this, the Fellow will be expected to do a ward round of all aortic
surgical patients in the hospital and liaise with the Aortic Surgery ANP and
the Consultants in their management.
Additional
information:
Annual
Leave and study leave:
Allowance as per standard NHS SpR
contract and by written application to Aortic Lead.
Priorities
in theatre:
Where possible the aortic fellow will
have priority over in-house SpRs as operating surgeon or first assistant
however compromise may be required to meet the needs of our SpRs with some
cases performed by SpRs in part or whole.
Learning
agreements:
At the start of the fellowship a formal
learning agreement will be written up based on experience and interests
Contacts
Mr Field and Mr Kuduvalli
Liverpool Heart and Chest Hospital
NHS Trust
Thomas Drive
Liverpool, L14 3PE Telephone
(0151) 228 1616
The Trust is committed to approaching
the control of risks in a strategic and organised manner.
The postholder must be aware of their
individual responsibilities as detailed in the Trusts Risk Management, Health
& Safety and Incident policies, and those under the Health and Safety at
Work Act. This includes the reporting of any untoward incident, accident,
potential or actual hazard identified.
All
staff are required to be familiar with the arrangements for safeguarding
children, young people and vulnerable adults and support the organisation in
promoting the welfare of children, young people and vulnerable adults.
Staff
working directly with children, young people and vulnerable adults will have a
responsibility to ensure safeguarding and promoting their welfare forms an
integral part of their duties.
Staff
who come into contact with children, vulnerable adults, parents and carers in
the course of their work and/or have access to records will have
responsibilities to safeguard and promote the welfare of children, young people
and vulnerable adults.
Staff who come into contact in the
course of their duties, with parents, carers or other significant adults or
children, young people and vulnerable adults should always be mindful of
safeguarding and promotion of the welfare of these individuals.
The
Trust is a Health Promoting Hospital.
The Trust expects that when you are presented with opportunities to
improve the lifestyle of our patients you seek help from appropriately trained
clinical staff to ensure patients are supported and assisted in making the
necessary lifestyle changes. This is in
accordance with best practice as described in the DoH white paper
Choosing
Health Making Healthy Choices Easier.
This
document is intended to be used as a guide to the general scope of duties
involved in this post. It is not exhaustive and should not therefore be used as
a rigid specification. It will be kept under review and amended as required in
consultation with the postholder.
The Liverpool Heart & Chest Hospital
NHS Foundation Trust is committed to achieving equal opportunities. All
employees are expected to observe this policy in relation to the public and
fellow employees.
All staff are expected to adhere to, and act in accordance with, the values & behaviours of the Trust
