Critical Care Consultant: Shock service - Cardiothoracic ICU (CTICU), St Georges Hospital

We are looking for an outstanding candidate to join the Critical Care Team working on theCardiothoracic Intensive Care Unit (CTICU) at St. George's Hospital this is a great opportunity to join the Critical Care Team of a progressive London teaching hospital.

This is an exciting time for the Critical Care Directorate at St Georges, with funding in place for a new 20 bedded Critical Care Unit to add to our existing estate, as well as developments in outreach and a new SHOCK pathway planned over the next 06 months, providing the perfect opportunity for new team members to develop their own interests and support the growth of the department.

Applicants should have the FFICM or an equivalent intensive care qualification and have suitable experience and qualifications in their proposed secondary specialty. Applicants must be on the GMC Register or within 6 months of obtaining a Certificate of Completion of Training or Certificate of Eligibility for Specialist Registration (CESR). For further information please refer to the person specification in the job description.
Main duties of the job

We are looking for an excellent individual to join the Critical Care team of this progressive London teaching hospital. In addition to General Intensive Care, the Directorate specialises in Cardiothoracic/Cardiology Intensive Care, Neuro Intensive Care and supports an Outreach service, Critical Care Retrieval Service and a Survivorship programme. Experience or interest in these areas is beneficial and training will be given to those who wish to pursue such sub-specialisation.

Cardiothoracic Intensive Care Unit (CTICU)

CTICU offers all aspects of level 2 and level 3 Critical Care to a wide variety of patients, from all surgical and medical specialties. In terms of case mix admissions:

• Approximately 35% are post-operative cardiac surgery patients
• Approximately 21% are acute cardiology patients (e.g. Out of hospital cardiac arrest, acute left ventricular failure, decompensated chronic heart failure)
• Approximately 7% post-operative vascular surgical patients
• The remainder are a mixture of general medical and surgical admissions
• The unit has 6 side rooms, so has a strong relationship with the Infectious Diseases department. CTICU is the primary destination for COVID-19 and influenza patients and other patients requiring source isolation within Critical Care.

The unit is developing a cardiogenic shock service which will include mechanical circulatory support with impella and VA ECMO.

About us

Our main site, St George's Hospital in Tooting - one of the country's principal teaching hospitals - is shared with St George's, University of London, which trains medical students and carries out advanced medical research.

St George's University Hospitals NHS Foundation Trust serves a population of 1.3 million across southwest London. A large number of services, such as cardiothoracic medicine and surgery, neurosciences and renal transplantation, also cover significant populations from Surrey and Sussex, totalling around 3.5 million people.

The trust also provides care for patients from a larger catchment area in southeast England, for specialties such as complex pelvic trauma. Other services treat patients from all over the country, such as family HIV care and bone marrow transplantation for non-cancer diseases. The trust also provides a nationwide state-of-the-art endoscopy training centre.

We are committed to equal opportunities and improving the working lives of staff, we will consider applications to work flexibly or part time.

Job description
Job responsibilities

Please see below job description and person specification for more detailed information on this post.

Main Duties and Job Plan

It is envisaged that the post holder will carry out the majority of their duties as a full time Consultant Intensivist on the CTICU. They will be expected to be part of the cardiogenic shock rota and take on the following responsibilities:

• Chair shock calls of core members of shock team to rapidly establish immediate management, ongoing support and contingency plans for patients in cardiogenic shock.
• Work with the Echo/Shock Fellow to obtain and integrate haemodynamic and functional data with other assessment modalities to inform the management plan.
• Maintain oversight of the patients management during their ICU stay, working in collaboration with the relevant Intensive Care Team to ensure implementation of the management plan.
• Perform or supervise point of care echocardiography.
• Participate in delivery of the Shock team education programme.

The post is planned as 8 programmed activities (PAs) per week, of which 6.5 are Direct Clinical Care (DCCs) and 1.5 are supporting professional activities (SPAs). Locum appointments will also be considered for increased SPA allowance where justified. Amongst the current Consultant team extra SPA work is allocated for Education, Simulation, Research, Governance, Quality Improvement and Management activities.

The job plan will be fully annualised. Current job planning guidance at St Georges expects Consultants to work a minimum of 42 clinical weeks per year.

There is prospective cover for all rotas, hence the post holder is expected to liaise with his/her consultant colleagues in providing internal cover for annual, study and professional leave, which necessarily requires some flexibility. The Consultant rota is usually written up to a year in advance, taking into account individual wishes and commitments as far as possible. The post holder is expected to be flexible both in terms of session and day of the week for additional ICU clinical and supporting work.

DCC work in Critical Care will consist of:

• A number of First-on weeks: Monday to Friday 08:00 to 18:00 and Weekend on-call from Saturday 08:00 to Monday 08:00.
• A number of Second-on days: Monday to Friday 08:00 to 18:00 followed by overnight on-call Mondays to Fridays only. These will not be sequential unless there are exceptional circumstances.
• A number of Outreach Consultant days and/or post ICU Follow-up Clinic Sessions: Monday to Friday 08:00 to 18:00.

As a guide, a typical full time Intensivist on CTICU will do between 4-6 First-on weeks, 20-25 Second-on days and 5-20 Outreach/Follow-up shifts. The exact balance can be adjusted to individual preferences and departmental need and a secondary clinical interest will necessarily reduce these numbers. This job plan may be subject to change depending upon the needs of the service.

Please see the Summary of CTICU Consultant commitments at the end of the advertisement for a depiction of the DCC activities that need to be covered by CTICU Consultants.

The successful candidates will be dynamic, collegiate and have a proven track record of working will within teams. Experience in specialist cardiothoracic or cardiology ICU is essential. The candidate must have experience with mechanical circulatory support including with training and education. Successful candidates will be actively involved in helping to shape the development and direction of the unit and services we provide.

Posts are available from November. Later start dates will be accommodated for the right candidates.

Post graduate Education / Education and Clinical Supervision of Trainees

CTICU benefits from both a junior and a senior tier of junior medical staff rotas. These are staffed by a mixture of National Training Number holders in ICM and Anaesthesia, and Clinical Fellows. In addition we usually have a Foundation Year 1 post.

Clinical teaching is an integral part of the delivery of clinical care and the post holders will be expected to deliver a daily teaching ward round during their clinical duty weeks. In addition, the post holders may be asked to deliver clinical and education supervision to trainees as part of SPA. In order to fulfil these roles, the post holders will need to complete the necessary training as per the current London Deanery guidance (see http://www.faculty.londondeanery.ac.uk/professional-development-framework-for-supervisors/mandatory-training-requirements-for-supervisors/). They will be expected to develop their educational skills over time and will be encouraged to participate in educational appraisal.

Postgraduate educational activities are co-ordinated by Drs Alan Williams and Alex Dewhurst.

Undergraduate education

The Adult Critical Care Directorate provides scheduled, week long, clinical placements for all SGUL final year medical students. In addition, we provide supervision of special study modules, elective periods and Foundation Year 1 shadowing attachments. It is expected that the post holder will contribute to these education and supervision activities.

Undergraduate activities are co-ordinated by Dr Susannah Leaver (GICU).

Research

Research is an integral component of Directorate activity. We have an international reputation both for basic science and clinical trials. We supervise a wide range of research theses and degrees. We have active links and hold management roles in our regional research network. CTICU is currently recruiting for the Bling III, Tight K, Aspiflu and UK ROX trials.

Up to date Good Clinical Practice training is desirable and the post-holders will be expected to support the research activities of the unit. Post-holders will be supported in any research activities of their own.

Research activities across the Directorate are co-ordinated by Dr Susannah Leaver (GICU).

Clinical Management

The Consultant team currently undertake a number of local, regional, national and international clinical management roles. Post-holders will be expected to contribute to the clinical management of the unit and offered the opportunity to develop their skills in this domain. Further training and qualifications in Healthcare Management will be actively supported.

Generic expectations and responsibilities

To observe the Trusts agreed policies and procedures on clinical matters and to follow the standing orders and financial instructions of St Georges Healthcare NHS Trust.

• To participate in clinical governance activities within all relevant service centres.
• To complete an annual appraisal and participate in the annual job planning process.
• To have responsibility for the Health, Safety and Welfare of self and others and to comply at all times with the requirement of the Health and Safety Regulations.
• To ensure confidentiality at all times, only releasing confidential information obtained during the course of employment to those acting in an official capacity in accordance with the provisions of the Data Protection Act and its amendments.
• To work in accordance with the Trusts Equal Opportunities policy to eliminate unlawful discrimination in relation to employment and service delivery.
• To ensure skills are up-to-date and relevant to the role, to follow relevant Trust policies and professional codes and to maintain registration where this is a requirement of the role.
• To comply with St. Georges Healthcare No Smoking Policies
• To undertake such duties as may be required from time to time as are consistent with the responsibilities of the grade and the needs of the service.

The successful applicant will need commitment, enthusiasm, leadership qualities and the ability to work as part of a large multidisciplinary team.

This job description is not an exhaustive document but is a reflection of the current position. Details and emphasis may change in line with service needs after consultation with the post-holder.

St Georges University Hospitals NHS Foundation Trust is an Equal Opportunities employer and operates No Smoking Policy.

Person Specification
Qualifications and Training
Essential

• Evidence of having completed a formal training program in Intensive Care Medicine or be within 6 months of completing such a programme
• EDIC and / or FFICM and / or equivalent
• Specialist registration and a valid license to practice with the General Medical Council

Desirable

• MSc, MD(res), PhD or similar in a topic related to Intensive Care Medicine
• Good Clinical Practice (GCP) certification
• Postgraduate qualification in Healthcare Management
• PgC(H)E, MA(ed) or similar
• Educational supervision training that fulfils the Trust's minimum requirements*
• Intermediate or advanced level accreditation/s in echocardiography or POCUS

Experience
Essential

• Ability to take full and independent responsibility for the clinical care of ICU patients
• Working independently within a centre which provides mechanical circulatory support
• Education and training within a cardiogenic shock service
• Any attachments will be accessible after you click to apply.
  
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