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Job Description
1. JOB DETAILS
Job Title:
Grade:
Reports to:
Accountable to:
Location:
Specialist Cardiac Clinical Physiologist
AfC Band 6
Operational Manager
Head of Diagnostic Cardiology Unit
Diagnostic Cardiology Unit at both RHH and NGH sites
2. JOB PURPOSE
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To liaise with other Specialist and Highly Specialist Cardiac Clinical Physiologists in
delivering the Invasive Cardiology service
In conjunction with Consultant Cardiologists to perform a wide range of invasive
cardiology investigations.
To deliver clinical sessions within Invasive Cardiology.
To undertake non-invasive investigations and procedures.
To provide a safe, efficient and effective Cardiology service to our customers.
To provide a high standard of cardiology services both in and out of normal service
hours.
Undertake clinical supervision and training of trainee physiological staff.
To assist in the training of Cardiac Physiologists to degree level in conjunction with the
departments training co-ordinator. Regularly participate in CPD, other developmental
activities.
Responsible for participating in clinical audit activities, research and development and
equipment evaluation.
3. ROLE OF THE DEPARTMENT
The Diagnostic Cardiology Unit at Sheffield Teaching Hospitals NHS Trust provides an
extensive range of non-invasive, invasive and specialist cardiac investigation to the South
Yorkshire region. The investigations provided by the department include:
Non–invasive Cardiology Investigations:
1. 12 Lead ECG recording and interpretation performed on in-patients, out-patients, GP
Open Access and Rapid access Chest Pain Clinic.
2. 24 Hour Ambulatory ECG application and analysis.
3. 24 Hour Ambulatory BP application and analysis
4. Long Term Ambulatory ECG application and analysis.
5. Tilt Table Testing
6. Autonomic Function Testing
7. Signal Average ECG
8. Physiologist led Exercise Tolerance Testing (ETT)
9. Physician led Exercise Tolerance Testing (ETT)
10. Trans-thoracic Echocardiography including 3 Dimensional assessment, Valve
assessment, Stress and Congenital heart disease.
11. Tran-oesophageal Echocardiography including 3 Dimensional assessment
Invasive Cardiology Investigations
1.
2.
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4.
5.
Physiologist led Permanent Pacemaker interrogation.
Physiologist led Implantable Cardioverter Defibrillator interrogation.
Physiologist led Cardiac Resynchronisation Therapy Device interrogation.
Implantable Loop Recorder interrogation.
Left and Right Heart Catheterisation including simultaneous intracardiac pressure
measurements.
6. Atrial Septal Defects and Patent Foramen Ovale Closures.
7. Blood oximetry analysis for calculation of intracardiac shunts, atrial septal defect &
ventricular septal defects.
8. Pulmonary vascular resistance measurements.
9. Mitral valvuloplasty procedures.
10. Coronary angioplasty procedures including primary percutaneous coronary intervention.
11. Pressure wire analysis and calculation of coronary fractional flow reserve.
12. Intra coronary ultrasound.
13. Intra-Aortic Balloon Pump Therapy.
14. Temporary Pacemaker insertion.
15. Permanent Pacemaker including single and dual and resynchronisation therapy
devices.
16. Implantable cardioverter defibrillator device implantation including single and dual and
resynchronisation therapy devices.
17. Cardiac device and lead extractions.
18. Implantable Loop Recorder insertion.
19. Diagnostic and therapeutic Electrophysiological Studies for the treatment of SVT, atrial
fibrillation, atrial flutter and ventricular tachycardia.
20. 3 dimensional mapping of complex cardiac arrhythmias.
DEPARTMENTAL/DIRECTORATE ORGANISATIONAL CHART
DIAGNOSTIC CARDIOLOGY UNIT
Head of Diagnostic Services
PA to Head of Diagnostic Services
Supplies Officer
Operational Manager
(NGH/RHH)
Invasive Lead
Echocardiography Lead
Non Invasive Lead
Highly Specialist
Cardiac
Physiologist
Highly Specialist
Cardiac
Physiologist
Specialist Cardiac
Physiologist
Specialist Cardiac
Physiologist
Specialist Cardiac
Physiologist
Cardiac
Physiologist
Cardiac
Physiologist
Cardiac
Physiologist
Training Lead in
Echocardiography
Highly Specialist
Cardiac
Physiologist
Student Cardiac Physiologist
Associate Practitioner
Cardiographer/Healthcare Science Support Workers
Cardiac Apprentice
Admin Manager
Admin Officers
5. MAIN DUTIES AND AREAS OF RESPONSIBILITIES
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To work collaboratively on a day to day basis with others and ensure service needs are
met.
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Demonstrates the ability to prioritise and organise the clinical caseload within a
designated area of Cardiology.
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To be able to exercise initiative as an autonomous practitioner in both Invasive and
Non-invasive areas of, the Cardiology Department. The individual uses their discretion
to re-adjust plans as the clinical situation / need of the patient changes.
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To analyse 24 hour holter monitoring data using digital technology. To correlate data
and make decisions based on own interpretation and information within appropriate
professional and clinical guidelines. To provide factual reports and take appropriate
action to ensure patient safety and treatment maintained in accordance with
professional and clinical guidelines.
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To perform clinical physiologist led/medic supervised outpatient/inpatient exercise
treadmills. To assess referrals and direct to appropriate exercise treadmill test based
on the clinical information. To act independently and make decisions based on own
interpretation.
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To perform and provide a technical report for physiologist led tilt tests.
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To perform basic autonomic function tests.
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To provide factual reports on GP 12 lead ECG recording referrals.
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To fit ambulatory blood pressure and ECG monitors.
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To fit, analyse and interpret event recorders.
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Access to advice from Highly Specialist Cardiac Physiologist is available if required but
clinical work is not routinely evaluated / supervised. The individual may also seek
advice from external sources if required e.g. technical specialists from industry.
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Undertakes and assists with Single, Dual Chamber and Cardiac Resynchronisation
Therapy pacemaker follow – up checks including detailed interrogation, analysis of
pacemaker parameters.
Assessment of patient’s symptoms and appropriate
reprogramming of device to optimise quality of life, safety and battery longevity.
Predominantly performed on NGH Campus.
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Undertakes and assists with Internal Cardiac Defibrillator follow up. Including Cardiac
Resynchronisation Therapy devices. Detailed interrogation, analysis of the device
parameters. Including diagnosis of life threatening arrhythmias and preventative action
is taken to avoid inappropriate therapy and device optimisation. Reassurance and
counselling of patients and their relatives with regards to any problems. Predominantly
Northern General Hospital Campus.
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Assessment and interrogation of implantable loop recorder device to assess patient
rhythm and symptoms to enable adjustments in medication and treatment to optimise
patient care. Predominantly Northern General Hospital Campus.
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To perform unsupervised, full highly specialised and complex interrogations of all
implantable cardiac pacemakers and implantable devices, checking all parameters and
stored data to HRUK standards.
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To communicate and discuss service related information to Clinical Managers.
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Communicates with all members of the Multidisciplinary Team to ensure the best
possible care for the patient. Including giving detailed advice to other specialist
professions which will influence patient care / outcomes.
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Reassurance to patients who anxious about their clinical findings.
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Immediate Life Support training including manual defibrillation is essential during
procedures performed on acutely ill patients and those at very high risk of sudden
cardiac death.
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Expected to undertake informal training by means of periodic ‘in – house’ assessments.
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Non clinical skills to include computer literacy.
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To communicate information about specialist cardiac investigations to patients and
relatives/carers including those with learning difficulties and/or physical disabilities.
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Performs analyses and interprets a wide range of highly specialist and complex cardiac
investigations. Generates factual reports that are documented in patient clinical notes
and/or on relevant databases and directly used to influence patient management.
These sources are used to aid audit and compilation of statistical information.
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80% of the post holder’s time will be spent on clinical duties/carrying out diagnostic,
therapeutic or interventional technical work as appropriate, to a high quality standard,
demonstrating expertise in current clinical practice.
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Carry out all aspects of clinical work as approved by the Clinical Manager.
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Participate in the clinical Physiologists 24 Hour on-call rota for acute emergency
services in the Cardiac Catheter Laboratory and/or Implantable Cardiac Devices or
performs clinical duties out of hours. This requires a high level of autonomy, often
giving advice to medical staff with limited specialist knowledge thus directly influencing
patient care/outcomes.
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To be professionally and legally accountable for all aspects of own work, including the
management of patients in your care.
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Has highly developed level of sensory skills and good hand to eye co-ordination in
order to immediately analyse and respond to complex life threatening physiological
signs. Following interpretation of these the Physiologist uses judgemental skills in
order to make instantaneous decisions about further patient care.
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Requires a high level of manual dexterity with enhanced precision and timing skills in
order to ensure the accurate application of a range of diagnostic tools e.g.
measurement of cardiac intervals to the nearest millisecond during pacemaker
implants.
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The post holder will work in such a way that contributes towards the achievements of
the Cardiology Directorate and STH challenges.
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Commitment to high quality patient care.
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Value the contribution and individuality of staff and team members.
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Commitment to providing patient focused care.
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Commitment to working within teams.
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Commitment to personal development and the development of others.
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Motivates and develops others by instilling confidence using encouragement and
helpful, constructive feedback.
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Coaches and provides advice to others adopting a positive encouraging style.
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Provides support and guidance to other team members.
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Will listen to, communicate with, value and acknowledge contributions from others.
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Will accept the need for change and will open to new ideas and approaches, proposing
strategies in response to change.
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Makes logical, sound, reasoned decisions using relevant information.
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Relates well to people at all levels and different backgrounds showing tolerance and
patience towards others.
Promotes the importance of service quality and continuously looks for ways of
improving service quality.
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Committed to learning, seizing opportunities to further personal development and
orchestrates appropriate development opportunities.
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Seeks and welcomes feedback from others and actively learns from positive and
negative experiences.
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Complying at all times with departmental policies and guidelines.
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In conjunction with the clinical manager develop protocols which ensure compliance
with clinical governance and safe practice guidelines.
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Ensure adequate documentation and adherence to development protocols and
procedures following national guidelines and evidence based practice, updates these
protocols as necessary.
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Comply with STH trust policies including health and safety policies e.g. COSHH etc.
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To maintain accurate patient data for audit and other appropriate uses. Having full
regard for patient confidentiality.
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Knowledge and understanding of cardiology to degree level or equivalent.
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Extensive experience and knowledge of highly specialist cardiac investigations and
techniques that are performed in Regional Cardiology centres.
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Attends short courses and professional meetings in own specialist field.
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Professional examinations appropriate to clinical area.
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Routinely undertakes assessment of both in-patient and out-patients prior to a range of
cardiac investigations and uses own discretion in order to ensure the patient is suitable
for the investigation.
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Gives lead specialist advice during complex situations where analytical judgement is
required to all other members of the multidisciplinary team including Consultant
Physicians.
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Works within and towards national guidelines and directives, e.g. NICE, NSF.
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Works as an autonomous practitioner within established departmental policies and
those recognised by international organisations, e.g. British Cardiac Society, British
Heart Foundation, Heart Rhythm UK.
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Communicates with all members of the multidisciplinary team and trust-wide staff to
ensure the best possible care for patients by using negotiating, reassurance, and
persuasiveness skills.
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Communicates sensitive information about routine and complex cardiac investigations
to patients and relatives/carers including young adults and those with learning and/or
physical disabilities.
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Have advanced theoretical knowledge of cardiac anatomy, physiology. To practice
independently as an expert practitioner.
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Calibrates and manipulates a wide range of complex, expensive technical equipment
which processes, creates, updates and stores information.
Carries out a broad range of fundamental and complex Cardiac investigations and
provides accurate factual reports following analysis and interpretation of physiological
data.
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Performs / provides factual reports for a number of the following investigations on a
region – wide range of Cardiac and Medical patients including acutely ill, young adults,
elderly patients and those with a range of physical and learning disabilities:
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Demonstrates personal duty of care for safe use of expensive and highly complex
equipment. Is responsible for ensuring that others are fully trained in the safe use of
such equipment within their specialist area.
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Maintains stock levels of consumable items.
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Responsible for the day to day security of expensive equipment e.g. speciality
monitoring equipment.
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Responsible for maintaining own technical competencies in clinical areas.
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Responsible for reporting clinical incidents and adverse events to the Clinical Manager
e.g. equipment malfunctions.
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To maintain valid up to date registration with the professional bodies and comply with
guidelines in relation to professional issues.
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Responsible for formal mentorship and co-ordinates training designated junior staff and
students within own specialist area.
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To participate in the development of the educational programme for technical staff
within the department. Ensure all individuals are trained and skilled to an appropriate
level to carry out the technical work, developing competency based framework training.
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Be an active member in the in-service training programme by attendance at, and
participation in, in-service training programmes, tutorials, individual training sessions,
external courses and peer review.
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Undertakes Continuous Professional Development (CPD) in accordance with Personal
Development Plan (PDP) as developed with Lead Clinical Manager.
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Attends and participates in departmental staff meetings.
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To annually complete the Immediate Life Support certificate including manual
defibrillation certification as defined by the UK resuscitation council.
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Maintains and develops current knowledge of evidence based practice in each clinical
area.
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Undertakes collection of data for use in audit, research projects and equipment testing.
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Regularly provides training in highly specialist cardiac techniques to staff members
including specialist physiologists and medical staff.
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Regularly undertakes clinical trials involving new and emerging technologies.
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Collaborates with the Lead Clinical Manager / Clinical Manager towards implementing
changes in service within own speciality.
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Demonstrates the ability to prioritise the clinical caseload within a designated area of
Cardiology. Including planning and organisation of expected and acute workload.
Required to exert moderate physical effort. Frequent transferring of patients and
equipment on both trolleys and wheelchairs.
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To comply with Trust’s manual and handling policy at all times.
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Is forced to deal with confrontation from industry representatives who can be
demanding and intrusive.
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There is a frequent requirement for prolonged periods of concentration. Occasional
requirements for both prolonged and highly intense levels of concentration.
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Frequently interrupted during clinical work to give highly specialist advice to peers,
physicians and tackle urgent calls from other sources, e.g. staff at other hospitals within
the region that are seeking urgent advice, GP’s etc.
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Frequent exposure to highly distressing situations e.g. cardiac arrests during rescue.
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Angioplasty/coronary intervention while the patient is having a heart attack.
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Frequent exposure to highly emotional circumstances, e.g. emergency admission of
patient from Rapid Access Chest Pain Clinic due to newly diagnosed acute unstable
Coronary Heart Disease. Direct emergency admission through Accident and
Emergency Department following myocardial infarction.
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Frequent exposure to unpleasant working conditions on regular daily basis e.g. bodily
fluids including blood, sputum, vomit, urine, fleas and lice.
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Frequent exposure to highly emotional situation away from own clinical area e.g.
attending mortuary to disable implantable devices.
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Occasional exposure to highly emotional situation away from own clinical area e.g.
disabling of cardiac devices of the terminally ill in whom life-saving treatment has
agreed to be withdrawn.
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Occasional exposure to verbal and physical aggression.
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Occasional exposure to highly emotional situation following death of patient undergoing
invasive cardiac procedures.
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Deals sensitively with patients who have high levels of anxiety and aggression caused
by pain, dementia or limited mobility.
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Communicates regularly with out – patients and in-patients (day case patients and ward
stay patients) as the sole member of staff within a section and as part of a
multidisciplinary team.
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Works closely with other members of the multidisciplinary team towards a common goal
in team orientated procedures.
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Works closely with junior staff and peers to deliver agreed training protocols by means
of formal and in formal teaching sessions. Reports their progress to the individual’s
mentor and overall Head of Service.
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Communicates complex information to physicians relating to patients conditions which
may be contentious, e.g. advanced rhythm recognition – diagnosis of ventricular
tachycardia or supra ventricular tachycardia with aberrancy.
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Works closely / regularly reports to the Head of service in order to pass on any
problems and any significant incidents relating to their specialist area of Cardiology.
Receives calls from a wide range /variety of hospital staff including physicians
requesting cardiac investigations. Also receives calls from Consultant’s secretaries and
clinic support staff that need patient results from previous cardiac investigations.
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Gives advice to Physicians and other healthcare professionals as the lead technical
specialist during the working day and during emergency procedures.
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Uses tact and sensitivity to give information to patients relating to results of
investigations, the patient’s condition and further action/investigations needed.
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Plans and delivers formal teaching sessions to external sources, e.g. university
students. Performs lectures to under graduate / post graduate students/medics.
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Advises patients on medications that need omitting prior to forthcoming investigations.
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Communicates detailed instructions to patients which need to be followed after hospital
discharge, e.g. use of an ‘activator’ device to record arrhythmias following symptoms of
collapse in patients with an implantable heart rhythm recorder.
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Receives calls and gives advice to cardiac patients whom are anxious / concerned that
their device is not functioning correctly.
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Receives calls from patients enquiring about the appointing of, information about and
the implications of forthcoming cardiac investigations.
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Receives calls and gives advice to peers at other regional hospitals whom are less
experienced in specialist techniques and procedures.
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Takes calls from outside referrer’s, GP’s, Physicians from other centres e.g. on behalf
of physicians who are performing an invasive technique.
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Required to participate in the service rota as required. This service is multi-site and
occasionally necessitates travel between Trust sites.
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Occasional exposure to infectious patients e.g. Hepatitis B, HIV, MRSA.
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Almost constant use of VDU screens throughout the day when monitoring patients
during cardiac investigations and when inputting data into report systems.
6. FINANCIAL MANAGEMENT RESPONSIBILITIES
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No direct financial management responsibilities
7. HUMAN RESOURCES RESPONSIBILITIES
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No direct human resources responsibilities
8. ASSET MANAGEMENT RESPONSIBILITIES
To be responsible for the use of highly specialised technical equipment used during
specialised cardiac diagnostic procedures performed within the speciality field of
invasive cardiology.
9. WORKING RELATIONSHIPS
a)
Communicate with:
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b)
Consultant Cardiologists
Specialist Registrars
Clinical Manager
Deputy Clinical Manager
Sectional Manager, Echocardiography
Sectional Manager, Invasive
Clinical Specialists in Electrophysiology
Cardiac Physiologists AfC grade 5-7
STP Students
PTP Students
Cardiographers
Junior Medical Staff
Nursing Staff all grades
Radiographers
General Practitioners
Patients and Relatives
Provide advice to:
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Consultant Cardiologists
Specialist Registrars
Clinical Manager
Deputy Clinical Manager
Specialists in Electrophysiology
Cardiac Physiologists AfC grade 5-7
Student / Regional Students
Cardiographers
Junior Medical Staff
Nursing Staff all grades
General Practitioners
Patients and Relatives
This job description is not meant to be finite and may be changed subject to the exigencies of the service.
Similarly the postholder may be requested to undertake such other duties not mentioned in the job
description which are commensurate with the grade.