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Detailed job description and main responsibilities

Roles and responsibilities

To provide, to a high standard, the full range of specialist diagnosis, treatment and care to patients requiring vascular services, as outlined in the proposed programme

• To organise, manage and be responsible for the diagnosis and treatment of patients in the Somerset and North Devon Vascular Network
• Except in emergencies or where otherwise agreed with your manager, you are responsible for fulfilling the duties and responsibilities agreed with your supervisor
• You are responsible for the associated duties set out in of the Terms and Conditions
• To provide a general vascular service, in collaboration with other medical, nursing and technical staff
• Teaching of Junior Staff Medical Students, APH and other professionals
• To provide supervision and training to Junior Hospital Doctors
• To participate in clinical audit, evidence based practice and Clinical Governance within the Department
• To participate in regional audit and Clinical Governance
• To participate actively in continuing professional development (CPD), including ongoing engagement with ISCP.

The Vascular Service/Network and facilities

Somerset and North Devon Vascular Network is a successful, progressive and ambitious Vascular Network with an excellent reputation for providing a comprehensive range of vascular specialist services. Vascular services for all patients in Somerset and North Devon are provided through the hub site in Taunton with spoke services at North Devon District Hospital, Yeovil District Hospital and community hospitals around Somerset and North Devon.

The Taunton site is the site of centralised elective and emergency vascular surgery and host provider of NAAASP screening for Somerset and North Devon. The South West of England has an increasingly elderly population with the highest proportion of over 65 year olds in the UK. The increasingly elderly population and high life expectancy of the local population has led to a significant vascular workload with the Network performing more than 300 index arterial surgical reconstructions and 300 angioplasties per annum.

The Vascular Unit is supported by Nurse Practitioners and Vascular Nurse Specialists who work closely with the surgical team to provide care for vascular patients with integration of specialist leg ulcer nursing care across primary and secondary care.

We have a dedicated Vascular Surgery Department in Musgrove Park Hospital with vascular outpatient facilities including access to specialist POAC including CPET, a 4 bed dressing/treatment bay and procedure room for local anaesthetic endovenous interventions. Our inpatients are cared for on Montacute Ward located in the Jubilee Building at Somerset NHS Foundation Trust.

A stand-alone vascular duplex service with 2 duplex rooms, diabetic podiatry service with podiatry treatment room, network administration, consultant offices, MDT co-ordination and NAAASP screening are all co-located within our Vascular Department

The Trusts Vascular Surgical Service benefits particularly from the excellent facilities of the Diagnostic Imaging Department (e.g. MRI and CT scanning, angiography, and interventional techniques) and the critical care (ITU 12 beds/HDU 6 beds) facilities. In collaboration with our interventional radiology colleagues we have established an Endovascular Aneurysm Repair programme, and perform approximately 40 elective infrarenal EVARs per year, many with challenging anatomy and requiring complex grafts such as branched iliac endografts. A new surgical theatre suite, including a hybrid theatre, and critical care facility is under construction to be opened in early 2025.

The work of the surgeons is supported by the skilled ward nursing teams and complemented by Vascular Nurse Specialists, who run leg ulcer clinics, provide specialist inpatient wound care, integrated community ambulatory leg ulcer care and advice/education to District and Practice Nurses.

The Trust employs 4 vascular scientists, to deliver a comprehensive duplex ultrasonography service including dedicated carotid duplex slots to maximise the efficiency/effectiveness of the working relationship between vascular surgery and the stroke service, minimising delays to urgent carotid surgery.

The Somerset and North Devon Aortic Aneurysm Screening Programme (NAAASP) commenced in February 2011. The programme office is based in Musgrove Park Hospital with screening of a cohort of 5700 per year at local GP practices across the region, regularly achieving some of the highest attendance figures in England.

Current medical staff within the vascular department

Medical staffing

• Mr AHR Stewart, Consultant Vascular Surgeon (East team) and Clinical Service Lead
• Mr PS Eyers, Consultant Vascular Surgeon (West team)
• Mr ID Hunter, Consultant Vascular Surgeon (East team)
• Mr JE Coulston, Consultant Vascular Surgeon (East team)
• Mrs KA Darvall, Consultant Vascular Surgeon (West team)
• Ms N Chinai, Consultant Vascular Surgeon (West team)
• Mr M Ajit, Associate Specialist (West team)
• Mrs V Tuff, Associate Specialist (East team)
• 4 Foundation Year 1 doctors
• 2 Core surgical trainees
• 2 Vascular specialist registrars (including this post)
• 1 General surgery specialist registrar

Operating Theatres and Recovery

The current 5 general inpatient Operating Theatres and 10 bed Recovery Unit at Musgrove Park are situated in the Old Building, close to the main surgical wards. Theatre 3 is the vascular theatre with vascular lists provided Monday-Friday. One of the theatres has been developed into a fully integrated laparoscopic suite and one for robotic surgical use.

There is a dedicated emergency theatre which is staffed for 24 hour care every day of the week.

The new theatre facility is due to open in 2025 including a 75m2 Siemens ARTIS Pheno equipped hybrid operating theatre suite

Critical Care

The fully staffed, 12-bed ITU is close to the main Theatres. 6 High Dependency beds are available adjacent to the ITU. Beds are booked for specific major elective cases. The Unit was expanded/upgraded in 2019 and will be replaced with further expansion in a newly built critical care facility in 2025.

Adult Wards

Adult surgical inpatient beds are provided in the new Jubilee Building on Barrington, Hestercombe and Montacute Wards, with en-suite WCs and showers and integrated hoisting.

Day Surgery Centre

The Day Surgery Centre is a dedicated 30 bed Centre including 6 Paediatric beds built on a separate site close to the main hospital complex. The two theatre Centre was opened in July 1994 and enables a high turnover of Day Cases. A 3rd theatre and expanded patient waiting/recovery opened in January 2004. A 4th theatre was opened in 2015 and modular ophthalmic theatre suite in 2021.

Parkside

Parkside, the Trust's own 10-bedded private patient ward is located in the Old Building close to the Childrens Ward and is accessible to the General Theatres. It was built and opened in 1990 and has successfully contributed significant income to help fund NHS developments in the Trust.

Community Outpatient Departments

The vascular service has several community based out-patient clinics in Minehead, Bridgwater, Chard, Burnham on Sea, Glastonbury and Bideford. The vascular service provides twice weekly out-patient clinics in Yeovil District Hospital and North Devon District Hospital, including ward rounds to review any vascular inpatient referrals. In addition, day case vascular surgery and interventional radiology are delivered and supported in North Devon.

Interventional radiology/ radiology investigations

There is a close working relationship with the Department of Diagnostic Imaging, which is located in the Duchess building. The vascular unit is supported by 6 interventional radiologists Dr Richard Keogan, Dr Tim Ward, Dr Kajendran Balasubramanian, Dr Katharine Lewis, Dr Hilary White and Dr Michael Ashcroft. An on-site 24/7 interventional radiology rota is in place, shared with Royal Devon and Exeter NHS Foundation Trust.

A comprehensive diagnostic imaging service including CT, MRI, and CT/PET amongst other services. The main radiology interventional suite has been reconfigured to facilitate Endovascular Aneurysm Repair (EVAR), prior to the development of the new hybrid theatre surgical build.

Venous and arterial duplex, CT and MR angiography are also provided at Yeovil District Hospital and North Devon District Hospital.

Twice weekly Vascular/X-ray multidisciplinary meetings allow the review of peripheral arterial and aneurysm cases.

Directorate Management

• Dr Helen Hopwood - Associate Medical Director
• Mr Ed Smyth- Clinical Director
• Johannah Taswell, Service Manager Urology, Vascular, AAA Screening, Breast Symptomatic, Breast Screening

Service Management

• Clinical Service Lead, Mr Andrew Stewart
• Clinical Service Manager, Mrs Lorna Hewart
• Vascular Governance Lead, Mrs Vanessa Tuff

Anyone who wishes to visit the hospital prior to interview should contact:

• Mr Andrew Stewart, Consultant Vascular Surgeon and Clinical Service Lead
• Email: [email protected]
• Phone: 01823 343200