Royal Papworth Hospital is the largest heart and lung specialist hospital in the country. There are 20 cardiology consultants and 11 SpRs at Papworth with training being offered in all the areas of cardiology notably: intervention including primary PCI (~1000 cases annually), EP and devices, imaging (simple and advanced echo, CT and MRI) cardiomyopathy and transplant cardiology. Cardiology on call is 1:10 with no GIM commitment; however SpRs are expected to manage medical problems in patients under cardiology. There is no A+E in the hospital, but emergency cases can be admitted through DGH A+E 24/7.
Norfolk and Norwich University Hospital is a large, modern hospital with close links to the Norwich Medical School. The Cardiology Department works within the hospital and is well integrated. There are currently 14 full-time cardiologists with plans for expansion covering all the cardiac subspecialties. Subspecialty training in imaging, intervention (including primary PCI, complex procedures), simple Electrophysiology procedures and devices/complex devices is possible. NNUH is a level 2 specialist centre for adult congenital heart disease and provides both generic and initial specialist ACHD training. The cardiology registrars out of hours cover cardiology patients and primary PCI as well as dealing with certain referrals from the rest of the hospital but there is no acute GIM rota commitment.
Addenbrooke’s hospital is a very large teaching hospital comprising of in excess of 1100 beds. There are 4 academic and 4 clinical consultants, 4 training SpRs, 4 research SpRs and 1 senior fellow. There is 1:5 cardiology on call during day time and 1:10 out of hours, with variable commitments to GIM. There is training in diagnostic angiography, basic and complex pacing and imaging (predominantly echocardiography and limited CT/MRI). SpRs usually have 2 clinics per week in general cardiology although specialist clinics in inherited cardiac conditions also exist.
Bedford is a medium sized DGH with 440 beds, however it has a large cardiology unit, offering PCI services to other surrounding hospitals. The cardiology training received from 5 consultants is regarded very highly by SpRs who can expect to get good experience in angiography, angioplasty, pacing and basic echocardiography. There are three cardiology registrars (2 with training number) who alternate on a monthly basis between covering the wards, covering referrals and a free slot for training, with clinic and cath lab time spread between these. Registrars work in GIM in a 1:12 rota together with the other specialist registrars.
Ipswich hospital is a large DGH compromising of 800 beds and covering most medical specialties located in Suffolk. It has 7 cardiology consultants with subspecialties in intervention, complex devices, heart failure and imaging. Registrar training is a high priority and trainees have regular sessions for angiography, bradycardia pacing, and echocardiography (transthoracic) in addition to in-patient and out-patient work. Trainees also have the opportunity to gain experience in the PCI lab, advanced ECHO (TOE and DSE) and Nuclear Medicine (MPI reporting with a dedicated consultant Radiologist), and in community cardiology. There are 2 SpRs with training numbers and 2 trust registrars. There is only GIM on call averaging 1:12.
Lister is a large district general hospital aiming to expand its services across the spectrum. Since July 2014 cardiology has expanded dramatically- with a 38 bed acute cardiac unit, a 24 hour primary PCI service and a busy echo department. There are 8 cardiology consultants and 9 registrars. 3 are SpRs with a training number (usually 2 from EoE and 1 from London) and the remaining are trust grade registrars. One SpR participates in GIM on-call, which tends to be well staffed, and the others participate in the 24 hour cardiology on-call rota. There is good experience in the cath lab and good exposure to acute cardiology at the front door.
Luton and Dunstable Hospital is a 600 bed hospital located in South Bedfordshire. It is an acute hospital with one of the top performing emergency departments in the country. There is a 13 bed coronary care unit with 6 high dependency beds. There is a modern cardiac centre opened in 2013, which provides modern facilities for diagnostic angiography, cardiac pacing, and percutaneous coronary intervention. There are 5 cardiology consultants with a mix of special interests including coronary intervention, heart failure and cardiac imaging. There is 1 training registrar and 3 long-term trust grade doctors. Cardiology clinics include rapid access chest pain clinics, general cardiology, rapid access heart failure clinics and a visiting consultant clinic for arrhythmia/electrophysiology. Trainees participate in the acute medical registrar rota approximately about 1:12.
Peterborough is a reasonably large DGH (~600 beds) with most general medical and surgical specialties on site. There are 2-3 cardiology SpRs and 3.4 full-time consultants with interests in coronary intervention, complex devices and imaging. The SpRs between them cover the inpatients, referrals, lab and 5 outpatient clinics per week as well as doing GIM SpR on call 1:12. The cardiology unit comprises 29 cardiac ward beds and 12 CCU beds. The firm manages both cardiology and general medical patients in the unit. There is an on-site cath lab in which trainees can get the opportunity to perform both diagnostic angiography and simple device insertion (bradycardia pacemakers, ILRs) most working days. Trainees can also get TTE and TOE experience.
West Suffolk Hospital is a 430 bed hospital in Suffolk. There is a 7 bed coronary care unit and a further ward shared between general medicine and cardiology. There is a mobile coronary angiography suite which comes to the hospital once or twice a week for outpatient diagnostic angiography. It is anticipated that by August 2016 West Suffolk Hospital will have its own dedicated diagnostic catheter laboratory. There are four cardiology consultants with interests in complex device and imaging. There are two training SpRs, one clinical fellow and one junior doctor as part of the cardiology team. There are a mix of general cardiology clinics including heart failure and rapid access chest pain clinics. There are opportunities for trainees to learn specialist imaging including stress echocardiography and transesophageal echocardiography and diagnostic angiography. Trainees will be part of the acute medical registrar rota approximately about 1:11.
Essex CTC is a large dedicated cardiothoracic unit. There are 8 SpRs with training provided in all the subspecialties. On calls are purely for Cardiology with referrals from the region for tertiary care management or urgent PCI. Training is driven by SpR interests and includes imaging, electrophysiology or intervention. There is ample consultant supervision for training. Four available labs for cardiac catheterisation and devices. Dedicated CT coronary angiography and cardiac MRI facilities on site. There is opportunity for specialist outpatient clinic training. Specific teaching occurs at the monthly regional audit meeting which includes supervised dedicated registrar teaching from the Cardiology curriculum and SpRs are also encouraged to present at the Audit meeting.
Basildon District Hospital has a dedicated cardiology ward with 33 patients. There are daily Consultant led ward rounds. There are 4 cardiology consultants with 2 middle grades, out of who one is a training SpR. Training involves experience in cardiac catheterisation and bradycardia pacing. There is GIM on call commitment. Basildon District Hospital operates separately to the neighbouring Essex Cardiothoracic Centre.
Broomfield hospital has four cardiology consultants and four middle grades (out of whom two are training SpRs) with GIM on calls. It is a unit with positive attitude towards fostering independence in cath lab and clinic. There is significant cardiac catheter experience and opportunities for pacing with consultant supervision. There is frequent outpatient work and regular specialised cardiology teaching. SpRs are actively encouraged to attend audit days and monthly training days at the Essex Cardiothoracic Centre. There is a British Society for Echocardiography accredited physiology department offering Transthoracic Echocardiography, Transoesophageal Echocardiography and Stress Echocardiography.
Colchester hospital has a 24 bed cardiology ward (12 CCU and 12 stepdown) with 5 cardiology consultants. There is good training opportunity particularly in echocardiography (with active encouragement to train towards BSE qualification). SpRs participate in GIM on call. There are two SpRs with training numbers and one middle grade supported by two SHOs and three house officers on the ward team. There is ample opportunity for training in myocardial perfusion scanning, Dobutamine stress Echocardiography and CT coronary angiography with all being performed on site. There are also daily lists for cardiac catheterisation with bradycardia pacing.
Southend hospital has five cardiology consultants and six middle grades (two of which are training SpRs). There are 11 CCU beds with 18 beds on a stepdown cardiac ward. Daily consultant ward rounds. There are two FY2s and one FY1 with a trust grade SHO. It offers great opportunity for training in the cath lab and echocardiography (transthoracic, transoesophageal, stress and 3D ECHO). There is good outpatient clinic exposure with two clinics per week. There is also GIM on call.
Princess Alexandra Hospital has 4 cardiology consultants and 2 associated specialists. There are 4 middle grades out of who 1 is a training SpRs. There is good training in diagnostic angiography, bradycardia pacing, echocardiography and SpRs cover GIM on call.
West Hertfordshire Hospitals NHS Trust is a medium sized district general hospital with 600 beds, spread across three sites. There is a large cardiology department, comprising 12 consultants (4 intervention, 4 imaging, 3 EP/ devices, 1 inherited cardiac conditions) providing comprehensive diagnostic and interventional cardiac services. Junior members of the team include 5 specialist trainees, 3 clinical fellows (SpR level), 3 CMTs and 2 F1s. There are two fully functional cath labs providing exposure to diagnostic angiography, coronary intervention, pacemaker/ complex device implantation and electrophysiological assessment and treatment of arrhythmia. Plans to introduce day case AF ablation are in advanced stages. In 2017, a state of the art cardiac imaging suite housing cardiac MRI and cardiac CT scanners, was opened offering unique access to advanced cardiac imaging technology. There is a well established echocardiography service, and trainees are actively supported to achieve BSE accreditation in transthoracic/ transoesophageal echocardiography. WHHT has a busy A&E/ acute admissions unit, and specialist trainees are expected to participate on the GIM rota.