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LOCUM CONSULTANT IN MEDICAL ONCOLOGY Breast Cancer CONTENTS Job Description Page 2-8 Job Plan Page 7 Person Specification Page 9 1 1. The Christie NHS Foundation Trust The Christie Hospital and Holt Radium Institute was founded in 1932 and has grown to be the largest Cancer Hospital in the UK and one of the largest Cancer Centres in Europe covering a large population in North West England. The trust is a designated teaching hospital of the University of Manchester and is the focal point of the Regional Cancer Network. All cancer related specialties are fully operational and more than 12,000 new patients with cancer are seen each year. It is a major Cancer research centre and combined with the Paterson Institute and University of Manchester comprises the Manchester Cancer Research Centre. The Christie is composed of three clinical management divisions: Networked Services Division – Director, (vacant) – includes the Departments of Medical Oncology, Clinical Oncology, Palliative Care, Paediatric and Adolescent Oncology Cancer Centre Services – Director, Miss Sarah O’Dwyer - Surgery, Haematology, Anaesthetics, HDU, Endocrinology Clinical Support Services – Director, Dr Jeremy Lawrence - Radiology, Pathology. Pharmacy, Supportive care Other support services are provided by the Corporate services Division including Finance, Nursing & Governance, and Estates and Facilities. Both the Departments of Medical Oncology (Director: Dr Mike Leahy) and Clinical Oncology (Director: Dr John Logue), have international reputations for their clinical work. All consultants are site specialised and common treatment policies are developed through the multi-disciplinary Disease Groups (DGs). Links to the cancer units are maintained through a number of peripheral and outreach clinics across the network. A radiotherapy satellite centre opens at Royal Oldham hospital in March 2010 with 2 linacs and facilities for outpatient oncology services. In addition, a radiotherapy centre at Salford opens in 2011. The present Executive Directors of the Trust are: Caroline Shaw Chief Executive Ian Moston Director of Finance & Business Development Dr Chris Harrison Medical Director Alison Norman Director of Nursing & Governance Roger Spencer Chief Operating Officer 2. Other Partner Institutions 2.1. University of Manchester The University became the largest single site University in the UK in 2005 with the merger of the Victoria University of Manchester and the University of Manchester Institute of Science and Technology (UMIST). Approximately 50th in the world rankings, it has an ambitious programme of development to become one of the top 25 universities in the world by 2015. Development is occurring University wide and cancer is one of two areas selected for rapid development. It has significant existing activities in cancer research within the Faculties of Medical and Human Sciences and Life Sciences. This has been enhanced by the recent transfer merger of the Paterson Institute for Cancer Research within the University. 2.2. Salford Royal NHS Foundation Trust Salford Royal NHS Foundation Trust was licensed as a Foundation Trust from August 2006. It is a teaching hospital with 870 beds and provides District Hospital services for Salford. It is also a subregional centre for renal medicine, immunology, neurosciences and neonatal intensive care and there are many other highly specialised facilities including interventional radiology, intestinal failure, pain management, dermatology, urology, orthopaedics and rheumatology. 2 The Trust is a teaching hospital for the University of Manchester Medical School and has an established Research and Development programme. Salford is the site of a major initiative and investment called the ‘SHIFT’ project (Salford Health Investment For Tomorrow) This project spans primary and secondary care and will involve novel modes of working and major investment in both primary and secondary care. On the hospital site this involved a PFI scheme to redevelop facilities. The Trust is a designated Associate Cancer Centre as outlined in the ‘Harrison’ Strategy for Greater Manchester, and as such is the identified sector centre for Oesophagogastric, Urological, Gynaecological and Haematology services. For these services it provides specialist services for the populations of Ashton, Wigan and Leigh, Bolton and Salford PCT’s. The Trust hosts the specialist services and MDT’s for Brain and Central Nervous system and Skin Cancers as well as providing a full range of other local cancers services. The Trust is working collaboratively with The Christie to develop satellite Radiotherapy services on the Salford Royal site and to implement the Chemotherapy strategy. The Trust Board comprised of the Executive Directors of the Trust and is responsible for the overall performance of the Trust and delivery of its strategic and operational objectives. The following groups feed into the Trust Board. Strategy Advisory Group Clinical effectiveness Patient and Staff Experience Risk Management Finance and Performance The Trust has a clinical governance strategy, which describes key roles and responsibilities for staff providing services. The present Executive Directors of the Trust are: David Dalton Chief Executive Dr Stephen Waldek Medical Director Tony Whitfield Director of Finance Elaine Inglesby Executive Nurse Raj Jain Director of Workforce and Corporate Affairs Simon Neville Director of Strategy and Development (and Executive lead for Cancer) 2.3. The Faculty of Medical and Human Sciences The Faculty is large and comprehensive with all the important healthcare disciplines represented in both research and teaching. Today, the Faculty has an annual research income of £51M, almost a third of the University’s total research income. There are 7,600 undergraduate students and 1,600 post graduates on award-bearing courses. More students graduate each year from the School of Medicine than from any other medical school in the UK. The Faculty’s goal for 2015 is to be a world leader in the translation of key elements of biomedical research to patient care, working in collaboration with the NHS and industrial partners. The Greater Manchester Research Alliance (GMRA), brings the Faculty together with its six partner teaching trusts and with other NHS trusts in the Greater Manchester region. 2.4. The Cancer and Imaging Sciences Research School in the Faculty of Medical and Human Sciences The focus for academic cancer medicine in the university is the Cancer and Imaging Sciences Research School. With over 50 academic staff including 12 academic clinicians, the school currently 3 has approximately £11M per annum in research income. Interests span from biomarker studies using clinical proteomics and microarray analyses to phase I/II/III clinical trials. The School has a first rate publication record in high impact medicine and cancer journals. 2.5. The Paterson Institute for Cancer Research The institute is a leading cancer research institute funded by CRUK. Research spans the whole spectrum of cancer research, from programmes investigating the molecular and cellular basis of cancer, to those focused on translational research and the development of novel therapeutic approaches. 2.6. The Cancer Research UK Department of Medical Oncology at The Christie The CRUK Department of Medical Oncology is now one of the largest departments of cancer medicine in the UK. Professor Robert Hawkins is Director of Medical Oncology and the major remit of the department is to develop improved methods for cancer patient management. There are both clinical and laboratory scientific research components that are closely integrated with clinical research and service work. The Department is based at the Christie Cancer Centre (Christie Hospital and Paterson Institute for Cancer Research) with a Breast Cancer Unit at Wythenshawe / Withington Hospital (University Hospital of South Manchester NHS Foundation Trust) and a Thoracic Oncology Unit at Wythenshawe Hospital (Cardiothoracic Centre). More than 2,500 new cancer patients are seen each year by staff in the Department of Medical Oncology. The Department has links with Preston Oncology Centre and with the Department of Medical Oncology at Lancaster Royal Infirmary, which is included as part of the Medical Oncology SpR rotation (total 17 NTNs). The institute works in close collaboration with the neighbouring Christie NHS Foundation Trust and the FHMS Cancer and Imaging Sciences Research School and is a partner in the newly formed Manchester Cancer Research Centre. 3. The post: Locum Consultant in Medical Oncology 3.1. General This is a locum consultant post, supported by the Greater Manchester and Cheshire Cancer Network and The Christie NHS Foundation Trust. The appointee will join one of the countries largest departments of Medical Oncology, which provides comprehensive medical oncology services to patients with all forms of cancer both common and rare. The Consultants in Medical Oncology are responsible for seeing new referrals, treatment appointments and follow-ups in outpatients and taking full responsibility for the patients admitted under their care to the wards. Consultants have the responsibility for managing their workload within their agreed Job Plan including prioritisation of care for the patients referred to them. Typical expected caseload for consultants follows national benchmarks with an average new referral target of 200 – 250 new patients and 1000 – 2000 treatment events. Initial cancer site specific responsibilities are detailed in this job description but are subject to variation depending on service pressures and changes in circumstance within the department. Consultants are bound by the professional standards enshrined in Good Medical Care as described by the Royal Colleges and by the General Medical Council. This includes an expectation to contribute to and to drive clinical audit as it pertains to their own clinical service. It is preferable that candidates be on the General Medical Council Specialist Register in Medical Oncology. The appointee will be expected to take responsibility for service development within their own clinical field. 4 The post-holder will be expected to participate in appropriate CPD activities. The Trust supports the requirements for continuing medical education as laid down by the Royal College of Physicians, and is committed to continue providing time and financial support for these activities. The post carries automatic membership of the Medical Staff Committee and the post-holder will be expected to contribute to the general running of the clinical services at Christie through participation in committees etc within the time allocated for supporting professional activities. The Trust identifies teaching and training as essential core activities and the consultant will support the educational agenda of the Trust wherever possible including offering training to undergraduate medical students from University of Manchester Medical School and the junior doctors at Foundation year and Specialty trainee level. The Christie is a research centre of excellence and the post-holder will be expected to support the research activities and encouraged to develop research within their own practice. The post-holder will have office accommodation and the support of a secretary. The new Consultant will have appropriate IT support, including internet access, and training will be provided. 3.2. Disease group and MDT team membership 3.2.1. Breast Subgroup & MDT The successful post holder will provide a medical oncology service for Breast cancer patients at The Christie , linking with the existing consultants specialising in breast cancer –Drs Anne Armstrong, Greg Wilson and Sacha Howell. Currently there are 2 middle grade doctors (SpRs or ST3 – 6) attached to the Breast team and the post holder will take an equal role with the other Breast medical oncology consultants in supervising these doctors and also the junior grade medical staff in clinic and on the ward in the care of their patients The post holder will undertake out patient clinics and provide in patient care. They will work as part of the multidisciplinary team (MDT) and be a key decision maker in the MDT meetings held at the University Hospital of South Manchester (Wythenshawe Hospital). The post holder will be expected to partake in supporting professional activities including audit and teaching. There will be Supporting Programmed Activities (SPAs) allocated to the post-holder for the above (see job plan). The post holder will be expected to attend medical oncology consultants’ meetings and Breast Disease Group meetings (both monthly). 4. Clinical Staff Consultants in the department of Medical Oncology: Dr Anne Armstrong Breast cancer Dr Fiona Blackhall Lung Cancer Dr Mike Braun Lower GI cancer Dr Andrew Clamp Gynaecology & ovary cancer Dr Jurjees Hassan Colorectal and Ovarian cancer Professor Robert Hawkins Renal, Gastric and Immunotherapy Phase I Trials Dr Sacha Howell Breast Cancer Professor Gordon Jayson Ovarian Cancer and Phase I Trials Dr Michael Leahy Sarcoma, germ cell cancer and TYA Dr Kim Linton Lymphoma 5 Dr Paul Lorigan Melanoma and Lung Cancer Dr Was Mansoor Upper GI cancer Dr Saifee Mullamitha Lower GI cancer Professor John Radford Lymphoma Professor Malcolm Ranson Clinical Pharmacology and Lung Cancer Dr Yvonne Summers Lung cancer Dr Paul Taylor Lung cancer Professor Nick Thatcher Lung cancer Dr Fiona Thistlethwaite Upper GI cancer Dr Juan Valle Colorectal, Hepatobiliary cancer Dr Andrew Wardley Breast cancer Dr Greg Wilson Breast and Colorectal Cancer There are at present ten Specialist Registrars, six SHO level posts. Two Specialty Doctors and a number of Clinical Research Fellows also participate in clinical activities, in addition to their laboratory research. There will be further posts developed as the Foundation programme rolls out. 4.1. Associated Departments 4.1.1. Clinical Oncology (Director - Dr John Logue) Clinical Oncology has thirty one consultants and state of the art radiotherapy equipment along with a major research centre - The Wade Centre (Director Dr John Logue). The Clinical Oncology Division provides a service to Greater Manchester and North Cheshire through clinics (mainly weekly) staffed by its consultants in every main town in the area. A good liaison exists between the divisions of Clinical Oncology and Medical Oncology. Many of the clinical protocols are run jointly between the two departments and there are excellent opportunities at Specialist Registrar level to participate in joint teaching programmes. Within the department there are eleven service linear accelerators, a research linac suite, and a Pantak superficial x-ray therapy unit. There is a purpose built, dedicated Radiotherapy Theatre housing a high dose rate microselectron. Adjacent to one ward is a low dose rate Selectron remote afterloading suite. There is a fully equipped Mould Room and facilities are present for interstitial therapy (including prostate brachytherapy) and manually afterloaded brachytherapy. In 2008 approximately two hundred permanent Iodine one hundred and twenty five seed implants were conducted. HDR brachytherapy is now in place for prostate patients. There is a large group of therapeutic radiographers. The Christie is a teaching unit of the University of Liverpool School of Therapy Radiography. 4.1.2. Haematological Oncology (Director – Dr Mike Dennis) Dr James Cavet, Dr Adrian Bloor and Dr Mike Dennis run a major transplant unit with 18 dedicated beds. 4.1.3. Other Departments The Department of Histopathology (Clinical Director – Dr Lia Menasce) provides a regional cancer service. The Department of Diagnostic Radiology (Director – Dr Rhidian Bramley) has two whole body spiral CT scanners and two MR scanners, in addition to standard radiological and radionuclide imaging facilities. This department is currently undergoing major refurbishment, and will be re-commissioned with new and more extensive equipment next year. A PET-CT scanner was installed in early 2008. 6 The Department of Psychological Medicine is involved in collaborative research projects concerning psychological assessment and counselling in the context of clinical trials and is responsible for staff training in aspects of psychological support. 4.1.4. Clinical and Laboratory Scientific Research A wide range of clinical research studies are in progress. The breast, lung and GI research groups are major contributors to national and international trials of new treatments. These include Phase I/II and III chemotherapy studies, combined surgery, radiotherapy and chemotherapy studies and patient evaluation studies (staging procedures, psychological assessment etc). A special interest is taken in the development of new biological therapies particularly anti-angiogenic therapies (lead by Professor Gordon Jayson) and gene/immunotherapies (led by Professor Robert Hawkins). These link laboratory research in the Paterson Institute with early phase clinical trials. The Derek Crowther Unit was opened in 2003 (lead clinician Dr Malcolm Ranson) and provides excellent clinical research facilities for early phase clinical trials. Excellent computer facilities are available within the Medical Oncology Division and there is a close association with the Department of Medical Statistics. Data managers are in post to help handle clinical and laboratory research data. Training is given in this important aspect of clinical research. 4.1.5. Administrative facilities The post holder will have office accommodation with computer, intranet and internet access at both sites. Similarly there will be secretarial support in line with the provision for the other consultants in the Directorate. For most consultants this will mean 0.8 – 1 FTE band 4 support with support typing (A&C band 3) as required. 5. Job Plan: 7.5 DCC (Direct clinical care) 2.5 SPA (Supporting professional activity) 10 PAs Total DCC includes outpatients, ward rounds, attending MDT meetings including the travel required to attend these if off-site. The 7.5 PAs DCC includes 1 PA for clinical administration. SPA includes audit, CPD, teaching research and attendance at Trust committee meetings. Job plans are reviewed annually. The annual review will examine all aspects of the job plan and should be carried out jointly by the Clinical Director and the post holder A nominal allocation of sessions if the appointment is full time is shown below but this will be subject to change within the limits of the job plan outline above Monday Tuesday Wednesday Thursday Friday 8-9 am Radiology meeting 9 am – 3 pm Christie Clinic 3-4:30 pm MBC meeting 9 am – 1 pm Christie Research Clinic am 9 am – 1 pm Christie Clinic 9-10.30 am New patient meeting 11.30-2 pm – W/R & MBC meeting pm 1 – 3 pm MDT SMUHT 2-5 pm Christie Clinic 1-2 pm Grand round 2- 5 pm SPA The agreed work plan will be subject to annual review in line with Trust policy. This review will also include an assessment of professional development and defined goals for the future. In the event of 7 the consultant electing to work part time a pro rata adjustment of fixed sessions would be anticipated. This will be discussed and agreed with the Division. Work practice may change over time and this will be reviewed regularly at an annual job plan review and appraisal. Every effort will be made to ensure that activity levels are kept in line with other colleagues in the Trust and in line with national benchmarks. All consultants are associated in pairs where possible within disease groups to provide cross-cover for absence. The Department has evolved, over many years, a policy of mutual co-operation between the consultants. The department consultant group meets monthly to discuss joint management policies. Consultants are grouped in teams of two to six supported by junior staff .The teams accept responsibility for agreed fields of work and for cover for absence arrangements. All consultants are expected to co-operate in these arrangements and to be involved in a number of clinical areas of work. Clinical Director, Dr M Leahy, chairs the department. The medical oncology department works with the departments of clinical oncology, young oncology and palliative care as part of the Network Services Division, chaired by the Divisional Director, (vacant), with Jason Dawson as General Manager. All new consultants are expected to join the on-call rota that involves commitment to a full week - 115, which is maintained according to an agreed set of guidelines. Duties may vary and are defined in the Trust's bed management policy which will be updated from time to time, but in essence, the oncall consultant is expected to be available to review patients and advise junior staff regarding patients (under the care of the consultants on the medical oncology on-call rota) on clinical management issues when admitted as emergencies and for other in-patients requiring consultant input out of hours. These duties will be reimbursed according the standard on-call supplement as explained in the NHS Consultant terms and conditions. The current rota is 1 in 15 and is remunerated at category A..This covers the Specialist Registrar who is second on-call. 6. Administration The appointee will be a member of the Department of Medical Oncology Consultant Group. The appointee will also be a member of The Christie Medical Liaison and Advisory Group. The Clinical Director within the consultant group negotiates administrative duties within the Clinical Oncology Department and consultants are expected to accept responsibility for at least one area. This responsibility is regularly reviewed and can be altered following consultation and agreement with the Director and colleagues. 7. Particulars of Contract Any consultant who is unable for personal reasons to work full-time will be eligible to be considered for the post. The job content will be discussed on a personal basis and agreed with the Trust. 8 Person Specification LOCUM CONSULTANT MEDICAL ONCOLOGIST – BREAST 10 234 REQUIREMENTS ESSENTIAL DESIRABLE Qualifications MBBS or equivalent MRCP or equivalent MD, PHD Certificate of completion of subspecialty training in Medical Oncology (or equivalent), or evidence of completion within 6 months of the date of the Appointments Committee Training & Experience Evidence of wide experience of general and oncological medicine Demonstrated interest in teaching / education An interest in teaching medical, nursing and allied health professional staff Experience of teaching undergraduate / postgraduate trainees Academic / Research achievements Able to demonstrate continuing research interest and activity Recent articles in peerreviewed publications MSc, MD or PhD The ability to initiate design and supervise clinical research Personal Skills Clinical leadership and people management skills, with the ability to motivate staff Demonstrable interpersonal skills Evidence of excellent written and oral communication skills Flexible approach to work The ability to work as part of as multi-disciplinary team Good time management skills, with the ability to handle competing demands Personal Circumstances Occupational Health Clearance Enhanced CRB Clearance Living within reasonable travelling distance from the trust 9