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THE CHRISTIE NHS FOUNDATION TRUST
APPOINTMENT OF A CONSULTANT HISTOPATHOLOGIST
(LOCUM)
TITLE
LOCUM CONSULTANT HISTOPATHOLOGIST
BASE
THE CHRISTIE NHS FOUNDATION TRUST
JOB DESCRIPTION
This is a whole-time/maximum part-time post based at The Christie. It is a locum
post to replace one of the consultants going on maternity leave. Appointment of the
postholder will enable the activities of the department to be maintained and will meet
the clinical needs of the hospital. It is expected that the appointee will hold the
FRCPath or show evidence of equivalent training and experience. Applicants must
have their CCT.
A.
PRINCIPAL DUTIES AND RESPONSIBILITIES
1.
The successful applicant will share the diagnostic workload with the six
existing consultant histopathologists and will help to provide an integrated
service in oncological histopathology.
2.
The appointee will be expected to cover GI, skin and soft tissue work although
there is some flexibility in this and is open to discussion.
3.
The appointee will be expected to attend multidisciplinary team meetings and
discuss problematic cases with clinical colleagues.
Job Content
1.
Diagnostic histopathology (The Christie surgical specimens and biopsies;
frozen sections; pathology reviews; second opinions). There is no on-call rota
or week-end work.
2.
Autopsy service: The appointee will participate in the trust and Hospital
Coroner’s autopsies. Community coronial work is not performed. Performing
coroner’s autopsies is a specific part of the job description and appropriate
time will be made available in the job plan for performing them.
3.
MDT meetings:
o Lymphoma (x 4/month)
Sarcomas (x4/month)
o Gastro-intestinal (x1/month)
1
o
o
o
o
o
o
o
o
o
Urology (x4/month)
Gynaecology (x4/month)
Skin (x 2/month)
Cutaneous lymphoma (x 1/month)
Haematology - bone marrows (x1/week)
Melanoma (x1/month)
Thyroid ( x 2 month)
Neuro- endocrine (x 2 months)
Anal cancer ( x 1/week)
Items 1 and 2 (viz. the diagnostic work of the department) will be shared equally
between the other Consultants on a rota basis.
B.
THE DEPARTMENT OF PATHOLOGY
The Pathology Department at The Christie is a Clinical Directorate within the
Clinical Support Services Division. The new Divisional structure was
introduced in 2006. The Clinical Director of Pathology is Dr. L.P. Menasce,
consultant Histopathologist. The Divisional Director of the Clinical Support
Services is Dr J Lawrance, consultant radiologist. The Pathology Services
Manager is Mr. M. Hamer and the Support Services General Manager is Ms.
S. Jenkins.
The Christie Pathology Department comprises:
a)
The Department of Histopathology
Staff: Consultants: Dr. S. S. Banerjee MD, FRCPath
Dr. J. H. Shanks BSc, MD, FRCPath
Dr. L.P. Menasce PhD, FRCPath
Dr. B. Chakrabarty MD,FRCPath
Dr. K. Sikand MD,FRCPath
Dr. P. Shenjere FRCPath
Dr. A. Norton FRCPath (head of HMD)
All consultants in post are full time NHS appointments.
Specialist Registrar: 3 WTE, from the North West Rotation
Consultant Clinical
Scientist:
Dr. B. P. Eyden PhD
[Electron Microscopy]
Clinical Scientist/Breast Tumour Marker Services Manager
Ms A. Cramer
BMS staff:
1 BMS3 [Mrs. K. Graham]; 3 BMS2’s;
4.8 BMS1’s
2
MLA:
MTO2:
MTO1:
(1 BMS1 post is currently funded by R+D Levy)
2.7 WTE
1 WTE
1 WTE
Admin and Clerical Staff
(Secretarial):
4 WTE
b)
The Department of Haematology, Blood Transfusion and the Stem Cell
Transplantation Laboratory.
The Haemato-Oncology team for leukaemia, myeloma and
transplantation consists at Consultant level of four Clinical
Haematologists. Their principal areas of interest are: Dr A Bloor (1.0
WTE) - lymphoid malignancy (transplantation), Dr J Cavet (1.0WTE) myeloma, Dr M Dennis (1.0 WTE) - myeloid disease, Clinical Director
and Head of Diagnostic Laboratory and Dr E Liakopoulou (1.0 WTE) Transplant Director. There are also two funded but currently unfilled
academic positions (Chair and Senior Lecturer in Haemato-oncology).
The laboratory encompasses routine blood counts, coagulation,
transfusion, morphology, cryopreservation and immunophenotyping.
The busy clinical unit provides tertiary cancer care- BCSH levels 1-4,
mostly intensive chemotherapy and bone marrow transplantation.
c)
The Department of Chemical Pathology [Head of Department,
Dr. D. Darby, Consultant Chemical Pathologist].
d)
Department of Oncology Cytogenetics [Head of Department, Mr. N.
Telford, Consultant Clinical Scientist].
e)
Microbiology and Virology Services are provided by the Health
Protection Agency which is situated nearby at Manchester Royal
Infirmary
The Department of Histopathology provides diagnostic tumour pathology services to
the Christie NHS Foundation Trust. The specimens are derived from two main
sources: (a) biopsies and surgical specimens from the theatres, wards and out-patients
in the hospital and (b) pathological material for review from other hospitals in the
North West for cancer patients referred to the clinical, surgical and medical
oncologists. A consultation service on problematic cases, referred by other
histopathologists in and occasionally outside the region, is also provided. A charging
system to cover costs from referring Trusts for opinion cases was introduced from
August 2006 to cover activity above historical baseline.
The case mix of the Department as a whole is unusual and includes a high proportion
of uncommon and difficult problems. The areas of oncological pathology covered
include breast, GIT (including occasional liver and pancreatic tumours,
neuroendocrine tumours etc), haemolymphoid*, skin*, soft tissue*, gynaecological*,
urinary and male genital*, head and neck (oral, salivary gland, thyroid, upper
respiratory tract and a few orbital tumours), lung/pleural and occasional bone tumours
3
(* constitute the main bulk of our cases). The department provides a service to
surgery in relation to pseudomyxoma peritoneii and the Trust is one of two in the UK
designated as a centre for the management of such patients (this receives central
funding). The department provides regional haemolymphoid diagnosis through
GMCHMD (lead Pathologist Dr. A. Norton). The cost of the bulk of the overall
pathology services is incorporated within the main hospital’s contracts with
commissioners (the lead commissioning body is Bolton Primary Care Trust).
Purchasing arrangements are scheduled to change with the introduction of Payment by
Results (PbR) in future. In addition to the main laboratory within which
immunohistochemistry and electron microscopy facilities are available, there is a
separate small frozen section laboratory within the theatre complex. The mortuary is
located at the periphery of the hospital. The cytogenetics laboratory is also
incorporated within the main pathology department. A range of FISH based tests for
breast, haemolymphoid and soft tissue tumours are available.
The appointed consultant will have his/her own office, a modern microscope with
facilities for photomicrography and a computer for his/her individual use in the
department. The computer will have internet access and a Trust e-mail address will
be provided. The department has its own seminar room with projection facilities and a
microscope with attached TV monitors. The Department of Histopathology has a
commercial system, IT system, Technidata, which links with the hospital IT system,
Medway. Teleconferencing links are in place.
Workload:
[2008]
Surgical specimens/requests
[Including reviews and opinions]
PM cases
Immunohistochemical tests
EM requests
Frozen section cases
:
6034
:
:
:
:
(Total Number of blocks: 23,160)
(Number of slides: 64,500)
17
50,872
78
26
The cytology services are provided by the Cytopathology Department at Manchester
Royal Infirmary.
Full CPA Accreditation has been granted to the Departments of Histopathology,
Haematology and Blood Transfusion, Clinical Biochemistry and Oncology
Cytogenetics.
The teaching programmes in the hospital are presently under the jurisdiction of the
Education committee; the Chairman is Dr. R. Cowan. A member of the pathology
department serves on this committee.
4
The consultants are also expected to participate in local, regional, national and
international scientific and educational meetings. Participation in CPD activities will
be obligatory and the Trust has a commitment to providing funding and time for CPD.
A staff appraisal scheme was introduced in 1999, in which all staff participates on an
annual basis. Appraisal of consultant medical staff in the Directorate is conducted on
an annual basis by the Clinical Director of Pathology (currently Dr L.P. Menasce).
Consultants may request an alternative appraiser, should they so wish. The appraisal
summary (Form 4) and personal development plan (PDP) are forwarded annually to
the Medical Director by the Clinical Director. Annual review of the job plan and PDP
is undertaken by the Clinical Director for the consultant medical staff in the
Directorate. Job plans need to be signed off by the Clinical Director, the Divisional
Director, the Medical Director and the Divisional General Manager. If it is not
possible to agree a job plan, either initially or at annual review, there will be an initial
referral to the Medical Director (or an appropriate other person if the Medical Director
is one of the parties to the initial decision) and, if required, a subsequent local appeals
panel in line with national guidance.
Health and Safety:
All the medical and technical staffs employed by the Trust are expected to comply
with the hospital’s health and safety policies. There is a departmental health and
safety committee which compiled a departmental H&S policy and oversees all aspects
of H&S within the Department. The laboratory manager acts as Safety Supervisor for
the Department.
C.
MANAGEMENT STRUCTURE:
The appointee will be accountable to the Clinical Director of Pathology [Dr L.P.
Menasce] who is responsible for the overall running of the Pathology Department.
The Clinical Director is accountable to Clinical Support Services Divisional Director
[Dr J. Lawrance]. Dr K. Sikand is currently Head of Histopathology. The role of the
head of the department is held on a rotational basis. The post of Clinical Director of
Pathology is determined by agreed fixed term appointment (not by rotation). The
total pathology annual budget is £4.0 million. The annual budget for histopathology
is £1.04 million. The annual budget for EM is £89.6K.
The present Executive Directors are:
Ms. C. Shaw
Mr. R. Spencer
Mr. I. Moston
Chief Executive
Chief operating officer
Director of Finance and Business
development
Medical Director
Director of Nursing and Governance
Chairman
Dr C Harrison
Ms. A. Norman
Mr. J. Martin
5
The management structure is in accordance with the Strategic Review of Pathology
Services, paragraph 4.22 to 4.26.
D.
THE CHRISTIE
The Christie hospital was formed in 1932 and has grown to be one of the largest
cancer hospitals in Europe. It is the base hospital for the North Western Regional
Department of Clinical Oncology. Along with the North Western Regional Medical
Physics Department, it forms The Christie NHS Foundation Trust. The Paterson
Institute for Cancer Research adjoins the Trust and has recently been incorporated
into Manchester University. In partnership with Cancer Research UK and Manchester
University the Trust has formed the Manchester Cancer Research Centre (MCRC).
The Trust serves a network population of 3.2 million people (Greater Manchester and
Cheshire), the largest network in the country. The health economy of the Greater
Manchester and Cheshire Cancer Network includes 15 acute and mental health Trusts.
Approximately 20% of patients are referred from outside this network. In 2005 there
were 12,000 new patients with cancer referred to the hospital and around 180,000
treatments were administered. The Trust has 1,900 staff, 257 beds and three surgical
theatres. A new critical care facility (6 beds with room to expand to 8 beds) opened in
late 2006.
The Trust introduced a new management structure in 2006 in which three Divisional
Directors were appointed, each supported by a Divisional General Manager. This
new structure was in preparation for Foundation Status, which the Trust achieved in
spring of 2007. The Divisional Directors are Dr J. Lawrance, consultant radiologist
(Division of Clinical Support Services), Dr W. Makin, consultant in palliative care
(Division of Clinical Network Services) and Miss S. O’Dwyer, consultant surgeon
(Division of Clinical Cancer Centre Services). The respective general managers for
the three divisions are Ms S. Jenkins, Ms F. Isaacson and Ms M. Silcock. The Trust
has been designated as the cancer centre for the Greater Manchester and Cheshire
Network by Dr C Harrison in a report commissioned by the Strategic Health
Authority (the ‘Harrison report’). The Trust has achieved financial break even
position at financial year end over the past 5 years.
The largest clinical department is the Regional Department of Clinical Oncology with
35 consultants which provides a service to Christie Hospital and other hospitals in
Greater Manchester and some in the surrounding region through regular clinics staffed
by consultants. The Clinical Director is Dr. N. Slevin
There is a University Department of Medical Oncology with 21 consultants, headed
by Dr.M.Leahy. The clinical staff of the hospital also includes two physicians with an
interest in Endocrinology and visiting specialist surgeons with interest in plastic,
breast, head and neck, urological, gastro-enterological, ENT and gynaecological
surgery, all of whom have access to beds. The current Clinical Director of Surgery is
Miss S O’Dwyer.
The hospital also has dedicated departments of Radiology, Haematology/Oncology,
Epidemiology, Psychological Medicine, Anaesthesiology, Occupational Health and a
Statistics Department, which, in addition to the collection of basic statistics, offers
support to clinicians involved in clinical studies and trials.
6
Specific disease groups comprised of multidisciplinary teams have been active for 8
years. Their function is to facilitate investigation, treatment and research on cancers
of site specific areas. The DGs are also linked to the Cancer Network Clinical
Subgroups, responsible for ensuring that NICE directives and Improving Outcomes
Guidance are implemented. Fourteen such DG groups exist in the Trust and
pathologists are members of those groups.
The North Western Regional Department of Medical Physics and Bioengineering is
situated at The Christie [Director Professor P. Williams].
The trust has a Medical Library staffed by professional librarians. The range of
services include a modern journal collection, extensive book library and on line search
facilities. The library is also connected with the Internet. A new postgraduate centre
has recently been constructed at The Christie and is now fully operational.
Attached to the hospital is the Paterson Institute of Cancer Research, [Director
Professor. N. Jones], part of Manchester University. It includes an extensive complex
of laboratories supported by the Cancer Research UK. The Institute is dedicated to
fundamental and clinically orientated cancer research in many fields, including
radiation chemistry, radiobiology, cell population kinetics, molecular biology, tumour
chemotherapy and cytogenetics. Some of these laboratories are involved in joint
collaborative research projects and Clinical Research Fellows have been appointed
between the Institute and the hospital.
Research facilities exist in the Paterson Institute for Cancer Research. The consultant
may need to negotiate collaborative projects with Professor Nick Jones, Head of the
PICR.
Arrangements to visit may be made with:
Dr K. Sikand (Head of Department) or Dr L. P. Menasce (Clinical Director)
Department of Pathology,
Christie NHS Foundation Trust,
Manchester
M20 4BX.
Contact telephone
Numbers:
Christie NHS Foundation Trust:
Consultant Histopathologists: 0161 446 3275 (Dr K
Sikand).
Clinical Director: 0161 446 3273 (Dr LP Menasce)
Medical Director: 0161 446 3705 (Dr Christopher
Harrison)
Fax Number:
Email address:
Internet:
0161 446 3300
[email protected]
www.christie.nhs.uk
7
HISTOPATHOLOGY ORGANIZATION PLAN
Director of
Pathology
Pathology
Service
|Manager
Dr. LP
Menasce
Dr. A. Norton
Mr. M. Hamer
Clinical Head
Of
Histopathology
Cons
Histopathologist
and head of
HMD service
Dr. K Sikand
Dr. P. Shenjere
Dr. S. Banerjee
Dr. J. Shanks
Cons
Histopathologist
Cons
Histopathologist
Cons
Histopathologist
Dr. B.
Chakrabarty
Cons.
Histopathologist
Dr. B. Eyden
Principal Clinical
Scientist
E.M.
Ms. A. Cramer
Mrs. K. Graham
Clinical Scientist
Breast Tumour
Marker Service
Histopathology
Laboratory
Manager
BMS 1
BMS 2
Clinical
Scientist
X2
BMS x 5
MLA x 2
MTOx2
The Pathology Department is a Clinical Directorate; the Clinical Director is
Dr.L.P.Menasce
8