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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