Download Direct Clinical Care

THE CHRISTIE NHS FOUNDATION TRUST
CONSULTANT IN CLINICAL ONCOLOGY
with an interest in the non-surgical management of oesophageal and lung
cancers
1.
Background Information
This new post is supported by the Greater Manchester and Cheshire Cancer
Network and The Christie NHS Foundation Trust.
The candidates must by law be on the General Medical Council
Specialist Register in Radiotherapy (Clinical Oncology) or they must provide
evidence that they will be on the register by the time that they take up this
appointment.
The purpose of this post is to develop the clinical oncology service for
patients living in the North East/North West Sectors of the Greater
Manchester and Cheshire Network, with particular emphasis on oesophageal
and lung cancer.
The successful applicant would become an active member of the Upper GI
and Lung Cancer Network and The Christie Disease Orientated Groups
consisting of surgeons, physicians, clinical oncologists, pathologists,
radiologists, nursing and allied health professionals. The new consultant
would be based at The Christie, but also work closely with the upper GI team
in Salford and Rochdale Hospitals in terms of providing advice on
radiotherapy/systemic therapy; in addition they would provide clinic support
and development of lung cancer services at Salford and Macclesfield.
2.
The Cancer Centre
The Christie and Holt Radium Institute moved to the present Withington site
in 1932 and has grown to be the largest single site cancer hospital in the
United Kingdom. The hospital has been designated a separate teaching
hospital of the University of Manchester. Along with the Paterson Institute
for Cancer Research and North Western Regional Medical Physics
Department, it formed The Christie NHS Foundation Trust in 1991. The
hospital became a Foundation Trust in 2007.
200 beds are in use at The Christie. Beds have recently been reconfigured
into 4 non surgical wards with a total of 100 beds designated by disease
group, as well as an Acute Admissions Unit and general chemotherapy ward.
There is a Haematological Transplant Unit with a full transplant program.
There is a new Critical Care Unit with a rolling programme of staff
recruitment well underway.
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There is an Out Patient Department and designated Outpatient chemotherapy
suite.
The Department of Clinical Oncology presently provides a service to Greater
Manchester and Cheshire, and parts of Lancashire, through regular clinics
(mainly weekly), staffed by its consultants (see appendix 1). The population
of the Hospital’s catchment area is approximately 3.2 million. A total of
11,000 new patients with cancer were seen by the hospital and associated
clinics in 2006. In 2006, 8,000 patients were treated with radiotherapy. We
have close links with the Rosemere Cancer Centre at Preston.
The Radiotherapy Department has eleven service linear accelerators, a
research linac suite (Wade Centre), and a Pantak superficial x-ray therapy
unit. Two of the linacs are Elekta Synergy linacs with facilities for image
guided radiotherapy. There are three simulators, 2 with CT attachments, one
with cone beam imaging and an application for a CT-Sim is ongoing. There is
an ADAC Pinnacle computerised treatment planning system. IMRT has been
in use for several years.
There are plans to develop Satellite Radiotherapy facilities over the next 3
years away from the Withington site. These are most likely in the first place
to be built at a site in the north of the conurbation. The successful candidate
would be expected to take a role in supervising treatments at one of the
satellite units.
There is a purpose built Radiotherapy Theatre housing a high dose rate
microselectron used for endobronchial brachytherapy;this service is provided
in conjunction with Dr Phil Barber, visiting Chest Physician.. Adjacent to one
ward is a low dose rate Selectron remote afterloading suite for
Gynaecological patients.
There is a fully equipped Mould Room.
Facilities are present for interstitial therapy (including
brachytherapy) and manually afterloaded brachytherapy.
prostate
The Isotope Department provides facilities for the therapeutic use of I 131, P
32, Sr 89 and Samarium. There are three rooms for the management of
patients being treated with unsealed Isotopes.
The hospital has dedicated Histopathology, Haematology, Biochemistry and
Diagnostic Radiology Departments. In addition to standard radiological and
radionuclide imaging facilities the Radiology Department has three whole
body CT scanners, two MRI scanners and CT - PET. The Radiotherapy
Department has access to CT scanning & MR scanning sessions for treatment
planning. An electronic PACS system for viewing radiological images is in
place across the hospital.
There is a large group of therapeutic radiographers. The hospital is a
teaching unit of the University of Liverpool, School of Therapy Radiography.
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The North West medical physics group is based at The Christie, is directed by
Professor Peter Williams and supports the Radiotherapy Department. IMRT
has been developed for prostate cancer, breast cancer, head and neck
cancer, and will be introduced in other tumour sites in due course.Image
guided radiotherapy and stereotactic radiotherapy are being explored for
management of thoracic cancers.
The University of Manchester, CRUK and The Christie established a Chair in
Radiation Oncology in September 2000. Professor Price is supported by a full
time academic Clinical Oncologist, Dr Andrew Jackson. The University, the
Trust and the CRUK have built the Wolfson Molecular Imaging Centre with a
dedicated cyclotron, PET scanners and associated clinical and research
facilities. Professor Tim Illidge is the lead for targeted radio-immunotherapy.
The Christie has a University Department of Medical Oncology headed by
Professor Robert Hawkins.
There are 17 other Consultant grade
appointments in Medical Oncology. There is a close working relationship with
the medical oncology group who are responsible for the systemic
management of stomach, hepatobiliary and small cell lung cancers as well as
sharing the chemotherapy service for non small cell cancer and oesophageal
cancer
The Department of Surgical Oncology is actively involved in research.
Clinical Oncology and Surgical Oncology Consultants work closely together in
site specialised Disease Orientated Groups
The hospital also has clinical groups specialising in Palliative Medicine,
Paediatric and Adolescent Oncology, Endocrinology, Psychological Medicine
and Clinical Genetics.
The hospital has a Statistics Department, directed by Mr R Swindell, which
offers support to clinicians involved in clinical studies and trials. The Trust
has opened a Trial Support Unit for ongoing clinical studies and trials. The
hospital has a specific intranet with IT support.
Sectorisation of the Greater Manchester and Cheshire Network
The Network (3.2 Million) has been ‘divided’ into 3 sectors, each with a
catchment population of approximately 1 million. In addition to the Christie
the aim is to have an ‘associate cancer centre’ for each sector: Wythenshawe
Hospital for South, Hope Hospital for the North West and MRI for the North
East/Central Sector. The non surgical lung team have 2-4 specialists for each
sector; the non surgical oesophagus radiotherapy service will be shared with
Dr Andrew Jackson(South Sector).In addition each sector has a medical
oncologist for upper GI:Dr Mansoor for South, Dr Thistlethwaite for NW and
Prof Hawkins for NE/Central.
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Details of the Post
a)
Oesophagus Cancer Service
Oesophagus cancer service in the Greater Manchester and Cheshire Cancer
Network is divided into 3 sectors, the northwest, northeast and south. Each
sector has a designated surgical site and to host the weekly MDT. . The
appointee, in conjunction with Dr Jackson, would provide a (chemo)
radiotherapy service to patients with cancer of the oesophagus within the
northeast sector comprising the Pennine Acute Hospitals (Bury, Oldham,
North Manchester and Rochdale) and Manchester Royal Infirmary, with a
total population of approximately 1 million as well as within the northwest
sector comprising Wigan, Leigh, Bolton and Hope Hospitals with a catchment
population of a further 1 million. Patients with pre op oesophagus cancer for
chemotherapy are managed primarily by medical oncology colleagues. Hope
Hospital has recently been designated as the oesophagus surgical treatment
centre for the NW sector and all major surgery is planned to be done there.
The current surgical team includes Miss Formela, Mr Vickers and Mr Axisa.
For the NE/Central sector, discussions continue on centralisation of surgery;
the current surgical team includes Mr Aktar, Mr Senapati, Mr Pearson, Mr
Amori and Mr Sheen.
At The Christie approximately 150 oesophagus cancer patients are treated
annually with radical external beam radiotherapy(ie about 100 new cases per
year for the appointee).External beam is routinely provided by standard
conformal therapy but there is potential to use IMRT for selected patients.
The upper GI team have a nurse clinician and a full time clinical nurse
specialist. The team is actively involved in clinical and translational research.
b)
Lung Cancer Service
The appointee, in conjunction with a new appointment (in lung/breast), will
provide radiotherapy treatment for patients from the North West
sector(Salford) with lung cancer(approx 2 new cases per week from
Salford)and be involved in the NW sector MDT held weekly in Bolton(approx
14 new cases discussed each week).Currently there are no facilities at Hope
Hospital to deliver solid tumour chemotherapy though there are plans to do
so. Patients would have access to the full range of clinical trials as agreed
through The Christie Disease Group for lung cancer. At Macclesfield there are
appropriate facilities for delivering chemotherapy and we would wish for
palliative NSCLC chemo to be delivered locally if possible. The lung Disease
Group has an international reputation for clinical trial activity.
Chemoradiotherapy protocols are evolving and technical radiotherapy
developments include stereotactic approaches and image guided techniques.
The Clinical Oncology lung group comprises Drs Stout, Burt, Faivre-Finn,
Harris, Lee, Chittalia and Pemberton.
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c)
Consultant in Clinical Oncology
Employing Authority - The Christie NHS Foundation Trust
Clinical Staff in Clinical Oncology
The medical staff establishment provides for twenty-seven Clinical Oncology
Consultants, (see appendix 1) 3 full time academics and fifteen Specialist
Registrars in Clinical Oncology. There is a junior doctor team at F2 level,
working jointly with medical oncology, within the Division of Networked
Services.
d)
Duties of the Post
The appointee will be based at the Christie and a member of the Clinical
Oncology consultant group.
The post will involve the care of patients with oesophageal cancer particularly
from the NW, NE/Central Sectors as well as lung cancer patients from Salford
and Macclesfield.
At The Christie they will be required to conduct Out Patient clinics involving
chemotherapy delivery, radiotherapy planning sessions , to supervise patients
receiving radiotherapy and chemotherapy and to conduct ward rounds in a
manner providing optimum patient care and efficient use of the hospital’s
resources.
The initial allocation of Programmed Activity if the appointment is full time is
expected to be:
SERVICE
Location
Direct Clinical Care
Programmed Activity
Oesophagus and lung Out–
patient Clinics, and MDT
Hope Hospital; MDT for NE
sector; clinic in Macclesfield
Ward Rounds,
The Christie
Radiotherapy simulator
computer planning
The Christie
Outpatient clinic
The Christie
3.0
Research
0.5
0.5
2.5
1
5
Supporting professional
Activities
(training, CPD, teaching, audit,
clinical governance, appraisal
and clinical management)
2.5
Total
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This may be altered in response to the requirements of the Clinical Oncology
service in agreement with the Director of Clinical Oncology.
The agreed work plan will be subject to annual review in line with Trust
Board policy. This review will also include an assessment of professional
development and defines goals for the future. In the event of 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 Trust.
The Department has evolved, over many years, a policy of mutual cooperation between the consultants. The department consultant group meets
monthly to discuss joint management policies. Consultants are grouped in
teams of two to four supported by junior staff and the teams accept
responsibility for agreed fields of work. All consultants are expected to cooperate in these arrangements and to be involved in a number of clinical
areas of work.
A Clinical Director, Dr NJ Slevin, chairs the department. The clinical oncology
department works with the departments of medical oncology, haematology,
young oncology and palliative care as part of the Network Services Division,
chaired by the Divisional Director, Dr. W.P. Makin, with Fiona Isacsson as
General Manager.
All consultants in the department share in an on-call rota that involves a
commitment to a full week in every six months. A mobile phone is provided.
This covers the Specialist Registrar who is second on-call.
The appointee will have office accommodation and access to a secretarial
service.
e)
Administration
The appointee will be a member of the Department of Clinical 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.
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The present Executive Directors of the Trust are: Ms C Shaw
Mr I Moston
-
Dr C Harrison
Mr R Spencer
Ms Alison Norman
-
The Trust board is chaired by
f)
-
Chief Executive
Director of Finance and Business
Development
Medical Director
Chief Operating Officer
Director of Nursing and
Governance
Jim Martin
Teaching
The Department of Clinical Oncology participates in the clinical undergraduate
teaching programme of the University of Manchester and students visit the
hospital for seminar, outpatients and bedside teaching at different stages in
their training. There are dedicated courses designed for postgraduate
students studying for the Part I and II examinations of the Fellowship of the
Royal College of Radiologists. Consultants are expected to participate in the
specialist registrar and F2 teaching programme.
Post-graduate training is co-ordinated by the clinical oncology specialty
training group, chaired by Dr J Loncaster. The Regional Postgraduate Adviser
in Clinical Oncology is Dr JP Logue.
The hospital has a Medical Library staffed by professional librarians offering a
range of services including a modern journal collection, extensive book library
and on line search facilities.
g)
Research
Attached to the hospital is the University of Manchester Paterson Institute, an
extensive complex of laboratories supported by the Cancer Research UK
(Director - Professor N Jones). The Institute is dedicated to fundamental and
clinically orientated cancer research in many fields including radiobiology,
haematology, molecular biology, immunology, tumour chemotherapy and
cytogenetics. A translational research facility is being planned.
4)
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.
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5)
Job Planning
All job plans will be 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 postholder.
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THE CHRISTIE NHS FOUNDATION TRUST
TERMS AND CONDITIONS OF EMPLOYMENT
The terms and conditions of the New Consultant Contract are applicable
Salary:
Will be on the New Consultant Contract payscale
Annual Leave:
six weeks per annum (pro rata for part time
employees)
Bank Holiday:
8 public holidays
Resident:
The successful candidate will be required to
live within a reasonable travelling distance of
the Trust.
Arrangements to visit the hospital may be made direct with the: Dept of Clinical Oncology
The Christie NHS Foundation Trust
Wilmslow Road
Withington
Manchester M20 4BX
Telephone number: 0161 446 8457
Clinical Director:
Tel: 0161 446 3361
Dr N Slevin
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APPENDIX 1
Clinical Oncology Consultant Staff (October 2008)
NAME
PERIPHERAL CLINIC SERVICE
PRINCIPAL
INTEREST(S)
Crewe
Head and Neck
Dr R A Cowan
Wigan/Hope
Genito Urinary
Lymphoma
Dr J P Logue
Stockport
Genito Urinary
Director
Dr N J Slevin
Deputy Directors
-------------------------------------------------------------------------------------------------------Dr P A Burt
Crewe /MRI
Lung
Dr A Chittalia
Stockport
Dr A Choudhury
Oldham/MRI
Breast
Lung
Urinary/Sarcoma
Dr S E Davidson
Hope MDT
Gynaecology
Dr T Elliott
Bolton
Hope
Urology
Dr C Faivre-Finn
Lung
Dr H R
Gattamaneni
Hope (CNS)
Childrens Hospital
Children/Young Adult
CNS
Dr M Harris
Tameside
Lung/Lymphoma
Dr L Barraclough
Macclesfield
Wythenshawe
Breast
Gynaecology
Prof T Illidge
Lymphoma
Dr A Jackson
Upper GI
Dr L Lee
Bury /NMGH
Head and Neck
Lung
Dr E Levine
Bolton/Wigan/MRI
Gastro Intestinal
Dr JE Livsey
Oldham
Gynaecology/urology
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Dr J Loncaster
North Manchester
Breast, PDT for
skin cancer
Dr L Pemberton
Oldham/Wythenshawe
Lung
Dr B Magee
Hope
Breast cancer
Dr V Misra
Oldham
Breast
Colorectal
Dr C McBain
Macclesfield (GI)
Hope (CNS)
Colorectal
CNS
Prof P Price
Upper GI
Dr M Saunders
Hope
Gastrointestinal
Dr E Smith
North Manchester
Children’s Hospital
Lymphoma
Paediatric/Young Adult
Dr A L Stewart
Bury
Breast
Dr R Stout
Oldham
Lung
Dr A Sykes
Tameside
Head & Neck/Melanoma
Dr R S Welch
Bolton/Hope
Ovarian Cancer
Testicularcancer
Breast cancer
Dr J Wylie
Crewe/South Manchester
Genito-urinary
Soft Tissue
Sarcoma
Dr B Yap
Wigan/Leigh
Thyroid/Head &
Neck
Dr E Allan
(Part-time)
PDT for skin
cancer
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APPENDIX 2
PERSON SPECIFICATION - CONSULTANT IN CLINICAL ONCOLOGY
ATTAINMENTS
Education
ESSENTIAL
DESIRABLE
RCR Fellowship or
equivalent
Higher Degree
Training
Certificate of completed
specialist training or
equivalent (or within 6
months of CCT by
interview)
Job experience
With reference to
oesophagus/lung
GENERAL
INTELLIGENCE
SPECIAL APTITUDES
Demonstrates knowledge,
logic and efficiency
Integrity, management and
communication skills
including teaching
Developments in oncology
practice
INTERESTS
DISPOSITION
Acceptability
Is a team player prepared
to adapt to changing
circumstances.
Leadership
Dynamic, decision-making
motivator.
Self-reliance
Confident in ability, but
knowing own limitations.
Motivation
Hardworking, enthusiastic
achiever.
Good attendance record.
Patient friendly.
Professional demeanour
Must be resilient and well
organised
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Research experience
Computer skills
Knowledge of continuing
NHS and Royal College
Reforms.