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CHRISTIE HOSPITAL NHS FOUNDATION TRUST CONSULTANT IN CLINICAL ONCOLOGY with an interest in the non-surgical management of Urological cancer and soft tissue sarcoma 1. Background Information This new post is supported by the Greater Manchester and Cheshire Cancer Network and the Christie Hospital Foundation NHS Trust. The candidates must be on the General Medical Council Specialist Register in Radiotherapy (Clinical Oncology) or be eligible to be listed within six months of the ACC and 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/Central Sector of the Greater Manchester and Cheshire Network, with particular emphasis on urological cancer. The successful applicant would become an active member of the Urology Cancer Network and Christie Hospital Disease Orientated Group, consisting of urologists, 5 clinical oncologists, pathologists, radiologists, nursing and allied health professionals. The new consultant would be based at the Christie Hospital, but also work closely with the Urological team in Central Manchester and Oldham Hospitals in terms of providing advice on radiotherapy/systemic therapy; this could include contributing to the brachytherapy service for prostate cancer patients. In addition the post holder would provide a Radiotherapy service for patients with soft tissue sarcoma. 2. The Cancer Centre The Christie Hospital 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 Hospital NHS Trust in 1991. The hospital became a Foundation Trust in April 2007. 200 beds are in use at the Christie Hospital. 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. D:\582766131.doc 1 There is a new Critical Care Unit with a rolling programme of staff recruitment well underway. 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 for prostate cancer 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 leading role in supervising treatments at the satellite unit. There is a purpose built, Radiotherapy Theatre housing a high dose rate microselectron. 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 prostate brachytherapy) and manually afterloaded brachytherapy. In 2006 approximately 200 permanent Iodine 125 seed implants were conducted. A business case to develop HDR brachytherapy is in place and treatment of patients will begin in 2007/08. 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. D:\582766131.doc 2 There is a large group of therapeutic radiographers. The hospital is a teaching unit of the University of Liverpool, School of Therapy Radiography. 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. The University of Manchester, CRUK and the Christie Trust 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 radioimmunotherapy. The Christie Hospital has a University Department of Medical Oncology headed by Professor Robert Hawkins. There are 15 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 renal cancer. The Department of Surgical Oncology is actively involved in research. The research programme is led by Professor Noel Clarke. 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 urology team have 2 specialists for each sector; Drs Logue/Wylie in South, Drs Elliott/Cowan in NW and new appointment/Dr Livsey in North East/Central. D:\582766131.doc 3 3 Details of the Post a) Urological Service Urological cancer services 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 to provide level II work and to host the weekly MDT. Level III work takes place at Christie following discussion in the Christie specialist MDT meeting. The appointee, in conjunction with Dr Livsey, would provide a non-surgical urological oncology service to patients with cancer of the prostate and urinary tract 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. Patients with renal cell carcinoma are managed primarily by medical oncology colleagues. Manchester Royal Infirmary (MRI) has recently been designated as the urology surgical treatment centre for this sector and all level II surgery is planned to move to this location by April 2008. A weekly clinic will be conducted by the appointee at Royal Oldham Hospital in order to see new and follow up patients from the Pennine Acute Hospitals. A weekly Pennine Acute MDT meeting presently takes place at Oldham but this should move to the MRI in October 2007 and will discuss all patients with level II/III urological cancer from the northeast sector. Commitment to this will be shared with Dr Livsey. A weekly clinic will be conducted at Christie in order to see new and follow-up patients from the MRI and in order to supervise those patients requiring chemotherapy. There is also a weekly specialist MDT meeting at Christie, which reviews all testicular, complex renal, penile, and difficult bladder/prostate cancer patients and the appointee would be expected to attend this. There is also a monthly research meeting, an alternate week radiology meetings and a monthly pathology meeting at Christie. At the Christie approximately 700 prostate cancer patients and 100 bladder cancer patients are treated annually with radical external beam radiotherapy and 200 patients are treated with I-125 brachytherapy. External beam is routinely provided by standard conformal therapy but there is provision to use IMRT for selected patients. The I-125 brachytherapy service has been running since 2000 and treats approximately 4 patients per week. We are also planning to start a high dose rate brachytherapy service for patients with intermediate/high risk disease in the next 6 months. The urology team have a nurse clinician and a full time research nurse. There is also a full time trials co-ordinator and 2 data managers. The team is actively involved in clinical and translational research. b) Soft Tissue Sarcoma Service The appointee in conjunction with Dr Wylie (JPW) will provide radiotherapy treatment for patients with STS, and be involved in a STS clinic, MDT and radiotherapy planning session. D:\582766131.doc 4 The majority of patients presently managed with STS are treated at Christie, MRI or Oswestry Hospitals. The group operate collectively as the Greater Manchester and Oswestry Sarcoma Service (GMOSS) and hold MDT meetings at the MRI hospital on alternate weeks where all new bone/STS seen at the three sites are discussed. The present Christie service is predominantly a treatment service and many of the new patients are referred from peripheral hospitals following unplanned excision of STS, from Oswestry or MRI Hospitals, patients presenting with metastatic or inoperable disease or patients presenting with particular sarcoma types (e.g. GI stromal tumours). The service involves a joint surgical and radiotherapy clinic presently staffed by Mr Barr (LB) and Dr Wylie (JPW) and a parallel medical oncology and surgical clinic staffed by Dr Leahy (ML) and Mr Cool (PC). Those patients needing further surgical excision are referred to the onco-plastic service supported by Mr Murphy (JM), those requiring chemotherapy are managed by ML and those requiring radiotherapy are seen by JPW. Approximately 150 new STS patients are seen at Christie per annum and around 50 require adjuvant radiotherapy. Future Service Since the publication of the NICE IOG document the network have been developing plans to provide an IOG compliant service. This is likely to see the number of surgical sites condense down to 1-2. The Christie hope to be pivotal to this and have submitted a detailed proposal outlining their intention to provide a fully integrated and centralised service for patients diagnosed with STS irrespective of stage or site, and propose to host the supra-regional STS MDT, to offer a single surgical treatment service for patients in Greater Manchester with extremity and truncal STS, and to provide the supranetwork service for patients with intra-abdominal and pelvic STS. c) Consultant in Clinical Oncology Employing Authority - Christie Hospital 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 sixteen Specialist Registrars in Clinical Oncology. There is a junior doctor team at ST1-2 and F2 level, working jointly with medical oncology and haematology, within the Division of Networked Services. d) Duties of the Post The appointee will be based at the Christie Hospital and a member of the Clinical Oncology consultant group. D:\582766131.doc 5 The post will involve the care of patients with urological cancer particularly from the Network NE/Central Sector. At the Christie Hospital they will be required to conduct Out Patient clinics involving chemotherapy delivery, radiotherapy planning sessions including brachytherapy, 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 sessions if the appointment is full time is expected to be: SERVICE Location Direct Clinical Care Programmed Activity Urology Out–patient Clinics, and MDT Oldham Hospital and MRI Ward Rounds, Christie Hospital Radiotherapy simulator computer planning +/brachytherapy Christie Hospital Outpatient clinic Christie Hospital Soft tissue sarcoma clinic/MDT Review Clinic at Radiotherapy Satellite 2 0.5 2.5 1 1 0.5 Supporting professional 2.5 Activities (training, CPD, teaching, audit, clinical governance, appraisal and clinical management) Total 10 This may be altered in response to the requirements of the Clinical Oncology service in agreement with the Clinical 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 D:\582766131.doc 6 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 Hospital 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. The present Executive Directors of the Trust are: Ms C Shaw Chief Executive Mr I Moston Director of Finance and Business Development Dr R Stout Medical Director for internal Affairs Dr C Harrison Medical Director for external affairs Mr R Spencer Chief Operating Officer Ms Alison Norman Director of Nursing and Governance TBA Director of Estates The Trust board is chaired by D:\582766131.doc - 7 Jim Martin f) 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. 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. D:\582766131.doc 8 CHRISTIE HOSPITAL 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 Christie Hospital NHS Trust Wilmslow Road Withington Manchester M20 4BX Telephone number: 0161 446 8457 Fax: 0161 446 3084 D:\582766131.doc Clinical Director: Tel: 0161 446 3361 Dr N Slevin or Medical Director: Tel: 0161 446 3417 Dr R Stout 9 APPENDIX 1 Clinical Oncology Consultant Staff (January 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 Crewe/Stockport Genito Urinary Director Dr N J Slevin Deputy Directors -------------------------------------------------------------------------------------------------------Dr P A Burt Crewe Lung Dr A Chittalia Stockport Breast Lung 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 New Post Holder Macclesfield Wythenshawe Breast Gynaecology Prof T Illidge Lymphoma Dr A Jackson Upper GI Dr L Lee Bury Macclesfield Head and neck Lung Dr E Levine Bolton/Wigan/MRI Gastro Intestinal Dr JE Livsey Oldham Gynaecology/urology D:\582766131.doc 10 Dr J Loncaster North Manchester Breast, PDT for skin cancer Dr L Pemberton Wigan/Bolton 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 Rochdale/Oldham Genito-urinary Soft Tissue Sarcoma Dr B Yap Wigan/Leigh Thyroid/Head & Neck Dr E Allan (Part-time) PDT for skin cancer D:\582766131.doc 11 APPENDIX 2 PERSON SPECIFICATION - CONSULTANT IN CLINICAL ONCOLOGY ATTAINMENTS Education ESSENTIAL DESIRABLE MBBS or equivalent Higher Degree RCR Fellowship or equivalent Training Certificate of completed specialist training or equivalent. (or within 6 months of CCT by interview) Job experience With reference to urological experience GENERAL INTELLIGENCE Demonstrates knowledge, logic and efficiency Integrity, management and communication skills including teaching Developments in oncology practice SPECIAL APTITUDES 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 D:\582766131.doc 12 Research experience Computer skills Knowledge of continuing NHS and Royal College Reforms.