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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.
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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.
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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.
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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.
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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.
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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
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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
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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.
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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
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Clinical Director:
Tel: 0161 446 3361
Dr N Slevin
or Medical Director:
Tel: 0161 446 3417
Dr R Stout
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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
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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
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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
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Research experience
Computer skills
Knowledge of continuing
NHS and Royal College
Reforms.