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CONSULTANT IN CLINICAL ONCOLOGY with an interest in the management of Colorectal and Breast cancer and acute oncology 1. Background Information This is a new post, supported by the Greater Manchester and Cheshire Cancer Network and The Christie NHS Trust. Candidates must by law be on the General Medical Council Specialist Register in 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 the new post is to strengthen the clinical oncology service for patients living in the Greater Manchester and Cheshire Network, with particular emphasis on Colorectal Cancer and Breast cancer. In addition this post will provide Acute Oncology input in Salford Foundation Hospital trust. The successful applicant would become an active member of the Christie Colorectal Cancer and Breast cancer disease groups, consisting of surgeons, clinical oncologists and medical oncologists, pathologists, radiologists, nursing and allied health professionals. The new consultant would be based at The Christie, but would also work closely with the Colorectal Cancer and Breast cancer team at Salford in terms of providing advice on radiotherapy/systemic therapy. 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 Trust 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 Trust in 1991. The Christie became a Foundation Trust in 2007. 200 beds are in use at the Christie. The Department of Clinical Oncology beds are sited in 4 wards which are organised on a site group basis. A medical admissions unit was opened in December 2007 to improve access for clinical emergencies and provide immediate clinical care of non elective admissions. The 1 remainder of the beds are used for chemotherapy, haematological oncology, endocrinology and surgery. There is an Adult Outpatient Department and separate facilities for minor surgical procedures. There is designated Outpatient chemotherapy suite which opened in November 2010 which will in addition to chemotherapy delivery houses a Phase I / II / III research facility and a Private patient in patient suite. Plans are in place for the development of a chemotherapy delivery unit in Salford. 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 Christie’s catchment area is approximately 3.2 million. A total of 10,500 new patients with cancer were seen by the Christie and associated clinics in 2008. In 2008, 7,500 patients were treated with radiotherapy. We have close links with the Rosemere Cancer Centre at Preston. The Radiotherapy Department has 10 service linear accelerators, a research linac suite, and a Pantak superficial x-ray therapy unit. Three of the linacs are Elekta Synergy linacs with facilities for image guide radiotherapy. There are 2 conventional simulators, one with cone beam imaging and 1 CT simulator. There is an ADAC Pinnacle computerised treatment planning system. There is an active IMRT programme with 30% of all patients treated with radical radiotherapy receiving IMRT. There is a dedicated linear accelerator for private patients which is operated in a joint Venture with HCA. A Satellite Radiotherapy facility opened in Oldham in March 2010 and a further opened at Salford Royal NHS FT in July 2011. The Salford satellite radiotherapy facility has 2 state-of-the-art Varian Novalis Linear accelerators. This is the first UK site with a pair of these exciting, recently developed machines, which offer full capacity for intra-cranial and extra-cranial stereotactic radiosurgery, on-treatment imaging with cone-beam CT and EXACTTRAK and rapid-arc IMRT. The centre also has a CT-simulator and fully-equipped mould room. The opening of the centre will bring a stereotactic radiosurgery service to Greater Manchester for the first time, and the centre will also deliver radiotherapy for the common cancers (GU, breast, lung, GI) to patients from the North West Sector (Wigan, Bolton, Salford) and for CNS patients requiring 2 conventional radiotherapy treatments of greater complexity or who live in the North West or North East (Pennine Acute) sectors. At the Christie central site there is a purpose built, dedicated Radiotherapy Theatre with an active Brachytherapy service There is a high dose rate microselectron unit and a Pulsed dose rate Brachytherapy system. Facilities are present for interstitial therapy (including prostate brachytherapy) and manually afterloaded brachytherapy. In 2010 approximately 200 permanent Iodine 125 seed implants were conducted. HDR brachytherapy is now in place for prostate patients. There is a fully equipped Mould Room. 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. A dedicated Brachytherapy and radionuclide facility will be opened in 2012. The Christie 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 There is a large group of therapeutic radiographers. The Christie is a teaching unit of the University of Liverpool School of Therapy Radiography. A dedicated on-site medical physics group directed by Dr Ranald Mackay supports the Radiotherapy Department and is active in implementing novel technological developments in radiation technology. There is an active Academic Radiation Oncology department led by Professor Tim Illidge. In addition there are currently 3 research active Senior Lecturers. The trust and the CRUK have built the Wolfson Molecular Imaging Centre with a dedicated cyclotron, PET scanners and associated clinical and research facilities. The Christie also has a University Department of Medical Oncology headed by Dr Juan Vallle .There are 18 other Consultant grade appointments in Medical Oncology. The Department of Medical Oncology is actively involved in research and routine clinical work and in joint collaborative programmes with the Department of Clinical Oncology in the field of lymphomas, sarcomas, melanoma, leukaemia and lung, breast, ovary, renal, testis and upper and lower GI cancer. Clinical 3 Oncology and Medical Oncology Consultants work closely together in site specialised Disease Orientated Groups The Christie also has clinical groups specialising in Palliative Medicine, Surgical Oncology, Paediatric and Adolescent Oncology, Endocrinology, Psychological Medicine and Clinical Genetics. The Christie has a Statistics Department, which offers support to clinicians involved in clinical studies and trials. The Trust has a specific intranet with IT support The Christie has dedicated facilities for Private patients. These facilities have been advanced following the creation of a joint venture with HCA in September 2010. This has seen the development of new in patient wards, a dedicated outpatient and chemotherapy facility and in September 2011 the opening of a dedicated radiotherapy facility . 4 3 Details of the Post It is envisaged that the post-holder would split their clinical commitments between breast cancer and colorectal cancers and would take a leading role in the development of an Acute Oncology service which the post holder would provide together with established Consultant colleagues within other disease site groups to Salford Royal Hospital NHS Foundation Trust. The post would be co located at Salford Royal Hospital NHS Foundation Trust and the Christie Withington site. a) Breast Cancer The post-holder would join the 10 existing Breast consultant Clinical Oncologists, to support the expanding breast service. This service encompasses all of the breast tumours diagnosed throughout the Greater Manchester and Cheshire Cancer Network. This service is integrated with the Medical Oncology department at the Christie hospital The post-holder will provide a comprehensive breast cancer service to patients from Salford Royal Hospital NHS Foundation Trust and will develop local chemotherapy delivery and MDT support. The post-holder will join Dr Magee in providing this service and initially will conduct a joint clinic at the Christie alongside Dr Magee. The delivery of radiotherapy will for the majority of patients take place in Salford. Initially chemotherapy will be delivered at the Christie but in time this will transfer to Salford as the local facility is developed. b) Colorectal Cancer The post holder would work alongside Dr Mark Saunders to provide a comprehensive colorectal cancer service to patients from Salford Royal Hospital NHS Foundation Trust and will develop local chemotherapy delivery. In addition the post holder would hold a joint clinic at the Christie with the colorectal team and work with colleagues to deliver the rectal radiotherapy service. The GI non-surgical oncology group has an international reputation for clinical trial activity. Chemo-radiotherapy protocols are being examined in clinical trials and technical radiotherapy developments and image guided techniques are being developed. The post holder would be expected to take an active role in research and development, particularly in developing radiotherapy techniques for GI cancer. The Clinical Oncology Group comprises Drs Saunders, McBain, Alam and Misra. The Medical Oncology consultants that specialise in colorectal cancer are Drs Valle, Wilson, Hasan, Mullamitha and Braun The GI colorectal and hepatobiliary trials unit comprises at least 15 members of staff. They include a trials coordinator, a grants / senior trials administrator, 7 research nurses, 6 data managers, a trials administrator, 2 nurse clinicians, a GI 5 research radiographer and a GI specialist nurse. All are dedicated to the management of patients being treated as part of clinical trials. Presently we are recruiting into about 20 clinical trials and we also have a similar number of studies that are closed but have patients on follow-up. Trials include NCRN trials, Pharmaceutical trials, biotec trials, Investigator Initiated Trials (IITs) and tumour biomarker studies. In 2007 we screened approximately 25% of our patients and entered 17% into clinical trials. b) Acute Oncology Salford Royal Hospital NHS Foundation Trust in collaboration with the Christie are planning to implement an Acute Oncology service. It is envisaged that this will build upon the current service which provides site specialised support through the disease groups both at the Christie and within Salford Royal Hospital NHS Foundation Trust, together with the generic “Christie Hotline Clinic”. This post holder will join a team of established consultants who are currently providing the clinical aspects of this service. This post holder together with nursing support will formalise this service to provide dedicated and comprehensive support. It is expected that in addition to their other clinical roles they will contribute 2-3 PAs of activity to this role. c) Clinical Staff in Clinical Oncology The medical staff establishment provides for 32 Clinical Oncology Consultants, (see appendix 1) including 3 academic consultants and eighteen Specialist Registrars in Clinical Oncology. There is a junior doctor team at F2 and CMT level, working jointly with medical oncology and haematology, within the Division of Networked Services. d) Duties of Post The appointee will be based at The Christie and Salford Royal Hospital NHS Foundation Trust and will be a member of the Clinical Oncology consultant group. The post will involve the care of patients with Breast and colorectal as defined above. The post holder will be required to conduct outpatient clinics involving chemotherapy delivery, radiotherapy planning sessions, to supervise patients 6 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 Programmed Activity Direct Clinical Care Out –patient Clinics, Christie 2 MDT meetings Acute Oncology 0.5 2 Out-patient Clinics Radiotherapy planning / simulator / on treatment reviews, The Christie / Salford 2 1 Supporting professional Activities 2.5 (1 to support Acute Oncology) (training, CPD, teaching, audit, clinical governance,research, 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 policy. This review will also include an assessment of professional development and defined goals for the future. In the event of the consultant electing to work part 7 time a pro rata adjustment of fixed sessions would be anticipated. This will be discussed and agreed with the Division. The Department has evolved, over many years, a policy of mutual co-operation between the consultants. The department consultant group meets monthly to discuss joint management policies. Consultants are grouped in teams of two to six supported by junior staff .The teams accept responsibility for agreed fields of work and for cover for absence arrangements. All consultants are expected to co-operate in these arrangements and to be involved in a number of clinical areas of work. A Clinical Director, Dr J Logue, chairs the department. The clinical oncology department works with the departments of medical oncology, young oncology and palliative care as part of the Network Services Division, with Jason Dawson 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. This covers the Specialist Registrar who is second on-call. The appointee will have office accommodation and access to a secretarial service. d) 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. The present Executive Directors of the Trust are: Caroline Shaw Ian Moston Dr Chris Harrison Jackie Bird Roger Spencer Chief Executive Executive Director of Finance & Performance Medical Director Executive Director of Nursing & Governance Chief Operating Officer The Trust board is chaired by Lord K Bradley e) Teaching 8 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. The Training Programme Director in Clinical Oncology is Dr Lip Lee Undergraduate training is coordinated by Dr R A Cowan, Director of Education. 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 Christie 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 built. There are opportunities for clinical research in developmental RT, chemoradiotherapy and biological therapies. 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. 9 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: 0 - 7 years seniority six weeks and 2 days per annum (pro rata for part time employees) 7+ years seniority six weeks and 4 days 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: Department of Clinical Oncology The Christie NHS Foundation Trust Wilmslow Road Withington Manchester M20 4BX Telephone number: 0161 446 8457 Fax: 0161 446 3084 Clinical Director: Dr J Logue [email protected] Tel: 0161 446 3407 Colorectal Enquiries: Dr M Saunders [email protected] 0161 446 3357 Breast Enquiries: Dr B Magee Brian.magee @christie.nhs.uk 0161 446 3404 10 APPENDIX 1 NAME Clinical Oncology Consultant Staff PERIPHERAL CLINIC SERVICE Clinical Director PRINCIPAL INTEREST(S) Dr J P Logue Stockport Genito-Urinary Dr R A Cowan Wigan Lymphoma Dr N J Slevin Crewe Head and Neck Dr P A Burt Crewe / MRI Lung Dr A Chittalia Stockport Breast Lung Dr A Choudhury Oldham Dr S E Davidson Salford MDT Gynaecology Dr T Elliott Bolton Salford Urology Dr C Faivre-Finn nil Lung Dr H R Gattamaneni Salford; Children’s Hospital GU CNS / Paeds Dr M Harris Tameside Lung/Lymphoma Dr L Barraclough Macclesfield Breast Gynaecology Prof T Illidge Lymphoma Dr L Bhatt Tameside Breast/ Oesophagus Dr L Lee Bury /NMGH Head and neck Lung 11 Dr JE Livsey Oldham/St Marys Gynaecology/urology Dr J Loncaster North Manchester Breast Dr B Magee Salford Breast Dr V Misra Oldham Breast Colorectal Dr C McBain Macclesfield Salford Colorectal CNS Dr J Coote Oldham Breast Lung Dr H Lander Oldham Breast Lung Dr M Saunders Salford / Wythenshawe Gastrointestinal Dr H Sheikh Salford /Macclesfield Lung/oesophagus Dr E Smith North Manchester Children’s Hospital Lymphoma Paediatric/Young Adult Dr L Pemberton Oldham Lung Dr A Sykes Tameside Head & Neck/Melanoma Dr R S Welch Bolton/Hope Ovarian Cancer Testicular cancer Breast cancer Dr J Wylie Crewe/South Manchester Genito-urinary Soft Tissue Sarcoma Dr B Yap Thyroid/Head & Neck Dr E Allan (Part-time) PDT for skin Dr N Alam Bolton / Salford / Stockport Pennine Acute Salford Gastrointestinal Genito-urinary CNS Genito- Urinary Dr A Tran cancer 12 13 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 Appropriate experience in Breast and GI oncology Demonstrates knowledge, logic and efficiency Integrity, management and communication skills including teaching Developments in oncology practice GENERAL INTELLIGENCE SPECIAL APTITUDES INTERESTS DISPOSITION Acceptability Leadership Self-reliance Motivation Research experience Knowledge of continuing NHS and Royal College Reforms. Is a team player prepared to adapt to changing circumstances. Dynamic, decision-making motivator. Confident in ability, but knowing own limitations. Hardworking, enthusiastic achiever. Good attendance record. Patient friendly. Professional demeanour Must be resilient and well organised 14 15