CLINICANin LATE EFFECTS OF PELVIC rADIOTHERAPY

beatson west of scotland cancer centre/qUEEN ELIZABETH UNIVERSITY HOSPITAL

INFORMATION PACK

REF: 49527d

cLOSING DATE: 8th DEcEMBER 2017

SUMMARY INFORMATION RELATING TO THIS POSITION

Post: CLINICIAN IN LATE EFFECTS OF PELVIC RADIOTHERAPY FUNDED BY THE BEATSON CANCER CHARITY AND MACMILLAN CANCER SUPPORT

BASE: BEATSON WEST OF SCOTLAND CANCER CENTRE / QEUH GLASGOW

The Beatson West of Scotland Cancer Centre (BWoSCC) is seeking to appoint a Clinician with specialist interest in lower GI toxicities and late effects of pelvic radiotherapy. This post may be desirable to a medical Consultant or a motivated and committed Specialty Doctor who has an interest in this area. Funding for training will be provided by both the charities.

The post holder will have a back ground in General Medicine. It is expected that the post holder will promote close links with The Beatson Cancer Charity and Macmillan Cancer Support to ensure all appropriate protocols and systems are in place so the partnership can deliver to a high standard.

The post-holder will help establish and lead the Late Effects Clinic at the Beatson. Funding is also available for a 0.4 WTE Band 7 Clinical Nurse Specialist and a 0.4 WTE Band 7 Specialist Radiographer to support this post holder. This clinic will be promoted as a Macmillan and Beatson Cancer Charity jointly funded initiative in association with NHS GG&C and the project will maintain regular contact with both charities.

The Beatson West of Scotland Cancer Centre (BWoSCC) opened in May 2007, completing a state of the art comprehensive cancer centre that has cost £110 million. It is Scotland’s largest cancer centre, and the second largest in the UK. The centre has undergone unprecedented investment and our clinical teams deliver oncology services to a catchment population of 2.9 million people across 4 Health Board areas. The centre is part of the CRUK virtual comprehensive cancer treatment and research centre which also includes the Beatson Institute for Cancer Research and soon to be built Translational Research Centre. It incorporates the Regional Haemato-oncology Autologous Transplant Unit and the National Allogeneic Transplant Service for haematological malignancies.

The equipment in the new centre is state-of-the-art, and includes 11 linear accelerators with on board imaging, and incorporates Image Guided Radiotherapy (IGRT), IMRT, and Stereotactic Radiotherapy into our portfolio of available technologies. The centre uses VMAT technology to more effectively deliver IMRT. A completely new brachytherapy unit and programme has been established in the centre. A state of the art satellite centre opened on the Monklands hospital site in Lanarkshire in November 2015.This was conceived and delivered to specifically address radiotherapy capacity issues with the added benefit of local radiotherapy delivery. This facility provides a further 2 LINACS fully integrated with the parent site.

The Beatson is an internationally renowned academic centre, with Professors of Medical Oncology, Clinical Oncology, Translational Research and Palliative Care currently in post. In addition, the Beatson West of Scotland Cancer Centre Clinical research unit is the largest of its kind to be funded by Cancer Research UK. The unit offers support to all clinicians within the BWoSCC to initiate and conduct first-in man clinical trials. The unit has a large portfolio of Phase I-III studies across the range of cancer sub-specialties and has a particular interest in the development of new anti-cancer drugs, supported by designated staff and facilities for Phase I/early Phase II clinical trials. The unit also houses Scotland’s first ever co-ordinating centre for the National Cancer Research Institute.

Glasgow has excellent schools, public transport and recreational facilities.

For further details of the posts please contact:

Dr Nazia Mohammed, email

Dr Rosie Harrand, email

Dr Nick Macleod, email

Applicants must have full GMC registration and a licence to practise.

You can also visit our website:

ACUTE SERVICES DIVISION,

NHS GREATER GLASGOW & CLYDE

Post

bEATSON CANCER CHARITY/MACMILLAN

CANCER SUPPORT

LATE EFFECTS CLINICIAN

(0.4 WTE)

BEATSON WEST OF SCOTLAND CANCER CENTRE

Ref: 49527D

1.Brief description of the Beatson West of Scotland Cancer Centre

  1. Role of the Cancer Centre

3.The work of the Directorate/Department/Specialty

4.The job itself

5.Duties of the post

Clinical Commitments

Teaching, Research and Audit Study and Training Research Opportunities Provisional Timetable

6.Arrangements to visit the Cancer Centre

  1. Person Specification
  1. Terms & Conditions
  1. Further Information

BEATSON WEST OF SCOTLAND CANCER CENTRE

Further Particulars of the Post of Macmillan Beatson Supportive Care Consultant

Based at Beatson West of Scotland Cancer Centre

1. Description of the Beatson West of Scotland Cancer Centre

The Beatson West of Scotland Cancer Centre (BWoSCC) is one of the United Kingdom’s largest and busiest cancer centre. The centre has undergone unprecedented investment and our clinical teams are redesigning the way oncology services are delivered to a catchment population of 2.9m people across four Health Board areas. It offers our team of professionals a truly state-of–the-art environment in which to practise and develop their skills. The Scottish Government and NHS Greater Glasgow and Clyde will have spent 1.6b by 2015 on capital and infrastructure to best deliver care for the West of Scotland population.

An internationally-renowned teaching centre, the Cancer Centre incorporates the academic units of Medical Oncology, Clinical Oncology, Translational Research and Palliative Care. Glasgow is a large, lively and friendly city and a great place to make a home. In addition it has excellent transport links to other parts of Scotland, the UK and beyond.

2. Role of the Cancer Centre

The role of the Cancer Centre is to deliver all non-surgical oncology services provided for residents of the West of Scotland on the basis that:

Services meet equitably the assessed needs of the population served,

a high quality service, integrated within the Cancer Centre and also with other cancer care providers, is provided services provided compare favourably with those elsewhere in the UK and there is continual focus on improving care and treatment for patientsexpenditure represents value for money

staff are valued and encouraged to maintain high standards of patient care through, for example, access to continuing professional developmentclinical outcomes are monitored and are discussed in the context of clinical audit and clinical governanceresearch and development are encouraged.

3.The Work of the Cancer Centre

The Beatson West of Scotland Cancer Centre provides specialist oncology services to 60% of the Scottish population. The centre sees over 10,000 new patients a year and over 50,000 return patients. Over 100,000 fractions of radiotherapy and 30,000 cycles of chemotherapy are given each year. An equivalent amount of chemotherapy is delivered in the surrounding Board District General Hospitals under the auspices of Specialist Oncology Services.

The centre has 170 beds in 9 wards (including haemato-oncology). One of these wards runs as an 8 bedded Brachytherapy Unit and one as an 18 bed 5 day/week ward. There is also a day case chemotherapy unit. Up to 8 appropriate patients are accommodated in a local hotel while they undergo radiotherapy. The centre has its own out-patient department pharmacy where cytotoxic drugs are reconstituted. The Beatson also delivers significant cancer services from the new Victoria Hospital South of the Clyde.

The Centre is fully equipped to deliver optimal radiotherapeutic care, including IMRT, IGRT and Stereotaxy. Rapid Arc Technology for the delivery of IMRT is used routinely.

There is excellent access to CT scanning facilities for radiation planning, both in the Cancer Centre, the WestGlasgowHospitals and many of the District General Hospitals throughout the Region where digital communication links can transmit CT scan images to the centre. There is an excellent MRI service within the Cancer Centre and Gartnavel General. A second CT-PET scanner was commissioned at the West of Scotland PET Centre in 2011. There is very good co-operation with the Regional Department of Clinical Physics and Bio-Engineering whose headquarters are nearby. The Radiotherapy Division is based in the Cancer Centre. A dedicated research physics resource facilitates new developments in radiotherapy.

National services at the Cancer Centre include sarcoma, allogeneic stem cell transplantation, prostate brachytherapy and ophthalmic oncology. The Cancer Centre offers the full range of evidence-based regional oncology services, and CHART is also delivered.

The Cancer Centre is an internationally renowned academic centre, with Professors of Medical Oncology, Neuro-Oncology, and Translational Cancer Research currently in post. Professor Karen Vousden heads the laboratories at the internationally renowned Beatson Institute for Cancer Research. This initiative, developed in collaboration with Cancer Research UK, offers unrivalled opportunity for collaboration in basic cancer research. The Beatson Institute has undergone a £20 million redevelopment funded by Cancer Research UK and the University of Glasgow. The BICR, BWOSCC and the soon to be built translational research centre. This virtual comprehensive cancer treatment and research organisation has recently been awarded CRUK centre status.

For the Cancer Centre as a whole, there are particular close links with the academic departments in GlasgowUniversity of gynaecology, surgery, pathology, dermatology and ophthalmology. These involve several joint clinics as well as clinical research projects. Close links also exist with CaledonianUniversity (therapy radiography), StrathclydeUniversity and PaisleyUniversity (radiation physics).

In addition, the Clinical Research Unit at the BWOSCC is the largest of its kind to be funded by Cancer Research UK. It houses Scotland’s first ever co-ordinating centre for the National Cancer Research Institute. The unit offers support to all clinicians within the BWOSCC to initiate and conduct clinical trials. The unit has a large portfolio of Phase I - III studies across the range of cancer sub-specialties and has a particular interest in the development of new anti-cancer drugs. It is supported by designated staff and facilities for Phase I/early Phase II clinical trials. The trials unit has been rated alpha-star by external review. Already, at least 11% of the regional cancer centre’s patients are entered into clinical trials.

The Specialist Palliative Care team has recently undergone expansion and now include 4 consultant posts and 3 clinical nurse specialists.

Clinics are held in eight hospitals within NHS Greater Glasgow & Clyde and in seven in other board areas. Chemotherapy is prescribed and delivered in nine hospitals out with the city of Glasgow.

4.The Job Itself

(a)Title: Late Effects Clinician

NHS Greater Glasgow & Clyde is the employing authority.

The Names of current consultant members of the Service are:

Clinical Oncology

Prof Anthony ChalmersDr Stefano Schipani

Dr Azmat Sadozye, Clinical DirectorDr Nazia Mohammed

Dr Noelle O’RourkeDr Azmat Sadozye

DrDiana Ritchie Dr.David MacIntosh

Dr Richard D Jones Dr Derek Grose

Professor Nick S ReedDr Fiona Cowie

Dr Claire PatersonDr Allan James

Dr CarolynnLambDr Jan Wallace

Dr Norma SidekDr Carrie Featherstone

Dr Graeme Lumsden Dr Brian Clark

Dr Abdulla Alhasso Dr Aisling Hennessy

Dr Jonathan HicksDr.Christina Wilson

Dr.Ross CarruthersDr Vivienne MacLaren

Dr Rosie HarrandDr.Nick MacLeod

Dr.Grainne DunnDr Stephen Harrow

Dr.Stefan NowickiDr.Sam Marashi

Dr.Rosemary StephensDr Aqilah Othman

Dr Mohammad AlfayezDr Ioanna Nixon

Medical Oncology

Dr David Dunlop Dr Ros Glasspool

Dr.Hilary GlenProf. Rob Jones

Professor T R Jeff EvansProfessor Iain McNeish Dr Iain Macpherson (Senior Lecturer) Dr Jeff White

Dr Sophie BarrettDr Judy Fraser

Dr Lucy Scott Dr Ashita Waterston

Dr Nicola SteeleDrClinton Ali

DrJanet GrahamDr Anne McKillop

Dr Jen BrownDr Sarah Slater

Dr Patricia Roxburgh (University)

Palliative Medicine

Dr Alison Mitchell

Dr Jane Edgecombe

Dr Helen Morrison

Dr.Emma Dymond

Consultant Haematologists

Dr Edward Fitzsimons

Dr Pam McKayDr Anne Parker

Dr Grant McQuakerDr Richard Soutar

Dr Mark DrummondDr Andrew Clark

Dr Mhairi Copeland (Senior Lecturer)

Number and Grades of Junior Medical Staff

“Specialist Registrars” 22 in Clinical and Medical Oncology

“Ward based junior doctors” 15

Associate Specialist in Oncology 1

Speciality Doctors 5

Departmental Organisation

In order to facilitate medical management the BWOSCC is divided into 6 teams for specialist oncology services based on the following tumour sites:

Breast

Lung

Urology

GI

Head & Neck (& neuro-oncology)

Gynaecology (including neuro endocrine and sarcoma)

All wards within the BWOSCC (with the exception of brachytherapy) are allocated to the teams and have integrated medical and clinical oncology. There are 2 Consultant on-call rotas, one for Medical Oncology and one for Clinical Oncology. The BWOSCC is committed to multi-disciplinary team working and the Cancer Managed Clinical Networks for the West of Scotland.

Each team has a trainer who supervises the trainees. The teams are headed by a team leader who is responsible for the development of departmental medical protocols and responsible for absence management. All Consultants are members of the Consultants’ Committee where matters of general concern, including protocols are discussed.

There is a multidisciplinary Chemotherapy Team consisting of Specialty Grade Doctors, Clinical Nurse Specialists, IV Nurses and Phlebotomists who administer most of the IV chemotherapy given in the Department. Many of the senior nurses, radiographers and pharmacists deliver non-medical chemotherapy and radiotherapy review clinics.

All beds are shared and managed by a Bed Management Team who arrange elective and non-elective admissions on the basis of need.

Clinic referrals and MDTs in the various tumour sites are managed by teams who provide a cooperative approach to absence management to provide sustainable consultant led input into the MDTs. These teams of consultants are essentially independent of registrar support but have defined, permanent clinical support from clinical nurse specialists, prescribing pharmacists and specialty doctors.

5.Duties of the Post

Clinical Commitments: Late Effects Clinic at the Beatson

The Gastro-intestinal and nutrition (GIANT) service provided at The Royal Marsden Hospital is a dedicated, comprehensive care package for patients experiencing ongoing GI symptoms and nutritional issues after completion of their cancer treatment. It is internationally acknowledged as an unprecedented, pioneering, multi-disciplinary approach to managing gastro-intestinal consequences of cancer treatment.

In the UK, the GIANT service is routinely cited as a demonstration of The Royal Marsden’s commitment to supporting patients living with and beyond cancer. Services for managing the consequences of treatment are becoming a key national cancer priority as part of the cancer survivorship agenda. The Royal Marsden GIANT service is highlighted as an example of best practice within the “Improving Outcomes: A Strategy for Cancer” Third Annual Report, issued by the Department of Health in December 2013.

This is an amazing service for patients however, this post seeks to go further and provide a similar yet more inclusive service as GI symptoms are only one of the problems that patients suffer from.

The Beatson West of Scotland Cancer Centre is regarded as a centre of excellence and has always been at the forefront of innovation and advancement of cancer services. This record of excellence extends to radiotherapy which is used in the treatment of more than 50% of cancer patients. As a result of the rapid technological advancements in radiotherapy, increasing numbers of patients survive their cancers and it is estimated that at the moment the UK has 2 million survivors and this will increase to 4 million by 2030. However, it is estimated that 500,000 of these survivors live with more than one long term problem as a consequence of their cancer treatment. From a Scottish perspective, every year about30,000 people are told they have cancer and trends predict that the number is likely to rise to almost35,000 from 2016-2020.

The total number of people diagnosed with cancer is growing year on year, largely due to the rising number of elderly people in the population and the fact that life expectancy is increasing. Over the last twenty years, almost all cancers have shown improvement in survival five years after diagnosis, and survival from cancer in Scotland is similar to that in England and Wales. Data is lacking when it comes to cancer survivorship figures for Scotland but we constantly strive for improved techniques and increased survival rates.

In doing this we must take cognizance of the recent Scottish cancer plan where it states that we should “promote the adoption of follow-up that is person-centred and risk-stratified” (2016). We must place new emphasis on developing essential support to help patients feel empowered and educated about their ongoing health in living with and beyond cancer. Patients often have specific support needs which if left unmet, can damage their long-term prognosis and ability to lead active and healthy lives. Services for managing the consequences of treatment are becoming a key national cancer priority as part of the cancer survivorship agenda, issued by the Department of Health in December 2013. As the requirement for services to manage the consequences of cancer treatment is introduced to site specific NICE guidelines (The National Institute for Health and Care Excellence) e.g. prostate cancer, it is increasingly likely that this requirement will be extended to the service specifications for commissioning of specialist cancer services.

Patients suffer from a huge variety of late effects after radiotherapy to the pelvis including sexual dysfunction, neuropathy, lymphoedema, bone necrosis and psychological distress. It is hoped this new service would not only address, but measurably improve their cancer journey.

Phase I of the service would initially run one day per week for an 18-month period with 6 monthly evaluation. At the end of Phase I a detailed analysis of the service would be available for review, and continuance on to Phase II would be dependant on these results. This approach offers us early indications of success, failure and the necessity of a fluidic and proactive approach to Phase II offers the greatest chance of improving the service available to the patient.