IN paediatric haematology with an interest in stem cell transplantation
royal hospital for sick children
Closing Date: noon 10th OCTOBER 2014
Post: consultant in paediatric haematology with an interest in stem cell transplantation
Base: ROYAL HOSPITAL FOR SICK CHILDREN
Applications are invited for the post of Consultant in Paediatric Haematologist with an interest in stem cell transplantation based at the Royal Hospital for Sick Children, Glasgow.
The Royal Hospital for Sick Children, Glasgow, is the largest paediatric teaching hospital in Scotland and is a world leader in the provision of child health services. It provides care, not only for children resident within Greater Glasgow, but is also a tertiary referral centre for children from the West of Scotland and, in some sub-specialties, including stem cell transplantation, for the whole of Scotland.
The successful applicant will join the existing team of four haematologists and three oncologists to provide a secondary and tertiary haematology and oncology service to the West of Scotland. On call responsibilities will be for both the paediatric haematology and oncology clinical services and the haematology and blood transfusion laboratory service.
Applicants must possess full GMC registration, a licence to practice and be eligible for inclusion in the GMC Specialist Register. Those trained in the UK should have evidence of higher specialist training leading to CCT in Haematology, have appropriate experience in paediatrics and possess a Postgraduate qualification (MRCPCH, MRCP or equivalent), or be eligible for specialist registration (CESR) or be within 6 months of confirmed entry from date of interview. Non UK applicants must demonstrate equivalent training.
Acute Division Women & Children’s Directorate
Further Particulars of the Post of Consultant in Paediatric Haematology with an interest in Stem Cell Transplantation , RHSC, Yorkhill
This document is split into the following sections:
1. Information on paediatric services in NHS Greater Glasgow and Clyde
- General description of children’s services (section 1)
- Paediatric Services (section 2)
2. Information on the job and the selection process
- The Job Itself/Description of Service and Contacts (section 3)
- Personal Specification
- Terms and Conditions of Service
- Further information (section 6)
The overall job pack also contains documentation around equal opportunities monitoring.
Section 1 Children’s Services across NHS Greater Glasgow and Clyde
The Royal Hospital for Sick Children, Glasgow
The Royal Hospital for Sick Children, Glasgow, is one of the largest paediatric teaching hospitals in the UK and the largest in Scotland. It provides secondary care for more than 900,000 people resident within the Greater Glasgow and Clyde area, and tertiary care for the 3m people living across the West of Scotland. There are 17 nationally designated services delivered from the hospital including cardiac surgery, stem cell and renal transplantation, Extracorporeal Life Support (ECLS) and complex airway management. The hospital provides care for children from newborns up to around 16 years of age.
There is a complement of up to 266 beds, which include 23 integrated neonatal medical and surgery cots. There are 16 nationally funded intensive care beds and 6 high dependency beds within an integrated critical care facility. This facility has the physical capacity to extend to 26 integrated critical care beds. A new theatre complex comprises of 7 full theatres, scope room and dental suite. The Emergency Department currently sees over 43,000 patients per year.
All paediatric medical and surgical subspecialties are represented, including general medical paediatrics, cardiology, neonatology, neurology, nephrology, respiratory, endocrinology, gastroenterology, immunology and infectious diseases, dermatology, haematology, oncology, rheumatology, metabolic medicine, audiology, ophthalmology, ENT surgery, orthopaedics and general paediatric and neonatal surgery. There is a neonatal retrieval service. The hospital provides a national ECMO service and is the centre for all paediatric cardiac surgery, bone marrow transplantation and renal transplantation in Scotland. A selection of child and adolescent psychiatry facilities are located within the campus.
In its role as a major academic institution, the Division is home to a number of University departments as well as internationally acclaimed research groups. The hospital provides the major Undergraduate Paediatric Teaching facility for the University of Glasgow and accommodates the University Departments of Child Health, Child and Family Psychiatry, Human Nutrition, Paediatric Pathology, Paediatric Biochemistry and Paediatric Surgery. There is on site clinical audit and research and development support to assist with departmental research projects.
The diagnostic imaging department located within RHSC provides ultrasound, CT, MRI and isotopic studies on site. All imaging is now film-less and is accessed through the PACS system. Specialist laboratory services have re-located to the new laboratory complex at the Southern General Hospital (SGH) site, but appropriate laboratory services will remain at the RHSC site until the hospital relocates in 2015.
Other Paediatric services in NHSGG&C
There are currently three maternity hospitals in Greater Glasgow and Clyde; Princess Royal Maternity Hospital, Southern General Hospital and the Royal Alexandra Hospital, all with neonatal intensive care facilities.
Paediatric neurosurgery has historically been located in the Institute of Neurosciences at SGH, but recently co-located to the RHSC site.
There is one children’s ward at the Royal Alexandra Hospital providing local care for the children of Paisley.
There is an extensive range of specialist community based children’s services across NHS Greater Glasgow and Clyde. Specialist Children’s Services are managed within community health and social care partnerships, these services are closely linked to primary care and social care services.
New Children’s Hospital
A new children’s hospital is being built on the Southern General Hospital site and this will be co-located with a new adult hospital and a re-developed maternity hospital. The predicted commissioning date for the new children’s hospital and re-location of RHSC Glasgow is summer 2015. The adult stem cell transplant unit will also relocate to this site facilitating a closer relationship of the two transplant programmes. Cytogenetics and diagnostic molecular haematology are located on this site.
Section 2 Paediatric Services
Medical services are a key component of integrated hospital paediatric services within the Women and Children’s Directorate (of the Acute Operating Division, NHS Greater Glasgow and Clyde).
Dr Jim Beattie (Consultant Paediatric Nephrologist) is the Associate Medical Director for Women’s and Children’s Services
Dr Philip Davies (Consultant Paediatrician) is the Clinical Director for Medical Paediatrics.
National Service Contracts
The Royal Hospital for Sick Children hosts a number of paediatric national services including paediatric intensive care. These national services are listed below:
- Paediatric Cardiac Surgery
- Paediatric Interventional Cardiology
- Brachial Plexus Surgery
- Complex Airways
- Extracorporeal Life Support (ECLS)
- Paediatric Intensive Care Transport
- Paediatric Intensive Care (in conjunction with RHSC Edinburgh)
- Renal Transplant
- Stem Cell Transplant
Section 3: The Post
Title:Consultant Paediatric Haematologist with an interest in Stem Cell Transplantation
National Networks and Services
Managed Service Network for Children & Young People with Cancer (MSN CYPC):
In Scotland, cancer services for children and young people (CYPC) until their 25th birthday in Scotland are provided within a Managed Service Network. Whilst care is delivered in 3 treatment centres – Glasgow, Edinburgh and Aberdeen – and 3 shared-care centres – Dundee, Inverness & Dumfries, the MSN acts as a cohesive single service for all children and young people with cancer in Scotland to deliver equity of care irrespective of geography or age. Weekly national MDT meetings take place by videoconference or teleconferencing for leukaemia and stem cell transplantation. The Cancer Plan for CYPC was launched by the Cabinet Secretary in March 2012. Professor Gibson is the Clinical Lead of the MSN and the department has representation on the Executive Group and all Steering committees.
National Managed Clinical Network for Haemoglobinopathies:
The paediatric haemoglobinopathy service at Yorkhill is part of the SPAH (Scottish Paediatric and Adult Haemaglobinopathy) National Managed Clinical Network which was established in April 2011. The Lead Clinician Post alternates between paediatrics and adults and is currently an adult haematologist - Dr Beverley Roberson, Consutlant Haematologist, Aberdeen. There are several working sub-groups including one designated to paediatric clinical services. The network supports regular nationals MDT meetings which are conducted via video-conferencing as well as educational meetings for different professional groups. Both the Network and the clinical service at Yorkhill have close links with the national newborn blood spot screening programme for sickle cell disease which is based at the Southern General Hospital Site. Paediatric transcranial doppler scanning and Ferriscan are centrally funded and are provided at Yorkhill as national services.
National Designated Service:
The Stem Cell Transplantation Programme is a national service with National Service Division (NSD) recognition and funding. It has JACIE and HTA accreditation as both an allogeneic and autologous clinical transplant centre and collection site for bone marrow and directed cord blood collection. It is currently undergoing NSD review.
The clinical Haematology and Oncology service is part of the Medical Directorate and this post resides within the Medical Directorate. The department provides care for children with leukaemia, solid tumours, bleeding disorders and a range of benign haematological conditions for patients, predominantly from the West of Scotland. The department houses the National Stem Cell Transplant Unit and is the Regional Paediatric Haemophilia Centre.
There are approximately 70 new patients with cancer annually, of which a third will have leukaemia. All eligible patients are entered into NCRI clinical trials. The department is an Innovative Therapies for Cancer Consortium (ITCC) centre and delivers Phase II trials for Scotland.
Paediatric Haematology is provided by 4 Consultant Haematologists. Within this compliment there are specialist interests - one consultant has an interest in haemophilia, haemostasis and haemoglobinopathies, a second in adolescent haematology, a third in leukaemia and stem cell transplantation and a fourth is 0.9 WTE academic.
The Stem Cell Transplantation Programme is a national service with National Service Division (NSD) recognition and funding. It has JACIE and HTA accreditation as both an allogeneic and autologous clinical transplant centre and collection site for bone marrow and directed cord blood collection. The programme is supported by a SCT data manager, CNS and Quality Manager. The service is delivered by a Consultant Haematologist and an Associate Specialist and this post holder will complete the team.There are close relationships with the Regional Stem Cell Processing laboratory, the Regional Transfusion Centre and Apheresis Service and the Paul O’Gorman Scottish Leukaemia Research Laboratory. The adult Stem Cell Transplant service will co-locate on the Southern General Site and closer working relationships will be encouraged where possible. The molecular laboratory haematology laboratory on the SGH site provides a Minimal Residual Disease (MRD) service to Scotland, Ireland, Newcastle and Liverpool and a chimeric service for SCT. There is an EFI accredited tissue typing laboratory whose location is yet to be agreed.
The haemoglobinopathy service cares for approximately 50 children and adolescents with sickle cell disease and 8 transfusion dependent thalassaemia patients. The service is delivered by a consultant haematologist and a Haematology Clinical Nurse Specialist. The postholder will join this team. Children attend the day care unit for red cell transfusions. There is a monthly sickle cell disease clinic which runs concurrently with Transcranial Doppler scanning as a one stop clinic. Children from out with Glasgow also attend this clinic for TCD scanning and in some cases e.g. children from Dundee, for tertiary clinical review.
There are 4 surgeons on-site who have an interest in oncology, all of whom insert port-a-caths and hickmen lines. Radiotherapy facilities are at the nearby West of Scotland Beatson Oncology Centre and two Consultant Clinical Oncologists support this service. The West of Scotland Blood Transfusion Service provides an apheresis service for harvesting peripheral blood stem cells for intensive chemotherapy support. Specialist in-house Paediatric Renal, Respiratory, Cardiology, Gastro-Enterology and Endocrinology Consultants support the Unit. There is an on site Intensive Care and High Dependency Unit.
The clinical work is supported by a full range of laboratory services. Haematology / Blood Bank provide a comprehensive range of investigations, including marrow diagnosis, haemostasis and thrombosis investigations, flow cytometry and molecular genetics. The Radiology Department has ultrasound, CT and MRI scanning facilities and nuclear medicine. There is access to interventional radiology. The Histopathology service is provided by 3 Paediatric pathologists. Medical Genetics is sited within the new laboratory complex at the Southern General Hospital.
Clinics are held weekly for on treatment leukaemia, haemophilia /haemostasis and haemoglobinopathy, twice weekly for general haematology, fortnightly for long term follow up leukaemia and stem cell transplantation and monthly for lymphoma .
There are two weekly theatre lists; one for bone marrow, lumbar puncture and intrathecal administration and one for central line insertion/removal.
The dedicated Haematology/Oncology Unit (Schiehallion Ward) opened in 1996. It has 22 inpatient beds, of which 18 are single occupancy cubicles, plus two 2-bed cubicles. In addition, there is a recently refurbished 6-bedded TCT Unit with recreational facilities for teenagers between the age of 13-16yrs in another ward (Ward 7a). All inpatient beds allow for a parent to be resident 24 hours a day. Four cubicles are fitted with laminar air flow to support Stem Cell Transplant. There is a comprehensive Day Care Unit with both consulting rooms and day-care beds. There are separate waiting facilities for Stem Cell Transplant patients who also have a separate facility for infusion therapy.
There is an on-unit Pharmacy Suite, with dedicated oncology pharmacists, for the preparation of drugs including cytotoxic chemotherapy. Chemocare is in place with ongoing development. There is an on-unit classroom which provides both primary and secondary education. There are generous supported play facilities, in both inpatient and outpatient areas.
There is a small suite for resident parents of bedrooms, a kitchen and a sitting room. There is also parent accommodation in an adjacent Ronald McDonald House and family rooms solely for haemato-oncology patient use at Cruachan House, run by CLIC-Sargent.
Activity Outcome (RHSC – Glasgow):
Solid tumour new patients per annum20 - 25
Brain tumour new patients per annum20 - 25
Leukaemia new patients per annum20 – 25
Haemoglobinopathy (total numbers)58
Autologous3 - 5
Sibling 2 - 4
Unrelated 8 - 12
Prof Brenda Gibson, Consultant HaematologistFull time
Dr Elizabeth Chalmers, Consultant HaematologistFull time
Dr Nicholas Heaney, Consultant Haematologist5 sessions
Dr Christina Halsey, Consultant HaematologistUniversity
Dr Milind Ronghe, Consultant OncologistFull time
Dr Dermot Murphy, Consultant OncologistFull time
Dr Jairam Sastry, Consultant Oncologist Full time
Dr Fiona Cowie, Consultant Clinical OncologistSessional commitment
Dr Richard Jones, Consultant Clinical OncologistSessional commitment
ii)Other Medical Staff:
- 1 Associate Specialist with interest in Stem Cell Transplantation
- 3 Staff Grades – 2.2 WTE who work predominantly in DCU and OP clinics. A 4th post is about to be appointed.
- There are 2 foundation doctors Year 2, 1 grid oncology trainee, 1 /2 adult haematology trainees and 2/3 paediatric trainees. These numbers are subject to variation.
- Middle grade staff do not participate in the general medical paediatric on-call rota, but provide dedicated out-of-hours cover to the Haemato-Oncology Unit up to 22:00hrs Monday to Friday and 9:00 to 22:00hrs Saturday and Sunday. Overnight cover is provided by The Out of Hours Hospital Service.
The Haematology Department is a recognised part of the West of Scotland Specialist Haematology trainee rotation with trainees attached to the department for a 6-month period. Similarly Paediatric Oncology Department is recognised as a Training Centre for Oncology Grid trainees.
All nursing staff are appropriately experienced and trained in caring for children with haemato-oncology conditions. The department benefits from the employment of two Advanced Nurse Practitioners, Research Nurse and two Nurse Educators. In addition there is a Stem Cell Transplant nurse who coordinates patient care during transplant. There are also Nurse Specialists responsible for haemophilia care and haemoglobinopathy. There are 4 outreach Nurse Specialists providing support in the community, including chemotherapy administration, throughout a child’s treatment as well as in the palliative care phase.
The CLIC-Sargent Fund provides social work support for Haemato-Oncology patients.
v)Data Management and Secretarial Staff:
There is secretarial support provided to the Haemato-Oncology Consultants. 3 data managers provide clinical trial and administrative support to the team, plus one stem cell transplant data coordinator. The role of the data-manager includes the registration and computerised collection of patient related information.
In addition, there are dedicated paediatric physiotherapy, psychology, occupational therapy and dietetics staff.
Shared care arrangements currently exist between Yorkhill and various District General Hospitals around Scotland. Regular shared-care clinics take place in Raigmore and Dumfries and Galloway.
Shared care units provide varying levels of support, including blood count monitoring, treatment of febrile neutropenia and bolus chemotherapy administration. This reduces travelling and disruption to families, without compromising quality of care. They also have an important role in the delivery of palliative care.