SPECIALTY TRAINING PROGRAMME IN HAEMATOLOGY FOR HEALTH EDUCATION ENGLAND - WESSEX

This is a 5 year training programme in Haematology at ST3 aimed at doctors who can demonstrate the essential competencies to enter this level of training. The

programme is designed to support training for a CCT in Haematology. Details of essential competences and qualifications are detailed in the HEE person

specification for Haematology at ST3 which is available from http://specialtytraining.hee.nhs.uk/

This 5 year Specialty Training programme will allow the successful applicant to achieve the award of a Certificate of Completion of Training (CCT) in Haematology, subject to satisfactory progression.

The programme is based in hospitals in Health Education England - Wessex including:

HOSPITAL LOCATION

Hampshire Hospitals NHS Foundation Trust Basingstoke

The Royal Bournemouth Hospital Bournemouth

Dorset County Hospital Dorchester

Poole General Hospital Poole

Queen Alexandra Hospital Portsmouth

Salisbury District Hospital Salisbury

University Hospital Southampton Southampton

Health Education England - Wessex is responsible for the planning, development, education and training of the healthcare and public health workforce across Hampshire, Dorset, Isle of Wight and Salisbury. We also provide medical training for

the States of Jersey and GP appraisal services for Jersey and Guernsey. We believe that the key to improving the health and healthcare of the 2.8 million people living in Wessex is investment in the skills and values of the 52,000 people working in the

NHS and in primary care. Within the field of postgraduate medical education and training, we manage across

primary and secondary care for these health communities – totalling around 2,400 doctors in training at any one time across 12 Trusts and 160 GP practices. In addition, we support the workforce development for GP Practice Nurses and Public

Health practitioners as well managing a bespoke GP appraisal service for established GP Practitioners to meet the requirements for revalidation in accordance with the statutory requirements set by the General Medical Council.

We manage training programmes for postgraduate medical training according to the statutory standards set by the General Medical Council (GMC) and have

responsibility for establishing and maintaining quality management systems for all posts and programmes as required by the GMC.

The work of Health Education England - Wessex is guided by the principles embedded within the NHS constitution.

Rotation Information It is usual that trainees will spend at least two of their five years training at University

Hospital Southampton where specialist training in paediatrics and allogeneic transplantation is available. The remaining three years will be spent at the other district general hospitals on the rotation.

Rotational placements will be made each year with the training need of the registrar being the most important factor. After this, the preference of the trainee for a

particular post is taken in to consideration. It may not be possible for a trainee to go to a placement of their choice. Usually each post is for one year’s duration. In exceptional circumstances you may need to rotate for a shorter period

Study and Training

The primary aim of all posts is the training programme developed and there is a

region wide syllabus and minimum standards of education agreed by all Trusts within the rotation.

Health Education England - Wessex is committed to developing postgraduate training programmes as laid down by GMC, Colleges and Faculties and by COPMED

- the Postgraduate Deans Network. At local level college/specialty tutors work with the Programme Director and Directors of Medical Education in supervising these programmes. Trainees will be expected to take part in these programmes (including

audit) and to attend meetings with their nominated educational supervisor.

All posts within the training programme are recognised for postgraduate training by the General Medical Council (GMC) in accordance with their standards for training.

Study leave is granted in accordance with Deanery/Trust policy and are subject to the maintenance of the service.

All posts have a service element and the following covers the majority of duties. There will be minor variations in different hospitals but the list is aimed at covering

the majority of duties:

1. Supervise, monitor and assist the House Officer (F1) in the day-to-day management of in-patients in posts with an attached F1.

2. Liaise between nurses, F1 and F2 Doctors, patients, relatives and senior medical staff.

3. Attend and participate in ward rounds as timetabled

4. Attend outpatient clinics.

5. Take part in rostered emergency work.

6. Dictate discharge summaries.

7. Study for higher examination and maintain continued professional development.

8. Attend weekly educational and multidisciplinary sessions.

9. Undertake audit at various times throughout the rotations.

10. Teach medical students as directed.

11. Co-operate with members of the personnel department when monitoring hours of

work and other personnel issues.

12. Attend induction in each hospital or new department

13. Comply with all local policies including dress code, annual and study leave

Specialist training may be extended to accommodate less than full time training. One year of specialist training may be approved for research, which is relevant to the specialty and in an area approved by the Chair or Secretary of the Specialty

Advisory Committee. Approval will take account will be taken of the generic training value of the research and any clinical experience gained during the period of research. On award of CCT a haematologist will be able to work as a consultant

specialist within the National Health Service and will have the competencies required to do so, as well as to develop further special interest expertise if desired.

For the full haematology training curriculum please refer to the JRCPTB website specialist haematology page.

Teaching The Wessex haematology training programme runs a very successful teaching

programme. This involves compulsory ‘training days’ which are held at one of the rotation placement hospitals on a 6 weekly basis. Trainees must attend >75% of these training days to successfully progress though training.

In addition ‘on the job’ teaching is provided at all the placement hospitals on a regular basis during a placement.

Information about Hospital Trusts in the rotation

Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust

Clinical Haematology

The clinical haematology unit has adjacent inpatient and day wards. Ward 11 is the Haematology inpatient ward and has 15 beds, which include 2 single rooms with laminar airflow and en-suite facilities, 3 single rooms and a 2 bedded

room with filtered air, 5 single rooms and a 3-bedded bay. The inpatient unit has facilities for BCSH level 3 and is JACIE-accredited for autologous stem cell procurement and transplantation.

The Unit transplants 20-25 patients annually. Ward 10 is the day ward, has two 6 bedded bays and is used for clinical

assessments, chemotherapy clinics, administration of chemotherapy, blood products and coagulation factors, diagnostic and therapeutic procedures including venesections, aphaeresis, tunnelled central venous catheter (CVC) removals, bone

marrow biopsies and intrathecal chemotherapy. Tunnelled CVC and PICC are inserted in Radiology. The day care facilities on ward 10 are shared with medical oncology. In 2011-12, the day unit managed 7786 Haematology and 8698 Oncology

day-case patients. Outpatient clinics include 8 Consultant-led weekly general haematology and disease-

specific LPD, myeloma, transplant, haemostasis and thrombosis clinics. There are, in addition, weekly nurse-led chemotherapy, MPN and venesection clinics. The Department has 6 Consultants, a Consultant Nurse and 5 Specialist Nurses.

Most nurses working on wards 10 and 11 have post-registration qualifications in haematology, oncology, blood & marrow transplantation and/or care of the dying. The Department has a Clinical Trials Unit staffed by Trials Coordinator, Data

Manager and 3 Research Nurses, and participates in many national and international clinical trials in acute leukaemia, lymphoma, CLL, myeloma, MDS and

MPN. The Department houses the Dorset hub of the Wessex Haemophilia Comprehensive

Care Network (WHCCN). The Network Comprehensive Care Centre (CCC) is based at Basingstoke and North Hampshire Hospitals NHS Foundation Trust. Comprehensive care for patients with inherited and acquired bleeding disorders in

East Dorset is led by a full-time Consultant in Haemostasis and Thrombosis based in Bournemouth. Adult patients are managed in Bournemouth and children are managed in Poole. Elective orthopaedic surgery and GUM services for East Dorset

are based in Bournemouth. Paediatrics, ENT and Oral Surgery are based in Poole. The anticoagulation service is led by Consultant Nurse with 4 trained anticoagulation

practitioners. There are 4000 patients registered with the anticoagulation clinic. The clinics are managed according to pre-defined algorithms authorised by the hospital’s Thrombosis Committee and Drugs & Therapeutics Committee. Majority of patients

on oral anticoagulation therapy are managed by postal dosing using DAWN-AC v7.9 software. The team also runs peri-operative bridging clinics for patients on warfarin. The anticoagulant service is linked to the hospital’s fast-track DVT service which is

run from the Emergency Department. Laboratory Haematology

The haematology laboratory is CPA and MHRA-accredited and performs approximately 240,000 blood counts annually using two ADVIA 2120 analysers.

About 500 diagnostic marrow aspirates are processed annually. Serum ferritin, B12 and folate levels are analysed on Beckman-Coulter ACCESS 2 analyser. Haemoglobinopathy screening is performed at Poole hospital.

The coagulation laboratory uses two ACL TOP analysers. Approximately 100,000 INR samples are analysed annually. Comprehensive thrombophilia screening

including molecular tests are performed electively. Thromboelastogram (TEG) is available for 24/7 use. PFA-100 screening test is available at Poole Hospital. Light-transmission aggregometry is performed to assess platelet function on an elective

basis. The laboratory has trained personnel to perform a full panel of special coagulation tests e.g. clotting factor assays.

The transfusion laboratory performs 25,000 group and screen and 7000 cross matches per year. There is an automated grouping machine and the department uses DIAMED column technology. All of the laboratories use the Telepath 1 system

from i-Soft.

A Haematological Malignancy Diagnostic Service (HMDS) for Dorset Cancer Network is being developed and is expected to be fully operational by 2014. Flow

cytometry is performed in-house using a FACSCalibur analyser. Bournemouth provides the immunophenotyping service to Dorset Cancer Network. Molecular and cytogenetic laboratories are on site but are used mainly for research. All routine

diagnostic cytogenetic and molecular genetic studies are performed at Wessex Genetics Laboratory in Salisbury District Hospital.

Research

There is an active laboratory research unit within the department. The main research

interests are in diagnosis, genetic abnormalities, prognostic features and management of chronic haematological malignancies, especially chronic lymphocytic leukaemia, low-grade lymphoma and myelodysplastic syndromes. The department

attracts funding from the Leukaemia Research Fund as well as other grants and local charities.

Duties of specialist trainee in haematology

The Department trains 3 specialist haematology (ST3-7) and 2 core medical trainees

(ST1-2). The ST3-7 trainees rotate between inpatient ward, day ward and laboratory every 2 months. The ST1-2 trainees rotate between inpatient ward and day ward every month. The trainees are expected to provide inpatient, day ward, outpatient

and laboratory haematology services under Consultant supervision to East Dorset population of 500,000.

The Haematology on-call service is non-resident, 1-in-5, first-on-call for periods 3-7.30pm and 8-9am on weekdays, 8am-7.30pm on weekends, and second-on-call for periods 7.30pm-8am. The Hospital-at-night (HAN) will take over the first-on-call

clinical duties 7.30pm to 8am. All laboratory and coagulation related out-of-hours calls will bypass the HAN team and will go directly to the Haematology doctor on call. The on-call trainee for Haematology on the previous night will have time off in lieu

the next day from 3pm.

Day Ward 11 Ward 10 Laboratory

Monday AM Registrar ward round

Clinic – day ward Haemostasis clinic

PM Ward work Procedures Prescriptions

BM reporting Film Q

Tuesday AM 1245

Consultant ward round Morphology meeting

Day ward clinic Morphology meeting

BM list Morphology meeting

1315 1400

PM

Teach-in session

Ward work Film Q

Teach-in session

Procedures Prescriptions

Teach-in session HMDS sign-out

Consultations Bridging clinic

Wednesday AM Registrar ward round

Day ward clinic Outpatient clinic

PM Ward work

BM list Prescriptions

BM reporting

Thursday AM Registrar ward

rounds

Day ward clinic Outpatient clinic

PM Ward work Procedures

Prescriptions

BM reporting

Consultations

Friday 0830

AM

MDT meeting

Consultant ward round

MDT meeting

Day ward clinic

MDT meeting

Consultations

1245 PM

Grand round Ward work

Grand round Prescriptions Film Q

Grand round BM reporting

Training Opportunities

The post will provide excellent training opportunities for work-based experiential learning in diagnostics and clinical management of haematological disorders through

clinics, Consultant-led and personal ward rounds, consultative haematology on other wards, placements in haematology laboratory, multi-disciplinary team meetings, participation in clinical trials as sub-investigators, supervised on-call experience,

audits and teaching of junior trainees. Trainees are well-supported by Consultants who will provide clinical supervision at workplace with regular assessments through standard curriculum-approved assessment tools. Trainees are expected to complete

at least one major audit in a year. Although the clinical and laboratory experience offered is primarily aimed towards

practice of Haematology in district general hospital, the Unit has acquired a

reputation for academic excellence with a sound clinical and laboratory research base, particularly in chronic lymphocytic leukaemia and myelodysplastic syndromes.

Trainees will gain excellent experience in clinical management of all haematological cancers in adults including acute leukaemia, lymphoma, myeloma and autologous stem cell transplantation.

Diagnostic haematology training will be provided throughout and laboratory placements will allow trainees to acquire expertise in routine diagnostics e.g.

morphology, specialist diagnostic techniques e.g. flow cytometry, and laboratory management e.g. NEQAS. In addition, the Consultants will provide regular teaching sessions in morphology, flow cytometry, obstetric haematology, haemostasis and

thrombosis. Further Information

Detailed information on all aspects of the Department’s activities can be obtained from the Unit’s web page at http://www.rbch.nhs.uk/haematology

Portsmouth Hospitals NHS Trust - Queen Alexandra Hospital

Introduction

Portsmouth Hospitals NHS Trust is a provider of Acute Health Services under

contract to a range of Purchasers in the area of the Hampshire basin and Western South Downs. The current main purchasers are the 3 Local CCGs. The catchment population for the Trust extends from Warsash in the West to the

Sussex border and its northern boundaries encompass Petersfield and Liss. With the exception of the rural north, it is an essentially urban area, having grown around the Royal Naval establishments of Gosport and Portsmouth. As well as Naval bases it

now provides a wide range of modern high-tech industry and the facilities associated with a commercial port and cross-channel ferry terminal. Southsea and Hayling Island are popular holiday resorts and the city of Portsmouth continues to undergo

major development along its waterfront including Gunwharf Quays, the Spinnaker Tower and plans for a new stadium for its football club. There is easy access to the many sailing and water sport facilities on the coast, the countryside of the new South

Downs National Park and good transport links to the M27, Southampton airport and, via the ferry terminal, to the Continent.

Portsmouth Hospitals NHS Trust provides a range of acute services concentrated at

Queen Alexandra Hospital in Cosham. The Queen Alexandra Hospital site has undergone a major redevelopment to create a modern and 'fit for purpose' hospital, which opened in June 2009. This work was done in partnership with 'The Hospital

Company', a consortium of Carillion plc and the Royal Bank of Scotland. This

development includes new spacious ward facilities, a purpose built Main OP department and state of the art pathology laboratories.

The Trust is also home to the Wessex Renal and Transplant Unit and it holds prestigious Cancer Beacon Status for the Head and Neck Cancer Services. Hosting a Ministry of Defence Hospital Unit (MDHU), the Trust enjoys strong military

connections and is proud of this association. This means that as a Trust, we have wider responsibilities than those of standard NHS organisations.

Portsmouth Harbour QA main entrance

General Information

Portsmouth Hospitals NHS Trust is one of the largest in England with an annual

income of £400 million. It provides acute healthcare services for almost 1,000,000 people, has a regional speciality in its renal and Transplant Unit and is a designated Cancer Centre. It encompasses postgraduate teaching facilities and is involved in

training of nurses and undergraduate doctors from the University of Southampton. The Trust is the lead body for the local Research and Development Support Unit and has close links with the University of Portsmouth and its new School of Postgraduate

Medicine for both education and research.

The Trust provides most of its services at Queen Alexandra Hospital in Cosham with 1396 beds.

Haematology Services

The Haematology service is based at Queen Alexandra Hospital with peripheral clinics in Gosport War Memorial Hospital, St Mary’s Hospital Fratton, Petersfield Hospital.

The Haematology Department consists of 6 WTE Consultants, a 0.6 WTE consultant with a 0.7 wte Speciality Doctor and two Speciality Registrars from the Wessex Rotation. The post is based at Queen Alexandra Hospital.

The department works as a team, with cross-cover of ward patients, and rotation

through laboratory duties, liaison patients, but individual clinic lists. At present all the consultants see the full range of haematological oncology, with the exception of lymphoma which is run as a separate clinic service jointly with oncology.

Haematology Staff

Consultants

Dr Helen Dignum Clinical Director, General and Malignant Haematology

Dr Robert Corser General and Malignant Haematology, Lymphoma

Dr Mary Ganczakowski General and Malignant Haematology, Haemoglobinopathy

Dr Hussain Hirri General Haematology, Haemophilia, Thrombosis

Dr Chris James General and Malignant Haematology, Pathology Director, Associate Medical Director

Dr Charles Alderman New appointee to start Jan 2015

Dr Tanya Cranfield General and Malignant Haematology

(part time retired)

Other Staff

Dr Gwynn Matthias Speciality Doctor (0.7 wte)

2 Speciality Registrars from Wessex Rotation, rotating annually

Haematology Clinical Nurse Specialist Donna Burgess

Lymphoma Clinical Nurse Specialist 1 wte.

0.4 wte Haemophilia Nurse Specialists, secondment from North Hampshire Hospitals

3 wte Anticoagulation Nurse Specialists

The size and population base of the hospital mean a busy wide-ranging clinical

service. The service is Level 2B, providing the full range of adult haematology care including acute leukaemia induction and complex chemotherapy, as well as the full range of other benign and malignant haematological conditions. Bone marrow

transplant referrals are sent to Southampton; the department has an excellent working relationship with the Wessex Bone Marrow Transplant Centre at Southampton which performs autologous, sibling and matched unrelated bone

marrow transplants. In future, Portsmouth hopes to become a satellite centre for autologous transplants.

The regional Renal Service is based in Portsmouth giving additional exposure to

myeloma patients in renal failure and plasma exchange treatment facilities for TTP. Paediatric haematological malignancy is managed at Southampton with shared care at Portsmouth by the Paediatricians. The lymphoma CNS also provides Teenage

and Young Adult Cancer CNS expertise.

Inpatient Facilities

Inpatients are housed on the 45 bedded F5, F6, F7 haematology/oncology ward complex in the new PFI build. F6 has 10 HEPA filtered rooms; further cubicles are on F5 and F7. There are 12-18 haematology inpatients at any time, principally acute

leukaemia treatment, myeloma, elderly haematology and non-malignant haematology. The ward consultant manages all the haematology inpatients, assisted by the ward registrar; ward consultant cover rotates every 1-4 weeks.

There is a weekly ward multidisciplinary meeting, supported by microbiology and palliative care. There are seven haematology-oncology SHO doctors covering the 45 beds and day unit..

Outpatient Facilities

Clinics are held in the Haematology Oncology Centre on Level B. All consultants have two main clinics for general and malignant haematology on weekday mornings

which include both new and follow-up patients. There are additional emergency/rapid review clinics on Monday and Friday lunchtimes. Specialist thrombophilia and haemophilia clinics are held weekly. There are two nurse-led anticoagulation

education clinics week. Additional general haematology peripheral clinics are held at least once a month at other sites: St Mary’s Hospital (Portsmouth), Gosport War Memorial Hospital, Coldeast Hospital (Fareham), Petersfield Hospital.

Lymphoma clinics are run led by Dr Ann O’Callaghan, Consultant Medical

Oncologist, and Dr Corser, Haematology, with Dr James, on Tuesday and Wednesday afternoons.

Day Unit

The Haematology Oncology Day Unit is adjacent to Outpatients on Level B and administers intravenous chemotherapy, blood and platelet transfusions, immunoglobulin infusions iron infusions, venesections etc. Bone Marrow Biopsies are performed in the Laboratory with MLA support

Haematology Activity 2011-2012

Outpatient New 757

Outpatient Follow-up 7283

Anticoagulation New 700

Anticoagulation Follow-up 435 clinic, 100,000 Anticoag tests

Thrombophilia New 266

Thrombophilia Follow-up 141

Day Unit Activity 1313

Inpatient numbers: elective 144

Inpatients: non-elective 235

Haematology MDT’s

Haematology has two weekly video conferenced Cancer MDTs with its MDT partner Western Sussex Hospitals Trust, Chichester, supported by an MDT coordinator in a purpose-built MDT room. There is Leukaemia/Myeloma MDT and a Lymphoma

MDT which is also attended by a specialist lymphoma histopathologist from Southampton by videoconferencing. Bone marrow transplants are arranged by

referral to Wessex Bone Marrow Transplant Centre, with whom there are close working relationships.

MDT new diagnosis 2010 (Jan-Dec) April 2011- March 2012 AML 30 32

ALL 4 4 Myeloma 52 37 CML 2 10

CLL 29 25 Lymphoma 98 132 Hodgkins 13 14

MPD 38 32 MDS 12 10

Haemophilia and Thrombophilia

The department is a District Haemophilia Centre. Dr Hirri leads the service and works with the Regional Haemophilia Network. Haemophilia Clinical Nurse

Specialist and A&C are seconded from North Hampshire NHS Trust at Basingstoke. There are 51 Haemophilia A patients on the database, including 9 severe haemophiliacs. Dr Hirri runs a monthly joint paediatric haematology clinics. Dr Hirri

and Dr James run a weekly thrombophilia clinic. Research

The department actively participates in a number of NCRI haematology and lymphoma trials and is supported by two clinical trials practitioners and a clinical trials assistant. There is excellent administrative support from the Central South

Coast Cancer Research Network.

Blood sciences - Automated Haematology Track

Laboratory Haematology

The Blood Sciences Department is an integrated haematology and biochemistry

department in a purpose-built PFI laboratory which opened in 2008. There is a high level of automation, with an integrated robotic track system. One of the haematology consultants is the lead clinician for transfusion and attends the Hospital Transfusion

Committee, supported by two transfusion nurse practitioners. Currently we have an onsite flow cytometry laboratory. Haemoglobinopathy testing provides a regional service for universal neonatal screening.

Future pathology services may be subject to change, for example a network pathology consortium is under consideration, with some redistribution of services, which could involve increased Blood Sciences at Portsmouth. Training will be given in flow cytometry interpretation, morphology.

Anticoagulation

The department operates a postal anticoagulation service for 8000 patients (2012).

Community phlebotomy INRs are analysed in the laboratory and dosed on RAID software by anticoagulation specialist nurses with assistance from the medical staff.

Management Structure Haematology works across administrative boundaries:

Clinical Haematology is part of the Cancer and Surgery Clinical Service

Centre. The Chief of Service is Mr Constantinos Yiangou..

Laboratory Haematology is part of Blood Sciences, Clinical Lead Dr David

Sinclair, part of the Pathology Directorate, Clinical Director Dr Chris James, within the Support Services Clinical Service Centre, Chief of Service Dr Simon

Ward. Clinic Timetable

Mon Tues Wed Thurs Fri

9am Warfarin clinic QA Gen Clinic QA

Gen Clinic QA Gen Clinic QA

Warfarin clinic QA

9am Petersfield Clinic GWMH OP clinic

9 am Once/month Gen Clinic SMH Thrombophilia

11am Acute FU clinic Haemostasis Acute FU clinic

2pm Lymphoma Clinic Lymphoma clinic

Special Clinic alternate weeks,

Duties of the post The Specialty Registrar will be involved in all aspects of clinical and laboratory haematology. Routine laboratory work will include the reporting of blood films, bone

marrow aspirate and trephine biopsies together with advising on blood transfusion and haemostatic problems.

Routine clinical work will include:

The day-to-day management of Haematology inpatients.

Co-ordinating the treatment of outpatients and day patients.

Management of patients with bleeding disorders.

On Call Requirement: The Specialty Registrar will be expected to provide laboratory and ward cover on

one Weekend in 4, on Saturday and Sunday.

Current Time Table for Speciality Registrar

Speciality Registrar Ward

AM PM

Monday

Academic Meeting or

Business meeting) Day unit review

Multi-disciplinary team meeting

Consultant ward round (teaching)

Tuesday Ward Work Lymphoma Clinic (optional – by

discussion)

Wednesday Out patients Clinic Lymphoma Clinic

Ward work / Audit

Thursday Ward Work Consultant ward round

Friday MDT meetings Day unit review

Teaching

Speciality Registrar Laboratory

AM PM

Monday

Academic or Business Meeting

Laboratory work

Multi-disciplinary team meeting

Consultant ward round (teaching)

Tuesday Out patient clinic (QAH) Laboratory work

Audit

Wednesday Out patient clinic (QAH) Thrombosis clinic

Day Unit Review

Laboratory work

Thursday Out patient clinic (QAH) Haemostasis Clinic

Audit / Bone marrow reporting

Friday MDT Meetings Laboratory work

Teaching

Education and Training

In Portsmouth the Specialty Registrar will receive an induction pack and attend Trust induction. The Specialty Registrar will meet regularly with the educational supervisor and the Regional Specialty Education Committee will further assess their progress.

The Specialty Registrar will attend the local Wessex training programme and will be encouraged to attend all local and a reasonable number of national meetings.

Protected study leave will be given for individual study, research or audit. Teaching will be given for a programme of laboratory procedures.

Clinical experience will be gained on a daily basis with consultant supervision. Regular discussions of laboratory findings will take place with the consultant staff. Additional training in blood transfusion will be arranged with the Wessex Blood

Transfusion Centre. Research

The Specialty Registrar will be encouraged to participate in research. In-patients are entered into the NCRI leukaemia trials. Specialty Registrars are encouraged to develop areas of personal interest where appropriate in active research projects.

Recent studies undertaken by the Specialty Registrar and presented at ASH and BSH include: Occurrence of auto antibodies following allogeneic transplantation, Hydroxyurea induced leg ulceration and A Review of Home Chemotherapy for

Haematological malignancies. The Specialty Registrar must undertake some specific audit activity either laboratory

or clinical. Current and planned audit projects can be discussed with the consultants concerned.

Accommodation

The post is non-resident in Portsmouth.

University Hospital Southampton NHS Foundation Trust

The University City of Southampton has a long maritime history and is now a busy

container port and cruise liner terminal. It is close to the New Forest and the Cathedral City of Winchester and the area provides excellent housing, schooling and recreational links, particularly for sailing enthusiasts. There are excellent road links

via the M3 and M27 and a fast direct rail service to London (Waterloo). Domestic and European air services are provided from Southampton Airport.

University Hospital Southampton NHS Foundation Trust (UHS) provides acute healthcare services for the Southampton area (population 550,000). This covers an area bordering on the Solent and extending to the boundary of Winchester in the

north, the Wiltshire border in the west and the River Hamble in the east. In addition, many specialist services are provided to a much wider area extending to Chichester, Portsmouth, Winchester, Basingstoke, Salisbury, Bournemouth and Poole,

Dorchester, the Isle of Wight and the Channel Islands. These include the defining services of the Trust in cancer, neurosciences, respiratory, gastrointestinal, women and children and cardiothoracic. Southampton forms one of the two teaching

hospitals in the South Central Strategic Health Authority and, as a Regional Cancer Centre, provides comprehensive cancer services for a large population in excess of 3 million. UHS encompasses two sites, Southampton General Hospital (SGH), with

1,200 beds and Princess Anne Hospital (PAH) with 124 beds. UHS is one of the largest NHS Trusts in the country. The University of Southampton

is one of the country’s leading research intensive higher education institutions and its strategy is to become world class in all activities. The Faculty of Medicine has a clear strategy to provide a research environment that will allow it to secure a long term

future as a leading biomedical research institution. Central to this are the Biomedical

Research Units (BRUs), a partnership between the National Institute of Health Research (NIHR), University Hospital Southampton Foundation NHS Trust (UHS)

and the University Of Southampton School Of Medicine. Southampton is home to two units: the Respiratory BRU and the Nutrition, Diet and Lifestyle BRU. Work is underway on a new 2800m² building on the Southampton General Hospital site

which, along with the Wellcome Trust Clinical Research Facility, will form a focal point for research at the heart of the hospital, with a total area of 4000 m². This will help to bring more research activity to Southampton and foster a centre of

excellence, bringing the best of new research ideas into clinical care. There is an active research program in Haemato-Oncology attracting funds from the LLR and CRUK. The department of Haematology is committed to providing a high quality

clinical service and to develop the R&D potential through collaboration with existing successful R&D activity areas.

UHS Department of Haematology Medical Staff

5 Consultants 2 Senior Lecturers/Consultants

2 Consultant Paediatric Haematologists Associate specialist 6 Specialty Registrars on Wessex rotation

4 SHOs – on medical rotation working partial shift system with oncology SHOs The consultants work as a team and have individual areas of responsibility for both

clinical and managerial parts of the service in which they provide leadership. Existing Leads are shown below.

UHS Clinical Haematology Clinical Haematology, incorporating Haemato-oncology, Transplantation, General Haematology, Haemoglobinopathy and Haemostasis and Thrombosis services is

part of the Cancer Care Group. The Cancer Care Group is part of the Surgical and Cancer Services Division (Division A) and is formed of the departments of Clinical Haematology, Medical Oncology, Clinical Oncology and Palliative Care.

All Clinical Haematology services including inpatients, all day cases, chemotherapy and cell separator services and Haemostasis & Thrombosis Centre are located on the UHS site. There is a well-developed clinical service for patients with myeloma,

acute and chronic leukaemias with the emphasis on a multi-disciplinary approach to care. There are also comprehensive clinical and laboratory services in haemoglobinopathy, coagulation and general haematology.

General Haematology Clinical Haematology has access to 7-day inpatient beds utilised for patients

requiring low dependency care, and a busy day care facility operating 6 days a week offering the full range of supportive procedures.

Haemato-Oncology All in-patient and day case haemato-oncology services transferred to the UHS site in December 2001. An intensive chemotherapy and transplant unit was created at UHS

by conversion and upgrading of existing ward accommodation (C6L). Following the opening of the purpose built extension to C6L in 2010, there is currently a 21 bedded acute leukaemia and transplant ward, providing level 4 care for patients with

Haematological Malignancies (BCSH Guidelines 1995). The unit provides level 2 care for acute leukaemia for neighbouring NHS Trusts. A dedicated haematology day unit is located adjacent to this ward. Patients with haematological malignancies

not requiring intensive chemotherapy and non-malignant haematological disorders are generally admitted to other beds within Cancer Care on wards D2, C4 or D3.

The clinical inpatient work of the department predominantly relates to the full range of adult leukaemia, multiple myeloma, myelodysplastic, myeloproliferative and lymphoproliferative disorders. There are approximately 30-40 new adult acute

leukaemia and 30 new myeloma referrals per annum – the reference base is growing rapidly. The clinical workload is supported by Clinical Nurse Specialists in Myeloma and Leukaemia.

All outpatient haemato-oncology services transferred to the UHS site in March 2010. There is a core of oncology trained nursing staff, specialist cytotoxic pharmacy

services with a centralised intravenous additive service and nurse/counselling support.

The Wessex Blood and Marrow Transplant Service The Wessex Blood and Marrow Transplant Unit based on C6L has been providing an allogeneic transplant programme to a large geographical area encompassing the

Central South Coast Cancer Network and Dorset since 2001 to supplement the existing autologous transplant service established in 1989. The Transplant Programme received JACIE accreditation in December 2008. The program performs

approximately 50 autologous transplants per annum, mainly for patients with myeloma or lymphoma (in conjunction with Medical Oncology) for patients from Southampton and surrounding hospitals. The unit provides an allogeneic

transplantation service for the Central South Coast Region with approximately 40-45 allogeneic transplants per year, including unrelated donor transplants. There is active collaboration with other haematologists within the region and a thriving clinical

network specifically relating to transplantation. The unit delivers outcomes that are

some of the best in the UK. The stem cell collection facilities are accredited with the Human Tissue Authority (HTA).

The Transplant Program is supported by a Clinical Nurse Specialist, two WTE Transplant Co-ordinators and a Quality Manager. A Transplant Data Manager is due

to be appointed shortly. There is an integral Apheresis service with a lead Apheresis nurse with the support

of additional trained nurse operators. This busy unit performs over 250 procedures per year providing peripheral blood stem cell harvesting, plasma exchange, therapeutic leucopheresis and red cell exchange procedures. The Apheresis service

received a license from the Human Tissue Authority in September 2008. The Wessex Blood and Marrow Transplantation Service works closely with the NHSBT Steve Mills Laboratory which provides stem cell processing and storage services on

site. The NHSBT laboratory has MHRA and HTA licenses and JACIE accreditation. Haemostasis & Thrombosis Centre

University Hospitals Southampton NHS Foundation Trust is a Haemophilia Comprehensive Care Centre. It mainly serves patients from Hampshire and the Channel Islands although patients from further afield are also registered. At present

there are more than 420 congenital bleeding disorder patients including 50 patients with a severe bleeding disorder. A fully comprehensive service from initial diagnosis to the subsequent care in the hospital and community is provided. The Haemostasis

& Thrombosis team includes two adult and two paediatric haematologist. The Centre provides diagnostic services for thrombophilia, and follow-up anticoagulation service for outpatients who are not managed in the community. There is also a joint

haematology/obstetric clinic for the management of high-risk bleeding or thrombotic pregnancies, every two weeks. The Centre is actively involved in national and international trials and has research collaboration with the University.

Haemoglobinopathy Southampton has a growing Asian and Afro-Caribbean population with

approximately 70 to 80 patients with haemoglobinopathy using the service. There is a regular haemoglobinopathy clinic, a dedicated haemoglobinopathy laboratory service including antenatal screening and plans to further develop the adult

haemoglobinopathy service including transitional care from paediatrics. Paediatric Haematology

There is a regional paediatric oncology/haematology service at University Hospital Southampton which covers the Wessex region. The service is responsible for the diagnosis and treatment of children with acute leukaemia, bone marrow failure

syndromes, haemoglobinopathies, bleeding disorders and non-malignant haematological disorders. The paediatric haematologists provide a consultative

service for the regional PICU, NICU, paediatric cardiology and child health departments as well as the 10 district hospitals. The department performs high dose

chemotherapy with stem cell rescue; allogeneic transplants are referred to Bristol Children’s Hospital but the immediate aftercare is undertaken at Southampton. Haemoglobinopathy cases have increased significantly, with a specialised clinic

being held for paediatric patients. The paediatric haematologist participates in a 1 in 4 rota with the paediatric oncologists, so the Consultant Haematologist on call may need to advise on non-oncological paediatric patients, with the support of the on call

Haematology SpR. The haematology SpR is attached to the department for 4 months.

Outpatient and Day Care Facilities Outpatient facilities for Haematology are based at UHS, predominantly in the purpose built Oncology Outpatients Department that opened in March 2010. There

are 2 large combined haematology clinics per week run jointly by the Consultant Haematologists, one for general haematological disorders and one for haemato-oncology. In addition, there are specialist clinics in transplantation, myeloma,

haemostasis, thrombophila and haemoglobin disorders. A clinic for women with high-risk pregnancies is held jointly with the Department of Obstetrics and Gynaecology at PAH. There is also a weekly general haematology clinic at Lymington New Forest

Hospital. Overall, there are approximately 660 new referrals and 5300 follow-up patients seen in the haematology out-patient clinics per annum.

A new day unit was opened in 2013 providing chemotherapy, apheresis, minor procedures such as bone marrow biopsies and intrathecal chemotherapy and patient follow-up. Clinical Haematology currently has access to beds utilised for patients

requiring low dependency care in addition to a number of chairs. Each working day, approximately 15 to 25 haematology patients attend the day care facility. The cell separator unit is also centred at SGH, directed by the Haematology department and

is currently an integral part of the day care facility. All haematology day cases, including apheresis services, are now in the new dedicated unit, adjacent to the current in-patient leukaemia and transplant ward at UHS.

UHS Laboratory Services Laboratory Haematology is part of the Radiology and Pathology Care Group within

Division B, alongside the Emergency Medicine, Specialist Medicine and Ophthalmology Care Groups.

Haematology laboratory facilities are provided at UHS. The laboratory has full CPA accreditation and HPC approval for the training of BMS staff. The laboratory has been equipped with the latest instrumentation and has the CliniSys Labcentre

laboratory computer system. There is a high degree of automation and recent

benchmarking shows its workload and efficiency to be in the upper quartile in the teaching hospital peer group. The services provided are excellent.

Laboratory Haematology The laboratory houses a comprehensive, modern diagnostic facility. Specialised

haemostasis investigation and haemolytic anaemia investigation are available. Immunophenotyping and molecular studies are performed at SGH. SGH possesses 2 Futura analysers, 2 TEGS, platelet aggregometer and PFA100. In 2009, the

laboratory processed 590,000 automated haematology tests, 390,000 haemostasis and special haematology tests and 66,000 blood transfusion requests. 32% of haematology laboratory tests originate from general practice.

Laboratory Haematology is organised in to two sections, Blood Transfusion and Haematology & Coagulation.

Staff Whole Time Equivalents

Senior Manager / BMS 4 band 8c 1.5

BMS 3 band 8 2

BMS 2 band 7 16.66

BMS 1 band 6 6.53

Trainee BMS band 5 1

MLA band 2 5

Diagnostic bone marrow services are carried out at UHS. The department of cellular pathology processes trephine biopsies which are then returned to Haematology for

reporting or reported in conjunction with the cellular pathologists. Regular regional multidisciplinary diagnostic team meetings are held; Thursday mornings for Paediatric reviews and Friday mornings for Adult Haematology. UHS also hosts the

Central South Coast Cancer Network (Western) MDT meeting for Leukaemia and Myeloma.

Molecular Pathology and Immunophenotyping In addition to the routine haematology laboratory services there is a specialised molecular pathology laboratory under the supervision of a Consultant Clinical

Scientist. The laboratory provides essential diagnostic and molecular monitoring assays including chimerism, BCR-ABL quantification by PCR, minimum residual disease analysis, B and T cell clonality. The immunophenotyping labaoratory,

managed by the Immunology Department, provides a full repertoire of diagnostic and MRD immunophenotyping for haematological malignancies. Cases are jointly reviewed at the diagnostic MDTs.

The Wessex Regional Genetics Laboratory (WRGL) is located at Salisbury District Hospital. There is a close working relationship between WRGL and the Haematology

Consultants at UHS with regular clinical meetings. There are plans to fully integrate reporting of haematological oncology specimens with the aim of developing IOG

compliant integrated haemato-pathology reporting.

Steve Mills Stem Cell Laboratory

Bone marrow processing, culture and preservation facilities are located at the

Southampton National Blood Service Facility on the UHS site in the Steve Mills Transplant Laboratory.

Current Departmental Research Activity

Recruitment and participation in NCRN AML, ALL, Myeloma and CML trials.

Participation in high quality drug evaluation studies to GCP standards

Targeted radiotherapy as part of conditioning for stem cell transplantation

Clofarabine pre-conditioning in allogeneic transplantation for high risk AML

Development of quality of life as a clinical endpoint in myeloma and chronic

lymphocytic leukaemia.

Molecular methods for the evaluation of minimal residual disease in stem cell

harvest material and in patients following stem cell transplantation.

Evaluation of molecular methods for monitoring patients following stem cell

transplantation

Immune reconstitution post allogeneic SCT

Analysis of tumour related immunoglobulin genes in paraproteinaemias.

Clinical pilot studies in administration of patient specific DNA vaccines in patients

with myeloma.

Role of the Speciality Registrar

Clinical Duties

The Speciality Registrar will be trained and involved in all aspects of clinical and laboratory haematology and blood transfusion. The timetables are enclosed. Clinical work includes:

The day to day management of Haematology inpatients

Co-ordination of the treatment of outpatients and inpatients

Management of patients with bleeding disorders

Investigation of patients with thrombophilias and management, including

The treatment of recurrent miscarriage in the high risk pregnancy clinic.

Supervision of patients receiving plasma exchange (for TTP and inhibitors usually)

Attend supervised* outpatient clinics (*until final year)

Paediatric haematology

Laboratory Duties Laboratory work reporting of blood films, bone marrows, other haematological tests.

Training in immunohaematology is an integral part of this. The post holder will be required to participate in medical audit. Undergraduate medical students from Southampton University Medical School are taught throughout the Trust and the post

holder is required to participate in formal and informal undergraduate clinical teaching but will not be responsible for curriculum organisation development.

UHS Haematology Timetable Overview

Mon Tues Wed Thurs Friday 8.45-9.30

Weekend Handover- SpR room

Junior SpR Morphology Teaching –SpR room

Haemostasis and Thrombosis Journal Club- SpR room

Network MDT- E Level Histopathology

Morphology MDT – SpR room

9.30-1pm

Transplant Clinic Paediatric handover and clinic from 9am Piam Brown Ward

Myeloma Clinic (starts 9am) Paediatric leukaemia Clinic

Bleeding Disorder Clinic

Transplant Clinic Paediatric morphology MDT

Paediatric ward round

1-2 X-ray meeting SpR Teaching with lunch

Inpatient MDT D level

Haem lunchtime seminar

2-5 Consultant Ward Round Lymphoid Clinic (starts 1.30pm) Thrombophilia Clinic Paediatric haemophilia Clinic

Myeloma Clinic General Haematology Clinic (starts 1.30pm)

Myeloid Clinic (starts 1.30pm)

Consultant Ward Round Paediatric Clinic Platelet disorder Clinic Haemoglobino-pathy clinic (1st Thursday)

Weekend Handover SpR Room 4-5pm

West Dorset General Hospitals NHS Trust, Dorchester

The new Dorset County Hospital was completed in 1997 and achieved the centralisation of all services for acutely ill patients into a modern Hospital on one site, approximately 1 mile from the town centre.

The Trust provides excellent facilities to a largely rural population of 220,000 (with concentrations in Weymouth and Dorchester) and many innovative services such as an award-winning art collection to enhance the environment for patients. Housing

500 beds Dorset County Hospital has been recognised as an Exemplar Site by the Department of Health. There are only eight such sites in the country, which have been chosen because of the high quality of the patient environment. In 2001 the

Trust won the national 'Clean Hospital Award'. The Trust currently employs around 2,500 personnel, treating more than 100,000 patients each year and provides a wide range of services.

The Hospital is recognised as a Cancer Unit within the Dorset Cancer Network for the provision of services for patients with Breast, Colorectal, Urological, Upper

Gastrointestinal, Lung and Haematological Malignancies. While most Chemotherapy is given locally, the Radiotherapy Centre is in the Cancer Centre at Poole

Palliative Care Services are provided by the local hospice (Joseph Weld) where

there are 18 beds. Two Consultants regularly visit patients with malignant and non-malignant diseases within the Hospital.

Dorset County Hospital is the hub of the district's inpatient facilities but community

Hospitals are situated in the surrounding major towns and provide the spokes to the central unit. These include, Weymouth Community Hospital, Bridport Hospital, Blandford Hospital and Yeatman Hospital, Sherborne.

PATHOLOGY STAFF:

General Manager

Head Biomedical Scientist

Haematology:

3 X Consultant Haematologist

Speciality Registrar

Staff Grade (Haematology)

S.H.O. Chemical Pathology:

Consultant Chemical Pathologist

Consultant Grade Biochemist

Microbiology:

3 X Consultant Microbiologist

Histopathology/Cytology:

4 x Consultant Histo/Cytopathologist HAEMATOLOGY DEPARTMENT

Nursing Staff - Day Chemotherapy Unit:

1 G Grade Sister

1 F Grade SRN

3 Grade E-F Chemotherapy Nurses

Inpatient Nursing with a Ward Sister (Grade G) and 9 Grade D-F Nurses are shared with other medical teams using Ilchester B ward

Laboratory Staff:

1 x BMS4

5 x BMS2 (+ funding for Hospital Transfusion Practitioner)

15 x BMS1

4 x Trainee BMS (rotating)

Clinical Haematology

The clinical facilities at the Dorset County Hospital are excellent. Ilchester B Ward,

the inpatient area, has a two-bed suite with en-suite bathrooms and WCs and HEPA ventilation. In addition there is 14-bedded unit containing 2 single isolation rooms. We have used intensive chemotherapy for the treatment of Acute Leukaemia and

relapsed Lymphoma since 1985. Support facilities within the hospital necessary for the comprehensive care of

seriously ill haematology patients include an intensive care unit, the Dorset Renal Unit, full radiology services, echocardiography, bronchoscopy and gastroenterological endoscopy.

Consultant Physicians in neurology, rheumatology, dermatology, endocrinology, nephrology, diabetology, cardiology and thoracic medicine are readily available. A

palliative care consultant is attached to the unit.

Fortuneswell Day-chemotherapy Unit The Fortuneswell Chemotherapy Unit caters for both haematology and oncology

patients. More than 1400 clinical episodes were seen each year. Oncology patients, account for around 20% of the in-patient occupancy. Nursing staff have post-registration qualifications in Haematology, Oncology, chemotherapy and care of the

dying. The Unit housed the haematology and oncology outpatient services and is used for the administration of chemotherapy, bone marrow aspirates and trephines, cell separator procedures and clinical assessments. Blood and platelet transfusions,

lumbar punctures and IV infusions of Iron and Immunoglobulin are performed in the Day-medicine Unit of the hospital.

Haematology Outpatients

Eight outpatient clinics are held weekly. More 500 new haematology patients are seen each year in addition to more that 5000 follow up general haematology and 1300 chemotherapy episodes. The anticoagulant department managed more than

18,000 dosing episodes last year. Specially trained Biomedical Scientists, supervised by medical staff, run the anticoagulant service. An average of 5-7 ward referrals are seen weekly. Around 180 new patients with haematological

malignancies are seen annually, the commonest diagnoses being NHL (c 84 cases), Myelodysplasia (c 36), Chronic Lymphocytic Leukaemia (c 30), Myeloma and macroglobulinaemia (c 20) and myeloproliferative disorders (c 10). Around 2 to 4

patients with acute leukaemia are undergoing treatment. One multi-disciplinary meeting and a Friday grand round are held weekly.

The Haemophilia centre with around 10 severe haemophiliacs is based at the Dorset

County Hospital. Laboratory Haematology

The laboratory is spacious and well equipped. It has full CPA accreditation and participates in all appropriate NEQAS schemes. There are sub-departments of routine and special haematology, coagulation and blood transfusion. Routine

laboratories are provided with the Sunquest computer system. Around 500 blood counts are performed per day on two Coulter STKS analysers. Haematinics assays are performed with the Beckman Coulter Access immunoassay system. The

coagulation laboratory is equipped with Sysmex 1500 with ACL 1000 machines. The Blood Transfusion Laboratory uses the Diamed system and has recently introduced new automatic Blood Grouping machinery, as well as evaluating the electronic cross

match. Immunological, Cytogenetic analysis and molecular investigation are performed at the regional centres in Southampton and Salisbury

Please note laboratory Services may be subject to change as they may be contracted out over the next year.

Research

The department has an active participation in clinical trials for Leukaemia, Myeloma and Lymphoma. Two research/clinical trial nurses facilitate local entry and documentation of clinical trials.

The Role of The Speciality Registrar This post gives good training in laboratory and clinical haematology. Its strengths are

the wide experience gained in the management of haematological malignancies, including lymphomas, myeloma and acute leukaemia. The Speciality registrar is expected to attend the MDT and departmental grad round. You will have weekly

outpatient clinics and will have responsibility for the day-to-day management of in-patients and for the training and instruction of the SHO who works with them. At least one of the consultants will work closely with the Speciality Registrar and will always

be available for consultation. The Speciality Registrar will have laboratory sessions for training and for providing a service to other departments in the hospital. The three consultants, the associate Speciality and the staff grade are all responsible for the

laboratory for one day in the week, and each will work closely with the Speciality Registrar.

Example Timetable – Speciality Registrar

AM Lunch PM

Monday Ward Work MDT / Ward Work

Tuesday OPD Bone Marrow Clinic

Laboratory Session

Wednesday Chemotherapy Clinic / Ward Work

Teaching

Thursday OPD SHO teaching / Ward Work

Friday Regional MDT Consultant Ward Round

Ground Round /Teaching

Laboratory Session

Audit and Continuing Professional Development Time will be allocated in the job plan for audit and CPD activities. There are regular haematology journal clubs, multidisciplinary meetings, a weekly medical journal club,

grand round case presentations and an active post graduate society hosting weekly lectures for all hospital staff and local general practitioners. There is also a “Wessex” haematology group that meets regularly for educational purposes. Apart from regular

local teaching there will also be release for the fortnightly regional teaching sessions that rotate between the hospitals that currently make up the Wessex rotation.

On-Call One Saturday every 4 weeks

Hampshire Hospitals NHS Foundation Trust

Hampshire Hospitals NHS Foundation Trust came into being in January 2012 as a result of the integration of Basingstoke and North Hampshire NHS Foundation Trust,

which achieved Foundation Trust status in 2006, and Winchester and Eastleigh Healthcare Trust. Hampshire Hospitals NHS Foundation Trust serves a population of approximately 600,000 across North and mid-Hampshire and parts of west Berkshire. The population is predominantly centred around Basingstoke, Winchester,

Eastleigh and Andover as well as the surrounding towns and villages across Hampshire and parts of west Berkshire including Tadley to the north; Alton and Bordon to the east; Romsey and Chandlers Ford to the south, Stockbridge, Bishops

Waltham and Alresford. It is a fundamental principle of the new combined Trust that it will provide fully integrated clinical services across the two acute hospitals in Basingstoke and Winchester, with the provision of outpatient services within

community hospitals at Andover and Alton and the future development of services within primary care.

Clinical Haematology is managed within Cancer Services, which includes clinical and medical oncology, clinical haematology and palliative care. These services are currently provided at both BNHH and RHCH sites. At the BNHH site it is within the

Basing Unit (Outpatients and Day Unit), Wessex Ward (inpatients), Lyford unit (supportive care – transfusions etc) and at the RHCH site it is provided on the Nick Jonas Ward (Outpatients and Day Unit). Palliative care is also provided at St

Michael’s Hospice, which is on the BNHH site. Currently radiotherapy provision is from Southampton University Hospital, though there are now facilities on site at BNHH for selected radiotherapy.

Clinical Haematology Medical Staff

4 Consultants

1 Associate Specialist

2 Consultants at RHCH share weekend on-call responsibilities though are primarily based at RHCH

1 Speciality Registrar (one year rotation at BNHH)

1 Clinical Fellow

1 CT1/2 / GP trainee on 4 monthly medical rotation

Nursing Staff

2 Haematology CNS

2 part time Haematology Research nurse

1 part time Clinical Trials Administrator

Matron and Ward Sister Wessex

1 Sister Basing Unit and Nick Jonas

2 Transfusion Practitioners

Team of chemotherapy trained nurses

The Elizabeth Hall Centre in BNHH consists of a purpose built in-patient unit (Wessex Ward) and day care unit (Basing Unit). The Wessex ward is an 11bed ward providing isolation rooms with positive pressure ventilation and HEPA filtration and

en-suite facilities for patients receiving high-intensity chemotherapy. The Basing Unit is used for outpatient clinics, chemotherapy clinics, administration of chemotherapy, blood products, diagnostic and therapeutic procedures including venesections, bone

marrow biopsies and intrathecal chemotherapy. Lyford ward provides non chemotherapy supportive care.

The Nick Jonas ward at RHCH provides outpatient clinics, day case chemotherapy and supportive care as well as bone marrow biopsies and venesections.

There are plans in the advanced stages of development for an Associate Cancer Centre to be built which would combine many of these services.

Referrals for autologous and allogeneic stem cell transplant are predominantly to the regional stem cell transplant centre in University Hospital Southampton and occasionally to other transplant centres.

MDT

All cases of haematological malignancy are reviewed and discussed locally with regular bone marrow, radiology and histology meetings. Network MDT management

meetings are run twice weekly by video-conference with network leads in Southampton. There is also a new Superregional Myeloma MDT due to start in late 2016.

There is a weekly local MDT ward round with participation from the nursing staff, haematology CNS, oncology pharmacist, consultant microbiologist, oncology

dietician, and palliative care and haematology doctors. The conditions treated include acute and chronic leukaemia, lymphoma (including

primary CNS lymphoma, Burkitt Lymphoma and relapsed lymphoma), myeloma,

myelodysplasia, myeloproliferative disorders and non-malignant haematological disorders. BNHH is also a designated site for treatment of Teenage and Young Adult

patients (TYA). There is a strong commitment to clinical trials with participation in many NCRI trials.

The current clinical trials portfolio open for recruitment within the Trust include: AML18, AML19, LI-1, UKALL14, FLAIR, RIAltO, GALACTIC, CHEMO-T, IELSG 37, EBV associated NK/T cell malignancies, MCL Biobank, MaPLE, Understanding and

Managing the Coagulopathy of APL, The Molecular Investigation of Unexplained Anaemias, MEASURES, ITP Registry, CML National Registry. The trials closed to recruitment and in follow up include: AML 15, AML16, AML17,

SPIRIT, SPIRIT 2, PT1, InCiTe, REMoDL-B, PACIFICO, RATHL, LRF CLL4, R-CHOP 14 vs 21, R2W, TEAMM, BNLI Stanford V, BRIGHTLIGHT Study.

Comprehensive Care Centre for Haemophilia and Thrombosis The Network Comprehensive Care Centre (CCC) is based at Basingstoke and North Hampshire Hospitals NHS Foundation Trust. The multidisciplinary team provides

comprehensive care for patients with congenital and acquired bleeding disorders. It is also the site for the thrombophilia and anticoagulation clinics. The team of 3 consultants oversee the MDT, run adult and paediatric thrombosis and haemostasis

clinics, high risk pregnancy clinic and are involved in the running of the specialist haemostasis laboratory. There is a strong commitment to the clinical trials involvement.

Laboratory Haematology Currently there are fully CPA accredited laboratories offering a full range of services

on both the BNHH and RHCH sites. These services include routine haematology (FBC and ESR automation, blood film, blood parasitology, haemoglobinopathy, bone marrow aspirate processing and reporting), blood transfusion and routine

coagulation. There is also a specialist haemostasis and thrombosis laboratory at BNHH. The blood transfusion service provides full genotyping where required and complies with MHRA. It is well represented in the Trust’s transfusion committee and

laboratory management meetings. Clinical haematology input is provided for the issue of blood products to enable appropriate use of these products. The laboratory out of hours service provides 24hr cover for both the laboratories enabling provision

of all tests required for the immediate clinical management of patients. Specialist or batched tests are completed in normal working hours. There are well developed referral pathways for complex investigations not provided locally.

The laboratory has full CPA accreditation and MHRA approval for blood transfusion and participates in all relevant NEQAS EQA schemes. The laboratory is recognised

by the College and Council for Professions Supplementary to Medicine (CPSM) for training.

Role of the Speciality Registrar This post provides an excellent training in clinical and laboratory Haematology. The post holder will be based in Basingstoke and North Hampshire Hospital. The

Speciality Registrar will gain the wide experience in malignant and non-malignant haematology, including an extensive exposure to the lymphoma care. The trainees are well supported by Consultants who will provide clinical supervision.

Exams Trainees will be well supported in preparation for FRCPath exams with an emphasis

on morphology, haemostasis and transfusion. There are good opportunities to gain experience in the laboratory as well as clinical aspects of haematology.

Inpatient and Outpatient There is a named consultant of the month who is responsible for overseeing the care of the Haematology inpatients and new admissions/inpatient referrals. The Specialty

Registrar will be responsible for day-to-day management of Haematology inpatients and day patients, reviewing ward referrals and responding to clinical and laboratory enquiries. The Specialty Registrar will attend the local and network multidisciplinary

meetings. The Specialty Registrar will participate in teaching of medical, nursing and laboratory staff. There are regular Haematology and medical journal clubs and grand round case presentations.

The Specialty Registrar will attend Consultant-led general haematology and disease-specific outpatient clinics. The cases are discussed after the clinic with attending

Consultants. The Specialty Registrar will undertake BM biopsies and IT chemotherapy on the Day unit.

Laboratory The Specialty Registrar will be encouraged to undertake reporting of blood films and bone marrow aspirates and trephines (under supervision). There is a weekly

Morphology MDT when bone marrows and trephine biopsies are jointly reviewed. The trainee will be encouraged to spend time in the general haematology, transfusion and special coagulation laboratories to gain further experience.

SPR/Cinical Fellow Timetables Ward cover

Monday Tuesday Wednesday Thursday Friday

AM Post weekend ward round

BM list requiring send away samples

Ward round 9.30 Paeds haem clinic G floor**

8.30 MDT 9.15 Journal club 10am Paper round 11am ward round

9.30 CT meeting New patients

PM New patients/ward discharges

Paper round with SHO BM reporting

Review purple forms

2.30 Morphology MDT Pre-weekend ward problem solving and handover to on-call

Other Thrombosis clinic – TE HTC meeting – NS

Meet with research team to ensure I/P up to date

Update transplant team SUHT with any problems

Lab and clinic Monday Tuesday Wednesday Thursday Friday

AM Myeloma Clinic

Lab reporting/ audit*** Lymphoma MDT

Lymphoma clinic

8.30 MDT 9.15 Journal club* 10am Paper round 11am ward round

9.30 CT meeting New patients to see Perform OP IT chemo

PM New patient clinic + bone marrow list

General haem clinic

Prepare/ report BM bx MDT

2.30 Morphology MDT Blood film/BM reporting

Blood film/ BM reporting Review cytospins

Other Haemaglobinopathy screen

Platelet function assays in lab

Organise circulation of BM of Quarter

Ensure all NEQAS up to date

*to maintain rota and ensure everyone aware ** monthly d/w Dr Sarah Mangles – should attend at least 4 during 12 months *** Should complete training for lab audit during the 3 months in lab and clinic and in 12 months complete at least 1 lab based audit

On call: 1:4 weekends with Consultant cover (no weekday on calls)

Management Specialty Registrar will further develop an understanding of the key management

areas, including the management structure of an NHS Foundation Trust, clinical governance, risk management, CPA and MHRA accreditation, internal and external quality assurance including NEQAS schemes.

Research Trainees will be expected to complete their GCP training and take an active role in

screening, recruiting, consenting and supporting patients through the clinical trials with an active support from the local PIs, Co-Investigators and the Research team.

Audit Specialty Registrar will undertake at least one audit annually. They will be supported

in gaining training in laboratory audit and encouraged to complete one laboratory audit during their rotation at BNHH.

Salisbury NHS Foundation Trust

Medical Staff

3 Consultants

1 Speciality Registrars (one year rotation)

1 FY2 doctor (4-monthly medical rotations)

Nursing Staff

1 Haematology CNS

1 TP

2 Anti-Coagulation Nurses

1 Chemotherapy Nurse Practitioner (currently Oncology only)

Scientific Staff

BMS3 HAEMATOLOGY

1 BMS 3 BLOOD TRANSFUSION

BMS 2 HAEMATOLOGY

1 BMS 2 BLOOD TRANSFUSION

9.5 WTE BMS1 + TRAINEE

6 MLA (HAEMATOLOGY&BIOCHEMISTRY)

Clinical Haematology The Haematology/Oncology Department combines Clinical Haematology and

Medical Oncology services and operates from the Pembroke Unit: this comprises Pembroke Ward, a 21 bed inpatient ward (6 siderooms) housing Haematology and Medical Oncology inpatients as well as other inpatients with cancer-related problems

and general medical patients, and the Pembroke Suite, where day case investigations and treatments, including outpatient chemotherapy and blood component transfusions are administered. Facilities include a COBE Spectra cell

separator for plasma exchange and blood stem cell collection. A weekly venesection clinic is run by a Clinical Assistant. There is a team of Oncology trained nurses fully experienced in cannulation and administration of cytotoxic drugs.

The Clinical Haematology service provides care at BCSH Level 3 for adult patients from beyond the whole catchment area of Salisbury Healthcare NHS Trust with a

wide variety of malignant and non-malignant haematological conditions, and includes

a satellite service (in conjunction with Royal Bournemouth Hospital) for autologous peripheral blood stem cell transplantation. Peripheral blood stem cell mobilisation

and collection is performed in Salisbury, but cell processing and storage is arranged through the Steve Mills Laboratory at Southampton General Hospital. Preparations are underway for JACIE accreditation of this service. A Quality Manager has recently

been recruited to facilitate this. A number of patients with inherited bleeding disorders are managed in Salisbury,

under the care of a consultant and in conjunction with the Comprehensive Care Centre is Southampton/Basingstoke.

Patients requiring allogeneic transplantation or radiotherapy are referred to Southampton General Hospital. There is active recruitment to national clinical trials for patients with haematological malignancies.

Salisbury District Hospital is a Cancer Unit and a member of the Central South Coast Cancer Network. It participates in the Western Multidisciplinary Teams to comply

with the NICE Improving Outcomes Guidance in Haematological Malignancies. MDT meetings are held on a weekly basis in Southampton with video-conferencing links to Salisbury/Basingstoke/Winchester. Separate meetings are held for Lymphomas and

Leukaemias/Myeloma. The Trust’s chemotherapy services underwent Peer Review in December 2005 and Haematological Malignancies were peer reviewed in 2007.

The Department of Clinical Radiology provides a full range of diagnostic and therapeutic modalities, including CT and MRI, as well as insertion of indwelling venous catheters. Patients requiring PET scans are currently sent to the InHealth

NHS PET/CT Diagnostic Centre in Southampton. Medical Microbiology service is on site.

Up to thirteen outpatient clinics are held weekly, including specialist paediatric / haematology, thrombophilia and myeloproferative disorders clinics. Daily anticoagulant clinics are run by specially trained nurses.

Clinical Haematology workload figures for 2005 are shown below:

New outpatients 448

Follow-up outpatients 3011

Inpatient episodes 249*

Ward referrals >100

Day case attendances 1686

*Average inpatient numbers at any one time 5-10.

In general, paediatric haemato-oncology cases are referred to Southampton University Hospitals NHS Trust for investigation and management.

The Medical Oncology service is led by 2 Medical Oncologists and 1 Clinical

Oncologist who divide their time between Southampton and Salisbury. The majority of the work is out-patient based with chemotherapy being administered on Pembroke Suite.

Junior medical staffing for the Clinical Haematology/Oncology service is currently

provided by the Haematology F2 and the Respiratory team (2 Speciality Registrars, 1 F2 and 2 F1s) who share a system of ward-based working on Pembroke Ward. Oncology patients requiring admission for neutropenic sepsis are admitted under the Haematology team, others under the Respiratory team.

The department is committed to providing flexible and high quality care for patients that meets locally and nationally identified standards. There is close liaison with the

Salisbury Palliative Care service. Staffing – Clinical Haematology/Oncology

3 x Consultant Haematologists

2 x Consultant Medical Oncologists

1 x Consultant Clinical Oncologist

2 x Joint Lead Cancer Nurses

Haematology Nurse Specialist

Sister, Pembroke Ward

Sister, Pembroke Suite

Chemotherapy Nurse Practitioner

F2, Haematology/Oncology on rotation

Laboratory Medicine

The Department of Laboratory Medicine was created in 1995 by a merger of Haematology and Blood Transfusion with Chemical Pathology, and provides an analytical service to Salisbury, South Wiltshire and parts of Hampshire and Dorset.

The department is housed in modern laboratories and has full CPA accreditation (inspected in September 2008).

The routine haematology laboratory is well equipped with 2 Abbott Cell-dyn Sapphire FBC analysers and processes approximately 600 samples per day. Blood film and bone marrow staining are carried out using an automated slide maker stainer. Blood

coagulation uses Sysmex CA1500 analysers for both coagulation screens and for

the monitoring of anticoagulant therapy. The department currently operates a postal service for monitoring of anticoagulant therapy. Investigation of haemostasis and

thrombophilia are carried out in the laboratory. The laboratory processes approximately 2000 requests per annum for Antenatal screening for Sickle cell & thalassaemia. Haematinic assays are carried out within Laboratory Medicine using

the Roche modular system and the Beckman Access. Samples for Factor V Leiden, Prothrombin G20120A or cytogenetic malignancy markers are referred to the Regional Genetics department here at Salisbury.

The department is enrolled in all relevant NEQAS EQA schemes.

The Immunology section carries out autoimmune profiles as well as thyroid antibodies and rheumatoid factor detection. Cell markers for both lymphoid and myeloid malignancies are sent to the Wessex Immunology department at

Southampton General Hospital. Blood Transfusion uses the Ortho Innova blood grouping analyser and is working

towards the imminent introduction of electronic blood issue. The Genetics service is adjacent to Laboratory Medicine and is headed by Professor

Nick Cross: there is an extremely strong research element and the two departments have close liaison and offer excellent opportunities for collaborative research.

The Anticoagulant Service is run using the Dawn computer package by 1.5wte Anticoagulation Nurse Specialists. The department received 867 new referrals for anticoagulation last year, and currently monitors 2250 patients. There are plans to

organise a nurse-led thrombophilia clinic alongside the consultant thrombophilia clinic.

A 0.6 WTE Transfusion Practitioner is in post with plans to increase this to a full-time role.

The Role of the Speciality Registrar This post gives excellent training in laboratory and clinical haematology. Its strengths are the wide experience gained in the management of haematological malignancies,

including lymphomas and the close contact with high quality research. Only one Speciality Registrar is in post and therefore gains experience in all aspects of clinical and laboratory activity. The Speciality Registrar is expected to attend the

multidisciplinary meetings on Tuesdays and Fridays, weekly outpatient clinics and is responsible for the day-to-day management of in-patients and for the supervision of the F2 who works with them. The consultants rotate on a monthly basis through

inpatient, outpatient (Pembroke Suite) and laboratory roles. At least one of the consultants is always be available for consultation. The Speciality Registrar is

expected to report all his / her marrows and to present these at a weekly morphology session and also receives blood films on a daily basis for reporting. The Speciality

Registrar is expected to present cases at the fortnightly joint Haematology / Radiology meeting and the monthly Histopathology meeting. The Speciality Registrar is also expected to present at the Grand Round.

Poole Hospital Acute NHS Trust

Department of Haematology

Medical Staff:

3 Consultant Haematologists – Dr Fergus Jack, Dr Rebecca Madden, Dr Darshyani Furby

Dedicated SHO 1 Specialist Registrar Haematology

Laboratory Staff: 1 Haematology Laboratory Manager

2 BMS Grade 3 4 BMS Grade 2 13 BMS Grade 1

2 Trainee BMS 8 MLA

28 Phlebotomists (Most part time) 2 Secretaries

Nurse Specialists:

2 Anticoagulation 1 Clinical Haematology Nurse Specialist

0.5 Research nurse Department Statistics:

Clinical Haematology (2007-8) Inpatients 560 Outpatients 4800 (1st visit = 580) Day Unit 2600

Laboratory Services

The haematology laboratory provides all the usual routine and specialist diagnostic

tests including flow cytometry, specialist haemostasis and thrombosis investigations, haemoglobin electrophoresis, haematinics, and PCR for

thrombophilia-associated mutations. About 35% of the workload is from GP users. Poole is the Wessex centre for antenatal haemoglobinopathy screening. Laboratory

instrumentation includes 2 Abbott Cell-dyne Sapphires, 2 MDAs, 2 automated ESR analysers, 1 Autovue Blood Grouping analyser, 1 flow cytometer, 1 PFA100, 2 Menarini HPLC analysers, Beckman Coulter Access immunoassay system and one

thermo-cycler PCR analyser.

The blood bank comprises a separate area within haematology providing standard blood products as well as factor concentrates. There is an active Blood Transfusion

Committee which meets regularly, and an intra-operative red cell salvage machine. Out of hours laboratory service is provided for haematology and blood transfusion by state registered Biomedical Scientist staff. Poole is currently implementing a

barcoded-patient wristband system for blood product issue.

Basic diagnostic support is offered to paediatric cases. Haemophiliac paediatric cases are managed at Poole but paediatric oncology by local Paediatricians in

conjunction with Southampton.

The haematology department has full CPA accreditation, last inspected 2008. There is full participation in NEQAS with excellent performance.

Inpatient Services

Clinical Haematology is part of the Oncology Directorate, laboratory part of the Pathology Directorate. Poole Hospital forms the hub of the Dorset Cancer Centre, comprising Poole, Dorset County Hospital and the Royal Bournemouth and

Christchurch Foundation Trust. Haematology shares two dedicated wards with Clinical and Medical Oncology. There are two HEPA filtered isolation rooms. The unit provides a comprehensive service for haematological disorders including acute

and chronic leukaemia, lymphoma and myeloma. Poole is consistently one of the busiest District

Health Education England - Wessex

Health Education England - Wessex is part of the South Central Strategic Health

Authority and provides postgraduate medical and dental education for Hampshire, Isle of Wight, and the States of Jersey, and for Dorset and South Wiltshire on behalf of the South West Strategic Health Authority

General Hospitals for autologous stem cell and marrow transplants in the UK.

Allogeneic transplants are referred externally. There is also a busy day case facility for the outpatient treatment of patients with haematological and oncological disorders. Specialist nurses are fully trained in venepuncture, chemotherapy

administration, venesection and PICC-line insertion. There are facilities for stem cell harvesting and plasma exchange. Hickman lines are inserted within the

department and training available for Specialist Registrars. The Haematology department is supported by a dedicated SHO on the general medical rotation and a Haematology Nurse Specialist. There is a weekly multidisciplinary meeting video-

linked to RBH and DCH.

Outpatients

There are 6 regular outpatient clinics per week at Poole and alternate week clinics

at Swanage Hospital and at the Victoria Hospital, Wimborne. Occasional haemophilia clinics are held jointly with Paediatrics. There will be ample opportunity for the Specialist Registrar to attend any of these clinics. Anticoagulant dosing is

performed by 3 dedicated staff using Dawn 4S software.

Role of the Specialist Registrar

The role of the Specialist Registrar will include:

Day-to-day management of Haematology inpatients, day patients and

outpatients.

Haematological advice to GPs and hospital staff including seeing ward

referrals.

Practical procedures including: bone marrow aspiration and biopsy, pleural

and ascetic aspiration, lumbar puncture, Hickman line insertion, peripheral blood stem cell and bone marrow harvesting and plasma exchange.

Laboratory duties including the reporting of blood films and other laboratory

results, and advice on specialist further investigations and transfusion issues.

Ward supervision of the Haematology SHO

Teaching of SHOs, medical students and other clinical staff.

Presentation of at least one audit.

A research interest leading to a publication would be strongly encouraged.

Management

The post holder will be managerially responsible to the Specialty Clinician for

Pathology.

Timetable

The proposed timetable for the Specialist Registrar is:

AM PM

Monday Laboratory / ward work

Histology MDM

Lab / ward work/FJ/RM

ward round

Tuesday General Haematology

Clinic

AJB Ward Round

Wednesday Haemato-oncology

clinic

Admin / CPD

Thursday General haematology

clinic. Grand round.

Laboratory / ward work

Friday Haemato-oncology

multidisciplinary meeting Consultant Ward Round

Oncology educational session

Admin / Teaching

Audit and Continuing Professional Development Time will be allocated in the job plan for audit and CPD activities and the registrar

will be expected to present at least one audit. There are weekly multidisciplinary meetings, a weekly medical journal club, weekly Grand Round case presentations in term and excellent facilities for reading and on-line research based in the

Postgraduate Medical Centre Library. Apart from regular local teaching, attendance at the regional training days is expected.

Main Conditions of Service

The posts are whole-time and the appointments are subject to:

1. The Terms and Conditions of Service (TCS) for Hospital Medical and Dental

Staff (England and Wales)

2. Satisfactory registration with the General Medical Council

3. Medical Fitness – You may be required to undergo a medical examination and

chest x-ray. Potential applicants should be aware of the Department of Health

and GMC/GDC requirements with regards to HIV/AIDS and Hepatitis viruses.

Candidates must be immune to Hepatitis B. You will be required to provide, in

advance of appointment, evidence of immunity or have a local blood test (as

deemed necessary by the Occupational Health Department)

4. Right to work in the UK

5. Criminal Records Check/POCA check carried out by the Trust Medical HR

department.

6. Pre-employment checks carried out by the Trust Medical HR department.

Hours

The working hours for junior doctors in training are now 48-hours averaged over 26 weeks (six months). Doctors in training also have an individual right to opt-out if they choose to do so, but they cannot opt-out of rest break or leave requirements.

However, the contracts for doctors in training make clear that overall hours must not exceed 56 hours in a week (New Deal Contract requirements) across all their employments and any locum work they do: http://www.nhsemployers.org/your-

workforce/need-to-know/european-working-time-directive. Pay

You should be paid monthly at the rates set out in the national terms and conditions of service for hospital medical and dental staff and doctors in public health medicine

and the community health service (England and Wales), “the TCS”, as amended from time to time. The pay scales are reviewed annually. Current rates of pay may be viewed at: http://www.nhsemployers.org/your-workforce/pay-and-

reward/pay/agenda-for-change-pay. Part-time posts will be paid pro-rata. Pay supplement

Depending upon the working pattern and hours of duty you are contracted to undertake by the employer you should be paid a monthly additional pay supplement

at the rates set out in paragraph 22 of the TCS. The current pay scales may be viewed at: http://www.nhsemployers.org/ . The pay supplement is not reckonable for NHS pension purposes. The pay supplement will be determined by the employer and

should be made clear in their offer of employment and subject to monitoring.

Pension

You will be entitled to join or continue as a member of the NHS Pension Scheme, subject to its terms and rules, which may be amended from time to time.

Annual leave Your entitlement to annual leave will be five or six weeks per annum depending upon

your previous service/incremental point, as set out in paragraphs 205 – 206 of the TCS. The TCS may be viewed at: http://www.nhsemployers.org/your-workforce/pay-and-

reward/nhs-terms-and-conditions/junior-doctors-dentists-gp-registrars. Sick pay

Entitlements are outlined in paragraphs 225-240 of the TCS.

Notice You will be required to give your employer and entitled to receive from them notice in

accordance with paragraphs 195 – 196 of the TCS. Study leave

The employer is expected to offer study leave in accordance with paragraphs 250 – 254 of the TCS. Local policy and procedure will be explained at your induction.

Travel expenses

The employer is expected to offer travel expenses in accordance with paragraphs 277 – 308 of the TCS for journeys incurred in performing your duties. Local policy and procedure will be explained at induction.

Subsistence expenses

The employer is expected to offer subsistence expenses in accordance with paragraph 311 of the TCS. Local policy and procedure will be explained at induction.

Relocation expenses The employer will have a local policy for relocation expenses based on paragraphs

314 – 315 of the TCS and national guidance at: http://www.nhsemployers.org/your-workforce/pay-and-reward/nhs-terms-and-conditions/junior-doctors-dentists-gp-

registrars. You are advised to check eligibility and confirm any entitlement with the employer before incurring any expenditure. In addition to local policy there is

Deanery guidance which can be viewed on www.wessexdeanery.nhs.uk Pre-employment checks

All NHS employers are required to undertake pre-employment checks. The employer will confirm their local arrangements expected to be in line with national guidance at:

http://www.nhsemployers.org/your-workforce/recruit/employment-checks. Professional registration

It will be a requirement of employment that you have professional registration with the GMC for the duration of your employment.

Health and safety

All employers have a duty to protect their workers from harm. You will be advised by the employer of local policies and procedures intended to protect your health and safety and to comply with these.

Disciplinary and grievance procedures

The employer will have local policies and procedures for dealing with any disciplinary concerns or grievances you may have. They will advise you how to access these, not later than eight weeks after commencement of employment.

Educational supervisor

The employer will confirm your supervisor on commencement. General information

Health Education Wessex’s management of Specialty Training programmes, including issues such as taking time out of programme and dealing with concerns or

complaints, is available at www.wessexdeanery.nhs.uk and in the national ‘Gold guide’ to Specialty Training at: http://specialtytraining.hee.nhs.uk/news/the-gold-guide/.