Faculty and Hospitals Individual rotations - Northern Deanery

Faculty and Hospitals
Individual rotations
Royal Victoria Infirmary Newcastle upon Tyne
The RVI department of Haematology has historically been the Centre within Newcastle
where intensive haematology has been practised. This is a level 4 centre undertaking bone
marrow transplants for the Northern Region and is also the Regional Haemophilia centre.
There is a 20 bedded in patient unit (new build planned), outpatient and day case facilities
and the Haemophilia Centre. There is an NHS laboratory which houses the whole range of
haematological services for the hospital plus additional specialist services. In addition there
is a purpose built academic department with laboratory research facilities, which are also
integrated to the NHS laboratory. This allows a substantial research opportunity and major
research projects are conducted within this setting.
Consultant staff:
Professor SJ Proctor
Dr. GH Jackson
Dr. A. Lennard
Dr. J Hanley (Clinical Director)
Dr. K Talks.
Dr. G. Jones
Dr. P Carey
Dr. S.G O’Brien (Senior lecturer)
There are currently 5 separate posts based at the RVI. Rotation is 4 monthly but a minimum
of 6 months Paediatrics is undertaken during the training scheme.
RVI Ward
Clinical post Supervisor Dr. A. Lennard
Main responsibilities:
Coordinate the care of inpatients with the support of junior doctors.
Review all patients on a daily basis.
Prescribe chemotherapy for inpatients and also administer intrathecal chemotherapy
to inpatients (after appropriate training has been given) Cross cover with the haemoncology
registrar for intrathecal chemotherapy to be given to out-patients.
Attend the Monday and Thursday consultant ward rounds.
Attend the Tuesday Medical Grand Round and the Thursday MDM.
Attend designated general Haematology review and new patient clinic.
Gain experience in bone marrow harvesting.
Attend morphology teaching and report Bone Marrows from in patients.
Liaise with the laboratory re inpatient results, investigations and transfusion
requirements.

RVI –Paediatrics
Clinical Post supervisor- Dr. P Carey
Main responsibilities:
Involvement in the care of paediatric patients with haematological malignancy.
Performing bone marrow biopsies under consultant supervision
Laboratory review of paediatric blood films, bone marrows and all relevant
investigations.
Liaison with SCBU/Fetal Medicine Department as necessary
Outpatient clinics for paediatric haemato- oncology, non malignant conditions
including Haemaglobinopathies.
Attendance at MDT meetings.
Laboratory liaison for general paediatrics. No on call commitment for paediatrics,
participation in the adult on call rota.
RVI – Haemostasis & thrombosis
Clinical post Supervisor –Dr. J Hanley
This person will be part of a multidisciplinary team closely involved in the inpatient and
outpatient care of patients with coagulation abnormalities. The Haemophilia Unit is based in
the hospital and there will also be close contact with the Coagulation laboratory.
Main responsibilities:
Attendance at the specialist Haemophilia clinics Care of elective and drop-in day
cases for assessment and treatment.
Liaison with the ward 8 (adult) and ward 6 (paediatric) team re inpatient care of
Haemophiliacs.
Attendance at alternate week thrombosis clinic (thurs AM)
Attendance at the alternate week Obstetric/Coag clinic
Liaison with the Coagulation lab re abnormal results and the daily ‘clotting queue’.
Attendance at the weekly Haemophilia MDM, Medical Grand Round l
RVI –Haemato-Oncology
Clinical Supervisor Dr. G Jones
This person will be part of a multidisciplinary team closely involved in the outpatient care of
patients with haematological malignancies. The Haematology Day Unit (ward 6A) manages
most of the acute leukaemia and general follow-up and the adjacent Oncology Day Unit
(ward 6B) manages the lymphoma cases.
Main responsibilities:
Attendance at the general Haematology outpatient clinic.
Attendance at the specialist outpatient clinics: Bone marrow transplant, Multiple
Myeloma, Lymphoma, Chronic myeloid leukaemia
This person will have responsibility for the Haematology Day Unit (ward 6A) which is
also staffed by an designated junior doctor (rotational) and Haematology Clinical
Fellow Procedures such as bone marrow examinations and intrathecal chemotherapy
administration will be undertaken.
Patient referrals.
Laboratory sessions will include reporting of relevant bone marrow specimens.
Attendance at the weekly educational meetings such as Lymphoma MDM, General
MDM Lymphoma meeting.

RVI – Transplant/Laboratory post
Clinical post supervisor- Dr. G Jackson
Main responsibilities:
Be the first point of call for the lab and for other specialities requiring haematology
advice.
Attend appropriate laboratory meetings to gain exposure to laboratory management
and problems.
Report all the blood films in the morning and meet the on call consultant at 1630
each day to go over blood films and any liaison issues from the day.
Attend morphology teaching led by the on-call consultant.
Report relevant adult bone marrows and review these with the appropriate consultant
at prearranged times each week.
Attendance at Bone Marrow Transplant meeting, outpatient clinics, reviewing
inpatients undergoing allogeneic and matched unrelated donor transplants.
Attend Thursday MDM.
Newcastle/ Northumbria post
One post based in Newcastle (RVI) and is shared with the Northumbria NHS Trust,
Wansbeck Hospital. This four month post involves specialist clinics and on-call
commitments in Newcastle with good experience of Level 1 haematology at Wansbeck. This
will enable the trainee to gain a different perspective on the delivery of haematological
care. Training at Northumbria will be gained in general laboratory management, general
haematology excluding acute leukaemia and in the management of anticoagulant services
including a thrombosis clinic. The trainee will spend three days a week in Northumbria. The
on-call commitments during this post are for the Newcastle Hospitals (see below).
Consultant Staff
Dr I. Neilly
Dr M. Dewar
Dr C. Tiplady
Freeman Hospital, Newcastle upon Tyne
The Freeman Hospital is one of the teaching hospitals that makes up the Newcastle upon
Tyne Hospitals Trust. There are 750 beds on this site in addition to extensive Day Case and
out patient facilities. Many of the specialist surgical services for the North of England are
based here including all urology, cold orthopaedics, ENT, lower GI, vascular and cardiac.
Heart, lung, kidney and liver transplantation also occur on this site. In support there are large
units dealing with general medicine, care of the elderly, hepatology, GI, cardiology and renal
medicine.
The work covers all areas of general haematology and haemato-oncology, with the
exception of marrow transplantation and aggressive chemotherapy, paediatrics, and
haemophilia – such cases are referred to the RVI. The very large anticoagulation service
(both hospital and community) is based on this site. In addition a great deal of time is taken
up with liaison work, both for in-patients, and advice to hospital and general practice
colleagues

Consultant staff:
Dr. P Kesteven
Dr. J Wallis
Clinical post supervisor – Dr. P. Kesteven
Main responsibilities:
Inpatients: responsibility for the management of inpatients with the help of the
Haematology Sister and junior doctors who are shared with one of the medical
teams. The consultants hold ward rounds through the week.
Outpatients: attendance at general haematology clinics and one thrombophilia clinic
a week. These clinics contain a mixture of new patients and returns. Ward 21 is a
day case unit where clinics are held twice a week for patients needing infusions /
chemotherapy / transfusions / close review.
Liaison: the trainee is on call for haematology at the Freeman during the normal
working day for both clinical and laboratory issues. Freeman has a large dialysis unit,
the regional liver unit and cardiothoracic unit and is the centre for solid organ
transplantation. Liaison haematology forms a substantial part of the work and
provides specialist Haemostasis and Thrombosis experience.
National Blood Service
The Newcastle Blood Centre serves a population of 3 million, and provides a full range of
blood transfusion services to hospitals in the region. The Red Cell Immunohaematology
Laboratory undertakes investigation of serological problems associated with transfusion or
pregnancy and there is close liaison with the Department of Fetal Medicine at the Royal
Victoria Infirmary. The Histocompatibility Laboratory provides a comprehensive, modern
histocompatibility service to the Region. The laboratory also provides HLA typing for patients
requiring specialised platelet support.
Clinical Post Supervisor – Dr. A. Wells
Main responsibilities:
To undertake a full training rotation to cover all aspects of blood transfusion practice.
To participate under supervision of Consultant staff, in the provision of medical
advice as required to hospital clinical and Blood Bank staff, and to staff within the
Blood Service; and participate in medical on-call rota.
To undertake other medical functions as required under supervision of Consultant
staff. These functions will include:
provision of advice on the selection of donors
provision of HLA matched platelets
organisation of autologous predeposit donations
investigation of transfusion reactions (eg bacterial contamination, TRALI).
To assist with teaching of medical and non-medical staff, and to contribute to the
undergraduate teaching programme in Blood Transfusion.
The Specialist Registrar will be encouraged to take part in clinical audit.
To be familiar with and maintain the transfusion centre quality system.
On call commitment: No on call commitment (please note there is no on call
payment for this 4 month post)
James Cook University Hospital, Middlesbrough. South Tees NHS Trust

This hospital has a capacity of just over 1000 beds and provides all major specialities on a
single site. It serves a population of 430 000 for district services and 1.2 million for an
extensive range of specialities. These include cardiothoracic, renal, neurosurgery, trauma,
spinal injuries, vascular and upper GI surgery. The hospital is the cancer centre for the
Teesside with Radiotherapy and Medical Oncology on site. The Trust is linked to the
University of Durham Medical School at Stockton.
Clinical Haematology provides a BCSH level 3 service including autologous bone marrow
transplantation. There is a 35 bedded ward shared with oncology with a dedicated team of
haematology nurses and a separate Haematology day unit that includes a nurse led
chemotherapy unit. Children with malignant disease are referred to Newcastle however there
is a general paediatric clinic and a paediatric Haemoglobinopathy service. Shared care
arrangements exist with the Regional Comprehensive care centre for patients with bleeding
disorders.
There are purpose built pathology facilities. The Laboratory has full CPA accreditation and
provides routine haematology services together with specialised coagulation,
haemoglobinopathy and flow cytometry. The Registrars have a dedicated office with access
to the computer and microscopes.
Consultant Staff
Dr. John Chandler
Dr. Angela Wood (Clinical Director)
Dr. Dianne Plews
Dr Ray Dang
Dr. Chris Millar
There are 3 posts, 2 at JCUH and 1 post JCUH/North Tees. Each trainee will participate in a
rotation between JCUH and North Tees, spending 8 months in JCUH and 4 months in the
JCUH/North Tees post. On call is for South Tees NHS Trust with no on call commitment at
North Tees.
JCUH Posts
Clinical Post Supervisor – Dr Dianne Plews
Ward post
Main responsibilities:
The registrar is part of the multidisciplinary team responsible of the care of Haematology
inpatients at the James Cook University Hospital.
To oversee the care of inpatients with responsibility for the ward junior doctors.
Responsibility for day case patients attending the Haematology day unit.
Attendance at designated clinics (1 new and 1 review per week).
Liaison with other specialities and General Practitioners providing Haematology
advice when on call.
Inpatient referrals as designated by Consultant.
Liaison with the Laboratory regarding abnormal results
Reporting bone marrow biopsies for inpatients.
Attendance at weekly regional educational session.
Teaching medical students and juniors attached to haematology.
Cover as required for the Laboratory Registrar depending on annual leave.
Laboratory/Liaison post
Main responsibilities:

Liaison with other departments re lab results
Reporting of specialist investigations
Ward referrals as designated by Consultant
Bone Marrow reporting of out patient and referral marrows
Attendance at designated clinics
Attendance at network MDT meeting
Attendance at local MDM for morphology
Laboratory audit or management project
Cover as required for Ward Registrar depending on annual leave
JCUH/North Tees Post
North Tees and Hartlepool NHS Foundation Trust provides local health care services to
400,000 people in East Durham, Hartlepool, Stockton-on-Tees and surrounding areas. The
University Hospital of North Tees (UHNT) currently provides 557 beds. Services include
Accident & Emergency (A&E), General Medicine, Obstetrics and Gynaecology, Acute
Orthopaedics and Trauma, Paediatrics, General Surgery, Critical Care and Cancer Services.
Acute clinical haematology service is based at UHNT with a 9-bedded level 2 haematooncology
facility. The Unit is closely linked to the Chemotherapy Day Unit. The Haematology
Laboratory at UHNT is CPA-accredited The Laboratory also provides routine tests such as
haematinic assays, thrombophilia screen and transfusion serology.
Consultant Staff
Dr. Z Maung
Dr. P. Mounter
Dr. A. Youart
Clinical Post Supervisor – Dr Zor Maung
This post spends three days a week at North Tees undertaking general laboratory
responsibilities, new and review outpatient clinics and ward work. The trainee will undertake
specialist clinics at James Cook including paediatrics, medical obstetrics and thrombosis.
On-call will be based at JCUH.
Teaching
There is a regional teaching programme (see below) on a Friday morning, however, on two
mornings a month trainees will return to the base unit after the initial Registrar teaching
session. On these days there will be a formal teaching session for all three trainees either at
JCUH or at North Tees. Individual teaching will be provided as part of each of the posts on
this rotation.
Sunderland Royal Hospital
South of Tyne Clinical Haematology service is combined across three sites, Sunderland
(City Hospitals Sunderland NHS Foundation Trust (SRH)), South Tyneside and Gateshead
(Queen Elizabeth Hospital (QE)), with a combined catchment population of 750,000. The
focus of in-patient activity is at the 16-bed Haematology unit based in Sunderland providing
level III care (to BCSH standards), including autologous bone marrow transplantation. There
is an adjacent nurse-led chemotherapy/day unit and outpatient area. There are currently 6.5
whole time equivalent haematology consultants working across all 3 sites. Each trainee will
participate in a rotation between the Sunderland and Gateshead site, spending 4 months in
each of the 2 Sunderland posts, and 4 months in a Sunderland/Gateshead post. The trainee
does not undertake any routine activities at South Tyneside.

There is a purpose built laboratory on all sites for routine haematology tests together with
flow cytometry, specialised coagulation and haemoglobinopathy screening. The Registrars
have a dedicated office with access to the computer and microscopes.
Consultant Staff – Sunderland, South Tyneside
Dr Mike Galloway (Clinical Director)
Dr Lucy Pemberton
Dr Simon Lyons
Dr Victoria Hurvey
Consultant Staff – Queen Elizabeth, Gateshead/Sunderland
Dr Scott Marshall
Dr Yogesh Uppadhy
Dr Geoff Summerfield
Posts
Clinical Post Supervisor – Dr Lucy Pemberton
Posts 1 and 2 are solely based at Sunderland, while post 3 works between Sunderland and
Gateshead. Registrars are expected to spend 4 months in each post.
Collective responsibilities:
Post One:
Post Two:
Care for Haematology in-patients in Sunderland and Gateshead on the dedicated
haematology wards and assessment of out-patient attendees.
Attendance at dedicated Consultant led teaching New and Review Out-Patient clinics
(Three clinics in Sunderland and two clinics in Gateshead).
Supervision of rotating junior medical staff in haematology.
Supervised liaison clinical and laboratory haematology.
Training and supervision of laboratory reporting in the haematology laboratory.
Attendance at weekly morphology meeting.
Attendance at weekly Haematology/Lymphoma/Leukaemia Multi-disciplinary
meetings.
Attendance at weekly Haematology Grand Round.
Attendance at weekly SpR teaching and NRHG/South of Tyne educational meeting.
Weekly dedicated laboratory and audit sessions.
Weekly attendance at a Consultant led teaching session (one hour).
Participation in a 1 in 6 prospective On-Call rota with Consultant supervision
Ward and day unit cover
Attendance at ‘Consultant of the Week’ ward round
Attendance at one out patient clinic per week with prospective cover of post two
clinical commitments
Registrar led ward round weekly
Ward and day unit cover when post one not available
Attendance at ‘Consultant of the Week’ ward round when on call at the ‘weekend’
Attendance at two haematology out-patient clinics per week
Provision of supervised liaison haematology services, inclusive of laboratory liaison
at Sunderland

Post Three:
Procedures list on Tuesday pm inclusive of supervised bone marrow biopsy, intrathecal
chemotherapy and line removal
Attendance at ‘Consultant of the Week’ ward round at Sunderland when on call at the
‘weekend’
Attendance at two haematology out-patient clinics in Gateshead per week
Provision of supervised liaison haematology services inclusive of laboratory liaison at
Gateshead
Procedures list on one afternoon per week inclusive of supervised bone marrow
biopsy