Faculty and Hospitals Individual rotations - Northern Deanery
Faculty and Hospitals Individual rotations - Northern Deanery
Faculty and Hospitals Individual rotations - Northern Deanery
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<strong>Faculty</strong> <strong>and</strong> <strong>Hospitals</strong><br />
<strong>Individual</strong> <strong>rotations</strong><br />
Royal Victoria Infirmary Newcastle upon Tyne<br />
The RVI department of Haematology has historically been the Centre within Newcastle<br />
where intensive haematology has been practised. This is a level 4 centre undertaking bone<br />
marrow transplants for the <strong>Northern</strong> Region <strong>and</strong> is also the Regional Haemophilia centre.<br />
There is a 20 bedded in patient unit (new build planned), outpatient <strong>and</strong> day case facilities<br />
<strong>and</strong> the Haemophilia Centre. There is an NHS laboratory which houses the whole range of<br />
haematological services for the hospital plus additional specialist services. In addition there<br />
is a purpose built academic department with laboratory research facilities, which are also<br />
integrated to the NHS laboratory. This allows a substantial research opportunity <strong>and</strong> major<br />
research projects are conducted within this setting.<br />
Consultant staff:<br />
Professor SJ Proctor<br />
Dr. GH Jackson<br />
Dr. A. Lennard<br />
Dr. J Hanley (Clinical Director)<br />
Dr. K Talks.<br />
Dr. G. Jones<br />
Dr. P Carey<br />
Dr. S.G O’Brien (Senior lecturer)<br />
There are currently 5 separate posts based at the RVI. Rotation is 4 monthly but a minimum<br />
of 6 months Paediatrics is undertaken during the training scheme.<br />
RVI Ward<br />
Clinical post Supervisor Dr. A. Lennard<br />
Main responsibilities:<br />
Coordinate the care of inpatients with the support of junior doctors.<br />
Review all patients on a daily basis.<br />
Prescribe chemotherapy for inpatients <strong>and</strong> also administer intrathecal chemotherapy<br />
to inpatients (after appropriate training has been given) Cross cover with the haemoncology<br />
registrar for intrathecal chemotherapy to be given to out-patients.<br />
Attend the Monday <strong>and</strong> Thursday consultant ward rounds.<br />
Attend the Tuesday Medical Gr<strong>and</strong> Round <strong>and</strong> the Thursday MDM.<br />
Attend designated general Haematology review <strong>and</strong> new patient clinic.<br />
Gain experience in bone marrow harvesting.<br />
Attend morphology teaching <strong>and</strong> report Bone Marrows from in patients.<br />
Liaise with the laboratory re inpatient results, investigations <strong>and</strong> transfusion<br />
requirements.
RVI –Paediatrics<br />
Clinical Post supervisor- Dr. P Carey<br />
Main responsibilities:<br />
Involvement in the care of paediatric patients with haematological malignancy.<br />
Performing bone marrow biopsies under consultant supervision<br />
Laboratory review of paediatric blood films, bone marrows <strong>and</strong> all relevant<br />
investigations.<br />
Liaison with SCBU/Fetal Medicine Department as necessary<br />
Outpatient clinics for paediatric haemato- oncology, non malignant conditions<br />
including Haemaglobinopathies.<br />
Attendance at MDT meetings.<br />
Laboratory liaison for general paediatrics. No on call commitment for paediatrics,<br />
participation in the adult on call rota.<br />
RVI – Haemostasis & thrombosis<br />
Clinical post Supervisor –Dr. J Hanley<br />
This person will be part of a multidisciplinary team closely involved in the inpatient <strong>and</strong><br />
outpatient care of patients with coagulation abnormalities. The Haemophilia Unit is based in<br />
the hospital <strong>and</strong> there will also be close contact with the Coagulation laboratory.<br />
Main responsibilities:<br />
Attendance at the specialist Haemophilia clinics Care of elective <strong>and</strong> drop-in day<br />
cases for assessment <strong>and</strong> treatment.<br />
Liaison with the ward 8 (adult) <strong>and</strong> ward 6 (paediatric) team re inpatient care of<br />
Haemophiliacs.<br />
Attendance at alternate week thrombosis clinic (thurs AM)<br />
Attendance at the alternate week Obstetric/Coag clinic<br />
Liaison with the Coagulation lab re abnormal results <strong>and</strong> the daily ‘clotting queue’.<br />
Attendance at the weekly Haemophilia MDM, Medical Gr<strong>and</strong> Round l<br />
RVI –Haemato-Oncology<br />
Clinical Supervisor Dr. G Jones<br />
This person will be part of a multidisciplinary team closely involved in the outpatient care of<br />
patients with haematological malignancies. The Haematology Day Unit (ward 6A) manages<br />
most of the acute leukaemia <strong>and</strong> general follow-up <strong>and</strong> the adjacent Oncology Day Unit<br />
(ward 6B) manages the lymphoma cases.<br />
Main responsibilities:<br />
Attendance at the general Haematology outpatient clinic.<br />
Attendance at the specialist outpatient clinics: Bone marrow transplant, Multiple<br />
Myeloma, Lymphoma, Chronic myeloid leukaemia<br />
This person will have responsibility for the Haematology Day Unit (ward 6A) which is<br />
also staffed by an designated junior doctor (rotational) <strong>and</strong> Haematology Clinical<br />
Fellow Procedures such as bone marrow examinations <strong>and</strong> intrathecal chemotherapy<br />
administration will be undertaken.<br />
Patient referrals.<br />
Laboratory sessions will include reporting of relevant bone marrow specimens.<br />
Attendance at the weekly educational meetings such as Lymphoma MDM, General<br />
MDM Lymphoma meeting.
RVI – Transplant/Laboratory post<br />
Clinical post supervisor- Dr. G Jackson<br />
Main responsibilities:<br />
Be the first point of call for the lab <strong>and</strong> for other specialities requiring haematology<br />
advice.<br />
Attend appropriate laboratory meetings to gain exposure to laboratory management<br />
<strong>and</strong> problems.<br />
Report all the blood films in the morning <strong>and</strong> meet the on call consultant at 1630<br />
each day to go over blood films <strong>and</strong> any liaison issues from the day.<br />
Attend morphology teaching led by the on-call consultant.<br />
Report relevant adult bone marrows <strong>and</strong> review these with the appropriate consultant<br />
at prearranged times each week.<br />
Attendance at Bone Marrow Transplant meeting, outpatient clinics, reviewing<br />
inpatients undergoing allogeneic <strong>and</strong> matched unrelated donor transplants.<br />
Attend Thursday MDM.<br />
Newcastle/ Northumbria post<br />
One post based in Newcastle (RVI) <strong>and</strong> is shared with the Northumbria NHS Trust,<br />
Wansbeck Hospital. This four month post involves specialist clinics <strong>and</strong> on-call<br />
commitments in Newcastle with good experience of Level 1 haematology at Wansbeck. This<br />
will enable the trainee to gain a different perspective on the delivery of haematological<br />
care. Training at Northumbria will be gained in general laboratory management, general<br />
haematology excluding acute leukaemia <strong>and</strong> in the management of anticoagulant services<br />
including a thrombosis clinic. The trainee will spend three days a week in Northumbria. The<br />
on-call commitments during this post are for the Newcastle <strong>Hospitals</strong> (see below).<br />
Consultant Staff<br />
Dr I. Neilly<br />
Dr M. Dewar<br />
Dr C. Tiplady<br />
Freeman Hospital, Newcastle upon Tyne<br />
The Freeman Hospital is one of the teaching hospitals that makes up the Newcastle upon<br />
Tyne <strong>Hospitals</strong> Trust. There are 750 beds on this site in addition to extensive Day Case <strong>and</strong><br />
out patient facilities. Many of the specialist surgical services for the North of Engl<strong>and</strong> are<br />
based here including all urology, cold orthopaedics, ENT, lower GI, vascular <strong>and</strong> cardiac.<br />
Heart, lung, kidney <strong>and</strong> liver transplantation also occur on this site. In support there are large<br />
units dealing with general medicine, care of the elderly, hepatology, GI, cardiology <strong>and</strong> renal<br />
medicine.<br />
The work covers all areas of general haematology <strong>and</strong> haemato-oncology, with the<br />
exception of marrow transplantation <strong>and</strong> aggressive chemotherapy, paediatrics, <strong>and</strong><br />
haemophilia – such cases are referred to the RVI. The very large anticoagulation service<br />
(both hospital <strong>and</strong> community) is based on this site. In addition a great deal of time is taken<br />
up with liaison work, both for in-patients, <strong>and</strong> advice to hospital <strong>and</strong> general practice<br />
colleagues
Consultant staff:<br />
Dr. P Kesteven<br />
Dr. J Wallis<br />
Clinical post supervisor – Dr. P. Kesteven<br />
Main responsibilities:<br />
Inpatients: responsibility for the management of inpatients with the help of the<br />
Haematology Sister <strong>and</strong> junior doctors who are shared with one of the medical<br />
teams. The consultants hold ward rounds through the week.<br />
Outpatients: attendance at general haematology clinics <strong>and</strong> one thrombophilia clinic<br />
a week. These clinics contain a mixture of new patients <strong>and</strong> returns. Ward 21 is a<br />
day case unit where clinics are held twice a week for patients needing infusions /<br />
chemotherapy / transfusions / close review.<br />
Liaison: the trainee is on call for haematology at the Freeman during the normal<br />
working day for both clinical <strong>and</strong> laboratory issues. Freeman has a large dialysis unit,<br />
the regional liver unit <strong>and</strong> cardiothoracic unit <strong>and</strong> is the centre for solid organ<br />
transplantation. Liaison haematology forms a substantial part of the work <strong>and</strong><br />
provides specialist Haemostasis <strong>and</strong> Thrombosis experience.<br />
National Blood Service<br />
The Newcastle Blood Centre serves a population of 3 million, <strong>and</strong> provides a full range of<br />
blood transfusion services to hospitals in the region. The Red Cell Immunohaematology<br />
Laboratory undertakes investigation of serological problems associated with transfusion or<br />
pregnancy <strong>and</strong> there is close liaison with the Department of Fetal Medicine at the Royal<br />
Victoria Infirmary. The Histocompatibility Laboratory provides a comprehensive, modern<br />
histocompatibility service to the Region. The laboratory also provides HLA typing for patients<br />
requiring specialised platelet support.<br />
Clinical Post Supervisor – Dr. A. Wells<br />
Main responsibilities:<br />
To undertake a full training rotation to cover all aspects of blood transfusion practice.<br />
To participate under supervision of Consultant staff, in the provision of medical<br />
advice as required to hospital clinical <strong>and</strong> Blood Bank staff, <strong>and</strong> to staff within the<br />
Blood Service; <strong>and</strong> participate in medical on-call rota.<br />
To undertake other medical functions as required under supervision of Consultant<br />
staff. These functions will include:<br />
provision of advice on the selection of donors<br />
provision of HLA matched platelets<br />
organisation of autologous predeposit donations<br />
investigation of transfusion reactions (eg bacterial contamination, TRALI).<br />
To assist with teaching of medical <strong>and</strong> non-medical staff, <strong>and</strong> to contribute to the<br />
undergraduate teaching programme in Blood Transfusion.<br />
The Specialist Registrar will be encouraged to take part in clinical audit.<br />
To be familiar with <strong>and</strong> maintain the transfusion centre quality system.<br />
On call commitment: No on call commitment (please note there is no on call<br />
payment for this 4 month post)<br />
James Cook University Hospital, Middlesbrough. South Tees NHS Trust
This hospital has a capacity of just over 1000 beds <strong>and</strong> provides all major specialities on a<br />
single site. It serves a population of 430 000 for district services <strong>and</strong> 1.2 million for an<br />
extensive range of specialities. These include cardiothoracic, renal, neurosurgery, trauma,<br />
spinal injuries, vascular <strong>and</strong> upper GI surgery. The hospital is the cancer centre for the<br />
Teesside with Radiotherapy <strong>and</strong> Medical Oncology on site. The Trust is linked to the<br />
University of Durham Medical School at Stockton.<br />
Clinical Haematology provides a BCSH level 3 service including autologous bone marrow<br />
transplantation. There is a 35 bedded ward shared with oncology with a dedicated team of<br />
haematology nurses <strong>and</strong> a separate Haematology day unit that includes a nurse led<br />
chemotherapy unit. Children with malignant disease are referred to Newcastle however there<br />
is a general paediatric clinic <strong>and</strong> a paediatric Haemoglobinopathy service. Shared care<br />
arrangements exist with the Regional Comprehensive care centre for patients with bleeding<br />
disorders.<br />
There are purpose built pathology facilities. The Laboratory has full CPA accreditation <strong>and</strong><br />
provides routine haematology services together with specialised coagulation,<br />
haemoglobinopathy <strong>and</strong> flow cytometry. The Registrars have a dedicated office with access<br />
to the computer <strong>and</strong> microscopes.<br />
Consultant Staff<br />
Dr. John Ch<strong>and</strong>ler<br />
Dr. Angela Wood (Clinical Director)<br />
Dr. Dianne Plews<br />
Dr Ray Dang<br />
Dr. Chris Millar<br />
There are 3 posts, 2 at JCUH <strong>and</strong> 1 post JCUH/North Tees. Each trainee will participate in a<br />
rotation between JCUH <strong>and</strong> North Tees, spending 8 months in JCUH <strong>and</strong> 4 months in the<br />
JCUH/North Tees post. On call is for South Tees NHS Trust with no on call commitment at<br />
North Tees.<br />
JCUH Posts<br />
Clinical Post Supervisor – Dr Dianne Plews<br />
Ward post<br />
Main responsibilities:<br />
The registrar is part of the multidisciplinary team responsible of the care of Haematology<br />
inpatients at the James Cook University Hospital.<br />
To oversee the care of inpatients with responsibility for the ward junior doctors.<br />
Responsibility for day case patients attending the Haematology day unit.<br />
Attendance at designated clinics (1 new <strong>and</strong> 1 review per week).<br />
Liaison with other specialities <strong>and</strong> General Practitioners providing Haematology<br />
advice when on call.<br />
Inpatient referrals as designated by Consultant.<br />
Liaison with the Laboratory regarding abnormal results<br />
Reporting bone marrow biopsies for inpatients.<br />
Attendance at weekly regional educational session.<br />
Teaching medical students <strong>and</strong> juniors attached to haematology.<br />
Cover as required for the Laboratory Registrar depending on annual leave.<br />
Laboratory/Liaison post<br />
Main responsibilities:
Liaison with other departments re lab results<br />
Reporting of specialist investigations<br />
Ward referrals as designated by Consultant<br />
Bone Marrow reporting of out patient <strong>and</strong> referral marrows<br />
Attendance at designated clinics<br />
Attendance at network MDT meeting<br />
Attendance at local MDM for morphology<br />
Laboratory audit or management project<br />
Cover as required for Ward Registrar depending on annual leave<br />
JCUH/North Tees Post<br />
North Tees <strong>and</strong> Hartlepool NHS Foundation Trust provides local health care services to<br />
400,000 people in East Durham, Hartlepool, Stockton-on-Tees <strong>and</strong> surrounding areas. The<br />
University Hospital of North Tees (UHNT) currently provides 557 beds. Services include<br />
Accident & Emergency (A&E), General Medicine, Obstetrics <strong>and</strong> Gynaecology, Acute<br />
Orthopaedics <strong>and</strong> Trauma, Paediatrics, General Surgery, Critical Care <strong>and</strong> Cancer Services.<br />
Acute clinical haematology service is based at UHNT with a 9-bedded level 2 haematooncology<br />
facility. The Unit is closely linked to the Chemotherapy Day Unit. The Haematology<br />
Laboratory at UHNT is CPA-accredited The Laboratory also provides routine tests such as<br />
haematinic assays, thrombophilia screen <strong>and</strong> transfusion serology.<br />
Consultant Staff<br />
Dr. Z Maung<br />
Dr. P. Mounter<br />
Dr. A. Youart<br />
Clinical Post Supervisor – Dr Zor Maung<br />
This post spends three days a week at North Tees undertaking general laboratory<br />
responsibilities, new <strong>and</strong> review outpatient clinics <strong>and</strong> ward work. The trainee will undertake<br />
specialist clinics at James Cook including paediatrics, medical obstetrics <strong>and</strong> thrombosis.<br />
On-call will be based at JCUH.<br />
Teaching<br />
There is a regional teaching programme (see below) on a Friday morning, however, on two<br />
mornings a month trainees will return to the base unit after the initial Registrar teaching<br />
session. On these days there will be a formal teaching session for all three trainees either at<br />
JCUH or at North Tees. <strong>Individual</strong> teaching will be provided as part of each of the posts on<br />
this rotation.<br />
Sunderl<strong>and</strong> Royal Hospital<br />
South of Tyne Clinical Haematology service is combined across three sites, Sunderl<strong>and</strong><br />
(City <strong>Hospitals</strong> Sunderl<strong>and</strong> NHS Foundation Trust (SRH)), South Tyneside <strong>and</strong> Gateshead<br />
(Queen Elizabeth Hospital (QE)), with a combined catchment population of 750,000. The<br />
focus of in-patient activity is at the 16-bed Haematology unit based in Sunderl<strong>and</strong> providing<br />
level III care (to BCSH st<strong>and</strong>ards), including autologous bone marrow transplantation. There<br />
is an adjacent nurse-led chemotherapy/day unit <strong>and</strong> outpatient area. There are currently 6.5<br />
whole time equivalent haematology consultants working across all 3 sites. Each trainee will<br />
participate in a rotation between the Sunderl<strong>and</strong> <strong>and</strong> Gateshead site, spending 4 months in<br />
each of the 2 Sunderl<strong>and</strong> posts, <strong>and</strong> 4 months in a Sunderl<strong>and</strong>/Gateshead post. The trainee<br />
does not undertake any routine activities at South Tyneside.
There is a purpose built laboratory on all sites for routine haematology tests together with<br />
flow cytometry, specialised coagulation <strong>and</strong> haemoglobinopathy screening. The Registrars<br />
have a dedicated office with access to the computer <strong>and</strong> microscopes.<br />
Consultant Staff – Sunderl<strong>and</strong>, South Tyneside<br />
Dr Mike Galloway (Clinical Director)<br />
Dr Lucy Pemberton<br />
Dr Simon Lyons<br />
Dr Victoria Hurvey<br />
Consultant Staff – Queen Elizabeth, Gateshead/Sunderl<strong>and</strong><br />
Dr Scott Marshall<br />
Dr Yogesh Uppadhy<br />
Dr Geoff Summerfield<br />
Posts<br />
Clinical Post Supervisor – Dr Lucy Pemberton<br />
Posts 1 <strong>and</strong> 2 are solely based at Sunderl<strong>and</strong>, while post 3 works between Sunderl<strong>and</strong> <strong>and</strong><br />
Gateshead. Registrars are expected to spend 4 months in each post.<br />
Collective responsibilities:<br />
Post One:<br />
Post Two:<br />
Care for Haematology in-patients in Sunderl<strong>and</strong> <strong>and</strong> Gateshead on the dedicated<br />
haematology wards <strong>and</strong> assessment of out-patient attendees.<br />
Attendance at dedicated Consultant led teaching New <strong>and</strong> Review Out-Patient clinics<br />
(Three clinics in Sunderl<strong>and</strong> <strong>and</strong> two clinics in Gateshead).<br />
Supervision of rotating junior medical staff in haematology.<br />
Supervised liaison clinical <strong>and</strong> laboratory haematology.<br />
Training <strong>and</strong> supervision of laboratory reporting in the haematology laboratory.<br />
Attendance at weekly morphology meeting.<br />
Attendance at weekly Haematology/Lymphoma/Leukaemia Multi-disciplinary<br />
meetings.<br />
Attendance at weekly Haematology Gr<strong>and</strong> Round.<br />
Attendance at weekly SpR teaching <strong>and</strong> NRHG/South of Tyne educational meeting.<br />
Weekly dedicated laboratory <strong>and</strong> audit sessions.<br />
Weekly attendance at a Consultant led teaching session (one hour).<br />
Participation in a 1 in 6 prospective On-Call rota with Consultant supervision<br />
Ward <strong>and</strong> day unit cover<br />
Attendance at ‘Consultant of the Week’ ward round<br />
Attendance at one out patient clinic per week with prospective cover of post two<br />
clinical commitments<br />
Registrar led ward round weekly<br />
Ward <strong>and</strong> day unit cover when post one not available<br />
Attendance at ‘Consultant of the Week’ ward round when on call at the ‘weekend’<br />
Attendance at two haematology out-patient clinics per week<br />
Provision of supervised liaison haematology services, inclusive of laboratory liaison<br />
at Sunderl<strong>and</strong>
Post Three:<br />
Procedures list on Tuesday pm inclusive of supervised bone marrow biopsy, intrathecal<br />
chemotherapy <strong>and</strong> line removal<br />
Attendance at ‘Consultant of the Week’ ward round at Sunderl<strong>and</strong> when on call at the<br />
‘weekend’<br />
Attendance at two haematology out-patient clinics in Gateshead per week<br />
Provision of supervised liaison haematology services inclusive of laboratory liaison at<br />
Gateshead<br />
Procedures list on one afternoon per week inclusive of supervised bone marrow<br />
biopsy