Consultant physicians working with patients - Royal College of ...

More documents

Recommendations

Info

2 Specialties Medical oncologyset by the ACP and the medical oncology specialistadvisory committee (SAC).The academic nature of medical oncology is recognisedwithin the curriculum and the award of a Certificate ofCompletion of Training (CCT) recognises time spent inresearch. In addition, the National Institute for HealthResearch (NIHR) has established a number ofacademically based training opportunities in which 30current trainees have basic and translational researchembedded in their training programme.Clinical governanceWith its tradition of audit and research, medicaloncology is strongly oriented towards maintainingclinical standards and effectiveness. The rigours ofresearch governance through good clinical practice(GCP), 10,11 which defines standards for the conduct ofclinical research, prepare medical oncologists fordelivery of high standards in routine practice. Medicaloncologists lead and support audits which are anessential part of the peer-review process; these includethe NICE assessment and implementation of new drugs.Research – clinical studies and basic science Medical oncology is a research-based specialty.Therapy is in a constant state of evolution,depending on the latest, validated, clinical research.Medical oncologists must be competent andcommitted clinical scientists, whether working inacademiccentresorcancerunits. Ithasbeendemonstratedthatpatientstreatedwithin a clinical trial fare better. The NationalCancer Research Network (NCRN) has set a targetof 10% of cancer patients to be entered intorandomised clinical trials. All medical oncologistsare expected to support this activity. Many will haveundertaken laboratory research during training(obtaining a PhD or MD) and can develop andsupport translational, pharmacological and basicclinical research.Local, regional and national dutiesMedical oncologists are increasingly involved in rolessuch as: leadership of tumour group at trust or network level leadership and involvement in drug and therapeuticcommittees leadership of acute oncology teams leadership in guideline development clinical service lead/medical director roles regional specialty advisers education programme leadership/trainingprogramme directors educational and clinical supervisors for trainees leads for tumour-specific research groups – local,network and national regional and national committees – RCP, ACP, JCCOand national working parties.Specialty and national guidelinesMost medical oncologists contribute to continuingdevelopment of comprehensive guidelines for themanagement of different cancers through regionalprotocols and national guidelines, often through NICE,IOG, 5 specialist societies, JCCO and NCRN.Medical oncologists have also led work for the ‘Map ofMedicine’ and national information pathways tosupport patients at key points during their cancerjourney, through partnership with Cancer Research UK(www.cancerresearch.org) and Macmillan CancerSupport (www.macmillan.org.uk).Quality tools and frameworksAs indicated in other sections, through development ofrobust databases and prescribing systems andcontribution to the development of guidelines that arefollowed nationally, medical oncologists are at theforefront of creating benchmarks for clinicallymeaningful outcomes through audit, peer review andother quality assessment tools.6 Clinical work of consultantsHow a consultant works in this specialtyThe medical oncologist is the leader and coordinator ofan extended team of professionals through regularMDT meetings, and will attend one or more each weekdepending on the volume of work and sitespecialisation. This should be a maximum of threetumour sites because of the increasing range andcomplexity of treatments and patient numbers.Most cancer patients receive their care in the outpatientsetting and day-care wards. Patients may be admitted fordiagnosis, treatment and management of complications.All medical oncologists manage patients with multiplecomorbidities and treat critically ill patients withoncological emergencies. Medical oncologists supportacute medicine through provision of the acute oncologyservice.C○ Royal College of Physicians 2013 157
Consultant physicians working with patientsTable 1 Sample job plan for consultant medical oncologistActivity Workload Programmed activities (PAs)Direct clinical careOutpatient clinicDay-care ward work3–4 new patient consultations per week: approximately 1 houreach. Routine follow-up of well patients: 10–15 minutes’consultation. Management of patients with relapsed or metastaticdisease: approximately 30 minutesMay form part of a mixed outpatient clinic. Patient assessmentand chemotherapy prescribing: approximately 30 minutes2–41–2Acute oncology 1 or more PAs may be appropriate in some job plans
Page 1 and 2:
Consultant physiciansworking with p
Page 3 and 4:
The Royal College of PhysiciansThe
Page 5 and 6:
AcknowledgementsWe would like to th
Page 7:
AbbreviationsA&EAACsAMUsARCPCCGsCCS
Page 12 and 13:
1 Physicians in the NHS todaycan be
Page 15 and 16:
Consultant physicians working with
Page 17 and 18:
Page 19 and 20:
Page 22 and 23:
2 The work of the specialties2 The
Page 24 and 25:
2 Specialties Acute internal medici
Page 26 and 27:
Page 28 and 29:
Page 30 and 31:
Page 32:
Page 35 and 36:
Page 37 and 38:
Page 41 and 42:
Page 43 and 44:
Page 45 and 46:
Page 47 and 48:
Page 49 and 50:
Page 51 and 52:
Page 54 and 55:
2 Specialties Cardiovascular medici
Page 56 and 57:
Page 58 and 59:
Page 60 and 61:
Page 62 and 63:
Page 64 and 65:
Page 66 and 67:
2 Specialties Clinical geneticsClin
Page 68 and 69:
2 Specialties Clinical geneticsPati
Page 70 and 71:
2 Specialties Clinical genetics6 Cl
Page 72:
2 Specialties Clinical geneticswork
Page 75 and 76:
Page 77 and 78:
Page 80 and 81:
2 Specialties Clinical pharmacology
Page 82 and 83:
Page 84 and 85:
Page 86 and 87:
Page 88 and 89:
2 Specialties DermatologyDermatolog
Page 90 and 91:
2 Specialties Dermatology run monit
Page 92 and 93:
2 Specialties DermatologyDermatolog
Page 94 and 95:
2 Specialties DermatologyTable 1 Ex
Page 96:
2 Specialties Dermatology4 Parkin D
Page 99 and 100:
Page 101 and 102:
Page 103 and 104:
Page 106 and 107:
2 Specialties Gastroenterology and
Page 108 and 109:
Page 110 and 111:
Page 112 and 113:
Page 114 and 115: 2 Specialties Gastroenterology and
Page 116: 2 Specialties Gastroenterology and
Page 119 and 120: Consultant physicians working with
Page 134 and 135: 2 Specialties HaematologyHaematolog
Page 136 and 137: 2 Specialties HaematologyTable 2 A
Page 138 and 139: 2 Specialties Haematologythey have
Page 140 and 141: 2 Specialties HaematologyTable 4 Sp
Page 142: 2 Specialties Haematology11 Departm
Page 160 and 161: 2 Specialties Medical oncologyMedic
Page 162 and 163: 2 Specialties Medical oncologyaroun
Page 166 and 167: 2 Specialties Medical oncologyTable
Page 168 and 169: 2 Specialties Medical ophthalmology
Page 174 and 175: 2 Specialties Metabolic medicineMet
Page 176 and 177: 2 Specialties Metabolic medicineof
Page 178: 2 Specialties Metabolic medicinemet
Page 196 and 197: 2 Specialties Palliative medicinePa
Page 198 and 199: 2 Specialties Palliative medicine-
Page 200 and 201: 2 Specialties Palliative medicineA
Page 202 and 203: 2 Specialties Palliative medicineTa
Page 204: 2 Specialties Palliative medicine24
Page 212 and 213: 2 Specialties Rehabilitation medici
Page 214 and 215:
2 Specialties Rehabilitation medici
Page 216 and 217:
Page 218 and 219:
Page 220 and 221:
2 Specialties Renal medicineRenal m
Page 222 and 223:
2 Specialties Renal medicineLocal a
Page 224 and 225:
2 Specialties Renal medicineInvolve
Page 226 and 227:
2 Specialties Renal medicineAcademi
Page 228 and 229:
2 Specialties Renal medicineTable 1
Page 230:
2 Specialties Renal medicinekidney
Page 233 and 234:
Page 235 and 236:
Page 237 and 238:
Page 239 and 240:
Page 241 and 242:
Page 243 and 244:
Page 245 and 246:
Page 247 and 248:
Page 249 and 250:
Page 251 and 252:
Page 253 and 254:
Page 255 and 256:
Page 257 and 258:
Page 259 and 260:
Page 261 and 262:
Page 263 and 264:
Page 265 and 266:
Page 267 and 268:
Page 270 and 271:
3 Supporting the delivery of high-q
Page 272 and 273:
Page 274 and 275:
Page 276 and 277:
Page 278 and 279:
Page 280:
show all

Consultant physicians working with patients - Royal College of ...

Create successful ePaper yourself

Delete template?

Save as template?