Haematology

Sub-Speciality Training at ST3+

Specialty School of Medicine,

East Midlands Deanery (South)

 

UNIVERSITY HOSPITALS OF LEICESTER NHS TRUST

 

LEICESTER ROYAL INFIRMARY

 

Specialist Training in Clinical and Laboratory Haematology

 

 

This whole-time Specialty Registrar post forms the basis of a training programme in Haematology, leading to CCT.  The post will rotate between the University Hospitals of Leicester NHS Trust, Northampton General Hospital and Kettering General Hospital.

 

The Specialist Training (ST3) programme is normally for a term of 5 years, during which time the Trainee’s work is monitored for evidence of satisfactory progress. Progress will be reviewed after the first six months and once a year thereafter.  The Specialty Registrar will also have a Personal and Professional Development Plan or Learning Contract with regular Appraisals.

 

The rotation is expected to include the following:-

 

            3-month                     Induction course at the Leicester Royal Infirmary

12-18 months           Experience in a District General Hospital, either Kettering General Hospital or Northampton General Hospital.

            3 months                   Regional Blood Transfusion Centre

            36-42 months           University Hospitals of Leicester NHS Trust

 

 

Opportunity will be available by mutual agreement for suitable applicants to take time out from the rotation to complete a period of research and submit a higher degree (MD or PhD).

 

Applicants considering applying for the post on a flexible basis should initially contact the Leicestershire, Northamptonshire and Rutland Deanery for a confidential discussion.

 

The Postgraduate Dean has confirmed that this post has the required educational approval. 

 

In accordance with Department of Health guidance, applications will not be accepted from visiting doctors with less than 12 months permit free stay remaining, and where a visiting doctor is appointed, a contract will not be issued for longer than the duration of his/her permit free period.

 

This Post attracts a National Training Number and provides training towards a Certificate of Completion of Training in Haematology. The laboratories in Leicester. Kettering and Northampton are approved for training purposes by the Royal College of Pathologists, and the post is approved by the Joint Committee for Higher Medical Training.

QUALIFICATIONS/EXPERIENCE REQUIRED

 

Candidates should possess MRCP Part 1 (UK) or equivalent.  Applicants without MRCP Part 1 must provide evidence of appropriate knowledge, training and experience, including two years as an SHO with at least 18 months experience in Acute Medicine including 6 months unselected take.

 

CONTRACTED HOURS

                                                                        Leicester        Kettering        Northampton

 

Basic Hours:                                                 40                    40                    40

                                                                       

LEICESTERSHIRE HEALTH

 

Leicester has three acute teaching hospitals: Leicester Royal Infirmary, Leicester General Hospital and Glenfield Hospital. Together they make up the University Hospitals of Leicester NHS Trust. The Accident and Emergency Department is sited at the Leicester Royal Infirmary as are the Haematology and Clinical Oncology Services.

 

The Trust is currently planning a major reconfiguration of its services.  This involves proposals for a Centre for Planned Care on the site of the Leicester General Hospital with the establishing of the Leicester Royal Infirmary and Glenfield Hospitals as sites delivering emergency services.  The detail of services to be placed on each of these sites is currently the subject of debate with particular involvement of clinicians.

 

The population served is approximately 900,000.

 

LEICESTER ROYAL INFIRMARY

 

 

This is a large busy teaching Hospital with 1162 beds. The Hospital houses both Medical and Surgical Specialties along with Obstetrics, the Children’s Hospital and Haematology and Clinical Oncology.  It is also the site of the A&E Department. The Hospital is housed in several purpose built facilities which include the Sandringham and Osborne Buildings.

 

The Osborne building houses the Directorate of Cancer Services and Clinical Haematology. This includes in-patient, daycase and out-patient facilities. The Bone Marrow Transplant Unit is in a separate dedicated area in the adjacent Windsor Building.

 

The haematology laboratories are located in the Sandringham building along with the secretaries and offices of the Haematology Medical staff including the Registrar’s room.

                                                        

 

 

 

LEICESTER GENERAL HOSPITAL and Glenfield hospitals

 

These two large Hospitals provide comprehensive facilities for a wide range of Specialties.  For example the Renal Unit at the Leicester General Hospital and the Cardiothoracic Unit at the Glenfield Hospital.  Each site has a fully staffed acute Haematology Laboratory which is supported by the Medical staff based at the Leicester Royal Infirmary.

 

THE WORK OF THE HAEMATOLOGY DEPARTMENT IN LEICESTER

 

The Department of Haematology is part of the Directorates of Pathology and Cancer Services and Clinical Haematology within The University Hospitals of Leicester NHS Trust.

 

The Department is based for its laboratory and clinical work in the Leicester Royal Infirmary.  The laboratory space is located in the Sandringham Building. Automated haematology processes have merged with automated biochemistry tests in a ‘Fast Track’ laboratory.  The work pattern in Haematology, Blood Transfusion and Coagulation is fully computerised.  The computer is a Hewlett Packard with APEX software.  The Haematology laboratories at Leicester General Hospital and Glenfield Hospital are on line.

 

Thirteen hundred blood count samples are processed on an average day and 54,000 units of blood used per annum.

 

The clinical service is located in a new purpose built facility, the Osborne building and is adjacent to the laboratories.  The clinical service is divided into Haemostasis and Thrombosis, stem cell transplantation, in-patient, daycare and out-patient areas.

 

The Haemostasis and Thrombosis service covers both the community and hospital based care of patients with coagulation defects and anti-coagulant monitoring. Each hospital site has anti-coagulant clinics run by nurse practitioners and clinical assistants and there is a community based service run in partnership with the PCT’s. The Leicester Comprehensive Care Centre for Haemophilia is sited in the Osborne Building.  There are 3 full-time Clinical Nurse specialists, a dedicated physiotherapist, a data manager and a thrombosis nurse.   There are 400 patients registered with bleeding disorders, and a greater number with thrombotic disorders. A weekly Obstetric clinic is held in the Women’s Hospital by Dr Pavord and Mrs Oppenheimer. The Department is also involved with providing a DVT diagnostic and management service available to both GP’s and hospital staff.

 

The Clinical Haematology Service provides in-patient, daycase and out-patient care for patients with both malignant and benign haematological disorders. Clinics are held every day. Many clinics are orientated to specific disease states such as haemoglobin disorders, immunohaematology, stem cell transplantation, myeloma and lymphoma. There is a busy daycase unit with 5,000 attendances per annum; for patients leading transfusion lives, out-patient chemotherapy, therapeutic phlebotomy, bone marrow examinations etc. The in-patient facilities include 22 beds on the haematology ward and 4 Transplant beds. There is, therefore, extensive opportunity to gain clinical experience.

 

Paediatric Haematology is run within the Children’s Hospital at the Leicester Royal Infirmary. There are purpose built facilities for the care of children with leukaemia and other malignancies requiring chemotherapy.

 

MEDICAL STAFFING

 

Consultants

 

Dr A. Rejman, MD (Lond), FRCP, FRCPath Head of Service

Dr. C. S. Chapman, FRCP, FRCPath

Dr. A. Hunter, FRCP,  FRCPath  Director of Transplantation

Dr M Garg, MD, MRCP, MRCPath           

Dr. E. Psiachou-Leonard, FGHA, MRCPCH, MRCPI, FGPA, Paediatric Haematology

Dr. B. Kennedy MRCP, MRCPath – Head of Lab Haematology

Dr. F. Miall, MRCP, MRCPath

Dr. H. Qureshi, MRCP, MRCPath (UK)

Dr. S. Pavord, MBChB, FRCP (UK), MRCPath Director of Haemophilia

Dr J van Veen, MRCPath

 

Academic Staff

Prof. M.J.S. Dyer, PhD, FRCP, FRCPath

 

Associate Specialists

Dr P. Mensah, MRCP(UK), Haemostasis and Thrombosis

Dr G Asagba, MRCP(UK), Dip RCPath, General Haematology

 

Junior Staff

 

This post is 1 of 9 full-time Higher Specialist Trainees

2 Part-time flexible specialist trainees

2 Haematology CMT posts – part of the General Medicine rotation.

2 FY2 Doctors

2FY1 Doctors

 

Laboratory scientific staff

 

4          Process Managers (Transfusion and special haematology, Fast track Laboratory, Leicester General Hospital, Glenfield Hospital)

3          Specialty managers (Haemostasis and special haematology, haematology Fast Track and Blood Transfusion)

15        Senior Medical Laboratory Scientific Officers    -           MLSO 2

25        Basic Grade Laboratory Scientific Officers         -           MLSO 1

3          Trainees                                                                   

9.5       MLA

3.5       WTE Secretaries


Kettering General Hospital

 

Kettering

 

Kettering is situated in the North of Northamptonshire and the surrounding area includes the market towns of Corby, Rushden and Wellingborough, together with a variety of smaller towns and attractive villages.  Northants, the” “Rose of the Shires” is in the heart of England between the industrial Midlands and East Anglia.  The A14, which links the M1 and A1, passes near the hospital and provides easy access to London, Leicester, Birmingham and Cambridge.  There is a frequent fast train service to London and there are three international airports within an hour’s drive.

 

Kettering General Hospital

 

Kettering General Hospital NHS Trust is has 520 beds.  It provides for the north and east of the county with all of the acute services that would be expected of a hospital of its size including ICU and satellite dialysis unit.  The population served is approximately 279,000.

 

Most of the hospital is of relatively recent construction and there are excellent laboratory and radiology facilities on site.

 

As part of the Leicestershire, Northamptonshire and Rutland Strategic Health Authority, Kettering has well developed links with Leicester Medical School, receiving medical students, pre-registration house officers and Specialist Registrars in several disciplines.

 

Kettering General Hospital  Department of Haematology

 

Consultant Staff

Dr H Kelsey FRCP FRCPath

Dr M Lyttelton FRCP FRCPath

Dr I Wilson-Morkeh FRCPath

Dr M Kwan MRCPath

 

Junior Staff

1 SpR

1 SHO

 

Nursing Staff

4 chemotherapy nurses (shared with oncology)

3 anticoagulant nurses

1 transfusion specialist nurse

 

Technical Staff

Senior Chief BMS4

2 Chief BMS3

3 Senior MLSO2

7.5 BMS1

5 MLA’S

 

Laboratory Services

The laboratory is a fully integrated clinical laboratory housed in a single area, supporting Kettering General Hospital, the Woodland Hospital, Rockingham Forest NHS Trust (Community), and the local General Practitioners.  There are 2 satellite laboratories in Corby and Wellingborough. The laboratory is equipped with 2 Sysmex XE2100 automated blood counters, 2 Sysmex CA1500 coagulation instruments, a Coulter flow cytometer, and Toseh G7 HPLC for Haemoglobinopathy work. The Transfusion laboratory has recently adopted a system of electronic blood issue.  The laboratory is fully computerised (Telepath) with direct links to general practice, and a comprehensive ward Results Reporting System.  The laboratory is managed within the Pathology Directorate.  All Departments are fully CPA accredited. Current annual workload consists of approximately 200 000 FBC’s, 50 000 ESR’s 22 000 coagulation screens and 19000 cross matches.

 

Clinical Services

Clinical Haematology is managed as a free standing minidirectorate with a 9 bed in-patient unit on Lilford ward with dedicated haematology nursing staff and 4 side rooms and a recently constructed dedicated Day Case Unit (Centenary Wing) for out-patient chemotherapy, clinics and day case procedures.  The Department meets category II BCSH standards for inpatient care.  A full clinical Haematological service is provided except for Transplantation procedures and treatment of young leukaemic patients, both of which are referred to the Leicester Royal Infirmary.  The Department supports six haematology clinics and additional daycase sessions.

The Haemostasis and thrombosis service supports all in-patient anticoagulation, and hospital and peripheral anticoagulant clinics.  The Service is fully computerised with Dawn software and supported by 3 WTE anticoagulant nurses.  The Service also supports a District wide domiciliary service, and a policy of selective immediate outpatient treatment of deep vein thrombosis.  There is a weekly thrombophilia clinic. The Department is a recognised Haemophilia Centre and the treatment of patients with haemophilia and other bleeding disorders is shared with the Churchill haemophilia Comprehensive Care Centre in Oxford.

 

 


Northampton General hospital NHS Trust

 

The Hospital

 

Northampton General Hospital serves a population of approximately 320 000 including Northampton town and South Northamptonshire.  An acute Trust since 1994, the hospital 700 beds and provides a full range of acute services. The Trust is a Cancer Centre providing services for patients in Northamptonshire and Milton Keynes.

 

There is a well equipped Post-Graduate medical Centre and Library, with an active Post-Graduate teaching programme. Plans are afoot to make Northampton General a DGH Teaching Hospital.

 

There is a comprehensive laboratory (CPA accredited) and clinical haematology service (Level 3). Laboratory services fall within the Directorate of Pathology. Clinical services are provided in conjunction with the Department of Oncology. The Haematology ward is shared with Oncology.

 

Laboratory

 

The laboratory is CPA accredited and is situated in the main hospital block next to the clinical haematology areas. The department handles approximately 250 000 requests a year ad issues around 12000 units of blood. Workload comes from within the hospital, local GP’s and nearby Princess Marina, St Andrew’s and the Three Shires Hospitals.

 

The Department is well equipped. Automated blood analysis is performed using 2 ABX Pentra 120 analysers, and coagulation/haemostasis work on 2 Sysmex CA1500 analysers. ESR’s are automated using the Starrsed Compact. Haemoglobinopathy investigation is carried out using the Variant 2 HPLC (also HbA1c’s). Ferritin, B12 and folate assays are carried out in the biochemistry laboratory. In addition, we have a Coulter EPICS FACS machine for immunophenotyping. Blood grouping and screening is performed using an Autovue analyser with immediate-spin cross-match. Anticoagulant clinics use near patient testing technology.

 

This year a combined biochemistry/haematology reception and laboratory has been completed, with plans to combine automated routine analysis. Technical staff include:

 

            1 BMS 4

            3 BMS 3

            4BMS 2

            10 BMS 1

            7 MLA’s

            12 (WTE) phlebotomists

 


Clinical haematology

 

Consultant Medical Staff at NGH

 

            Dr. Hamish Ross

            Dr. Archie Haines

            Dr. Sonia Swart

            Dr. Angela Bowen

 

 

The department of haematology has its own outpatient area for 8 adult clinics a week. There is a weekly joint Paediatric haematology clinic which takes place in children’s outpatients.

 

There are 2 anti-coagulant clinics and an outpatient DVT service run by nursing staff (5WTE).

 

We have a treatment area for examining patients and performing procedures. The clinic nurses (4WTE) carry out venesections and give outpatient chemotherapy and transfusions in this area.

 

Haematology inpatients are cared for on Talbot-Butler ward, a joint haematology and oncology ward adjacent to the outpatient clinic. It has 24 beds, with 16 single rooms. 4 SHO’s (2 haematology and 2 oncology) cover the ward during the day and out of hours. A staff grade in Oncology participates in the SHO on call rota. SHO’s currently see new patients/admissions in the clinic.

 

The Department provides a comprehensive clinical service to the hospital and general practitioners. The full range of haematological conditions is catered for, at service level 3.

Approximately 10 peripheral blood stem cell transplants are performed per annum.  The leucopheresis service is provided by Leicester.  The department is a Haemophilia Centre. Paediatric haematology is managed jointly by ourselves and the paediatricians.  Haem-oncology shared care is provided by Birmingham Children’s Hospital.

 

 


DUTIES OF THE POST

 

The Leicester Royal Infirmary

 

Induction

 

All newly appointed ST3 postholders will undergo a period of induction training at the Leicester Royal Infirmary in line with the curriculum set out by the SAC in Haematology and JCHMT.  This will introduce the SpR to safe laboratory practice and basic diagnostic skills relating to laboratory work such as morphology and interpretation of coagulation tests.

 

Clinical and Laboratory

 

The Specialist Registrars rotate through each of the specialist areas within the Department.  This includes laboratory, haemostasis and thrombosis, paediatric and clinical haematology. The adult unit is divided into myeloma, lymphoma and stem cell transplant teams. For examples of the working week within each area please refer to the appendix.

 

During each attachment the Specialist Registrar is expected to take a full role in the work of the Department and to achieve specific targets as set out in the JCHMT curriculum in Haematology.

 

The laboratory work includes the development of skills to enable the reporting of abnormal blood films, bone marrow aspirates and trephines, the interpretation of cytogenetic and immunological features of haematological disease. The post holder will be expected to develop an understanding of laboratory procedures and practices, including the investigation of abnormal haemoglobins, coagulation, and transfusion problems and to advice to laboratory and other staff on the interpretation of laboratory results.

 

The clinical department has out-patient, in-patient and daycase facilities.  The Specialist Registrar will be responsible for the assessment and management of patients within all 3 areas under the supervision of the appropriate consultants. They will also be responsible for teaching and supervising both SHO’s and PRHO’s working within the team.

 

The Specialist Registrar will be involved in undergraduate teaching and case presentations.  The Specialist Registrar will be expected to take an active part in the audit programme of the Department and to attend the Audit meetings held each month.  The Specialistic Registrar will also be expected to keep their log book up-to date for regular review to ensure satisfactory progress is being achieved and targets met.

 

Research

 

Opportunities are available for research in either laboratory, molecular or clinical Haematology.  There are current studies on thrombosis and hypercoagulability; haemoglobinopathies - incidence and molecular structure; erythropoietin and bone marrow culture; myeloma stem cells; apoptosis in CLL; genetic manipulation of leukaemia blast cells and lymphoma molecular biology.

 

 

Location of Duties in Leicester

 

As will be apparent from the foregoing, the Specialist Registrars are located primarily in the Department of Haematology at the Leicester Royal Infirmary but occasional visits to, for example, the Leicester General Hospital, Glenfield Hospital and other Units in the Health District may be required.

 

Blood Transfusion Service

 

The Regional Blood Transfusion Service is located in Sheffield.  A four week course in Transfusion is held each year and the SpR will be expected to attend this course prior to sitting the MRCPath Part 1 examination.  In Year 4 or 5 a further two month period is spent in the Regional Transfusion Service Centre to complete Transfusion training prior to the MRCPath Part 2 examination.  The SpR will be expected to take part in the Transfusion on call medical rota to gain valuable experience in the field of Transfusion.

 

Kettering General Hospital

 

Training Objectives

To obtain a sound working knowledge of laboratory and clinical haematology typical of a District General Hospital

Teaching and responsibilities will be adjusted to match the stage in the rotation of the individual post holder

 

Formal teaching arrangements

One afternoon a week for self directed learning/reading/audit work

Weekly topic teaching from consultant staff

Weekly supervised reporting of bone marrow reports and selected blood films

Monthly journal club

Attendance at Specialist Registrar teaching in Leicester each week

 

Opportunities

Undergraduate teaching

MRCP teaching

Case presentations and clinical review within the Medical Unit Friday afternoon postgraduate meeting

Audit

Attendance of Directorate and Laboratory Management meetings as an observer

 

Duties and Fixed Commitments

The exact timetable will be adjusted to suit the experience and requirements of the individual and the stage in their training, but will be based around:

  • Overseeing the management of haematology inpatients and day case patients, including a daily ward round and direct supervision of the Haematology SHO
  • Taking ward referrals
  • Participation in 2 full clinics each week selected from:
      • General haematology clinics (Wed pm; Fri am)
      • Lymphoma clinic (Tues am)
      • Haemostasis clinic (Wed am)
      • Haemoglobinopathy clinic

 

  • Responsibility for weekly bone marrow biopsy list
  • Laboratory work including
      • Reporting of blood films and bone marrows with review of final reports of all bone marrows and selected film reports in a supervised session with consultant
      • Allocated time in Transfusion and Haemostasis Laboratories
  • Clinical and Laboratory meetings
      • Radiology meeting alternate (Thursdays 0830)
      • Anticoagulant service meeting (monthly Thursdays 0830)
      • Laboratory  management meeting (monthly Thursday  0830)
      • Grand Round (Thursday  0930)
      • Morphology meeting (Thursday 1230)
      • Paediatric haematology meeting (monthly Thursday 1300)
      • Combined Histopathology meeting (Friday 1300 alternate weeks)
      • Audit/Journal club (monthly Friday 1300)

 

 

Northampton General Hospital

 

Training

 

Training will be provided in all aspects of laboratory and clinical haematology including morphology, laboratory techniques and management.  Specific training in transfusion and coagulation can be incorporated as required.  Access to haematology journals is available within the department and through the library.  A half-day for private study/research/audit will be included in the timetable.

 

Teaching

 

There is an active Postgraduate medical education programme, in which the Specialist Registrar would be expected to take part.  The department is committed to Audit and involvement would be encouraged.  Medical students visit in 8 week blocks from Leicester Warwick Medical School.  Assistance with their teaching would be anticipated.

 

On-Call

 

The Specialist Registrar would be expected to join the Consultant’s on-call rota which would then be 1 in 5, with Consultant cover.  A daily ward-round at weekends is expected.

 

 

Timetable (provisional)

 

 

Monday

Tuesday

Wednesday

Thursday

Friday

AM

Ward round

 

AB clinic

 

XR meeting *

Ward MDM

SS clinic

Ward

Round

AH clinic

Laboratory

teaching

 

PM

Lab work

Ward round

Histopath

MDM *

Protected

Time

Ward round

 

  • 2nd /4th Wednesday of month
  • Physicians’ teaching Wednesday 2-4
  • Consultant’s meeting 2nd/4th Wednesday of month 1-2

 

STUDY AND TRAINING

 

The posts are recognised for postgraduate training.

 

Specialist Registrars are expected to attend a four week Advanced Course in Transfusion Medicine for the Part I MRCPath and a further 2 months attachment in the fourth year at the Trent Regional Transfusion Centre. The statutory study leave period may be utilised for attendance at appropriate courses in consultation with the Consultant Haematologist and in consultation with the Regional Haematology Education Committee. 

 

There is a weekly education programme for the Specialist Registrars on a Monday afternoon. The programme covers the areas set out in the JCHMT curriculum for training in haematology. Weekly morphology sessions and seminars are held within the Department of Haematology.

 

A half day study is timetabled every week for Research, audit and private study.

 

LIBRARY FACILITIES

 

Current Haematological texts, both clinical and technical, are kept within the department.  The Clinical Sciences Library of the School of Medicine, which offers extensive borrowing and photocopying facilities, MedLine etc, is located 50 metres away on the Royal Infirmary campus.  Libraries are present at the Leicester General Hospital, Glenfield Hospital, Northampton and Kettering Hospitals.

 


Other Facilities

 

The Medical School Library in included in the Clinical Sciences Building at the Leicester Royal Infirmary.

 

There is a Postgraduate Medical Centre situated at the Leicester Royal Infirmary, which has a large Lecture Theatre, Seminar Room, Laboratory and a Museum. Lectures on all topics are held regularly.

 

There is a weekly postgraduate clinical presentation or lecture on Fridays, in addition to many other postgraduate activities.

 

The Leicester Royal Infirmary is situated approximately 400 yards from the main city shopping centre.  It has its own staff multi-storey car park.

 

The Leicester General Hospital is approximately 4 miles from the main city centre and has ample car-parking facilities.  It is also served by an excellent public transport service.

 

Glenfield Hospital is approximately 2 miles from the main city centre and also has its own car parking facilities.  The hospital is also covered by the public transport service.

 

 


LEICESTER WARWICK MEDICAL SCHOOLS

 

School of Medicine

 

Dean: Professor Ian Lauder, MB BS, FRCPath, FMedSci

 

As part of the School of Medicine’s commitment to the maintaining and improving on its existing high standards of research and teaching, it has recently carried out an extensive restructuring process.  There are five substantial academic departments, defined primarily by their research interests and spanning the traditional clinical subject areas. These are Cancer Studies and Molecular Medicine (Head: Professor W P Steward); Cardiovascular Sciences (Head: Professor N J Samani); Health Sciences (Head: Professor R H Baker); Infection, Immunity and Inflammation (Head: Professor P W Andrew); and Medical and Social Care Education (Head: Professor S Petersen). 

 

These Departments are able to bring considerable intellectual resources to bear on a range of vital medical challenges and reflect the priorities of the National Health Service. They provide a stimulating environment for research and for study at all levels, and offer a wide range of opportunities for professional training and development.

 

In addition to the departments there are newly formed clinical divisions, which bring together clinical academics from cognate specialties, and whose role is to co-ordinate links with NHS colleagues, the Royal Colleges and postgraduate medical education. There are clinical divisions for Anaesthesia, Critical Care and Pain Management; Child Health; Epidemiology and Public Health; General Practice and Primary Health Care; Medical Physics and Radiology; Medicine; Obstetrics and Gynaecology; Oncology; Pathology; Psychiatry; and Surgery, Orthopaedic Surgery and Ophthalmology.

 

The Leicester Warwick Medical Schools

 

The Leicester Warwick Medical Schools were established formally on 1 March 2000, in order to create the additional capacity needed to support the Government programme for increasing nationally the numbers of medical graduates. For the past 25 years, the University of Leicester has admitted students to a five-year MB ChB undergraduate course.  The Leicester Warwick Medical Schools have introduced new four-year graduate entry streams recruiting from Biological Sciences for the Warwick campus and in 2003 from Health Sciences at Leicester.   The four-year students undertake a shortened Phase I of the course (one and a half years), compared to two and a half years for the non-graduate direct entry students based on the Leicester campus.   All students undertake a common Phase II.   The pre-existing Leicester curriculum is followed.

 

The total annual intake of medical students was 303 in 2001and this has risen to 403 in September 2003 resulting in an MB ChB student population of 1,800.  Sixty-four graduate entry students enrolled on the Warwick campus in September 2000 & a further 128 in September 2001, rising to 164 in September 2003.   The expansion at Leicester has resulted from an annual intake of 64 Health Sciences graduates, which commenced in 2003. 

 

The Leicester Warwick Medical Schools comprise the School of Medicine at the University of Leicester and the School of Medicine at the University of Warwick.  The Dean is an employee of the University of Leicester, but has responsibility for both Schools.  The Dean leads an Executive Management Team of the Leicester Warwick Medical Schools consisting of a Vice-Dean at each University, the Head of Medical Education, and the Secretaries of the Leicester and Warwick Schools.

 

The NHS in Leicestershire & Rutland

 

There has never been a more exciting time to be involved in the delivery of healthcare in Leicestershire & Rutland.

 

Healthcare in the two counties that the University Hospitals of Leicester NHS Trust serves will be transformed and modernised over the next 10 years.  Already a Strategic Outline Case for the reconfiguration of acute services has been approved by the Regional Office and work is fast progressing towards the completion of the Outline Business Case for a £286m project which will increase bed stock from the current 2,400 to well in excess of 2,700.

 

This capital project, which will be one of the biggest in the country, will see significant positive changes at the Trust’s three prestigious teaching hospitals including the creation of a centre of excellence in the delivery of planned care and rehabilitation at the Leicester General Hospital and the concentration of acute services on the Leicester Royal Infirmary and Glenfield Hospital sites.

 

These exciting developments will be supported by the substantial linkage with the Leicester Warwick Medical Schools, and with De Montfort University in respect of nursing and midwifery training.

 

The Strategic Health Authority (commenced 1 April 2002) covers Leicestershire, Northamptonshire and Rutland and serves a population of in excess of 1.5m.

 

The counties of Leicestershire & Rutland are served by six Primary Care Trusts/Groups with each having a defined group of services for which it acts as host and this includes responsibilities for the community hospitals within the county boundaries.

 

The Leicestershire Partnership NHS Trust (commenced 1 April 2002), established from the former mental health and learning disabilities service, completes the health services picture for the two counties.

 


POSTGRADUATE TEACHING

 

Trent Region is committed to developing postgraduate training programmes for both general and higher professional training as laid down by Colleges and Faculties, and by the Postgraduate Deans’ network.  At local level, college/specialty tutors work with Unit Postgraduate Clinical Tutors in supervising these programmes.  Trainees will be expected to take part in these programmes (including audit) and to attend appraisal, feedback and counselling sessions/professional review.  Study leave will form part of these educational programmes and will be arranged in conjunction with the appropriate tutor.

 

CONDITIONS OF SERVICE

 

The appointment is subject to the Terms and Conditions of Service of Hospital Medical and Dental Staff (England and Wales) as amended from time to time and also such other policies and procedures as may be agreed by The University Hospitals of Leicester NHS Trust.

 

The successful candidate, although contracted to The University Hospitals of Leicester NHS Trust, will work in Leicestershire and Lincoln.  As a consequence he/she is expected to be aware of local policies and procedures and take note of the standing orders and financial instructions of these hospitals.

 

Salary

 

The nationally agreed pay scale for this grade is payable.

 

Medical Examination

 

This appointment is subject to medical fitness and the appointee may be required to undergo a medical examination and chest x-ray and will be expected to produce a certificate of Hepatitis-B Immunisation or be prepared to be screened.

 

HEALTH & SAFETY

 

The University Hospitals of Leicester NHS Trust recognises its duties under the Health and Safety at Work Act 1974 to ensure, as far as is reasonably practicable, the health, safety and welfare at work of all its employees and, in addition, the business of the Trust shall be conducted so as to ensure that patients, their relatives, contractors, voluntary workers, visitors and members of the public having access to hospital premises and facilities are not exposed to risk to their health and safety.

 

The duties of this post may require the postholder to carry out exposure prone invasive procedures on patients of The University Hospitals of Leicester NHS Trust.  In order to protect its patients from acquiring blood borne viral infections from staff  it is required that the following conditions be met before appointment to the post is made:

 

1.                  The candidate must provide documentary evidence to the Occupational Health Service as part of pre-employment screening of immunity to Hepatitis B infection, either by immunisation or natural immunity.  If the candidate is non-immune The University Hospitals of Leicester NHS Trust will require a blood test to be carried out for Hepatitis B antigen before appointment.  The duties of this post are such that no Hepatitis B antigen positive candidate could be appointed.

 

2.         Any appointee who is not immune to Hepatitis B, but is currently carrying out exposure prone invasive procedures, accepts that regular checks on Hepatitis B markers may need to be carried out by the Occupational Health Service appointed by The University Hospitals of Leicester NHS Trust.

 

The tests can be arranged, if the candidate agrees, in confidence through a local consultant microbiologist or the Occupational Health physician.  All costs for testing will be borne by The University Hospitals of Leicester NHS Trust.

 

Residence

 

This is a non-resident post.  Irrespective of his/her place of residence it is the responsibility of the appointee to ensure that when on-call he/she will be available by telephone and able to reach the hospital in time to meet his/her clinical commitments.

 

Removal Expenses

 

Removal expenses on appointment may be paid in accordance with the provisions of the Terms and Conditions of Service of Hospital Medical and Dental Staff (England and Wales) which should be read in conjunction with Section 26 of the General Whitley Council Conditions of Service.

 

Accommodation

 

The three Leicester acute hospitals are extremely short of married accommodation, and this cannot be guaranteed. 

 

The three Leicester hospitals only pay abatements when you are living and working at the same hospital.  If you choose not to move in the course of a rotation you will lose your abatement.

 

For details regarding hospital accommodation or married accommodation, enquiries should be made to the appropriate Medical Staffing Officer.

 

Study Leave

 

This is granted in accordance with the recommended allowance (A Guide to Specialist Registrar training MD 2/96) This can either be day release with pay and expenses for the equivalent of one day a week during university terms; or leave with pay and expenses within a maximum calculated at a rate of thirty days in a year, subject to the maintenance of the service and to prior formal approval by the Clinical Tutor.

 

 

Criminal records Check

 

This post requires a enhanced disclosure by enhanced criminal records certificates as this post is regulated by the Protection of Children Act 1999, The Criminal Justice Courts Act 2000 and / or the Care Standards Act 2000 and such other authority committed by statute.

 

Failure to disclose details if you are currently / or in the future are the subject of police investigation / proceedings which could result in a conviction, caution or bind over order is a disciplinary matter, and may result in dismissal.

 

Notification of Termination of Employment

 

Specialist Registrars are required to give The University Hospitals of Leicester NHS Trust a minimum of three months’ notice of termination of their employment.  Only in exceptional circumstances will less than three months’ be allowed.

 

Contact

 

Further information about the training programme can be obtained by contacting:-

 

Dr. A. Hunter

Consultant Haematologist

Department of Haematology

The Leicester Royal Infirmary

University Hospitals of Leicester NHS Trust

Leicester

LE1 5WW

 

Tel: (0116) 258 6602


Appendix 1

 

Higher Specialist Training Programme For Haematology

The Leicester Northampton and Rutland Rotation

 

This programme will include both clinical and laboratory aspects of haematology, in keeping with the JCHMT's core training programme for Haematology.

 

The Trainee will keep a training record, with regular assessments throughout the rotation, carried out by the trainer, Chief MLSOs and representatives of the JCHMT, Royal College of Pathologists and PostGraduate Dean.  Appraisals will be carried out at six-monthly intervals.  The final assessment will be the MRCPath Part II examination.  The Trainee will be based at the Leicester Royal Infirmary. At least one year will be spent in a District General Hospital and a total of 3 months at the NBS, Trent Centre, Sheffield.

 

Induction Programme - 3 months

 

This period will include 4 weeks training in general haematology and morphology, 2 weeks blood transfusion, 2 weeks coagulation.

 

District General Hospital Experience

 

The Specialist Registrar will rotate to either Northampton General or Kettering General Hospital in Year 1 or 2 for 6 months experience in a District General Hospital and again in Year 4 or 5 to give a total of 12 months experience.

 

Blood Transfusion Training

 

The post holder will be expected to attend a one month training course in Blood Transfusion prior to the MRCPath Part 1 examination and a further 2 months in Year 4.  This experience is usually completed in Sheffield.

 

Teaching Hospital Experience

 

In Leicester the Specialist Registrar will rotate between the different posts listed below to ensure a good grounding in each specialist field. The rotation includes experience in myeloma, lymphoma, acute leukaemia, laboratory, Haemostasis and Thrombosis, stem cell transplantation, liaison and general haematology and paediatrics.


 

Timetable for Specialist Registrars in Haematology in Leicester

 

 

 

 

Lymphoma

myeloma

Laboratory/

Liaison 2 posts

Haem/Thromb

BMT/AL

Paeds

Monday

AM

Ward

Ward 

Immunohaem clinic 

Centre

BMTU

Paed ward round/ Adult New patient clinic (Alternate weeks)

PM

4-5pm

Teaching

Ward

Teaching

Ward

Teaching

Lab

Teaching

Centre - meeting

Teaching

Lab

Teaching

Lab

Tuesday

AM

CLL Clinic

Ward Round

Lab

SP Clinic

BMTU

Lab

Marrow List/ Lab

PM

4pm

Ward Round

Lymphoma MDT

Study

Lab

Centre/Lab

 

Paed MDT/Lab

Wednesday

AM

Lymphoma Clinic

Ward

Study

 

Haem/Obs or Haemostasis clinic

BMTU MDT/ Clinic           

Leukaemia Clinic/ Lab

PM

Ward

Myeloma MDT/ Gen Haem Clinic

Lab

Study

Study

Lab

Thursday

AM

Ward

Myeloma Clinic

Lab/LP/Harvest

Clinic

BMTU

Lab

PM

Study

Ward

Lab

Clinic

AEH clinic

 

Paed Clinic

Friday

AM

Ward Round

Ward Round

MPD Clinic

Centre/Lab

BMTU Ward Round

 

Haemoglobinopathy Clinic/Lab

PM

Ward/ Chemo prescribing

Ward/ Chemo prescribing

Lab

Centre/Lab

management

Study