North Bristol NHS Trust

Exceptional healthcare, personally delivered Job Description

Job Details

Job Title: Consultant Paediatric and Perinatal Pathologist

Division: Core Clinical Services

Department: Cellular Pathology

Location/Base: The base for the service will be Southmead Hospital however the post holder will spend part of their time at the Paediatric & Perinatal mortuary in St Michaels Hospital and, to a lesser extent, the Essential Services Laboratory on Level 8 of the Bristol Royal Infirmary.

SECTION 2 – THE WORK OF THE DEPARTMENT

North Bristol NHS Trust is seeking two full-time (10 PAs) Consultant Paediatric and Perinatal Pathologists within the Department of Cellular Pathology.

These replacement posts offer an exceptional opportunity to join the Bristol Paediatric Pathology Service, and to develop specialist diagnostic and research interests with the enthusiastic support of the corresponding clinical teams. The post holders will, with one other full-time colleague, contribute to both the provision of paediatric pathology for Bristol Royal Hospital for Children (BRHC) and the provision of perinatal pathology for St. Michael’s Hospital and the South West Region.

It has been agreed that the future model for paediatric pathology is for all the pathologists to practice in both paediatric and perinatal pathology.

General Information:

Severn Pathology lies at the heart of patient care. Severn Pathology's mission is to provide a best in class, high quality, innovative, value for money pathology service that serves the needs of the healthcare market in the South West region and beyond. In doing so, we strive to put pathology at the heart of a modern patient pathway, serving an increasingly diverse

market. The combination of general pathology services with a thriving and growing genetics laboratory service will ensure continued development of state of the art pathology services in to the future.

On 1 May 2016, North Bristol NHS Trust’s (NBT) Department of Cellular Pathology and the Department of Histopathology at the University Hospitals Bristol NHS Foundation Trust (UHB) merged and co-located the bulk of their services to a new, purpose-built facility on the Southmead Hospital site. The service is managed by NBT which also manages the Essential Services Laboratory and Paediatric / Perinatal mortuary located on UHB premises. The department provides services to the two acute hospital Trusts in Bristol as well as to a number of other local Trusts and other local organisations. From April 2019, the service provided at Weston General Hospital transferred to Southmead Hospital to provide a single Cellular Pathology service for the Bristol, North Somerset and South Gloucestershire (BNSSG) area.

The department has accreditation by UKAS to ISO15189:2012.

Cellular Pathology:

The nature of the work of Bristol Cellular Pathology Service reflects the clinical services in Bristol with both NBT and UHBristol providing secondary care and extensive tertiary and specialist services. Bristol Cellular Pathology Service provides much of the specialist cancer work for the Somerset, Wiltshire, Avon and Gloucestershire (SWAG) Cancer Alliance and therefore a wide range of resections for cancer work are performed in the hospitals. Cases are referred to the Network MDMs requiring review of their pathology. Please see Appendix B for details on departmental workload.

There are specialist renal services for both adults and children including transplants. The Bristol Dental Hospital is a tertiary referral centre for oral medicine, paediatrics and restorative services and is supported by specialist pathology.

The department incorporates the Avon Cervical Screening Service that provides a centralised service for Bristol and surrounding districts. The South West Regional Cytology Training Centre is situated in the laboratory complex.

The Genetics Department is based at Southmead hospital incorporating both conventional cytogenetics by G-banding, FISH, and also molecular genetics by FISH, PCR with facilities for array based analysis at UHBristol there is provision of several GI-related molecular tests, including KRAS and BRAF mutation analyses, and KIT/PDGFRA mutation analyses. Neuropathology, albeit located alongside Cellular Pathology, is currently a separate and independent service affiliated to the Musculoskeletal and Neurosciences Division, and carried out only by specialist neuropathologists.

A new Laboratory Information and Management System (Clinisys Winpath Enterprise) went live across Pathology in October 2016.

Bristol has introduced specialist reporting though the methodology used supports both those who want to maintain a broader range of specialist practice as well as those who wish to work in a smaller number of specialist areas. The consultants are members of one to three specialist teams working to common standards. A number of the consultants support referral practices.

The service monitors its performance using the RCPath KPIs and strives to achieve a satisfactory level of service as measured by these and other criteria.

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There are opportunities to participate in collaboration with several well-established research groups allied to NBT, to UHBristol and/or the University of Bristol.

The job plan which is included with this job description is by necessity indicative only and the candidate will be expected to agree a substantive job plan with the departmental lead at NBT within three months of starting.

Any candidate who is unable to work full-time for personal reasons will be eligible to be considered for the post. If such a person is appointed, modification of the job content will be discussed on a personal basis with the Trust, in consultation with consultant colleagues.

SECTION 3 – MANAGEMENT STRUCTURE

PHE STRATEGIC EXECUTIVE REVIEW OVERSIGHT MEETING GROUP

Severn DIRECTORATE Pathology MANAGER Board

PHE HEAD OF LEAD PUBLIC CLINICAL HEAD OF PATHOLOGY OPERATIONS HEALTH PATHOLOGY SERVICES Jon Turner CONSULTANT MANAGER Professional Accountability David Gibbs

LEAD CONSULTANT SERVICE MANAGER SERVICE MANAGER SERVICE MANAGER SERVICE MANAGER INFECTION SCIENCES INFECTION GENETIC SCIENCES BLOOD SCIENCES CELLULAR SCIENCES Dr Kim Jacobson SCIENCES Lorraine Warne Paul Virgo Andrew Heryet Jon Steer

LEAD CONSULTANT GENETIC SCIENCES Rachel Butler

LEAD CONSULTANT BIOCHEMISTRY Dr Paul Thomas

LEAD CONSULTANT HAEMATOLOGY Dr Alastair Whiteway

LEAD CONSULTANT IMMUNOLOGY Dr Sarah Johnston

LEAD CONSULTANT CELLULAR SCIENCES Dr Nidhi Bhatt

The appointee will be contractually accountable to the North Bristol NHS Trust for the provision of services. The appointee will be managerially responsible to the Chief Executive through the Medical Director and the Clinical Director. All consultants are required to undergo an annual appraisal carried out in accordance with the Trust’s policy.

This is a substantive appointment.

The post holder will be a member of: -

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 The NBT Department of Pathology  The NBT Medical Advisory Committee.  The NBT Core Clinical Services Division

The appointee is expected to participate in delivery of services within their agreed specialties and assist with developing the direction of the future service through liaison with department colleagues and clinical users.

The appointee is required to take an active and co-operative approach to their job planning which will be reviewed on an annual basis by their Divisional Lead. Any dispute that may arise as a result of job planning or any other aspect of the job will be referred to the relevant Medical Director for resolution if they are related to clinical activity and to the Chief Executive if the dispute is around management activity that cannot be solved within the Divisional Structure.

Consultants will, at all times, be expected to have exemplary standards of professional and personal behaviour, and to act as role models within the Trusts. It is a requirement that if the employee has concerns about the professional performance of a member of the medical staff, they have a duty to speak to the person concerned. If the matter is potentially serious or satisfaction is not obtained with a direct approach, such concerns should be discussed with the Trust’s Medical Director. There is a protocol in place in the Bristol Cellular Pathology Service specifically covering this area. The appointee will be expected to be fully involved in the developments of the Speciality, to take account of the Trust policies, including Risk Management Strategy and developments in Clinical Governance.

SECTION 4 – LOCATION

The Paediatric and Perinatal pathologists work across different sites in Bristol. The Core Laboratory is based in Southmead Hospital and an Essential Service Laboratory is based in the Bristol Royal Infirmary. The Paediatric & Perinatal mortuary in located in St Michael’s Hospital. The paediatric multidisciplinary meetings are held in Bristol Royal Hospital for Children (BRHC) and the perinatal meetings are held in St. Michael’s Hospital.

All posts are regarded as being Trust-wide however the base Hospital will be Southmead Hospital. An essential services laboratory remains at the BRI and staff may need to spend time there.

All consultants in cellular pathology in addition to their contract with their employing organisation have an honorary contract in the other Bristol Trust enabling them to work there as required.

SECTION 5 – DUTIES OF THE POST

(i) Clinical Leadership

 To participate in the strategic development of Severn Pathology, in line with the business aspirations of NBT.

 To work with the Clinical Lead for the service on the continued development of cellular pathology services embracing the clinical and operational requirements

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including meeting KPIs and other quality standards and ensuring maintenance of ISO accreditation.

 Represent the department at all appropriate clinical forums necessary to deliver optimum clinical effect.

(ii) Clinical Duties

You will join the team of Consultant Pathologists making up the Cellular Pathology Service. You will be employed by NBT and will be based at Southmead.

The responsibilities of this post include perinatal pathology taking part in the delivery of this service including the perinatal and paediatric autopsy service and the examination of placentae and paediatric surgical pathology. The paediatric histopathology spans a wide range of specialities including paediatric tumours, gastrointestinal biopsies, skin biopsies and general surgical work. The current activity level and case mix is summarised in Appendix B.

On a rotational basis, you will contribute to the clinicopathological and MDT meetings (up to 14 per month) as required and as summarised in Appendix C.

It has been agreed that the best model for the future is for all the pathologists to practice in both paediatric and perinatal pathology.

More specifically as part of your direct clinical care (DCC) you will: -  Work to the standards set by the Cellular Pathology Service described in its policies, protocols and procedures  Cut-up and report specimens as required within your areas of specialist practice. This will include cut-up and reporting of placentas.  Contribute to the running of the MDMs and CPCs as appropriate to your areas of practise  Cover for colleagues' annual leave and other authorised absences  Manage your workload to deliver a safe service to patients

The Trust supports fully the concepts of CPD, clinical audit and EQA and time for undertaking such activities is included in job plans. Therefore, in addition to the direct provision of the diagnostic service the following are other activities in which you will be expected to participate: -  To take part in continuing professional development and to join the RCPath CPD scheme  To audit aspects of your work and to produce or contribute to at least one audit per year relevant to your areas of work  To participate in the Paediatric Histopathology EQA scheme  To use your study and professional leave allowance of 30 days over 3 years to attend relevant professional and educational meetings  To develop and maintain a portfolio of evidence to support GMC revalidation  To undergo an annual appraisal carried out in accordance with the Trust policy.  To contribute to the training and supervision of junior medical staff sharing these responsibilities with your consultant colleagues

The successful candidate will be expected to comply with all relevant Trust policies relating to administration of patient care. Consultants are also expected to work with service managers and clinical colleagues to manage their caseload in a flexible way, to ensure that clinical, national and local priorities are achieved.

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The post holders will be required to split their time between the core laboratory at Southmead Hospital and the Mortuary and to a lesser extent, the Essential Services Laboratory based on UHBristol premises. Majority of their time will be spent at the core laboratory where they will be provided with office accommodation for sole use with appropriate facilities including microscope with imaging facility, computers, and email access to support both management and clinical functions. Specific requirements may be subject to further negotiation and agreement however will necessarily involve IM&T tools and appropriate levels of secretarial support. Office accommodation with similar facilities will also be provided at the other site to enable them to carry out their duties although this may not necessarily be space for sole use.

The specialist team will establish the most effective means of rotating members to provide cover for all aspects of their activity including case review. Digital scanning technology is available to facilitate the sharing of images when individuals are on different sites. It may be that individuals will spend an entire day at one location or, if cross-site travel is required during the day, taxis are available to enable this.

Post-mortems

Paediatric and perinatal post-mortems are performed by the dedicated perinatal pathologists at St Michael’s Hospital. Consented adult post-mortems may also be carried out at this location.

Following a period in which very few paediatric Coroner’s autopsies were undertaken in Bristol, the pathologist currently in post has repatriated much of this work and now undertakes work for Avon Coroner, and other Coroners in the South West and Wales. There is considerable scope to expand this service and there are good links with the clinical teams, including specialist Paediatric Radiologists based at Bristol Royal Hospital for Children.

Adult coronial post-mortems are not performed on hospital premises in Bristol but at a purpose built mortuary operated by Bristol City Council

(iii) Teaching and Supervision of Junior Medical Staff & Students

The Cellular Pathology departments at both NBT and UHBristol have been approved for Higher Specialist Training by the Royal College of Pathologists.

The post holder will be responsible for the professional supervision and management of junior medical staff. Where appropriate, the post holder will be named in the educational contract of junior staff as the person responsible for overseeing their training and as an initial source of advice to such doctors regarding their careers.

In liaison with the Director of Postgraduate Medical Education the post holder may be required to contribute to undergraduate and postgraduate training.

(iv) Study & Research

The post holder can request up to a maximum of 30 days study leave within a 3-year period (pro rata for part-time posts) as stated in the Terms and Conditions of Service. The Trust is committed to ensuring that support is given for Continuing Medical Education. The post holder will be required to fulfil the requirements laid down by the relevant Royal College, and to fulfil the requirements for revalidation laid down by the General Medical Council. There is a budget for study leave of approximately £650

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per Consultant.

The post holder will not necessarily be expected to undertake research however opportunities do exist and encouragement is given to develop collaborative projects with other departments within the Trust or with the University of Bristol and the University of the West of England. The post holder will be required to submit all research development plans which have resource implications to the Clinical Director prior to implementation.

There are professionally staffed Medical Libraries in the Medical Postgraduate Centre at Southmead Hospital, with a rapid service between these and the University Library situated in the centre of Bristol City. A computer literature search facility is available for which a charge is made and the library has links with other networks. The libraries are at the forefront of developments in electronic knowledge delivery.

The Severn Pathology buildings are located in the Science Quarter of Southmead Hospital Site with a large L&R facilitate that contains a permanent University of Bristol presence and a clinical research unit which are laid out in a campus basis.

(v) Audit

The post holder will be required to take part in a Clinical Audit Programme. The Trust has an audit department which supports and monitors such activity. There is an active Trust Clinical Audit Committee.

(vi) Out of hours

NBT runs a Saturday and bank holiday service for urgent renal biopsies. This is currently treated as on-call in the contract though this is under review. If the successful applicant wishes to participate in the rota, it can be arranged.

The work of the department includes the interpretation of frozen sections during Hirschsprung’s disease surgery. There is the possibility that this work will run beyond normal working hours; time is taken back in lieu of any hours worked beyond the normal working day to report these specimens

(vii) Major Incident Or Civil Unrest

In the event of a major incident or civil unrest all trust employees will be expected to report for duty on notification. All Trust employees are also expected to play an active part in training for and preparation or a major incident or civil unrest.

(viii) Privacy & Dignity & Respect and Equality of Opportunity

The Trust is committed to ensuring that all current and potential staff, patients and visitors are treated with dignity, fairness and respect regardless of gender, ethnicity, disability, sexual orientation, age, marital or civil partnership status, religion or belief or employment status. Staff will be supported to challenge discriminatory behaviour.

(ix) Equal Opportunities

The Trust is committed to the development of positive policies and practices to promote equal opportunity and will take all possible steps towards eliminating discrimination and promoting good employee relations and equality of opportunities generally

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SECTION 6 – PROPOSED JOB PLAN

The job plan below is by necessity indicative only and the candidate will be expected to agree a substantive job plan with the departmental lead at NBT within three (3) months of starting.

Any candidate who is unable to work full-time for personal reasons will be eligible to be considered for the post. If such a person is appointed, modification of the job content will be discussed on a personal basis with the Trust, in consultation with consultant colleagues.

Day Time Work Categorisation No. of PAs MONDAY 08.30 – 12.30 Cut up and DCC 1 reporting or autopsy work 12.30 – 13.00 lunch 13.00 – 3.00 Cut up and DCC 0.5 reporting or autopsy work 3.00 – 5.00 Joint meeting SPA 0.5 TUESDAY 08.30 – 12.30 Cut up and DCC 1 reporting or autopsy work 12.00 – 12.30 lunch 12.30 – 2.30 Cut up and DCC 0.5 reporting or autopsy work 2.30 – 4.30 Audit/CPD SPA 0.5 WEDNESDAY 08.30 – 12.30 Reporting MDT DCC 1 prep 12.30 – 13.00 lunch 13.00 – 5.00 Reporting and MDT DCC 1 THURSDAY 08.30 – 12.30 Reporting MDT DCC 1 prep 12.00 – 12.30 lunch 12.30 – 2.30 Reporting DCC 0.5 2.30 – 4.30 Audit/CPD SPA 0.5 FRIDAY 08.30 – 12.30 Cut up and DCC 1 reporting or autopsy work 12.30 – 13.00 lunch 13.00 – 5.00 Cut up and DCC 1 reporting or autopsy work

SATURDAY

SUNDAY

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Predictable Direct Clinical emergency on Care call work Unpredictable Variable Direct Clinical emergency on Care call work (Max per week until 31 March) Total PAs 10

Programmed activity Number Direct clinical care (including unpredictable on-call) 8.5 Supporting professional activities 1.5 Other NHS responsibilities (to be discussed with Clinical Director) External duties (to be discussed with Clinical Director) Total Programmed Activities 10

On Call Availability Supplement Rota Frequency (Schedule 16, para 5) the number of consultants on rota) Frequency of Rota Value of supplement as a % of WT basic salary Commitment (please tick appropriate box) Category A Category B High Frequency: 1:1 to 1:4 8.0% 3.0% Medium Frequency: 1:5 to 1: 5.0% 2.0%  18 Low Frequency: 1:9 or less 3.0% 1.0%

NOTE This is a proposed job plan. Only those times that need to be fixed, such as the start and usual finish times of clinics are detailed. All other times must be discussed with the appointee. The timetable will be reviewed after the appointee has been in post for three months. It must therefore be regarded as a temporary work programme only

INDICATIVE WEEKLY ROTA FOR THREE PAEDIATRIC & PERINATAL PATHOLOGISTS (CONSULTANTS: A, B, C)

The paediatric pathologists cover the service in weekly rotations alternating one week in Paediatric Pathology and one week in Perinatal Pathology. There is a rota to ensure cover of relevant MDT meetings.

CONSULTANT MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY A PAEDIATRIC SURGICALS (BRI) Cover for surgical meetings B PERINATAL WORK (St Michael’s) Cover for perinatal meetings C OFF ROTA (Catch-up with reporting)

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DAY SCHEDULE FOR PAEDIATRIC SURGICAL PATHOLOGY

Time Location Activity 08.30 to 17:00 OFFICE Reporting (NBT or ESL) Paediatric surgical Cut up Urgent biopsies There is no definite cut-off time for the cut-up or the lunch break.

DAY SCHEDULE FOR AUTOPSY & PERINATAL PATHOLOGY

Time Activity 08.30 to 12.30 St. Michael´s Autopsy work Placental cut-up

12.30 to 13.00 Lunch 13:00 to 17:00 OFFICE Reporting (NBT or ESL) Surgical specimens cut-up and urgent biopsies

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SECTION 7 – PERSON SPECIFICATION

Assessment at Shortlisting stage

Category Essential Desirable Scoring Matrix Qualifications Full and specialist registration (and Higher academic Qualifications And with a licence to practise) with the qualification Registration General Medical Council (GMC) (or be (e.g. MD or PhD) eligible for registration within six months of interview) Management qualification Applicants that are UK trained must ALSO be a holder of a Certificate of Completion of Training (CCT), or be within six months of award of CCT or equivalent by date of interview.

Applicants that are non-UK trained, will be required to show evidence of equivalence to the UK CCT

FRCPath or show evidence of equivalent qualification Training Knowledge of the NHS Healthcare Recent experience and Experience And system and of Cellular Pathology familiarity of UK hospital Experience service redesign processes systems and practices (or equivalent). Experience in Paediatric and Perinatal pathology Further Evidence of participation in Clinical Completion of a general Knowledge Training, Audit projects. management course or Management, programme. Audit Awareness of the requirements of clinical governance and experience in merging processes to single system demands Research, Commitment to undertake teaching Published research and Skills Teaching, and training of medical and dental peer review publications Publications undergraduates and postgraduates Experience in the teaching of undergraduates and clinical trainees

Ability to teach effectively

Willingness to lead medical staff and biomedical scientists in research activities Personal Excellent motivational, communication Evidence of attendance Other Requirements and organisational skills. at a healthcare (e.g. management course. Communication Ability to influence peers and previous Leadership experience of engagement with Skills, Flexibility) executive leads of Trust organisations.

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Assessment at Interview stage

Further Training, Evidence of thorough and broad Recent experience and familiarity Management, Audit training and experience in of UK hospital systems and histopathology and cytopathology practices (or equivalent).

Willingness to develop a special interest in Paediatric and Perinatal Pathology

Knowledge and skills Evidence of self-directed learning in Completion of a general developing and maintaining management course or professional skills programme.

Knowledge of evidence based practice

Evidence of performing and contributing to clinical audit projects Understanding of the role of management in running pathology services

Understanding of how teams work Evidence of working constructively with consultant colleagues in pathology Research, Teaching, Commitment to undertake teaching Experience in the teaching of Publications and training of medical and dental undergraduates and clinical undergraduates and postgraduates trainees Demonstrable research experience. Ability to teach effectively

Willingness to assist medical staff and biomedical scientists in research activities. Published research and peer review publications Personal Ability to communicate effectively Requirements (e.g. with clinical colleagues, colleagues in Communication, pathology and support staff Leadership, Skills, Flexibility) Good knowledge of, and ability to use, both spoken and written English Ability to present effectively to an audience, using a variety of methods, and to respond to questions and queries Any other General Ability to fulfil all the duties of the Requirements post, including on-call commitments.

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SECTION 8 - Commitment to Patients, Infection Control, Health and Safety, No Smoking, Confidentiality, Equal Opportunities, Safeguarding

Improving the Patient Experience through your work

Patients are the most important people in the health service and are at the centre of what we do. Patients and carers are the ‘experts’ in how they feel and what it is like to live with or care for someone with a particular illness or condition. The patients’ experience of our services should guide the way we deliver services and influence how we engage with patients every day in our work.

All staff should communicate effectively in their day to day practice with patients and should support and enable patients/carers to make choices, changes and influence the way their treatment or care is provided. All staff, managers and Board members should work to promote effective patient, carer and public involvement in all elements of their work

We have a duty to involve, engage and consult with patients, carers and families about plans for health facilities and the provision of our services. North Bristol NHS Trust wholeheartedly embraces the principles of patient partnership and has made clear its commitment to involve patients in key aspects of its work, which will be further strengthened through becoming a Foundation Trust.

Infection Control

Compliance with all infection control policies and procedures will form an integral part of the practice of all staff working in a clinical environment. Each staff member will be responsible for familiarising themselves with the Infection Control Manual in the clinical areas and on the Trust’s Intranet site. Staff must keep up to date with new policies and subsequent implementation in practice.

Staff must seek support and advice from Infection Control in all instances where cross infection is likely to have occurred or when managing situations involving patients with infections where guidance provided in the Policies is not applicable.

All staff must contact the Occupational Health Dept if they are suffering from any form of infection which may put patients and other staff at risk.

Health and Safety/Security

It is the duty of every employee to work in such a way that accidents to themselves and to others are avoided, and to co-operate in maintaining their place of work in a tidy and safe condition, thereby minimising risk. Employees will, therefore, refer any matters of concern through their respective line managers. Similarly, it is each person’s responsibility to ensure a secure environment and bring any breaches of security to the attention of their managers.

No-Smoking Policy

As an NHS employer, the Trust has a duty to its staff and patients to protect them from the health hazard that smoking represents. Consequently, from 8 March 2006, in line with the public health white paper, Choosing Health, smoking will not be permitted anywhere on Trust property including all buildings, grounds and within leased/owned vehicles of the Trust. This applies to all staff, patients and visitors of the Trust. Failure by staff to comply with this requirement may result in recourse to the disciplinary procedure. Employees also have a responsibility to remind members of the public, visitors and other staff to refrain from smoking on Trust premises and to inform the appropriate manager if they witness repeat non-compliance.

Equal Opportunities

North Bristol NHS Trust has given its full commitment to the adoption and promotion of the key principles of equal opportunities contained within current legislation and the Trust’s Equal

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Opportunities Policy.

All staff hold personal responsibility for the application of this policy on a day-to-day basis and should not undertake any acts of discriminatory practice during the course of their employment. Similarly all staff have a responsibility to highlight any potentially discriminatory practice to their line manager, human resources department or trade union/professional associations.

Copies of the Equal Opportunities Policy are available in the Personnel Policies and Procedures file in every department and on the intranet.

Harassment and Bullying

We believe that all people, whether staff, patients or visitors, are entitled to an environment in which the dignity of the individual is respected.

We are also firmly committed to promoting an organisational culture which values diversity and equality of opportunity and to preventing discrimination in all aspects of its employment practices and services. We regard harassment and bullying as totally unacceptable forms of behaviour that will not be tolerated or condoned.

The person appointed to this post is reminded this organisation is committed to safeguarding and promoting the welfare of children and young people. It is the responsibility of all staff to be clear about appropriate and inappropriate practice and further information on ‘Guidance for Safer Working Practice for Adults who Work with Children and Young People, Nov 2007 can be found at www.everychildmatters.gov.uk/resources-and-practice/lG00311/

Confidentiality and Freedom of Information

Information relating to patients’ records, diagnosis and/or treatment of patients, staff records, or information concerning contracts, tenders and other commercially sensitive matters etc. are considered to be confidential and must not be divulged without prior authority other than in accordance with the provisions of the Trust’s Policy on raising concerns about Health Care Services as may be amended from time to time. Breaches of confidentiality will result in disciplinary action, and may result in dismissal. Managers are also required as a condition of this Contract to represent the views of the Trust in any dealing they may have with Trust employees, their representatives, the media, general public or other organisations in which they may come into contact.

However, as a public body, the Trust has a requirement to publish particular information. Therefore, in addition to the above confidentiality requirements you must also comply with all aspects of the law concerned with information handling. For this purpose, the relevant legislation is the Freedom of Information Act 2000. This Act places a legal duty on all staff to comply with the rights of the public to access information. Any altering, destroying or concealing of information held by the Trust with the intention of preventing the legitimate disclosure of all or part of that information will result in disciplinary action, and may result in dismissal.

Safeguarding

North Bristol Trust are committed to safeguarding and promoting the welfare of children, young people and adults and to protecting them from all risks of harm. The organisation expects all staff to work to national and local children and adult safeguarding policies and procedures. The trust expects all staff and volunteers to be dementia aware and to support the care of people with dementia. All staff are expected to share this commitment and meet the competencies relevant to their role.

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Appendix A. Staffing in Cellular Pathology

Consultant Staffing

Name FT/PT Areas of sub speciality interest Zainab Abdul-Rahman FT GI Pathology, Liver Pathology Kavita Amarasinghe 6 PAs Cytopathology, Endocrine Pathology, Cervical Pathology Andrew Bamber FT Paediatric and Perinatal Pathology Nahida Banu FT Urological Pathology, Cervical Pathology, Non-gynae Cytopathology Sophie Beavers FT GI Pathology and Endocrine Pathology Nidhi Bhatt1 FT Thoracic Pathology, Dermatopathology Helen Burrell FT Consultant Biomedical Scientist in Cervical Cytology Anastasios Chatzitolios FT Renal Pathology, Urological Pathology Richard Daly FT Thoracic Pathology, Gynaecological Pathology Karin Denton FT Cytopathology, Cervical Pathology Pav Gill FT GI Pathology Mo Khan FT Breast pathology, Renal Pathology, GI Pathology Hannah Lowes FT GI Pathology Francesca Maggiani2 6 PAs Soft tissue Pathology, Gynaecological Pathology Sarah McDonald FT Dermatopathology, Gastrointestinal Pathology (From 15/04/2018) Zsombor Melegh FT Soft Tissue Pathology, GI Pathology, Urological Pathology and Dermatopathology Keith Miller FT Dermatopathology, GI Pathology, Cervical Pathology Behrang Mozayani FT Liver Pathology, GI Pathology Tim Murigu FT Breast Pathology and Dermatopathology Jon Oxley FT Urological Pathology, Dermatopathology Joya Pawade FT Haematopathology, Gynaecological Pathology Demetris Poyiatzis FT Breast Pathology, Soft Tissue Pathology and Dermatopathology Miranda Pring2 2 PAs Oral and Maxillofacial Pathology (including ENT Pathology, H&N Non-gynae Cytopathology) Muhammed Sohail2 9 PAs Breast Pathology, Non-gynae Cytopathology, Urological Pathology (specifically germ cell tumours) Ed Sheffield 6 PAs ENT Pathology, Cardiovascular Pathology Judit Sutak 6 PAs Haematopathology, Renal Pathology Eleni Toumazou 4 PAs Gynaecological Pathology, GI Pathology Nicole Villeneuve FT Consultant Biomedical Scientist in Cervical Cytology Newton Wong FT GI Pathology Yve Zhang FT Dermatopathology, Haematopathology Vacant FT Oral and Maxillofacial Pathology, ENT Pathology

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Vacant FT Paediatric and Perinatal Pathology Vacant FT Paediatric and Perinatal Pathology Vacant FT To be advertised Vacant FT Recruitment in progress Vacant FT Recruitment in progress

Notes 1. Dr Nidhi Bhatt is the Clinical Lead for the service 2. Drs Mohammed Sohail, Miranda Pring and Francesca Maggiani are Consultant Senior Lecturers at the University of Bristol

Scientist staffing

Andrew Heryet FT Laboratory Manager Mark Orrell FT Operations Manager

WTE

BMS Band 8 6.60

BMS Band 7 13.75

BMS Band 6 19.36

BMS Band 5 15.10

Technical, Admin and Clerical staffing

WTE

MLA (Bands 2 – 4) 44.56

Cytoscreeners 3.42

MTO 4.10

Admin and Clerical 16.57

Numbers and Grades of Junior Medical Staff

Cellular Pathology has been approved for Higher Specialist Training by the Royal College of Pathologists both for general training and for training in Oral and Maxillofacial pathology and Paediatric/Perinatal Pathology. There is an active training programme with the following table showing the number of training posts.

Trainee cellular pathologists ST1s 0 SpRs (general) 8 ST3-5 (Paediatric and Perinatal Pathology) 1 ST3-5 (Neuropathology) 1

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The trainees on general histopathology training rotate to various training centres in the training region including Weston, Bath, Cheltenham, Swindon and Taunton. All the regional trainees come to Bristol for paediatric pathology, perinatal pathology, neuropathology and lung pathology training.

Bristol is part of the South West Histopathology Training School. This runs a dispersed model with a capacity of 8 ST1 trainees. Four of these training posts are in Bristol with the others based in Plymouth and Exeter.

For the last 5 years Bristol has organised the national block teaching week for all the ST1 trainees of England and Wales.

Appendix B: Annual workload in Cellular Pathology i) The following table gives the current workload in Cellular Pathology.

Histology requests 74,500 Histology specimens 124,000 Cytology (non-gynae) 4,600 Cytology (gynae) 320,000* Hospital adult postmortems 0 Clinics with rapid FNA 2 per week diagnosis Paediatric histology requests 2885 Paediatric and Perinatal 290 per year autopsies * When new contract is fully implemented

ii) Paediatric Pathology surgical case mix

Specimens Cases Breast 4 3 Cardiovascular 19 12 Cytology 9 8 Endocrine 24 16 GI 3965 953 Gynae 40 24 H&N 247 165 Lymphoreticular 175 113 Ophthalmology 5 4 Bone & Soft tissue 88 55 Placenta 950 950 Respiratory 73 31 Skin 236 179 Undefined 360 149 Urology 271 223 Total 6466 2885

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Appendix C: List of MDMs and CPCs. Meetings relevant to this post are in bold.

Details of Multidisciplinary team meetings and Clinical Pathology Conferences Day and UH Bristol NBT time Monday am  Tumour Board (Paediatrics) MDM.  Skin Cancer Network MDM, 8am to 12.30pm to 1.30 pm weekly at the 11am, in Southmead Children’s Hospital Monday pm  Gynae CIN CPC, 12pm to 2pm at St  Thyroid CPC, 12.15pm to 1.45pm Michaels, monthly in Southmead  Lung surgical MDM, 2 to 2:30pm at BRI attended via videolink Tuesday  Skin cancer MDM, 11:30am to  Lower GI MDM, 8.30am to am 1.00pm in the BRI 10.30am Southmead  Sarcoma MDM, 8.45am to 10am in Southmead Tuesday  Head and Neck MDM, 1.30pm to pm 3.30pm at BRI Wednesday  Gynae MDM, 8.30am to 12.30pm at  Interstitial lung disease CPC, am St Michaels (NBT and Weston 10.30am to 11.15am in Southmead pathology staff attend for the first 45  Lung Cancer MDM, 11.15am to minutes) 1pm in Southmead  Breast MDM, 8am to 10am in the  Gynae CIN CPC, 12pm to 2pm at BRI Southmead, monthly Wednesday  Paediatric Gastroenterology CPC,  Network Mesothelioma MDM, 1pm pm 1 pm to 2 pm in the Children’s to 1.30pm Hospital (Fortnightly)  Urology local MDM, 1 to 2pm at  Perinatal Mortality CPC, 2.30pm to Southmead 4.30pm, monthly on 3rd  Urology Network MDM, 3pm to Wednesday of the month 5pm at Southmead  Paediatric Dysmorphology, monthly, 1st Wednesday of the month Thursday  Unknown primary MDT, UHBristol,  Breast MDT, 8.30am to 11am in am 08:30-09:30 Southmead  Haematological MDM 9am – 12pm  Haematological MDM 9am – 10am  Skin Lymphoma sub regional MDM, via video link 2pm to 3pm at the BRI, monthly  Paediatric Haematology MDM, 10am to 11am in the Children’s Hospital. Monthly, 2nd Thursday of the month  Surgical MDM, 12.30 to 1.30 pm, monthly, 4th Thursday of month in the Children’s Hospital. Thursday  Endoscopy CPC, 1.30pm to 2.30pm pm  Testicular MDM, 8.30am to 9.30am at the BRI  Dermatopathology CPC, 2pm to 3pm at the BRI, every other week  Dermatopathology Combined Clinic, 3pm to 5pm at the BRI Friday am  Lung cancer MDM, 11.30am to 1pm

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at the BRI  Network Upper GI MDM, 9am to 11.30am in the BRI  Neuroendocrine MDT, bimonthly 11:15 – 12:30  Paediatric Surgical Mortality meeting CPC, Bi-monthly, 10.30am to 12.00 noon. BRI, King Edwards room. Friday pm  Urology MDM, 9.30am to 11am at  GI Medical CPC, 1pm to 2pm at the BRI Southmead  Lower GI MDM, 1pm to 2pm in the BRI  Network Anal MDM, 1.30pm to 2pm in the BRI

List of MDMs and CPCs for the Paediatric and Perinatal Pathology Service:

UHB PAEDIATRIC & PERINATAL MEETINGS

MEETING PERIODICITY DAY TIME VENUE COVERED BY

Tumour Board Weekly Monday 12:30 BCH Pathologist (TB) to 13:30 Level 3 on surgical rotation

Paediatric GI Fortnightly Wednesday 13:00 BCH Pathologist Meeting (1st and 3rd to Level 6 on Wednesday 14:00 surgical of the month) rotation

Surgical Monthly Thursday 12:30 to BCH Pathologist Meeting (4th Thursday of the 13:30 Level 6 on (SM) month) surgical rotation

Paediatric Monthly Thursday 10:00 to BCH Pathologist Haematology (2nd Thursday of 11:00 Level 6 on MDT the month) surgical rotation

Dysmorphology Monthly Wednesday 14:30 St Michael’s Pathologist Meeting (1st Wednesday of to 16:30 Level C on (DMM) the month) perinatal rotation*

Perinatal Monthly Wednesday 14:30 St Michael’s Pathologist Mortality (3rd Wednesday of to Level C on Meeting the month) 16:30 perinatal (PMM) rotation*

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Paediatric Bi-Monthly Friday 10:30 to BRI Pathologist Surgical 12:00 King’s Edward on Mortality Room perinatal Meeting rotation* (PSMM)

Child Death Ad-hoc Ad-hoc - BCH Pathologist Review Level 4 for (CDR) the PM case

BCH (Bristol Children’s Hospital) St Michaels and BRI (Bristol Royal Infirmary) are located on the same site at UHBristol NHS Foundation Trust

(*) Perinatal and Paediatric Mortality Meetings are covered by the pathologist on the perinatal rota in cases of short-staffing; however, each pathologist usually presents their own PM cases.

A further nine colposcopy CPC’s will be scheduled as part of HPV primary screening implementation, expected mainly to be supported by consultant BMSs

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Appendix D: Resources available

Facilities

A new purpose built laboratory opened in April 2016.

As well as routine histological and cytological techniques, there is a wide range of immunocytochemistry and immunofluorescence available.

Digital micro- and macro photography equipment including the supporting software has recently been purchased and installed in both laboratories. There is facility to view slides in real time through a network link between both sites and the trust is committed to further development of video linking and related technologies.

The diagnostic service is fully computerised with extensive databases. The department implemented a new LIMS, Clinisys Winpath Enterprise, in October 2016 and utilise the Leica Cerebro system for in-lab tracking.

The laboratory maintains an excellent selection of up-to-date textbooks

Secretarial Support/Office Accommodation

Within the department, you will be assigned an individual reporting room with a consultant grade microscope (with a teaching arm to allow teaching of pathology trainees to be carried out in the Consultant’s office), and a personal computer linked to the Trust’s IT system, internet, digital dictation and e-mail facilities. Secretarial and administrative support, predominantly for general diagnostic work and also for personal professional tasks (managerial, teaching and administrative) is provided from our team of excellent medical secretaries. The department has good facilities for digital photography of macroscopic and microscopic specimens.

Library Facilities

There are professionally staffed Medical Libraries in the Postgraduate Medical Centre at Southmead Hospital, with a rapid service between these and the University Library situated in the centre of Bristol city. A computer literature search facility is available and the library has links with other networks across the country, thus ensuring a comprehensive and rapid service in response to information needs.

The Postgraduate Medical Centre has an active programme of clinical meetings, lectures and symposia.

Academic Facilities

North Bristol NHS Trust currently has medical education facilities available on Southmead site. The Learning & Research Centre opened in December 2009 and has the following facilitates: 130 seated lecture theatre, Library (24 hour access), Seminar Rooms, Resuscitation training rooms, IT training suite, Clinical Skills Laboratory, Manual handling training rooms and University of Bristol laboratories and office base.

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Appendix D: Organisation information

Information about North Bristol NHS Trust

North Bristol NHS Trust is the largest Trust in the South West region and one of the largest trusts in the country. Last year the Trust treated over 100,000 inpatients, over 35,000 outpatients, 90,000 emergency department patients and helped deliver over 6,000 babies. It employs more than 8,000 staff, has approximately 1,050 inpatient beds and income in excess of £540 million.

The Trust provides Medical, Surgical, Neonatal, and Maternity Care for its local population of approximately a million people in Bristol, South Gloucestershire and North Somerset. The Trust also provides regional services in Neurosciences, Orthopaedics, Pathology, Plastic Surgery and Burns, Renal Medicine and Transplant and Urology and is the Major Trauma Centre for the West Country.

The health service in Bristol, North Somerset and South Gloucestershire is being remodelled to concentrate on acute facilities and where appropriate to provide more care close to patient home through a network community hospitals and facilities. The Trust recently moved the majority of its acute services to the Brunel Building, regarded as one of the best hospital facilities in Europe, on the Southmead Hospital Site. At Southmead Hospital, we also have our excellent maternity and women’s health services, the Bristol Breast Care Centre and the Trust’s Severn Pathology service.

As well as Southmead Hospital, the Trust also has Cossham Hospital, in Kingswood, that recently underwent a £19m refurbishment, the Bristol Centre for Enablement, at Cribbs Causeway (Bristol) and the Trust also runs children’s community health services across Bristol and South Gloucestershire.

The Trust has University Teaching status and is associated with both the University of Bristol and the University of the West of England.

The organisation of North Bristol NHS Trust

The Board of North Bristol NHS Trust comprises of the chairman and chief executive, 6 non-executive directors, and directors of capital projects, finance, facilities, I M and T, organisation, people and performance, as well as a director of operations, medical director and director of nursing. For further information, refer to the trust website, www.nbt.nhs.uk

NBT has five Clinical Divisions.  Medicine  Musculoskeletal and Neurosciences  Surgery  Women's and Child Health  Core Clinical services and Out-Patients

Pathology is part of the Core Clinical Services Division together with critical care, radiology and pharmacy. The Clinical Director of the Core Clinical Services Division is Dr Rommel Ravanan, Consultant Nephrologist. The Head of Pathology post is vacant and the Divisional Operations Manager is Ms Sarah Robinson. Within Pathology a unified management structure has been implemented.

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Information about University Hospitals Bristol NHS Foundation Trust

Situated in the heart of Bristol, UHBristol is a large city centre Teaching Trust employing over 7000 staff, with annual revenue of nearly £400 million and with a total of 1156 beds throughout the Trust. UHBristol are one of the largest employers in Bristol and provide a wide range of in-patient, out-patient and day-care services to the local population within Bristol, as well as being the biggest specialist referral centre for the South West of England.

Hospital and outpatient services are based over eight sites comprising: the Bristol Royal Infirmary, Bristol General Hospital, Bristol Eye Hospital, Homeopathic Hospital, Bristol Haematology and Oncology Centre, Bristol Dental Hospital, St Michael’s Hospital and Bristol Royal Hospital for Children. A significant capital redevelopment programme is underway with re-provision and expansion of facilities for Paediatric, Cardiac and Medical patients.

The Hospital has close links with both city Universities. University of Bristol is the largest Medical School in Southwest England, with Bristol Royal Infirmary delivering the largest proportion of teaching to its Medical and Dental Students. The Trust Executive Group has bi-monthly meetings with its teaching and research partners.

The organisation of University Hospitals Bristol NHS Foundation Trust

The Trust Board consists of seven Executive members and 7 Non-Executive Directors including 1 independent member. There are four public Board meetings a year, normally held on the fourth Tuesday of the month. In addition, the Trust Board holds an Annual General meeting, normally in September. Members of staff and public are welcome to attend these meetings.

The Public Trust Board Meeting agenda contains issues for decision on major strategy and policy direction, as well as regular public reporting on performance against key targets.

As a Foundation Trust, UH Bristol are accountable to the local community and patients. The community and patients are invited to become members of the Trust and currently the Trust has 8,500 members. The membership, which includes staff members, voted in a formal election for governors to represent them on the Membership Council which sits alongside the Trust Board. The Council advises the Board on strategic direction and members and governors are active in improving the services at the Trust.

The Trust structure is based on five autonomous Clinical Divisions:  Medicine and Emergency Care  Surgery and Head & Neck  Women’s and Children’s Services  Specialised Services  Diagnostic and Therapy Services

The Divisions are supported by a sixth Division, Trust Services, which comprises of a number of corporate functions including Finance, IM&T, and Human Resources. A clinical Head of Division, supported by a Divisional Manager leads each Division.

The Trust is committed to increasing both clinical engagement and the involvement of staff and their representatives in key decisions. A Clinical Reference Group comprising senior clinicians and representatives of clinical professions including the Heads of Divisions is

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chaired jointly by the Medical Director and Chief Nurse/Director of Governance. The group works collaboratively with a range of committees and groups within the Trust, in order to ensure that there is strong clinical advice, leadership and engagement in all decision- making processes.

Pathology is part of the Division of Diagnostic & Therapy Services, along with Radiology, Pharmacy, Medical Physics (incl. MEMO), Audiology, Neurophysiology, Physiotherapy, Occupational Therapy, Dietetics, Speech & Language and Orthotics.

The Clinical Chair is Kate Love and the Divisional Director is Alison Lowndes.

University Of Bristol Links

The University of Bristol Faculty of Medicine: http://www.bris.ac.uk/fmd/

The University of Bristol offers an exciting academic environment with centres of excellence in all of its faculties. It also has an ambitious programme for expansion and a well-established major “campaign for resources” to facilitate future developments. The University is in the city centre and the medical school and basic science departments are within walking distance of UHBristol.

Bristol is one of the few universities with schools of medicine, dentistry and veterinary science, all in close proximity. The Medical School has an intake of 250 students each year to its undergraduate medical course following recent expansion. The Dental School has also recently expanded and now has an intake of 75 undergraduate students per year.

The Faculty’s research philosophy is to undertake internationally recognised basic and applied medical and health services within a setting which patients are cared for in association with undergraduate teaching and postgraduate training.

Information about Weston Area Health Trust

The Trust provides a wide range of acute health and rehabilitation hospital services to the population of North Somerset from its main campus at Weston General Hospital. The Trust works closely with other hospitals in Bristol as part of ‘clinical networks’ including, for example, cancer, pathology and cardiology. The Trust employs 1800 people and provides 234 beds to service a 212,000-strong local population and for 3.3 million summer visitors to this popular West Country seaside resort.

In-patient surgical specialties include Breast, Colo-proctology, Upper Gastrointestinal, Urology, Trauma and Elective Orthopaedics, Oral Surgery, Gynaecology and ENT.

Medical inpatient specialisms include Gastroenterology, Diabetes and Endocrine, Respiratory, Cardiology, Rehabilitation and Elderly Care.

Weston Area Health NHS Trust has developed a North Somerset Health and Social Care Academy, in partnership with the local deanery and University Medical Schools. This Academy delivers and facilitates the training and development of all Health and Social Care Workers.

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