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Consultant Information Pack Front Cover Chairman Mr John Fry Chief Executive Mark Davies 2 Posts In Luminal Gastroenterology with a subspecialist interest in Inflammatory Bowel Disease and Lower GI Endoscopy Department of Gastroenterology NORFOLK AND NORWICH UNIVERSITY HOSPITALS NHS FOUNDATION TRUST May 2018 NORFOLK AND NORWICH UNIVERSITY HOSPITALS NHS FOUNDATION TRUST Consultants in Gastroenterology This advertisement is for 2 new posts within the department of gastroenterology. We are looking to attract applicants who have a subspecialist interest in Inflammatory Bowel disease and lower GI colonoscopy and wish to drive this service forward to deliver high quality and personalized medical care in IBD. These posts have arisen due to the need for expansion of our outpatient IBD service and the growing need to increase our lower GI endoscopic provision in alignment with the opening of our brand new endoscopy unit in the Quadram Institute (see below). A candidate who is unable for personal reasons to undertake the duties of a whole- time post will receive equal consideration. If such a candidate is appointed to this post, content will be modified as appropriate in consultation with the gastroenterology and GI Service director. We welcome all applications irrespective of age, disability, gender, sexual orientation, race or religion. Additionally, people with disabilities will be offered an interview providing they meet the minimum criteria for the post. The Trust operates job sharing and a flexible working programme. The Gastenterology Department The GI department is divided into 3 sub-specialist teams comprising Inflammatory Bowel disease/Luminal GI disorders/Therapeutic Endoscopy, Clinical nutrition and Hepatobiliary medicine and Hepatology. The 2 new successful applicants will join the former team and we welcome full time and part time applicants for these positions. The IBD team The IBD team is currently a team of 3 full time consultants lead by Dr Tremelling and 5 clinical nurse specialists. The team care for one of the UKs largest cohort of IBD patients in a single center and have a large biological registry. In addition to this the team offer: 1) A dedicated IBD adult clinic 2) A dedicated monthly paediatric transition clinic with our Gastroenterology paediatric consultants 3) 5 IBD nurse specialists (4 FTE) that offer pretreatment counselling and drug monitoring 4) Dedicated endoscopy lists for IBD patients (IBD surveillance chromoendoscopy) 5) A monthly IBD MDT with joint surgical clinics with IBD dedicated colorectal surgeons 6) An IBD Educational programme for junior doctors and specialist registrars Version April 2018. 2 7) Commercial Trial access for new and developing biological therapy for IBD and academic initiative studies 8) Participation in national audits 9) A pipeline for academic Gastroenterology Trainees 10) An IBD helpline run by the IBD nurse specialists to provide easier access and advice for those with flares of their disease 11) A virtual clinic for stable patients to reduce unnecessary clinic visits for patients, and to optimise the use of outpatient clinic consultations Other Subspecialty Departments in Gastroenterology Clinical Nutrition The department has a dedicated multidisciplinary clinical nutrition service led by Dr Charlotte Pither, with Dr Dana Ismail and Professor Alistair Forbes and is supported by 4 specialist clinical nurses. This team offers a regional service to James Paget Hospital, Kings Lynn and Ipswich Hospital. The clinical service offers - A weekly specialist nutrition MDT clinic which also supports complex IBD patients - A weekly nutrition MDT and specialist feeding issues MDT - A biweekly ward round of enteral and TPN feed patients - A inpatient service for metabolic stabilisation of patients with eating disorders - Clinical care of patients with PEG and RIG feeding tubes - Home support of patients with long term TPN feeding Hepatology and Hepatobiliary Medicine The clinical hepatology team currently is composed of 6 consultant Hepatologist s (Dr Simon Rushbrook, Dr Martin Phillips, Dr Syed Alam, Dr Marianna Mela, Dr Arun Shankar, Dr Helen Fellows) with Dr Sathis Mogan leading the advanced hepatobiliary spyglass endoscopy/EUS service here at NNUH alongside Dr Rushbrook and Dr Simpson. The hepatology team offer a wide range of specialist clinics dedicated to hepatobiliary cancer, viral hepatitis, PSC, autoimmune liver disease, alcohol and NAFLD. This is in addition to specialist liver transplantation clinics and a range of general liver clinics. The team has excellent working relationships with the Cambridge liver unit and works closely with our colleagues there in the management of patient’s pre and post liver transplantation. We are part of the regional HCV network providing DAA drugs to patients with HCV infection according to operational managed network. The core team is supported by consultant colleagues in Interventional Radiology (IRU), Clinical Biochemistry, Microbiology/virology, histopathology and hepatobiliary radiology (led by Dr Benedict Simpson). Version April 2018. 3 Our IRU team offer: a mobile PICC Line service, Percutaneous biliary stent placement, a range of embolization procedures, transjugular liver biopsies, TIPS and perform Trans-arterial chemoembolization and microwave radiofrequency ablation of hepatocellular carcinoma cases. The hepatology unit also run a number of fibroscan clinics and are able to offer MRE for liver fibrosis assessment. The service is supported by 4 dedicated liver nurses and 2 dedicated fulltime specialist nursing posts in alcohol and substance abuse. Bowel Screening Team and department (Led by Dr Richard Tighe) The department has been at the forefront of the national colorectal cancer screening programme. We were in the first wave of centres to start the programme in 2006 and were also first to pilot the extension of this programme to the 70-75 year old age group in July 2008. We were also one of the first wave of centres performing bowel cancer screening flexible sigmoidoscopy in 2013. The programme overseen by Dr Richard Tighe is led by a strong nursing and administration team. Successful applicants would be supported if they wished to become recognized national screeners or wished to continue this if already accredited. We are a leading national endoscopy training centre with courses every month which we hope the successful applicants would participate in. These include foundation endoscopy, intermediate colonoscopy and teaching the teachers courses. We would hope that the successful applicants would partipcate in these as teaching high quality endoscopy is a vital part of the NNUH gastroenterology departmental ethos. Acute Medicine The Norfolk and Norwich University Hospital has one of the busiest “Acute Medical takes” in the United Kingdom. The Acute Medicine department assesses and treats approximately 26,000 patients every year. This takes place on the NNUH site in close co-operation with the Emergency Department, the Critical Care Complex, Coronary Care Unit, Medical Specialties and Primary Care. An ambulatory emergency care unit is currently available 7 days a week 8-8. Approximately 30% of the medical take is currently seen through this service. A clinical decisions unit also allows patients who require short periods of observation to be cared for by the emergency team so preventing hospital admission. These and other innovative changes in our processes have seen a 10% reduction in the total number of emergency patients admitted to our hospital despite a 6% increase in emergency attendances to the ED over the last 12 months. It is anticipated that the successful candidate will continue with colleagues to support the medical AMU for specialist triages. The AMU has a resident consultant presence until 8pm 7 days a week with a separate physician of the day taking over the on call over night from 10pm. Version April 2018. 4 Departmental Organistaion Our department believes in delivering a high quality consultant led and delivered service across both inpatient and outpatients domains. Therefore each consultants job plan is reflective of time spent on and off ward cover. During ward cover periods time is allocated for supporting the Trust’s Red to Green programme (to ensure bed days are not lost and communication between ward teams is high quality and effective) and ensuring that inpatient care is consultant led and delivered. It is expected that patients are pulled early from A&E and AMU, and that a consultant DECT phone is carried which is coordinated within the department. Leave is coordinated between the teams and across the department in accordance with the Trusts annual leave policy. It is therefore expected that consultants on ward duty will generally carry out less of the outpatient or endoscopy workload than colleagues off the ward. Guist Ward is the home ward for Gastroenterology and our elective work is coordinated through the endoscopy unit and the General medical day unit. Endoscopy The Norfolk and Norwich University Hospital serves a population of 750,000 and is the busiest endoscopy unit in the country. In 2018 we will see the opening of the Quadram Institute which will house our brand new state of the art 10 roomed endoscopy unit. This will be a world class institute for teaching and training and research in endoscopic care. Of course as a gastroenterologist joining the team part of your work will be done in this new institute and will give you an opportunity to develop and establish your own academic profile within the department. This 10 roomed
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