The Directorate of Anaesthesia Manchester University Foundation Trust
Manchester University NHS Foundation Trust Manchester University NHS Foundation Trust (MFT) is the merger of Central Manchester University Hospitals NHS Foundation Trust (CMFT) and University Hospital of South Manchester NHS Foundation Trust (UHSM). This new organisation will provide a single hospital service across the city of Manchester and in April 2020 will also include North Manchester General Hospital.
The Trust comprises of Manchester Royal Infirmary, Manchester Royal Eye Hospital, University Dental Hospital of Manchester, St Mary’s Hospital for Women, The Royal Manchester Children’s Hospital, Trafford General Hospital, Wythenshawe Hospital, Altrincham Hospital and Withington Community Hospital.
Manchester University NHS Foundation was constituted on 1st October 2017 as part of a ‘new era for Greater Manchester’ when from April ’16 the region became the first in the country to take control of its combined health and social care budgets – a sum of more than £6 billion. It means that – for the first time – leaders and clinicians will be able to tailor budgets and priorities to directly meet the needs of local communities and improve the health and wellbeing of the 2.8 million residents. It presents health officials with a unique opportunity to tackle some of the poor health inequalities that currently blight the region and the past year has seen politicians, councillors and senior health officials work in partnership to establish a system of governance that will allow Greater Manchester to prosper. One of the of the key elements of this transformation is Healthier Together which aims to provide better joined up care for patients and to make sure everyone in Greater Manchester is able to benefit equally from the same high standards of specialist care.
The management of Manchester Foundation Trust compromises Group Executives and a Board of Directors
Group CEO - Sir Mike Deegan Deputy group CEO - Gill Heaton Group Chief Financial Officer - Adrian Roberts Group Medical Directors - Dr Jane Eddleston & Miss Toli Onon Group Chief Operating Officer - Julia Bridgewater Group Chief Nurse - Professor Cheryl Lenney Director of Strategy - Darren Banks Group Director of Workforce & OD - Margot Johnson
Clinical and Scientific Services The Directorate of Anaesthesia is a part of the Division of Anaesthesia, Critical Care and Perioperative Medicine. The Division is one of four in Clinical and Scientific Services (CSS), a managed clinical service that covers the hospitals across the entire Trust.
The Directorate of Anaesthesia is managed through two rotas one for staff covering the Hospitals on the Oxford Road Campus – Manchester Royal Infirmary, Manchester Royal Eye Hospital, University Dental Hospital of Manchester, St Mary’s Hospital for Women and Trafford General Hospital and the other for staff working Wythenshawe Hospital, Altrincham Hospital and Withington Community Hospital. Paediatric
The Clinical Scientific Services’ Executive Team comprises of: Chief Executive Officer - Ian Lurcock Medical Director - Dr Sarah O’Shea Director of Operations -Tim Keeler Director of Finance - Helen Cobb Director HR - Zara Pain
Staffing at Oxford Road Campus Consultants: 95 Fellows: 16.7 ORC; 7.6 TGH Trainees: 30 Staffing at Wythenshawe Hospital Consultants: 70 Fellows: 1 Trainees: 38
Oxford Road Campus Anaesthetic Services The department is situated in a recently constructed Anaesthetic Department within St Mary’s Hospital. There are work and rest facilities for both Junior and Senior Medical staff. These include a library, seminar room, rest/refreshment room, IT facilities, laboratories and a comprehensive museum unique in the region. In addition there is access to the main hospital, and the full facilities of Manchester Medical School and the University are close at hand. There is a separate Department of Paediatric Anaesthesia.
Anaesthesia provide as part of perioperative medicine specialty based pre-assessment clinics and there are also highly specialised clinics such as the Anaesthetic Reaction Clinic, staffed by Dr Andrew Parkes (Consultant Anaesthetist) and Dr Tomas Garcez (Consultant Immunologist) – this clinic is one of the few across the country and receives tertiary referrals from across the region.
The Preoperative Assessment Service also operates the Cardiopulmonary Exercise Testing Service (CPET). This service has the largest database in the UK and is run by Consultant Anaesthetists, many of whom are also transthoracic or TOE competent.
Wythenshawe Anaesthetic Department The department has extensive accommodation including offices for the medical staff, Acute Pain nurses and the secretarial staff, a seminar room and a trainee’s common room incorporating the Departmental Library. Computer and fax facilities are available within the department. There is one full time and one part time secretary supporting the General Anaesthetists. In addition, the Chronic Pain Team have their own secretarial support, including two full time secretaries and three part time secretaries.
The Anaesthetic Department has three separate on call rotas. The General on-call Consultants work a 1 in 10 with prospective cover, on a 2-tier rota and also cover anaesthetic emergencies at the Christie Hospital out of hours. We are currently reviewing these on call arrangements. The appointee may be required to do up to 50% of their (non-resident) on-call for general anaesthetic emergencies at the Christie but the on-call frequency over all would not be greater than 1 in 7. The Acute ICU has a separate rota of 1 in 15 with prospective cover. The Cardiac theatres/ICU has a separate 2-tier rota (which covers ECMO) of 1 in 8 with prospective cover.
There is a nurse-based pre-op service which liaises with the individual anaesthetists regarding high risk patients on their lists and an expectation that individuals will be pro-active. There are also three consultant-led high-risk pre-op clinics per week.
Pain Management Services (Acute and Chronic) www.mft.nhs.uk
Incorporating: Altrincham Hospital • Manchester Royal Eye Hospital • Manchester Royal Infirmary • Royal Manchester Children’s Hospital • Saint Mary’s Hospital • Trafford General Hospital • University Dental Hospital of Manchester • Wythenshawe Hospital • Withington Community Hospital • Community Services
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The Pain Management Service currently consists of a team of consultant anaesthetists and specialist pain nurses, supported by a multi-disciplinary team who work to support the medical and surgical teams to manage in-patient and outpatient pain.
The in-patient pain service offers education and specialist advice with the objective of empowering clinical staff to provide high quality pain relief to their patients. The service has developed telephone follow-up and outpatient clinics to support selected patients discharged on high dose opiates. It is also one of the few in-patient services in the country with input from a clinical psychologist. Use of multi- modal analgesic techniques is encouraged including regional analgesia, PCA and epidural analgesia throughout the trust.
The outpatient service provides patient clinics and intervention sessions. This is supported by access to physiotherapy and psychology services with specialist nurse care for post procedure follow up, TENS Quetenza clinics and Pain Management Programmes.
Clinical Services Supported by the Department of Anaesthesia
St Mary’s Hospital Saint Mary’s Hospital for Women and Children was founded over 200 years ago and relocated to a new purpose built, state of the art facility on the central site in 2009. The new Saint Mary’s Hospital benefits from being co-located with the new Royal Manchester Children’s Hospital, Manchester Royal Infirmary and the Manchester Royal Eye Hospital. The University of Manchester is situated within walking distance of the Trust and the Medical School is directly adjacent to the Trust.
In addition to providing secondary services for the local population, Saint Mary’s also provides tertiary services to the North West in Obstetrics, Foetal and Maternal Medicine, Gynaecological Oncology, Urogynaecology, Reproductive Medicine, Genetics, Neonatal Medicine and Neonatal Surgery. The current delivery rate is in excess of 8000 a year. The Obstetric Directorate has 72 ward beds, with an Obstetric Delivery Unit and co-located midwifery-led delivery unit, and a Maternity Assessment Unit consisting of a Day Unit and an Obstetric Triage facility and there is a well-established Critical Care facility within the Delivery Unit for care of women with complex medical problems or women with complications of pregnancy.
Foetal Medicine Services The tertiary foetal medicine service (Foetal Management Unit) for the Region sees over 1200 patients per year. Regular sessions are held within the FMU by a Paediatric Cardiologist and a Paediatric Neurosurgeon. There are close links with the Department of Radiology which has its own department situated within St Mary’s.
Maternal Medicine & High Risk Obstetric Services: Obstetric Haematology Clinic Renal / Hypertension Clinic Obstetric Diabetic / Endocrine Clinic Monochromic Twin Clinic HIV Clinic Obstetric Cardiology Clinic
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Teenage Pregnancy Clinic Maternal Obesity Clinic Premature Labour Risk Assessment Clinic Placenta Clinic
The Anaesthetic department provides dedicated consultant cover as well as outpatient antenatal obstetric anaesthetic services. Joint ward rounds occur and there are very close working relationships and involvement in risk management.
The regional Neonatal Medical, Surgical and Genetic Departments are based at Saint Mary’s, and there are regular joint meetings.
The Maternal and Fetal Health Research Centre in St Mary’s is one of the largest such groups in Europe (over 80 staff including clinician-scientists, scientists and research midwives) and is integrated with the St Mary’s Obstetric tertiary referral unit.
Within Gynaecology there are 30 in-patient and 12 day-case beds together with a gynaecological urgency unit. Specialist clinics include reproductive medicine (IVF, Andrology, and donor insemination), colposcopy, urogynaecology (The Warrell Unit), gynaecological oncology, endometriosis, and the Whitworth clinic for the care of women with an unplanned pregnancy. A comprehensive menstrual dysfunction and PMB clinic is provided in the Warrell Unit including facilities for therapeutic outpatient endoscopic procedures. Within the colposcopy unit, there is a joint vulval/dermatology clinic. Facilities exist for advanced laparoscopic and hysteroscopic surgery.
Emergency Services The non-elective anaesthesia team have responsibilities to a number of areas and services throughout the Trust: The non-elective (emergency) theatre service for Phase II. The general consultant leads the Emergency List Business Meeting commencing at 08.00 each morning. The emergency theatre service for the Royal Eye Hospital. The emergency theatre service for St. Mary’s Hospital (gynaecology services). The anaesthetic provision to the cardiac arrest team and the provision of airway management and resuscitation to acute areas within the Trust, including accident and emergency.
Manchester Royal Eye Hospital The Department provides a service to the Manchester Royal Eye Hospital, a 30-bed tertiary referral centre serving the whole of the North West Region. The Manchester Royal Eye Hospital currently has an expanding programme of Vitreo-Retinal Surgery and major Occuloplastic Surgery.
Christie Hospital The Anaesthetic Department have a Service Level Agreement with the Christie Hospital, providing 28 notional half day lists, together with an on-call commitment for out-of-hours anaesthetic emergencies
Research and Innovation At MFT
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The vision of MFT is to become the leading integrated health, teaching, research and innovation campus in the NHS. Within this context our aim over the next 5 years is to ensure that MFT is one of the top 5 NHS Trusts for research and innovation in the U.K. Our capacity for translation of research and innovation into improved patient care is internationally recognised, both in its own right and in partnership with Manchester Academic Health Science Centre (http://www.mahsc.ac.uk/). We have a number of important assets to help us achieve this ambitious goal: The Manchester NIHR Biomedical Research Centre (http://www.cmft.nhs.uk/brc/biomedical- research-centre.aspx), a partnership with the University of Manchester, is one of 12 such elite centres in the UK. The Wellcome Trust Clinical Research Facility (WTCRF), purpose built for experimental medicine research and incorporating an MRI research scanner suite, is one of only 4 in the UK with both adult and paediatric facilities. The Centre for Applied Diagnostics and Experimental Therapeutics, a multimillion pound new development uniquely designed and built within the hospital to enable application of proteomics, metabolomics and genomics to experimental medicine. A recently opened and staffed Biobanking facility, now collecting a range of well phenotyped human tissues for research within CMFT and across MAHSC. The largest single site clinical sciences centre in the UK. Our clinical research and innovation benefits from established partnerships with: o TrusTECH, the NHS Innovation Hub in the Northwest o MIMIT (Manchester Integrating Medicine and Innovative Technology), providing solutions to unmet clinical need. o Manchester Medical Technologies Development Centre, designed to accelerate the development of new devices and diagnostics o Greater Manchester Comprehensive Local Research Network o Medicines for Children Research Network o Science & Technology Facilities Council at Daresbury
These assets, coupled with a network of Clinical Division Research Leads and Research Managers facilitate enabling research throughout the organisation,
Research in Anaesthesia The Division has a broad research portfolio and will support all high quality research aimed at understanding the anatomical, physiological or pathological basis of disease. Whilst encouraging research with a clear patient-benefit focus within priority themes, we are also committed to supporting other broader interests. The appointee to the current post will be expected to contribute to this research culture by establishing a high impact, peer reviewed and externally funded research program either as the principle investigator or in collaboration with more established researchers within their allocated SPA sessions. Those who are successful is establishing a successful research program will then be considered for additional research time based on the merits and specific needs of their work.
The Directorate is keen to encourage research and has an extremely active research group, which has strong ties with the University. Financial support may sometimes be obtained locally, or alternatively, application for research grants for short term projects not exceeding two years may be made through the Regional Health Authority's Reactive Funding Scheme. The submission of an application is no
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guarantee that finance will be provided and all applications are considered by the Committee within the resources available.
Teaching The Trust has a commitment to the teaching of both undergraduates and postgraduate trainees. The successful applicant would be expected to participate in both informal and formal teaching programmes for all levels of junior medical, nursing and paramedical staff where appropriate. The Directorate offers trainees weekly tutorial session given by the Consultants and the Specialist Registrars. The teaching programme is organised by the College Tutor. There is a very active Postgraduate Centre in the Education, Research and Teaching Centre (ERC), which also contains two lecture theatres, seminar rooms, a large library and computer rooms, laboratories and offices. The postgraduate Tutor is Dr R Hunt. There are weekly grand rounds
New Consultant Development Programme All new Consultants to MFT are required to participate in the New Consultant Development programme. This programme is designed to aid the transition from trainee to Consultant through an iterative and interactive programme running over the course of a year. The programme is delivered through a monthly day- long sessions which replaces other activity on that day, including clinical activity. This equates to an additional 0.5 SPA over the year, with a corresponding decrease in DCC activity.
Consultants taking part in the New Consultant Programme undertake a service improvement project as part of their programme. Thereafter consultants are encouraged to continue this activity
Postgraduate Facilities There are well-equipped postgraduate departments, including a modern library.
Clinical Governance & Audit The Directorate of Anaesthesia hold regular clinical governance, management and quality audit meetings in which the appointee is expected to participate. is Consultant led, with two designated lead clinicians and a part share in a full time audit facilitator. Four full day audit sessions take place per annum During these sessions, a variety of anaesthesia and intensive care related audits are presented. There are also multidisciplinary audits. Trainees are encouraged to participate in data acquisition and presentation. Trainee hours and consultant supervision are audited on a monthly basis. Attendance at the audit meetings is required. The current audit lead is Dr Panchagnula.
Appraisal and Revalidation The appointee will undergo yearly appraisal and mandatory training in accordance with trust regulations and be subject to Revalidation in accordance with GMC requirements.
Health and Safety The Trust has a statutory responsibility to provide and maintain a healthy and safe environment for its staff to work in. You equally have a responsibility to ensure that you do nothing to jeopardise the health and safety of either yourself or of anybody else. The Trust’s Health and Safety Policies outline your responsibilities regarding Health and Safety at Work.
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The post holder must not wilfully endanger him/herself or other persons while at work. Safe working practices and safety precautions must be adhered to. Protective clothing and equipment must be used where appropriate. All accidents must be reported, and the post-holder is asked to participate in accident prevention by reporting potential hazards.
Infection Control It is a requirement for all staff to comply with infection control policies and procedures as set out in the Trust infection control manual.
Security The post-holder has a responsibility to ensure the preservation of NHS property and resources.
Confidentiality The post-holder must maintain confidentiality at all times in all aspects of the work.
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Equal Opportunities The Trust encourages Equal Opportunities and operates an Equal Opportunities Policy. All individuals regardless of race, ethnicity, nationality, gender, or disability are encouraged to apply for all posts advertised.
Smoking The Trust operates a No Smoking Policy.
Visit to the Department Potential applicants are invited to contact Department (Tel: 0161 276 4551).
Administration/Management Responsibilities The post holder would be expected to participate in the administration of the department, in order to maintain and develop standards within the Anaesthetic Directorate.
Professional Supervision All consultants take a responsibility for the supervision and teaching of junior staff.
Colleague Cover The post holder will be expected to provide prospective cover within each rota for consultant absence, to include holidays, sick leave and study leave
Residence The appointee will be required to live at an address acceptable to the Trust. Locum posts would not normally be eligible for removal expenses. Agreement of the Trust to any removal expenses should be sought prior to entering into any removal arrangements.
Rehabilitation of Offenders Act 1974 This appointment is exempt from Section 4(2) of the Rehabilitation of Offenders Act 1974 by virtue of the Rehabilitation of Offenders Act 1974 (Exemptions) Order 1975. You are required to reveal any information you may have concerning convictions which would otherwise be considered relevant to your suitability for employment. Any such information will be kept in strict confidence and used only in consideration of your suitability for appointments where such an exemption is appropriate.