SECTION 1 – SUMMARY OF POST Job Title: Consultant Immunologist, specialising in Immunodeficiency & Allergy (Replacement post) Grade: Consultant Directorate: Medicine Location/Base: Brunel Building, Southmead Hospital SECTION 2 – ABOUT THE TRUST North Bristol NHS Trust (NBT) is the largest Trust in the South West region, and one of the largest trusts in the country. It is a progressive and ambitious provider of health services, delivering for a large local population and with specialist regional services for major trauma, neurosciences, vascular centre, urology, plastics and burns, orthopaedics and renal services. With a turnover of £550m and 9,000 staff, our clinical teams have built a strong reputation for exceptional healthcare. NBT provides medical, surgical and maternity care for a population of approximately half a million people in the North Bristol, South Gloucestershire and North Somerset areas. In May 2014 the Trust relocated the majority of its acute services to the Brunel Building, one of the most advanced hospitals in Europe offering state-of-the-art care in a beautiful and purpose built environment, designed with the patients privacy and dignity in mind. As well as Southmead Hospital, the Trust also has Cosham 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. Southmead Hospital is located to the North of Bristol and has easy access from the motorways (M32/M4/M5) and by public transport. For those who cycle, Bristol boasts excellent cycling facilities and was chosen as England’s first cycling city in 2008, and was the European green capital 2015. In 2014 Bristol was nominated by the Times as the best city to live in the UK, citing: “one of the lowest unemployment rates in the country, varied and beautiful housing stock, decent schools, buzzy culture and night life and access to some fantastic countryside”. The location also allows easy access to the town centre which has theatres, a large shopping centre and a historical harbour-side. There is an array of annual festivals and events including the Bristol International Balloon Fiesta and the Bristol Harbour Festival. SECTION 3 – THE WORK OF THE DEPARTMENT Type of test/Properties measured/Range of measurement The Department is the regional Immunology and Allergy service for the northern end of the southwest region. It has referrals from Avon, Gloucestershire, Wiltshire and Somerset, as well as outreach clinics. The Allergy service is fully accredited and provides for all allergy patients. This includes diagnosis and testing for allergy, desensitisation, challenge clinics, anaesthetic allergy clinics and a specialist urticaria service for omalizumab patients. This is supported by a nurse practitioner and a team of nurses. The Clinical Immunology service has a caseload of 160 antibody deficiency patients on immunoglobulin replacement therapy supervised by the consultants, with registrar and nursing support. It also has a number of other diagnosed and undiagnosed immunodeficiency patients which are being investigated or followed up. There is a paediatric immunology and allergy service which links to the Adult service with joint clinics (allergy) and transition clinics (immunodeficiency). There are joint meetings to discuss cases. Accreditation will be applied for in June 2020. In addition there are 3 satellite services for Immunology and allergy based in Bath, Taunton and Gloucester. They provide an outreach service. The commissioners have indicated that the service will be reformed with the service coming under Bristol for all patients, but with a local delivery. This is currently being modelled for feasibility. The department is a lively and active department with all consultants being involved in teaching, training and/or research. It has a good academic output as well as successful training. We are looking for an enthusiastic colleague(s) to join this team. Workload Type of activity Requests in year 2018/2019 Clinical Workload (Immunology and Allergy) 4000 (New cases 1300) Immunology % (approx.) 25% GPvs Secondary and tertiary care 75% GP referrals The repertoire of tests and breakdown of workload should be provided in sufficient detail to allow an appreciation of the breadth of activities undertaken in the laboratory. This should include information on tests referred externally. Note the method used for each test offered and the equipment available next to the workload list. Scope of Work: Immunopathology. The Following tests are carried out within the Department Immunology examination activities for the purpose of clinical diagnosis and Immunopathology oversite. Test Total NBT Total UBHT Total Weston Total tested VES V1 (COMMON WASP PHOSPHOLIPASE A1) 1 1 1 3 VES V5 (COMMON WASP ANTIGEN 5) 1 2 1 4 WINE (WHITE) 0 1 0 1 YEAST 2 2 1 5 ADALIMUMAB AB 110 0 17 127 ADALIMUMAB LEVEL 109 0 16 125 ALLERGEN NOT LISTED 112 8 2 122 API M1 (HONEY BEE PHOSPHOLIPASE A2) 1 4 1 6 APRICOT 3 3 0 6 AQUAPORIN 4 92 37 1 130 ARA H8 (PEANUT PR-10) 0 1 0 1 BETA-2-GLYCOPROTEIN 1 34 0 4 38 ANTI BASAL GANGLIA 1 0 0 1 CARDIAC 8 0 0 8 CALCIUM GATED CHANNEL 39 12 2 53 CSF NEURODEGENERATIVE MARKERS 46 0 0 46 ENTEROCYTE 16 0 0 16 GANGLIOSIDE SCREEN 125 15 0 140 HMGCOAR ANTIBODIES 7 0 0 7 HISTONE 9 0 0 9 INTRINSIC FACTOR ABS 527 283 189 999 INFLIXIMAB AB 25 0 20 45 INFLIXIMAB LEVELS 21 0 17 38 INSULIN ANTIBODIES 12 0 0 12 IMMUNOLOGY SENDAWAY NOT LISTED 216 2 0 218 POTASSIUM GATED CHANNEL 321 79 11 411 MYELIN ASSOCIATED GLYCOPROTEIN 28 17 2 47 MANNAN BINDING LECTIN 105 0 0 105 MANNOSE BINDING LECTIN PATHWAY 0 83 0 83 MUSCLE SPECIFIC KINASE ABS 56 53 0 109 FIXED NMDA RECEPTOR ANTIBODY 241 67 3 311 NEURONE SPECIFIC ENOLASE 0 10 0 10 ANTI OVARY ANTIBODIES 12 6 1 19 PNEUMOCOCCAL SEROLOGY 246 0 0 246 PNEUMOCOCCAL AB REFERRAL 247 0 0 247 INFLIXIMAB - REMSIMA 81 0 0 81 SKELETAL MUSCLE 2 7 0 9 SALIVARY GLAND 6 0 0 6 TETANUS ANTIBODIES 23 0 0 23 TOTAL IGD 11 0 0 11 ANTI-THSD7A 80 0 0 80 TSH RECEPTOR ABS 312 207 73 592 BEEF 5 5 0 10 SAVED SAMPLE - PRE IVIG 29 0 0 29 SECTION 4 – ORGANISATION AND ACCOUNTABILITY 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 Clinical Director. All consultants are required to undergo an annual appraisal carried out in accordance with the Trust policy. Consultants are also required to take an active and co-operative approach to their job planning, which will be reviewed on an annual basis by their Clinical Director. The appointee will be expected to be fully involved in the development of the service, to take account of the Trust policies, including Risk Management Strategy and developments in Clinical Governance. The appointee may be asked to participate in managerial and administrative work and will be expected to be aware of the broader context within the NHS in which Consultants operate. Directorate Management Team: Clinical Director – Dr Kiaran Flanagan General Manager – Ms Valerie Clarke Head of Nursing – Ms Luisa Goddard Clinical Consultants - Immunology & Allergy Dr Mark Gompels – Specialty Lead – Consultant Immunologist, Allergist & HIV Dr Sarah Johnston - Consultant Immunologist, Allergist & HIV Dr Philip Bright – Consultant Immunologist, Allergist & HIV Dr Joe Unsworth (retired, fixed term only) - Consultant Immunologist, Allergist Associate Specialist - Allergy Dr Nikos Tsiougkos Spr Trainee Dr Alexandra Grammatikos, and there is likely to be a second specialty registrar post in the future Nursing staff - Clinical Immunology & Allergy Sister Lisa Smith Sister Jen Whittle Sister Catherine Fox Sister Violetta Alvarez Carbonell Sister Gaynor Rogers SECTION 5 – MAIN DUTIES & RESPONSIBILITES OF THE POST The post holder will be responsible for the diagnosis and clinical management of patients managed by the Clinical Immunology & Allergy Service at North Bristol NHS Trust. The successful applicant will be responsible for; (i) Teaching and Supervision of Junior Medical Staff & Students 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 education. Identification of training opportunities and needs across the pathway. Delivery of appropriate ad hoc training as required. Attendance at relevant conferences as required. Be responsible for and maintain own competencies in relation to CPD. Update and extend own clinical and managerial skills appropriate to speciality by attending relevant study sessions and courses. (ii) 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. 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 Trust or with the University of Bristol and the University of the West of England.